Vocal and Musical Interaction Games:
Mouth and Face Games
Play music with your face
there may be, to recreate face-to-face situations that are interactive, playful and fun. The baby’s earliest vocabulary includes grunts, gurgles, shrieks, coughs, smacking his tongue or his lips, blowing raspberries, making bubbling and lots of other sounds, impossible to describe in words, but happily echoed by any tuned-in adult. They require no tools or equipment, just looking, listening, copying and echoing each other’s sounds. All we need in our tool-kit is our face, eyes and voice, a thoughtful and feelingful mind, an interest in careful observation, some sensitive awareness of our own pre-verbal communicative potential, a willingness to wait, watch and respond rather than to teach and demand, and to keep our concentration tightly focussed on the child’s face and subtle communications.
‘Pure interaction games’ are the developmentally very early baby-games which do not involve symbolic understanding. They can be played anywhere at any time and in between. Initiated by adult or child, they usually last only a few minutes or seconds, and many people are probably not even aware that and when they are playing them. What we are trying to recreate with the autistic child are such interactions as this between 4.5 month old baby Joey and his mother:
“Joey is sitting on his mother’s lap, facing her. She looks at him intently but with no expression on her face, as if she were preoccupied and absorbed in thought elsewhere. At first, he glances at the different parts of her face but finally looks into her eyes. He and she remain locked in a silent mutual gaze for a long moment. She finally breaks it by easing into a slight smile. Joey quickly leans forward and returns her smile. They smile together; or rather they trade smiles back and forth several times. Then Joey’s mother moves into a gamelike sequence. She opens her face into an expression of exaggerated surprise, leans all the way forward, and touches her nose to his, smiling and making bubbling sounds all the while. Joey explodes with delight but closes his eyes when their noses touch. She then reels back, pauses to increase the suspense, and sweeps forward again to touch noses. Her face and voice are even more full of delight and ‘pretend’ menace. This time Joey is both more tense and excited. His smile freezes. His expression moves back and forth between pleasure and fear. Joey’s mother seems not to have noticed the change in him. After another suspenseful pause, she makes a third nose-to-nose approach at an even higher level of hilarity, and lets out a rousing “oooOH!” Joey’s face tightens. He closes his eyes and turns his head to the side. His mother realises that she has gone too far, and stops her end of the interaction, too. At least for a moment, she does nothing. Then she whispers to him and breaks into a warm smile. He becomes re-engaged. “ (Stern 1991)
Our face and what I call ‘Mouth-and-Face-Games’ have an important function in our attempts at helping the young autistic child catch up with some of his developmental delay. Nothing more than larger-than-life elaborations of the earlier baby-babbling games of ‘pure interraction’, they aim to use whatever remnants of instinctive interest and responses
Although Joey is actively seeking social and communicative contact, the success of the interaction is almost entirely dependent on his mother being exquisitly responsive to him in timing, intensity and content. Rather than expecting the baby to join in with what the adult wants to do, all baby-games of early communication depend on the adult being responsive to what the baby is already doing, has done, is about to do. Joey’s mother responds to what he is doing: in this
However, we must bear in mind throughout that although the autistic child may be able to, he is likely to be very unused to using his mind in such ways. His threshold for being over-stimulated by too much of anything, and to feel pushed over the edge, may be minute. Therefore, while one autistic child may need us to greet him with the broadest and warmest smile we have, another may need a much cooler version, like the faintest and most unobtrusive smile or look we have available. It is our responsibility
as adults to remain sensitive to the level of stimulation and frustration each child can tolerate at any given moment, and to stop and tune down our
efforts at the slightest sign of seeing him withdraw or get frightened. With normal babies we abandon ourselves to the joy of such social contact and mucking about. But with the autistic child we must be much more aware of what exactly we are doing, which precise elements attract, which subtle variations will maintain his attention, and which don’t. He needs us to regulate these interactions for him, constantly adjusting the ‘temperature’ and intensity of our encounters to fit his variable and hyper-sensitive tolerances. In order to sustain his interest and delight, we need to try not to transgress his tolerance for frustration and to concentrate on an ‘optimal range’-band of interaction without letting it become rigid, lifeless, and boring.
