My friend has a younger sister, 14 years who always seemed odd to
me. I have known her since she was born and see her as if she were
my own sister. Lately another family friend of ours has been dating
a doctor, and as soon as he met my friend’s sister he noticed
that she suffered from a very mild form of Autism. So far no one has
told her parents or anyone in her family, because they would never
accept something like this. They would also never speak to whoever
told them for the rest of their lives. We are currently trying to
find a way to break it to them.
wanted to ask if there is any advice about telling parents their child
is autistic. Also until someone finally tells the family, is there
anything that can be done to help her without the family’s knowledge?
There are two things I understand you want to address: how
to tell the family and how to help the girl. It may not be possible
or appropriate to tell the family their girl has autism without a
formal diagnosis. And since the family is not willing to go for a
diagnosis this is obviously ruled out. An option might be to leave
information on the noticeable symptoms particularly of persons with
high functioning autism, in their home, for the family to come across
and come to their own conclusion.
helping the young girl it depends on what specific and evident issues
she requires help on. Particularly given that she appears functionally
quite able we would need inputs on specific areas where she requires
My son is 23 months old, but he has not started speaking.
But on his own he has learned certain things by observing other family
members. He is very active, enjoys playing with other children, loves
music and watching TV and builds with blocks at a good level. He feeds
himself. He tries to copy and do what others do. He is healthy and
has achieved all milestones except two:
speech is not clear except a few words like 'bye', and 'ma', and that
too not meaningfully sometimes.
follows only a few commands like ‘do’, and comes when
called. But if we show him something he does not pay attention. He
prefers to do what he wants: like he will bring rotis and serve you
if he sees that you have finished your roti and your plate is empty.
When he wants to eat something he will try and get it or he will point
to the objects and take us to the kitchen. He is able to make us understand
all his wants: whether he wants to go to the toilet or to the market.
I have no doubt about his intelligence as he leans very fast by observing
others. I just want to know what the real problem with my son is.
Are these the symptoms of Autism?
can I undertake the proposed two year bio-medical programme of chelation
and HBOT for my son.
It is difficult to say on the basis of your description whether your
son has autism or not, as for that it would be essential to make an
observation of your son’s behaviours and have an interview with
you and your wife. Receiving a diagnosis for your son’s condition
should be of top priority, as that would help direct you to an appropriate
treatment approach. If we know where you are based we could refer
you to a competent diagnostician, ideally a developmental paediatrician
or a child psychiatrist with extensive experience of autism.
undertaking the advised bio-medical programme, perhaps you want to
first arrive at a diagnosis for your son’s condition before
you can consider whether to go for it or not?
year old daughter is diagnosed 'Autistic Featured' by JSS Hospital
Mysore and KMC Hospital, Manipal, in their differential diagnosis.
She is taken for speech therapy to KMC regularly and I could notice
a slight change in her activities but not in her speech. Kindly suggest
for further steps that I can take to cure my daughter at the earliest
before it is too late.
The purpose of a differential diagnosis is to rule out all other developmental,
neurological or genetic disorders which may show characteristics or
'features' that are similar to, or that may overlap with those seen
on the Autistic spectrum. From your letter, it appears your three
year old has been diagnosed as falling within the Autistic Spectrum.
suggest that giving speech therapy alone may be helpful; however,
progress can be limited due to the nature of the disorder. It is vital
for you to understand your child's difficulties. We suggest you speak
additionally to a special educator or psychologist, who has a sound
understanding of Autism and perhaps you yourself read up on autism
to help you understand your child better.
research indicates that giving early intervention in the form of specific
and appropriate training methods that are tailored to your child's
needs and learning style is the one way to help your child reach her
maximum potential. Prior to this, it is important that a special educator
take a detailed assessment of your child's strengths and difficulties
to develop an individual education plan for your child. There are
a number of intervention styles / methods, and you would want to choose
one that would benefit your child most.
is a complex lifelong developmental disorder, and has no cure, medical
or therapeutic. However, through early intervention, many children
have been able to lead productive and meaningful lives with support
from their family, friends and professionals. A number of other organisations
around India provide early intervention such as at Action For Autism.
an insulin-dependent mother to a boy just turned three this November
[living in the Phillippines]. He has been diagnosed to have Global
Developmental Delay when he was a year old. Since then he has been
on occupational therapy, and just three months ago we have incorporated
speech therapy. What I noticed is that he frequently tiptoes and shakes
(or wiggles) his arms and hands. Could these be signs of autism? I
need some light on this please.
The behaviours you mention may not mean anything. Or they may: only
a direct observation of your son can help clarify this.
would you say is your son's developmental age now? Supposing if he
is at an 18 month level physically, does he do other things a child
of 18 months would do?
he look when you try to draw his attention to anything? When there
is an aeroplane in the sky and you say "look at the plane"
does he look or does he not respond? If you point to the aeroplane
with a pointed finger and say "Look at the plane" will he
look up directly at the sky or will he first look at your finger before
following the direction where you are pointing. A typically developing
child will be more apt to do the latter. Does he turn to look at you
when you take his name? When you come into the room after a period
and take his name does he look at you and then follow you with his
gaze as you move around the room? What does he do when there are other
the best way to clarify your doubts would be to contact the Philippines
My daughter is 27 months old and still has a vocabulary of about 10
words. Recently she had some tests done in Ranchi (Jharkhand) for
hearing as well as brain scanning as suggested by a neurophysician.
She has been given medicines for Autism. We have not started the medicine
still. I want to get my daughter diagnosed to ascertain whether she
really has Autism. Please suggest where we should we take her for
diagnosis. Also if you can advise on Speech therapy centres in India.
You can obtain a diagnosis for your daughter from NIMHANS in Bangalore,
PGI Chandigarh, All India Institute of Medical Sciences Delhi, Ummeed
in Mumbai, Hinduja Hospital Mumbai, as well as in most major hospitals.
In addition there are many individual professionals who can give you
a diagnosis. I would like to add that you do not require a brain scan
for a diagnosis of autism; however the scan can help rule out other
conditions. Also, there are no medications forAutism though there
are medications to help counter some of the symptoms of autism.
you want to get a diagnosis, it would be helpful to start teaching
skills to your daughter as soon as possible.
The last one week has been the most traumatic one for my husband and
myself. We discovered that our first and only child, who seemed so
completely normal to us has PDDNOS. It is devastating though we have
been trying to let it sink in. It only now occurs to us, that every
single task that our beautiful little girl performs on an everyday
basis must be painful for her physically and exhausting mentally.
said that she is a high functioning PDD child. We hope to God that
it can only mean that the best for her is yet to come.
parents, we have several queries that we would like to bother you
with; maybe once too often. We have accepted that God has chosen her
in order to bring us closer together as a family and as friends. But
we are terrified of what the future holds for her. We also believe
that God works through people like yourselves. You are our Angels
of Hope. Please help us in any way that you can.
that the early evaluation of her condition and her high functioning
are positive signs for her development, but it still leaves us with
many fears and apprehensions.
P ever lead a normal life in the company of normal people? Will she
find peers in school and college who will not pick on her and reduce
her selfesteem to dust? Can we find means in which at least her sleep
will be restful? Are there any handbooks for daily reference as to
how we can handle our dear child? Will reprimanding or removing privileges
when she has done something wrong cause her condition to worsen? Can
we just be normal with her or does she constantly require our undivided
playschool turns her down, is there any hope that she can be brought
up with the right conditioning?
how many months or years of therapy would it take for her to progress
in a normal fashion? Well, there are several hundred queries that
come to mind as I write to you. Will she ever speak like you or I
do? I can not wait for her to tell me that she is hungry or happy
or hurting or just anything!
sure that I have bombarded you with too many things too suddenly but
that is in the hope and belief
that you will support us in this long arduous journey.
Receiving a diagnosis of autism for ones child can be a most painful
experience. But as we learn to deal with the pain we also begin to
accept that though that one moment when we receive the diagnosis seems
like the one defining moment in our lives; yet our child after that
moment is actually the same child who was there before. Nothing has
really changed except the way we view her.
the fact that our child is that bit different from typically developing
children with various complex needs means that we have to make adjustments
for that difference. Many adjustments. Not merely in our expectations.
But also in how we had planned our lives and what we might have to
do for her.
with autism is a very complex situation for any individual to deal
with, just as it must be for P. We want to understand that and help
her, yet not teach P that hers is a terrible and difficult life. The
initial weeks and months after a diagnosis is always a period of confusion
and fear - fear of something we do not quite understand. But as our
understanding of autism grows that fear and trepidation is overcome
and replaced with the knowledge that yes there will be progress. How
much progress will vary from child to child and hard to predict, but
there will be considerable progress and we will learn to celebrate
every step that P takes towards that progress. Because she will be
putting in as much effort as any of us.
you will want to learn as much as you can about autism. There are
many good books available. Knowledge will lead to the confidence to
deal with P in a manner that will be most beneficial for her. There
are numerous books you can read up - and the Forum for Autism Mumbai
library will help you with that. So will the net. Learn from P's therapist
how you can help P and generalize her learning. For instance simply
removing privileges may not teach her anything. Whatever you do must
be based on sound scientific principles of behaviour modification.
Whatever methods you adopt to bring about behavioural changes must
make sense to you.
P may or may not eventually go to a regular school, she may or may
not go to college, she may or may not speak like you or I do. But
she can be a happy child. And that will depend on us. P will always
have autism. Autism cannot be cured. But yes the symptoms are often
minimized through early appropriate intervention. So read up on autism,
help P have the best learning environment possible, and enjoy her.
Despite her diagnosis she is still the P you love.
you a wonderful journey with your child.
Recently we came to know that our five-year-old son is autistic. The
symptoms are as follows:
learnt to speak very late, at three to four. Now he is five. He can't
speak fluently and often speaks in the third person. He can't mix
with other children and plays with unusual things, like a small stick
or paper pieces or broken wheel of his toy train and spends almost
the whole day with that. If he is asked ten questions, he answers
only one or two, either properly or improperly in spite of knowing
the proper answer. He does not respond to outsiders, does not even
make contact with them with his eyes. He protests if wearing a new
shirt or a pair of new shoes, or following a new path to his school
or to taste a new food. He likes to strike objects with his fingers
creating a sound and occasionally is found, rubbing both his jaws
together. He shows little interest in learning anything new, as a
result, neither can he sip water or milk, nor can he spit water out
from his mouth after brushing his teeth. He cannot tolerate the sounds
of horns. He is very restless, inside his home, but very calm outside.
Sometimes he laughs without any apparent reason and sobs for minor
memory is good and he seems quite intelligent. At the beginning of
his school, teachers complained about his non-cooperation. However,
at present, he is co-operative with them. He reads in nursery and
doing well with his studies in a regular school.
after knowing about his autism, we became anxious about his education
and future life. There is no special school in our town and we don't
want him to get admitted in Kolkata, far away from us. Kindly help
us with your advice for continuing his studies in the normal school
he is attending and regarding his other deficiencies.
the internet, we found the name of a book, "Biological Treatment
for Autism and PDD", authored by U.S. based scientist, William
Shaw, Ph.D, which claims dramatic improvement of autistic child by
As you can figure from observing your son, autism, unlike mental retardation,
is not a global developmental delay. Your son is young and of course
the best course is for you to educate yourself about autism in order
to facilitate your sons progress.
primarily affects the areas of communication, social skills, and thought
and behaviour. For instance your son cannot play with other children
or respond to adults. He appears to have difficulty looking at people
when addressed or when addressing them to get his needs met. He has
good speech, yet answers questions infrequently, and that too sometimes
is also affected, so that a child might not play appropriately with
toys and which is why M keeps himself occupied with sticks and odd
bits and pieces. Many individuals with autism have a good memory.
Others may be of average or above average intelligence. There is also
often a need for sameness. Which is why M has difficulty taking a
new route or trying new food. There may be differences in the use
of sensory modalities. So your son finds it difficult to tolerate
some sounds, yet enjoys striking notes and listening to them. Or rubbing
his jaws together.
son appears to be managing well in a regular school. Rather than look
for a special needs school to send him to, you want to focus on helping
him continue in his current setup. Take note of his strengths and
work to minimise his deficits.
improving his communication skills check the issue of Autism Network
Vol IV No 3 December 1997. M might have speech, know the answer to
a question, and yet when queried may not be able to come up with a
reply on every occasion. What you want to do is to provide the correct
response, so that he understands the function of speech. Example:.
"How many biscuits do you have?"
Supposing you know that he will say "One," incorrectly when
he actually has three, you pre-empt his "One" with your
all, avoid asking him needless questions. For instance if he knows
his name and can answer "M" when asked his name, then you
do not want to ask him his name. Only let outsiders and visitors do
so. And if he then does not respond prompt him as mentioned earlier.
There is an entire range of exercises as well as things you can do
in the course of daily interaction with SR to help his communication.
help develop his ability to look at people when addressed try the
When giving an instruction or telling him something first take his
name, pause for a couple of seconds, and then say the rest. For instance,
"M?" pause, "come have dinner."
giving him something - rather than just handing it to him - hold the
object between your and your sons eyes in the line of vision, such
that in order to look at the object and reach for it he has to inadvertently
look in your eyes. When addressing him, whenever you can, lower yourself
to his eye level in order to make it easier for him to look at you.
And whenever you get a spontaneous look from him acknowledge it. Avoid
telling him "Look", "Look", repeatedly. We often
fail to realise how irritating it can be for a child to be continuously
told to look when it is actually difficult and sometimes painful for
him to do so.
your account M is doing well in his class. As he learns and grows
be aware of a couple of issues. M has good memory. This is a strength
that you want to use and that will also enable him to learn well.
At the same time, good memory in our children can mask a learning
disability. So while he might learn to read and calculate, you want
to be aware to ensure that simultaneously his concepts are clear and
that he is not doing these things by rote, as a mechanical ability.
is currently a great deal of research being carried out on the biological
basis of autism. Some children have improved with changes in diets
and allied methods. Some do not show much improvement. You could give
those a try if you want to.
We do not have the book by William Shaw. However we do have something
on the subject by Paul Shattock which you can access at the AFA library.
You could also check out the following issues of Autism Network:
Vol VII No 3 December 2000, and Vol VIII No 3 December 2001.
We have a five-year-old son whose behaviour, intelligence, reflex
and mental expression are not like other children of his age. We were
informed of AFA by the Institute of Child Health, Calcutta, who say
he is autistic. Please advise us on what we can do to help our son:
He learned to talk a bit late.
2. His fondness of music, TV programmes, general play and interest
in nature and animals, trees, the moon and sky is day by day decreasing.
3. He was admitted to a local nursery school but in no way is he having
any interest in books, writing or drawing.
4. Only he loves to play with toy buses.
5. He has some hand mannerisms that are peculiar as well as strange
sounds he makes with his mouth.
6. He responds to only such talk as he likes.
7. Sometimes he does mischief, drawing the attention of elders.
Let me explain a little about the nature of autism; it will help
you understand why your son behaves in the way he does.
is a lifelong condition. When a person has autism there are difficulties
in three main areas. They are: communication, social skills and imagination.
children with autism do not develop speech at all. Some of those who
do, may speak very little and their speech is mostly need based that
is they speak when they need or want something. They will ask for
things they need like "water" or "food". Other
times they may use words which seem to make no sense to us. All this
is because they have difficulty in understanding how to use language.
child with autism may not respond to certain questions because it
makes no sense to him, like "what is your name?", "what
happened at school?" etc. But if someone said "do you want
a toy bus?" it would be meaningful because he likes playing with
with autism have few social skills. Therefore they very often do not
interact in socially appropriate ways or know how to draw attention
would a child without autism draw attention to himself? He may do
something that he knows his parents want him to do. He may draw a
nice picture, or recite a poem, or sing a song. But a child with autism
does not know how to get attention and like any other child he wants
attention or wants to be able to manipulate his environment in some
way. Therefore he may do something which will seem a mischief. He
may be scolded but to him it is still attention, therefore even though
he anticipates a negative reaction to his behaviours he may want to
do it. Therefore you could try and totally ignore what mischief your
son has done. But when he is behaving in a way you like, let him know
this. Praise him, give him attention - then he will learn to get attention
in an appropriate manner.
have mentioned that your son only plays with toy buses. What you can
do is to join him in his play. Talk to him clearly about the buses.
Where are they going? Who is sitting inside? Tell him, but avoid asking
questions. Just make comments. By joining him in his play you will
be interacting with him in a way he understands. Then slowly you can
teach him other forms of games.
your letter you have said that your son has certain mannerisms and
makes peculiar sounds. You may see many children with autism who have
what are known as sensory difficulties. We all take information about
our environment in through our senses. In children with autism, one
or more of the senses may be over sensitive or under sensitive. So
a child may cover his ears to cut out a sound or make strange sounds
with his mouth to cut out a particular sound. Children with autism
often flap their hands or hop to help them to deal with sensory difficulties,
and this in some way relaxes them.
I have a worry about a niece of my husband's who is 18 months
old. She is a beautiful child but I see symptoms that I have seen
before. I help part time in a school for children with behavioural
problems and have helped with children with autism. Little S shows
a lot of the same traits as in other children with autism. I know
that time is a great benefit on the road to helping in problems like
this. However, I cannot find a way to tell my family of my fears.
Should I leave things until someone of the medical profession notices?
Since you know about autism you are also aware that the earlier a
child receives help the better the prognosis. I dont think you want
to wait for the family to happen to meet a medical professional who
will then inform them of their child's condition. Many parents lose
precious years of their child's life for the same reason.
are in a difficult situation. I think what you could do is leave some
literature around that lists some of the traits your niece exhibits
so that they come to her parents notice. Maybe a list of behaviours
that are the red flag for an autism diagnosis.
you not talk to your husband about it and share your concern? Since
it it his family he might have a better idea how to deal with the
you do - just do it. The parents might find it hard to forgive you
for it now, thats understandable, but in a few years they wil be grateful
for the years you saved them. In addition, check to see if your area
has a helpline run by a local society that could guide you.
I am a resident of Kolkata. I have a child of two years of age. As
per the Doctors she has some abnormality in responding to our spoken
speech. Though she sometimes responds to our spoken speech but she
has not yet developed speech and only utters fragmented words like
"Dada", "Baba", "Kaka", "Ma' etc.
Otherwise she continues to utter words as per her own. In this circumstance
we are very upset as some of the doctors have said that she may have
some symptoms of Autism. Please provide us information on this subject
The symptoms of Autism
2. Its treatment and chances of recovery
3. Whether autistic child can lead normal life as others
From the information about your daughter that you have provided it
is possible your child does have Autism. Autism is a behavioural syndrome
and by the age of two you can see symptoms in the social, communicative
and play behaviours. There are a wide range of these behaviours and
all children do not show all of these, as Autism is a spectrum disorder.
have asked about the treatment and the chances of recovery. Autism
is a life long developmental disorder but with an early diagnosis
such as your daughter has received, and an intervention (training
and teaching) that is very specific to the special needs of your daughter
you can help her to progress towards her maximum potential.
people with autism can lead a fairly independent life but that depends
to a great extent on the degree of autism and the kind of the training
that is given. Training, not only refers to teaching but also the
comfort and acceptance from people in the child's immediate environment.
This is of course true for every child whether typically developing
or not. But for the child with autism, living in a confusing world
where social rules appear so arbitrary and confusing, we believe that
comfort and acceptance is crucial.
of our therapists shall be visiting Calcutta at the end of December
for a two-week period. If you want to contact her, do get in touch
with us for details.
came to know of Action For Autism from the local pediatrician. It
restored my courage to some extent. My son aged three years and four
months has provisionally been diagnosed as autistic at PGIMER, Chandigarh
in September 2000. The tests done were MRI, EEG, besides which the
psychiatrist asked questions to arrive at her diagnosis. Before diagnosis
my son had no proper training due to lack of knowledge and lack of
infrastructure. He wasn't pointing or speaking much, had almost no
eye contact, and was hyperactive and restless. He has been taking
a herbal medicine since June 2000.
diagnosis the boy was sent to his uncle's place where unlike my home,
there are boys of his age and his mother did as much as she could
do to teach and train him. Within fifteen days he improved remarkably,
such as using finger pointing, eye contact, language etc. From mid
October he has joined a play school as directed by the psychiatrist
and according to feedback received from the school he plays with other
have gone through your URL which is in question and answer format
and it helped me a lot to clear my doubt but also created confusion.
For example it suggests that autistic boys may be very sensitive to
noise, touch, that they have sleeping problem etc. I also read this
on the web site of TEACCH. This is not present in my son.
I am glad to know that you found our website useful, and that it 'restored
your courage.' It is so important for parents to have hope and to
know that though autism is a serious developmental disorder, with
appropriate intervention all children with autism can move forward.
As you have noted yourself, your son made progress when put in a stimulating
positive environment. This progress can be accelerated by a focussed
and structured program that uses things in his environment that motivate
him, to teach him to communicate and interact. Many parents all over
the world have successfully carried out home programs to help their
children and there is no reason why you and your wife should not be
able to do the same. AFA will be very glad to help you do so, as this
is our focus.
parents who live outside Delhi, we offer one week and three month
outreach services. During this period, the parents can come in daily
with their child, and while the child attends our model school, the
parents observe and get training from our staff. We also have a Mother-Child
Program, where mothers run a day school program where they work with
their children and get feedback and suggestions from our staff.
said you were confused by some statements on the web site that did
not apply to your son. Autism is a spectrum disorder i.e. children
with autism can have varying skill levels in different areas. What
is common is difficulty in communication and social skills - but this
too can manifest itself in very different ways. Many children with
autism have problems in processing sensory information, in different
ways. Some may have acute hearing, which may cause them pain. Some
may have tactile issues, leading to sensitivity to textures or pain
insensitivity, or difficulty with hair cuts or nail cutting or bathing.
However not all children with autism, have these issues, and if your
child does not have it - just be grateful! It is useful to know that
these may exist, so that if you see some unusual behaviour, you can
know that this might be a possible cause, and you will know how to
deal with it.
is no medicine that can cure autism. Products such as the one you
refer to should be viewed as tonics at best, not medicines. The only
proven method of intervention is a structured program based on behavioural
principles. Your son will benefit, and you will feel more empowered
by getting more informed and aware about autism.
have a large collection of books on autism at our center where you
may read at no charge. You can also access a lot of information on
the net - but do try and visit good peer reviewed sites, or you can
get overwhelmed by all the unproven theories on autism treatment that
you may encounter on the internet.
four year son is suspected to have autism. He has been provisionally
diagnosed by the All India Institute of Speech & Hearing, Mysore,
as having autistic features. We had also taken him to AIIMS, New Delhi
where Doctors are not too sure whether he can be termed as a pure
autistic child. It is the opinion of some of the Doctors that he is
a borderline case of autism, which can be cured by proper Behaviour
Therapy. We are taking him to a clinical psychologist in Bhopal where
we are currently staying.
have heard lot of good things about AFA and would like to benefit
from your experience in this field. Please advice and counsel me as
a worried father of an autistic child.
A. Having conflicting diagnoses can be very confusing and distressing,
but hard though it may be - it is important for your son's sake that
you focus on what is important. It is not the label that matters but
figuring out what your child needs and finding a way of helping him
to compensate for or develop the skills he lacks. As autism is a complex
disorder as well as being a spectrum disorder it is important for
parents to spend some time understanding the ways it is likely to
affect their child, so that if the child has a challenge in a particular
area, then appropriate intervention can be delivered. Unlike a disability
like blindness - where the skill area that is lacking is easy to understand,
autism can effect the child
in so many different subtle ways that the parent needs to develop
expertise to figure out the specific areas of challenge for their
child. The good news is that with appropriate intervention all children
with autism make progress - some more than others. It is hard to give
a definitive prognosis for any child because each child's skill levels
are different, and the environment the child lives in has an enormous
impact on the child's progress. Rather than searching for a cure -
look instead to train yourselves in affective teaching methodologies
that have had proven success so that you can help your child compensate
and develop the skills he lacks step by step, perhaps for a good part
of his life. We would be very willing to help you and be your partners
in your journey.
My baby is not yet signing but I’ve started trying
to introduce a few signs. I do have a question though and am wondering
if you have any advice. My wife speaks Hindi and is trying to teach
it to our son. She speaks only Hindi and I speak English to him. But
I am wondering how to fit signs into this. Whether I just use the
signs with the English words or also with the equivalent words in
Hindi as well?
I had a thought that if I was to teach the sign for
the word in English and then in Hindi, it might be too confusing and
our son might be at the risk of using neither languages and just signing.
A. Good question! Research has shown that sign language
actually helps children learn more than one language simultaneously.
I would suggest using the signs along with both the English words
AND with the equivalent words in Hindi – this way the signs
will help bridge the gap between the two languages and your baby will
learn that signs and words are symbols for objects and concepts.
One parent in a bilingual family could show their
child a ball while at the same time showing the sign for “ball”
and then another family member could sign “ball” while
saying the word in the other language. Seeing the same sign while
hearing different words helps children understand the meaning of the
concepts behind the words and the signs. Using sign language in this
way has also been helpful for families who speak two or more languages
or for families who have adopted children from another country who
speak a different language.
Sometimes children who learn two different languages
will mix up the words from both languages at first, simply because
they don’t yet know enough words to separate the languages.
