Table of contents

Abstract Preface: Welcome to Holland Introduction Week 1, understanding autism, and parenting Week2, communication, and self help skills Week 3, behaviour management, and alternatives to punishment Week 4, play for fun and learning Conclusion Reference list 2 4 6 8 11 14 17 20 21

Abstract
The birth of a child is one of the major events in life, and is often planed for years. Therefore, it can be devastating news for any parent to discover their child is less than perfect when diagnosed with a disability or major illness. With a diagnosis of childhood autism many of lifes milestones are in doubt. Family life can be severely affected for every member of the household.

This proposed parenting program aims to give parents the knowledge, belief, and skills to unlock the potential that exists within their child. People with disabilities and their families are very often pushed to the margins in Irish society and shunned even by their own extended family. Whispers, judgements and stares follow the family and as a result public outings are fraught with difficulty, leading to isolation. The program has benefits for the child, as it will allow parents to learn skills that will narrow the developmental gap that exists with their typically developing peers. There are also benefits for the parents. The skills they learn will lead to a reduction in challenging behaviour, thus, making family life more harmonious and increased social interactions a real possibility. Finally, there are benefits for government backed health service providers. As the child develops life skills, their dependence on care agencies will reduce, leading to substantial cost savings in the longer term. Early intervention has been shown to greatly reduce the requirement for expensive residential care later in life. Society will also benefit. As the child develops new social and communication skills they are more able for inclusion in mainstream society.

At present, there are no formal guidelines to inform parents what to do when their child is diagnosed with autism. They can often be overwhelmed by a lack of, or an avalanche of information. This paper proposes a program that will inform and educate parents on how to help their child through simple techniques. Currently no such program exists through voluntary or statutory agencies. However, if implemented, this program will have real benefits for the child, their family, service providers and society as a whole.

This program does not seek to reinvent the wheel, but uses well proven theories of social work, play and psychology to aid the development of the child. The beginning of any education program is to understand fully the subject matter. This in turn will allow parents to realise that the challenging behaviour that can often accompany autism is not simply a bold child and can be reduced. People with autism have great difficulty communicating but can shown how to do so, even if they are non-verbal. This has a consequence of increasing social interactions and reducing challenging behaviour. Children enjoy play but this can present major difficulty for the child with autism. Parents will learn how to develop their child socially and physically through fun play with very little effort.

In essence this paper aims to provide guidance for parents where currently, there is none.

Preface: WELCOME TO HOLLAND

I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this...... When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting. After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland." "Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy." But there's been a change in the flight plan. They've landed in Holland and there you must stay. The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place. So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met. It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts. But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned." And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss.
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But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland. (Perl Kingsley, 1987)

Introduction
Parenting is a difficult task when everything is perfect. There are sleepless nights, teething problems, dirty nappies, the list goes on. The difficulty is however compounded with a diagnosis of childhood autism. Parents are often devastated by the news that their child is not perfect and will perhaps not lead a normal life. Major life milestones are all in doubt. Will the child make their first communion, get married or go to college?

The aim of this parenting program is to help parents of children diagnosed with an Autistic Spectrum Disorder (ASD) to gain a better understanding of this developmental disability and acquire skills that will allow them to parent in such a manner as to maximise their childs potential. We all have enormous potential in life, including children with an ASD. This course will disseminate knowledge and skills that will enable parents to unlock this potential. As early intervention is seen as critical in autism this parenting course will focus on parents who have children between the age of two and six.

Week 1 will concentrate on understanding ASD and what it means for the child. Additionally parenting techniques will be discussed and how each parent can use strengths they already possess to help their child. Communication is one of the key skills in life and will be the focus of week 2. Children with autism often have severe communication deficits so parents will learn how to develop communication, communicate with non verbal children and socialisation techniques. When functional communication has been established, there is then the possibility to teach self help skills through visual schedules and social stories. Week 3 will address behaviour management and will adopt a positive perspective by looking at alternatives to punishment. ASDs have difficulty playing and this will be the subject of week 4. Parents will learn about child centred play, creative play and how to get their child to learn from play, while having fun.