However, as we are human, fallible and prone to making mistakes, despite trying not to transgress this will happen naturally through little mistunings and mismatches. These have their place too, as we saw in the example of Joey. The stuff of human relationships and communication, they help to keep things alive. But balancing this is like tight-rope walking. It requires much patient perseverance, great attention to detail and determination. If you make sure that things remain definitely playful, by smiling broadly, with the very occasional tickle perhaps to enliven his flagging life-spirits, and using a dramatic tone of voice, pulling all the registers from softest to louder and higher pitched, from slow to faster and then - suddenly - : ‘plop!’ with your lips, then even the most autistic child won’t be able to resist looking in your face. At that moment, we want to use our intuition to sense how each child feels about the world, what he or she enjoys or finds (too) scary, and to amplify whatever there is with a certain layed-back and relaxed confidence, a definite sense of humour, playfulness and fun, much empathy and understanding, while being aware that we are with a very much younger person (developmentally speaking). In this way we will be able to meet him on his level to invite him into some ‘fun and games’ of human interaction.
efforts at the slightest sign of seeing him withdraw or get frightened. With normal babies we abandon ourselves to the joy of such social contact and mucking about. But with the autistic child we must be much more aware of what exactly we are doing, which precise elements attract, which subtle variations will maintain his attention, and which don’t. He needs us to regulate these interactions for him, constantly adjusting the ‘temperature’ and intensity of our encounters to fit his variable and hyper-sensitive tolerances. In order to sustain his interest and delight, we need to try not to transgress his tolerance for frustration and to concentrate on an ‘optimal range’-band of interaction without letting it become rigid, lifeless, and boring.
However, as we are human, fallible and prone to making mistakes, despite trying not to transgress this will happen naturally through little mistunings and mismatches. These have their place too, as we saw in the example of Joey. The stuff of human relationships and communication, they help to keep things alive. But balancing this is like tight-rope walking. It requires much patient perseverance, great attention to detail and determination. If you make sure that things remain definitely playful, by smiling broadly, with the very occasional tickle perhaps to enliven his flagging life-spirits, and using a dramatic tone of voice, pulling all the registers from softest to louder and higher pitched, from slow to faster and then - suddenly - : ‘plop!’ with your lips, then even the most autistic child won’t be able to resist looking in your face. At that moment, we want to use our intuition to sense how each child feels about the world, what he or she enjoys or finds (too) scary, and to amplify whatever there is with a certain layed-back and relaxed confidence, a definite sense of humour, playfulness and fun, much empathy and understanding, while being aware that we are with a very much younger person (developmentally speaking). In this way we will be able to meet him on his level to invite him into some ‘fun and games’ of human interaction.
We can use our MOUTH to make silent shapes or funny noises like blowing raspberries, plopping our lips, smacking our tongue or lips. We can smile, laugh, giggle, grin, show our teeth, whistle in many different ways, high and low, long or short, loud and quietly. We can stick out our tongue, wiggle it from side to side, up and down, in and out, with our mouth open or shut. It can pop out for the briefest peek-a-boo, disappear again only to pop unexpectedly out of the other corner of our mouth. We can blow up our cheeks, or just one, and suddenly let the air explode, disappear or pop out.
Our FACE is capable of expressing a huge range of emotions. We can widen or narrow our eyes, in real and pretend surprise, joy, fear, shock, amazement. We can frown, take up an 'attention-getting face', a ‘greeting-face’ or a pretend-cross one. We can pretend to cry, to be frightened, bored, appalled, or open our eyes and mouth wide with the most extreme pretend-amazement, of the ‘make it bigger'-fashion.
We can use our HEAD and BODY to increase or decrease distance. We can move just our head back, or our whole body, or get up and take a step back. We can move away and then suddenly swing back again, with our face only or our entire body, or just our hand. We can move further away than expected by just a tiny bit or a lot. We can come much closer than expected, but only for a split second. We can make out as if we were to come close and touch him, and then suddenly stop and withdraw instead, or freeze in mid-motion, or mid-talking, or in the middle of being about to tickle him. We can freeze for a short moment and continue, or we can freeze in a pre-climax way for as long as it takes him to take his turn and look, or move, or make some sound in order to get us to continue. We can accompany all this by talking, singing, - or ominous silence.
With our HANDS and FINGERS we can touch, stroke, point, pat, tap, tickle or finger-march up his arm or leg. We can use a ‘wiggly worm’-finger to create anticipation and a humourous giggly situation. We can clap, wave or hide our hands, snip our fingers, - once and unexpectedly, or alongside the rhythm or tune we are singing. We can creak and squeak while moving our arms and hands like the robotic ‘rap-dances’ of some youngsters in the streets. Last but not least there is of course also the wide communicative field of EMOTIONAL BODY LANGUAGE.
