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Schooling the autistic child

KNOW AUTISM
Last Updated 28 September 2011, 11:47 IST
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Naren was a healthy, beautiful child at birth but as he turned two his stare became glassy, his responses minimal. His behavioural pattern was not that of a child his age. He did not play, or make eye contact with anyone but chose to fiddle with a toy for hours on end.

Alarm bells began ringing when, on a friend’s advice, his parents consulted a psychiatrist at NIMHANS.  The diagnosis was not something they were hoping for. Naren had mild autism — a developmental disorder that appears in the first three years of life and affects the brain’s normal development of social and communication skills.

As a concerned and worried parent, Naren’s mother, Srividya, dug deep for details. She found that the exact cause of autism was not known though genetic factors seemed to be one of the causes. Other possible, but unproven causes are diet, digestive tract changes, mercury poisoning, the body’s inability to properly use vitamins and minerals, and vaccine sensitivity. Autism affects boys more than girls.  

On the doctor’s advice, Naren’s parents approached Apoorva Foundation for Autism in Bangalore where Nitya, the centre head became their first point of contact.

Ignorance
There are many parents who are unaware of the symptoms of autism.  Children with autism have difficulty in social interactions and verbal / non verbal communication, perform repeated body movements (like flapping hands), usually stick to a routine and show unusual attachment to objects.

They are also overtly sensitive to sight, touch, smell and sound. In addition, dysfunctional behaviour such as self injury (head banging, hand biting), eating and sleeping problems, hyper/hypo activity and attention deficit behaviour are quite common in an autistic child.  Children with high functioning autism may not have the ability to interact with others appropriately.

Autism cannot be cured completely but can be controlled. Applied Behavior Analysis (ABA) and the use of Vitamin B6 with magnesium supplements are the two treatments which support autistic children. Apoorva Foundation’s head, Nitya says, “The earlier a child starts treatment for autism, the better.  If a child is diagnosed with autism as early as when he is 18 months of age, offering the toddler age-appropriate, effective therapy can lead to raised IQ levels and improved language skills and behaviour. Early intervention (2.5 to 6 years) can be very effective for toddlers with autism.”

At Apoorva, a speech therapist and a psychologist work with the children and they are grouped according to their level. The pre-academics period is from 6.5 to 9 years which concentrates on functional academics. This has more to do with daily living skills, ways to be independent, ways to take care of themselves, reading and writing for everyday use, etc.

These little things that we take for granted, daily and necessary activities such as crossing the road, value of money, and environmental studies etc. are painstakingly taught to children.  “Spoken language can be difficult for kids with autism as most understand words better by seeing them. They love to look at colourful pictures so therapists teach them how to communicate by pointing or using pictures or sign language. This does not happen overnight but some kids, with dogged determination, eventually learn to talk”, says Nitya.

Just as Nitya is talking, a 12-year-old boy walks in requesting a photo album. Nitya says the boy never tires of looking at the album. But just to say, “Please, can I see the album” took him months of practice and patience. When he came in, he would raid the cupboards looking for that photo album but gradually after being repeatedly and lovingly corrected, he started asking for it and finally he has come to a stage when he does not demand but requests to look at the album.

Children are taught social skills, such as how to greet people, wait for their turn and follow directions. Some children improve over a period of time but the path is long and difficult. That is why the most important factors for a teacher working with autistic children is patience and love for children.

The other phase is when a child is 15 or above and seems capable of following basic instructions. At Apoorva’s Bannerghata centre, they are taught basic farming activities — compost making, planting saplings or even assembling motor parts. 

Functional academics also include typing and documentation within its realm so that a mildly autistic child can be self-sufficient too. Yoga also helps them relax and teaches them to take control over their bodies. Some kids take medications to help their moods and behaviour, or extensive therapy to help them control their behaviour.

Looking at strengths
Building upon an individual’s strengths and interests is a wonderful approach to achieving success. Topics of interests are very motivating and many children excel in their specific subjects. Some children have intense focus and concentration, are organised, honest, reliable, adhere to routines and schedules and are extremely knowledgeable in the subject of their choice.

Children like Naren with mild autism can go to a regular school but most of them need calmer, more orderly surroundings. Srividya says, “Since Naren has mild autism, I was advised by Dr Karanth of Communication Deall in Bangalore to look for a regular school which admits children like my son.”

As Dr Deepak Tibrewal who looks after over 300 autistic children says, “Genetics loads the gun and environment pulls the trigger. The crux of the problem is that an autistic child’s mind is locked and he is not connected to the environment.  About 60 per cent improvement can be expected from therapies such as occupational therapy, speech therapy, ABA etc. They are unable to learn by themselves as their sensory organs are either hypo- functioning or hyper-functioning. Homeopathy sometimes helps.”

Dr Tibrewal says that some children with autism respond to a gluten- (found in wheat, rye, and barley) free or casein- (dairy products) free diet. But dietary restrictions should be made only after consulting a doctor as one has to be sure that the child is still receiving enough calories, nutrients and a balanced diet. Right nutritional support is essential for an autistic child.

With patience, understanding and good care, some autistic children can become independent enough to be self reliant. As Srividya says, “We have to keep our frustrations in check, try to understand the child and put the child ahead of the self and think of what we can do for their future so that they can be moderately independent. The key to helping a child grow into a successful adult with autism is to provide support and guidance. Parents should learn about the strategies teachers and therapists use in the treatment of Autism Spectrum Disorders.”

Autism may not allow a person to function normally, yet, many are able to achieve great things with the right support and guidance.

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(Published 28 September 2011, 11:40 IST)

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