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 Arjuna and Krishna  click the link

Teach with meaning, not with grammer.

Teach will words and sentences not with letters and phonics 

Teach with linked sentences and not broken words .

Teach with contextual references and not just monotonus.

Teach without asking questions, a good teaching ahs teachers asking questions.

Teach in a flow, understanding and not grammer is the key 

Teach without perfection at each step 

Teach without repititions,, dynamic diverse different and difficult learning is key for better cognition.

Teach face to face looking into eyes without touching.

Use many sentences to describe one meaning.

Just keep adding affirmative narrations, events actions conversations, mythology stories, panchtantra stories with moral lessons, Akbar birbal wisdom stories.   Before thevkis ready for schooling.

Dr kondekar http://autismdoctor.in 

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.

cry in autism kids, meltdown or temper tantrums or pain?

A good number of time children with autism are seen cranky, crying or irritated, restless and not receptive or cooperative.

There are few reasons which can help us settle the issue.

1. Tantrums: These also called temper tantrums, often have a reason or need not being met. The reason can be as stupid or simple but may not be often obvious. The cry is mainly because the demand is denied. So when a child showing tantrums, he may giving a good eye contact and some response to communication or bargain or deal. Often it's close to stubbornness. 

Tantrums is best tackled not by meeting the demand but by ignoring it.

2. Stubbornness: is often associated cry as there is obvious resistance from both sides. The resistance can be for any specific pattern of behaviour action communication or need of some object. When a child starts developing his social communication, his ego starts developing. With his ego, he tries to get his demands and needs met by controlling others. If there is any resistance or denial or neglect by others, child gets agitated , the ego being hurt and it results in hurting or cry or pinching or biting or pulling hair or throwing in Autism kid. The best way to treat this is by ignoring, going out of scene, going away from eyes of child, running out of room for at least 3 minutes.  Even standing like a statue facing wall with eyes closed also helps. But dealing, bargaining, trying to explain or counsel the kid or falling from demands or even looking into kids eye will worsen the situation. 

3.meltdowns: often when an autism kid has a meltdown, the reason cannot be judged or found. The child keeps crying relentlessly. There will be no eye contact, no demand. Child any roll on floor or keep walking while crying. Often this is result of child's inability to cope up with nature, situation or frustration. Often this is cry of frustration and depression.

4. More commoner causes of crying in autism kids:

Constipation/ indigestion

Colic or cramps

Nose block or runny nose

Pain due to any trauma or injury

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Always ask:

Is he passing motions daily? Are they very hard?

What are exact sleep hours from what time to time?

Stubbornness related cry is a learned behaviour  or manipulation

Cry without stubbornness is frustration.

Cry as response to a person or environment is sensory issue.

Cry is often seen with cold, ear ache, colic , constipation and confusion

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*FEEL FREE TO WHATSAPP FOR MORE DETAILS. TO. 9869405747*

So often doctor or therapist dealing with autism has to keep these reasons mind.

When a child is in crying phase, often the therapy session goes waste.

A developmental pediatrician helps sort out understanding and treating such issues with appropriate medications when needed.

Counselling and behaviour therapy works better only when the child is in a state of LISTENING. 

It's the neuro pediatrician doctors job to make a kid more receptive, responsive and responsible.

DR Kondekar http://autismdrmumbai.com

Do ask about Block Hypothesis 

autismwallah WhatsApp channel for helping autism kids and parents beyond awareness

Click below 

Click on follow to start seeing tips for day to day help with development of autism kids

https://whatsapp.com/channel/0029Va7vhoc5Ejy6ArGJGx1F

autism reversal principles and some basic advice PARENTS ARE KEY

WWW.AUTISMDOCTOR.IN

if you feel you have learnt all tricks of OT etc , and you can teach OT to any kid with autism or take care of your 

autism kid for years, *you are wrong*; it just means that you dont know the next step. Sometimes it's good to 

accept we are wrong, then only we can *see the ray of hope.*

When we work with medicines and therapy *we develop connections and cross connections to processing 

centers;* which shows extended level of communications in the form of development in various *domains of 

understanding* including knowledge, nonverbal communication, behavior, emotions, socialization, interactive 

games and talking and writing skills apart from physical things.

