THE L.I.T.T.L.E. PROGRAMME

Looking, Imitating, Turn-Taking and Language Exercises

The sessions take place in the loft room. We will endeavour to ensure that all the props are available each time.

You will get things off to a good start If you can let Jack know that you are pleased to see him when you arrive. We will provide you with a name card with which you can show Jack each time you come, so that he gets to know who you are.

Expect to find the sessions a bit difficult at first. Familiarity with the activities and with Jack will soon give you confidence.

You can do the activities in any order. You do not have to do all of them. Continue with an activity if it is going well. You will learn when to move on to a new one.

Accept that there will be good days and bad days. Try to be firm with Jack and continue an activity if he doesn't initially co-operate or protests. Try a different activity if necessary. If he gets really upset (tears, howls etc.), stop the activity and try to comfort him (this has never happened so far). He quite likes a cuddle. If he is tired, take a break (see below).

Give yourself a break during the session if you need one. Choose a simple book from the bookcase, sit with Jack on your lap and either read the words or comment on the pictures. Try to avoid situations where Jack is allowed to lie on the floor and drift aimlessly as it may be hard to re-start the session.

We will leave you alone with Jack in the loft. We will not interrupt your time with him - so if you need us then please come downstairs.

The following description of the programme is very detailed, so that you know exactly the kind of thing we want you to do, and why. It may seem a bit complicated at first, but if you keep in mind the basic aims and the basic method of doing things it seems much more simple;-

AIMS - to teach Jack to make eye contact

to imitate

to take turns

to learn new concepts and vocabulary

METHOD - playing simple games which encourage Jack to practise these skills.

rewarding Jack when he does practise these skills.

Jack finds ordinary speech very hard to understand. He can't 'tune in' to it in the way that everyone else can, as people's voices have no more significance to him than any other background sound. In many ways English is like a foreign language to Jack, in which he only understands a few simple phrases.

We've found the best way to communicate is as follows

1. Get down close, so you're at eye level with Jack.

2. Make physical contact, for example put your hand on his arm or back.

3. Try to make eye contact. Say 'Jack, look at me'. If he doesn't respond to the command, look away from him for a few seconds and try again. (Jack finds it hard to make eye contact if he can't see any immediate purpose in it, so you may have to carry on without it on sometimes).

4. Speak slowly, clearly, and simply as soon as he makes any eye contact. Speak more loudly than you would normally.

1. Have the particular props that you need right by you, so that you can start the activity as soon as you introduce it. This helps Jack associate what you're saying with what is going to happen.

2. If you need to move Jack to a particular part of the room take his hand and lead him, saying 'Come on'. This works better than calling him to come to you. If you need him to sit down tell him 'Sit down, Jack' and indicate the chair or pat the floor with your hand.

Sometimes Jack gets engrossed in some activity on the floor and it's difficult to get his attention because his head is down. The best way to deal with this is to say 'Stand up, Jack'. If he doesn't comply try again and take his hand to help him up. This works better than just calling his name or saying 'Come here, Jack'.

3. Introduce the activity firmly and clearly. For example, say 'Jack, let's roll the ball', or 'Let's do the jigsaw puzzle', or 'Let's look in the mirror'.

4. Launch into the activity straight away.

Rewards are very important for Jack as they provide the motivation to co-operate, and they can also be used to reinforce the particular skills we are trying to teach him. To be effective the reward needs to come immediately after Jack has produced the particular behaviour you are working on. For example, with eye contact, as soon as Jack looks at you reward him so that he associates making eye contact with getting a reward.

1 Praise

The reward that usually works best with Jack is praise. Praise needs to be immediate and specific, for example "Good boy, waiting your turn", or 'Good looking at me, Jack'. It also helps to praise Jack simply for co-operating and joining in, for example, 'Good rolling the ball, Jack!', 'Good looking in the mirror, Jack', etc.

The praise needs to be fairly exaggerated for Jack to appreciate it. Give lots of smiles, shake his arms and generally lay it on thick. He likes 'Well done, Jack, good boy!' and he's not averse to a quick round of applause! Try to make every success a real celebration!

