Parenting a child with Autism

Dr Priti Mhatre
Developmental Paediatrician
Founder Director – Tender Kids CDC
MBBS,DCh, PG Dipl. Developmental Neurology
Fellowship in Developmental Paediatrics (MUHS)
• What is Autism??
• Causes??
• Diagnosis??
• How does it affect my child??
• How can I help my child??
Causes???
 Diagnosis….

• Team
• Interview + observation
• No medical test
HOW CAN I HELP A CHILD WITH AUTISM?

• Developmentally-based
techniques encourage therapists and
parents to work with the child’s own
interests or actions to slowly build
engagement, interaction, and
communication.
Assessment & Intervention: Multidisciplinary team approach

Developmental
Paediatrician

Psychiatrist / Occupational
Ped.Neurologist therapist

Social worker
Child & Clinical

Family
psychologist

Behavioural
Special educator
therapist

Speech language
pathologist
 Functional assessments
The current level of performance of the child in
various skill areas including
1. motor & speech development,
2. imitation skills,
3. cognitive development,
4. academic skills and
5. activities of daily living.
 Management
• Pharmacological
• Non Pharmacological
– Occupational Therapy
– Speech & Language Therapy
– Verbal & Behavioural Therapy
– Special Education
– AAC
– CAM??
 Functional Communication & Behavioral Therapy for
Reducing and Replacing Challenging Behaviors in
Autistic children

Ms Shilpa Sethi
(Behavioral Therapist - Autism. In charge of Autism Therapy Services -
Tender Kids Child Development Centre )
What is Applied Behavior Analysis?
• A therapy based on the science of learning and
behavior.
• Behavior analysis helps us to understand:
– How behavior works
– How behavior is affected by the environment
– How learning takes place
• ABA therapy applies our understanding of how
behavior works to real situations.
• The goal is to increase behaviors that are helpful and
decrease behaviors that are harmful or affect learning
• The methods of behavior analysis have been
used and studied for decades.
• Therapists have used ABA to help children
with autism and related developmental
disorders since the 1960s
• An evidence-based “best” practice treatment
by the US Surgeon General and by the
American Psychological Association.
• “Evidence based” means that ABA has passed
scientific tests of its usefulness, quality, and
effectiveness.
 How does ABA therapy work?
• Applied Behavior Analysis involves many techniques
for understanding and changing behavior.
• Applied Behavioural Analysis (ABA) – based
techniques focus on the child’s interests and
motivation to learn new, more adaptive
behaviours.
• Teaches skills that are useful in everyday life
• Can involve one-to-one teaching or group
instruction
 Positive Reinforcement
• One of the main strategies used in ABA.
• First, the therapist identifies a goal behavior. Each
time the person uses the behavior or skill
successfully, they get a reward.
• The reward is meaningful to the individual – examples
include praise, a toy or book, watching a video, access
to playground or other location, and more.
• Positive rewards encourage the person to continue
using the skill.
• Over time this leads to meaningful behavior change.
 Planning and Ongoing Assessment
• A qualified and trained behavior analyst (BCBA) designs and
directly oversees the program.
• Treatment goals are written based on the age and ability
level of the person with ASD. Goals can include many different
skill areas, such as:
– Communication and language
– Social skills
– Self-care (such as showering and toileting)
– Play and leisure
– Motor skills
– Learning and academic skills
• The instruction plan breaks down each of these skills into
small, concrete steps.
• The therapist teaches each step one by one, from simple (e.g.
imitating single sounds) to more complex (e.g. carrying on a
conversation).
• The BCBA and therapists measure progress by collecting data
in each therapy session. Data helps them to monitor the
person’s progress toward goals on an ongoing basis.
• The behavior analyst regularly meets with family members
and program staff to review information about progress. They
can then plan ahead and adjust teaching plans and goals as
needed
 ABA Techniques and Philosophy
• The person with autism will have many opportunities
to learn and practice skills each day. This can happen
in both planned and naturally occurring situations.
• The learner receives an abundance of positive
reinforcement for demonstrating useful skills and
socially appropriate behaviors.
• The emphasis is on positive social interactions and
enjoyable learning.
• The learner receives no reinforcement for behaviors
that pose harm or prevent learning.
 What is Verbal Behavior Therapy?
• Verbal Behavior (VB) therapy teaches communication and
language.
• It is based on the principles of Applied Behavior Analysis and
the theories of behaviorist B.F. Skinner.
• This approach encourages people with autism to learn
language by connecting words with their purposes.
• The student learns that words can help them get desired
objects or results.
• Verbal Behavior therapy does not focus on words as labels only
(cat, car, etc.). Rather, it teaches why we use words and how
they are useful in making requests and communicating ideas
• Language is classified into types, called “operants.”
• Each operant has a different function.
• Verbal Behavior therapy focuses on four word types:
– Mand: A request, such as saying “Cookie,” to ask for a
cookie
– Tact: A comment used to share an experience or draw
attention, such as “airplane” to point out an airplane
– Intraverbal: A word used to respond or answer a
question, such as “Where do you go to school?” “Castle
Park Elementary”
– Echoic: A repeated, or echoed, word, such as “Cookie?”
“Cookie!” This is important as imitating will help the
student learn
 How does Verbal Behavior work?
1. Teaching mands (requests) as the most basic type of language. For example, the
individual with autism learns that saying “cookie” can produce a cookie.
2. As soon as the student makes a request, the therapist repeats the word and
presents the requested item. The therapist then uses the word again in the
same context to reinforce the meaning.
3. The person does not have to say the actual word to receive the desired item. At
first, he or she simply needs to make a request by any means (such as
pointing). The person learns that communicating produces positive results.
4. The therapist then helps the student shape communication over time toward
saying or signing the actual word.
5. In a typical session, the teacher asks a series of questions that combine easy and
hard requests. This allows the student to be successful more often and reduces
frustration. The teacher should vary the situations and instructions in ways that
keep the student interested.
Who can benefit from Verbal Behavior
therapy?
– Young children beginning to learn
language
– Older students with delayed or
disordered language
– Children and adults who sign or use
visual supports or other forms of
assisted communication
Any Questions
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