With all these we try to (re-)create the most basic situation of ‘shared attention’. Initially the adult will be copying the child’s sounds, once he makes any, exactly and almost simultaneously, as with a baby. At the next level of communicative development, a little pause is left before echoing the child’s sounds, exactly at first, - with little variations with a child like Patrick, who has mastered the earlier stages. Throughout, the game is characterised by both players developing little routines together and rhythms of mouth-shapes, noises and gestures. Such familiar sequences set up expectations in the child, which, if sensitively used, can stir him into communicating what should be next:
Once Patrick and I had developed a sequence of sounds and actions, we could each add bits for the other to copy. I also used two other ‘tricks’: often I would start, then pause suddenly, smiling expectantly. Or I might make as if I was going to click my tongue, but then freeze with my tongue visibly in my mouth, - which would invariably get him to finish or to put in the next bit of the sequence, like the tongue-click.
At other times, I would get it wrong: playful ‘messing up’ often motivates a young child into communicative action. I’d start off alright, but then leave a bit out, - and hesitate, e.g.:“‘raspberries’ - vocal sound - punch air with right fist and - tongue-click (instead of shout)”. Pretending to be surprised, when he ‘corrected’ me, I’d apologise (all in good humour) and start again from the beginning, ...: it’s fun.
Our FACE is capable of expressing a huge range of emotions. We can widen or narrow our eyes, in real and pretend surprise, joy, fear, shock, amazement. We can frown, take up an 'attention-getting face', a ‘greeting-face’ or a pretend-cross one. We can pretend to cry, to be frightened, bored, appalled, or open our eyes and mouth wide with the most extreme pretend-amazement, of the ‘make it bigger'-fashion.
We can use our HEAD and BODY to increase or decrease distance. We can move just our head back, or our whole body, or get up and take a step back. We can move away and then suddenly swing back again, with our face only or our entire body, or just our hand. We can move further away than expected by just a tiny bit or a lot. We can come much closer than expected, but only for a split second. We can make out as if we were to come close and touch him, and then suddenly stop and withdraw instead, or freeze in mid-motion, or mid-talking, or in the middle of being about to tickle him. We can freeze for a short moment and continue, or we can freeze in a pre-climax way for as long as it takes him to take his turn and look, or move, or make some sound in order to get us to continue. We can accompany all this by talking, singing, - or ominous silence.
With our HANDS and FINGERS we can touch, stroke, point, pat, tap, tickle or finger-march up his arm or leg. We can use a ‘wiggly worm’-finger to create anticipation and a humourous giggly situation. We can clap, wave or hide our hands, snip our fingers, - once and unexpectedly, or alongside the rhythm or tune we are singing. We can creak and squeak while moving our arms and hands like the robotic ‘rap-dances’ of some youngsters in the streets. Last but not least there is of course also the wide communicative field of EMOTIONAL BODY LANGUAGE.
With all these we try to (re-)create the most basic situation of ‘shared attention’. Initially the adult will be copying the child’s sounds, once he makes any, exactly and almost simultaneously, as with a baby. At the next level of communicative development, a little pause is left before echoing the child’s sounds, exactly at first, - with little variations with a child like Patrick, who has mastered the earlier stages. Throughout, the game is characterised by both players developing little routines together and rhythms of mouth-shapes, noises and gestures. Such familiar sequences set up expectations in the child, which, if sensitively used, can stir him into communicating what should be next:
Once Patrick and I had developed a sequence of sounds and actions, we could each add bits for the other to copy. I also used two other ‘tricks’: often I would start, then pause suddenly, smiling expectantly. Or I might make as if I was going to click my tongue, but then freeze with my tongue visibly in my mouth, - which would invariably get him to finish or to put in the next bit of the sequence, like the tongue-click.
At other times, I would get it wrong: playful ‘messing up’ often motivates a young child into communicative action. I’d start off alright, but then leave a bit out, - and hesitate, e.g.:“‘raspberries’ - vocal sound - punch air with right fist and - tongue-click (instead of shout)”. Pretending to be surprised, when he ‘corrected’ me, I’d apologise (all in good humour) and start again from the beginning, ...: it’s fun.
Email: info@reachingautism.org
case no more than seeking her attention. Due to Joey’s perseverance, she finally notices his unspoken question and replies. He was not just looking at her, he was looking for her, and without words they play a question-and-answer game, have an argument, fall out, apologise, and make up again. When his mother goes too far, Joey cuts off and withdraws. In this example the adult uses nothing more sophisticated than simply waiting in silence, letting some suspense build up as a natural motivator, while keeping her attention tightly focussed on the child. She thus supports his drive for mastery and control, helps him regulate how much he can take, and to remain in touch with another person. When she whispers to him he is able to re-connect with her.