But it won’t be long before these children will learn to code-switch,
or separate their languages and use each one appropriately in the
daughter P has difficulty connecting with people. NIMHANS has diagnosed
deficiencies in eye contact and speaking ability and advised us to
improve eye contact first. After certain efforts we have observed
some improvement in her eye contact. Her tantrums have been reduced
to some extent. But there is no change or improvement in speech and
she is not speaking a single meaningful word.
working in Airports Authority of India and presently posted at Guwahati
with all India transferable service. I will be transferred out from
Guwahati within one or two months. I am a Bengali with mother tongue
Bengali but not settled in any one place due to the nature of my service.
I am in a confused state to decide my next posting either at Delhi
or Kolkata. Except that in Kolkata my mother tongue will be used,
Delhi will be better in all other respects including facilities available.
I will be thankful if you kindly advice me for the following: is the
mother tongue environment is essential for my daughter to develop
it most useful to have an environment that only uses the child's mother
tongue? That is a difficult question to answer. If your job profile
is such that you have to travel around and mostly be posted to larger
cities, then chances are you will be mostly in multilingual environments.
Whether you communicate with P in her mother tongue or otherwise,
what is perhaps most helpful is to communicate in the language that
is used the most around her. So as you say her mother tongue is Bengali,
but most people in her environment speak Hindi for instance and Hindi
is the language she hears the most, then Hindi is the language that
would be most useful to use, initially.
will agree with this view: but as I said this is a difficult question
what is even more crucial is that P understands the purpose of communication.
For you see, it is not so much that she cannot speak, as that she
does not understand that she could use speech to regulate her environment.
Therefore, when she says "Baba" you want to act as though
she is addressing you, and respond accordingly. When she says "Ma"
her mother has to act as though she has been addressed, and respond
accordingly. In addition, keep providing her the words she needs to
use in various situations. When P begins to use speech she may begin
to follow, and later perhaps may use, more than one language.
After six years of marriage God blessed us with a beautiful daughter
L. We are thankful to God for the precious gift he has given to us.
Now she is three and a half years old. From the fourth month onwards
my daughter was suffering from seizure disorder - epileptic attack
- it was regular and for long periods. Through the medication and
medicines it is now under control. Now this epileptic attack happens
only once in 5-6 months.
one year of age she was trying to talk. Then it stopped and we noticed
some of her actions are different. We felt something else is wrong
with her. After a check up and assessment from Hinduja Hospital Mumbai
we learnt she is autistic. We are again thankful to God for throwing
a special challenge in our life. It is his wish and his decision.
He will have his own plans
wish to have your support and help to go through the special challenge
in our life. Kindly give us the information that will shape her future
about teaching speech, medicines, and schools in Mumbai.
It was humbling to read your letter of total acceptance of your daughter.
Most of us have so much difficulty in accepting our children. We believe
we love the child we have when actually we love the image of what
we want our child to be. Your total acceptance of the 'special challenge
in your life' is very special, an example to families, and will enable
you to help your daughter far more effectively.
main areas of difficulty for a child with autism are communication
(not just speech), social interaction, and imagination. In addition
children have difficulties in processing sensory information. Your
daughter had speech but lost it with the manifestation of Autism.
What you will want to work on is teaching her communication. You can
teach her to communicate with a cause and effect approach, so that
she comprehends the function behind speech..
example, a child might bang on the door when he wants to go out. Usually,
as soon as we have figured out what the child wants we provide the
want. So when the child cries so as to be taken out, she is at once
taken out. This reinforces the behaviour which means the child learns
that when I want to go out I have to cry. Instead, when the child
bangs on the door I first provide the word/words that should be said,
and then provide the consequence. The child then learns that these
words precede the need being met. So child bangs on the door:
I first say "Go out." Then I open the door.
say the child takes my hand to the water bottle to indicate that she
I first say "Paani." Then I give some water.
the same time, whenever I make a request or give an instruction I
ensure that the child follows through. We might need to prompt the
response in the initial stages. For instance I ask the child to "sit"
and she continues standing. I then 'follow through' on my request
by making her sit and then of course always reinforce the behaviour.
teaching techniques that are effective with children with autism are
based on principles of behaviour analysis. Every child needs a structured
behavioural program keeping in sight the individual's strengths and
needs. There is no medication to treat autism. Medication can be used
to alleviate symptoms of the condition if it comes in the way of the
child learning skills, and along with structured behavioral teaching.
Medication cannot be used in place of teaching.
Mumbai there are a number of schools that take in children with Autism.
For detailed information you would be best served by contacting the
local, very active parents group:
for Autism, 2nd Floor, Block A, Jyeshtaram Baug, Dr.Ambedkar Road,
Dadar, Mumbai 400014, Email: firstname.lastname@example.org
They would be able to give you more information about services available
grandson is autistic and cannot talk though he is four and a half
years old. He used to talk when he was two years old. He has had a
traumatic birth, and stopped talking or even babbling after an occasion
when my daughter insisted that I take him for a holiday to my beach
bungalow, where he played hell with me and kept crying the whole night.
Next I knew that he was running high fever and became very sick. I
packed him to his mother the next day early morning, but I have noticed
ever since then he stopped talking or even babbling. Though after
surfing the net, I have a feeling that autism may be because of neglect
by the parents. He has also had a trauma because of his teeth which
had to be capped and a tongue tie which had to be clipped.
daughter had been taking him to a speech therapist. We have now put
him on to a homeopath doctor, and there are signs of improvement.
Eye contact is slowly improving and he is responding to actions. But
he likes to open and close doors, and is very aggressive with the
younger sister who is two years old. He will suddenly push her down
or pull her hair. He even does this to other little children and some
of us in the family. I would like to know whether he should be corrected,
by reacting in the same way towards him. My daughter does that, and
I tell her constantly not to shout or yell at him or lift her hand
on him, but to talk to him firmly and lovingly. I believe the teacher
in his school has told her to react in this fashion. Please enlighten
us. Will he turn normal like other children?
It is clear that you are a very concerned grandmother, and have
good instincts about appropriate ways of helping your grandson. You
can be a huge help to him and his mother. However it will require
that you spend time understanding the complexity of the handicap your
grandson has, and are able to be patient and understanding with your
daughter, while she takes time coming to terms with her grief, and
is able to help her son in a positive manner.
need to first correct some misconceptions that you seem to have about
autism. Autism is a neurological developmental handicap that primarily
affects the social and communication skills of the child. As such
it is fairly common, that the signs begin to be noticed only around
the age of two, and parents typically think that the child has regressed
at that time, and tend to blame myriad circumstances that coincidentally
happened at that point of time, as the reason for the regression.
a new sibling, an illness, a change of diet or place of stay, the
mother going back to work etc are often erroneously thought to be
the reason why the child suddenly seems unresponsive. Actually it
is just that the child's lack of social reciprocity is more apparent
at the age of two when a neuro-typical child starts using a lot of
functional forms of communication to explore his world. Thus a single
visit to your beach bungalow, or your perceived parental neglect or
the dental and tongue tie issues could not be the reason for his autism.
the other hand his autism could well be the reason why he 'played
hell' with you - as children with autism often have difficulty coping
with a change in schedule or surroundings. His lack of social reciprocity
would make it difficult for his parents to be warm and affectionate
with him. Children with autism often battle with sensory defensiveness
- i.e. a hyper sensitivity to certain textures, sounds, tastes etc
- which may have made him resistant to hugs and the typical social
overtures that parents make, that gradually build the bond between
effects the ability to understand social rules and both verbal and
non-verbal communication. It would have been hard for your daughter
- without an understanding of why her child was not responding to
her overtures, and the usual means of engaging his attention and getting
him to listen to her - to not get dejected and feel unable to cope
with the stress of bringing him up. The diagnosis of autism with the
typically bleak prognosis that is usually given, would have only deepened
her level of distress, and that would explain why she reacts in inappropriate
ways to his behaviour even though she has been told more appropriate
ways of dealing with the issues.
is where you can play a huge role. By being supportive and understanding,
perhaps giving your daughter some respite, and by becoming more and
more knowledgeable about autism and the effective behavioural intervention
methods that exist for working with children with autism, you can
be a real support and help for her. Give her time to come to terms
with her very real grief, and also give her hope.
a sustained, consistent, structured behavioural intervention program
all children with autism show real progress. How much each child progresses
is dependent on that child's ability and the environment the child
is growing up in. What we can do is maximize his potential by giving
him the most positive and nurturing milieu in which he can do so.
For us to make that possible it is important that we deal with our
stresses, come to an aware acceptance of autism, and decide to do
whatever needs to be done in a truly positive way.
My three-and-a-half-years old son has not started speaking yet. We
are in touch with a speech therapist. In her opinion he is not yet
ready to start therapy
Lets put it this way: Z is ready for intervention right now. The sooner
you start the better. He does not require 'speech therapy' so to speak.
Children with autism usually do not have any physical difficulties
with regards to speech. Put simply, it is more an 'autistic inability'
in using speech. What they really require is communication therapy
rather than traditional speech therapy. However some speech therapists
do figure out appropriate methods of teaching. If your speech therapist
says he is 'not ready to learn' either she is not well aware of autism,
or is not comfortable working with a child who is not easy and compliant.
Which is fair enough, because we all have different teaching styles.
What you can do is try and find a therapist or special educator who
will be comfortable working with your son, and has a clear understanding
finally, given the levels of misinformation regarding autism, you
have to be knowledgeable about the disorder and about teaching methods
because only then would you be able to tell whether what is happening
with Z is appropriate or not.
Akash has a problem with language, started talking at three and a
half but now his vocabulary is impressive - it doesn't take him long
to learn anything new - visual and auditory memory is very good, but
he can't really use language to communicate. He still doesn't respond
to "what is your name", but can answer, if asked, "what
is the colour of...? Or will ask, "please give me water"
etc. when he wants something. He repeats words and phrases quite often.
He's going to a mainstream school since June and since August is quite
adjusted after he was moved down from KG to Nursery and has a maid
attending class with him. Any suggestions?
Akash's inability to respond to "what is your name? " unlike
"what is the colour of...", is understandable. When we ask
'what is the colour of' the response is unchanging. Always the same,
if it is red to me, so is it to you and to Aakash. But when someone
uses the phrase "what is your name? ", the response could
as easily be 'Carol' as ' Shanti' as 'Aakash'. It's a fairly unpredictable
kids who have ASD you often have to teach them spontaneous communication.
You will want to teach him to respond to his name. Have one person
ask the question as another facilitates. For instance you stand directly
in front, or better still kneel down to his level directly in front
of him and say 'What is your name? '. Have another person who is standing
behind Akash, respond immediately from behind Aakash's head, "Aakash".
Not "Say my name is Aakash", not "Say Aakash",
but simply "Aakash". Rope friends and relatives into the
act. Teach them how, and when they visit get them to ask, and you
respond. Very soon you will have Aakash pick up the cue and respond
with an "Aakash".
Once he gets the idea he will move on to responding spontaneously.
It might take a while, but it will work.
time you will want to vary the question and teach him to respond with
an "Aakash" to that too. There are a number of excellent
manuals that you can refer to, to help you develop Aakash's language
such as 'Teach Me Language' by Sabrina Freeman and Lorelei Dake.
is great that you have got Aakash into a regular school that is friendly.
Its great if one can find a friendly regular school that our kids
can go to and work on their deficits simultaneously at home where
the parent has the time and resources to do so.
Our 3 year old child is found to be autistic. A detailed assessment
will be ready shortly. Doctors have said it is high functioning autism.
Our problem is the child gets done from us everything she wants by
means of holding our hand and taking it to the object. She does make
has no speech, except that she can utter many unspecific words. We
make a request to advise us what treatment/therapy could be adopted
and how we could go about it.
It is good that you have had a detailed assessment done, as that will
help you in deciding on the programme for your daughter.
behaviours you have mentioned in your child are ones that are common
to young children with autism. You have by now read up a fair amount
of information on autism; the more you understand about the disorder
the more you will be able to help her. As you are aware, your daughter
has an impairment in understanding communication as well as in conveying
her needs and feelings. As a result though she has speech she uses
it in 'unspecific' ways. You can do a few things to help her improve
your daughter looks at something or otherwise appears to be interested
in something, label that object. So if she is playing with a piece
of string, point to it and say 'string'. Similarly if she is looking
at a car on the road, say 'car'. Verbally label whatever she is looking
at. When she wants something like say water, and leads you to it by
hand then before you hand her the glass of water say - 'water' and
then give her the glass. Remember to keep all your communication simple
and clear. Avoid using too many words. If you want her to remove her
shoes before coming into the house you want to just say 'remove shoes'
versus saying 'Take off your shoes before coming in. They are dirty,'
or any such complicated instructions.
great that she already has good eye contact. What you want to check
out is if it is on the same level as other kids or it is less. If
less than you want to work on that too.Your daughter may have a few
sensory difficulties as a result of which perhaps she does not want
to take solid food. Keep trying to introduce new foods, but you do
not want to force her. If she resists the new food, drop it for some
more time and come back to it after another ten days or so. Food sensitivities
come and go, but they all reduce with age and the more comfortable
we are the sooner.
keeping in mind that the one strategy that is effective with all children
with autism is structured behavioral teaching; perhaps you could check
out your neighbouring countries for training for yourself? Additionally,
if you visit India, check out page 13 of this issue for details of
our Annual Training Workshop, that we believe you will find useful.
give me guidelines in improving P's communication.
You have mentioned that he communicates his need by pointing or using
single words. Keeping in mind his autism where communicative skills
are impaired, and his age, he does communicate a fair bit. This is
something that you definitely want to encourage. Praise and encourage
him whenever he communicates spontaneously.
him with language - Since he already uses single words, build on his
language by introducing two word phrases where he uses single words.
For example, "give water", "eat banana" etc.and
continue to provide him with the appropriate words to use when he
does not know what to say. Even if he does not repeat the words immediately,
it is necessary to provide the words. Avoid saying " Say Hello
" or "Say Give biscuits" because there is the chance
that he will learn to say "Say Give biscuits" instead of
one question about his pointing. Does he point with a single finger
or does he point generally in a particular direction. If he points
specifically then that is great. If not, then you could get him to
do so by moulding his hand in a pointing manner and then help him
to point to the item he desires.
through your instructions - Because of the communication impairment
in Autism, very often the person with autism does not understand either
the purpose or the meaning of words used. They do not understand that
when something is said, something happens. So to help them understand
both these, it is very very important to always follow through an
instruction. If you tell you son to pick up a toy, make sure that
he eventually does it. There will of course be days when he does it
immediately and other days when he won't. Tell him once. And wait.
Tell him again and wait. If he is still unable to comply then you
physically prompt him to respond. If he still does not do it, physically
walk him through he activity and then praise him as if he has done
it himself. This again needs to be done with a lot of comfort.Aside
from teaching him the purpose of language it will also teach him that
when you say something you mean it. Not carrying through instruction
teaches him that you will try a couple of times and eventually do
it yourself so why should he bother at all.
- Always acknowledge any attempt to communicate especially when it
is spontaneous. Sometime it may not be possible to speak to the child
if you are busy or talking to someone else. What you can do is just
stop for a second and tell you son, " I'll speak to you in just
a minute", finish what you are doing and then respond to him.
You could also tell him, "Papa is busy, go tell mama", thereby
acknowledging his attempt to communicate but doing what you have to
do as well.
to him - As often as possible talk to him. Use very simple language
and tell him things that are happening in his surrounding, tell him
details about what he is dong what you are doing, things that you
see while travelling by bus or car, that you watch on TV. The important
thing here is that you talk about things only while he can see them
or while he is doing them, like talking about eating during meals.
"Rayan is having lunch"
"eating rice and dal
with a spoon"
"sitting with papa and eating"
"papa eating bhindi with rice" and so on. Keep it very concrete
and factual and specific to the situation, the reason being that it
is sometimes difficult for autistic people to make connections between
words spoken and objects or situations so as to use them appropriately
in the future. Talking about a situation while in it helps them to
make these connections
himself - Teach him to learn basic things about himself like his name,
the names of his family members, parts of his body, names of objects
in everyday use by frequently repeating the information to him. You
could also ask him simple questions like "What is your name?"
and then take his finger and point to himself and say "P".
This will give him both the correct words to use as well as teach
him how to respond to such questions.
opportunities for him to communicate - Most often when we have children
with communicative difficulties we feel like we need to figure out
what the child wants every time he comes near. We anticipate their
needs even before they have thought about it. But if we anticipate
each need the child has, we really never give the child the opportunity
to communicate. The child learns that if he waits long enough someone
or the other will eventually give him what he wants and he learns
not to make an effort. So do not anticipate needs. Leave the situation
open for him to communicate to you in any way that he can find and
then respond to him. Of course do not forget to provide him the appropriate
words to use in that situation before you respond. As an example,
when he comes into the kitchen looking for biscuits instead of just
giving it to him, stop and ask him, "What do you want?"
Then say "Biscuits" and give him some.
I have a question regarding the Turn Taking procedure that you have
outlined on your website – I find it incredibly helpful and
was hoping for some clarification around what the visual should look
like for turn taking between two or more children.
Not sure which article you might be referring to. However, here is
an illustration of where two children Tia and Sunny take turns throwing
a ball. Each is to take three turns. First Tia, then Sunny, then Tia,
then Sunny again, and so on. As each child takes a turn they strike
out one of the balls on the illustration (or the facilitator may do
it for them). This gives a clear indication of whose turn next and
how many turns left etc. Trust this is what you wanted:
December 2006 Autism Network for original
Q. Our five-year-old son has been diagnosed as mild to moderate
autism and we have been working with him since last one and half years.
We had been to your workshop in Mumbai and we have benefited from
the same. During this summer vacation we want to organize some sort
of a playschool with such children between the age group five to eight
and restricting the group to four or five children only. I would request
you to give your valuable inputs as regards how we should proceed
and what are the things we should do, our primary focus being improving
socialization in our children and making them more self-reliant in
It is a great idea to run a summer play group. First and foremost
you will want to identify families that are genuinely interested in
such a play group and not merely look on it as a place to leave their
child somewhere for a few hours. Decide how many hours you would be
able to comfortably run it every day or how many days in a week. Depending
on this you can plan group activities involving music, art and craft,
pretend play and drama, picnics and outings to parks, restaurants
etc. Since many
of our kids love watching television you can have video shows for
them in a group. The program could include the following:
o Sit down group activity including painting, music, pasting, colouring,
story telling, pretend play
o Relaxing time with massages, music, and other sensory input like
trampoline, therapy ball, water play
o Physical group activities involving throwing ball at a target, walking
on elevated path, climbing and reaching at targets, pulling, pushing
weighted baskets or cartons across a demarcated area
o Snack time involving opportunities to communicate for desired food
o Free play time on a mat or a carpet with freedom to choose a desired
toy or object.
o Class time if the children in the group are going to a school. In
this session you can revise previously acquired concepts.
are just a few of the things you could do.
o Perhaps have a therapist observe the group and suggest additional
o If possible get an Occupational Therapist, a Music Therapist, an
Art and Craft Teacher to visit for short periods.
o Mothers can (in most cases will have to!) be the main teachers.
o Mothers can take a break once a week or however it suits the group.
o Include Siblings, kids from neighborhood.
o Look for young people to work as volunteers as many of them are
keen on such summer holiday projects. Chose friendly and active people.
Social Interaction is your focus turn taking activities, going to
a shop, visiting one child's house once every week for a small well
planned party and organizing a cultural program such as a dance, play,
fancy dress, on a terrace or veranda or a living room. All these could
be done with your kids together with the regular kids.Use a lot of
visuals such as pictures, objects, visual time table with pictures
denoting activities to take place that day, in all activities.
the 3E's Enthusiasm, Energy, Excitement!
And of course Fathers to join on holidays and stay cool!
Best of Luck
I have a 20 year old student who was just recently diagnosed with
autism. Until this time he was treated as someone having mental retardation.
My question is: How does one teach someone with moderate to severe
autism the concept that stealing is not a good thing to do?
The concept of theft is a very abstract concept. It also requires
an ability to read minds in order for me, for instance, to understand
how a person would feel if I stole her favourite table linen since
it was her mother who had embroidered and gifted it to her. For a
person with moderate to severe autism, this level of understanding
of minds might be difficult. Therefore rather than trying to teach
that 'stealing' is 'bad', what one would have to teach is the concept
of 'mine' and 'not mine' and that I do not take something that is
'not mine' without asking or without being asked to. Such a concept
would perhaps be easier to teach.
The National Geographic aired a programme called Dogs with Jobs. It
was about a 7 - 8 year old severely Autistic boy. They strapped the
boy at the waist with the dog and the dog controlled him. He used
to run here and there uncontrollably on roads. After a few days he
started showing affection towards the dog and playing with him. After
a few months they showed him playing on the slide along with other
children very much like typical children.
as for my son he can manage the studies in school. But somehow inspite
of being with children he is not social. He wants to be social but
then he has a limited language so he is left out. I was wondering
if keeping a dog at home can make a difference at this stage because
he is still very small and if it gets corrected now it would be great.
Dogs do not speak so he will have to talk. Has anyone else tried it?
psychologist who helps me in school says that he might get stuck to
the dog and not talk to people. I doubt so. Lately he has been spending
too much time on the computer and piano so his behavior regressed
during the winter break. Now we have removed them. Tell me would it
be a good idea to keep a dog or would it have an adverse effect.
That's an interesting letter! That R does not become sociable despite
being around other children is to be expected. Being around other
children can help if R is facilitated in his social interaction. It
would be hard for him to make connections on his own. And even when
he does try it may not be on a level that other kids his age understand
and therefore they may not respond to his overtures unless facilitated
by an adult. I don't know whether being around a dog will make R speak
more. I am not aware of any research findings on the subject. But
it will help him in other ways as he will learn companionship and
could view having a dog like having an interaction with a child older
or younger than oneself! The dog does not speak or make verbal demands
on the child as a peer age child might. And at the same time it is
very undemanding and accommodating like an older person! I don't think
having a dog will get R 'stuck to the dog and not talk to people'.
That has not been our experience or the experience of any other family
with a dog that we know of. We do believethat it is not beneficial
to spend too much time on the computer. Of course our kids are good
computer. And of course we can use it as the amazing educational tool
that it is. But computers also are so predictable that our kids get
hooked on it. However computers do not provide social interaction
time. So while it is good to use computers, it helps to limit the
time spent on it for more interactive time. So I would suggest get
a dog definitely if you can, and keep an eye on time spent on the
am a mother of a four year old autistic son. Both of us parents work
in Guwahati. Our son was diagnosed with autism by a pediatrician in
Guwahati, Dr. Sabinah Ahmed, when he was two-and-a-half years old.
From the age of three years he is being trained by a psychologist
specializing in developmental delays of children. My son is not retarded
and in fact is quite smart. Hence we have been able to teach him a
few things. He is also very emotional. He does everything possible
to keep me from getting annoyed. Therefore he is more than compliant.
Due to the progress made by him in academics we have been able to
get him admitted to a regular school. He is quite gentle with other
kids and does not hurt them.
problem is that his odd behaviour and responses to touch etc appear
very bizarre to his own peers. He gets over-stimulated by external
stimuli, like touch, sound and sight. I do not want him to be shunned
by his classmates and hence I need to modify his odd behaviours with
more appropriate behaviours. If we can help him manage his over sensitivities,
I am sure he will improve a whole lot more, especially in social aspects.
He likes his classmates, but really does not know how to approach
and behave with them and does not realise that his odd responses puts
some of his friends off. Kindly let me know if we can become a member
of AFA and how we could benefit.
It is wonderful to learn of the progress your son is making. You have
indeed taken him very far on his developmental path and helped him
cope with a regular school. You refer to some difficulties he is having
with his peers at school because of the unusual ways he expresses
excitement. You naturally want him to learn more regular ways of doing
so and generally learn to control himself. As you are aware, individuals
with autism spectrum disorders may have sensory difficulties. As a
result they may respond in unusual ways to touch, or sound etc. Your
son could benefit from desensitizing exercises. Your letter does not
explain in what way your son responds to over stimulation. Without
this information it is difficult to suggest exercises that can help
him. Perhaps you could write in with a few specific examples.
addition you want to teach your son alternative behaviours for when
he is excited. For instance if his unusual behaviours are to do with
his hands: give him something to do with his hands when he is excited.
Teaching the concept of private and public in relation to behaviours
can also be helpful. He thereby learns that it is okay to have certain
behaviours when he is on his own, and not when he is in company. Try
also using social stories to help him learn appropriate behaviours
in specific situations (see Autism Network Vol VI No 3 and Vol VII
No1). Social stories can be amazingly effective when well written
and used. You might consider discussing with the principal, the possibility
of giving a talk to the kids at his school to create awareness about
disability and help his classmates see the reasons behind your son's
behaviours. Kids can be very unaccepting, but they can be great buddies
also if an adult can facilitate them well.
For Autism is a parent organisation. Its aim is to create a society
that is inclusive of our children. AFA is a movement aimed towards
this end, through the creation of awareness, developing teaching methods,
imparting training, facilitating the formation of parent support groups,
changing legislation, and so on. Every member contributes directly
or indirectly to this goal and a brighter future for our children.
