Teacher Sonja Stanley worried about four-year-old “Jennifer,” in Concord’s Centre Court preschool program. “We couldn’t get her to engage with anyone,” recalls Stanley. When she tried to draw the little girl into play or conversation, she usually just got a blank stare. Jennifer would talk, but did not engage in any give-and-take interaction.

Four-year-old “Stephen,” at the Martinez Early Childhood Center, “would use words that sounded to us like gibberish,” recalls his teacher, Cassandra Campbell. “At first we thought maybe it was his home language. But he would also talk to the air or to trees.” When Campbell asked Stephen’s mother to translate, she replied, “He’s not saying anything.”

Stanley and Campbell knew that such severe problems with speech and social interaction can be signs of autistic spectrum disorders (ASD)— disabilities that harm a person’s ability to relate to others and often in-volve rigid routines and repetitive behaviors. So they got help. “We (teachers) have a gut feeling,” says Campbell, “but we’re not trained in this area.”

“Help the teacher help the child”

In Contra Costa County, where Stanley and Campbell work, First 5 funds a mental health collaborative, Child Care Solutions, available to all licensed child care providers. Consultants from Child Care Solutions observe children, help decide whether they need a mental health assessment, help teachers talk to parents about their concerns, work one-one-one with children, and help teachers figure out approaches for a particular child. “Our goal,” says Wynne Osborne of We Care, program coordinator for Child Care Solutions, “is to help the teacher help the child to have a better day at school.”

Gentle with mom

After watching Jennifer for a while, Stanley approached her mother and said gently, “There are some things I’m concerned about.” Stanley asked for permission to bring in a consultant from Child Care Solutions, stressing that she was the one who needed support: “I want someone to help me help your child.”

Jennifer’s mother also agreed to have Jennifer assessed for special education services by the school district. “Even though it’s sad and hard,” says Sally Goodwin, director of the ACORN Learning Center in San Ramon, “starting the assessment process can get a child the help he needs. Our job is not to do the diagnosis but lead them to the people who can.”

“Try this” in the classroom

The Child Care Solutions consultants emphasize that what works with one child may not work with another. For example, a child who is wandering around at circle time might be able to sit still if a caring adult sits next to him with a hand on his shoulder. Another child might do better holding a ball or wearing a heavy backpack. The phrase teachers hear from consultants the most is, “Try this.”

Changes in program

“Currently, ACORN has two four-year-olds who have been diagnosed with high functioning autism (Asper-ger’s),” says Goodwin. With suggestions from Child Care Solutions consultant Phong Simpson, the center has made changes:

• “Routine is very important for them so we keep the same daily schedule,” says Goodwin.
  
  
• Transitions: “Autistic kids need help with transitions so we give more warnings: ‘It’s 10 minutes, 5 minutes, it’s almost time…’”
  
  
• Reducing noise and stimulation: Noise is a problem for one of the children, so the teachers divide the children. One group stays inside for “work time” (structured play) while the other group goes outside. A smaller group, Goodwin says, is “not as stimulating.”
  
  
• Benefiting everyone: “The things we do to help these children work for other children also,” Goodwin adds.

One-on-one

Jennifer, eventually diagnosed with Asperger’s syndrome, needed lots of one-on-one attention:

• Help in connecting: The consultant suggested holding Jennifer’s hand to get her attention, then asking her to “look at my nose,” to help her learn to make eye contact.
  
  
• Extra attention: The consultant played with the girl on the floor, talking her through activities.
  
  
• Going slowly: “We were gentle, taking time with her,” says Stanley. “Jennifer began talking to us more, engaging in projects.”
  
  
• Comfortable tasks: “She was great at cognitive (tasks) such as sorting and rhyming—she knew what was expected so she seemed more comfortable,” Stanley says.
  
  

The teachers’ efforts combined with the consultant’s help enabled Jennifer to stay in the class. At the end of the year, Stanley “could see a twinkle in Jennifer’s eyes—gone was the blank stare.”

Different needs, different programs

“Sometimes we do everything and it just doesn’t work,” says Goodwin. Even with support from mental health consultants, not every child can be helped in a regular early care and education program.

Stephen was tested in the county hospital for autism spectrum disorders and the consultant worked with teachers in the classroom, but “his behaviors got worse,” Campbell recalls. “While he didn’t harm anyone, he kept talking to himself. Sometimes he would go into the bathroom and scream.” So before Stephen entered kindergarten, the consultant contacted the school district. “We Care was instrumental in bridging that gap,” says Campbell, “making sure Stephen got services.”

Connecting children with school district resources is crucial, Stanley agrees: “You have to know that when they walk in the door in kindergarten there’s something set up for them.”

When should a teacher ask for help

“For many, many children, delay in speech is the signal that the child needs an assessment,” advises Osborne. “The sooner a child receives services, the better the chances of success.”

Other behaviors that might be signs of autism spectrum disorder:

• Lack of social connection
• Lack of participation
• Not listening
• Making odd noises
• Engaging in repetitive behaviors
• Lack of eye contact.

But the problem is not always ASD, Osborne cautions. For example, one child who was not paying attention turned out to have a hearing loss. And sometimes children are just late in beginning to speak.

To learn more

Web sites with information and resources on autism:

• National Dissemination Center for Children with Disabilities, http://www.nichcy.org/
• Autism Speaks: www.autismspeaks.org

Support for inclusive child care:

• California Inclusive Child Care, 760-682-0271, http://www.cainclusivechildcare.org/

To find local mental health resources:

• Contact your school district, First 5, www.f5ac.org/regionlist.asp, or child care resource and referral agency (800-543-7793) or call the California Child Care Health Program’s Healthline, 800-333-3212, www.ucsfchildcarehealth.org