Friday, May 10, 2024

basic advice to parents of autism kids about how learning is to be initiated and in what direction

When we need to do correct, we need to stop doing wrong.
When going ahead is our goal. Let’s not go behind.
Whatever child used to do in past and has regresses, lets keep that as a goal to get back in 6 months and move ahead.
Our kid has learning deficit. It’s not delay. Delays get catch up, deficits need double speed to overcome to an extent.
In autism the social and cognitive development is slowed down to say 0.0005 x zoom.
All developmental soft milestones which appear normally at an age and maturity wil seem to appear slowly, slower, later and develop over months than just 2 weeks in normal kids.
Development Of social and cognitive milestones is important for learning.
Our kid has learning deficit. Kid couldn’t learn like normal kids bcos child is not receptive for learning.
Whatever child has learnt, had learnt in extremely slow speed with heavily repeated conditioning.
Our aim is to help the kid learn on his own from environment.
So, when learning is our motive, and we have serious learning deficit, we need to be very serious about this goal and work towards it.
So when learning is our motive, at least for 2 months let’s give 200% percent to it and strictly stay away from entertainment
If maximum time of the day is not spent on learning it means that maximum time of the day is just time passed or spent on entertainment. And if so, means we are not serious about learning.
What child has to learn is being human to become a member of the family.
Being a member of family. One who can become a member of family then only one can become member of society.
To become a member of family, the kid has to learn to connect with family members.
Only when u connect with someone we communicate with them.
Without connection and communication  there is no onversation.
What one has to learn is to
 1. Be with humans 
2. Look at humans 
3. Listen to humans 
4. Follow humans 
5. Feel humans 
6. Develop a relationship with humans 
7. Listen to humans
 8. Copy the feelings, looks, communication and conversations 9. Copy the language and intellect and behaviour . 

To develop awareness of human word  it’s important that child should develop awareness of environment. Initially (basic non living and ) most importantly basic living environment.
Awareness of environment is developed only when child gives attention to the environment.
To notice any thing or any one or feel any thing or any one , one needs to notice the environment 
To notice the environment,  one needs to develop posture of attention.
Posture of attention is like being receptive. 
Without receptiveness, there is no learning 
So let’s make the kid receptive. Only when we can make the kid receptive, we can expect a response. Initially without understanding  and later with minimal understanding, which will grow as per inputs.
Posture of attention means steadyness of body and mind. It’s like fixing the dish antenna to receive signals. Only when body receives signals, in time and adequate, the signals are noted and processed.
Autism kids are not receptive as per age. Mainly bcos their mind or body is not in a state of receptiveness.
For example, 
1. One may need to call by name or action many times to get attention
2. One may fail to get child’s attention to the learning objects or people
It means eyes are there to notice and ears are there to listen, the kid is not blind or deaf, but cannot see or hear promptly to a signal.

One most common reason why someone cannot pay attention despite repeated attempts being..
1. The child is not steady by body or child’s body hands or feet or eyes are in continuous state of movement. When one is in movement, attention takes backfoot 
2. The child is not steady by mind or child’s thought behaviors action feeling or sensing the environment are not steady. Unless the body is steady, mind cannot  be steady
3. Only when body  and mind is steady , eyes can focus.
4. To learn something , eyes and ears attention needs to be given to the person who is teaching throught eyes and sound /language.
5. Unless u look at a person or human, u cannot connect with them.
6. Listening by ears , need a sustained focus with eyes.
7. Humans are best connected by eye to eye connection.. longer and sustained
8. Only when u develop a good eye to eye connection , u can initiate listening.
9. Ears are there to listen.
10. To become aware of environment, we need to appreciate, understand and learn signals given to eyes and eats
11. 99% of our knowledge and learning comes through listening or verbal learning.
12. Verbal or listened learning has language, vocabulary, imagination, past tense and future tense 
13. Visual learning lacks all this and surely touch based learning doesn’t  help u understand language communication and no 12 above.
14. To conclude, one has initiate sustained sitting, sustained looking and sustained listening in preferablybverbal form to develop awareness of surroundings.
15. Learning by eyes and ears through verbal form is 1000 times superior to nonverbal learning through skin and toys.
Dr Santosh Kondekar www.autismdoctor.in
Continued..

what therapist to choose? choose the one that is closest and works as per your needs and guidance of your developmental pediatrician - Dr kondekar

Psychologsts versus therapists .. 