Should you decide to become a member you will be part of this pioneering
It has been one year since I put my son on GFCF Diet. The improvement
I see is from his two or three word sentences he can speak much more.
He is able to recall events, read story books. His grip is weak but
by making him write everyday he has improved. He draws and colours
and can write fairly well. I am working on teaching him taking others
perspective and predicting events, WHY which is most difficult to
used to call children home for play sessions during the summer vacations.
Initially he resisted but then started enjoying. He liked the action
games like follow the leader, jumping over, statue. He shows little
interest in board games. In mainstream school he would be required
to follow instruction in a group which it seems he is not responding
so well. What can I do about it. Is there any book in AFA regarding
social skills that would be helpful in school?
It is good to learn that your son is doing so well. Regarding predicting
events, to do this a certain amount of visual clarity is required.
How are you doing this? Are you using calendars and, if it is events
in the same day, may be schedules? He needs to know and understand
how his own time is organised before he can start predicting events.
your son can be taught to take other people's perspective but first
he needs to identify his own emotions and then those of others. There
are books and activities on this subject. Your son enjoys action games
because it is clear what he has to do and the enjoyment is immediate,
but board games where the aim is winning is rather an abstract concept.
You could get him to play some structured physical games first and
then move on to simple table top games where it is very clear what
he is supposed to do.
will also need to work on joint attention especially if you want him
to sit in a group and pay attention. There are a number of things
one can do to enhance social skills some of which we have discussed
in earlier issues of the journal.
will also find useful material in the AFA library.
My son likes to be on his own. How do I change this?
We don't know how much time you are able to spend with your son daily.
If, say, you are able to devote about one hour one-on-one with him
on a daily basis, then you may want to break this time into shorter
periods: of interaction based on your son's attention span, and periods
of being left alone. If, for example, your son's attention span extends
to about ten minutes, plan on an interaction lasting 8-9 minutes.
Give him total attention during that time. Engage in activities that
are to his liking. Just have fun with him singing/chatting, playing
games/rough and tumble, reading, colouring. At the end of the period
tell him that he can be on him own for a specified time, maybe 3-4
minutes. Mark a clock to show him the specified time when you want
him to rejoin you. If he joins you on him own after the given time,
acknowledge. If not, remind him by showing the clock. Repeat the process.
Once he is comfortable with this arrangement, you may want to shorten
his time to be alone and increase his time to be with others. This
will allow him to enjoy the company of others as well.
My child is unable to make friends in school. She cannot play or talk
with others. Please give a few suggestions.
Although your daughter wants to have friends she is unable to initiate
and/or sustain her friendships. Also due to her communication difficulties
she will be unable to initiate and sustain a conversation over a length
of time like other children of her age. You might want to assist the
process by inviting just one child of her age to your home and organise
games, which involve each child talking in turn. This will help your
daughter join into a shared activity and learn to enjoy this simple
her also how to play simple turntaking games.
A simple one could be one in which each child takes a turn to fit
one block onto another to build a tower. If there are no other children,
you could take the place of the second child. Say "lets play
a game. Mama will take one turn and then N will take one turn, then
Mama, then N, until all the blocks are fixed onto the tower."
Ensure you put all the blocks to be used in a tray or box next to
the two of you. In any case, avoid spreading them out on the floor
or a table. The game ends when the all the blocks have been fixed
into the tower and the tray is empty. Please be careful never to add
more blocks half way through. The game must end when the number of
blocks in the tray or box is exhausted. Remember, if the activity
is an endless one, your daughter is likely to feel de-motivated.
N is with her friends, she would have a genuine difficulty trying
to find the right words to use. As you know, Autism is a communication
disorder and not just a speech disorder. Therefore though she may
have the ability to speak and a wide vocabulary, she would be unable
to use the words appropriately (the right words for the right situation).
You can start by teaching her some very basic social communicative
skills like greeting people or saying goodbye. When there is a visitor
to your home for instance, position yourself behind her and say "Hi"
or "Hello" or "Namaste" to the other person as
though she herself were speaking. Avoid prompting with a "Say
Hi" or "Say Namaste." You want to prompt with a simple
"Hi" or "Namaste." Similarly, when the visitor
leaves or you are leaving after a visit, have someone bid goodbye
to your daughter, stand behind her and prompt with a "goodbye"
and raise her hand and wave it appropriately.
hope these suggestions help you make a start in dealing with your
Please give me guidelines in improving P's socialisation.
It is great that your child is very fond of you all and likes to interact.
An important note - people with autism do interact, though often not
in a manner that is appropriate, or rather appropriate to their age.
They seem to interact mostly when they choose and not when others
do. What we want is to teach him to interact in a manner similar to
that of other children his own age or simply in a manner that will
be socially acceptable
and to enjoy the interaction.
times of interaction fun and exciting so that he continues to want
it. Use every opportunity to initiate contact. Continue to include
him in as many family activities as possible and get him to help around
taking in clothes when they are dry, clearing the table
after a meal, putting by newspapers neatly. This will help him to
feel a useful part of the family as well as teach him the joy of doing
things together with someone.
children with Autism find it hard to wait. Along with being a social
concept waiting also has to do with time which is an abstract concept
and so autistic children find it difficult to understand the purpose
of waiting. But since this is a very important learning for them,
we need to teach it early. To begin with specify the waiting period
by marking it with a clear end. The cue to mark the end should be
concrete and preferably visually clear. For example, you are talking
to a visitor and your son wants your attention. You could tell him,
" I will speak to you when I finish drinking my tea", or
when I finish talking to Uncle". Keep the waiting
period very short at first and gradually extend it. A half minute
to a minute to two minutes to three and so on. The important thing
is to make sure you keep your word. If you have told him you will
get up in two minutes then you have to regardless of who you are with
or what you are doing. (So keep your waiting period realistic. Do
not promise to get up after the tea is finished if you cannot).
a lot of turn-taking games with him. They can but need not be the
conventional games that we find. Turn-taking can be incorporated into
like peeling peas, picking up toys, fitting blocks,
shaking sound producing toys, throwing a ball (or crumpled pieces
of paper) into a basket, sorting onions and potatoes etc. The idea
is for him to do his bit and then wait until the other person has
finished before starting again.
connection with both communication and socialization, provide him
with the appropriate word to use in that context each time he makes
an attempt to initiate an interaction by saying one word or pointing.
For eg. If he is asking for a toy by pointing to it, you can say "Give
car" and then give it to him.
My eight year old son Rahul always laughs when other children
cry. This habit is very disturbing to his mother and the parents of
the child he is laughing at. How do I teach him not to laugh?
This is a comment we often hear from parents. We also have parents
say that they have felt frustrated when they have hurt themselves
and their autistic child doesn't even seem to notice. This apparent
lack of empathy is very much related to the way autism affects a child.
Keep in mind that autism is largely an impairment in social communication;
people with autism often have difficulty interpreting facial expressions,
gestures, and other forms of non-verbal communication. In addition,
we know that people with autism often are unable to take the perspective
of another person, called the "theory of mind." Therefore,
try to understand what is happening from Rahul's perspective: he sees
his cousin standing in the middle of the room with "water"
coming from his eyes, making strange faces, and loud noises. All the
while, his cousin's face is turning more and more red and he starts
to jump up and down. Perhaps this scene even looks funny to Rahul,
and he laughs. You may think, "but Rahul understands what crying
is! He uses it all the time when he doesn't get what he wants!"
However, remember that Rahul may not be associating what he does with
what another child does, since he likely has an inability to put himself
in their position. If he is confused at all, he becomes anxious from
his lack of understanding, and begins laughing, which may well be
a sign of stress. In fact, it commonly occurs among all people that
upon hearing terrible news, or when something bad happens, the person
begins laughing instead of crying.
making comments such as 'dont you know how he feels?' or 'how
would you like it if he laughed at you when you were crying!' Instead,
try to teach the appropriate social behaviour by explaining what is
happening. You can start by telling Rahul that when you see a person
doing this, it is called crying, and these are called tears. Explain
that people cry for different reasons, but usually, it is when they
are sad or in pain. Model the appropriate behaviour for him, and you
could try role playing to let him practice. Also, explain to the parents
of the other child something like, "Rahul isn't laughing at your
son because he thinks it is funny that he is hurt. Rahul has trouble
understanding that crying is a way people show they are unhappy or
in pain" so they understand, as well.
Please give suggestions because my son feels bad to be around
Down's syndrome and mentally retarded children.
As far as being in a special needs school is concerned, there is no
reason why it will be unhealthy for him. These other children have
social and communication skills that P does not have and therefore
there is a lot that he can learn from them. Children learn to be accepting
or intolerant about other differences in people by watching adult
reactions to them. So if you can be accepting and comfortable with
those children, P will be too.
Just a note about his eating independently in school: we want to give
our children control but not so much that they control our lives.
For example: if you decide not to be present during his tiffin time
in school, he may or may not eat for a few days but he will surely
learnt to accept the fact that he has to eat on his own at school.
If need be talk to his teachers about not forcing him to eat and just
let him be. Let him decide whether he wants to eat or not and then
respect that decision.
We recently found out that my son has PDD-NOS. He is 4 years 8 months
old. We got his diagnosis at the Spastic Society of Karnataka. The
main problem that we have is a behavioural issue. His behaviour is
very different when we compare with other kids of the same age group.
Suddenly he pushes some body. He distracts other children in the class
room. When school is over, he does not get into the bus as easily.
Every day he finds a new way of misbehaving with the other children.
He is very adamant and very difficult.
The Spastics Society of Karnataka would have given you some
information on Pervasive Developmental Disorders (PDD), and you would
too would have got some information. So you would be aware, that a
primary area of impairment in PDDs is that of social understanding.
The behaviours your son has are because he has a PDD and not because
he is a “bad boy.” He is not misbehaving. Much of the
behaviours that our children manifest which appear “odd”
or “different” or “unusual” are because of
this impaired understanding of social rules. His pushing other children
could be due to a variety of reasons: to get the attention of the
other children, an inappropriate effort to play with them, or even
to get the adult in the environment--the teacher or you-- to pay attention
to him. Depending on what happens after he pushes or distracts, it
could even be his way of getting out of a situation that he finds
aversive. To determine what is fuelling the behaviour you will have
to find out what happens before he does what he does. And what happens
an example, if the adult in the environment, which is you or the teacher,
scolds him after he pushes, then maybe this attention could be the
reason for the behaviour. Or if the teacher excludes him from the
activity as a punishment, (and supposing your son does not like that
activity!), then he would push more often as a way of getting out
of the activity. So you will need to do some observation to understand
your son’s behaviours. You would also then know what to do to
change them. But a simple rule of thumb that you can follow is to
“catch him being good.” Simply put, when your son is sitting
quietly, flipping a paper, or maybe rocking to himself, most people
would just ignore him. But the minute he pushes someone, he ends up
with a production! Try and reverse this. For instance, your son pushes
other children. When he does that I am sure he generates a lot of
reaction. Reverse that. When he is NOT pushing, just sitting in his
place then tell him, .Great sitting.. If he is pushing a car back
and forth you could say: ‘Playing with the car!’ or ‘Red
car!’ And when he pushes, try to not pay him any attention.
Instead attend to the child who has been pushed. Give the pushed child
a hug maybe. Simultaneously, the pushing could simply be your son’s
way of trying to play with the other children.
a PDD, he would have an impaired understanding of play and not know
what to do with another child. So teach him to play. It could be something
as simple as greeting each other every morning, and saying goodbye.
Or rolling a car back and forth between the two children. The difficulty
with getting into the bus could again be for a variety of reasons.
A possible one could be a difficulty in dealing with transition. Transition
times are difficult for children on the spectrum. His teacher could
prepare him by telling him ten minutes before school gets over. She
could show him a picture of the bus and point to a timer. Or simply
a bell. She could say, ‘The bell will go in ten minutes, and
X will get into the bus’ (showing him the picture of the bus).
When the bell goes she can hand the card to him and lead him to the
This is regarding my seven-year-old son. He has autism and he attends
a mainstream school. He insists on sitting with one particular girl
and wants to be with her all the time. She gets very upset about it
and her parents have also complained to the school about this behaviour.
Please give some suggestions.
The situation perhaps arises because your son is most comfortable
around his classmate and therefore only wants to sit with her. Your
son perhaps has difficulty in interacting with his peer group and
the girl is someone he has decided is the most comfortable one to
sit with. He now feels much in control of the social environment and
is secure with her. Having done that, it is possible that due to the
impairment in social skills and his difficulty in reading social messages,
he is not able to differentiate when she wants to interact with him
and when she wants to be left alone. As a result she perhaps finds
his proximity intrusive and therefore gets upset. It could even be
a nonfunctional routine or ritual. So in addressing this situation
we will have to keep the needs of both the children in mind. It may
be helpful if your son is given very clear instructions as to .when.
and .how long. he can sit with his classmate. Initially, they could
perhaps sit together for two consecutive classes. After this another
child could be made to sit between them. When your son sits away from
the girl, his behaviour could be reinforced. Gradually the sitting
away time could be increased. However, you son will have to be prepared
for this development. One of the ways you could do this would be by
writing or drawing a simple social story. For more information on
social stories you could visit our website www.autism-india.org.
below is one example of a social story you can use with changes and
improvements as you think fit. Read it out to him two to three times
in a day for a week or so.
in my class in school.
All children have their own seats in the class.
I may want to sit with Sonali every day.
My teacher wants me to sit with other children also.
My teacher is happy when I sit with other children.
It is OK to sit with other children.
I can try to sit with other children.
On Wednesday and Friday I can choose who I want to sit with.
son's school is open to suggestions, his classmate could also be supported
to view your son's behaviours differently, and to actually actively
buddy him when he sits with her, and in time, at other times during
the day as well. However if his little classmate does not want to
sit with him as a result of negative feedback she has picked up from
her family, about disability and autism and about him, as often happens,
then it is the little girl's family who really need help in order
to help them view the world from a more positive perspective!!!
My daughter always touches every one in the house and also some times
people at her school. She sometimes bites at home, pinches, repeats
utterances, and makes faces. Also she does not know how to react with
her peers. She likes to talk like someone a lot older than her.
We would suggest that you start with just one or two difficulties
that you would like to target as a priority. Perhaps you might like
to work on those behaviours that are either causing injury to your
child or other people, or that are coming in the way of your child’s
direct learning time. For eg.if pinching or biting other children
at school is your primary concern, you could try behaviour modification
techniques. This would be finding out through observation why the
pinching is taking place, for e.g., is it a sensory need or is it
to get attention of other people, to access an activity or object,
or to escape from the situation?
deal with the behaviour. e.g., if you feel it is to get attention,
do not pay undue attention to the behaviour, and rather pay attention
to the child who has been pinched. Keep yourself neutral and comfortable
within the situation and do not talk about what happened and do not
say ‘no’ or ‘don’t’ etc. Instead, when
your child is behaving appropriately, praise and acknowledge that
time (when the behaviour is not occurring) you can facilitate social
interaction with another child by taking your child’s hand and
helping her say hello, take turns on a game, and so on. All this while
you may need to remain focussed to ensure no inappropriate behaviours
happen during this time. If the behaviour is a sensory need, fulfill
that need during another time by structuring it into her daily routine
also try preparing your child with visual cues about what is going
to happen in school or at the park and talk about the situation. However,
make sure you do not use words like ‘we must say hello’
and so on. Instead, keep language positive and use language like ‘we
can try to stay smart’, etc. Social Stories are another technique
you could try if your child is ready for them. Going through all the
steps of a social story is beyond the scope of this column but a book
like ‘Social Stories’ by Carol Gray would help. You could
also see ‘Social Stories’ in previous issues of Autism
behaviours like making faces and repeating are all a part of the difficulty
in social understanding and inflexibility in thought and behaviour
associated with having a diagnosis of Autism. It may be useful to
focus on what your child is already doing well, and use her strengths
to teach her more skills. For example if she repeats words or sentences,
put it in context for her and make it meaningful. You can also model
appropriate language for her to copy in a social situation.
My autistic grand daughter is 10 yrs old. She attends regular school
in Standard Three. Of late her hyperactive behaviour in school has
increased a lot and is causing concern to all of us. There is nobody
in the school who can keep a watch on her throughout the school hours
to prevent this behaviour. The school has no full time Special Educator
or Counsellor, and as such the teacher tries to manage her abnormal
behaviour whichever best way she can.
daughter attends therapy sessions with the special educator on three
days and with a behavioural therapist on two days. She destroys the
pictures that are stuck on the wall, or sometimes she throws her tiffin
on the floor. She sometimes continues to laugh for a long time or
sometimes bursts out crying for no reason. Academically she is very
good. She scored 78% marks in the unit test with excellent remarks.
Can you offer us some remedial measures which will effectively control
her abnormal behaviour?
Your grand daughter seems to be managing well with the academics as
many other children with autism but she appears to have other difficulties
in coping with the school situation. Very often these difficulties
can act as triggers for challenging behaviors.
to find out what happens before she resorts to tearing paper displayed
on the walls or laughing, when these behaviours happen, whether they
occur with different teachers or with the same teacher. Similarly
it is important to know what the teachers do when she exhibits these
behaviors. If despite the intervention behaviors are increasing as
mentioned by you then it is very clear that even though her school
may be trying its best to support her and deal with the challenging
situations, the strategies are not working to reduce the behaviors.
rather difficult to comment on the possible reasons and give suggestions
without having answers to the situations referred to above. However
we can suggest a few things that can be tried out. But most crucially
it is important to remember that your grand daughter has autism. Her
apparent skills often make us expect far more from her than she is
your grand daughter is ten years old and is entering adolescence.
For her this is a new phase of life in which she may be confused with
her own bodily changes and also the awareness of being different from
other children may be setting in gradually. Therefore the family needs
to have a lot of patience and acceptance and a positive attitude.
We find that families are generally aware of this and surely you may
be having the same approach.
her with an environment that is predictable and prepare her about
changes if and when they happen. For example in case of a change in
the timetable talk about it in advance. Tell her clearly and specifically
about the change. Your grand daughter has autism. Despite her communication
skills she may not be able to ask ‘Why are we not taking out
our Math book in the Math period,’ and get confused and stressed
keep instructions to her brief, precise, and concrete. Do not assume
she will follow an instruction that has been given in general to the
entire class. The teacher may have to take your grand daughter's name,
pause to get her attention, and then repeat the instruction. For example
if the teacher has told the class, ‘Take out your work books
and give them to the class monitor’; she may have to address
your grand daughter by her name: ‘Shweta, take out your English
workbook from your bag. Now give it to Shalini’.
practice having your grand daughter learn to pay attention in a group
at home, where the mother says, “Everyone, come for dinner”.
have a lot of distractions that can be problematic for a child with
autism. Teach her to deal with these at home. Expect her to complete
her task or follow instructions with the TV or music on. Contrive
interruptions that she has to work around.
clearly what is expected of her. Be concrete. Say and give the child
time to process your instruction in her mind and then carry it through.
Avoid verbal overload. Too many instructions may be confusing.
grand daughter has to be helped to see that when she does NOT tear
paper she gets praise and attention. Catch her when she is good and
by and large do not provide too much attention for inappropriate behaviours.
times like the tiffin time a lot of interactions take place between
children and obviously she has difficulties in interacting with her
peer group. Therefore she may throw her tiffin in order to either
get attention of others or out of confusion. She needs to know what
she can do during recess. Assign an area for eating that is quiet
and she is in the company of very known and preferred kids. Give her
clear indication of what she can do after she has had her tiffin and
still has time before the next class starts.
My son P is 5 years old with mild traces of autism. He holds something
or other in his hands most of the time, which he flips. His teacher
for special needs says it is due to sensory needs particularly in
the palms and his feet. When we go to park he likes to wear others
slippers and sandals. Can you please give some suggestions?
The behaviours you have described may be for tactile as well as visual
stimulation. Telling him to stop the behaviours would not be very
helpful. Rather providing him with the stimulation he requires as
a part of his daily activities will actually help devease self-stimulatory
hands and soles of his feet with different and alternating textures
like plastic scrubbers, silk fabric, scotchbrite, velvet, fine sandpaper,
cotton wool. Do this with firm and deep strokes. You can make a mat
from squares of different textures like sponge, small pebbles, bubble
wrap, scotchbrite, sand, for him to walk on or feel with his hands.
Toys that have give off flashing or blinking lights at the press of
a button could provide visual stimulation.
he is otherwise unoccupied or has not been taught to occupy himself,
and everyone else is busy, he can flip objects if that is the only
way he can occupy himself. Regarding wearing other people's slippers,
what we do will depend on why he wears others slippers. One reason
could be that he has difficulty distinguishing his own slippers then
he could be taught to distinguish them with some identifying mark
on his own slippers. When he puts on other's footwear he could be
told "These are XYZ's slippers. P will wear his own slippers."
Encourage him to wear his own slippers at own as well.
We are members of AFA based at Mumbai. I have some queries regarding
the development of our autistic child D who is four and a half. My
son is echolalic but does not take any initiative to speak using a
variety of words. He utters the same one or two words such as 'papi'
(pan i- water ) and 'tote' (means chocolate) for all his needs . He
has been receiving speech therapy daily for the last one and a half
fully toilet trained and used to pull us to the toilet with an indicative
word like 'susu.' At present he is back to his untrained period and
often urinates at any place. He is fully aware of his mischief which
he indicates either by shying away or by babbling his protest.
nursery with one-to-one teacher attention and with his mother present.
Recently his attention deficit and the impatient behavior have increased
a lot. He is unwilling to sit in the class. His unwillingness to follow
instructions often leads to a physical attack on the teacher or his
mother such as hitting or pulling their hair. This behaviour was not
at all there three months back. We try to calm him down by explaining
the situation but he rarely responds to the same. His emotional imbalance
is also on the rise. We seek remedy for the above.
A. I am sure you have informed yourself about the ways autism
affects an individual. One of these is the different ways from the
norm that language develops as well as the persisting difficulties.
So while many typically developing children go though a period when
they echo speech, in children with autism echoing persists beyond
age three when it typically stops. In addition children with autism
do not merely have a limited vocabulary, rather there are difficulties
with understanding of language, with phonetics, with the rules of
communication. It is almost as though they do not understand the purpose
of language and how the rules of communication work. There are not
just difficulties in communicating but also difficulties in processing
and understanding communication.
things the way we do with regular children does not work with most
children with autism. In fact such explanations of why a behaviour
is bad or good and therefore etc only adds to the child's frustration.
It is difficult for me to say why exactly D exhibits the behaviours
he does during one on one. But if I had to make a guess I would say
that what you are seeing in your child is not so much emotional imbalance
as frustration in not understanding what is expected of him and not
in not being able to convey his wants. It would help to try and understand
why D does not want to sit. Why does he not want to attend to the
task? Is it too easy? Too difficult? Are the instructions too confusing?
Is there clarity and consistency of communication with D? Training
yourself is of course the ideal situation.
I am from Pakistan, father of A. A is four and a half years old with
a mental age of two to three years. His problem is that he is hyperactive.
Please let me know what type of help can be provided to cure A.
We do not know of a Pakistan National Autism Society as of yet, although
we are hopeful that one will begin. We have had families from Pakistan
attend our training workshops, which occur each year in September
or October, and we have also heard of families in Pakistan organizing
some programs themselves. Are you in touch with any other families
in Pakistan? Would that be helpful information for you to have? As
you may have learned there is no cure for autism, so we cannot provide
you with that information. However, early intervention is the best
known approach to overall improvement as well as for improvement for
Our four and half year old boy D has echolalia. He repeatedly utters
one or two words like 'papi,' or 'tote,' but not otherwise speak.
He has been receiving speech therapy daily since the last one and
a half years.He was fully toilet trained and used to indicate his
pulling us and saying 'susu.' But now he urinates at any place. He
indicates his mischief by shying away and babbling.
in Mumbai where D attends a nursery school with one to one teacher
attention and where his mother is also present. Recently the attention
deficit and the impatient behavior have increased a lot. D is unwilling
to sit in the class and follow instructions. When one insists it often
leads to physical attack on the teacher or his mother like hitting
and pulling the hair. This behaviour was not at all there even three
months back. When he behaves like this we try to calm him down by
explaining the situation but it does not seem to work. Emotional disbalance
is also on the rise
advice for his violent behaviour. Can D's parents train at AFA on
how to handle D?
I am sure you have informed yourself about the ways autism affects
an individual. One of these is the different ways from the norm that
language develops as well as the persisting difficulties. So while
many typically developing children go though a period when they echo
speech, in children with autism echoing persists beyond age three
when it typically stops. In addition children with autism do not merely
have a limited vocabulary, rather there are difficulties with the
understanding of language, with phonetics, with the rules of communication.
It is almost as though they do not understand the purpose of language
and how the rules of communication work. There are also difficulties
in processing and understanding communication. The speech therapy
D receives will have to be more oriented towards teaching him communication
rather than focussing onarticulation.
things the way we do with regular children may not work with children
with autism. In fact such explanations of why a behaviour is good,
or bad, and so on, only adds to the child's frustration. It is difficult
for me to say why exactly D exhibits the behaviours he does during
one on one. But if I had to make a guess I would say that what you
are seeing in your child is not so much emotional imbalance as frustration
at not understanding what is expected of him and in not being able
to convey his wants.
help to try and understand why D does not want to sit. Why he does
not want to attend to the task. Is the task too easy? Too difficult?