** *Leaving things half way will develop connections half way and loose connections always die.* ** Often with a 

spark.

*Development is decided by connections, speed is decided by myelination.* 

At least keep a *minimum goal of readiness for primary school* admission over 2 year phase. Then divide them 

into steps. 

*Later the age of intervention or medicines harder will be recovery or development of milestones.*

Work towards reducing severity of level, A child who can take main stream schooling for primary usually is 

*independent* and can be educated and trained to take care of family responsibly , when he or she grows up.

*Remember every one has limits.. even God too does.. we all are attempting to look beyond the perceived limit 

and find a higher achievable limit, in the best interest of the child, when we walk towards horizon attempting to 

touch the limit, the limit too moves ahead.*giving us hopes to improve further every month 

Dr Kondekar #MakingSense

I want all parents to understand when we are looking for improvements, what all changes we may look for. A keen 

parent would like to note down minor details about every change on weekly basis rather than saying sir no 

improvement. 

Other parents may have similar ideas but if u don't note down In details, it's not easy to compare the improvement 

across time line. See the monitoring chart. Given at website neuropediatrician.com for getting a serious idea to see 

objective change.

The improvements can be minor when we expect changes every week , it's always better to note down.

*Try to list changes as per gains since last visit and goals till next visit*

Also you have headings

activities - living, household,, skills and gross /fine motor

Communication

Interaction

Academics

Langauge concepts

Pre match concepts

Story concept

Math concept

Abstract concepts etc

Medicines :

As I told u most of them are raw material used for building block for forming bridges in brain. These combinations 

will reduce or change every month after every weekly titration across whatsapp. After first positive response we 

follow gradual reduction in nutrients...systematically.

Half hearted efforts will give incomplete response, more so in a situation where world say nothing can be done 

except exercises.

Exercises only effect the input but has no major role in processing connections in brain

WWW.AUTISMDOCTOR.IN

key principles in autism reversal:

1.Dont be Special, turn into social

2.To make social, switch from object world based teaching to people and action based teaching

3.To develop communication; switch from screen based learning to body language based learning

4.To develop language, switch from seeing-doing activities to listening talking activities

5.Sitting tolerance increases by sitting activities with sensory breaks as per childs requirement.Making a child 

continuously jump and run will make him expert in jumping and running

6.Constant hugging kissing and carrying skin to skin, make the child get physically pampered and stubborn. keeping 

your child 2 feet away face to face helps develop eye contact and social communication

7. If you dont make rules for child behaviour, child will start ruling you and throw tantrums to change your 

behaviour.

8.Children copy what they see, hear and feel. Dont let them see ,hear and feel what u dont want them to learn, for 

example saying no or physically handling the child or shouting to grab attention.

9.Dont teach letters and alphabets,or what is this type of teaching; they are for picture recognitions. Teach in 

sentences, it means language. Dont ask questions, just go on narrating.

10.Music/rhymes is good only for momentary solo pleasure. Switch to lyrics and language if you wish the time to 

be utilized for learning and communication. 

Dr Kondekars ten commandments on Autism reversal

*Understanding-Goal Directed Approach :*

Dear Parents

Make a list of all things u feel will be impossible in your kid and work towards it.

if you believe nothing is impossible, list things or issues your kid has difficulty in and list what all you did for your 

kid for same issue for last 3 months. list what all you made possible.

if you can list all changes you brought in last 3 months, discuss with expert about next step and how rapidly it can 

be achieved.

if you are stuck at a step for more than 3 months, we are losing time and raise an alarm.

*Accept autism, don't accept disability, work towards enabling same*.

Understand and re understand the issue differently and work towards it.

Its true that you know best for your kid, but *its equally true that u don't know what is best for others kids* 

;Parenting an autism kid since ages, doesn't make you an expert for others kids unless you get through details of 

thousands of cases.

So unless you are expert *don't start teaching other parents,* you may be giving some information halfway which 

is true only for your kid. It's not a routine parenting issue in autism.