The idea of such baby-interaction provides us with a mental model to help us when we want to draw the young autistic child, who may be watching out of the corner of his eyes, or ears, or not at all, into face-to-face communication. Unexpected, funny or unusual noises are especially suited to this, but the first ‘attention-catcher’ is our breath: a sudden voiced in-breath, drawn in deeply, as when suddenly faced with the perhaps most shocking sight, is likely to get even the most withdrawn autistic child to look up at least for a split second. It plays on an instinctive startle-reflex that both signals alarm and sends an instinctive warning-message. It may take as much as this to ‘startle’ or ‘kick-start’ his hibernating mind into alertness, to where we can then meet it with the warmest or gentlest smile. Once we have ‘caught’ his attention, we want to hold this precious capacity, to stretch and extend it as far as it will go. This was more difficult with Tim than with Patrick:
Tim was an expert in avoiding communicative encounters. If I faced him closely, at about 30 cm and in his line or peripheral field of vision, making some noises with my mouth, he would simply sweep his eyes past my face and stare the other way. But if I then moved my face back a little together with a noisy warning-gasp, his eyes would follow the movement and we would be looking into each other’s eyes, at least for a split second. If I immediately burst out into an exaggerated smiling ‘greeting face’ together with a surprised and extremely welcoming “HellooOO?! Hello TIM!?!”, I could hold his attention and interest for perhaps a few more split seconds. If I repeated this, making surprising and unexpected noises with my mouth, such as blowing raspberries, suddenly plopping my lips or wiggling my tongue quickly and noisily from side to side, he would watch with surprise. With slightly different variations each time, it was possible to stretch Tim’s attention and to hold his interest for some minutes.
Minutes for Tim are a very long time compared with the fleeting split seconds which he has become used to. Normally, he seems incapable of such human connectedness and contact. But there were islands here of unexpected potential and possibilities. Could we help Tim to enlarge these islands, to expand the time and reduce the empty spaces inbetween? Could we show him that such face-to-face games are fun, and whet his appetite for more? Could we develop little routines of social ‘mouth-and-face-games’, so he would come to ask for an interrupted game-sequence to be completed?
Patrick wasn’t one for joining in. He had his own agenda. But finally he relented and sat down. Sitting opposite I made the most peculiar vocal noises I could. He looked up with sudden interest. I did it again, all my attention focussed on him, trying to hold his interest through the expressivity of my own face. Then I paused mid-way, to encourage him to take over the sound-making himself, widening my eyes to show that my attention was still all on him, before offering a weaker version myself, anxious not to lose our hard-won ‘shared attention’. And indeed, he tried to copy my ‘raspberries’. I echoed him, and he did it again, this time with more ‘umph’. After a few rounds, I added a tongue-click, then waited for him to take his turn. He did. We were now having a dialogue-game of ‘raspberries - tongue-click - : your turn!’. I added a vocal sound at the end, and Patrick copied this too. And then it was my turn to be surprised. Patrick’s next turn went:“‘raspberries’ - tongue-click - vocal sound - punch air and shout!” He looked at me with a broad grin. It was wonderful. Patrick had not only understood the idea of copying vocal sounds, but also the idea of sequencing and adding new elements. This was creative. We continued for about 10 minutes, and only stopped because we had to. From then on, Patrick ‘asked’ daily for ‘mouth-and-face-games’.
We can make an infinite abundance of shapes and noises with our mouth, which can all be separately adjusted and fine-tuned according to each individual child. Each of us is like an orchestra of which we are the conductor. Many of the players we have never met, and most of us are unaware of a large section of our personal orchestra’s potential, - here are some of them:
We can speak, sing, hum, and make all sorts of sounds and noises with our VOICE, which has a wide range of volume, from totally soundless to loud voiced whispering, from ‘room-temperature’-volume to loud shouting-pitch. We can decrease and increase its volume, play around with speed and tempo: slow or fast, suddenly or gradually, or gradually at first and suddenly much faster, or louder, or vice versa, - then suddenly stop or change modality. It has a wide range of pitch: we can speak or sing in a high voice or a deep one, growl, quack, miauw, bark, grunt, squeak, make vocal sounds that are funny, silly, surprising or even rude, from silly high-pitched ones like a mouse or a deep lion’s roar. We can develop different rhythms, to be repeated or not. We can speak in a distinctive rap-rhythm, sing what we want to say, or speak it to the rhythm of a particular favourite song. We can take a noisy in-BREATH, or sigh with an equally noisy out-breath. We can even make a pretend version of a dramatically exaggerated 'mock-shocked' gasp clearly different from one of more real shock, concern or alarm.