Are the instructions too confusing? Is there clarity and consistency
of communication with D?
the renewed toileting accidents, we want to check out a number of
things. Has there been a change in the environment? What happens before
a toilet accident. What happens after? When do accidents usually happen?
With whom? This will help us ascertain whether toilet accidents are
due to sensory issues, control issues, a behaviour that has been inadvertently
reinforced, and so on. However in the meantime you could try and put
D on a toilet schedule.
if he wets himself after approximately every two hours, then take
him to the toilet after every one hour and 45 minutes. If he urinates
in the pot, point to the urine in the pot and praise him. You may
even give him a small reinforcer, which could be a candy, or
a string, or whatever D likes. On the other hand when D wets himself
is he reprimanded? Sometimes a reprimand can act as a reinforcer for
a child. If that be the case you want to stop reprimanding D for toilet
accidents while you maintain the toilet schedule.
yourself would of course be very helpful. You could indeed receive
training at Action For Autism. This could be a week-long programming
for your home, or it could be a three month Mother-child training
programme. You could also benefit from attending our four-day training
workshops in October.
son six-and-a-half years old is suspected to have mild autism and
he is also hyperactive and has behavior problems. For this he is going
to special education and speech therapy center. His speech was delayed:
he used to speak only two to three words but nowadays he is trying
to speak sentences. He is able to sing songs, rhymes, stories, TV
and Radio jingles. He is academically good and can write A to Z both
small and big letters, names of fruits and vegetables, name colours,
days of the week, months animals, body parts. He can give his address,
his own name, father's and mother's name, and his telephone number.
He can count from 1 to 100, say the tables from two to four, and identify
15 international flags.
has a problem which we don't know how to solve: since childhood he
will have any two plastic things of same size and shape in his two
hands. When he was small we had no problem. But when he started going
to school we started facing a problem. We have consulted a doctor
who prescribed Fludac Syrup for two months. But even then he is carrying
the plastic things in his hand. Due to this he is losing his concentration.
Kindly advise us what to do to make him forget this habit.
We have gone through your letter and have tried to understand the
function behind the particular behavior mentioned by you. However
it is difficult to analyse the behaviour and give suggestions based
on the letter. We will try and respond as best as we can based on
the information you have provided.
son appears to have learnt various concepts at an early age. According
to the information you provide his behaviour of holding objects in
his hand has been there for quite sometime. However the behavior does
not appear to have interfered in his learning. The difficulty now
arises because he is going to school.
work towards helping him to stay comfortable without the objects while
he is in school. Trying to stop this behaviour suddenly may not work.
Instead, let him hold the objects some times. Since he obviously loves
holding these objects in this hand you can use them instead as reinforcer
for completing tasks given to him. For example, take the objects from
him and make him do a task that is simple and easy for him, like clap
hands two times, or finish eating one biscuit, and then he can get
the objects. If he cries or tantrums do not give them back. Make him
complete the task before you give them. If you anticipate that he
may 'tantrum', ensure that the task is very short. In this way he
learns to stay without the objects for a short time. Gradually increase
the time that he stays without the objects.
also talk to his teachers and use these objects as rewards for completing
his work in class. At the beginning of class he can be encouraged
to hand the objects over to the teacher. He will have to be told very
clearly that the teacher has the objects and when he completes his
work he can have them. In this way in the beginning of the class he
gives them to the teacher and gets them on completing his task.
he goes out for a walk with you, or goes to a park, give him something
else to carry that is more appropriate. Like a ball or a shopping
objects around may have a sensory basis as well. So when he is at
home with you and you have some free time, rub different textures:
soft, rough, silky, woolly, etc on his palms. You can also use brushes,
lotions, talcum powder, a rolling pin (belan) on the palms.
Teachers want me to prevent F from playing with strings. Initially,
sometimes they used to snatch the string away from him as soon as
he entered school and he cried the whole day. However a new behaviour,
i.e. mouthing and licking has started. Is the new behaviour the result
of the suppression?
It is very difficult for me to say why the mouthing and licking has
started without having a background to the situation. Behaviours do
not happen in isolation. So it would not be fair to F, you, or the
school to comment without having more information. Incidentally, F's
fascination with strings is something that could actually be used
to motivate him to learn
My job is a teacher assistant for an autism student in a local
private school in Indonesia. Here autism is not well understood. I
have access to little information about it and so I have a problem
in handling my student. This student is six years old. I have been
handling him for over a year now.
I first met him I had no clue on how to handle him but my old boss
convinced me and trained me to handle him. But now she is not here
anymore and the new teacher does not know how to treat him either.
This student will be put out from school if he does not make any progress
in the class. I better tell you about his situation from the first
time I met him - until recently. The first month of my work he could
not speak properly and was always hiding under the table every time
I got near him. But I approached him gently and non-intrusively.
last December he could talk to his friend and express his feelings.
He can also read some words like I, am, cat, dog, see, is, in, on,
Mom, Dad, James. He is really good in maths. But when he came back
from the X-Mas holiday, he seems to have regressed to like when the
first time he met me. Maybe even worse now as he is even hitting and
yelling at me which he had never done before. I really need your help.
I do not want him to be put out of school. I need your advice to make
him like before he had a holiday. For your information his Mom is
now pregnant. Do you think it has anything to do with it ?
By Dennis Debbaudt* and AFA:
First of all thank you for choosing to work with our sons and daughters
who have autism. I wish there were millions more people out there
like you. You had a sensitive and knowledgeable senior and it must
be difficult to not have her support and advise any longer. Your gentle
and non-threatening approach - for instance when he was under the
table got the child to trust in you. His changed behaviour after the
break can seem very confusing.
might be that he lost some of his skills during the holiday break
because he did not have a chance to practice them. Sometimes children
with autism do appear to lose some skills when they are away from
the school (or any familiar structured environment) for even short
periods of time. Many children with autism in the U.S. attend school
year round in order to address this erosion - or apparent loss of
he needed more preparation for the Christmas break. Most children
with autism require predictability. They often have difficulty dealing
with unexpected changes. It is possible that before the break he perceived
you as a steady part of his environment. Then suddenly you were not
there and he was confused. Now that you are back he does not know
how long you will be there for and if you will again suddenly disappear.
Changes can be very hard for our kids since they do not have the skills
to ask what is happening.
could also be that he was having so much fun during the holiday that
he acted out when he got back to school. Or it could mean that something
bothered him over the X-Mas break and he is reacting to that. It could
be something entirely different - medicine, diet, other illness -
or many other factors. I would not want to speculate about his intentions
or behaviors without speaking at length with his mom and family. It
would be hard to know if the fact that his mother is now pregnant
is bothering him. It might. For instance if that has led to a lot
of changes at home in anticipation of the new arrival. In any event
it would be worthwhile to prepare him for the new arrival, by talking
to him about the sibling he will have shortly, in a very concrete
manner. Maybe a calendar could be used to mark the expected date of
birth, and the days marked as they pass. In addition his mother could
sometimes rock a doll or hold a doll close - along with your student.
we (DD and family) learned early on to act as if our son could hear,
see and understand everything - we assumed he could make meaning out
of his environment. While these would prepare him for changes your
immediate concern must be more to do with how to deal with the current
situation. You are doing the right thing by investigating what the
possibilities might be. What you are doing is also known as a functional
behavioral analysis. The hitting and yelling could be due to any number
of reasons. So do a functional analysis without making any assumptions.
Take notes, try to remember what he was doing just before a negative
behavior started - to determine what the cause may be - remove things
from his sensory diet, if necessary, to determine if it is his sensory
environment that is causing the negative behavior. This could include
lighting, sounds, smells, touch, fabrics, tastes. Keeping a written
log will help you figure out a way to deal with things. You can spot
trends easier. Perhaps send the log home each day so his mom can add
her comments and information. Keep it simple and informal. Also, while
the hitting or yelling happens, do not give the behaviour any immediate
as you are aware most of our kids have significant impairment of social
skills, they have difficulty in drawing attention to themselves and
their needs. So when they get any form of attention - and that would
include scolding for behaviours they might exhibit - they often repeat
the behaviour in order to get the attention again. So when he is hitting,
while you ensure you do not get hit again, do not pay the behaviour
attention. Stay comfortable and non-reactive. At the same time 'catch
him being good'. So when he is being calm and happy tell him how much
you like it when he is being gentle. Rather than commenting that "I
don't like it when you hit" or "I don't like it when you
shout" use positive terminology!
wishes in helping this child and his family and for the committed
job you are doing.
Debbaudt is a parent, a resource person, and founder of 'Autism Information
for Police' for which he gives conference presentations and direct
trainings, as well as a friend of Action For Autism.
My son M is chewing the neckline of his shirt I am ignoring it. Is
there anything else I should do?
I understand from the information in your letter that M is chewing
his garment to satisfy a sensory need. I think you want to try working
ondesensitizing. Try the following and see if it works for him.
M the following things to chew:
o a rubber tube o soup sticks o cake and milk rusks
o plain grains of wheat that have been coarsely crushed mixed with
a sprinkle of water. This makes it of a chewy consistency.
a piece of thin towel or other fabric wrapped around your finger,
try to massage his tongue and gums. To help him accept the massage
you could flavour the fabric with fruit flavours or any other flavour
of the child's liking. In addition, in the summers get him to wear
vests with very low necklines.
Whenever we do an activity with toys, my son throws them. How to stop
To get around the throwing of toys when you are trying to do an activity
there are a number of things you could try: Prepare him for the activity.
Structure the worktable so that he cannot throw. Reduce clutter and
keep exactly what you will use on the table. Structure the activity
so he knows exactly what is to happen, how much, what will happen,
when it will end. If he does manage to chuck something despite all
this, do not give the behaviour a reaction. Instead catch him being
good. Which means that if you get through an activity without him
having thrown anything, then acknowledge, praise, reward.
On our road we have a family whose son is suffering from Autism.
To us, autism was not known but his father made us aware of it and
ever since I have been reading about this with a view to helping,
as much as I can. I would like to give you my observations of the
child seeking, thereby, your guidance to know how to deal with such
children. This eight year old boy called P is 'jumpy', he cannot stay
still for a moment and neither can he be held down. It's just running
and jumping about. Yet, if he is held down and is asked to read something,
be it English or Gujarati, he just looks at the sentence in a flash,
turns his head away and says the correct sentence out aloud , difficult
though it may be. It's just amazing!
observation is that whatever he gets his hands on he bangs hard and
is ready to break it up to see what is beneath or within it. Any new
room, unknown to him, as is our place that he is just coming into,
seems to invite discovery, but, he just gives a quick glance around
in wonder and seems to take in, again in flash, all that he has seen,
and then he goes for one object to experiment with. He seems to recognise
me, now that he has come here often, but except for the first moment
that he gives a smile of recognition, after that he is not bothered
about my presence and prefers his freedom of running about. I am sending
these observations with the hope that we will all be able to bring
out the best in the child.
It was a pleasure to read your letter. Your concern for the child
in your neighbourhood, your ability to pick out his strengths and
look at him so positively, not letting his challenging behaviours
get in the way of your seeing him as a child with possibilities and
your initiative and proactiveness in doing all you can to help him
grow is truly heartwarming. We would feel very privileged to help
you in any way we can.
as you may know is a developmental disorder, affecting the communication
and social skills of a child. Unlike mental retardation, children
with autism typically show an uneven profile of skill levels, that
can vary greatly from child to child. P seems to have excellent cognitive
skills, given that he has learnt to read so early, and probably has
very good spatial skills. However as you have noted he has great difficulty
in even the most basic social interactions. This is his challenge,
and the area he needs the most help in.
all of us, P will learn best in a positive encouraging environment,
structured to his needs, and using his strengths and interest areas.
Praise and encourage even the smallest efforts in those skills that
you want him to become stronger in, and ignore or pay very low attention
to behaviours that you want to discourage.
when greeting him, bring yourself to his eye level, or bring objects
that he is interested in close to your eyes, and the moment you get
eye contact, tell him very enthusiastically how much you love it when
he looks into your eyes. Be different and exciting every time. You
could model an appropriate greeting as well. When you want to have
focussed interaction with him, try and structure the environment -
so that there are not many distractions around, and it is easy for
you to get him to look at you, and pay attention to you. So keep the
table empty of everything but the book or toy you want to share with
him, have him seated against a wall maybe, make sure there aren't
objects around that he would rather be exploring.
you plan to work with him regularly, you could maybe ask his parents
to set aside a room that is structured in this manner. A big mirror
to encourage body awareness, imitation skills and increase opportunities
for eye contact, a high shelf to keep things that you want him to
ask you for, perhaps a table and chair and neutral uncluttered walls
and floor would be helpful.
Whenever I go out of sight my son cries. If I am in the kitchen he
calls Amma, Amma, repeating the word even
for half an hour. When I am with him he is quiet. My brother-in-laws
three-year-old son tries to play with him, but my son is not playing
with him. He should play with other children. He should avoid
repeatedly doing the same actions like swinging towels and clothes.
His has to learn more things.
My child has the behavior of hand-flapping.
Children with Autism are over sensitive or under sensitive in at least
one of the senses (hearing, vision, touch, smell, taste, body balance)
at any given time. Stereotypic movements like rocking or hand flapping
are a way of coping with these difficulties. Stopping a child from
doing them is not helpful as these behaviours often provide comfort.
Instead, at a time when he is not flapping his hands, give him relaxing
exercises like pressing his body gently (or even very hard if that
is what he prefers. These movements will also reduce once your son
has a routine for his day, like going to a school, and when he is
taught other ways of occupying himself.
You have mentioned that he cries every time you are out of sight
and quietens when you are around. Very often we assume that autistic
children are not really bothered about what goes on around them. In
fact, the reason why he cries is probably because he sees you are
gone and is stressed about it. His communication difficulty hinders
him from asking where you are going, why you are going, how long youll
be away, etc. as a regular child would do. That is why it becomes
very important to talk to your son and prepare him for everything
that is going to happen. If you have to go to the shop, explain it
to him. Keep your explanation very simple and clear. You will find
that this will reduce his stress to a great extent. If it so happens
that you tell him you are going away for an hour and you take longer,
just remember to talk to him about the delay when you get back.
remember that crying and repeating Amma over and over
is Ss way of communicating with you. What you can do is
provide him with the appropriate words or gestures to use. Right now
he does not know of any alternative way of communicating with you.
When he cries Amma in order to have you come to him or
attend to him in any other way, you can say Amma come here,
or Amma give food before responding to it. This way he
learns the appropriate language in the appropriate situation.
is a very complex social skill that autistic people find very difficult
to deal with. Their impaired imagination makes it even more difficult
for them to understand pretend games and unwritten rules. That is
why autistic people work much better than they play.
When a game is organised and methodical they are much better able
to understand what is expected of them. To start with you can use
simple card games such as making pairs of the same picture,
building blocks, fitting puzzles, etc. to build on his play. Take
turns with him so that he learns the skill of taking turns and waiting
for his turn. Play a lot of pretend games with him even if they are
childlike. They will help him to use his imagination. If possible,
teach him to ride a bike, swim, play badminton, etc. - anything that
he can do alongside other children without the pressure of interacting
or figuring out social rules.
your son is not occupied by you or any other member of the family
in an activity, then he will indulge in various obsessive activities
to keep himself occupied: such as swinging a towel. Unlike other children
he is unable to occupy himself in a manner that would be considered
socially appropriate. You mention that at home he spends a lot of
time lying on the floor on a mattress and pillow. Perhaps you could
set up a schedule of activities during the day. When he returns from
school and after he has rested a bit involve him in certain household
activities. Perhaps he could bring in the washing; help you to lay
out lunch; help family members in making the bed. Help in making the
bed could, to start with, be something as simple as S standing there
holding the pillows while you straightened and tucked in the sheets.
. All these jobs you will perhaps be able to do far quicker without
his help. You could just as easily put the pillows on a chair instead
of having S hold them.. But the idea is to involve him and get him
connected versus staying lost in his own world. The more you
can involve him and the more he enjoys it the less opportunity he
will have to indulge in towel-swinging. Telling him, S
stop that might stop the behaviour for the moment but
will not help in either reducing or eliminating it.
Even better would be if you could enlist his teachers help to
set up structured activities for S in the house.
is really good that he is attending a school where he can learn some
academic skills. More important, however, is for him to learn to take
care of his day to day needs. It is good for a child to know 200 and
35 is 235 but it is more helpful if he learns to pour himself
a glass of water or know how to ask for help.
I have been facing a lot of problems with my daughter, age 9 years.
Her physical growth has started. (It is earlier than other children
of her age.) She has become very moody and throws a lot of tantrums.
In between she was ill for 15 days during which she was given an antibiotic
course for ten days. During that period she wouldn't have her
bath, wouldn't let us comb her hair, and would scream in general at
everyone. I find myself helpless at such times when no amount
of explanation or tempting can make her have her bath or comb her
hair, even when going out. Even after her illness, she doesn't
want to have her bath and comb her hair on holidays.
problem I face with her is that she is very negative towards me.
She will say, " Mummy, you don't give me milk, let the servant
give me the milk." Whenever she is upset she goes on repeating,
"Mummy, you go away." Formerly she was very fond of going
out. These days she is all ready to go out, but at the last
moment she will say that she wants to go out alone and not with everyone.
Please suggest ways to handle the above behaviours.
Your letter describes a situation that many families with teenagers
and children going through puberty face. As you must be aware,
any regular child at this age begins to look for areas of control;
situations in which they can have their own way. Many children
also have difficulties in behaviour and management. It seems
to me that what you describe is quite clearly your daughter's desire
for control over her world.
now, more than at any other time, your daughter is finding it very
difficult to understand the puberty-related changes in her body and
the accompanying see-saw of emotions. Every person goes through
phases of being up and down and these phases are marked in people
with autism. M cannot control these changes and the way they
affect her, and so she needs to find some areas of control.
If you recall, at the training workshop it would have been discussed
how control over one's own body is the ultimate control that no one
can take away. What M is doing is essentially exercising this
control. If she does not bathe, or does not want to brush her
hair, this is after all her way of asserting control, and maybe we
could accept that. Also, like many people with autism who periodically
go through phases of heightened sensitivity, brushing her hair or
bathing mighehave been painful at that point of time. If we
can let her have her way, with comfort, she will be much more willing
to revert back to doing what you want her to do.
another instance she keeps saying she wants to go out, and when you
are finally ready to do so, she says no. She is basically looking
to see what you are going to do, i.e. if you will go against her.
Most often what we tend to do is to react with, "What?
You said you wanted to go out! Now we are ready, so we have
to go". What you could do, is be prepared for her to say
'no' and if she does, then say "Okay, that's alright, we'll stay
back", and go back in; or say "That's okay if you don't
want to come. I think I will go out anyway". The
more you can be comfortable about her wants, the easier she will be
to deal with. M's behaviour is akin to that of most pre-teens
and teens. The difference is that non-autistic youngsters have
social skills and therefore keen to have the approbation of others.
This does not apply to someone with autism.
is slowly moving into her teens and she is going to want a lot more
privacy and personal space, so if at times she asks to go out alone,
maybe she is actually wanting some time alone (which is something
we all want at some time or another). We realize that sending
her out on her own may not be a safe possibility, so you can provide
her an alternate place and time where she can be undisturbed, a place
she can be alone. This is not something personal against you,
it is just a normal part of her growth. Perhaps the most important
thing to remember is that her behaviour is not directed against you
even though it may appear to be.
is a phase that can continue to ebb and flow through much of her teens
as it does with every child; but it is also a phase that will eventually
pass. Please always remember that there is no one way of dealing
with any situation. You will need to find different ways of
working around this negativity without going directly against her.
Amit uses bad language. He also does some obsessive talking.
Kundan is twelve. In class he talks constantly disturbing everyone.
He will ask the teacher the same question over and over again even
when he knows the answer.
Romit troubles me a lot. He will say Say chup-chup, say
chup-chup. He will repeat many many times. He will say Say
blue car. Say blue car. He does this all the time. If I do not
repeat after him he gets very agitated.
Many children with autism, particularly those with better language
skills appear to go through phases of obsessive talking. Perhaps they
derive some kind of security out of getting a safe answer to a safe
question.?! I think it was Temple Grandin who recounted how she enjoyed
asking a question repeatedly and waiting with excited anticipation
the very predictable reply. She adds that it never occurred to her
how exasperating the entire exercise could be to those around her.
What I want to first get out of the way is that the child is not asking
the questions repeatedly to get your goat! He simply wants to
what can we do about it?
best time to actively deal with this is when the child is talking
outside class, at break time, in the playground, or at home. Keeping
in mind that the child perhaps wants to hold a conversation and does
not know how, and therefore does repetitive talking - one method we
have found useful is to talk about or around
a favoured repetition.
example if the child says Say Chup-Chup.
Carer : Shall I say it loudly or softly?
Child : Loudly
Carer: How many times will I say chup-chup?
Child : Three times
Carer : Chup - Chup. Chup-Chup. Chup-Chup.
There can be endless variations to this.
Carer : Shall I say Chup-chup to the dog
or shall I say Chup-Chup to the mirror?
talking around a childs obsession we want to be creative. We
do not want to repeat the same conversation since tha t defeats the
purpose. One can talk around just about any subject the child
perserverates about. All it wants is a bit of creativity.
other method that might work is to completely ignore the perserevation.
Pay no attention. Make absolutely no comment on the childs talk
- no matter how persistent. However, if I ignore nine times and the
tenth time I am exasperated and acknowledge, - that will only strengthen
the childs resolve to persist till he gets a reply!
(as we keep repeating!) as in everything else CONSISTENCY is of paramount
importance: consistency and comfort. If I create a conversational
situation out of his perservation, I too want to enjoy it as much
as the child. When I want to help my child deal with a behaviour
and I am angry about it, it reduces the chance of success. I have
to be comfortable about whichever method I choose to deal with the
behaviour. The same consistency and sense of comfort must operate
in dealing with bad language.
not react. Give the bad language no power. Let it pass as another
everyday comment. However this reaction has to come from every person
in the environment for it to be definitely effective.
I have a lot of difficulty with my sons behaviour. When
we take him anywhere he runs away. He takes things from shops. It
is very difficult. He is going to a school for mentally retarded.
There are many children with autism also there. We have meeting
with teachers and parent. I tell the teachers about my
sons problems. His teacher says he does not give problem at school.
He only gives problem at home. Please guide us what we should do.
Our son A is 13 years old and attends a special school. We are concerned
that he does not sit for more than 10 minutes at home to do any activity.
He runs out of the door if it is left open. We have shared this concern
with the school but they said that he never does this there. Can you
It is very good that your sons behaviour is appropriate in the
school environment and that he sits for long periods and does not
run away. Since his behaviour is different at home and you are concerned
about it, I would suggest that you ask the school for suggestions
on dealing with the behaviour at home. We have not seen your son and
do not know him at all. On the other hand his school sees him everyday.
Your child is attending a special school because he has special needs
and since he spends several hours there every week they will know
his behavours well. The school will want to provide a holistic education
so explain to them the situation and ask for guidance.
often, with autistic people, a skill may not be generalised. A skill
learnt at school may not automatically be exhibited at home, and vice
versa. So the skill has to be taught in every environment to help
generalisation. Learning and teaching is not limited to the school
environment alone and As school will be happy to advise for
the home. Ask his teachers what methods helped them deal with As
behaviour at school and ask them for help to adapt the suggestions
for the home.
I may add a couple of points here: Firstly many parents have the feeling
that they are somehow at fault when their child exhibits certain behaviours.
No. Absolutely not. Parents are not born experts in behavioural techniques.
Neither are professionals. Both have to learn. And it is the latter
who must help the former. And actually in many situations parents
naturally know the appropriate approach to take, better than many
we often receive queries about behaviour at home that parents want
to change and which they have been informed does not occur in the
school. Dont drop it there. Pursue it. Ask the school, why?
Why does it not occur in the school. What is different? Though we
are always happy to provide suggestions, those are far more general
because often we do not know the child concerned, and each child is
an individual with distinctive behaviours. In all such situations
we suggest that parents approach the school for guidance first. It
is the right of every parent to ask and the duty of each special needs
school to guide in home management. Most schools are happy to help;
so go ahead and ask.
My daughter hits her little brother, and other members of the family.
She removes her clothes.
To start with, it would be important for you to know a little about
autism, so as to understand the REASONS why your daughter, may be
doing, the things she does. Now to your queries. There are many
times when our children are throwing things around and shouting or
hitting, and then there are times when they are sitting very calmly
and nicely. Most often, we tend to ignore them, when they are quiet,
and yell at them or tell them over and over again to 'stop', when
they are exhibiting unwanted behavior. Now all children want attention.
And if they get attention by kicking, and screaming then they are
definitely, going to do that more. On the other hand, if you can be
focused and aware to catch your child every time she is quiet or calm,
and PRAISE her profusely, but IGNORE her anytime she does something
you do not want, then these unwanted behavior will go away.
is very important to remember to be very consistent and persistent.
