Use a Baby Doll to Work on Speech,Feeding and Social Skills

Sometimes taking the pressure off a child is the best way to get them to verbalize and work on self feeding. Using a baby doll is also a great way to begin to work on theory of mind, which is something that many of our kids diagnosed as on the spectrum have difficulty with. Theory of mind is defined as the ability to understand that others have their own feelings, beliefs, intentions and desires that differ from our own ( Byom, 2013). It is a necessary skill to work on in order to further develop successful social interactions and better interpersonal relationships.

Feeding

Developing comfort with the tools you are going to use during sensory feeding is essential for your child. For a child with aversions and anxiety around sensory tools, utensils they developed negative association with, or those who are hypersensitive to touch/textures, using a baby doll will help develop familiarity with the tools and how it's used. This allows you to work on establishing a new baseline behavior.

Parent and child pretend playing with utensils

A child can develop a negative association with specific utensils during feeding because of force feeding, or because textures they have serious aversions to, were consistently presented on the fork or spoon and now they want nothing to do with those utensils. In order to reintroduce the utensil, you have build trust by demonstrating that there is nothing to be scared of, you can use these utensils with foods they already enjoy. Before that, I use a baby doll to work on pretend play mealtime activities. I create scripts that will eventually be carried over into activities with actual food. Initially it will be as simple as mixing with a spoon and empty bowl during pretend play, and then feeding the baby doll. Usually I incorporate phrases and words to cue the specific actions into a simple tune. That sounds something like, " Mix, mix, mix the food, mix the food in the bowl" What does this accomplish? Familiarity. Even if I've just placed something in the bowl that they don't particularly like, they are more likely to comply with directives because they know what to expect and I have already worked on developing a positive association with the song and the sequence of actions. During those activities, I'm not pressuring them to eat, we are just mixing, and feeding the baby doll. When you're working on any skill in therapy, it's important to develop, and maintain trust. The easiest way to do that it is , mean what you say. Feed baby, means feed baby.If you say, "Match 1 more puzzle and then all done" that means after they match 1 piece, that's it, clean it up, put it away. The mistake that is often made in this situation is , "Well, you did that one, let's just finish the rest of these". Once you do that, what reason would your child have to believe anything else you promise. You have already gone back on your word. So make sure, you mean what you say, so that you maintain the trust you built. Eventually you can work those cues and prompts that you practiced into direct feeding activities.

Speech & Language

Whether you are targeting specific sound productions, or working on increasing utterance length, taking the pressure off the child by using a baby doll can help create more opportunities to practice without them realizing what you are up to. You can use flash cards, or specifically choose the vocabulary you are going to incorporate, based on sounds or phrases you want them to practice. For some children, pretend playing the role of teacher is enough. For others, they will look at you like you have three heads.They know this isn't a real person, so how could this thing respond to them? For those kids, I hold up the baby in front of my face, pretend to speak for baby and purposely make mistakes. They have a good laugh, and I get them to practice. What often happens is they get such a kick out of this activity, that they want speak for baby. In these instances, I get to work on self- correction. When they incorrectly produce a sound, or neglect to use the full target phrase, I can use helping baby learn as the pathway to self-assessment. If I show a picture of a dog and I am working on the /g/ sound as well as lip retraction, the target word would be doggy. Now "baby" says "Doddy" for doggy, then I would bring their attention to what "baby" said and ask them if that's right. This gives me the opportunity to repeat their production and ask them if it is correct, so they can work on correcting their own production, without the anxiety and pressure that some of our kiddos feel during therapy. This is especially true for those who are aware that their productions are often incorrect and they have, unfortunately, developed some insecurities and feelings of shame. With a baby doll, it's not the child's production you're bringing attention to, it's the baby doll. You can also use pretend play to work on developing inferencing skills and theory of mind. For example, "Baby looks hungry. What should we do?" While providing necessary cues to lead them towards the correct actions/responses.

Child pretend playing with baby doll

Social Skills

If you don't have access to other children to work on social skills, start off by using a doll as the communication partner. With pretend play, you can teach them how to request from another person, share, use polite markers give directions, use greetings, and terminating interactions appropriately.

You can use pretend play activities with a baby doll like teacher/school, restaurant, playground, etc., to work on specific phrases. This can be especially useful for some kids that are diagnosed on the spectrum who need scripting and rehearsing in context to develop the comprehension and ability to use language appropriately with others. You can have them alternate between roles of teacher vs student, server vs patron, etc, to learn how to request, "I'd like__", "Can I have__", "I want__ please", or how to ask and exchange items, "Do you want___", " Here you go", "You're welcome". The beauty of pretend play, is that you can alter and customize the vocabulary and phrases you target to the individual child's needs. By alternating between roles you can also reference this experience when working on developing theory of mind. Their role as a teacher, can help them understand their real teacher's view when making a request or placing a demand on them. The same can be done by referencing their pretend play roles as the waiter, or cashier, possibilities are endless!

References:

Byom, L. J., & Mutlu, B. (2013). Theory of mind: mechanisms, methods, and new directions. Frontiers in human neuroscience, 7, 413. https://doi.org/10.3389/fnhum.2013.00413