Saturday, July 26, 2008

An appeal to the Maldivan Government regarding the insurance package for all citizens.

We have read in the news lately that the Maldivian government is considering to introduce an insurance package for every citizen in the country. This is a great news, of course. However, our concern is how much will such a package cover treatment towards disabilities and other life-long treatments, when they are the ones who need is most. We are surprised as to why the Maldivian media is silent on this issue.

Hence, we call upon the Maldivian government not to neglect or forget about those special children in our country when they are planning to introduce a nation-wide insurance package, as these special children are also part of our society and they need more help and care than anyone else. Most of these children in our society gets no treatment at all due to lack of funds. One such example that surfaced on the papers lately is that of Thaa. Kinbidhoo. We strongly believe the child under question was in a treatable condition but enough could not be done due to lack of awareness as to the nature of treatment, but mostly due to lack of funds to analyse the cause and seek proper treatment.

We know few families who are seeking ABA therapy and Floortime therapy abroad while others are fending themselves with worries not knowing what to do with their autistic children.

Thursday, July 24, 2008

Floortime -- another therapy for autism/pdd!

Unlike Applied Behaviour Analysis, Floortime is a not a behavioural approach. The main difference in ABA and Floortime is in ABA the therapist controls everything and dictates the child's behaviour while in Floortime the therapist flows the child's lead and try to interact with him or her.

Click here for an introducotry program on Floortime on Youtube.
http://www.youtube.com/results?search_query=DIR%C2%A9%2FFloortime%E2%84%A2+Seminar+-+Italy&search_type=

Click here for Parent's Guide Book For Setting up a Program of Floor Time Volunteers
http://www.coping.org/intervention/fltmvols.htm

Monday, July 21, 2008

How to deal with autistic symptoms?

compiled by and with courtesy of asrik.net

below are some strategies to deal with developmental symptoms/pdd in a child.

Concern 1: Child has poor eye contact.
What you can do: 1. position yourself so that you are face-to-face with the child while talking, singing or addressing the child. 2. Whenever the child looks into your eyes reinforce the action immediately after. For example you can say: good looking, beautiful eyes, change your voice pitch, etc. 3. When you play and talk to him bend your knees to give him better chances for him to look in your eyes during play. 4. NEVER force him to look in your eye or turn his face to look in your eyes. If you do the above techniques it will come automatically!

Additional readings:

§ How to Establish Eye Contact in Children with Autism, http://www.ehow.com/how_2064753_establish-eye-contact-children-autism.html

Concern 2: Child does not respond to his name.
What you can do: 1. DO NOT call his name again and again since this can reinforce a bad/undesired behaviour if he usually does not respond to his name being called. 2. When he is comfortable looking at you during play session or when he awaits eagerly for his turn and look at you, do address him by his name. 3. If he’s really excited and look at you again and again, you can call him by name when it is his turn. 4. DO NOT get frustrated or upset even if he does not respond to you as this can be achieved through patience, hardworking and consistency.

Concern 3: Child prefers or enjoys playing all by himself.
What you can do: 1. Watch him closely for a minute or two. 2. Do parallel playing with him (i.e., copy him using similar or other toys) for few minutes before expanding the play methods (i.e., demonstrate what more he can do with the same toys which would be more fun and exciting.) This way you can establish a good rapport with you the child. 3. Once he follows your directions in the play and after playing that way for sometime you can move onto some play of your choice.

Concern 4: Child has a small vocabulary.
What you can do: 1. name objects and label actions during play. 2. AVOID asking questions. Instead try telling him what he is doing (parallel talk), what you are doing (self-talk), show him objects and tell their names. Do actions and tell him what actions they are. Practice these methods during playtimes. Initially let him say the words after you before letting him say them spontaneously. To encourage him say words and phrases spontaneously you can say part of the phrase and let him fill in.

Examples: “Twinkle, Twinkle, little ________” . (Child says, “star”)

If he did not fill in, do not insist more than twice. Try again some other time when he is more excited and motivated. Whenever he does, reinforce it immediately verbally or using an object or both.