Stop saying 'No' to her completely, and make absolutely no comment
about her acts at all even in reference to it later. If you ignore
it a few times and give it attention a few times its not going to
work. Consistency in every environment, by every person is important.
We realize this may be difficult for you at the start. We can assure
you that it will be worth while.
desire to be without clothes, and hitting other children to make them
cry, could also be attention getting behavior. Just be aware to remove
the other child or grandparent, so they are not hurt an ignore her.
These behaviors could also be due to sensory defensiveness. This is
basically a hypersensitivity or lack of sensitivity of the senses
(touch, taste, smell, hearing, sight). There is a possibility that
she is very sensitive to the feel of certain fabrics, against her
skin. Try on different types of fabrics, cottons, terrycots, polyesters
etc., and tight or loose garments, pants or shorts, T-shirts or shirts
and see which one she keeps on. If the reason of her sensitivity is
tactile sensitivity then chances are she will keep on one of the kinds
of garments/fabrics you try on her. If not and the reason is for attention,
then praise every time, you see her with her garments on, and if she
takes them of don't comment. After a few minutes, try to put it on
again. If she puts it on PRAISE big. Keep doing this and there is
every chance she will begin to wear her clothes again. Again you will
need to phase it in - start with only one garment.
inquired about the 'Option Method'. Basically this approach involves
a very accepting, non-judgmental happy attitude, by everyone around
the person with the disability. We believe that autistic people can
and do learn to be happy and content, which in turn helps them to
cope with their disability, particularly if all around them learn
to accept and understand their difficulties.
Integration therapy has been done with some autistic people. Of them,
it has helped some and not helped some. No one can guarantee a positive
change due to AIT at anytime. Right now there is noone in India who
is trained, to perform the therapy. Mrs Saroj Madan was here earlier
with Georgiana. The reason AIT helped Georgiana Stehli so much, was
perhaps because her hearing sensitivity was very high and that was
the main cause of a lot of her autistic behavior. But autism is a
lifelong disability, and though AIT has helped her come so far as
to lead a near normal life, she still has autism. She also still has
other sensitivities such as her acute sense of smell, which she told
us about on her visit here.
Of late S does not like to do anything and keeps pacing and throwing
things. He is especially moody in the evenings. Can you suggest anything
S's phase of not wanting to do anything - you want to stay relaxed
about that. Do not judge yourself as doing things inappropriately.
These phases will keep coming and going. Be happy and avoid giving
him the feeling that you are stressed about it. If he senses stress
in your behaviour, he may use this kind of non-compliance for getting
attention. What you want to do is to just relax, and think how you
can do things differently. For example change teaching numbers into
a physical activity. You could say - 'Let's jump two times in this
circle'( a circle drawn on the floor). Since he likes to pace, join
him in it and while doing it sing for him, Get your other son to join
and let S feel that its okay with you. In fact in the evening give
him control by telling him yourself 'Its time to walk' or pace.
want to be relaxed about Sunny's phase of not wanting to do anything.
Do not judge yourself as doing things inappropriately. These phases
will keep coming and going. Be happy and avoid giving him the feeling
that you are stressed about it. If he senses stress in your manner,
he may use this kind of non-compliance for getting attention. What
you want to do is to just relax, and think how you can do just do
things differently. For example change teaching numbers into a physical
activity. You could say "lets jump two times in this circle"
(a circle you have drawn on the floor). Since he likes to pace join
him in it and while doing it sing for him, get Bunny to join in and
let Sunny feel that it's OK. with you. In fact, in the evenings give
him control by saying yourself, "Its time to walk or pace".
He will soon get out of this phase.
Please give suggestions on improving my son's his behaviour.
As you are aware autism is a behavioural syndrome in which social
and communication skills of a child are impaired. At times Prasanth
may be expressing different feelings in a way that we find inappropriate
i.e. happiness by clapping, stress by babbling or making particular
sounds repeatedly. These are his ways of expressing himself and we
need to respect that. At times these are also ways he has found to
cope with a very confusing and socially demanding world. When we want
him to stop (or we want to 'correct him') we actually want to take
these coping strategies away from him.
social skill that we take for granted is the ability to get another
persons attention. Children with autism do not know how to get attention.
They learn as they grow is that when they are sitting alone or quietly
or doing their own thing, people may pay little or no attention to
them but as soon as they do something like yell or jump or flap, they
get an interesting reaction like a shout or a or a loud 'No. The behaviour
is often discussed at great length and a whole lot of attention and
importance given to it. For most children such behaviours are learned
and reinforced by the reactions they get.
if we want to eliminate these behaviours we want to catch the child
sitting quiet and praise him for that. Completely ignore him when
he is yelling. People in the environment need to be especially aware
not to discuss behaviours in the child's presence because this too
is attention to them.
them with alternatives of behaviour. Most often we tell our children
"Don't yell" or "Stop shouting" or "No! Don't
talk loud". We tell them what not to do but not what to do. So
give them alternatives. "Hands down," "Sit smartly."
And whenever he is behaving as desired we want to praise positive
. " Kept quiet
smart boy!" or "Being gentle when
want to remember that results will not show in a day or even in a
week for some children. But remain persistent and consistent. The
environment in its reactions also needs to be very consistent.
How do you deal with a situation like this: a water bottle is
not available in a public place like the market, hospital etc, and
parents know that the child is not thirsty. He is fond of drinking
water from a bottle; so he snatches or tries to snatch other people's
This is a situation that many families face. If the child is not carrying
a bottle and you are certain that he is not thirsty you can comfortably
and firmly tell him his water is at home, and then wait to get home
to give him water. You do not want to go out of your way to get your
child water as soon as he asks for it especially since you know that
he is not thirsty. Children learn very early to insist, if they know
they will finally get what they want. If they know that making a fuss
does not help, then they learn not to. If on occasion a decision is
made to buy water, you want it to be clear that it is so because you
want to and not because a fuss is being made in public. You want to
tell him something like, "We are going to be out for another
two hours and so we will buy some water today".
the other hand perhaps we do not want to make an assumption about
the child's thirst. It may not always be possible to tell whether
a child is thirsty or not. A child may be genuinely thirsty even when
we believe they should not be just because they may have had something
to drink just before leaving home for instance; especially in the
north of India where the summers are so dehydrating. We want to keep
in mind that different people have different requirements of fluids.
May be your son is genuinely thirsty and therefore tries to remove
other people's water bottles? Due to the impairment in social skills
the child may not see any reason not to take a bottle as long as it
has water, regardless of who it belongs to. Perhaps you could allow/teach
your child to carry a water bottle on outings. When he does reach
for a bottle in public, you want to tell him, "that is that man's
water, this is your water" (pointing to his own bottle) or just
simply, "give the bottle back". Finally and most importantly,
follow your instruction through.
My daughter wears only one or two frocks daily, not turn by turn.
She does not accept changes.
You have mentioned elsewhere too in your letter that your daughter
is not comfortable dealing with changes. You want to, as far as possible,
prepare her beforehand by talking about changes that are to happen.
This will reassure her that things are not out of her control and
help her to accept the changes.
need for sameness might have something to do with her wanting to wear
only the same one or two frocks every time. It might also be a sensory
thing in the sense that the texture of the old well-washed garment
might be what she finds acceptable.
could try keeping two additional frocks in her cupboard. Talk to her
about the new frocks: that they belong to her; that she would look
very smart wearing them. Prepare her with the repetitions. Then one
day ensure that when one set of her favourite clothes are in the wash
she is wearing the other. When it is time to change, just tell her
in a matter-of-fact tone that the clothes she has on will have to
go for a wash and would only be ready for wear the next day. Then
ask her to choose between her other two new frocks. There is a greater
possibility that she would consent to wear one of the others if she
were prepared like this.
having a choice of two frocks increases the possibility of her wanting
to choose one to wear. Once she does wear her new frock remember to
acknowledge this change and tell her how splendid she looks.
My daughter, age 8, generally does not want to come back from
outside, other people's homes, friend's relatives or even from the
market. She always cries, says, "don't want to go home, Stay
outside". Any suggestions/ advise?
One of the reasons for this could be that she is really enjoying
herself and does not want to go home, another could be that she does
not get to go out enough. Either way, preparing her before hand is
essential to reduce this behaviour. Before you leave for the outing,
tell her where you are going, how long you will be there and where
you will go next. Again begin to prepare her to return home about
15 minutes before you actually do so. While you are at the relatives
home for instance, she could be told," We will finish our tea
and then leave" or "You finish your game and then.... "
Or if you are in the market, "We will buy the bread and dahi
and then go home".
another reason could be that she is not able to handle sudden changes.
In our (social) lives, we do tend to make a lot of sudden decisions
and chop and change our plans often. For example you are at a friends
home and you get up to leave. Your friend says 'No, please sit for
another ten minutes'. The ten minutes usually stretches for an extra
five, and within that 1/2 hour the plan has changed three times, i.e.
the expected thing has not happened. People with autism need some
amount of predictability especially in unstructured social situations
and preparing them before hand and sticking to the plan as far as
possible really helps.
My son has been diagnosed with autism at Hyderabad. Right now he has
the feature of avoiding eye contact, and not responding to his name.
The behaviours you have queries about are common difficulties
with children having Autism. It will be good to start working on these
Contact: Making an eye contact can be very painful or just difficult
for many persons with autism. However we can work on increasing eye
contact. Sit with the child in such a way that your eyes are at his
eye level. For example place your son on a chair while the adult sits
on a low stool or cushion on the floor. Interact with him by doing
things that he likes like singing, playing with a favoured toy while
holding it between your and his eyes. Then for a sudden moment stop
singing or remove the toy from your joint line of vision. There is
a very good chance that this makes the child look at you. The moment
he does so praise him big or acknowledge big saying something specific
like "(daughter's name) gave me a look! Great looking!"
If we make ourselves very animated, very energetic, the child will
be more interested in us and this too will help increase eye contact.
responding to name: Many a time our children 'hear' their names being
called but have not learnt how to give a response, that is the social
response, that means looking at the person who is calling. Start teaching
the child to do so when you are in the same room. Call his name very
clearly and slowly. Wait for a few seconds. If you get a look, praise
the child. If not call out again and this time another person can
gently turn the child's head to your direction.
have some kind of consequence for his response. Turning his head to
look at you must never be a meaningless exercise. So when he looks
at you, praise him and give him either a material reward like a food
item, a favourite toy, or anything the child favours, or a social
reward like a praise or a hug.
you call your child try to vary your tone for example when calling
out his name use a musical tone, another time a squeaky voice, or
a whisper on another occasion. This will make him look at you with
surprise! And of course remember to praise him once he looks at you.
How do I improve G's eye-contact and response to his name?
To build on his eye-contact one of the things that you can do while
working with him is to sit opposite him preferably at a lower level
so he can look at you easily. Make yourself exciting and keep your
expression animated and do things that are exciting for him, like
blowing bubbles, tickling, playing with shiny wrappers. Remember to
maintain the three Es - Energy, Excitement, and Enthusiasm, while
working with him. Each time G looks at you praise him big and specific,
"Shabash, look diya" or "Good Looking, G." When
giving him an instruction if G is not looking at you get into his
line of vision and then talk to him. Avoid turning his face physically
to look at you
that can be perceived as force by him. If G is
playing with a favoured toy or object pick up a similar one and do
whatever he is doing. The chances of that catching his eye are pretty
high. Always praise for a look even if it is for a brief second.
you call his name, pause briefly for him to respond. It takes him
a while to hear, process the information and then find the correct
response. At times, G will respond quicker and at other times slower.
This may happen because his focus is on something else. Vary your
tone, request rather than command, whisper or sing, use squeaky and
deep voices to get his attention.
I am working in a special school as a special teacher. I have
a student who is autistic. He is 22 years old. He has little bit of
eye contact. He can listen, understand and obeys sometimes and does
some type of sounds. I want to cultivate eye contact and slowly train
him. Please give me hints or papers or something so that I can cultivate
eye contact as earlyas possible for my student.
A. The young man you have written about, is he a new student
at the school? Twenty two seems a bit late to start intervention.
However, no age is too late! In helping the student the one important
point you want to keep in mind is that you do not use force to teach.
Force can mislead with short term gains but is totally ineffectual
for long term learning apart from being a violation of the disabled
on this, to improve eye contact you do not force the person to look
at you. A few things you can do are:
1. Sit at a level that is slightly lower than the student so that
you actually make it easier for him to make contact with your eyes.
2. When presenting something to him, like handing him a pen/pencil,
hold the object at your combined eye level. What I mean is, if there
were a straight line from your eye to his, hold the object on this
line of gaze. This will create an opportunity for him to inadvertently
look into your eyes when reaching for or looking at the object.
3. If the student is interested in an object, bring your face, and
particularly eyes, within the line of gaze that is an extension of
the line from his eye to the object of interest.
4. Where possible hold the object of interest up between your eyes
as suggested above.
5. When making a request or giving an instruction, take the student's
name, give a brief pause, and then complete the instruction. Try and
lower yourself within eye gaze when doing this.
6. Whenever you get a look from the student, no matter how brief,
be excited and acknowledge. We have to be really and genuinely excited
in order for our true feelings to be communicated to the student with
enough intensity in order to really enthuse him.
7. Most importantly, we want to keep in mind that the student will
not improve eye contact because we want him to do so. Ultimately he
himself must want to look in order for the strategy to succeed.
that the student is 22, perhaps you want to focus on teaching him
to work independently and learn vocational skills. Perhaps he is doing
I am writing from Canada for a friend of mine. Her boyfriend has two
autistic children and they look for some kind of information on how
to teach them to put their shoes correctly on the left and right feet.
If you have any kind of written instructions that may help them teach
the children it would be very appreciated.
Ask your friend to put a sticker on the same foot of each pair. For
instance a Mickey Mouse on the right shoe of each pair. If this does
not work then try the following. Take a large sheet of paper and outline
her daughter's feet on them. Next to the outline of one foot, say
the right foot, place a small sticker of a Mickey Mouse or a red star.
Put an identical sticker on all the right shoes of every pair. When
she wears her shoe, place this paper on the floor and have her sit
with her feet "matched" to the outline of her feet on the
sheet, and then put the shoe on "matching" the stickers.
Slowly reduce the size of the sticker and finally remove completely.
Is it possible to teach behaviour control like toilet training, speech
and language development through audio visual approach (VCR) or through
computers? Do you have such video cassettes or discs for a child with
autistic features and no speech so she could be taught to indicate
desire for toilet?
You have asked an interesting question viz. - is it possible to teach
behaviour control, toileting as well as speech and language through
the use of videocassettes.
you are aware, most persons with autism have styles of learning that
are somewhat different from the non-autistic population. Often times
they do not learn social and communicative behaviour through imitation
effective method of teaching behaviours to individuals with autism
is through specific responses to specific behaviours.
am not clear from your letter whether you want video cassettes for
use with the child, or by the parents. Our library has a video cassette
called: "A family's visit". The cassette is of a BBC program
about a family that in part illustrates a method of dealing with some
basic behaviours such a "tantrumming". We are not allowed
to make a copy of it, but it can be watched in the library. You may
be able to obtain a copy from the Option Institute.
a video to teach communication to a non-verbal child I want to stress
that it is crucial to work on developing the child's receptive and
expressive communication skills regardless of whether a child has
speech or not. In addition there are alternative modes of communication
that may be taught.
instance there is a methodology called Picture Exchange Communication
System (PECS). Using PECS a child is taught to use word or picture
'cards' in order to communicate. Some children also use sign language,
mostly makaton - a sign language developed in the U.K. Using modes
of communication alternate to speech reinforces a child's communication
skills and increases the possibility of the development of speech.
Our library has a copy of the PECS teaching cassette. A copy of this
may be obtained from the Delaware Autistic Program USA.
are not aware of any cassettes for teaching toilet training. However,
toilet skills can be taught with consistency and persistence. Please
refer to Toilet Training: Vol IV No 3 (1997) and Learning to Wash
after a Toilet Job: Vol VI No 1 (1999) of Autism Network.
My son cannot wear his clothes by himself, but can remove them very
easily. If he gets angry he throws things around him, and often bangs
the doors and window panes, or bangs his head on the door or window
pane. Please give suggestions about his regular activities.
Since your son is toilet-trained, and can undress himself, maybe you
could now teach him to dress himself and bathe himself. You
could use the method of backward chaining. Start with the easiest
garment to put on, like a pair of shorts. You help both his feet into
the pants legs, and then help him to pull it up hand on hand. Your
son seems to be able to follow instructions, so you could also put
it on half-way and then give him short clean instructions "Pull
up", "Higher", AND DON'T FORGET TO PRAISE!!
a similar manner, you could teach him to bathe himself. It is summer
now, and this is a good time to start. In the beginning, you will
have to go through the initial bathing process and leave the last
couple of mugs for him to pour. Again break down instructions into
a short clear step by step process. "Dip mug", "Lift
up", "Pour". The pouring may have to be done hand on
hand, and usually means guiding and not doing it for him or forcing
him into compliance.
far as his behavior is concerned - you want to IGNORE unwanted behavior
and PRAISE BIG - desired behaviors. So if he is angry and throws things,
you want to a)IGNORE IT; b)Remove anything breakable from sight
and c) Remove him to another room. This must be done very, very comfortably,
with as little attention and verbal input as possible.
haven't mentioned whether he goes t school or not. But you could prepare
a daily schedule for him anyway. Specify times and activities, keeping
in mind, the various things he has to do, during the day, E.g. Wake
Up; Brush Teeth; Bathe; Dress; Breakfast; School etc. If he
does not read, you could use small pictures to represent each activity
like drawing a toothbrush, plate shirt etc. This will help him to
feel more organized and comfortable. As each activity is completed,
you can take it off the chart and tick off the word.
'Developing Appropriate Eating Habits' by Sandra Dawson is a useful
article. My son, Abhilash, 9 years old, used to eat only curd
and rice until two years back. Now he eats a variety of foods
like chappatis, fish, chicken, etc. But the problem is that
he just swallows without chewing. What he swallows is mostly
preparations like idli, dosa, rice. But he chews chapatis, chicken,
biscuits, wafers, nuts, etc. and eats them well. But he never
chews rice, idli or dosa even when we tell him many times. When
insisted upon he will just show an exaggerated chewing action and
swallow it. Our problem is how to make him chew all his food
before swallowing. Also he is particularly fond of eating salt,
coffee powder and sugar, tea leaves and sugar. Often when we
are watching TV or taking a nap he raids the kitchen for these.
I do hope Ms. Dawson can suggest some solutions.
I am glad you found the article on Eating Habits useful. These
are suggestions that have been tried and have worked with a vast majority
of children and young adults. It's great to hear that Abhilash
is now eating all kinds of food and that is something that you have
probably worked at and that is commendable. I would just like
to comment on a couple of things you have mentioned that are bothering
a) He chews chapatis, wafers, etc. but only swallows idlis,
b) When insisted upon he will make an exaggerated chewing motion
and then swallow.
begin with, maybe you want to sit back and evaluate objectively why
it bothers you. If, despite swallowing the food, he does not
have any digestive difficulties, then the best alternative would be
to accept that as "just something he does." The texture
of the foods mentioned are clearly different and it is possible that
Abhilash feels comfortable swallowing rather than chewing some of
these. This could be because of a sensory sensitivity.
It might also be a coping behaviour. By insisting on chewing
you are giving the behaviour unnecessary attention and maybe creating
a certain amount of stress, which is best avoided.
times children adopt habits that are coping strategies but they turn
into attention getting behaviour when given too much attention.
So maybe you want to just let the swallowing be. If you do,
be consistent about it. Also, eating all kinds of food is a
fairly recent change and you do not want him to lose this behaviour,
which he might if he feels forced. A lot of autistic people
often favour unusual combinations of eatables. The plain coffee
powder and sugar, etc. seems like a good example.
you want him to stop,
a) IGNORE it if you see him with it. (ignore ALL undesired behaviour
and PRAISE all desired behaviour.)
b) Put a lock on the cabinet in which these items are kept.
If he communicates his wants, you can have one specific time in the
day when you give him a bit of the desired item. (Salt and sugar may
do no harm, though coffee or tea may not be a good idea). At
all other times you just tell him once, "Time to eat salt is
in the morning", (or whatever time you have decided on.) and
do not pay any attention to a protest.
My daughter often sleeps very late or wakes up in the middle of
the night and cries. During the day, she goes or is taken to the toilet
and she does it there, but wets her bed most nights. Can you suggest
Very often children with Autism, have irregular, odd and disturbed
sleep patterns. They may sleep less than usual, get easily disturbed,
or may sleep at odd hours. We want to always remember that as parents
our own health and energy is important and necessary as we are the
ones who have to look after the child. So, even if A does not sleep
enough at night and remains awake arrange things in such a way that
she is safe on her own and you can sleep. The easiest thing is to
structure the bedroom. This means that you remove things that A might
want to explore but need supervision to do so: put away breakables,
fill in electrical points, bolt the room from the inside so she cannot
go out, and lock/ bolt any attached rooms that are there. Just make
the room child friendly, as you would do for any other young child.
If she tries to get attention by crying, screaming, pulling hair or
pulling you - just ignore it. Often when a child cries at night she
gets attention, and learns from this experience the she can cry and
get attention whenever she wants and that there is also an exciting
hu-ha every time she wakes up at night. Ignoring a child during this
time, (even a regular child) works well, if it is done consistently
and persistently. Initially it may be a little difficult as when you
start ignoring A may do more things to wake you, but continue to ignore
reason for lack of sleep could be her sensitivity to sounds. A child
may be distracted by or bothered by certain sounds that are of no
consequence to us. That's something you want to consider as well.
times when a child wets the bed, and we do not know how to cope with
it, it is very natural to get stressed out by that. We may react and
discuss it during the day, as a big deal and often this discussion
is in the presence of he child. We want to remember that this child
is enjoying the attention from all the discussion and will do it even
more to get that attention. Frequent wetting is often an issue of
control. We can force the child to do everything else and control
him completely in almost all areas except for his toileting. He is
the only one who can decide when and where to relieve himself. Hence,
we would suggest that you follow a toilet schedule, praise and ignore
appropriately as we have suggested in our toilet training information
and stay relaxed about the accidents. Rest assured that it would reduce
and go away in time. The better you can ignore the faster the unwanted
bed-wetting will reduce.
and School Related
My son is eight years old. He can do activities like colouring, writing
numbers up to 100, copying words and other activities like peeling
potatoes and putting toys by after playing. The problem I am facing
is that even though he can do all this, he mostly leaves the task
without completing it and has to be reminded to get back and finish
it. I want him to learn to do things completely on his own.
Many children with autism have difficult work behaviours. They may
start a task, walk away in between and may or may not return to complete
it in piecemeal fashion. This happens a lot because the child may
not understand the concept of “finish’ and therefore may
take breaks even though the task is not too lengthy or challenging.
It is therefore necessary often to teach the concept of ‘finish.’
To do this there are a few things we can do.
introduce the word ‘finish’ whenever he finishes an activity
that is a part of his routine. When he is done eating his food, or
drinking milk, we can say ‘Finished eating’ or ‘Milk
finished.’ In time, we slowly teach him what to do with the
plate, or glass, after eating or drinking is done. When doing table-top
work we can have a designated area as the finished area. The finished
area could be a flat tray, a mat, a box, or an outline traced on the
table, preferably to the right side of the child. When the work is
done we can say ‘finished,’ and guide him to place his
work (notebook, puzzle, beading, blocks, or whatever has been the
work) in the designated finished area.
child know through visual and verbal clarity what is expected from
him and what shall happen next when the work finishes. A reinforcer
at the end of the work can be a great motivation to complete the task.
Another suggestion is to be very sure of giving him an independent
task only when you are completely certain that he can accomplish it
on his own. The duration of the work also needs to be taken into account.
The child’s attention span during independent work would decide
how much work could be given. Sensory stimuli that can be distracting
also needs to be addressed.
My daughter aged five has been diagnosed with autism. We are trying
to get our daughter admitted in an integrated school in Jalandhar,
Punjab. The Principal wants to observe my daughter for a few days
in the school before taking any decision regarding admission. We have
1. Is it appropriate to decide by observing the child for a few days?
2. What should be the response of teachers/ students towards our daughter
as she sometimes starts laughing?
3. How shall the teacher explain to other students regarding above
mentioned behaviour as the students get disturbed?
It is good to know that your daughter has got an opportunity
for integration in a mainstream school with an opportunity for learning
along with her typically developing peers. I am sure the Principal
has good reasons for wanting to observe your daughter before taking
a decision. As far as we know, the school you refer to also has a
section for children with special needs and different learning styles.
Therefore the observation period is perhaps to help the school assess
how best to accommodate your daughter in the school so that her needs
are met. Regarding your daughters laughing without obvious reason
we need to first assess the behaviour. Why does she do it? What happens
when she laughs? What do people around her do when it happens? Only
after we assess all this we can work out a behavior management strategy.
Laughing can be an inappropriate emotional response, sometimes children
may laugh in order to cope with a difficult or a new social situation.
Or they may laugh to gain the attention of others, hence the need
for an assessment. Once you understand the function of the behaviour
you would be better able to help her to control the behaviour, indulge
in it at specific times, learn some alternative behaviours.
sensitizing other children and the teachers - the children in her
class would be very young and therefore would be accepting of differences.