2 Other rewards

Lifting him up and down (if you have the energy!).

Tickling him.

3. Self-rewarding activities.

Some activities are rewarding in themselves. For example, with the bubble blowing activity (see below) the bubbles act as a reward for eye contact.

Many of these exercises involve matching written words to pictures. The descriptions below of how to do them are fairly detailed, but please don't be put off by this! In practice all the exercises are very simple and as soon as you see the pictures and word cards it all becomes fairly obvious. However it's useful to have instructions to refer to when in doubt.

After some of the language exercises ideas are suggested for helping Jack use

the words he has learnt in other contexts, for example in pretend play or when looking at books. Generalising the teaching in this way helps to ensure that Jack really understands the new words he has learnt and can begin to apply them in practical ways.

These are the words that Jack finds easiest.

Each set contains seven or eight pictures. Each picture has a matching word card (for example there is a picture of a house and the word 'house' is also written on a word card).

Have Jack seated at the table.

Lay all the picture cards out on the table.

Hand a word card to Jack and wait for him to match it to the appropriate picture.

If he matches it to the wrong picture move his hand so that he places the card with the correct picture and praise him for getting it right.

Reward him with praise and/or a favourite toy from the props box when he has placed all of the cards correctly.

These are harder for Jack because he has to look to see what the person in each photograph is doing, rather than just seeing what is in the picture.

Each set contains four photographs of people doing various actions, for example, running, eating, catching, and swimming. There are four matching word cards (run, eat, catch and swim). When he becomes more familiar with the photographs we will increase the number in each set.

Have Jack seated at the table.

Place a photograph on the table, and name the action, for example 'Eat'. If possible mime the action (keep it brief and simple).

Follow the same procedure with each card, until all four are on the table.

Hand Jack a word card and wait for him to place it on the correct photograph.

If he goes to put the card on the wrong photo, move his hand to the right photo and praise him for getting it right (Jack is very easily discouraged by failure).

Reward him with praise and/or a favourite toy from the props box when he has matched all the words to the correct photographs.

If Jack is still interested, do the exercise again, this time putting the photographs in a different order.

There is also a set of jigsaw pairs depicting actions (each word card fits to it's appropriate picture) which is also a useful exercise.

Other ideas for practising verbs-

Use a soft toy to demonstrate some of the action words, or try to incorporate some of the new words in pretend play.

When Jack is looking at a book point out the pictures which show a someone performing an action, for example, 'Look Jack, "running". The chick is running'.

There are four different sets of cards, each set depicting only one pair of opposites. The sets are:-

full and empty (for example a picture of a full basket and a picture of an empty

basket, a full bottle and an empty bottle, a full truck and an

empty truck, etc.).

wet and dry

up and down

open and closed

Only one set of cards is used at a time.

Attached to each picture card in the set is some writing saying, for example 'The basket is .......' or 'The bottle is ........'. Jack has word cards saying 'empty' and 'full'. He has to place the correct word on the blank to complete the sentence.

Have Jack seated at the table.

Lay out the pictures. Make sure that they are in pairs, with the full basket next to the empty basket, the empty bottle next to the full bottle, etc.. Seeing the contrast makes it easier for Jack to work out which is full and which is empty. However, avoid making an obvious pattern such as full, empty, full, empty, full empty.

Put the word cards saying 'full' and 'empty' on the table in front of Jack (if there is no room hold up a card saying full and a card saying empty).

Point to the first picture. Jack should read the writing and put the appropriate word card on the blank, so that it says, for example, 'The basket is empty' or 'The basket is full' (he actually has no problem reading this kind of thing).

Give Jack lots of praise if he gets it right.

Point to the next picture, and wait for Jack to read the writing and fill in the blank.

When Jack has completed all the sentences reward him with lots of praise and/or a favourite toy from the props box.

If Jack is still interested, put the pictures in a different order (though still in pairs of opposites) and try it again.

If Jack found the exercise very easy the first time, rearrange the pictures so they are no longer in pairs of opposites. Be prepared to guide his hand if at any point he gets stuck.