*Dont give up your desire to learn and do something new every day.*

its true that home therapy is needed, but *don't make your house a therapy center with various toys and 

activities.*

Home therapy in true sense will mean practicing tricks with home based day to day objects and acts

milestones of speech development in children

Speech often confused as just a verbal expression, actually needs to understand as any mode of communication between two living beings in the form of  listening speech, understanding speech and expressing speech through action or gestures or words.

autism awareness in Marathi by Dr kondekar 2024

when language is the goal avoid teaching music

https://youtu.be/i5tU68uanY4When language is the need, don't teach kusic6.

https://youtu.be/i5tU68uanY4

train eyes and ears to sense humans.. not training the skin for objects..

When eyes and ears

Add 90% SENSE to life,

Have your 90% sensory activities 

With eyes and ears..

And not 90% sensory with

Skin touch texture pressure.

www.autismdoctor.in

Sensory issues is about not having sense of the world..

Add sense .. add life.

Therapy in autism should be sequential

Development is a sequential process .. so should therapy be 

If your therapist or your home therapy expert is using the same toys puzzles acitivities for your kid more than 3 months, you are wasting time.

After birth, kids learns to recognise mother first.

Recognising humans and eye contact with humans shall be the first stage of development and so for therapies..

So prime Goal is connect with humans... And not with objects, letters and numbers.

One who is not connecting with humans and u r trying to teach through objects letters numbers.. u r taking the kid away from communication.

DR Kondekar 

autism reversal principle 3

https://youtu.be/VuS5zPcEpOk?si=6JMehD8qe02rdJPt

Autism reversal commandment number 3 click the link above

To develop communication, switch to action and language based learning from object, picture and screen based learning.

autism: changing perspective

Learning occurs through sensory sensing.

95% learning occurs through sensing by ears...

And  focussed observing by eyes....

Only 5 % learning occurs through other "sensory"

Like touch,smell, pressure, joint, position sense etc

" It's unwise to spend 95% of therapy inputs on this 5%, when prime goal of child is Sit,look,listen & focus."

Have 99% of your efforts towards learning through major senses ears and eyes.

Ear is most powerful sensory organ as it makes u listen langauge with its power of adding tenses- past tense, future tense, imagination, adjectives and advanced vocabulary which helps us understand stories.

Learning through eyes is limited unless you teach kids to learn and read books, picture story books.

Learning the receptive communication and receptive socialiisation is the  most priority in autistic kids.

Don't waste your time on object identification and identifying pictures of letters and numbers as it's Not the priority ahead of human identification.

WORK HARD ON EYE TO EYE CONNECTION WITH HUMANS TO LEARN TO LISTEN.. HELP EVERY CHILD BECOME AN AUDITORY LEARNER.

ask me how... Dr Kondekar 9869405747 www.autismdoctor.in

3 ways to use mobile for helping autism kids

Autistic kids will go away from learning language and understanding if we increase screen time with YouTube or videos or repititive content. Music rhymes and videos only help in entertainment if child is not receptive for understanding।

Using mobile phones for selfie helps develop eye contact -connection।

Using mobile phones for video calls helps one socialise and develop understanding of social communication।

Using mobile phones for listening recorded call records will help kid understanding conversations।

But if u are using for showing videos to kid or for rhymes or repititive content, u r wasting time and life।

Remember learning abcd or 1234 or counting or animal or repititive content recognition is not important in life। Before teaching ato z alphabets, teach the kid ato z relatives by picture face video call and names।

www.autismdoctor.in

when you donot plan the right goals, you are not working on them. when the goal is socialization and communication, adding physical or mechanical goals will not help in socialization and communication?

online self screening of kids for autism (less than 3 year of age) mCHAT(R) A FREE

https://www.autismspeaks.org/screen-your-child https://www.autismspeaks.org/screen-your-child   

Click on above link and fil the form. Share the result across whatsapp 

The M-CHAT-R/F is designed to be used with the M-CHAT-R; the M-CHAT-R is valid for screening toddlers between 16 and 30 months of age, to assess risk for autism spectrum disorder (ASD).

