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Wed, Sep 22, 2010
New Straits Times
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Helping the autistic child to cope
by Prasanna Raman
TANTRUMS and other behavioural problems may seem typical of children and young adults with autism.

While many think little can be done about these, Denise Keller, a behaviour specialist says a communication strategy can be developed to help an autistic individual communicate effectively.

To do this, says Denise Keller, who is attached to the Mendocino County Office of Education in North California, US, a functional analysis must first be carried out to understand how such behaviour is actually an expression of a child’s needs.

“There are triggers in the environment that cause an autistic individual to display behavioural problems. For example, a room with loud music or a room that’s too brightly lit can be the cause. By avoiding an over-stimulating environment and by teaching the child the language they need to communicate, we can encourage the development of social and life skills,” says Keller.

She was here to speak at a half-day workshop on understanding the behaviour of an autistic individual.

She also discussed teaching strategies and alternative forms of communication such as communicative devices and applications so that an autistic individual can communicate better.

Keller, who has over 15 years of experience as a behaviour analyst, also develops and conducts training for school site personnel in functional behavioural assessment, behavioural support strategies and the development and implementation of positive behaviour support and positive behaviour intervention plans.

The use of vocal language, she says, is one strategy where communication can be taught to an autistic individual. “For example, when we tickle a child, and when he wants you to stop, we tell him to use the word ‘stop’. Through repetition, the behaviour is reinforced. If the child isn’t receptive to vocal language, then sign language can be used, if their motor skills are good. The other option is to use pictures or symbolic communication,” she says, explaining the Picture Exchange Communication System or Pecs.

“For example, a child is shown a glass of water and then a picture of a glass of water to demonstrate that both are same objects. That reinforcement helps the child to realise that if he wants a glass of water, he can point to a picture of that glass in the Pecs folder and ask for what he wants,” she says.

With the system, a child is exposed to a number of pictures that is usually associated with his wants, like food and toys. When he points at the picture of an object, out to something, he is given that object.

This, says Keller, is positive reinforcement and the process also encourages child-initiated communication. The more advanced stage in Pecs, a form of augmentative and alternative communication, says Keller, is the use of sentence strips. “For example, we create a sentence like ‘I want to...’ and use words like ‘play’, ‘sleep’, ‘rest’, and so on to help them expand their vocabulary,” she says, adding that they can also communicate with their parent, caregiver or even therapist, when they see or heard things around the environment they’re in.

Research, she adds, shows that autistic individuals need to be taught in a systematic way. Emphasising the use of positive reinforcement strategies that reward a child for showing appropriate behaviours, are steps in behaviour modification.

“A lot of unwanted behaviours go on because we let those behaviours escape,” she says, reminding parents and caregivers that if problematic behaviours are rewarded, they’ll have more problems on their hands.

Although eliminating stress and over-stimulation in any environment is crucial in the early stages of intervention, Keller says an autistic individual needs to be taught coping skills too.

Loud music, for instance, can trigger unwanted behaviour as autistic children need a calm and quiet room to function.

“But over time, they need to be exposed to music, little by little, because if they’re attending a party or are out in a shopping mall, there’s bound to be loud music around. That’s the real world that they’d eventually have to face at some point in their lives.

“Similarly, some autistic kids can’t stand the way some clothing feel on their skin. They may throw a tantrum when that shirt or dress is put on them. Pay attention to what triggers their unwanted behaviour.

“However, over time, these kids also need to be desensitised through contact with that certain material, bit by bit, until they can tolerate it,” explains Keller.

As a parent of a 28-year old autistic son, Keller knows that if a child can’t learn the way you teach, then you need to teach the way a child can learn. “Everybody has the ability to do something. We need to teach autistic children functional skills as well such as cooking, washing and cleaning as the objective is to have them functioning as able individuals when they’re much older,” she says, adding that autistic individuals perform well in matching and sorting jobs.

She says her son is able to run a dishwasher in a restaurant as the steps have been broken down into tasks or little steps that he can understand. Although a majority of autistic adults in the US end up staying at home, Keller is pleased that her son is now regularly helping out in a dining room that feeds the homeless. “He’s making a contribution to the society and doing that makes him feel a part of the society he’s in,” she explains.

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