If the teachers are sensitive, so will the children be. Children pick
up cues from adults on how to behave with others. From what we know
of the school, we believe they already have taken in a few children
with Autism and the teachers would be sensitive. Please do not worry
about your daughters behaviors beforehand. Also that the school is
not making any commitments without observation is perhaps because
they are still very new to this, and want to be sure their staff have
the skills to help your daughter. The very fact that this school in
Jalandhar is making an effort at inclusion is commendable. In case
the school feels that she can join the special needs section and not
the main school, you could always ask them for the reason. Not as
a confrontational issue, but to help you understand what you could
work on to support your daughter’s inclusion. We want to work
towards inclusion for all our children. To enable successful inclusion
we have to understand our child’s strengths and emerging skills,
and work on these as well as the weaknesses. This can be facilitated
by a functional assessment by an expert in autism. So please contact
a good professional in Jalandhar for a functional assessment.
I am a physiotherapist working for UNICEF in Maldives. I need
information regarding the management of my client having autism with
attention deficit hyperactive disorder. The child is seven years old
and has some behavioral problems such as poor eye-to-eye contact,
refusal to participate in regular activities at home or for schoolwork,
and breaking rules. But he is very interested in operating the computer
and plays for nearly three to four hours on it. I would be very thankful
if you give us information on any place where we can get CDs through
which he can learn to improve his academic skills, communication skills
and social skills.
A. From what you mention it appears that the child's family and
therapists would need to apply consistent behavioural techniques and
initially work towards compliance training. Along with this, one would
need to make the child's daily routine (or other activities that he
resists) more motivating. One would need to understand the principles
of behaviour modification, particularly that of reinforcement (rewarding
appropriate behaviour) and incorporate these methods into his everyday
life. You may also like to try structuring his everyday routine and
make what you expect of him, in terms of activities, visually clear.
It is also essential that you use simple, clear instructions or language
when talking to the child.
unusual for a child to get a clinical diagnosis of both Autism and
ADHD; you may like to revisit this diagnosis. You do not mention whether
the child is on any medication at all for the ADHD. If the hyperactivity
and inattention is simply due to the Autism, there are ways to teach
the child through small achievable steps, and motivate the child to
absolutely right to try and use things that the child already finds
interesting, such as the computer. While there are a number of CDs
available to teach pre-academic and academic skills, there are none
that we know of that can teach children social or communicative skills
directly. You might find it useful to teach the child alternative
and augmentative methods of communication (you do not mention whether
the child uses any words meaningfully), and other techniques to teach
social skills (eg social stories, depending on what the child needs).
There are a number of kinds of therapies for children on the Autism
Spectrum; one would need to choose those that would benefit your child
most. Aside from this, you would want to build on the child's strengths
- you mention that he enjoys play. Perhaps this could be extended
to more meaningful, functional or make-belief play.
and organize a number of workshops through the year that might interest
you or your client's family.
I work in The Concerned for Working Children. We are a private NGO
working to eradicate child labour through their participation and
realisation of their rights. I have been through your website - it
is extremely informative, comprehensive and up-to-date. I am doing
a research project on out-of-school children - reasons and factors
deterring them from entering the formal school system. I am doing
a section on children with disabilities. Can autistic children be
successfully integrated into the formal school system? A similar question
was posted in your 'Autism Q&A' section where you said a few schools
have managed to integrate autistic children. I was wondering how this
was done. What would be the required changes in policy to make this
happen in terms of training of teachers, infrastructure, learning
aids, methodology, etc. How would a government school integrate an
Your query would require a very long answer. Suffice to say that yes
some children with autism can be mainstreamed. Some require no support
and get by. Others do require support - often more social support
rather than intellectual since they have difficulty in negotiating
social rules. The best way to include children with autism is teacher
sensitisation and training: some teachers find it very hard allowing
for adaptations for a child with autism. Whereas with most other disabilities
you can 'see' what the difficulties are, with autism it is not so
obvious, and since the difficulties are social, teachers are often
resistant to making adaptations. One of the concrete learning aids
many children with autism would benefit from is computers; Other than
some change in methodology, and sensitive teachers who are willing
to make adaptations for the child. With adequate support government
schools too can include children with autism. Of course it goes without
saying that a student body that is by and large sensitized is essential
for successful inclusion.
My daughter P has difficulty connecting with people. We have been
advised that she be put in a school where there is a Neurologist,
Psychiatrist, Clinical Psychologist, Speech Therapist, play school
and special school meant for autistic child.
working in Airports Authority of India and presently posted at Guwahati
with all India transferable service. I will be transferred out from
Guwahati within one or two months. I am a Bengali with mother tongue
Bengali but not settled in any one place due to the nature of my service.
I am in a confused state to decide my next posting either at Delhi
or Kolkata. Except that in Kolkata my mother tongue will be used,
Delhi will be better in all other respects including facilities available.
I will be thankful if you kindly advice me for the following:
1. Is there any play school and integrated/ special school specially
for autism run by your organisation or by others at Kolkata.
2. Whether such a school is available near the International Airport,
3. Will Delhi or Kolkata be better for my daughter's treatment/ training/
schooling for her overall development?
are a few integrated schools and special needs schools for the child
with autism at Kolkata. Some schools that have services specifically
for autism are Reach, Pradeep, and Autism Society West Bengal. There
are a number of others that are meant for children with special needs
but also take in children with autism.
For more information please contact Autism Society
West Bengal at: email@example.com
Airport in New Delhi is outside town. The school closest to the airport
is the Air Force Golden Jubilee in Dhaula Kuan. It is a mainstream
school with a special needs section.
difficult question to answer is whether Delhi or Kolkata will be better
for your daughter. The answer depends on a number of variables. The
quality of the special education that you are able to access, the
extended family support that you have, how well the immediate family
viz parents are able to educate themselves about autism, and so on.
While the advice that P be put in a setup which has the services of
a Neurologist, Psychiatrist, Clinical Psychologist, Speech Therapist,
as well as a play school and special school meant for the autistic
child is perfectly valid, it is an utopian situation that I doubt
exists anywhere in India. I may be wrong of course. However while
most schools will not have in-house neurologists and psychiatrists
many have consultant neurologists and psychiatrists. However there
are a few trained setups in the country where though you may not have
all of these professionals available, they have excellent therapists
and would provide you with holistic training for P.
the Autism Network Journal: April 2003, Vol. X, No.1, an article named
"My son Kartik" was published where Mr. Chandrashekharan
described some features and behaviour of his autistic child Kartik.
Many of these features and behaviour is similar to that of our son
an eight year old autistic boy. His sitting habit and attention span
is very poor. He also sometimes cries without any reason. But his
receptive language is very good and up to the level. He can recognise
almost all the household articles either real or in pictures in books
or in any other form. In academic side also he is quite developed.
above mentioned article Mr. Chandrashekharan wrote that his son is
taught Science, Math, Social Studies, and English at Open Door School.
So if you can send us the curriculum of Kartik then we can adopt this
and can teach our son.
We are happy to learn that Mr. Chandrashekharan's article was encouraging
for you and that you want to help your son through the same experiences.
However we feel that sending Kartik's syllabus or individualised education
plan may not be very useful because every child with autism is different.
The same concepts have to be taught to a group of children in the
same class keeping each child's learning style in view. In addition,
the topics to be taught are based on the child's previous as well
as current level of knowledge. Along with this it is equally important
to be aware of how to teach these topics, what important learning
outcomes need to be focussed on and how to generalize the knowledge.
entire process requires child specific planning and implementation
we suggest that if possible you visit us along with S. Otherwise please
send us a detailed mail about S's current level and thereafter we
shall try and give some suggestions.
I am sending F to a new school since July 2002 which is near my house.
In his school they put a lot of stress on writing exercises. F does
not like writing, at the most he scribbles and puts the pen down as
soon as he can. Is he dyslexic? What am I supposed to do?
the teachers insist I teach F reading capital and small letters before
teaching him to sight-read. Otherwise they say he won't progress much
further in learning to read. I have tried to explain to them the method
I use i.e. using F's strength at sight-reading but to no avail. What
should I do, please guide me.
Many children with autism have difficulties with various motor functions.
From our experience we find that many have a difficulty writing, though
they may be quite willing to type on a computer.
situation might be such. On the other hand from what you say he is
not averse to using a pen. Maybe you could try and keep writing sessions
brief and pleasurable, following it up with a reinforcing activity.
Also make sure he sees and understands clearly what and how much he
is expected to do. So may be you draw a flower and a flower pot below
and F has to join the two. So it is clear what he has to do. Then
again maybe you have three such sets drawn and ready so he knows 'how
at the conclusion of the activity he could know that he would get
to play with his favourite toy or get to do something that he really
enjoys. In addition maybe he could do exercises on a vertical writing
you cannot get the teachers to understand what you want them to do
with F and why, maybe you just let it be and teach him sight-reading
at home. When you cannot change something that you have to live with,
do the best you can. Since explaining is not helping, use your energies
to teaching F rather than getting frustrated about what you cannot
Though my son's handwriting is poor, when he is in a good mood he
is able to write up to one or two pages himself. That is not permanent
because he is often not in the mood. Shall I introduce a computer
or typewriter instead of writing? Or shall I make him write in notebooks
when he is in the mood to write? His school is willing to introduce
a typewriter. Also, my son, (though otherwise able) is not able to
tie his shoe-lace and does not show interest in doing it also. Can
you give me some exercise to improve his fine motor co-ordination?
It is good to know that your son can write up to two pages on his
own. As you might be aware, many children with autism have difficulty
in holding a pencil with a firm grasp and therefore their handwriting
may not be too good.
is great that his school has agreed to allow him to use a typewriter.
But you also need to continue encouraging him to write by hand also.
Whenever he has written work that is not too lengthy encourage him
to use his hands and reinforce the effort. Some exercises you can
do with him:
o Use his fingers in a variety of activities like finger painting,
assembling nuts and bolts, zipping-unzipping bags, dialing the telephone.
o Hold his wrist very tight so as to exert pressure on his fingertips.
Do this a few times in the day.
o Play with kneaded wheat flour or play dough.
o For teaching him to tie his shoe lace try backward chaining. That
is you make the loops and let your son do the last step, namely just
pull the lace to tighten the final knot Gradually increase his role
in the activity.
I am the parent of an autistic boy diagnosed as high functional.
He is now 13 years old. He is attending a normal school apart from
getting training in National Institute of Mental Health Secunderabad.
Now he is able to understand the basics in science, maths, and social
studies. His writing is very poor. In spite of being given regular
writing practice, his writing has not improved. I request you to give
suggestions to improve his writing. He is verbally good. He is on
A. It is good to learn that you have, with support from NIMH,
succeeded in helping your son continue in a mainstream school. It
is so important that we be able to include our children, yet it is
so often hard to find schools that are willing to do so except with
the very able ones.
his writing, this is one area that many high functioning ASD children
have difficulty with, along with areas like joint attention, gross
motor movements, and social interaction. You could try some of the
following exercises: writing with a paintbrush on a paper stuck to
a wall, writing with a stick on sand, and of course practice with
handwriting exercise books.
his writing is nearly illegible, and there is not much improvement,
then perhaps you can persuade his school and if they are willing,
to allow him to use a computer. Sometimes schools are unwilling to
permit children with autism to use computers. If that is the case
you will want to advocate for him. When schools can incorporate ramps
and other assistive devices for children with CP, Braille for the
visually impaired, why not computers for children with Autism?
to his school that the computer for him is an assistive device, and
as necessary as a ramp for a child with CP.
My son was going to a normal play school till last session and
now he would be going to a special school. However, we are not very
sure how much support the school will provide as the school mainly
deals with children with Mental Retardation. We are considering moving
to the US.
I am curious as to why you took A out of the regular school. Did the
school ask A to be removed? Till such time as you can take a decision
to move to the US or not, you want A to continue at a regular school
that is comfortable around him, while you continue working with him
at home. This is just in case you decide not to relocate to the US.
you yourself have noted, the special school that he goes to is not
specially trained to deal with him anyway. So where is the advantage
of putting him there. On the other hand if the regular school is comfortable
having him then there is always the possibility of his continuing
there. Getting a child into a mainstream school in India once he is
older is always harder.
we are told by parents that as soon as their child received a diagnosis
they removed him from a mainsream school and put him in a special
school. Just because a school is called 'special' it does not automatically
become special. A special school is a school that is equipped to help
special needs children. If a special school is not equipped to deal
with your child then it makes no difference.
realise of course that it is possible that you had no option but to
take your son out.
My four-year-old S had learnt basic number concepts at school.
He can "give one biscuit," "take two spoons,"
and so on correctly. I have recently started taking him to a speech
therapist. The speech therapist says it is too early for S to be doing
numbers. He wants to teach him to recognise his mother and father
and other family members. He does not want any focus to be given to
teaching numbers or other such skills at this stage.
How do we decide what a child can now learn? Taking into account his
age, his ability, and his potential. S's school had made an assessment
and considered him able to start on various cognitive skills. It woud
appear they are on track since S has been able to learn number concepts
and not merely numbers by rote. Why would you want to stop this process?
According to S's assessment as well as going by your understanding,
your son recognises all family members without any difficulty: so
why does this skill have to be taught now.
things we want to keep in mind: One is that in teaching our children
we want to help stretch their minds, not 'teach' things that are below
their ability level or which they already know. Second is that we
always want to query what is being taught: just because someone says,
"Do this" we dont not want to blindly comply. So maybe you
want to ask S's speech therapist "Why?" I am sure a discussion
will help clarify goals for both the speech therapist and you, S's
Please give suggestions on difficulty in teaching, particularly
Children with autism have very good rote memory. They learn songs,
read sentences or even a history or geography lesson by rote without
quite understanding the meaning. In junior classes rote memory works
because a child will be asked to write the answers to
2+3=___ or 4-2=___
the child goes to senior class, this no longer works. He begins to
have difficulty, because his concepts were not clear to start with
and there is a lot more use of language such as problem sums that
need an application of language to figure out.
Help strengthen his number concepts by using real objects. Ask him
to pick 1, put 1 (in containers), give 1. Similarly teach other numbers.
Make teaching and learning as functional as possible. This means that
you will have make everything very practical and related to daily
life. "Give two biscuits to daddy" or "Bring five spoons
from the kitchen."
Reading more about autism will also help you figure out new ways of
teaching. You could also give his teachers some reading material on
My son D is born blind and has severe autistic tendencies. There
is hardly any material or information available on blind children
with autism. Only recently National Association for the Blind (NAB)
Started a programme to help children like D. This is a home-based
still at the experimental stage.
mobility is good and he has developed good sense of touch and smell.
He performs daily chores himself. He has a good memory, but his attention
span is very short. Sometimes he throws a severe tantrum and sometimes
he is very euphoric. His social awareness is minimal. Though his speech
has improved over a period of time, his communication skill is undeveloped.
How can we deal with his handicap?
It's great to see that the NAB has started a program for children
like D, even if it's at an experimental stage. The main areas we want
to work on are communication and socialization with D. Here are a
few things we could do.
Speak slowly and clearly. It is important for him to have the complete
and accurate sound. That will help him to express what he wants to
in a similar way, in other words, clearly. Many time children do not
respond verbally because though they can understand what is being
said they are not equipped with the words that will help them to respond.
Give clear instructions. Know exactly what you want D. to do and make
your instructions specific.
Sometimes you might need to break instructions down to simpler steps
depending on how focussed he is. For example: You are in a market
place and you are telling him to put back a box that has accidentally
fallen down. He does not respond. Break down the instructions into
steps. "Bend down." "Feel the Box." "Pick
up box." "Keep it on the shelf here"
the place where it is supposed to go.
Another reason for non-focus would be that children with Autism have
certain sensory sensitivities. For instance, if you and I were having
a conversation in a room, apart from us talking to each other, there
are other sounds and noises, say, the traffic outside, the fan, even
the movement of someone around. But, during the conversation, we choose
to filter out what we don't want i.e. sounds and noises, and focus
in on the conversation we are having. Children with Autism have a
difficulty in filtering sensory information. Being clear and slow
in our instruction to the child goes a long way in helping them to
respond more often.
Also we want to inform our child about changes, for instance, if we
are going to visit someone or even going out of station, we want to
inform and prepare our child before hand. Tell them, "Today we
are going to Khanna Uncles place for tea for two hours, we want to
life we all want to control our environment, we do this through communication.
Children with autism also have the same want, but because of their
communication disability are unable to come up to us and say it. It
is because of this lack of control that we often come across unwanted
behaviour or "severe tantrum". Since we know this, a great
way to work around this with your child is to give him choices- realistic
ones. We want to follow through with the choices we give our child,
example, if we as a family are going out, then giving my child a choice
like, "Do you want to go with us or stay at home," (when
everyone in the house has decided to go) would be unrealistic. When
we are giving a choice to our children we most definitely want to
stick to it. A realistic choice would be "Do you want to wear
your sandals or your shoes" or you could say, "Do you want
to go with Mama or with Papa?
way of dealing with this is by helping him to understand what to do
with his time. We want to inform our child about what to do? How much
to do? When will it finish? After finishing then what? Giving structure
to the child would be most ideal. The first thing that structure does
is it helps the child understand his environment. When he understands
his environment, he learns better. Structure also in the long run
provides independence, because our child learns what to do and when
without being told. We could structure play, work, or any other activity
that the child may be involved with.
you were to visit Washington. D.C. and had absolutely no clue about
the place, what would you do? Wouldn't a map make it easy for you,
rather than you getting confused about what to do? Structure for the
Autistic child is just like that map for you.
his time by providing a schedule to follow
A schedule tells the child what to do and what to do next? It could
be a written or picture schedule. Since D is visually impaired an
object schedule would perhaps work best.
a rack or shelf accessible to him, with a basket below it or just
next to it. In the sections of the rack put the things you want D
to do. For example, in the first shelf have a ball (indicating play),
second shelf have a cassette indicating that you would want him to
listen to music, in the third shelf have a plate and spoon (indicating
to go to table for food). The idea is for him to follow either a top
to bottom or left to right method of picking things up that will cue
him into what to do. D begins by going to the shelf and picking up
the object on the top shelf. He does the activity. After finishing,
D comes back and puts the object into the basket and then carries
on to the next shelf, e.g. After playing with the ball, go to the
shelf, put the ball into the basket, take the cassette and go listen
to music. D wants to be told how much to do ( one cassette completely)and
when the activity will finish( when both sides have finished playing).
This gives completeness to a whole process. D will get the message,
"I FINISH THIS, THEN I GO TO THE NEXT STEP".
we want to work with the child and give him simple and clear verbal
instructions, slowly fading our verbal prompts. For instance, "
D lets check schedule, (take him to the shelf). When you are at the
shelf, move his hands through the shelf and say, "D will play
with ball first (let D touch ball), do this activity (touch the tape),
then have lunch (touch plate and spoon)". First, D will play
with ball for 5 minutes, then go check his schedule. Initially play
with him, after 5 minutes are up (to give D a clue you could set an
alarm clock for the 5 min duration. When the alarm rings say, "
Playing with ball finish, time to check schedule". Go to the
shelf, "Put ball in basket, check schedule (touch activity tray)
and say, "activity time", take him to the area you want
him to do the activity and repeat the process as mentioned earlier.
It is best if D has a fixed areas to work, relax, eat, sleep etc..
This schedule could be changed as and when you want, with what you
want -depending on the day. As you are aware children with autism
have a need for routine and sameness and a need for control is always
there as mentioned earlier. A schedule works around that, it gives
our child a structure to follow and us the control to get what we
want the child to do.
we do activities with D we want to have excitement and energy in our
voice. We want to present our activity in such a fashion that D would
want to do it. But in all this we want to be clear and concise. Choose
your words, formulate your sentences before speaking to D, this way
you have D understanding you and knowing what to do next.
We will be sending you a few notes on teaching tips and how to work
in structure: where you are asked to work with cards or picture, use
I work with a child who is developmentally delayed, with autistic
tendancies. He has been biting other adults the children and me. Do
you have any suggestions on how to deal with/stop this behavour? I've
tried time-outs, using angry facial expressions, strong voice tones,
and giving him something else to chew on. But I'm not having much
luck. I think he understands most of what is being said to him is
simplfied but he has no verbal language. He is eight.
A. Okay. Firstly we find that in most cases, time outs, angry
facial expressions, strong voice tones do not work. We know that this
is a child who is socially impaired. Chances are that when he is occupying
himself twirling a thread or obssessively building with blocks one
feels 'Oh thank goodness' and generally leaves him be. However, when
out of stress, or frustration at his inability to communicate there
is an attempt to bite there is, if I may guess, always a big reaction.
So here is this child who learns soon enough that when I put my teeth
against a person's flesh there is this excitiing thing that happens:
there is a frisson in the air, this person makes a big noise and interesting
faces, and generally a lot of exciting things happening. So maybe
I want to try it again to watch the interessting developments that
follow! Soon it develops into what we call
reaction getting behaviour.
So what do I do? Do I sit there and ignore it and let this little
fellow bite a chunk out of my arm? I dont think so! Instead, since
I know he does this I could be focussed to catch some cue that tells
me he might do this, and position my body such that he cannt get a
bite. If I am in close poximity doing an activity with him maybe I
could keep my hands casually and gently on his shoulders so that even
if he wants to lean forward for a nip he is unable to. For group activities
with other children I seat him in such a manner that again he is unable
to get his teeth anywhere near for a bite. When a bite does take place
best if the child receives no reaction for it. If it is one of the
teachers just remove yourself. If one of the other kids, again maybe
you remove the other child and give the recipient of the bite a lot
of attention. Not 'oh poor you' kind rather a rub on the spot, or
a kiss or a hug. The idea is that the biter receives NO attention
for the act and instead the bitee(!) ends up with a lot of attention.
This is certainly not the only way but we find this manner of dealing
with most challenging behaviours very effective. Has worked with a
range of our kids. Perhaps you will find this useful.
I am seeking information on including autistic childrent in primary
school. How to handle negative behaviors such as biting, scratching,
hair pulling, pinching, and kicking.
We are often told by families that their children have behaviours
such as biting, kicking, pinching, hitting etc. that are a cause of
a lot of concern as they are undesirable and also difficult to deal
with at times especially in social situations.
As you are aware Autism affects the social development of a person.
A social skill that we take for granted is the ability to get another
persons attention. Children with autism do not know how to get attention.
What they do learn as they grow is that when they are sitting alone
or quietly or doing their own thing, people may pay little or no attention
to them but as soon as they do something like kick or scream or bite,
they get an interesting reaction like a shout or a scream, or a loud
'No'. the behaviour is often discussed at great length and a whole
lot of attention and importance given to it. For most children such
behaviours are learned and reinforced by the reactions they get.
So if we want to eliminate these behaviours we need to IGNORE ALL
BEHAVIOURS WE DO NOT WANT and ACKNOWLEDGE/PRAISE ALL BEHAVIOURS WE
DO WANT. Catch the child sitting quiet and praise him for that. Completely
ignore him when he is pulling hair. We also want to structure the
environment so as to avoid the behaviour happening in the first place.
Behaviours that hurt can be avoided by taking care not to be near
enough to get your hair caught. Take shoes off before sitting to work
so you don't get hurt when kicked. Hold the child's hand gently so
you can anticipate a pinch. Occupy the child's hands as much as possible
so he uses them for constructive activities instead of pinching!!
If anyone does get pinched, for this method to be totally effective,
it should just be ignored. People in the environment need to be especially
aware not to discuss any of the children in their presence because
this too is attention to them.
One other suggestion is to provide them with alternatives of behaviour.
Most often we tell our children "Don't pull her hair" or
"Stop Hitting" or "No! Don't bite". We tell them
what not to do but not what to do. So give them alternatives. "Hands
to yourself". And whenever he is behaving as desired we want
to praise positive . " Kept your feet to yourself
boy!" or "Being gentle when you touch
These are some of the methods used that we find very effective in
the long term. One important thing to keep in mind is that when we
ignore it MUST be done with comfort. Even if we don't look at them
or show our discomfort they can sense it and may use that as a button
to push everytime. I hope that this will be helpful. You want to remember
that results will not show in a day or even in a week for some children.
But remain persistant and consistant for the effort to eventually
I would like to know about 'Open Door' education system for autistic
children in detail. We are living in Bombay, and I have a son of two
years and four months who has been diagnosed as autistic. What I wanted
to know was, is it possible to attend the 'Open Door' education for
my son and how we should proceed about it.
is it possible to train parents with special training to take care
of autistic child? Does the 'Open Door' education system follow 'ABA'
Open Door is a laboratory school geared exclusively to the needs
of children with autism. The methods we apply and find useful we share
with families all over the country as well as other countries in South
Asia. It is therefore a small school. Another reason why it is small
is because we train every teacher that works with us.
do not want to encourage families to relocate just to put their child
into Open Door. However we do welcome families who want to come for
a short period to train with their child and go back to continue with
course it is possible to train parents. Parents know their child best
and often take the lead in helping their child. Since there are not
enough appropriate schools for children with autism, many of the children
attend whatever school is available while their parents run excellent
home programmes simultaneously.