Thursday, July 3, 2008

ABA video clips at Youtube

ABA or Applied Behavior Analysis is one of the most well-known therapies for Autism and other forms of developmental disorders, including down syndrome. It is a scientific method that is being discussed in medical journals and widely believed to be effective.

For those wondering what aba is about, click the links below for some video clip at youtube. Parents can try some of these techniques. But if you are really about it, it is also recommended to carry it out under the supervision of an ABA consultant or supervisor, who is well trained and qualified for the job.

For ABA clips click here.

Monday, June 30, 2008

Establishing eyecontact

Eye contact for children with autism is always a concern. Well, not always, but usually. I do work with one little boy that appears to love looking people in the eyes and teaching this skill took all of four days when he was two-years old. For the rest of our kids, it can be very challenging.

Different orientations go about teaching eye contact in various ways. While I've voiced my opinion on RDI in the past, I will discuss it as additional strategies here. But in summary of previous posts, behavior is behavior. If you want to teach a new behavior, like eye contact, it WILL be taught using behavioral principles, whether you are comfortable calling it that or not. RDI provides us with strategies that modify the environment and provide creative ways to elicit eye contact, but eventually that eye contact is reinforced (ABA) shaped (ABA) given differentiated reinforcement depending on quality of eye contact (ABA) elicited by modifying the environment (ABA) elicited by using a discriminative stimulus (ABA). It is all ABA.

Where ABA has fallen short on the eye contact issue, in my humble opinion, is by not exploring more creative methods to elicit eye contact, and to make giving eye contact important. I'll go over some traditional methods that have been used to elicit eye contact, and then how some RDI ideas can be incorporated into an ABA program (since they are all based on behavior principles anyway.)

DTT - Discrete Trial Instruction/Training programs tend to teach eye contact in very contrived situations. A child will sit opposite a therapist, and given the directive "look at me" or the child's name will be called. Depending on the level of the child, a reinforcer will be held at the teacher's eye to help the child understand where they should look. Contingent upon eye contact, the child will immediately receive the reinforcer, possibly providing a token, and providing praise. It make look like this.
Teacher: "Look at me" (while holding an M&M at her eye)
Child: Looks at M&M and glances at teachers eye
Teacher: "Excellent looking" and provides M&M immediately.

This is an effective method and will teach a child to look at someone at the eyes when a demand is placed, when their name is called, when a reinforcer is present. However it doesn't always generalize. Some children that I work with look at me beautifully in the eyes, but when their grandmother says hello, they are looking anywhere but her eyes. Why? Maybe because she is not holding an M&M or a reinforcer in her hand, so the MO (motivating operation) to look in her eyes is not there. The child has not generalized that looking at people in the eyes is reinforcing.

ABA - Applied behavior analysis will of course incorporate the strategies used above, slowly fading out the item at the eye, just like DTT, until the child looks at the teacher's/parent's eyes without have a reinforcer within eye sight. Other methods are always used. In my programs, I prefer not to demand eye contact, but rather to wait for the child to initiation eye contact and reinforce the spontaneous eye contact. An example of this is the following

Teacher: Holding Elmo toy that two-year-old child with autism clearly wants to play with.
Student: Pulling at the toy, while staring at the toy
Teacher: Teacher looking at child's face, not letting go of the toy
Student: Still pulling at toy
Teacher: Still holding toy....continues to hold on until child glances up at which point the toy is immediately provided with praise and excitement.

This method reinforces spontaneous eye contact as opposed to eye contact that is requested. What ABA therapists do is contrive the environment to elicit eye contact, and reinforcer the eye contact, assuring that future eye contact will occur at higher rates due to the reinforcement.

RDI? I don't think RDI strategies are inconsistent with applied behavior analysis (ABA). What I have learned by attending these seminars is how to be more creative with my children. How to give my a children cool reasons to look at me, give me eye contact and enjoy themselves while doing it. It is these cool creative ideas (reinforcing events) that when used in the environment (modifying the environment) will provide a stimulus (SD) to elicit eye contact (response). (Do you see how it all falls so nicely into behavior principles.