Repeatedly abnormal mCHAT score with gap of 1 month will require extensive evaluation.

Irrespective of the results, no therapy or treatment should be stopped or postponed pending any test results.

For DSM 4 AND DSM 5 ASSESMENT FORMS check the link at www.autismdoctor.in

Using Alexa app for speech therapy assistance : blueprint

Using Alexa for speech assistance and training

Use of voice for listening, understanding, copying, voice commands and voice modulations , kids stories, pronounciation, vocabulary and information, knowlege and importantly how to section all helps parents to use the device for kids learning vocabulary in Hindi and English both.

In addition, there is a secret option in alexa which can be used for information added by you for training your kid in your own way or judiciously adjusted for individual child's use.

This option in alexa is called alexa my questions. This option is hidden in alexa blueprint section, which can be modulated from your Using Alexa App and if the same account is for any alexa , your my questions will work for same alexa.

In this my questions section you can add your answers with questions changes in 3 different formats. So even if u change the format of the question, it may give same planned answer. You as parent can create such hundreds of answers like the one in rapidex English speaking course book available online for free. A child or caretaker can be trained to sue my questions app to bombard variety of information to the kid, a type of semidynamic interactive content for interactive langauge learning.

The kid has to be made auditory receptive before we assume that auditory vocal  signals will help initiate language. It can be done with help of medical support as needed. The more u make a child listen, the more the child will be Auditory learner.

Remember, in a child with speech delay, adding music (entertainment) in early years of life will only serve for rhythm and entertainment, which will make the child only entertained and that will be an escape from langauge or meaning of the vocals. Had the time used for music and nonvocal sound given to child ear been utilised for vocal inputs.. child will be learning the vocal inputs faster. 

*Stay away from screen (visual) learning, stay away from music based learning, insist for vocal based (Auditory) learning, insist for meaning based learning* Radio is a mode of passive audio input with dynamic and rich content. But prefer chanels with less music and more words like say bibidhbharti or akashwani.*

Dr Kondekar

constipation in autism kids

It's not uncommon to have constipation in kids with autism. It's seen in around 70% cases.

It is hypothesised to be due to lack of sensing the gut distention for evacuation and child starts reatining motions /stools inside.

In most kids it's not per se constipation to hard stools. But if the child has 5o strain, it's better to call it constipation and manage as early as possible.

A child refusingt I sit for potty or doingw eird gestures at potty time or making legs curved or not sitting properly or had pain or discomfort is likely to have indigestion which eventually causes constipation. 

The gut is 18 feet long and if the child passes less than 4 inches motion block at a time, it's likely 5o be constipation.

It's again constipation if the child passes very smal pellet like stool balls or smelly or gassy stools mean the child is retaining a lot and most potty is getting fermented and smelly.

Why do we need to know about constipation in autism kids? 

It's mainly because it adds to restless irritability crankiness indigestion reduced appetite poor weight gain and reduced water intake. Remember crankiness of constipated Amitabh Bacchan in movie Piku.

Eating less and drinking less is not a reason for constipation but it happens due to constipation.

Commonest constipation diet is hard food like high protein diet, dry fruits, milk, hard daals and pomegranate .

Soft foods like rice and potato being easy to digest cannot cause constipation.

Constipation is also possible due to some nutrients like fish omega or calcium or phosphate containing tablets.

Best way to treat constipation is not by giving extra water or adding fibre or dry fruits or fruits vegetables .

Best way to treat constipation is by using stool softeners, non absorbable sugar syrups and avoiding constipationg 4d diet as mentioned above. Google for *4d minus diet* for same.

It's common to have indigestion or not passing motions or reduced intake or crankyness with constipation.

There are some probiotic and enzyme supplements that help in constipation.

Constipation with blood ina tools and constipation with daily vomiting will need tests to rule out medical serious emergencies like intussusception, intestinal obstruction or pseudoobstruction or tuberculosis

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Standard sampleof advice given by a dr in a case of hard stools:in a 2 year old kid

In such situations

Syr gutclear / dofotil 10 ml 3 times a day for 3 days

If no relief double the dose for next 3 days

If no relief

Maintain 10ml 3 times a day and 

Add rectal suppository hallens glycerine  2gmsuppository or dulcolax suppository or babie less than 2 year age u can use neotonic enema.