The idea of such baby-interaction provides us with a mental model to help us when we want to draw the young autistic child, who may be watching out of the corner of his eyes, or ears, or not at all, into face-to-face communication. Unexpected, funny or unusual noises are especially suited to this, but the first ‘attention-catcher’ is our breath: a sudden voiced in-breath, drawn in deeply, as when suddenly faced with the perhaps most shocking sight, is likely to get even the most withdrawn autistic child to look up at least for a split second. It plays on an instinctive startle-reflex that both signals alarm and sends an instinctive warning-message. It may take as much as this to ‘startle’ or ‘kick-start’ his hibernating mind into alertness, to where we can then meet it with the warmest or gentlest smile. Once we have ‘caught’ his attention, we want to hold this precious capacity, to stretch and extend it as far as it will go. This was more difficult with Tim than with Patrick:
Tim was an expert in avoiding communicative encounters. If I faced him closely, at about 30 cm and in his line or peripheral field of vision, making some noises with my mouth, he would simply sweep his eyes past my face and stare the other way. But if I then moved my face back a little together with a noisy warning-gasp, his eyes would follow the movement and we would be looking into each other’s eyes, at least for a split second. If I immediately burst out into an exaggerated smiling ‘greeting face’ together with a surprised and extremely welcoming “HellooOO?! Hello TIM!?!”, I could hold his attention and interest for perhaps a few more split seconds. If I repeated this, making surprising and unexpected noises with my mouth, such as blowing raspberries, suddenly plopping my lips or wiggling my tongue quickly and noisily from side to side, he would watch with surprise. With slightly different variations each time, it was possible to stretch Tim’s attention and to hold his interest for some minutes.
Minutes for Tim are a very long time compared with the fleeting split seconds which he has become used to. Normally, he seems incapable of such human connectedness and contact. But there were islands here of unexpected potential and possibilities. Could we help Tim to enlarge these islands, to expand the time and reduce the empty spaces inbetween? Could we show him that such face-to-face games are fun, and whet his appetite for more? Could we develop little routines of social ‘mouth-and-face-games’, so he would come to ask for an interrupted game-sequence to be completed?
Patrick wasn’t one for joining in. He had his own agenda. But finally he relented and sat down. Sitting opposite I made the most peculiar vocal noises I could. He looked up with sudden interest. I did it again, all my attention focussed on him, trying to hold his interest through the expressivity of my own face. Then I paused mid-way, to encourage him to take over the sound-making himself, widening my eyes to show that my attention was still all on him, before offering a weaker version myself, anxious not to lose our hard-won ‘shared attention’. And indeed, he tried to copy my ‘raspberries’. I echoed him, and he did it again, this time with more ‘umph’. After a few rounds, I added a tongue-click, then waited for him to take his turn. He did. We were now having a dialogue-game of ‘raspberries - tongue-click - : your turn!’. I added a vocal sound at the end, and Patrick copied this too. And then it was my turn to be surprised. Patrick’s next turn went:“‘raspberries’ - tongue-click - vocal sound - punch air and shout!” He looked at me with a broad grin. It was wonderful. Patrick had not only understood the idea of copying vocal sounds, but also the idea of sequencing and adding new elements. This was creative. We continued for about 10 minutes, and only stopped because we had to. From then on, Patrick ‘asked’ daily for ‘mouth-and-face-games’.
We can make an infinite abundance of shapes and noises with our mouth, which can all be separately adjusted and fine-tuned according to each individual child. Each of us is like an orchestra of which we are the conductor. Many of the players we have never met, and most of us are unaware of a large section of our personal orchestra’s potential, - here are some of them:
We can speak, sing, hum, and make all sorts of sounds and noises with our VOICE, which has a wide range of volume, from totally soundless to loud voiced whispering, from ‘room-temperature’-volume to loud shouting-pitch. We can decrease and increase its volume, play around with speed and tempo: slow or fast, suddenly or gradually, or gradually at first and suddenly much faster, or louder, or vice versa, - then suddenly stop or change modality. It has a wide range of pitch: we can speak or sing in a high voice or a deep one, growl, quack, miauw, bark, grunt, squeak, make vocal sounds that are funny, silly, surprising or even rude, from silly high-pitched ones like a mouse or a deep lion’s roar. We can develop different rhythms, to be repeated or not. We can speak in a distinctive rap-rhythm, sing what we want to say, or speak it to the rhythm of a particular favourite song. We can take a noisy in-BREATH, or sigh with an equally noisy out-breath. We can even make a pretend version of a dramatically exaggerated 'mock-shocked' gasp clearly different from one of more real shock, concern or alarm.