It’s important to understand that the difficulties autistic kids face are not a form of disease and therefore there is no cure. These are special and permanent emotional and psychological needs of such children. loving attention and a positive environment enhance their natural potential, writes Surabhi Verma
Did you notice your child shying away from social interactions at an early age or having difficulty learning languageIJ Did you note your child having trouble making eye contact while conversing or making repetitive behavioural actionsIJ These little signs, which are usually overlooked during early childhood, can be the early indicators of a bigger issue which the child might be facing.
What is AutismIJ
Autism is a neuro-developmental disorder which affects the three main areas of development usually referred to as triad of impairments:
· Social interaction and understanding.
· All aspects of communication — verbal and non verbal.
· Flexibility of thinking and behaviour, including problems with imagination.
Autism is an extremely complex disorder but we can distill its myriad characteristics into four fundamental areas: Rigidities in thinking; speech/language delays and impairments; the elusive social interaction skills; and sensory processing challenges.
Though these four elements may be common to many children, it is important to remember the fact that autism is a spectrum disorder: No two (or 10 or 20) children with autism will be completely alike. Every child will be at a different point on the spectrum.
The term autism has been defined by the Autism Society of America (ASA) as “a complex development disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults with autism typically show difficulties in verbal and non-verbal communication skills, social interactions and leisure or play activities”.
Autism Spectrum Disorder (ASD) term is very new in our society, although it has been existing for many years. Children with autism struggle to manage their daily routine. For a long time they were considered to be careless, adamant, irresponsible, and lazy. About 10 years ago, most people would have considered ‘autism’ to be a fancy name for ‘mental retardation’ and unfortunately many professionals and people still consider it the same.
This is unfortunate as many individuals with autism have a normal IQ and can do very well socially and academically. However, it was only recently that their problems have been recognised and understood methodically.
As per statistics, till 1985, not a single case of autism existed in India. However, currently it is on a rise and more and more children are being diagnosed with autism. Unfortunately there is no concrete data available that tells us the number of children with autism specific to India. Now there is a much better environment with help from many awareness programmes on television and many movies which have helped in creating awareness about the disorder. Schools have become much sensitive towards the needs of children with autism and are also opening their doors to them.
Early signs of Autism
· Inconsistent or poor eye contact and lack of smile on eye contact.
· Hypersensitivity to noise.
· No reaction or inconsistent reaction when the name of the child is called out. The hearing test would be normal.
· Self harming behaviour like hitting and self-biting.
· Engrossed in his/her own world.
· Not following the objects visually.
· Not pointing or using gestures to communicate.
General symptoms
· Difficulty with verbal communication, including problems using and understanding language.
· Inability to participate in a conversation, even when the child has the ability to speak.
· Difficulty with non-verbal communication, such as gestures and facial expressions.
· Difficulty with social interaction, including relating to people and to his or her surroundings.
· Inability to make friends and preferring to play alone.
· Unusual ways of playing with toys and other objects, such as only lining them up a certain way.
· lack of imagination.
· Difficulty adjusting to changes in routine or familiar surroundings, or an unreasonable insistence on following routines in detail.
· Repetitive body movements, or patterns of behaviour, such as hand flapping, spinning and head banging.
Coping with Autism
For children with autism, the cognitive ability with verbal instructions is affected, thus they are unable to communicate or have appropriate social skills.
The first and the foremost task is to identify the areas which are affected and the extent to which it affects the day to day life of the child as each child with autism will be different. Since autism is a lifelong challenge, it is important to develop and practice effective coping strategies like preparing schedules to help the child understand the tasks that need to be completed and in which order. It also helps in decreasing the tantrums of the child as the child is mentally prepared with the work that needs to be done according to the schedule.
A crucial component of compensatory skills is concept development. The teacher or special educator can also utilise the visual abilities of the child with the use of pictures and drawings to teach different concepts to the child. Similarly through role play and games, a child can be taught various social rules or skills like turn taking or how to interact or play with other children. The idea is to teach the child to learn from part-to-whole, so the task should be divided into small parts or instructions so as to improve specific cognitive skills through practice.
Teaching social intervention would start with the basic requirement of non-verbal social skills which is focus of own attention and attracting someone’s attention (joint attention) and then working on developing skills to read facial expressions, gestures and verbal skills to communicate your needs/wants, understand what the other person/ child is saying, social greetings and turn taking.
The skills would also include understanding how to play with each other without being too attached with the results, to ask for help from peers when required, anticipating outcomes and using the learning (generalising) the rules/behaviour in other activities.
Social stories are also used to help the child understand the social situation. Possible social responses may be included, in a positive way, to help the child understand a social situation or cope with a stressful encounter.
These can be prepared in advance for the possible new situation which the child might face so that the child is not stressed about the new situation or environment and also does not have to think about the possible ways to interact or behave. The child is prepared through role plays and is able to show the desired social behaviour as learnt through the social story.
The child is also prepared with the social script to help him/her answer the basic social questions when meeting new people. It also helps provide structure and predictability of the situation which makes the child comfortable in a social situation outside the comfort zone.
A child with ASD may need social skills training throughout childhood and into adulthood, step by step, with basic skills leading to higher-level skills and later into the most complex skills required of adults living and working in the community.
One important point to keep in mind is to start intervention as early as possible. The work starts from the day you notice that your child is not behaving or developing as per the growth milestones. Do not wait for the time to take care of the problems or think that as the child grows, the problems will go away automatically. Unfortunately, the longer you wait, it would be more difficult for the child to overcome the difficulties.
Research has shown that the time between birth and age 36 months is a critical developmental period in a child’s life. These months offer a window of opportunity that will not be available later. Early intervention programmes minimise, and in some cases, prevent delays in development of infants and toddlers with disabilities. They can decrease the need for special education and related services when a child enters school, and increase independence.
Children whose special needs are identified and addressed during these crucial early years have a greater chance of reaching their full potential. Early intervention not only helps the child but it is helpful for the family as well to learn the best way to care for the child, support and promote the child’s development and help inclusion of the child into the family and community.
It’s important to understand that these difficulties are not a form of disease and therefore there is no cure. These are special and permanent emotional and psychological needs of such children. loving attention and a positive environment enhance their natural potential. These are the most valuable gifts parents can give to them. It is necessary to combine special and consistent attention by parents with personalised counselling by professionals. Parents shouldn’t be shy of seeking professional help to provide their child the best possible support.
The writer is Director, Sparsh for Children