Above medicines donot get absorbed in blood but just pull the potty out of body, meaning usually simple extra dose is harmless.

If loose motions, stop all of them.

Aristozyme drops 1 ml daily for 1 month, can be increased.

Can be continued long term. It doesn't cause habit.

Dofotil/gutclear/duphalac/laxolite/peg clear/evaq /move out etc all are same and dose is no limit when it's blocked gut.

For vomiting give domstal baby drops 1ml 3 times a day as needed

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For constipation/indigestion:

Stop milk,dry fruits, toor daals , daanewale fruits like pomegranate and guava.

Add syr laxolite or gutclear or dofotil 10 ml 2 times a day till stools are not regular. Can givetill next consultation or meeting 

1. Some medicines like fish oil and tablets can at times cause constipation when water intake is not enough to wash it off. Stopping them is not a solution because it will halt development. 

2. No constipation medicines are habit forming or addictive and most of them donot get into blood or body and stay in pipe and are extremely safe even in over doses. Doses need to change as per needs and can be easily doubled, they rarely cause loose motions and if they do u can just skip them for one day or reduce to 1ml

3. Syrups like laxolite, laxopeg, peg clear in doses 10 ml 1 to 3 times a day is preferred. Powder forms need more water which kids don't drink easily. 

4. Other levels of syrups that work are, syr dofotil, gutclear, lax or duphalac etc again dose needs to be doubled for results. 

5. Not treating it fully makes the kid cranky irritable and crying. So much so that commonest cause of crying in autism kid is indigestion. 

6. In autism kids, rarely a kid may need syr albendazole 400 mg single dose for deworming or antifungal like tab flucon 50 mg single dose

7. Adding digestive enzymes like tummysoft, aristozyme drops , pro CN drops in doses 1ml to 3ml daily helps like breaking the hard stools motions in gut. 

8. A child going to washroom many times doesn't mean he has loose motions. It can be constipation. 

9. Read more about constipation at https://kondekar.weebly.com/constipation-in-children.html

Whatspp 9869405747

autism is a disorder, we shall put it in order.

https://youtu.be/10-q08heMuo?si=ulDjAQenlDWMDwK_click here

basics of autism

https://youtube.com/watch?v=8nJLo-dtydI&si=12IB5UUAHN_MKala

click here for video talk on autism basics simplified

Speech Delay and Autism

 

http://pedneuro.weebly.com/ for downloading resources pdf files videos talks and general information related to autism

http://autismdrmumbai.com  For clinic address

http://autismdr.weebly.com for basic protocol 

https://pedneuromumbai.blogspot.com/2020/05/pediatric-learning-disability-autism.html?m=1 for appointment procedure

Preferably watch these 3 short videos before appointment  

https://youtu.be/FVr4f6Tetsw

https://youtu.be/b7Lkwr5HtHk

https://youtu.be/VIJMz9KMP9Y

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Speech is a form of expression that is not just a function or mouth and lips or vocal apparatus. 

Apart from above following are more common causes 

A child who cannot hear.. deafness 

A child who can hear but cannot listen, attention deficit 

A child who gives attention but cannot understand, cognition deficit 

A child who can understand but cannot express, apraxia/aphasia 

Apraxia of speech: non verbal Communication deficit 

Aphasia of speech: verbal communication deficit 

Often if the child has behaviour issues in addition, there is also likely hood or poor understanding and possibility of autism. 

Speech delay lasting more than three months is itself a form of disability 

Other speech issues are speech paucity, echolalia, only need based speech, poor vocabulary issues related to sentence formation, issues of syntax and grammer and speech with poor composition and poor comprehension 

Remember unless child hears, listens, understands...child cannot express Initial expression is by eye contact, facial or body language or pointing 

And then only expressing in words Understanding to expression journey is two years with normal brain, needs active inputs of wide vocabulary through stories, essays and compositions. 

Teaching by music, videos, questions and physical activity doesn't help in improving cognition and vocabulary. 