Suggestions for generalising:-

Full and empty, wet and dry. These two pairs of opposites are probably easier for us to generalise in real life situations such as mealtimes and bathtimes, than for you to generalise in the sessions.

Up and down. Put a soft toy at the top of the slide for 'up' and then send it down to the bottom for 'down'. Get Jack to go up and down the slide. Hands up and hands down.

Open and closed. Try giving Jack a verbal instructions, such as 'Open the door', 'Close the door'. This can also be done with a Jack-in-the-box, a box of toys, drawers and books (you may need to demonstrate the idea of opening and closing a book).

Songs - 'London Bridge is falling down'

'Ring a ring o'roses'

'Hickory dickory dock'

'The grand old Duke of York'

'Jack and Jill'

In and out

On and under

We intend to prepare two sets of pictures with matching wordcards, one set for each pair of opposites. They will work in the same way as the 'opposites' cards described above.

Suggestions for generalising:-

In and out.

This lends itself well to pretend play, with soft toys hiding in boxes and then jumping out again. Always emphasise the vital word, for example, 'Teddy is hiding IN the box', 'Teddy is jumping OUT of the box'). Soft toys can also go in bed for a sleep, then wake up and come out again. A Jack-in-the-box is also useful for illustrating the idea.

We have put a big cardboard box up in the loft, labelled 'In and out box'. Jack enjoys putting things in it (including himself!) and then getting things out of it again. We have put two big wordcards in the box, one saying 'in' and one saying 'out'. These can be used to emphasise the words when you say them, for example, 'Put Tigger IN the box' whilst holding up the word 'in'.

On and under.

Demonstrate this using soft toys, then see if Jack can follow verbal instructions using on for example, 'Put teddy ON the table. Put cat UNDER the table'. 'Under' and 'on' also lends themselves well to pretend play, with soft toys sitting on or hiding under the chair, the bed, the table, the slide etc..

The big cardboard 'in and out' box can be turned upside down to serve as an 'under and on' box. When we start teaching this we will label up the box (Jack likes reading labels) and put two big wordcards in it saying 'on' and 'under'.

Songs - 'Pussycat, pussycat, where have you been'.

'Little Miss Muffet'

'Little boy blue'

This exercise matching pairs of objects that commonly go together, for example, knife and fork, paint and paintbrushes, cup and saucer, toothbrush and toothpaste, etc.. There are two reasons for doing this. Firstly, Jack tends not to be aware of these kind of associations; learning them helps him to begin to make sense of things. The second reason is to help Jack understand the word 'and', which is a very useful for helping Jack to build up simple phrases.

Sort the picture cards into pairs and put the cards saying 'and' in a separate pile.

Sit Jack down at the table.

Start laying the cards on the table in pairs, with the word 'and' between each pair. Verbalise this as you do it, for example, 'Knife AND fork', 'Table AND chairs'.

Carry on until all the cards are laid out.

Now take away the second card of each pair leaving, for example, 'Knife and .......', 'Table and........', 'Toothbrush and.........'.

Put the second cards out (in the wrong order) in front of Jack.

Point to the first cards and say 'Knife AND .........?'. Jack should pick out the picture of the fork and place it correctly to complete the pair, e.g. ‘Knife and fork'. Give him lots of praise if he does this correctly.

Work through all the pairs in this way. Make a big fuss of him when he completes the whole exercise, and give him a favourite toy from the rewards box to have a short play with.

If he is still interested, do the exercise again, but with the pairs in a different order.

If he finds this exercise easy, try reversing each pair, so that you lay out the cards, for example, to show 'Fork and .......', 'Chairs and ........',etc..

Seat Jack in a chair facing you.

Part One

Say, 'Point to Jack's nose'.

Praise him if he gets this right, prompt him physically (move his hand to point to his nose) and then praise him if he seems unsure.

Say, ‘Point to Sheila’s * nose' (* obviously, use your own name). Again, praise and prompt as necessary.

Do several of these. Use parts of the body and clothes. Sometimes turn the pattern round, so that you say 'Point to Sheila's shoes' first, and then 'Point to Jack's shoes'. This ensures that Jack isn't just following a pattern without really understanding what you are saying.