Behaviour Analysis (ABA) is a programme that requires complete one
on one with extensive record keeping of every behaviour and so obviously
is difficult to apply in its entirety in a school setting, particularly
in India. Other than two schools in the USA that run ABA programmes,
we do not know of any other schools that do. It is a programme that
families use to home school their children. To implement ABA in your
home setting you require trained practitioners to come into your home
and give the programme to your son. But such practitioners are not
available in India.
what parents in India try and do is train themselves to set up a programme
for their child. Though the programmes do not fit any strict label
like ABA or TEACCH or whatever, that hardly matters. What is important
is many of them succeed in helping their children through structured
behavioural teaching. Most parents educate themselves and follow some
of the excellent books and manuals available on the subject to give
direction to their home programmes.
India it is unrealistic to expect to be able to apply ABA, TEACCH
or any other method in its entirety in any school setting. At least
not with the very modest fees that most schools charge. At Open Door
with our very limited means we obviously cannot apply ABA. However
our methods are behavioural (as is ABA), along with which we use many
of the TEACCH applications. What is most relevant is that Open Door
uses structured behavioural teaching along with an approach that is
respectful of the child, that is accepting, loving, and non-judgmental.
So far we find our methods help the children show progress, and more
importantly help families come to terms with their child. What is
finally most important is keeping an open mind to any methods that
we feel can help our children.
Q.Is it possible to integrate children with autism in a regular
school? If so what should be the curriculum? Where can I send my counsellors
for effective training so that they are able to deal with difficult
situations that may arise? I run a school.
Yes it is. A few schools are beginning to integrate children with
autism in India. In many of the developed nations it is of course
these are children in the regular school system you want to follow
the same curriculum as the other children. Sometimes a child with
autism might require a certain flexibility like learning two languages
instead of three - but this does not have to be the norm. Depends
on the individual child. What is more important is that the children
might require slightly specific teaching methods for maths for instance
or languages. However again it all depends on the individual child.
Also some of them might require some physical structuring within the
Perhaps we will be able to help your counsellors, if you could write
in exactly what kind of training you had in mind.
and Medication Issues
The Doctor has advised us to give Resperidon to our son.
I have a confused notion about medication. Please help me.
Your son’s doctor must have explained to you why he
has prescribed the resperidon. From what I recall your son has significant
sensory issues and a certain amount of over stimulation and over activity.
Providing activities for sensory integration, as well as specialized
teaching, will of course help. However, due to the stresses of parenting
a child with autism a family sometimes finds it difficult to handle
a child’s behaviour by training alone. A doctor might then prescribe
a drug like resperidon to enable the family start teaching the child.
Once the child ‘learns to learn’, the drug may be slowly
tapered off and stopped. Of course this must be done under the physician’s
I am an Indian living in the UK. I heard that the vaccine called MMR
which is for Mumps, Measles and Rubella causes Autism in children.
We cannot decide if we should get my sister vaccinated with the same.
She is about 16 months old. The doctor says we could get three different
vaccines for the three diseases. Would that be a safer option? Kindly
advice as we are greatly confused.
It is a hard decision given all the confusion on the issue. Not giving
the vaccination leaves the child susceptible to Measles, Mumps and
Rubella. Despite research clearly indicating prenatal and genetic
basis of autism there is a strong lobby that believes that the vaccine
will cause autism. Interestingly, we know families who vaccinated
their older child who now has Asperger's, and skipped the vaccine
for the younger one who later received a diagnosis of Autism. It is
a tough decision and finally one that the family alone can take. Perhaps
your GP can help you take the decision.
I have read in a magazine entitled 'Vanita' about medicine for autistic
children. The article says that autistic children can be cured by
that medicine. The name of the medicine was not given in the article.
Please advise me about such medicines by which autistic children can
People have experimented with a few drug treatments such as secretin,
fenfluramine, megavitamins, tranquilizers, naltrexone and homeopathic
alternatives. However there is NOT enough research to substantiate
any claims of benefit from these drugs.
point we do not know what causes autism and so cannot 'fix' or cure
it. However, an approach that has been found to help in all cases
is an appropriate training program that is very specific to the child's
need. Autism is a life long condition but with appropriate intervention
(teaching and training methods) the child can progress to his or her
I am one of the regular users of your web site. I live in Hong
Kong and have a son who is 3 years old and autistic. He has constipation
frequently. I want some advice whether I can use Sat-Isabgol - a kind
of husk which is a popular North Indian natural remedy for constipation.
I am not sure if this contains gluten as my son is on gluten free
diet. I wonder if you have any experience of any parents there using
this for their children or if you could advice on this issue.
Sat Isabgol is one of the best natural remedies for constipation.
Many of our parents use it. We do not have sufficient information
on whether it contains gluten. Off the cuff I do think it is gluten-free.
in a couple of weeks we will be hosting a conference on medical issues
in Delhi which will, amongst others, have a presenter from the UK,
a doctor who is very involved in biomedical issues. I will ask her
opinion when she is here and mail you her comments. If she has any
printed matter that is helpful we will mail that as well.
We were recently advised to take a CT scan of my four year old autistic
From our experience with families we find that children with Autism
are often routinely sent for CT scans as well as other tests. A scan
is required if one suspects disorders other than Autism. A scan does
not help in any way in dealing with the child's Autism. However, you
want to ask your doctor why the CT scan had been advised. That will
help you to make up your mind on whether you want to go ahead with
it or not.
Please give suggestions on the using of drugs to control hyperactivity.
Most children with Autism have age-appropriate physical development.
They eat as much as other children and therefore have the same energy
levels. The difference is that other children go out and play physical
games, use their minds for academics and generally use up energy in
so many different activities. As for the child with autism, he does
not get these channels to release energy. That is why he may walk,
jump, run endlessly etc. These are his way of keeping himself occupied.
the child usually does not work because he has to get rid if the energy
--The "hyperactivity" is really the child's way of keeping
himself occupied. If we don't want him to run or move around in excess
then we have to keep him occupied in some other way.
--Cutting down on chocolates, colas, chips, and processed foods often
--Take him for long walks or a run in the park.
--We agree with you about the possible side effects of drugs. Most
often we give our children drugs without checking out the side effects
completely and more importantly without proper monitoring. In our
work we do not use drugs except for medical reasons such as epilepsy.
We find that drugs often sedate the child and reduce his ability to
this is our view. There are different viewpoints on this. And finally
the decision to give or not give drugs has to be yours, the parents.
We have a daughter who was diagnosed as autistic at the age of four
way back in 1970 and since then we had the benefit of consulting many
psychiatrists and psychologists. She has been taking haloperiodol
(Hexidol, 1.5 mg. tablets 3 times a day along with Parkin, 1 tablet)
for the past seven years. We have been reading some books on Autism
and with the rapid strides that have been taking place in brain research
of late, some doctors who have authored books on autism are of the
option that more than drugs, our conduct towards autistic children
and our acceptance of them as normal makes a difference and raises
their self esteem. In fact, some authors advise discontinuance of
haloperidol after some years due to its bad effects. We shall be grateful
if you would kindly let us have more information particularly on the
continued use of drugs like haloperidol for the whole lifetime.
First of all, as you may already know, there is no medication to treat
autism. Medication is used only to treat specific symptoms of autism,
and as you accurately have pointed out, it is also very controversial.
Many of the drugs given to autistic children in India are unnecessary
and may actually worsen the problem by making the child sleepy, less
active, and less alert. The psychiatrist who prescribed this medicine
should have told you exactly what symptoms Hexidol was supposed to
change. Then, you could observe your daughter and see if there is
a positive change, and if so, you may feel the negative long term
effects are justifiable. But if parents don't ask, many times doctors
do not adequately discuss this information with parents and it is
possible that inappropriate medication may be given.
an organization, we advocate that parents try other methods of dealing
with their children's behaviours (other than seizures) before using
medication. However, if you are considering discontinuing medication,
you must do so very gradually with the consultation of a doctor. Drugs
such as Hexidol are extremely powerful and should not be suddenly
stopped. Incidentally, you are absolutely correct about attitude making
an enormous difference in the progress of an autistic child.
other note. Many parents have confided that they are unsure how to
approach their psychiatrist with regard to discontinuing medication.
Some parents have worried that the doctor will disagree or become
offended, especially when the medical profession is so respected here
in India. What you want to keep in mind is that it is your child who
is to receive the medication and you have every right to decide whether
you want your child to continue with the medication and share your
decision with your childs doctor. One researcher who interviewed
over a hundred families of autistic children in India found rather
alarming dosages and prescriptions being given, as well as dangerous
combinations of drugs. It is important to continue to read as much
as possible yourself about medications and autism, so you can make
informed decisions about your daughter's treatment.
My daughter hits her little brother, and other members of the family.
She removes her clothes. She is also a poor sleeper. Can we
give her Serenace to make her sleep?
You've inquired about 'Serenace'. Our belief is this drug and
the likes of it are best avoided. As you learn to be comfortable about
your daughter's autism, and be consistent in your responses to her,
she will also calm down. Many autistic people have erratic sleep patterns
and may sleep for only 4-6 hrs in the 24 hour period. If she is safe
in her bed or walking around the house, then you want to let her be,
and go to bed yourself. Ignore any noise she might make. Just make
sure that she is safe and the house is child proof.
is something we prefer not to advocate. Our belief is that in
sedating a child, we'll just be reducing the opportunity for her to
learn and progress. But we also want to make very clear that
this is our subjective opinion; you as parents have to take the decision
yourselves. We only make suggestions.
How do I prepare my son for a visit to the dentist?
The most important thing here is honesty. A visit to the dentist
can be stressful for anyone, even neurologically typical adults. Children
with Autism have sensory difficulties, difficulty waiting and holding
still and usually dislike doctors in general from having experienced
being dragged from one to another. Play pretend-games where you are
the dentist and do dentist-like things to him in a fun, exciting manner.
Tell him also what exactly the doctor will do. Be honest. Tell him
that it will hurt, but that the pain will go soon. Take him to visit
the dentist a few times just to talk and become comfortable with the
place. A reward planned before hand like an outing to a special relative's/
friend's home, a park etc is an added incentive.
I am a 28 year old lady with Aspergers Disorder. I am established
in my job and highly educated but cannot get my life partner and get
settled due to lack pf proper communication skill. I want your help
to overcome my problem.
As you have found yourself, getting a life partner requires rather
complex communication and social skills which can be an issue with
people on the spectrum. While we would like to help you, we work out
of Delhi and it would be difficult for us to have regular discussions
on your needs. If it is at all possible for you to travel to Kolkata
from Midnapore then you could contact the Autism Society West Bengal:
<firstname.lastname@example.org> for support.
My daughter is ten years old. She has Autistic Spectrum Disorder.
She has been attending a special school since three years in Mumbai.
We get lots of help from special educators, speech therapist, and
occupational therapist. She is developing. If possible she will get
vocational training from her special school in future. But we are
now worried about her long term rehabilitation we do not know about
residential centres in India. We know many centres where mentally
ill persons are rehabilitated but they are not equipped to care for
persons with autism after the death of the parents. We are looking
for your suggestion.
First of all we want to commend you on how well you have worked with
your daughter and appreciate your positive approach towards her learning
work skills. Your concern regarding her future when parents will not
be around is the worry of almost every family having an autistic child.
We presume that you are in touch with the parents support groups at
Mumbai and are aware about the guardianship issues under the National
Trust.We do not have information on any long stay rehabilitation centres
that are run exclusively for persons with autism. However we do know
of individuals with autism who are in Adhaar, a residential centre
in Thane District. In the past Jai Vakeel School in Mumbai also did
take in some youngsters with autism in their boarding and perhaps
are various models of long stay residences all over the world. One
option is that wherein the persons with autism can live within the
community in small group homes run by parents and if possible along
with relatives and friends. To make this dream come true one needs
to identify parents of children and adults with autism who would like
to work together to form trusts and set up such units. This of course
needs sincere team efforts that can be made with guidance from organizations/
parents / professionals with experience, and the National Trust.
An Autistic girl of 20 is self-sufficient to a great extent.
She shows signs of attraction for the opposite sex, has regular menses.
She is beautiful, and plays the violin quite nicely.
1. Is marriage advisable?
2. Is there a possibility of normal sexual behaviour?
3. Will it improve her condition?
It is very difficult to respond to your queries one and two with
such limited knowledge about the person in question. Many persons
with autism develop normally through puberty including developing
an attraction for the opposite sex. However, that may not automatically
equip them for marriage or 'normal' sexual behaviour. Marriage requires
the ability to take responsibility not merely of oneself, but also
of ones partner, as well as of possible offspring.
the other hand, there are persons with autism who are on the very
able end of the spectrum who marry and raise a family. Each individual
has his or her own potential and limitations. No one blanket judgment
can be applied to all. Each situation has to be seen it its own light.
The only question one can answer with confidence is the last: No.
Marriage will not 'improve' the condition of a person with autism.
I'm a student working in an institution with persons with autism.
I just wonder if you can give me some ideas about how to make autistic
children's parents participate more and show more respect and care
for their sons. I am trying to build a project for this institution.
Sometimes one does encounter families who appear not to particularly
care about their children. This is as true of families with typically
developing ('normal') children as it is of families that have a disabled
the child is disabled the situation is a little more complex. I don't
know how it is in Portugal, but in many traditional societies it was
seen as almost shameful to have a child with autism or any other disability
- physical or mental. In that sense one has to really work on social
we want to help parents change the way they feel about their child
we have to start by not judging them for their attitude. No one of
us can really know what it might be like for any family to have a
child with a disability. Any disability. Each one of us has certain
aspirations and expectations of our children. Often these have to
be set aside completely. That is not the easiest of things to do.
autism sometimes the situation is complicated by the fact that the
children often appear not to understand anything - when in fact they
do understand far more than they are given credit for. They may appear
not to be aware of their families. They may have a difficulty, because
of their sensory difficulties, in being able to deal with physical
shows of affection that involve physical contact and so on. Further
complicating the situation for parents is the fact that the children
usually 'look normal'
this situation there are two things that we find work: firstly, giving
parents a clear understanding of autism and the unique ways in which
it affects their child; secondly, taking them through a few simple
awareness exercises that helps them see the world through their children's
eyes and thereby understand how difficult and stressful the world
is for their autistic children. We find this method very effective.
It makes parents really sit up and say, "I never knew it was
One thing we have read on the internet is that if one child had autism
then it affects the other normal child also, We are really worried.
Please do not worry about your other son being affected by autism.
He is already nine years old. If he were to be autistic I think he
would have been so by now. I don't think nine-year-olds 'turn' autistic.
The onset of autism is by 30 months latest, remember? And it is not
contagious! So don't worry about that.
My child is now six years old. She is suffering from childhood autism
and taking treatment at Tamil Nadu. My wife is taking her to Speech
Therapy classes daily and giving her physiotherapy also. Please advice
what type of puzzles and toys would be suitable for her.
A. We do not have any list of toys specific to children
with autism because each child is different. Though many children
with autism do not show much interest in conventional toys, toys that
provide sensory input are liked by most of them. These days there
is a wide variety of such toys available. Cause and effect toys that
produce sound / light/ movement on pressing a button are easily available
and at very affordable prices
Get your daughter
simple toys that can enhance her learning in various areas. Play dough,
colourful blocks, activity centres, cush balls, beads, are things
a child can play with and they also enhance motor skills.
like to build blocks, scan through books. Picture books like the ones
in the Lady Bird 'Learning to Read' series, Children's Book Trust
and National Book Trust, may be useful as these have simple pictures
that the child can identify with.
can be fun if the child can to fix them. Some would enjoy playing
with educational puzzles such as the ones on ‘opposites’,
‘things that go together’, etc – that often come
in interlocking sets. However a child with autism may just follow
the pattern of the interlocking cut-outs and fix the correct pieces
together without ever following the concept. Therefore in the latter
case you can get cards that are simple square pieces (brands such
as Creative and Funskool have them) and come in interesting sets such
• what comes next picture sequencing
• match and learn
Every child with
autism is different and so are their interests. The best toys or equipment
would be the ones your child likes and finds exciting. It is not what
the toys are but how they are used that is important. Even a simple
ball if rolled at a line of empty upright plastic bottles that get
knocked down could be great fun provided the entire process of rolling
and knocking down is done with cheering and excitement.
your daughter lead the play. Join her in her kind of play and then
slowly modify and model play for her to imitate. Use toys like dolls
and kitchen sets to enhance pretend play through imitation. These
can be used by the speech therapist as well.
You mention in
your letter that your child has ‘childhood autism’. It
is important to be aware that though the term ‘childhood autism’
and ‘early infantile autism’ is sometimes used, autism
is not a childhood disorder that ‘goes away’ as the child
grows up. It is a lifelong condition. Of course it is also a condition
in which there can be often great progress if the intervention is
appropriate and early.
I have a son who is three and is an autistic child. We live
in Surrey in British Columbia, Canada. My son gets IBI treatment based
on behaviour analysis at a school which has been supported by the
provincial government. He has been showing some improvements in his
The reason for this mail is to inquire about any schools, organisations
in India that offer IBI to children with Autism. As we have decided
to settle in India in the very near future, but as informed earlier,
we are looking for schools/ organisations that have professionals
trained in behaviour analysis so that my son keeps getting the intervention
There are a few schools in India that have IBI based teaching methods
– more specifically Verbal Behaviour based. The ones we have
information on are:
Autism Society West Bengal Kolkata
Contact: Indrani Basu
Contact: Kamini Lakhani
Contact: Gita Srikanth
My grand daughter aged 4 years is autistic. I read that milk may
be one of the causes for autism. I have three questions.
o Is it only milk or the entire range of milk products like chhena,
cheese, butter, curd or yoghurt that have to be stopped?
o If milk is stopped what replacement can be thought of to ensure
proper nutrition? She does not like chicken soup or egg.
o How long should milk be stopped to determine whether milk is a culprit
or not in her case and whether she is benefiting from withdrawal of
If you are going in for a casein free (dairy free) diet you want to
remove all milk products including cheese, butter, curd. You can give
'ghee' as 'ghee' does not have casein. You can use soya products such
as soya milk, soya curd or 'tofu', nutria nuggets. However before
you put your child on a casein free diet you want to discuss with
her paediatrician as well as a nutritionist to ensure that your grand
daughter is on a balanced diet.
you put her on a casein free diet (or a gluten free diet), you want
to record her behaviors before starting. When you start the diet ensure
you are not starting any other therapy or intervention around the
same time. Once she is on the diet continue to record her behaviours.
After three months of the diet you should see some significant improvements
/ changes. Remember, your grand daughter will show some improvements
anyway as she grows. There has to be very significant improvements
for it to be credited to the diet. See also Autism Network Vol VII
No 3 issue of December 2000 for more information on the subject.
I have a son B, who has no speech. He is 14 years old and has a diagnosis
of autism and I have been helped immensely in his upbringing by Autism
Network since the last eight years. I have a few queries with reference
to your issue of December 2003, Vol X, No 3. In the Helpline section
of this issue you have referred to a set of four EASe CDs, which help
children deal with sound sensitivities. Can you give us some information
about these CDs and how to procure them? As my son is extra sensitive
to some sounds, I hope they can help him.
very upset when others talk normally among themselves, although he
does not mind when we talk to him continuously. Can we do something
about it? As we are staying in a small place in Orissa, we do not
have adequate school or professional facilities here. So B remains
at home and I am his parent, teacher and guide, all in one.
It is good to learn of the progress B is making and we are glad
that Autism Network has been of help in this. When you say that your
son gets upset when others talk amongst themselves, perhaps you could
try and see if it has anything to do with his feeling left out of
the conversation that leads him to acting upset? Without having all
the details it is a difficult to guess what it is about the situation
that makes him upset. It is only when we understand what is behind
the behaviour, and also what is maintaining the behaviour, can one
suggest a way to deal with it. However, some of the things you could
do is try and include him in your interactions with others. Ask other
members of the family to do the same. In addition, give him different
non-verbal modes of communication: using cards or signs for instance.
Being able to communicate will take care of a lot of difficult behaviours
since much of challenging behaviours are often a mode of communication.
Regarding the EASe CDs, the CDs are available from Vision Audio Inc,
611 Anchor Drive, Joppa, MD 21085, USA Tel: 001-888-213-7858. They
can be ordered over the internet from their site http://www.vision-audio.com
We are parents of a three-year-old son diagnosed with autism from
Hinduja Hospital. We have been running from pillar to post and are
feeling helpless. We have given him occupational therapy for more
than three months but there is no change. Now his therapist has told
us of a new treatment for autism called G-therapy. Please advise and
guide us. Will the medicine G-therapy make him lead a near normal
A. Occupational Therapy is certainly helpful particularly when
it takes the individual child's specific needs into account. The therapist
is probably doing sensory integration which can be very helpful.
you want to discuss with the therapist what exercises are being done
and most importantly why. You know your child best and can give the
therapist valuable inputs. However I must add that occupational or
sensory therapy in isolation is not an appropriate treatment option.
As you must be aware a diagnosis of autism implies impairment in communication
and social skills. Occupational therapy will not teach him communication
and social skills, though under a good therapist it can enhance his
ability to learn these skills. Your son needs special education in
addition to the therapy he is currently receiving.
get in touch with the support group Forum for Autism (details elsewhere
in Helpline). They will be able to give you information on services
available in Mumbai and Pune. With appropriate therapy provided early
and intensively some children with autism can come to leading a close
to 'normal' life. By which it means that they will be able to participate
in day to day life without too much additional and specialized support.
parents have asked us about G Therapy. But I am afraid G therapy will
not accomplish this. Neither is G therapy a new therapy. It has been
advocated by one individual in Pune for more than ten years. While
it may have its merits no studies have ever been carried out to judge
its efficacy. Neither are there any families who have used it long
term and reported any remarkable improvement.
it is a fact hard to accept, the truth is that there are no medications
that can 'cure' autism. Not in allopathy, not in homeopathy, not in
ayurveda, despite claims that are periodically made. The only effective
treatment is structured teaching and therapies that address the impairments.
I am the mother of an autistic boy aged 9 years, based at Chennai.
I would like to start the CFGF diet for my son. I request you to answer
the following questions:
Is there any pediatrician/doctor in Chennai, who knows about the Dan
protocol, and CFGF diet and can guide me? If so, please give me their
2. Is the peptide testing done in India (especially in Chennai). If
so please furnish their address.
3. What is the diary alternate that is available in our country? I
read even soya milk contains gluten. Is rice milk available here.
4. I am a South Indian, vegetarian. Rice is the major component of
our food. I would like to have a list of gluten free grains/cereals
that can be used. I would also like to know if vanaspati/dalda can
be used for cooking.
5. If you have the address or e-mail of parents who follow the CFGF
diet in India, especially in Chennai, please give them to me so that
I can get their views.
1. We do not have information on physicians in Chennai who have information
on the diet though I am sure there must be some who do. Perhaps you
could check with your son's pediatrician.
The same goes for the peptide testing. We really have no information
on places in Chennai doing it.
Soya is indeed considered the dairy alternative available. However
as you yourself observe it is now believed that soya too contains
traces of gluten. As for rice-milk parents make the milk themselves.
If your child is not particularly keen on milk and otherwise eats
a range of foods I don't think you need to worry too much about the
consumption of milk. However, ensure he gets a balanced diet.
South Indian vegetarians are the luckiest! Their diets are largely
gluten free!! Even your savouries like murrukkus are gluten free.
For a list of Cereals and grains please check out Autism Network Vol
VII No 3 December 2000.
dalda as well as ghee are all GFCF. Ghee though, derived from dairy,
is casein free.
We don't have a list of families following a GFCF diet. However we
will forward your mail to parent groups and ask them to get in touch
with you if there are parent members who follow the diet.
hope these answer your queries. Finally may I add a note. Follow a
GFCF diet for your child if you can. The diet may or may not help.
Those who do report changes usually find small ones. There will not
be a miracle. But whether you follow the diet or not you want to focus
strongly on structured behavioural teaching. That is really what will
My daughter Sharon, is three years and six months old, but has still
not started communicating verbally. Non-verbal communication is also
limited. A year ago, when we visited the Child Care Centre, Cochin,
they felt that she has Attention Deficit Hyperactivity Syndrome. But
since she shows autistic characteristics, I feel that she has Autistic
Spectrum Disorder/ PDD at a moderate level. I would like to get a
complete diagnosis and to start treatment and early intervention for
her. In this regard, can you please let me know the facilities available
at Bangalore or anywhere in South India for complete diagnosis and
treatment/ early intervention, the special schools, etc.
would also like to know the sources of websites for information regarding
GFCF foods in the Indian context. I have already seen many websites
regarding GFCF in a western context.
A. You are quite right in wanting a diagnosis as early as possible
as early appropriate intervention is always helpful. Since you indicate
that Bangalore is a city it is possible for you to visit, the best
place for a diagnosis would be NIMHANS. At NIMHANS families are also
provided with a comprehensive program for early intervention.
information on GFCF diet there are many sites but as you have noted
they are written by westerners. We do not have information on any
Indian GFCF site. If any of our readers have information on such a
site perhaps they could share the information. The December
2001 issue of Autism Network carried an article on GFCF diets
for children with autism which you might find useful.