Teaching by asking is like taking exam before the topic is understood. 

For more speech related tips by Dr Kondekar visit Facebook page 

http://facebook.com/speechandsenses

 Each one will have a different way of approach.

Speech delays are very common among children with autism, but they are also common in children without autism. In autism often hearing is normal, but the child doesnt seem to listen.

Speech delay can often be associated with hearing deficit. Hearing deficit can be commonly due to ear infections like ASOM, CSOM, Otitis Externa, Ear wax, damage to auditory labyrinth or cortex of brain following meningitis or antibiotic use and rarely due to congenital otosclerosis,congenital absence of any crucial part of hearing apparatus. 

Speech delays can also be due to speech understanding, processing, formation and expression of speech. Various disorders of speech expression like cortical dysphasia/ aphasia and speech articulation like dysarthria and also various disorders of brain and disorders of speech apparatus manifesting as specific speech types like scanning speech, stacacto speech, explosive speech, slurred speech are also responsible for speech delay.

Communication is a two way reciprocation of interpersonal relationship. It can be non verbal or body language or expressional and verbal that is with use of language of words/ sounds/voices. 

Communication involves understanding and processing of actions/ words i.e. receptive communication and expressing by actions of various types that is expressive communication.In social and communication disorders both these may be affected.

In autism, often the socialization and social communication is primarily affected but in addition to this autism has other key features which are absent in social communication disorder.

Whatever may be the reason for speech delay; following is the course of evaluation and management for speech delay.

1. Confirm hearing is not affected: It can be confirmed by a BERA test. Although clinically many people will be able to tell hearing is affected or not; the tests will help understand severity and level of hearing affection, whether in ear: outer ear canal or middle ear; or inner year or cochlea or nervous system. Test can at times be false; and may need repeat.

2.If hearing is affected; ear examination; ear cleaning and treatment of ear infection may be needed in cases of ear wax, otitis and adenoiditis. significantly affected /damaged ears with speech delay may need hearing aids. If the hearing is affected at cochlea or at Central nervous system the child may be considered for cochlear implant or devices like hearing aid.

3. Those cases who have no major hearing deficit; and good receptive speech and understanding of speech and have difficulty in talking; these kids will need to be started with speech therapy earliest for modulations of speech apparatus.

4. Children who hear but may not listen; children who may not understand or follow speech or have central speech affection or have difficulty having age appropriate eye contact and response to commands are often likely to be autism; in which only speech therapy may get a very slow or delayed response; unless the prime symptoms of autism are tackled with medicines and occupational therapy.

At our center, most kids establish eye contact and response to commands in 1-3 months

whatsapp 91- 9869405747 for further details. 

Common Genetic Syndromes of AutIsm:

1. Fragile x syndrome FMR1

2. Tuberous sclerosis TSC1 TSC2 

3. Rett syndrome MECP2

4. Prader willi syndrome  deletion of paternal allel at 15q11-q13

5. Angelman Syndrome del/mut in maternal UBE3A

6. WilliamsBeuren Syndro,e 7q11.23 del

7. Smith Magenis syndrome 17 p11.2 del

8. velocardiofacial/ Digeorge syndrome  22q11.2 del

9. PhelanMcDermid Syndrome 22q13.3 del

10. Untreated PKU PAH

Ten commandments: Dr Kondekar's Key Principles in Autism Reversal

 Key principles in Autism reversal: 

for details and downloading learning pdf and talks click here

Dr Kondekar's ten commandments on Autism reversal: 

GOAL DIRECTED COGNITIVE APPROACH

1.Dont be Special, turn into social 

2.To make social, switch from object world based teaching to people and action based teaching 

3.To develop communication; switch from screen based learning to body language based learning 

4.To develop language, switch from seeing-doing activities to listening talking activities 

5.Sitting tolerance increases by sitting activities with sensory breaks as per childs requirement. Making a child continuously jump and run will make him expert in jumping and running 

6.Constant hugging kissing and carrying skin to skin, make the child get physically pampered and stubborn. keeping your child 2 feet away face to face helps develop eye contact and social communication

7. If you dont make rules for child behaviour, child will start ruling you and throw tantrums to change your behaviour. 

8.Children copy what they see, hear and feel. Dont let them see ,hear and feel what u dont want them to learn, for example saying no or physically handling the child or shouting to grab attention. 

