Tehreem Khan Bangash
The Early Intervention Therapy Unit at Maroof International Hospital is now offering therapy services, assessments, and training for children from 1 year to 12 years of age under the supervision of International Behavior Analysts (IBAO).
The team of therapists, psychologists, and special education needs coordinators are available to take care of your little ones, said Rubina Afzal Head of Corporate Business.
What is Autism?
Autism spectrum disorder is a serious neurodevelopmental disorder that impairs a child’s ability to communicate and interact with others. It also includes restricted repetitive behaviors, interests, and activities.
These issues cause significant impairment in social, occupational, and other areas of functioning. People with ASD may behave, communicate, interact, and learn in ways that are different from most other people.
There is often nothing about how they look that sets them apart from other people. The abilities of people with ASD can vary significantly.
For example, some people with ASD may have advanced conversation skills whereas others may be nonverbal. Some people with ASD need a lot of help in their daily lives; others can work and live with little to no support.
ASD begins before the age of 3 years and can last throughout a person’s life, although symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life.
In others, symptoms may not show up until 24 months of age or later. Some children with ASD gain new skills and meet developmental milestones until around 18 to 24 months of age, and then they stop gaining new skills or lose the skills they once had.
Prevalence
• In 2021, the CDC reported that approximately 1 in 44 children in the U.S. is diagnosed with an autism spectrum disorder (ASD), according to 2018 data. Boys are four times more likely to be diagnosed with autism than girls.
Characteristics of Autism
• Deficits in language, communication, and social skills must be present prior to age three
a) Impaired social interaction
• Individuals may display deficits in the use of nonverbal behaviors such as eye contact, facial expression, and posture
• Individuals may fail to establish appropriate peer relationships and demonstrate a lack of emotional reciprocity
• Poor use of social signals and weak integration of social, emotional, and communicative behavior
• Smile and look at others less often, and respond less to their own name.
b) Impaired communication abilities
• May include a delay or complete lack of development of expressive speech
• Difficulties sustaining or initiating conversation with others
• Stereotypical or repetitive use of language
• Lack of developmentally appropriate play
c) Stereotyped interests or activities
• Individuals may be unusually preoccupied with one or more areas of interest
• May adhere to non-functional rituals or routines
• May display repetitive motor movements e.g. hand flapping
• Gets very upset by minor changes in routine.
• Overactivity, disruptive behavior, and temper tantrums may occur for little or no reason.
• Phobias, eating and sleeping disturbances
• stereotyped and repetitive play
When can Autism be diagnosed?
Research has shown that ASD can be diagnosed as early as 1 year of age.
• No big smiles or other warm, joyful expressions by six months or thereafter
• No back-and-forth sharing of sounds, smiles, or other facial expressions by nine months
• No babbling by 12 months
• No back-and-forth gestures such as pointing, showing, reaching, or waving by 12 months
• No words by 16 months
• No meaningful, two-word phrases (not including imitating or repeating) by 24 months
• Any loss of speech, babbling, or social skills at any age
Best Practice for ASD Assessment
• Early assessment and intervention are crucial to progress
• WHO?
• Trained professionals
• Psychologists, Neurologists, Pediatricians, Psychiatrists, and Speech and Language pathologists.
• WHAT?
• Developmental history, observations, direct interaction, parent interview, evaluation of social, communication, sensory, emotional, cognitive, and adaptive behavior.
• Must rule out MR, hearing impairment, behavior disorders, or eccentric habits
• WHERE?
– Multiple settings
Treatment
Medicine
No medication can improve the core signs of autism but they are often used to treat behavior or emotions that people with autism may have, including:
• Anxiety
• Attention Problems
• Hyperactivity
Behavior Management Therapy
Applied Behavior Analysis
• ABA, applied behavioral analysis, is simply the application of behavioral principles, to everyday situations, that will, over time, increase or decrease targeted behaviors.
• ABA has been used to help individuals acquire many different skills, such as language skills, self-help skills, and play skills; in addition, these principles can help to decrease maladaptive behaviors such as aggression, self-stimulatory behaviors, and self-injury.
Types of ABA
• Discrete Trial Training (DTT): It is a style of teaching that uses a series of trials to teach each step of a desired behavior or response. Lessons are broken down into their simplest parts and positive reinforcement is used to reward correct answers and behaviors. Incorrect answers are ignored.
• Early Intensive Behavioral Intervention (EIBI): This is a type of ABA for very young children with ASD, usually younger than five, and often younger than three.
• Pivotal Response Training (PRT): PRT aims to increase a child’s motivation to learn, monitor his own behavior, and initiate communication with others. Positive changes in these behaviors should have widespread effects on other behaviors.
• Verbal Behavior Intervention (VBI): VBI is a type of ABA that focuses on teaching verbal skills.
Sensory Integration Therapy
• Sensory integration therapy helps the person deal with sensory information, like sights, sounds, and smells. Sensory integration therapy could help a child who is bothered by certain sounds or does not like to be touched.
• Treatment may include having the individual handle materials with different textures or listen to different sounds.
• Sensory integration therapy is usually provided by occupational therapists (OT).
Speech therapy [Picture exchange communication systems (PECS)]
• Picture exchange communication systems (PECS) enable autistic people to communicate using pictures that represent ideas, activities, or items. The individual is able to convey requests, needs, and desires to others by simply handing them a picture.
Occupational therapy
Helps improve independent function and teaches basic skills (e.g., buttoning a shirt, bathing).
Physical therapy
Involves using exercise and other physical measures (e.g., massage, heat) to help people with autism spectrum disorders control body movements.
Autism Prognosis
People with autism have normal life expectancies. With early intervention and appropriate treatment, many autistic people can function productively and attain some degree of independence. Some people with autism spectrum disorders require lifelong assistance.
The writer is the Head of the Early Intervention Therapy Unit, International Behavior Analyst (IBAO) Cert.#39416240, and Consultant Speech and Language Pathologist and Behavior Analyst at the Maroof International Hospital
**The views expressed here in this article are the writer’s own and do not necessarily reflect the position of the institutions or staff.