Each module of this course will seamlessly feed into the next. The knowledge and skills learned on week one will enable the participants to have an understanding of week two and so
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on. All of this practical help will be theory and practice based and drawn from the fields of psychology, sociology, social policy and social work. However the course will be delivered in a manner that is not so academic as to put people off attending. This parenting program will be delivered using written notes, visual notes, pod casts, video films and practical role play. Therefore, any participant who has literacy issues will benefit greatly from the pod cast and the visual and practical elements of the training. To reinforce what has been learned each week, parents will be asked to carry out one piece of homework and report back on how successful it was.

Week 1, Understanding Autism and parenting

Autism is a developmental disability that is neurogenic in origin and has a dramatic effect on both the individual with autism and their family (Wetherby & Prizant, 2000). Typical children develop in life through transactions with peers and family, but this does not occur in children with autistic spectrum disorders resulting in a triad of impairments: impairment in social interaction, impairment in communication and a restricted repertoire of activities (Wetherby & Prizant, 2000). Some behaviour will vary in intensity; other behaviours may come and go in typically developing children but in autism maladaptive behaviours will persist beyond the normal developmental timeframe. Autism is usually diagnosed before 36 months of age and can vary in how severely it affects the individual in each of the triad of deficits. It is for this reason the autism is now best described as a spectrum disorder, with severe autism at one extreme and pervasive developmental disorder not otherwise specified (PDD-NOS) at the milder end of the scale (Lord & Risi, 2000). In addition to the above behaviours an ASD may co-exist with mild to profound mental retardation (learning disability), hyperactivity, a short attention span, impulsiveness, aggression, self injurious behaviour and temper tantrums (American Psychiatric Association, 1994). People with autism may also display oversensitivity to certain stimuli such as smells, certain foods, touch and noise. They may also exhibit problems with sleep, have a lack of fear or show no apparent reaction to pain (American Psychiatric Association, 1994).

This however, is an academic description of autism and often serves to confuse parents. While this information will be included in the course documentation, a better understanding of autism can be gained from a facilitated, peer led discussion. Each individual should introduce themselves in an informal manner stating their name, the name of their child and some of the characteristics that best describe their child, both good and challenging. In this situation parents learn from each other, and gain moral support and encouragement in a relationship that carries neutral power dynamics (McCabe, 2008). Parents value the experience of being in the company of people who share a common situation to themselves. Peer groups also embody anti oppressive practice, as any power dynamics are removed, one can connect their personal plight with others, they value peoples strengths and experiences and they enable the participants to gain knowledge that can help them in their lives (Dominelli, 2009).
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As already noted, autism is a disability that is defined by behaviour (American Psychiatric Association, 1994). Many of these behaviours can be distressing to family members especially when they occur in public. Public stares, judgements and whispering can make family life stressful and outings embarrassing (Domingue et al., 2000). Many children with autism exhibit challenging behaviour as they do not possess any other means of communicating their needs. Violent acts may occur as a result of blind panic, a frightening occurrence, frustration or not having their expressed needs met (Jordan, 2001). Parents will be given the skills to cope with such behaviour on this course.

Firstly, a parent should learn separate their childs behaviour from the child themselves. Do not let the behaviour define the child. Rogers (1961) terms this as having unconditional positive regard. Although challenging behaviour causes great stress, parents must learn to value their child regardless of how they behave. The parent should exhibit warmth, love, positivity and an accepting attitude towards their child at all times regardless of their behaviour. This allows for change to occur in the childs life (Rogers, 1961). This attitude will also have positive effects for the parents themselves in terms of stress reduction.

Parenting styles play a significant role in how children develop, and this is also true of children with autism. Baumrind (cited in Boyd & Bee, 2012), lists desirable characteristics that parents should possess as warmth or nurture, expectations of the child or maturity demands, clear and consistent rules or control and communication between parent and child. Of all the parenting styles, an authoritative style scores highly in all of these areas while the permissive style and the authoritarian perspective have many failings. Hence we should strive to teach parents the required skills to become more assertive as this style of parenting has been associated with consistent, positive outcomes for children (Boyd & Bee, 2012). Parents need to be encouraged to set clear rules and consequences for breaching these rules. They also need to identify and respond to their childs needs without allowing the child to rule the roost. Other elements that make up the authoritative style of parenting include displaying high levels of warmth and expecting the child to be socially mature for their age (Boyd & Bee, 2012). Participants on the course will already possess many of the skills required to parent effectively. This should not be seen as an attack on their parenting abilities but merely a sharing of techniques that are proven to work.
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To enable a parent to develop an authoritative style of parenting that works they need to be shown how to be more assertive. Assertiveness does not mean saying no, allowing poor behaviour or being aggressive. Many parents act in a passive or aggressive way when faced with challenging behaviour which will only make the situation worse. Assertiveness means clearly representing what you are thinking and feeling; you should never apologise for doing this as it is every persons right (LeMon, 1997). An assertive person should never be influenced by the imposition of guilt, or ever sacrifice the rights of other people to get their own way (LeMon, 1997). Facilitators need to encourage parents to follow through on what they say, grow their self-esteem, self-awareness and self-confidence.