I tried some of these strategies with a child that I work with. RDI talks about doing the unexpected, getting creative, and making kids care about giving eye contact. Now, I don't know if I am making them care about giving eye contact as it isn't something that I can observe, but what I CAN do is note the response, which was fantastic, and it didn't include reinforcing objects, rather reinforcing people (myself). That is one of the core tenets of RDI: to keep objects out of it and build relationships with people, which is quite different from ABA and DTT which rely on tangible reinforcers heavily.

I sat opposite a five-year old child with autism, removed toys and reinforcers out of sight in the environment, I positioned myself in front of him and waited. He didn't look at me, save the occasional glance. When he would glance, I smiled. See below

Child: Glanced
Teacher: Smiled
Child: Glanced again
Teacher: Blew air in his face
Child: Giggled
Teacher: Waited for eye contact again
Child: Gave it much more quickly
Teacher: Pinged child's nose
Child: Giggled, and while maintaining eye contact, blew air in teachers face
Teacher: Giggled, and made a raspberry on his cheek
Child: Giggled, and laughed, and said "blow"
Teacher: Blew air in his face, then by his ear, then on his toes
Child: Giggled, and pinged teacher's nose.

This went on, while maintaining eye contact. This is not an RDI program, this is an ABA therapist, using some of the creativity from RDI, and reinforcing and shaping the eye contact behavior of the child. At the end of this interlude, before he got tired of the game (satiated) I laid down on my back and left him alone. Normally, he would have walked away and found a toy to stim with. This time, that didn't happen. He watched me lay down, walked over to my face, looked at my eyes, giggled, and blew air at my cheek. I had made my eye contact and interaction reinforcing to him, so much, that he was seeking it out.

Source: http://appliedbehavioranalysis.blogspot.com/2007/08/eye-contact-aba-dtt-and-rdi.html

Saturday, June 28, 2008

Parents sharing experiences with eachother

For a parent with a special child life may see very indifferent and challenging. Because of this, it is always good to be in a support group where you can share and learn from other parents who are in the same boat.

If you are in the Maldives and looking for such a group try out with MvDisability (Maldivian Disability Support Group). Their website is http://mvdisability.siph.net/ Since autism has not been a national issue so far, there is no specific similar group for autism in the country. You can also view updates on the group from this link.

Having thought about the importance of sharing throughts with others, a new feature -- a webchat -- has been added to this webblog to enable visitors to interactive with eachother. We hope our visitors would make the best use of it.

Sunday, January 20, 2008

Who are we?

This is an interest group setup with the following objectives:

1. To educate the Maldivian society on autism, a developmental disorder affecting speech, social skills and behaviour;
(We aim to eduate the society on how to identify the symptoms of autism sothat parents can consult a concerned professional (a psycholigist or psychiatrist or a developmetal peadiarician) for a diagnosis before it is too late. While doing this we will discourage the society from labelling a child as autistic and feel indifferent towards him or her. On the contrary, we wish to make the society understand the need to be helpful and supportive towards them by providing information on how to treat such children and where the treatments or therapies are available.)

2. To voice the need for the establishment of diagnosis facilities throughout the country sothat intervention/therapy can be pursued as early as possible;
(Our understanding is that at present there is no means for parents to carry out a formal diagnosis on autism within the country, even if they wish for it. We should understand here that obtaining a formal diagnosis is not the best you can do for your child, but beginning an early intervention program or treatment for your child immediately after it, as success rates are high with those child who begins intervention/therapy at an early age.)

3. To voice the importance of establishing early intervention facilities/centres at the health institutions and elsewhere within the country; and
(We should understand that only a small number of families can afford to get treatment for their children overseas. So, early intervention facilities and scientifically proven therapies must be made available within the country and should be readily available at the local health institutions like other types of treatments. If not, the government must provide opportunities for these children to obtain treatment at affordable rates from places where they are available.)