After five or six of these reward Jack with a few goes at an interesting toy (for example the top, a book that plays music, etc.). Then go on to part two.

Part Two

This time you point to Jack's nose and say 'Whose nose?'. If he hesitates prompt him with 'Ja....' If necessary give him the answer, 'Jack's nose'.

Then point to your own nose and say 'Whose nose?'. Again, if he seems unsure, prompt him with 'Shei......', and if necessary give him the answer, 'Sheila’s nose'. Again, vary the pattern, so that sometimes you point to yourself first, sometimes Jack first.

Give plenty of praise and encouragement.

Try to use the same parts of the body or clothes that you used in the first stage, and if he was unsure of any of these at the first stage (for example, if he wasn't sure what a knee was) leave it out at this stage, to make it as easy as possible.

Reward Jack at the end with praise and/or a favourite toy from the props box.

This exercise is particularly good if there are two of you working with Jack, because then Jack can point at two different noses other than his own, which makes it more challenging and interesting!.

It is also possible to use a soft toy as a third person, for example, 'Point to Jack's mouth', 'Point to Sheila's mouth', and 'Point to teddy's mouth'.

We may add new language exercises as Jack progresses. For example, we are hoping to get some sequencing cards. These cards tell a very simple story in two or three pictures, and could be used to help Jack in a variety of ways. If we do introduce a new exercise we will make sure that we include clear instructions with it.

This is a set of word cards. Each word card has an action on it.

The list of actions is as follows:-

stand up

sit down

jump

arms up

walk

kick

cry

smile

tickle

run

blow

sneeze

wave

sit down

cuddle

sniff

blink

yawn

eat

drink

crawl

shiver

Chose ten or so cards to practise (the actions that Jack can do when seated in his chair are easiest).

Sit Jack in the chair, and sit facing him.

Have a selection of rewards from the props box at hand.

Make sure Jack is paying attention, (say 'Look at me' and wait for eye contact if necessary).

Hold up a card and say 'Do this'. Jack should read the card and perform the action. He quite likes it if you join in with the action.

If he doesn't act out the word prompt him by starting to act out the word yourself - he usually catches on and copies.

As soon as he has performed the action correctly reward him with a quick go at one of the toys from the props box (the books that play tunes or make funny sounds often work quite well as a reward with this exercise).

This is a very important area for Jack to work on for many reasons. It is a step toward abstract and imaginative thinking and it also provides a lot of opportunities for improving his language, both in terms of helping him to understand speech and encouraging him to use it. In addition to this it broadens his range of play activities, which tend to be quite limited.

Pretending is quite difficult for autistic children. Most normal children start pretend play at about 18 months; they give their teddy a drink or pretend to give their doll a bath without ever needing to be taught to do so. However, the only way that Jack can learn this kind of pretend play is by being shown what to do and encouraged to copy.

We have put a box of pretend play things in the loft. This consists mainly of dishes, cups and bowls, plastic food, party hats, etc. Jack is now familiar with a very simple birthday party scenario; putting hats on the soft toys, giving each one a cup, pouring them a drink, putting out plates, bringing out the (plastic!) birthday cake, singing Happy Birthday, and so on.

Other ideas:-

putting some soft toys to bed (use one of the real beds), then waking them up

and giving them breakfast.

giving some soft toys a bath (there is a pretend bath with bath things under

Jack's bed)

encouraging Jack to take some soft toys for a ride in his car

sending soft toys down the slide (they could take turns with Jack)

Other ideas would probably work equally well, as long as they were simple.

An important part of teaching Jack pretend play is to show him what to do, as he won't be able to come up with ideas of his own. The clearest way is to say 'Look Jack, do this' and then model the action for Jack to copy (for example, washing a soft toy's face or pouring a pretend drink into it's cup). This works particularly well if you take a soft toy for yourself. Then you can model the action so that Jack can copy you using his soft toy. Another method is to guide Jack physically through the action by taking his hands and moving them in the right way in order to show him, for example, how to wash the soft toy's hair.