To cement the learning of the first week (and each subsequent week) each participant needs to carry out one piece of homework and report back on the experience. In the long term, people remember information and techniques through practice and rehearsal (Eysenck, 2004). Parents should practice separating the child from their behaviour by treating them with unconditional positive regard. This is difficult to do, but the challenging behaviour must be ignored and the parent must continue to talk to the child in a neutral, calming tone of voice.

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Week 2, Communication, and self help skills

The session should begin with all of the parents in a circle to talk about what worked for them in the home that was learned in week 1. As McCabe (2008) notes, many parents enjoy this type of shared knowledge and learning. This element of the session is not about finding out who did not do the homework but merely to acknowledge what has worked and also offer more support and practice to those experiencing difficultly.

Communication is a process that is fraught with difficulty at the best of times. In ASDs, impaired communication is one of the triad of impairments that sets people with autism apart from their typical peers (Whetherby & Prizant, 2000). Many children with autism simply do not speak; others have limited verbal behaviour while other children may exhibit unusual repetitive utterances (echolalia). People with autism may have great difficulty in maintaining or initiating conversation and have problems with make believe play (American Psychiatric Association, 1994). However communication makes the world go round; therefore to be without any means of getting your message across is isolating and frustrating for an ASD. Hodgdon (1999) notes that an inability to get their needs satisfied is the root cause of much aggressive and challenging behaviour in non verbal individuals. While this type of behaviour is undesirable for the parent, the child is getting their need met or being attended to by exhibiting behaviour that is often termed as aggressive or violent (Hodgdon, 1999). It is imperative to give parents the tools to communicate effectively with their ASD child as this reduces stress in the child, reduces stress for the parent, reduces challenging behaviour, and facilitates the child becoming included by their peers and community.

Communicating with the non verbal child is easier than one may think, as many children with autism are superb visual learners (Hodgdon, 1999). Grandin (1995) explains that while many children with autism lack basic verbal skills they possess very advanced visual, spatial reasoning enabling them to learn through the language of pictures. Effective communication can be achieved via the Picture Exchange Communication System (PECS). The system is simple to use and can be taught to parents easily. This behavioural based program involves the child communicating their needs through small token pictures that when presented are fulfilled by the recipient. An individual will have their repertoire of verbal communication
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represented on small tokens contained in a small folder that they carry around for use. Modern developments have seen the system now available as an iPhone application (OBrien, 2010). PECS has been shown to allow non verbal people to communicate, augment communication and to develop verbal skills (Pyramid Education, 2012). A non verbal child is effectively gagged, but following a simple antecedent, behaviour and consequence model of behaviour they can learn to have their needs met. Antecedent: a non verbal child wants to go to the toilet. Behaviour: the child presents a token to a parent or carer displaying a toilet symbol. Consequence: the child is brought to the toilet. Simultaneously the child has their behaviour positively reinforced through having their needs immediately met and verbal praise. Behaviourists argue it is possible to increase behaviour (and PECS use) through positive reinforcement which is usually a pleasurable reward for performing certain behaviour (Martin & Pear, 1999). Not only does this intervention derive from behavioural theory, it also draws from the strengths perspective by tapping into the visual learning excellence of a person with autism, it empowers, it allows the client to collaborate and also to interact with their community and environment (Saleeby, 2009).

Visual strategies can also be used to develop routines for the child with autism, an area that can be highly problematic. A visual schedule can inform an individual what is going to occur, when it will happen, what will change or what they have to look forward to (Hodgdon, 1999). As change and routine are important for people with autism, parents can easily learn how to use visual schedules to their advantage and reduce problem behaviour.