The issue is settled with pure understanding that autism being a primary neurodevelopmental disorder with require a neuro developmental or SI OR OT therapists and it is not a primary psychological or behavioural or psychiatric disorder to require psychiatrists  or behavioural psychologist to manage the same.

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We even see arguments in psychiatrists  versus psychologists ..
It's because a decade ago autism was thought to be a behaviours disorder and 2 decades ago it was thought to be a psychaitric disorder and 3 decades ago it was called childhood psychoses or schizophrenia.

 I see maddening run for CBT , ABA,RDI, other branded therapies in autism. Please understand that your OT ST and neuro pediatrician is enough to manage holistically and help you decide when to go for it and whether it is really needed. 
Please save time and resources for early intervention, whatever u can do is best but always be least for your kids.
Some brands u will find only in cities and very far from your location, and it's not worth wasting that much time if u have a therapist locally who can learn those tricks and help u modify holistic care.
If available across the door go for both,. See what suits and stick to it. Autism is not a single set of symptoms presenting same way to be managed by short term courses (that cost a huge bomb.,)
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What is most important is something should be started and u should switch to other if u feel it doesn't work in 100 days.  Go for one who puts their heart into therapy .
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N SIMPLE WORDS... OT /ST is generic... And others are branded... But the key differences being the branded methodists are not trained in basic human neurosciences and diseases the way the Therapist education goes.  Branded therapies seem to be a shortcut but can't be holistic.

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ABA is a principle of life , every human and every therapist has to incorporate in their interventions. All ABA do use concepts of therapy for development of necessary socialisation.

 ABA can only be top up and not replacement for basic OT. AbA are not always trained in OT but it's easy for an OT to undertsand all ABA and practice. Don't spoil peace of Ur mind and waste money just bcos one doesn't have a brand ABA person within 20 km of ur stay. It's not possibly practical. Fees of specialists go on rising more the shortage is created with more special names and not dependent on quality care.
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When we say we all need rice and Dal to eat, each hotel comes up with their own dishes to say theirs is the best and most effective nutrition.  Now every one knows we all have home made daal rice is the best . But we do need some tips to make the home made daal rice a little more tastier and nutritive.
Same is aba on top up of OT. What ABA imhas created a brand name for different techniques... Is actually practised by many therapists world wide and ABA want to call it's separate name.. and in that brand it's forgetting the holistic and basic OT which is required for the child.
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All are parts of therapies just a section taken out and branded as name to market ... Only for a section of improvement. Don't fall for it. Sit with the therapist you have available and close, discuss with them and chalk downs plan.. don't run here n there...  Plan your goals . And u will start seeing improvements. If u find no change with an intensive program of therapy over 3 months . .. re-wise.   ***Discuss with neuropediatrician, ask for second opinion let there be healthy communication-between tow therapists.. and continue with closest and comfortable places. 
Otherwise we had seen people running for camels milk too spending all the resources and time which they would have used for the child at that moment.
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it's just a marketting strategy and many OT and ST practice same techniques world wide. It's a brand name that they had developed... And sell at high rates. Don't fall for it. More so ABA ARE NOT TRAINED IN BASIC HUMAN SCIENCES LIKE OT ARE. So they don't understand exact developmental disorders.. and hence they are ineffective in managing kids who have abnormal behaviour  due to brain issues. There is a specific role for ABA in learning. 
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OT with SI is the best form of therapy for autism .please discuss with your neurodevelopmental pediatrician how they can guide in achieving what therapist is best at what level of the issue and how to chalk out a collective plan if needed and also about medications to make child therapy ready and improve the speed of interventions.

Gestalt method of speech therapy in autism: how to teach langauge to autism kids

a video example of gestalt method.. Dr kondekar is explaining one line just talk and give but with context and example of Bhagwad gita Arjun...