What do we want from our children? Don’t we all want them to grow up healthy, have a successful career, settle down and have a happy family?
If you are a parent of a child with autism, this probably seems like an impossible dream. That is because, by now, you probably know a lot about the disorder, and the challenges that confront your child and your family – you have possibly googled the subject more than anything else! Hence this article is not meant to be an introduction to AUTISM. However, before I get to what I want to communicate to you, I would like to say a few things about the underlying characteristics of the disorder and how they impact a person.
Every person with Autism has varying degrees and types of challenges: Some may talk a lot, some not at all. Some may have very high level of IQ, some low. Some may not suffer any physical challenges while some may have sensory, gross motor and/or fine motor issues. These are not observed in similar degrees or with a consistent pattern in every person with Autism. That is why it is now specified as “Autism Spectrum Disorder” or ASD, which essentially means that people diagnosed with the disorder may exhibit a range and mix of issues, which may be unique to them, just as we all have unique finger-prints.
At the very basic level however, it is a complex neurological disorder which affects social behaviour, social understanding, speech and language development and sometimes cognitive development. Thus, a person with Autism, more often than not, is found to avoid social interactions and related ‘challenges’: many prefer to be left alone and indulge in repetitive behaviours.
That’s a bit about the disorder itself. The other worrying factor – not only for families and care-givers, but also for government and policy makers – is the rapid increase in the number of cases being diagnosed and reported. In the U.S, one child in 68 is being diagnosed with Autism. In India the incidence is reported to be about 1 in 200, and rapidly increasing.
The rise in incidence of Autism has undoubtedly led to an increase in awareness about the disorder, and we now see a number of professionals employing various therapies and protocols to help children with Autism cope with their challenges. A lot of work is being done in areas such as speech development, building of skills associated with daily activities like brushing, wearing clothes etc., development of cognitive thinking by teaching colour recognition, matching, sorting, etc., coping with academic work and also overcoming physical challenges emanating from poor muscle tone, poor muscle co-ordination etc. While targeting these skills individually and directly is often necessary as they certainly help in the child’s development, such an approach, in isolation, at best repairs splinter/disparate skills which only help the child cope with very specific or particular situations in this world. For example, a child can be taught basic social ‘DOs & DON’Ts’ which could help her fit into a particular social environment (like a classroom). But targeting such discrete skills do little to overcome the basic underlying challenges that are present in those on the Autism Spectrum Disorder – they do not really address or help overcome the core deficits of Autism, which are:
- challenges with regard to managing social communication and understanding, and the resulting inability to build relationships;
- incapability of flexible thinking and analysis which adversely impacts problem solving skills and higher level thinking;
- abstract language comprehension;
- lack of motivation;
It is important to target these deficits if we are aiming for a path of remediation and recovery that ultimately enables people on the autism spectrum to lead regular, self-reliant, independent lives that are based on successful professional and personal relationships.
Let’s try and understand one of the core deficits of Autism: social communication skills. Usually, lack of social communication is equated with absence of speech. Many parents think that if a child is taught to speak words, she will start communicating well and that will solve most of her problems. In thinking like that we are again looking at developing a particular skill in the child (speech) and not addressing the core problem. The core problem is not as much an absence of speech as it is an absence of social understanding. A child with Autism cannot really understand the “why” of social communication and social responsibility. Why is it important to engage with others? What is the fun in a relationship? Why do we say “hello” and “goodbye”? Teaching them how to greet others and say a few words, mechanically and without any emotion behind it, misses the fact that it is actually the emotional development of the child that needs to be targeted rather than speech.
Similarly, people on the Autism spectrum usually lack what we refer to as the capacity for “dynamic thinking” which is also referred to as “flexible thinking” or “common sense thinking”. For example, it may be possible to teach a child on the spectrum how to travel from destination A to destination by walking to the bus stop, taking a specific bus, paying the exact fare and getting off at destination B. But unfortunately, if the said bus does not ply on a particular day or takes a different route, the person may not be able to cope with these changes or take any on-the-spot decisions to adjust his plans as per the changed situation. The ability to take on-the-spot decisions, make adjustments, alter plans, think of alternative solutions is Dynamic Thinking, and this is what is found to be highly lacking in people on the Autism spectrum. Among the many therapies that seek to address the core deficits of Autism, I work with one that is called RDI (Relationship Development Intervention). In RDI, we guide parents on how to work with their children using everyday situations and activities. Through a step-by-step and manageable approach, RDI aims to correct the core underlying problems of autism, so that they no longer form an obstacle to our kids reaching their fullest potential and therefore can lead a high-quality life.
Autism Conversations with Rashmi 