Self help skills are difficult to master for any child and this is also true of ASDs. A visual schedule can help, by using the persons visual learning strengths to their benefit. Take the example of brushing teeth. A schedule will begin with a picture of the bathroom, the next picture is the tooth brush, this is followed by a picture of tooth paste being squeezed onto the brush, the next picture shows teeth being brushed and finally a picture showing the brush being rinsed. The schedule is constructed with step 1 at the top, followed by step 2 and so on. This is can be easily achieved by parents with the use of a digital camera, printer, laminating
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machine and Velcro strip. During the course, participants should be allowed to construct one schedule for use in the home and all materials required to do so. Visual schedules can also be used when going shopping, toileting, visiting the doctor and eating lunch (Hodgdon, 1999).

Additional visual tools that can be used to teach self help skills to children with autism are social stories. Both verbal and non verbal children can benefit from the use of social stories as can parents with limited literacy. The idea is to inform the child in advance what is to happen at a future event; there is therefore less chance of an incident as the child will know what to expect in any new situation. Social stories can be used in all aspects of life including going shopping, going to school and play (Gray, 2002). In addition to everyday routines social stories are a very effective way of teaching a child self help skills and sexual awareness. Children can learn about hygiene, puberty and the private nature of sex (Wrobel, 2003).

For homework on week 2 parents will be asked to reinforce their learning by implementing one schedule for their child using either a visual schedule or a social story. If the child is non verbal the parent should attempt to teach their child to communicate a request via PECS using one picture token to begin with. Communication with ASDs is problematic and additional support will be provided where necessary. There is also the possibility of additional training in the use of PECS either online or in facilitated workshops (Pyramid Education, 2012).

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Week 3, behaviour management, and alternatives to punishment

The session begins as usual with a parent led discussion on what worked or did not work in the home. Following this a discussion on discipline will be facilitated. Every parent has a different perspective on how to discipline their child and these views need to be understood before imparting new knowledge on what works and what does not work for children with autism.

The main problem for parents and carers of people with autism is dealing with the challenging behaviours that are often a part of the condition (Jordan, 2001). Children may exhibit behaviour such as head banging, assault of siblings or parents, constantly running away, screaming, tantrums, etc. It should be remembered that typically developing children exhibit many similar behaviour patterns prior to learning more conventional means of communicating their needs. Jordan (2001) points out that there is no such thing as autistic behaviour and that what we witness is the child reacting to stress in their environment. Parents need to understand the behaviour, and what is maintaining it before they can eliminate it. Additionally the child must be thought a positive behaviour to use in the absence of the undesirable action or else a parent will run the risk of replacing a challenging behaviour with more disruptive one (Jordan, 2001). As noted in the previous week a lack of communication may result in a child screaming to have their needs met. Hodgdon (1999) does not advocate eliminating the screaming but provides an alternative means of communication (PECS) for the child to have their needs met. As a consequence the

undesirable scream is reduced and replaced with the much more appropriate PECS. In essence a child will desist in one type of behaviour when there is an easier way to have their needs met.

Behaviour breaks down to the simple three part ABC concept of antecedent, behaviour and consequence. An antecedent is an occasion on which behaviour occurs; this is followed by the actual behaviour and finally the consequences of the behaviour itself. Kearney (2007) explains how to target a behaviour for change; firstly the behaviour must be analysed and defined. This needs to be as accurate as possible (Jordan, 2001). For example: John gets angry does not define any behaviour; however John punches his brother describes an
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observable, measurable behaviour. A behaviour baseline (frequency) in normal conditions must be recorded to note if any (future) intervention is effective. Next we need to identify any antecedents such as where the behaviour occurs, at what time does it occur, does Johns brother receive extra attention, is tiredness a factor, etc. (Kearney, 2007). Next, and most importantly, any consequences that follow the target behaviour must be recorded, in essence: what is maintaining the behaviour? What reinforces behaviour for one person will not motivate another; therefore reinforcement is highly individualised and may come in the form of an edible treat, a tickle or a video (Martin & Pear, 1999). To alter behaviour the subject must be motivated by a reinforcing consequence that is immediate, obvious and frequent so the person associates it with the new desired behaviour (appendix 5). Parents will be shown how to record and analyse behaviour in a simple manner and then to assess what is driving these actions. At this point with the use of positive reinforcement the parent can teach a more appropriate method for the child to behave.