May I have the recipe for Soya Milk.
recipe for Soya Milk is as follows:
- roast soya milk at 80 deg Celsius for 20 minutes
- soak for 8 hours
- grind into paste
- add 5 parts of water and boil
- then sieve it through a fine cloth
- add water to make it of milk consistency and refrigerate.
When serving add sugar or any flavour for taste.
We had the great chance of attending the Action for Autism training
workshop at Disha in Jaipur from 5 -7 April. I also went through your
book: "Compilation of Reading Material" and the December
2001 issue of "Autism Network" and found them a very good
guide for parents like us whose child has been recently diagnosed
my four-and-half-year old son, I would like to go for Megavitamin
Therapy, and seek your guidance on the following points:-
1. For Vitamin B6, the daily dose of 17 mg per kg of body weight is
advised, at what time of day should this be given, and is it only
once a day, or may be given in doses throughout the day?
2. The best pharma company for DMG in India or USA or UK?
Thank you for your kind words about our workshop at Jaipur. Regarding
Vitamin B6 it can be given at any time in the day. But the times remain
the same. So if you give it around eight in the morning after breakfast,
try and give it around that time each day. It can be given in two
doses; but not sure if it would be advisable to break it up into too
suggest you write to the Autism Research Institute directly and query
them. Their web address is:
and postal address is:
4182 Adams Avenue, San Diego, CA 92116, USA.
company in the USA that supplies DMG is:
Post Bag No 1009 Wilsonville,
OR 97070, USA
Tel: 503 694 1600, 503 694 1603,
Toll Free 800 245 8282.
the best of our knowledge there is no company in India that supplies
these food supplements. Send an SASE to the AFA office to receive
a sheet of information material on the subject. In addition, you will
find an article on the subject in Autism Network Vol VIII No 3 of
Your article about Sensory Integration Therapy in August '98 issue
was useful and interesting. Please let me know the names of any Sensory
Integration Therapist in South India or in any other part of the country.
SIT is an interesting and possibly useful therapy for individuals
with sensory sensitivities. The demand for this therapy is increasing
throughout the world and is used with people with autism as well.
We have found in our experience with people with autism that though
this therapy may help, it does not address the main areas of affect,
which are communication and socialization. The exercises involved
in the process can be enjoyable and fun. But for your child's development
it is crucial that he receives Behavioural Therapy in a structured
environment on a regular basis. You could do the different exercises
for SIT at home using things available at home in the most inexpensive
manner. However as a parent, the decision is yours finally
We do not know of any therapist who does only SIT but the Spastics
Society at Chennai should be able to give you a reference.
My eight year old daughter has been diagnosed as having Asperger's
Syndrome. These days she seems to scream a lot. Any question
she answers with a scream. When she is happy also she screams. When
she is upset, she screams. Formerly she used to scream, but after
her exams finished, and we went to Bombay and came back she did not
scream for about a month. But once I just shouted at her mildly, and
now her screaming has increased to more than before.
is a gentleman who has done Ph.D in music and is also in the education
field and has read a lot on the subject. He has started music
therapy on my daughter. If you have any information on this,
regarding its use in behaviour modification or increasing concentration,
could you please send it.
for your query, regarding your daughter, many a time such behaviour
like the screaming are done purely to get a reaction. You must
give a thought to whether or not you react to her screaming. If she
is getting any attention for it (even a comment, about it later on
can be enough attention sometimes), then chances are that she is going
to keep doing it. What you will need to do is IGNORE her COMPLETELY
whenever she screams, but pay her a lot of attention and praise her
a lot when she is quiet. And praise POSITIVE. Instead of saying 'Oh
Good! You're not screaming', you want to say 'Oh Good! You're sitting
important thing to remember will be to be very consistent and very
persistent. Please don't give up in a week or even two. This has been
going on for quite a while, and chances are that its going to take
a bit of time before it subsides, but we can assure you that it will.
you are responding to a scream, there are two things at work here.
a) We are reinforcing negative or unwanted behavior, and b) we are
losing an opportunity to teach her an appropriate way of responding.
If she screams a request at you maybe you could tell her, 'If you
want water say 'Give water'. " And CALMLY wait until she does
do. If she does not respond in the way you have requested, it is very
important, that you don't finally give in to her want.
therapy need not be a therapy on its own but can be incorporated in
with other teaching methods. I'm sure your daughter might be very
fond of music - use it as a reward. Also use it whenever possible
in the instructions you give. (Sing them out to her instead of speaking,
the chances of her responding will be higher!) If you know someone
who has enough knowledge about the disability, and is willing to teach
your daughter an instrument, or just spend time with her playing some
music, then that would be a great idea to explore.
This has reference to Help Line column in the December
96 (Vol III, No 3) issue of Autism Network in which
you have answered a question regarding Vitamin B6 and DMG therapy
for autistic children. You have, in your answer, stated:
the last few years many families in India too have been obtaining
the preparations from overseas and giving it to their autistic children.
Some have been formulating it here on the basis of Dr Rimlands
suggestions. Vitamin B6, also known as super Nuthera, and DMG
are food supplements
have an autistic grand child on whom we would like to try this therapy,
but these preparations viz. DMG and Super Nutera have to be imported
from the U.S. and are so exorbitantly priced that they are not within
the reach of a middle class Indian.
would like to know:
Whether preparations equivalent to these made by Indian pharmaceutical
manufacturers are available in India.
2. If the exact combination/formula made in India is not available,
can we make this combination by buying the individual drugs from the
3. Whether DMG is available in the Indian market?
4. An Indian pharmaceutical manufacturer markets Glutaneural
tablets containing 0.5 m.g. of L(t)Glutamic Acid, U.S.S.R.P and 3
mg of Thiamine mononitrate I.P. in each. It has been found to be useful
in certain conditions such as mental retardation, oligophrenia, involution
psychosis, cerebral injuries, hemiplegia, grandmal and petimal epilipsies,
mongolism, scholastic backwardness, intellectual fatigue etc. Dr Srinath
could not advocate its usefulness in Autism, but she stated that it
could be given as a trial to autistic children. Can you give your
opinion regarding Glutaneurol to be given to autistic children?
Here are answers to your questions, in numerical order.
To the best of our knowledge no preparations by Indian Pharmaceutical
manufacturers equivalent to DMG and SuperNuthera are available in
the Indian market.
2. Dr Bernard Rimland has suggested specific individual drugs
available in the Indian market from which Super Nuthera can be formulated.
We however do not not have any suggestion from him regarding DMG.
3. See 1.
4. I completely agree with Dr Shobha Srinath. Unless and until
exhaustive clinical trials have been conducted on a trial group with
a specific drug - which to my knowledge has not been done with Glutaneural
- it is not possible to comment on its usefulness or otherwise. Whether
you want to try it out on your grandchild will have to be your personal
parents/grandparents we want to try out every therapy that might have
even the minutest possibility of helping our child. However the only
therapies that can definitely help our children are those based on
the behavioural model.
My son is eight and has been diagnosed autistic. Should I give
him Vitamin B6 and DMG? They are strongly recommended by Dr.
Vitamin B6, often packaged as Super Nu Thera, and DMG are food supplements.
They have not been found to have any negative side effects, in contrast
with drugs. In the various studies conducted, reports of which
are carried in the Autism Research Review International by Dr. Bernard
Rimland, both preparations seem to give very encouraging results.
The ARRI frequently carries letters from very satisfied parents.
Over the last few years, many families in Indi, too, have been obtaining
the preparations from overseas and giving it their autistic children.
Some have been formulating it here on the basis of Dr. Rimland's suggestions.
suggests that for some reason none of our children appear to derive
any particular benefits from the formulations. Given that so
many children in the US appear to show quite remarkable changes after
the administration of DMG and Super Nu Thera, it is surprising that
our children appear not to gain at all. However, we have a theory
that might explain why. Children in developed countries consume
food that is polished, refined and highly processed; healthy food
but deprived of many essential nutrients because of heavy processing.
On the other hand, we eat food that is less processed, thereby retaining
much of its natural goodness. For instance, so many fresh fruits
and vegetables and home cooked foods. Few of us eat food out
we were to make a guess, we'd say that for Western children, Super
Nu Thera and DMG help replenish whatever is lost in the processing,
whereas Indian children get the vitamins provided by these products
in their normal diet. We invite our readers to share their ideas
on the matter. Also, if anyone has been giving DMG or Super
Nu Thera to their child with a positive feect, do write and let us
know. But ultimately, if you want to give the supplements to
your child, the decision rests with you.
and General Advice
I have consulted the doctors at Nagpur, and they have diagnosed autism
spectrum disorder for my son. They say it is in the middle order.
I started the treatment for about five or six months, and now I do
not have any facility in my hometown for the same. He is not sitting
in a place for long time. He is running around and saying only few
words. Can you suggest any type of treatment?
It is helpful to have more information on the child, like your son’s
age and current skill levels, and what you are already doing with
him. However, here are some things you could do. Have fun with your
child. Sit for short periods, do things he likes, maybe tickling or
singing a song to him. Play with your child so that he starts looking
at you as a person who is fun to be with. Try and do fun activities
with paint, water etc so that your son begins to equate learning with
fun. Keep something that your child likes, an interesting toy or a
small treat like tiny pieces of kurkure/ chips. Give him a simple
instruction, eg. ask him to put balls (about two or three) in a container.
As soon as he puts one ball in praise him and give him the toy or
treat immediately. Here the child is learning that when I do this,
something nice happens. If your son will not follow the instruction,
then induce compliance hand on hand. That is, you give the instruction,
.put in., and place your hand over his, guide his hand over the ball,
clasp his hand over the ball, lift his hand with the ball in it, and
release the ball in the container. And then be excited and praise
him and give him a small piece of chip immediately. Try talking slowly,
using a minimum of words while giving an instruction, breaking up
instruction into small steps. So if you want him to get up and put
a plate in the kitchen sink you can break it up into the following
‘Pick plate,’ ‘Put in sink.’
Try to keep instructions
clear and precise. Label the things the child is doing for example
if he is jumping, you can say ‘jumping.’ If he is using
words to ask for things he needs, then give him a lot of praise when
he does and give him what he is asking for immediately. If he is not,
then provide for him the exact words that he would need to use. So
if he brings the biscuit tin to you, rather than saying, ‘Oh
you want biscuit? Here you go,’ and then give him a biscuit
as we usually tend to do; just say ‘Biscuit,’ and hand
a biscuit to him. When your son is running around rather than saying,
‘Stop running’ you could say ‘Sit down’ or
‘Sit with Daddy.’ So you tell the child what to do versus
telling him what not to do.
I am a government servant working in UP cadre. My son is 10 years
old and has mild autism. He is hyper and lacks wisdom. He has delayed
speech and repeats words. He always carries an empty bottle in his
hand which he hits against things. He sleeps in the day and wakes
up at night. He watches a lot of TV. Please suggest relevant therapy,
institutions, and hostel (if available) in India.
A. We understand your concern for your son and hope
to guide you as much as we can. First, a little about the autism spectrum.
As you may already be aware, Autism is a lifelong developmental disorder,
which is characterised by three core difficulties. The concerns you
have identified fit these three difficulties. For instance, delayed
speech can be quite typical of children on the spectrum. This may
be accompanied by odd or formal speech or unusual use of words and
phrases. Holding on to bottles, banging them on surfaces (preoccupation
with, and non-functional use of the item, or fulfilling a sensory
need by hitting the bottle), and different sleep patterns may be considered
a form of ‘inflexibility of thought and behavour’ which
is again, a core deficit seen in individuals with Autism. Thirdly,
a different quality of peer interaction and social interaction in
general is also a core difficulty.
It is quite subjective
to classify Autism into mild, moderate or severe as each individual
shows a different skill profile. So while your son may excel in one
area, he may be behind on others such as speech and language. Another
child with the same diagnosis may have great language but may score
differently on other abilities. It may therefore be more useful to
isolate each strength and difficulty and to see how to use those strengths
to push your son’s development further.
As you mention,
the next step for you would be to find a trained autism therapist
with sound understanding of your son’s difficulties and to begin
a training programme based on his individual needs and strengths.
In UP we know that the King George Medical Hopsital in Lucknow has
a programme for children with autism. We currently do not have information
of other institutions and therapists from UP, though there may be
a few others.
You may also arrange
to visit us in New Delhi for a three day extended programme to assess
your child’s abilities and to start you off on a basic programme.
While there are
not many residential facilities in India for young children, we will
send you the list of facilities we have with us. We however recommend
highly that parents and families are fully involved in their child’s
educational programme, whether at home, school or at any other facility.
My son RM is 18 and currently studying in a special school. He was
a caesarian baby and his milestones were normal except for a big forehead
which was noticed by doctors when he was about nine months old. Immediately
various tests were carried out and he was examined by a group of neuro-surgeons
and neuro specialists. AIIMS advised that he has mentally subnormal
and referred him to the child guidance. We visited the child guidance
units for nearly three years after which they advised to send our
son to an integrated school. We put him in an integrated school when
he was four years and initially he learned to read, write, both English
and Hindi and some basic math. After a few years the school stopped
giving much care to the unit for special children beyond the usual
repetitive reading and writing. At this time RM began to love and
worship Lord Hanuman and regularly began singing the Hanuman chalisa,
Amritavani etc. He picks up tunes of devotional songs and film tunes
with remarkable accuracy. We shifted him to a new school and for the
last two years RM is in the school hostel. But there is not much progress.
RM has poor eye
to eye contact, poor response. He is always in his own world and unconcerned
about others around, and not willing to play. He gets irritated and
beats crying children. He is not violent but if he does not get his
wish then he becomes moody and aloof. He operates the radio and TV
and watches mostly religious channels. He can operate the computer
and sometimes play on it or listens to music. But his writing is odd
and not sensible. He repeats the words and speaks unfamiliar language
but obeys commands and understands what we say to him. His IQ level
reported is 54%.
RM may be having difficulty in expressing himself in an appropriate
manner. When hitting children who are crying, he maybe actually communicating
that the crying bothers him. It could be sensitivity to the sound
or an inappropriate emotional response. He needs to learn an alternative
way of coping with the situation. He can be trained to cover ears
or move away when a child cries. He also needs to know that sometimes
people cry and that it is okay.
Making and sustaining
eye contact is often very painful for people on the spectrum. Rather
than forcing him to look, reinforce his looking with praise or attention.
Interact with RM at his level. This means do things he likes, let
him take lead in the interaction. It could be through singing/ chanting/
puja. You can ask him to help you by putting the computer or the music
system on for you. Acknowledge and praise his compliance.
in engaging in play with others is typical of people with autism:
they find it difficult to interact with their peers. Games are difficult
because they involve social skills like turn taking, waiting, reciprocity,
understanding rules of the games. Playing within a small group, of
two or three persons, maybe easier. At the start the games chosen
too will have to be simple like ludo or snakes and ladders.
RM seems to have
a good rote memory and has therefore learnt Mantras and Chants by
rote. At present he is around 18 years and many of his behaviors like
being aloof and moody maybe a result of his age: many typical boys
also behave the same way at this age. RM will need sensitivity and
acceptance to weather this stage in his life. At the same time given
his age, priorities have to be set with a focus on functional and
pre vocational skills. We do not have information of any place in
Delhi that has a residential set up for people with autism or Mental
Retardation. However, there are residential places in Una in HP, Dehradun
and in Bhopal.
I was reading autism network issue for the month of August 2004. In
this issue there is an article by Ashwini Chaswal about income tax
concession (80 DD of Rs 40,000) to parents of children with disabilities.
Does this apply to children with autism and those with PDD-NOS?
the recent finance budget of FY 2004-05 Autism has also been included
as a disability for which income tax rebate U/S 80-DD and US 80 U
shall now be available. 80 DD (with similar retrospect for 80 U) allows
for income tax rebate to a person who has a disabled dependent. The
amount of deduction allowed is divided into two categories viz. Rs
50,000 for disability between 40% to 80% and Rs 75,000 for severe
disability above 80%. Norms have been set based on IQ levels to identify
the percentage of disability in case of mentally retarded dependents.
need a criteria for issuance of a disability certificate stating 'autism,'
but it is not yet clear how the 'percentage' of disability is to be
determined. Apart from the fact that to determine IQ in persons with
autism is difficult and requires a high level of expertise, IQ alone
in autism does not always indicate level of functionality. Therefore
one can try and get a certificate from a government hospital, but
the deduction in the tax will depend on the results of the assessment
that must state the percentage disability (measured on basis of the
I got this information from your web site autism-india.org regarding
Income Tax Relief U/S 80DD for Parents/ Guardians of Persons with
Disabilities. Kindly let me know if the disability certificate has
to be specifically got from government hospitals only or can the certificate
can be got from private hospital doctors.
We understand that the disability certificate can be had only from
government clinics and hospitals.
and half year old son has a diagnosis of autism. He has little eye
contact, and does not respond to his name. He is able to speak only
a few words, otherwise he is a little hyperactive. He listens to music
and sometimes likes to play with his elder brother. I would like to
get the details of how to train my child. It would be of great help
if you could send me the books on how to train my child, teach him
to speak books on how to teach him to speak, and books on neuro development
we are in Coonoor, a place far away from the city, we do not have
any special schools run for autistic children. So it would be of great
help to us if you could keep me informed of the latest developments,
and help us to train our child at home.
Regarding your concerns about your son now is the time to provide
him with the best possible intervention as early intervention can
show very good results.
program for the child would be the one that addresses his specific
needs and it can be best planned after doing a detailed functional
assessment of the child. Nevertheless, we can suggest reading material
that will help you to be more aware of his present needs. As he is
speaking a few words and has little eye contact it will be beneficial
to focus on his communication, activities of daily living (toilet
training, dressing, eating etc.) and play skills. We know that many
families have worked successfully with their children at home due
to dearth of services and surely you must be doing the same. It shall
be important for you to receive the right guidance as to 'how to teach'
because this is more important versus 'what to teach.' You can get
in touch with a suitable center and maybe visit them periodically
for a continuous program. We could provide the same if you could visit
us once. Thereafter we could correspond over the mail.
In starting to work with your son in a planned manner we would suggest
that initially you have lot of fun with the child, join him in things
he likes to do. This will help in bonding with him. We always want
to remember that with an autistic child it is important to go with
his interest versus forcing him to take interest in what we think
is important. Therefore, in the beginning play and interact with him
using his own likes and strengths and slowly put simple demands on
him. For every little compliance that he shows, reinforce by giving
him things he really likes and gradually he learns that doing things
on other people's request is followed by reinforcement.
we ask a child to put a block or a bead in a container by modeling
it for him and saying "do this". The moment he does it we
give him whatever he likes most. It could be a favorite food item,
toy, any other favorite item. If he does not follow the request we
can gently assist him by holding his hand and helping him to pick
the bead and put it in the container and then give him the reinforcer
and let him enjoy it. The child will soon learn that when he imitates
your simple actions on the verbal command "do this", it
is followed by something nice. It would be great if you can observe
such sessions of work taking place with other children.
of some the books that you can benefit from are:
o The Me Book - O Ivar Lovaas
o Behavioral Intervention for Children with Autism - Catherine Maurice
o Pre school Activities - Toni Flowers
o Teaching Activities to Children with Autism - Eric Schopler
o Autism - Explaining the Enigma - Uta Frith
o A Compilation of Reading Material by Action for Autism - Action
four books help in planning an individualized program for the child.
The fifth book deals with understanding autism and the last one of
this list is our own compilation of useful reading material for understanding
and teaching persons with autism spectrum disorders. You can also
visit our site at http://www. autism-india.org
A is a six year old boy from Kolkata. He has been diagnosed autistic.
He is being treated for delayed speech and ADHD. He receives speech
therapy and is being taught at home by his mother and grand parents.
showing exceptional skills in arithmetic and language. We have taught
him only the alphabet and numbers and nothing more, but he is writing
sentences comprising difficult spellings without any mistake. He is
also performing long additions and multiplications which are difficult
without a calculator. He simply looks at the problem on paper and
writes the correct answer within moments. He has not been taught any
of these by us and the doctors are unable to explain the phenomena.
He is attending a normal school as he lacks speech. We are at a loss
to decide as to what to do for the proper nurturing and development
of his talent.
working in Doha, Qatar where no special schools are available. I plan
to bring them to Doha but this problem is delaying our decision.
From your account it appears that A may have some exceptional skills
that are quite often seen in individuals with Autism, known as savant
skills. People with savant skills may excel in one or more area, in
particular, in mathematical / calendric calculations, music or art.
Researchers have proposed many reasons for the emergence of these
skills, however the most acceptable explanation is that individuals
with Autism are able to focus on one area phenomenally well due to
the very nature of Autism and its core deficits.
to this, it appears that your child is also exceptionally gifted in
literacy skills. However, it is difficult to say how far a savant
skill this is, as it could well be related to hyperlexia (an ability
to read beyond one's level of comprehension) or an exceptional memory
for words and sentences. If your child is being worked with following
any particular intervention at home, perhaps his skill in literacy
and numeracy could be tested in a variety of situations and his strengths
assessed. It would be ideal for you to take your child to a specialist
school for a full functional assessment of his skills.
are currently no specialized centres in India for the development
of savant skills. However, with the guidance of a special educator
who has a sound understanding of autism you could hone A's skills
using appropriate training methods. This needs to be carried out within
the framework of an individual education plan that is based on his
needs and learning style.
lives in Kolkata, you could contact the Autism Society West Bengal
where you could receive training and guidance. In the meantime, we
suggest you focus on developing alternative modes of communication
for your child. You will need a special educator with experience
of Autism to guide you. Speech therapy may help your child but success
is limited within the Autism Spectrum.
If your child is on medication for ADHD, do ensure that he has been
diagnosed with ADD or ADHD. Many individuals with Autism present hyperactivity
due to reasons related to their autism, rather than clinical hyperactivity
that may also be found in typically developing children. In such cases,
medication may only be a temporary solution that will enable you to
work with your child following appropriate training methods.
I work in a special school and have two children with autism in my
class. Sometimes I am not sure how to teach them. Do you hold any
short training workshops or courses?
A. We hold very comprehensive workshops before or after Dussehra
in Delhi each year, as well as a few at other times in the year. They
are either given by teams from AFA in which case they are practical
in content focussing primarily on training attendees on how to help
persons with autism on a day to day basis. Or they are given by visiting
professionals from Europe and the USA in which case they are wide
ranging in their focus covering medical as well as educational issues.
We also give workshops on request around the country - which are usually
organised by the local Parent Support Group and supportive professionals
working together. The AFA web site at: http//:www.autism-india.org
has information on upcoming workshops as well as back issues of Autism
Network in which you may find answers to some of your concerns.
Have you come across anybody who got properly treated, cured or outgrew
Autism is a lifelong disorder. You do not get cured of it. But there
are many individuals who have progressed to an extent that you would
not know unless told that they have autism. They are able to function
appropriately in their environment. Every child with autism who receives
appropriate help will progress. We have seen children travel amazing
distances. However some will progress more than others will.
We have set up a daily routine for our son. We want a few suggestions
on how to structure the day for an autistic child.
It is wonderful that you have set up a daily plan for your son and
are trying to implement it to the fullest. Children with autism
require structure in order to give them a feeling of control and sureness.
They enjoy structure in their environment. At the same time,
to help their rigidity and compulsive need for sameness, it is good
to have variations within the routine.
to have a routine for the basic daily activities. Have regular
times for meals, bath and bedtime. As your son goes to school
in the mornings, set aside a few hours in the afternoon when you are
free from household chores to be with him.
you are just beginning to set up a schedule of activities with him
at home, you do not want to view that time with him as "time
to work." Start with having fun--play tickling games, sing
and clap-- basically whatever will get him to enjoy sitting with you
for a few minutes when you want him to. As you slowly find your
time with him increasing, structure that period with a mix of the
quiet and the active. Follow a period of sitting down with a
period of jumping activities and so on.
will not be possible for you to keep your son occupied all day, but
you could try and involve him in household chores. For example,
you might have a time when you collect your washing after it's dried.
You could say, "collect washing." Take along a basket/clean
bucket and help him remove the washing from the line and place it
in the bucket. Simplify the process to accomodate his attention
and ability: use methods learnt at the workshop! So then
you have a "time to collect the washing."
important part of the child's routine is bed-time. Most children
with autism appear to have irregular bedtimes and erratic sleep patterns.
Whether your son falls asleep or not, or even remains in bed or not,
prepare him for bed at a regular time each day. You could give
him a nice warm bath before dinner. After he's eaten he can
change and be put to bed. Read a little to him every night.
It does not matter whether he appears to listen or not. Read anyway!
son could be helped to adjust to a routine easier if you could provide
him with visual cues to his daily schedule. You could have cards
for each activity. Simple line drawings will do. Howvever,
if drawings do not make sense to him you could use photographs of
actual situations to help him understands what happens next.
For instance, an actual photograph of him in the bath can be used
for 'bath-time,' dried clothes in a basket for 'collect-washing time'
and so on. A further advantage of using schedules is that if
for any reason an activity has to be suddenly omitted one day, he
can be shown that it is not on the schedule. This is quite an
effective was of taking care of any possible distress over change
final suggestion and something that is possibly already being done:
ideally, both parents share in the activities with the child.
Mother can help him with lunch, father with dinner for instance.
The variation will be good for him.