9.Dont teach letters and alphabets,or what is this type of teaching; they are for picture recognitions. Teach in sentences, it means language. Dont ask questions, just go on narrating. 

10.Music/rhymes is good only for momentary solo pleasure. Switch to lyrics and language if you wish the time to be utilized for learning and communication. 

Dr Kondekars ten commandments on Autism reversal

14 point protocol for weekly update of autism kids follow up

Format for giving information or follow up of your kid across whatsapp to Dr Kondekar

copy paste the following with answers

Name of child

Date of birth

City

Payment date and time and mode

See weekly symptom monitoring diary at http://bit.ly/monitoringautism

************

List changes as per--

Comparing now with two week back.. and send me pl

1. Eye to eye connection--

2.Concentration-

3-Obeying commands-

4.Response to sounds -

5. Unnecessary Jumping or running -

6.Biting mouthing throwing hitting hurting :

7.Sleep-

8.Constipation-

9.pointing, gripping, imitation, Writing -

10.Sounds from mouth-

11.Speech-

12. Pretend play, role play, Comprehension and Stories listening skills, sequential

13. Other (sensory issues/ school issues/behaviours)-

14. Mixing with peers in sitting games, group work

**********

List as gains and goals, rather than writing positives or negatives

List any medicine doses changed recently.

List any medicine couldn't be taken with number of days couldn't be taken. Read more at www.autismmumbai.com

14 wrongly understood and wrongly used terms in autism

 https://m.facebook.com/groups/685590788515887/permalink/1545102012564756/?mibextid=Nif5oz

*feel free to forward.*

*14 wrongly understood and wrongly used terms in autism*

In autism

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Whenever you visit an expert, u ask a question, expert uses some complicated terms which you take it to heart... Keep googling .  Keep worrying... Keep searching... Asking people.

Remember, there is nothing in a new name, as all of them are core features in spectrum kids and by new name we just add worries. Here is list of few names that i try to resolve in simple ways.

1. Genetic : it just means that there is a rare probability of recurrence in next child or having taken from any or both parents.

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2. epigenetic: it means genes are normal, and some unknown cause may be there.

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3. lets find out why this happened by EEG MRI TESTS: truly speaking none of these help in management unless child has fits or any other issue than autism.

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4. SPD: it just means child is not able to receive your signals or process them

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5. Sensory issues: means child basic and common sense is affected and thastwhy various non-sense issues are happening. Vision and listening are two prime senses for learning. 95% of learning is only through these two.  Only 5 % or less learning is through other senses like touch, proprioception etc . Sadly many therapists spend time only on these 5% neglecting 95%

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6. Apraxia: it just means child may know but cannot perform, doesn't add any more to the care plan

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7. Slow learner: it just should mean that child has potential to improve speed

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6. visual learner: it means we experts are neglecting the listening sense and have taken for granted that he will never use ears. Every autism kid has a right to learn from ears and experts should work for it 

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7. Special kid: all kids are special, we need to make them social. By special it means special needs are there for development of the kid.

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8. Hyperlexia: it just means that beyond some basic reading, writing skills , other skills are lacking, and should not be neglected 

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9. high functioning: this term is given up. It just means that in only some part of knowledge or a thread of a subject, the connections are intact and coordinating in brain and rest is not helping much. It doesn't mean a child is super boy.

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10. Low tone: it's normal to have low tone in autism kids. Low tone kids often sit in W fashion. Tone can be best managed by  exercises like statue, sitting properly, hands folded, finger on mouth etc to maintain tone in static  Posture.   Often experts confuse and make parents get confused tone as power. Tone and power are 2 different things. Tone adds to stability, power adds to strength of muscles. Here is what is biggest mistake most parents and experts do. To increase tone, they give physical exercises which helps in increasing strength, not stability. Yoga helps in tone and stability and not strength. We can not build intellectual and social development by increasing physical activities. We need physical stability for learning and posture of attention is needed for learning.