Self care is of paramount importance in parenting a child with autism. Many children with an ASD do not sleep well, resulting in parents being exhausted. Biology informs us, that sleep deprivation robs an individual of the ability to solve problems, focus or concentrate (Morrell & Palmer, 2006). A lack of sleep will also cause a rise in the stress hormones in the body, causing the individual to feel irritable, angry, depressed and have a sense of hopelessness. Parents should never be afraid to ask a friend or relative to help. Additionally, if necessary a parent should sleep during the day and try to ignore house work (ibid). Other practical solutions to the sleep problem include medication, respite care, keeping your sense of humour, talking to friends and avoiding trying to be the perfect parent (Morrell & Palmer, 2006). Physical activity is a natural way of ensuring a child is tired at bed time and should ideally be incorporated into their daily routine at school and at home.

A lack of sleep and high stress levels can lead to a parent using punishment as a means of attempting to control their child. In addition people learn how to discipline their children from others, through what Bandura (cited in: Eysenck, 2004) termed observational learning. Traditionally physical punishment was what defined discipline. However, Jordan (2001) explains that an ASD will not deter from their challenging behaviour through punishment and that this may even reinforce their actions. Punishment may also result in social withdrawal,
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aggression, emotional problems, a temporary solution only and may suppress other desirable behaviour (Donnellan et al., 1988).

To encourage the child to behave in a desired manner a parent needs to catch the child being good. If we want the child to desist from performing a certain action they need to be reinforced for not engaging in the behaviour (Donnellan et al. 1998). If we take the John example previously mentioned the child should be verbally praised and given a predetermined reward for not punching his brother for a day. This rewarding and acknowledgement of good behaviour decreases the likelihood of the bad action reoccurring. Johns, unwanted action of punching his brother, will be effectively extinguished by reinforcing a behaviour that it is incompatible with. This task is simple to do, but goes against what parents have experienced as children or been instructed to do by others.

Through thorough parental observation, reasons for a child behaving in a certain manner will become apparent. Jordan (2001) notes some of these causes as communication difficulties, stress, self stimulation, gaining attention, escapism, panic and the fear of something new to them. The homework for week three is for each parent to target one of their childs

problematic behaviours by assessing it for three days. Every time the action occurs the parent must note what was going on in the environment and what occurred directly after the target behaviour. A pattern will usually emerge. Once this has been completed the course delivery team will help in assessing the data collected and devise an alternative means of the child having their needs met through positive reinforcement. If any parent feels this task is overwhelming they can work on praising their child for good play or not engaging in challenging behaviour at least once each day for homework.

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Week 4, play for fun and learning

As usual the session begins with feedback on what worked at home. This is a parent led element of the session that allows for mutual learning and support among parents (McCabe, 2008). Also during this segment each person will discuss how their child plays and games they play with their child. This will give the facilitator an idea of games and pastimes that can be adapted to give enjoyment to parents and children alike while also being a learning occasion. Play and social interaction do not come easy to children with autism, but they can learn to have fun with their typical peers (Gammeltoft & Sollok Nordenhof, 2007). Game playing will also allow the young person to learn skills such as turn taking, waiting, sharing, interacting with peers and following rules, none of which come naturally to the child with ASD. While play is fun for children, theorists such as Brunner (cited in Bruce, 1991) explain that structured play allows children to learn rules and follow formats that prepare them for taking their place in society.

Gammeltoft & Sollok Nordenhof (2007) point out that a game should at first be simple in its nature. This allows the child to invest their energies into the social interaction element of the game by keeping the game itself simple and short to begin with. The parent can also use the visual strength of the child with autism and begin any new task with a visual schedule that enables the child to see what is going to happen (Hodgdon, 1999). Visual cues may also be used when distinguishing whose turn it is to have a go. For example, introduce a cap that must be worn when it is your turn (Gammeltoft & Sollok Nordenhof, 2007).