Pretend play is an ideal opportunity for improving Jack's understanding of language. It is very helpful to Jack if you talk to him about what is happening in very clear and simple language. For example, 'Let's give Piglet and Tigger a bath. Come on Piglet. Come on Tigger. Turn on the taps. Put in the bubble bath. Jump in Tigger. Jump in Piglet', etc.. Look out for any opportunities to practise the kinds of words we are working on in the language exercises, for example in the case of giving soft toys a pretend bath, the verb 'wash', and the opposites 'wet' and 'dry'. It helps if you emphasise the important words when speaking, for example, 'Look, Mouse is DRINKING', 'Cat is hiding UNDER the table', 'Piglet is SLEEPING', 'Tigger is IN the bath', etc..

Jack's favourite soft toys tend to be those that are not teddies. He is very fond of Winnie-the-Pooh, Piglet, and Tigger, and also an orange 'Garfield' cat which he has named 'Pussycat'.

Jack does have some other types of toy that can be used for pretend play. The Brio train set (kept in a labelled box under the bed) has models of Thomas the Tank Engine and other trains. There is also a farm set with lots of animals (kept in another labelled box under the bed); Jack loves to get this out, but then has very little idea how to play with it.

Good eye contact is important for normal social interaction. Prolonging eye contact helps children get more information about language through facial expression and gestures or signs. When working on eye contact activities, place the props near your face to encourage Jack to look at you.

BUBBLE BLOWING

1. Get down on the floor close to Jack, with bubble mixture at the ready. Hold the tub and wand up near your eyes.

2. Say 'Look at me'. If he fails to respond immediately, look away for a few seconds and then try again. If after a few attempts he still hasn't responded then put the bubble mixture in his line of sight. When he looks at the mixture, bring it towards your eye level so Jack will look at you. Say 'Look at me' again.

3. As soon as he looks at you, blow the bubbles. In this kind of activity the actual blowing of the bubbles acts as a reward in itself, but you could also say, ‘Good looking at me, Jack' sometimes.

4. Repeat the whole process again, making sure that Jack makes eye contact each time before you blow the bubbles. Keep going until Jack begins to lose interest.

BALL ROLLING

1. Sit at the opposite end of the room to Jack, with a large ball.

2. Say "Look at me, Jack". Repeat the command after waiting a few seconds, if he hasn't responded. When he makes eye contact immediately roll the ball to him.

3. When Jack has the ball, say "roll the ball to me".

4. Repeat this until Jack begins to lose interest. Make sure Jack makes eye contact before you roll the ball to him every time. Jack usually enjoys this so it's fairly self-rewarding, but a bit of praise for making eye contact is probably quite helpful anyway.

TICKLING

1. Place Jack so that he's lying on the floor.

2. On this occasion, there should be no need for the "look at me" command. Just wait for eye contact.

3. When eye contact obtained tickle him very briefly and repeat when eye contact made again. Continue for a short time only (maximum 2 minutes), otherwise he might get the hiccups!

PUPPETS

1. Put a hand puppet close to your face and give the command "Look at me". If he fails to respond immediately then look away for a few seconds and repeat the command. Bring the puppet into his line of sight if eye contact not obtained after a few attempts.

2. As soon as he looks at you tickle him with the puppet as a reward, or make the puppet do anything silly that makes him laugh (however, it's best to avoid making any fierce animal noises such as growling or roaring with the tiger puppet, as this frightens him).

He may like being chased by a puppet: here, again, stop every 10 seconds or so and wait for Jack to make eye contact (say, 'Look at me') before resuming.

PEEP-PO AND "BOO" GAMES

There are numerous variations on this very simple method of attracting eye contact. These will also usually work quite well. Examples :

Put a coloured scarf over your face and play peep-po.

Using a face mask play peep-po or boo games.

Wave your hands and wiggle your fingers. Hide your face behind your hands and play peep-po.

PARTY BLOWERS

1. Put the party blower close to your face and give the command "Look at me". If he fails to respond immediately then look away and repeat the command after waiting a few seconds. If he hasn't responded after a few attempts then bring the party blower into his line of sight.