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11. Hyper / behaviour : often parents and many experts take this wrong and may call same. To make it simple, hyper means unnecessary and unusual  increased physical movements that may be due to and may cause both inattention and distractability.

Behaviour is just child's response to a given environment/ stimulus/person, the way the child may sense on his or her own as per level of understanding and iq. Immature brains give excited behaviour of global loud response, partly mature brains learn to trick and show manipulating behaviour. Fully mature and cultured and disciplined Brains will show disciplined behaviour. Unusual and unnecessary physical activity if neglected, will eventually get physically restrained by parents or other people which will make one person being needed all the time for holding the child ( thus making a jail for child and jail for jailor too) or is handled by physical means by hitting hurting punishing, if not by parents but any one around, which will strike aggression and violent behaviour. This is best tackled by medicines. Behaviour therapy and counselling was first line therapy for this 25 years ago. In present Century, medicines is key and first line care and cure for these issues.

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12. No cure, nothing can be done, hopes are miniscule: it just means the person you are dealing with is not optimistic. The person has not seen these kids developing and actually improving for the enablement of schooling and independent daily leaving or independent survival.

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13. Inclusive or mainstreaming: it's often used restricted in the context of schooling only. Remember, schooling is not the only important thing in life. What is most important is to have the child as inclusive or mainstream member of the family. Mainstreaming of behaviour and communication along with relationship development for family structure  is most important than mainstreaming or inclusive ness of education. There is no point in teaching academics - numbers and letters if we are not helping the child to be a cultured, mannered and disciplined family member.

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14. Mild moderate severe autism: remember this terminology is given up in 2013. Now we use the term 

level 1 independent autism, often doesn't reach dr

 level 2 dependent autism, can perform day to day basic living, often needs therapies and meds

 level 3 fully dependent autism, often needs institutional care

Now practically speaking, any child less than 7 year age is actually partly dependent, whether autism or not. So it doesn't matter what we call as and pacify ourselves. What is most imp to know that, these scores are based on how one answers questions and how the expert interprets it. What a parent should remember is that what ever it is... The ground rule is severity or dependency can be changed with medicines and therapies towards enablement and mainstreaming. So what a parent should better remember is

 what the child is doing what the child is not supposed to do?

What better child can do what we want to do?

How early we can plan, and how we can plan small goals towards next step of age appropriate development.

www autismdrmumbai.com

autism: Free help for parents of kids with speech and behaviour issues.

 Autism and hyperactivity at times go hand in hand adding difficulty in learning .

In autism child is not able to SENSE the environment and hence sensory issues start coming. Once put the sense in order, all of them shall disappear.

Untreated SENSE, may turn a child cognitively weak and at times adding many neuropsychiatry morbidities like anxiety, fear, depression, hitting hurting, stubbornness, behaviour and sleep issues.

In ADHD, Sense may be normal, but there is unusual unwanted increased physical activity due to inpulsiveness, distractibility and lack of focus. When we tackle these three, kids with ADHD  will be sitting and attending.

Untreated hyperness will eventually be managed by people as physical restrain. More the physical restrain or pampering, more will be likely hood of violent behaviour and or other conduct disorders like lying stealing etc.

It's the job of neurodevelopmental pediatrician to quickly pick these issues and start with early intervention in the form of:

1.counseling: the parents and at times kids to under stand the need of 

2. early intervention: doing something earliest to make the child learnable and improve understanding and vocabulary with

3. treatments and therapies as needed and accordingly

4. Chalking out a plan for further management and periodic modifications to add speed and plan the next level.

www.neuropediatrician.com www.neuropediatrician.com

Remember, if a goal is not planned and revised monthly, we are not working towards a goal 

Any delay will turn into deficit sustaining longer.

Any unwanted thing permitted and promoted with persist.

Read more at www.autismdoctor.in www.autismdoctor.in

To download videos talks PDFs by Dr Kondekar visit www.pedneuro.weebly.com/autism.html www.pedneuro.weebly.com/autism.html