Once playing a game has been mastered the child can learn to play games that in addition to providing for much needed social interaction allow for learning. Jones (1998) points out that there are many fun games that can be used to develop teamwork, self esteem, communication skills, self discovery, anger management and coping skills. For example an excellent way of promoting problem solving, active listening and questioning is the game Guess who where a participant must figure out who their opponent has selected through a question asking elimination process. Other simple games parents can play to develop their childs repertoire of skills include memory, hide and seek, spin the bottle, pass the parcel, shopping games and dice rolling games.
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Drama is another excellent method of play that helps to develop the social skills of people with autism but is more effective with children who have functional communication. ORegan (2004) uses drama sessions to develop body awareness, attention span, listening skills, thinking process and social growth in pre-teens with behavioural problems. Aspire Ireland provide drama in education sessions for young people with Asperger Syndrome. These drama lessons provide encouragement for the young person while improving their social and communication skills (Aspire, 2012). Through contrived situations the participants develop many of the impairments associated with autism such as social interaction, non verbal communication and the breaking down of routines (Aspire, 2012). Parents can use drama in a fun way to teach their children many vital social skills and this is compatible with the social stories methods discussed earlier.

Due to the nature of autism, many children have poorly developed fine and gross motor skills. However parents can address these issues through fun play. Gross motor skills include actions such as running, jumping, climbing, pulling, throwing, hopping, skipping, etc (Drifte, 2002). Parents can easily develop these skills in their children by simply going to the playground or playing in their garden with affordable accessories such as skipping ropes, footballs and tennis rackets. Fine motor skills are performed mainly by the hands, fingers and thumbs and include pinch movements, cutting with scissors, threading, squeezing objects, grasping and so on (Drifte, 2002). While these skills on their own seem innocuous they are the prerequisite skills for performing tasks like writing, playing musical instruments, buttoning clothes, using the telephone and engaging in art (Drifte, 2002). Parents can easily help their child develop fine motor skills through board games such as operation, cutting shapes for art, sand play, Lego, water play, helping with the baking by kneading the dough, play dough and many other fun activities that the child will enjoy. A side effect of all this play is that the children will be more able to partake in school based physical education. This in turn will improve their social, personal and physical skills and their posture (Kirchner & Fishburne, 1998).

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Another fun method that allows the child to develop while having fun is visual art. Creativity between a parent and child using play dough for example helps to develop imagination, gross motor skills and fine motor skills. Creative play is something everyone can do, and helps in the development of learning and thinking (Bruce, 2010). Parents need little training in regard to creative arts. However they must understand that the process and fun of creativity is much more important than the finished product. This attitude enables creativity (Bruce, 2010). Children should not be constrained by colouring book templates or parental expectations of what looks good. When creativity in children is supported by a parent, it can allow for learning and personal development at a very high level (Bruce, 2010).

It is beyond the scope of this parenting program to discuss every type of play. As parents share how their child plays the facilitator can advise on how any game can be adapted to incorporate learning for the child. Play between parents and their offspring should be fun above all. However, play helps children to develop their intelligence in every way (Bruce, 2011). Play helps a child to be creative, imaginative, to explore the world and manage their feelings. It also encourages relationship building, and fosters a desire to learn (Bruce, 2011). To incorporate play, carers must make time for it in every day, enjoy reading to their child, dance, be relaxed, play music, join in with the child, provide creative materials, let the child lead play and play outdoors and in the park (Bruce, 2011).

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Conclusion
The first thing a parent of a child with autism must learn is to separate their child from any undesirable behaviour. This is aided by understanding the nature and characteristics of the disability and how it manifests in their child. Once this has been achieved the care giver is ready to learn how to aid the development of their child. Communication is always a good starting point. Being able to communicate is the basis of all social interactions and is therefore essential. An added benefit of giving a child the gift of communication is that it reduces challenging behaviour that previously served as a primitive mode of getting their message across. For the non verbal child a parent can exploit their visual learning strength through PECS.

Once communication has been established with the child, a parent can now set about managing challenging behaviour. It is usually best to anticipate problems and be proactive by using visual schedules and social stories. It is also important to incorporate the use of positive reinforcement, and not punishment to address problem behaviour when is does arise. Finally, when behaviour is manageable it allows for children to learn in the natural environment of play. With autism this does not occur naturally but parents can easily contrive play situations that appear natural and impart great learning to their child.

While the vast majority of parents are enjoying Italy and all of its delights hopefully this parenting program has given some others a good outline of Holland and the joy it can bring.

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