2. When eye contact obtained blow the party blower. Repeat until interest wanes, ensuring eye contact is obtained before each blow.

SONGS AND RHYMES

Some songs that involve a measure of eye contact are

Pat-a-cake clapping games (you would need to teach him this one).

'Round and round the garden, like a teddy bear' tickling games.

Row-the-boat rocking games.

BLOW UP BALLOONS

1. Sit opposite Jack and blow up a balloon.

2. Obtain eye contact as described above ("look at me"). If necessary bring the balloon into his line of sight.

3. When eye contact established, hold the balloon near your face and say "ready, steady, go" and let go of the balloon. Repeat until interest wanes.

This helps Jack to become more aware of other people, to watch and respond to them, and to work co-operatively with them. Learning to copy someone else is a useful skill that can be developed into self-help skills as the child gets older. Autistic children find the process of watching someone else's body movement and mirroring it with their own body quite difficult, so it is an area that needs to be practised.

PATTERNS

1. Using bricks from the bucket, make 2 identical piles of bricks on the table. Sit Jack on his chair by the table and kneel next to him.

2. Attract his attention to your hands, then make a very simple pattern with some of the bricks from one pile while at the same time saying "do this". (We suggest you start by putting just one brick on top or beside another.)

3. If Jack fails to respond, prompt him with your hands. Give verbal praise when he matches your pattern, even if he has needed lots of prompting. Put both sets of bricks back in their piles and repeat with a different pattern. Continue for a while to see if he gets the idea.

BODY ACTIONS

1. Choose a movement for Jack to copy. For example:

Raise arms

Tap the table

Wave

Clap hands

Crouch down

Turn around (360 degrees rather than 180 degrees)

Stamp feet

Kick

Ssh (index finger held up to lips whilst saying 'ssh')

2. Have Jack is seated opposite you with hands in lap, or standing (depending on the action you are going to practise). Make sure you have his attention ("Look at me").

3. Say loudly "Do this" while simultaneously doing the action.

4. If Jack does not respond by imitating your actions, prompt him so that he responds correctly. For example, if you are working on clapping hands, take Jack's hands in yours and make them clap. Praise him for this ('Good clapping, Jack' or 'Good doing this') even though you had to prompt him, so that he gets he idea.

5. Repeat this a few times. Try to fade out the prompt, for example by just putting his hands together instead of making them clap or even just bringing them forward from his sides.

6. If Jack finds all this easy pick another action to work on, for example raising arms. When he can easily copy that action (which may take a while), you could try swapping between the two actions, so that first Jack copies you clapping and then he copies you raising arms. Random swapping between the two rather than regular alternation would be even more challenging.

One point to remember is that it is best not to always start this activity by practising the same action, otherwise Jack may come to think that 'Do this' means only that particular action. For example he may think that 'Do this' means clap your hands and will be very confused when you start practising a different action.

WORKING WITH A MIRROR

1. Position the mirror so that you and Jack can look in it together comfortably.

2. Touch your nose and say 'Do this, Jack'. If he manages to copy you give him lots of praise ('Good doing this' or 'Good touching your nose, Jack').

3. However if he doesn't respond after a couple of tries do it again, saying 'Do this', and at the same time try to physically prompt him, for example by using your free hand to move his hand to touch his nose. Praise him (as above) for this so that he gets the idea of what you want.

4. Try a different action. Good ones to choose from are:-

Nodding your head

Smiling

blinking several times

Touching your chin

Blowing

Hands covering your face

Shaking your head

Hands on head

Cupping one hand behind your ear (listening gesture).

Try to avoid always starting this activity with the same action, because Jack may begin to think that , for example, 'Do this' literally means put your finger on your nose.

Many children find it difficult to learn to wait, share and take turns. Autistic children find it particularly hard to accept the rules of turn-taking and sharing. These skills need to be encouraged to help develop an understanding of the rules of conversational turn-taking as well as promoting good standards of behaviour.