4. To provide a platform whereby parents and professionals can discuss and share knowledge as well as resources to treat autism.
(Treatment of autism is rather difficult and complex, as there is no ONE cure for it. Symptoms of autism can go away or minimise with treatment. Although some claim autism is incurable records of children who have come out of it and no longer show the symptoms of autism do exist! Whichever the case is, treatment of autism can guarantee an autistic child to be more independent and better off than who has not obtained it. The most important aspect of treatment is obtaining learning resources and guidance from other parents as well as professionals to deal with the children with autism.)

We shall welcome local contributors in order to enrich this weblog with information and resouces useful for the Maldivian society. If you are interested to become a contributor please do not hesitate to write to us stating why you want to be become one. Our email is autismmaldives@yahoo.com

Friday, January 18, 2008

101 Ways to Praise your Child

When a child does something good that action must be praised. Praising is a way of encouraging good behaviours to repeat. This helps to reinforce good behaviour in the child. This is the starting point of behavior modification. Children with special needs require behaviour modification to correct their behavioural problems such as poor eye contact, bad hand writing, poor attention, undesired behaviors, etc. However, behaviour modification is not specific to children with special needs, it can be used on anybody to get a desired behaviour.

Some parents unfortunately do not know what to say when his or her child does something good. I've included below some words, hoping these will be of help to those parents.

Wow * Way To Go * Super * You're Special * Outstanding * Excellent * Great * Good * Neat * Well Done * Remarkable * I Knew You Could Do It * I'm Proud Of You * Fantastic * Super Star * Nice Work * Looking Good * You're On Top Of It * Beautiful * Now You're Flying * You're Catching On * Now You've Got It * You're Incredible * Bravo * You're Fantastic * Hurray For You * You're On Target * You're On Your Way * How Nice * How Smart * Good Job * That's Incredible * Hot Dog * Dynamic * You're Beautiful * You're Unique * Nothing Can Stop You Now * Good For You * I like You * You're A Winner * Remarkable Job * Beautiful Work * Spectacular * You're Spectacular * You're A Darling * You're Precious * Great Discovery * You've Discovered The Secret * You Figured It Out * Fantastic Job * Hip, Hip, Hurray * Bingo * Magnificent * Marvelous * Terrific * You're Important * Phenomenal * You're Sensational * Super Work * Creative Job * Super Job * Fantastic Job * Exceptional Performance * You're A Real Trooper * You Are Responsible * You Are Exciting * You Learned It Right * What An Imagination * What A Good Listener * You Are Fun * You're Growing Up * You Tried Hard * You Care * Beautiful Sharing * Outstanding Performance * You're A Good Friend * I Trust You * You're Important * You Mean Alot To Me * You Make Me Happy * You Belong * You've Got A Friend * You Make Me Laugh * You Brighten My Day * I Respect You * You Mean The World To Me * That's Correct * You're A Joy * You're A Treasure * You're Wonderful * You're Perfect * Awesome * A Plus Job * You're The Best * A Big Hug * A Big Kiss * I Love You!

Bear in your mind that when you use these words with children with special needs you must use them jointly with non-verbal cues. That is, make yourself sound excited and exaggerate the action with a tickle, kiss, pat or something. Then only the desired outcome can be achieved.

Tuesday, January 15, 2008

What is RDI? Another therapy for autism?

Applied Behaviour Analysis (ABA) is a proven method to improve development progress in children with autism. It is more therapist-focussed, systematic and well-structured with lots of data gathering. Although it is believed to be effective and well recognised by stake holders of autism, it has been criticised for 'making a robot out of a child'. As a result another therapy method called Floortime came to being. Unlike ABA, Floortime is more child-centred. While the child takes the lead the therapist follows and engages with the child through fun and excitement.

Now we have Relationship Development Intervention (RDI). It is more focussed on improving interaction with the child through joint activities. If you wish to know more about this approach log onto http://www.rdiconnect.com/

Here are some videos http://www.rdiconnect.com/video/default.asp

On the left I've also included a link to a good website. There you can see how RDI is implemented by the parents as a lifestyle to encourage the child to interaction and respond more to them.

Please note that I do not imply that RDI is better than ABA or Floortime approach. For a good result I advise parents to use a combination of them while keeping in mind each child is different and a method which had worked on another child might not work for your child.