Autism Spectrum Disorder

Autism Spectrum Disorder

Autism Spectrum Disorder is a neuro-developmental disorder present from birth and can be diagnosed in most cases before the age of 3 years. It is characterized by impairment in social interaction, communication and language difficulty and difficulty in imagination and abstract thinking. In most cases the child may display restricted and repetitive behavior. In addition to these, the child may also have additional difficulties in the area of Sensory Integration.

The characteristics of ASD are grouped under three heading and they are also called ‘The Triad of Impairment’.

  • Social Interaction: Many children with ASD may show deficit or impairment in social development i.e. may have impairment in developing appropriate social skills. Thus children could display problems in greeting others, empathizing and sympathizing with others.
  • Communication and language: Some children may be able to talk in detail about their preferred topic but may draw blank when they need to ask for basic need such as going to toilet or when asked a specific question. They may also display problems in simple turn taking, waiting or following other person’s thought process.
  • Rigidity in Thought and Behavior: Many children with ASD may show ritualistic or obsessive behavior, difficulty in imagination and weak central coherence (difficulty in observing the whole picture instead get stuck on one detail of the object). Thus the child with ASD could feel disturbed when some routines are suddenly changed.

 

Asperger Syndrome

Asperger syndrome, also known as Asperger's syndrome or Asperger disorder, is an autism spectrum disorder (ASD) that is characterized by significant difficulties in social interaction, alongside restricted and repetitive patterns of behavior and interests. It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. It forms the other end of the umbrella, where the children have much developed speech and cognitive abilities as compared to children with Autism. Some researchers feel that High Functioning Autism is synonymous to Asperger Syndrome. These children are sometimes labeled as “active but odd” i.e. they want to mix with peers and be part of the social environment but may lack appropriate social and communication skills for them to succeed.

We coordinate therapies that address core symptoms of the disorder, including poor communication skills and obsessive or repetitive routines. We believe that the earlier the intervention, the better, there is no single best treatment package. AS treatment resembles that of other high-functioning ASDs, except that it takes into account the linguistic capabilities, verbal strengths, and nonverbal vulnerabilities of individual.

 

Attention Deficit Disorder (ADD) and Attention Deficit hyperactive Disorder (ADHD) 

ADD is the difficulty attending to external stimuli in a sustained manner. ADHD has an additional component of body restlessness.

Important Characteristics:

  • Difficulty paying attention to something which is not of personal interest.
  • Impulsive behavior
  • Difficulty listening to and following complex instructions.
  • Difficulty in managing time and space
  • Lose things
  • Physical restlessness
  • Socially inappropriate behavior
  • Lack of confidence in social situations

 

Pervasive Developmental Disorders- Not Otherwise Specified (PDD – NOS)

Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) is a pervasive developmental disorder (PDD), also called an autism spectrum disorder (ASD). PDD-NOS is one of three forms of Autism Spectrum Disorders. Many children have some symptoms of one ASD and some symptoms of another, but not enough of any one of the four specific disorders to receive a diagnosis. Since PDD-NOS is a spectrum disorder, not every child shows the same signs. The two main characteristics of the disorder are difficulties with:

  • Social interaction skills characterized by difficulty in reading facial expressions, understanding sarcasm, figurative speech and empathy.
  • Inhibited communication skills characterized by limited vocabulary, narrow interest and poor non verbal communication

At present, physicians are not in agreement as to exactly when a child should be diagnosed with PDD-NOS, autism, or Asperger syndrome. As a result, it is very possible for the same child to receive different diagnoses from different physicians while exhibiting exactly the same symptoms.

For children with PDD-NOS, we believe that:

  • Irrespective of diagnosis, intervention must start on time.
  • No child is same and thus one therapy program may not suit all.

 We believe that no single treatment is best and treatment is typically tailored to the child's needs. Available approaches include:

  • Applied Behavior Analysis (ABA)
  • Structured teaching (e.g. the TEACCH program)
  • Speech & Language Therapy
  • Communication Interventions
  • Social Skills Therapy
  • Occupational Therapy
  • Parent-Communication Training

 

Study Group

Many children with attention issues or Leaning Difficulty cope very well in individual sessions but face great difficulties in the classroom. The reason for the same could be because concentrating on a task with an individual teacher and a clutter free environment is much easier as compared to doing the same in a class of 30 to 40 children with a single teacher. Thus we are conducting study group sessions which help children learn to:

  • Complete work independently.
  • Copy from board.
  • Borrow and share stationary with others.
  • Respond appropriately to the teacher.
  • Wait in line for their turn.

 

Social Skills Group

Deficit in age appropriate social skills is one of the main areas of impairment. Social skills include difficulty in social interaction as well as understanding ‘Theory of Mind’. Theory of Mind essentially means understanding other person’s perspective and thoughts. This difficulty may lead to range of problems in a child from being aware or tolerating peer presence to difficulty in initiating conversation.  We use structures, play-based group to help children learn basic social skills such as:

  • Initiating and maintain conversations
  • Making friends
  • Asking questions to others
  • Compliment others
  • Sharing and taking turns.

A combination of playing games, conversation, joint attention and coping with change are necessary components of the playgroups. Specific themes are determined based on the information provided by the parents during the screening appointments.

 

Special Education

Special education is the education of students with special needs in a way that addresses the students' individual differences and needs. This process involves the individually planned and systematically monitored arrangement of teaching procedures, adapted equipment and materials, accessible settings, and other interventions designed to help learners with special needs achieve a higher level of personal self-sufficiency and success in school and community than would be available if the student were only given access to a typical classroom education. Our special education program is customized to address each individual student's unique needs. Our Special educators provide a continuum of services, in which students with special needs receive services in varying degrees based on their individual needs.

Special education programs need to be individualized so that they address the unique combination of needs in a given student. We at Sparsh believe no one intervention method is useful for each child thus we follow an eclectic approach which includes:

  • Treatment and education of autistic and related communication handicapped children (TEACCH): Core tenets of the TEACCH philosophy include an understanding of the effects of autism on individuals; use of assessment to assist program design around individual strengths, skills, interests and needs; enabling the individual to be as independent as possible; working in collaboration with parents and families. Research has highlighted the role of structure for children with Autism. Thus we conduct the sessions in a structured manner to help children learn to their best potential.
  • Applied behavior analysis (ABA): It is a science that involves using modern behavioral learning theory to modify behaviors. Behavior analysts reject the use of hypothetical constructs and focus on the observable relationship of behavior to the environment. By functionally assessing the relationship between a targeted behavior and the environment, the methods of ABA can be used to change that behavior It is believed that some children work better when skills are broken down in smaller tasks hierarchical manner. There is a focus on rewards or reinforcing, desired behaviors and ignoring or re-directing undesirable ones.

 

Communication Skills

Language and communication are affected in most children with difficulties. Common problems are:

  • Lack of eye contact.
  • Poor attention.
  • Difficulty with simple instructions like 'give and take' in normal conversation.
  • Difficulty understanding non – verbal cues.

Our goal is to improve useful and functional communication based on child’s skills and decide which method would best suit the child’s ability and need. Based on the information, we use one or more than one approach to help the child speak and communicate:

  • Speech and Language therapy,
  • Picture Exchange Communication Systems.
  • Other forms of augmentative and alternative communication (AAC).

No single approach is found to be fully successful and thus the program needs to:

  • Begin early, ideally during the preschool years.
  • Be individually tailored to meet the child's need.
  • Targets both behavior and communication.