NESTING BEAKERS

1. Sit Jack in his chair at the little table.

2. Separate the individual nesting beakers and put them out on the table.

3. Put out the first nesting beaker (open end down).

4. Say 'Jack's turn'. He should be able to pick out the correct beaker and place it on top. If he seems unsure, gently guide his hand in the right direction.

5. Say 'My turn' and place the next beaker on top of the other two. Make sure Jack's hands go down in his lap when you say wait. If they don't, gently put them in his lap and say 'Hands quiet'. While you are taking your turn give Jack a bit of praise for waiting ('Good waiting Jack!'). If Jack's hands do start to creep up towards the beakers, gently put them down again.

6. Say 'Jack's turn' and allow him to have his go.

7. When it's your turn say 'My turn', as above. Carry on taking turns until the tower of beakers is built, at which point Jack will take great pleasure in knocking it all down!.

BUILDING A TOWER OF BRICKS

Take some bricks from the bucket and place them on the table. Sit Jack at the table and try either of these games.

a) Take turns with Jack to place one brick on top of another in order to build a tower. Use the same procedure as for the nesting beakers (see above), saying 'Jack's turn' for his turn and 'my turn' when it's your turn.

b) Tell Jack to wait (make sure his hands are in his lap) and quickly build a small tower of bricks. When you have finished say 'Jack's turn' and let him knock them all down.

The first few times you try this it's best to keep the tower fairly small so that Jack doesn't have to wait for more than a few seconds, but on subsequent occasions you could try making the tower a bit higher so that he has to wait a little bit longer. .

POSTING SHAPES

1. Find the posting shapes ball and extract all the shapes from the inside by pulling the two handles and shaking.

2. Sit Jack on his chair ("sit down Jack") and place the shape pieces and ball on the table.

3. Put a shape through it's appropriate hole. This shows Jack what he is expected to do.

4. Say 'Jack's turn' and let him choose a piece. He may need you to slowly turn the ball around so that he can find the right hole to place it in.

5. Carry on taking turns until all the shapes are posted.

JIGSAW PUZZLES

1. Choose a jigsaw puzzle from the selection in the white chest of drawers. Initially it's probably best to choose a fairly simple puzzle; these are kept in the middle drawer. The more difficult puzzles are in the bottom drawer; some of these would need to be done on the floor as they are too large for the table.

2. Sit Jack at the table ("sit down Jack"). Put the all the jigsaw pieces out on the table, leaving clear a large area in the middle to work in.

3. Place a piece of jigsaw in the working area.

4. Say 'Your turn, Jack' and wait for him to fit a piece. If necessary give him a suitable piece to fit.

5. Say "My turn' and fit another piece.

6. Carry on until the jigsaw is completed.

MATCHING GAMES

These are kept in the to drawer of the white chest of drawers. They are sets of jigsaw cards that fit together in twos. For example in a set there might be 20 jigsaw cards that fit together to make 10 little jigsaws. Each set of puzzles has a particular theme, for example, mother and baby animals. The idea is to match each card with its pair (cow with calf, horse with foal, etc.) until all 10 of the little jigsaws is completed.

1. Choose a matching game.

2. Sit Jack down at the table.

3. Arrange one half of each matching pair on the table.

4. Put the other halves on the floor beside you, where Jack doesn't see them.

5. Take a piece from the floor and fit it with it's pair on the table.

6. Say 'Jack's turn' and hand him a piece to fit. If he finds this difficult point to where it should go.

7. Say 'My turn' and take your turn.

8. Carry on taking turns until all the little jigsaws are finished.

LOTTO GAME

This game, involving matching words to their appropriate pictures, is also kept in the top drawer of the white chest of drawers.

1. Choose a board and select the nine cards that match with it.

2. Put the board on the table and the cards down beside you on the floor.

3. Put a card on its matching picture (or word) on the board.

4. Say 'Jack's turn' and hand him a card to place on the board.

5. Say 'My turn' and take your turn. Carry on taking turns until the board is completed.

At the end of each session please complete the questionnaire, rating the success of each activity. We would welcome any comments, criticisms, or suggestions on the activities. Your input is vital to ensure that the programme is pitched at the right level for Jack.