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     Volume 7 Issue 14 | April 4, 2008 |

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The Needs of Autistic Children

World Autism Awareness Day, observed on April 2, has brought to the forefront, the need to educate society on how to create an enabling, sensitive environment for autistic children. Parents too, need to be informed on how to bring out the best in their autistic children.

Dr. Leedy Hoque

Adil's fascination for ancient Egyptian history resulted in some remarkable artwork

On the road I live in Dhanmondi, Dhaka I already know of three children suffering from autism one being my own son Aadil , another a patient of mine and the third attends my son's school. There are schools mainly in the private sector mushrooming in Dhaka catering for the many autistic children yet to experience a formal education but hardly any or none exist in most other districts (apart from Chittagong ). This is why I have parents approaching me from all corners of Bangladesh-- Feni, Munshiganj, Faridpur , Panchagar etc all with the common grievance there is absolutely nowhere for their children to go. Even in Dhaka there is an acute shortage of mainstream schools that are willing to accept children at the more able end of the autistic spectrum. This crisis in the education sector must be urgently addressed by the education authority and ministry caring for the disabled.

Meticulous surveys must be performed throughout the country in both urban and rural areas to help identify not only the incidence of autism, but also to try to determine any risk factors ( eg. social , economical, geographical , medical, dietary ) that may account for the alarming surge in the incidence of autism .

The training of staff and monitoring the standard of education and care in all the schools and institutions is yet another urgent matter.

The above are issues that I desperately hope our government will address in the near future. However, on the home front, what can we do as parents to stimulate and bring our autistic children to their full potential, no matter where they are on the autistic spectrum?

First of all, one cannot bring out the best in a child unless that child is i) comfortable in the environment and ii) has a way to communicate his or her needs, likes and dislikes.

The majority of autistic individuals suffer from a myriad of sensory problems leading to numerous behavioural issues, anything from hyperactivity, poor eye contact, jumping continuously, climbing furniture, flapping their hands, rocking or spinning, appearing clumsy and bumping into people, walking on tiptoes, smearing their faeces, making loud unintelligible sounds, having difficulty in chewing foods, brushing their teeth, feeding and dressing themselves, difficulty with toilet skills etc. One has to assess these sensory issues by a qualified therapist and give the child the appropriate therapy without which the brain can not get organised . The sooner the problem is addressed, the better Neuronal pathways can still be laid down in the very young. It is more difficult to undo these behaviours in the older child. Giving the child medication to calm him or her is not or should not be the first line of treatment. Life will probably be more tolerable, but the child's potential may be suppressed if lethargy and drowsiness ensue. In certain cases, drugs may be employed, but only if the child's behaviour is so challenging, that the child and others in the immediate environment are at risk.

Alongside giving the child necessary sensory therapy, all out efforts must be made to provide a channel for communication. One has to encourage communication, not only by way of the spoken word, but also by providing a channel for those who are non-verbal. Inadequate communication leads to frustration and behavioural problems such as tantrums. This often becomes a learned behaviour, especially if the parent rushes to give whatever the child wants in order to pacify the child. This must be addressed at a very early age in order to avoid the problem escalating. Parents can take advantage of the fact that many autistic children are visual learners and can use symbols, flashcards with photographs or simply the written word to convey a message.

Both communication and behavioural problems may be improved by dietary intervention, so parents should be aware of sugar-free diet and / or gluten (wheat) and casein (milk ) free diets that are known to benefit some ( but not all ) autistic people .

From my personal experience, the autistic child learns best when strongly motivated. One may think it is near impossible to motivate a child with autism, but usually with patience, giving the child clear, simple commands, employing visual prompts, and using whatever it is the child is fascinated by, one can build a bridge between our world and the child's world. All too often I hear parents say they have been advised by other professionals to withdraw the child's favourite activity be it music, swinging, jumping on a trampoline, playing with a particular toy or object, or smelling bottles of lotion and perfume .I personally take a different stance.

Artist: Adil Hoque

Repeatedly I have found that when I follow my son's lead, it has invariably led to a positive outcome. Many may know that Aadil's passion for Ancient Egypt was the trigger for development of his communicative speech, reading, writing, drawing and painting. Recently he asked if there is a Bangla song with an Egyptian theme .Now he is enjoying music lessons with a teacher with a voice of a nightingale and a heart to match, Aadil's favourite song, obviously is “ Momero putul momer desher meye neychey jai”. A child who comes to me from Barisal is now learning to speak as a result of the intense stimulation he is receiving from his mother who works in close liaison with his teachers. Both mother and teachers stimulate him using rhymes and songs that he enjoys. I am urging his parents to provide a music teacher for him, just for his enjoyment. Who knows, may be one day he may even be able to sing a line or two of his favourite song. Another child, also seven years, but with multiple disabilities (Down's syndrome with autistic features and right sided weakness) has a spirit that is undaunted. She dreams of studying at BUET, like her brother. I tell her to dream on, that she can fulfil any wish. To her parents I advised not to waste further time pressing her to improve her hand writing (her hand has been weakened by the stroke she suffered a few years ago), rather by providing her with a laptop computer, she will be able to express all her wonderful ideas with the tap of a finger. My observations: the children who are motivated and have made the most progress are those who have had the fortune of having a parent (usually the mother) working intensely with the child . So the message is very clear: it is imperative for parents to get directly involved in the stimulation of their autistic child. With the unconditional love and support of parents and teachers alike the autistic child is bound to reach his or her full potential.

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