Taking Stock, Re-focus, Modify & Moving Forward

Autism is an extremely complex developmental disorder which is not as simple to manage as one may perceive, but when having the right understanding & given the right support is a joy of living when one chooses life over suffering in this path less travelled. Autism itself is not awful. Not understanding it, not having people around you who understand it, not getting the help that is surely out there for your child - that can be very awful. I am thankful that situation now compare to beginning has improved since I first begin this very special walk with my little STAR 2.5 years ago.

I shall now attempt to take stock of his various aspect of development into 4 fundamental focusd areas:-

1) Sensory processing
- single attention, impacted if the environment inputs get little overwhelm as he may not focus on where he suppose to be
- his sensory seeking behavior has reduced and only happen when he needs to self regulate to calm himself via visual stimulation
- gross motor, visual co-ordination & scanning has improved
- balancing and stability(vestibular) had improved as can be observed in his independence at various out door/ in door playgrounds
- body joint co-ordination(propriocetives) has progressed well like jumping, hoppping, catching and throwing/kicking balls
- fine motor on going, writing had improved lately
- organise task and problem solving emerging, independent on those he is familiar like re-arranging work by myself
- impulse control on going development & work in progress b y OT, this is one area most difficult and need patience and time to stablize

External Consultant with OT by Ozworks Therapy in collaboration, re-direction and repeat corrective reinforcement of child understanding until he gets it right are one of the few practises use to maximize his potential in persevering & managing success, my little STAR has since developed the never give up attitude in task involving visual-motor co-ordination & organization.

2) Speech & Language (Aidan Rush Therapy Practise)
- He is more verbal as compare to Jan 2009 when he first started EIP, able to speak short phrases between 5-8 words at home.
- Able to comment as he watches educational DVD or TV programs which he is interested like sport channel or Disney channel.
- Able to read alphabets, currently working on his phonomic awareness to improve his reading skill
- Reading short picture story book is one of a routine we develop and cultivate him to elevate this focus area in parallel
- Able to recognize more items/objects from fresh cards/picture books
- Other aspect of syntax/grammar have been touched on in his literacy skill development such as possessive, singular/plural
- Able to ask WHERE is a person/object, WHO is the person at the door/WHO's turn in board game/bathing etc... Emerging WHY questions like WHY is baby crying? WHY take unmbrella? WHY daddy stop at traffic light? Other question common is "Can I have..." "Can you turn on/off TV/radio/car wiper etc..." HOW question commonly involves teaching him to ask HOW are you to another person like mummy. WHAT question usually is WHAT is person doing from video he watches or "Ah Ma, what you doing?" when grandma is preparing cooking in kitchen.
- Despite the fact that he has improved in this focus area but still his limited language and vocabulary may at times render his communication ineffective and he may resort to getting his agenda through in the form of inappropriate behavior challenges. Visual support, social stories/rules may help to leverage or manage success.

3) Social Interaction
- His weakest link when come to interpersonal relationships relating to others in social situation like responding, expressing or recognizing emotions of others, communication and friendships.
- His only familiar emotion expression to date is sad/crying, happy/feeling great, angry & painful(once in a while when he gets hurt). Emerging and less understood one are excited, scared.
- In play and leisure time with friends, his sharing, co-operating, playing games and social cue recognition has still got to work on harder to close the gap in the next IEP for H2 2011, even though he is able to achieve this at home with family members but helping him generalize with friends and peers need further break through.
- This must be prioritized as waiting will result in the child establishing a negative reputation because of his socially inappropriate behaviors. The help the EIP teacher provide will depend a lot on assistance available to the teacher herself, the presence of 1-1 aides for my little STAR.
- If necessary, we may have to pull the available resources from internal, if not all his external professonals (OT/SLP/Therapist for special needs in literacy/behavior) to support & carry out the social skill intervention.

4) Behavior Challenges
- had first touched on this in last Oct 2010 and early this year in Jan, hence will not elaborate too much
- Less melt downs these day if we understand the child weaknesses and build on his strength to broaden his horizon of learning . If any, at time where he gets anxious due to autistic traits of rigidity, a little cry of protest not more than seconds if person is able to apply suitable remedy to calm him down or re-direction with visual support.
- When we refuse his agenda/request, we may apply non-verbal to persist, the little STAR will repeat his request though and cry a little but if we persist non-verbal, he will then self dialogue to follow our agenda & translate his little cry of protest to request for visual support instead (like drawing the thing/object he want on a white board & put a cross over) to confirm his understanding in self regulation before he calm down and follow our agenda again
- To re-emphasize, all behavior springs from a reason and all behavior is communication, it is important to try an identify what triggers a behavior problem
- We must believe that he would interact appropriately if only he could, but has neither the social cognition, the sensory integrative abilities nor langauge to achieve it.
- One good way of teaching appropriate behaviors is by addressing the emotional modulation issues that underlie or worsen many challenging behavior
- We can teach him a script for stopping and getting himself back in control such as:-
A. take a deep breath
B. count to 10
C. say "I can stop _____"
D. then say "I can ______"

The child can then use this script to say in a specific situation to help him control his own behavior.
- It is also importance to differentiate & address rigid behavior & non-compliance, setting limits on inappropriate behavior and reinforcing appropriate behavior is extremely important in reducing problem behavior in children with ASD. If my little STAR is demonstrating an inappropriate behavior in work by myself like shouting/messy work or gym play making noise, the teacher may try set the limts and redirect him & persist that he do it right by stating the consequences(sit at naughty corner) of his non compliance with the rule. At home, we have tried to make him repeat the task/action until it is right to focus more attention on details where applicable. Such as writing neatly, walking instead of running, no wetting the floor else clean up etc..

There is a deep pain in my heart when I see negative out come from a child with ASD not redirected or reinforce rightly in time, coz we know very well he/she will grow up with habit as he may think literally that he can still do it his way but may not necessary be right in others perspective.

I am hopeful that situation will improved if teachers can profit from experience through their proactiveness or be supported by available therapy driven programs/consultant team.

Winners Statement:-

‎"Faith doesn't mean the absence of fear. It means having the energy to go ahead, right alongside the fear." - Sharon Salzberg