Bringing you Caregiving Stories from the CaregiverAsia Community

The society has come a long way in helping children with special needs improve their welfare through global awareness movements that celebrate their differences, as well as government initiatives that help ensure adequate support. Earlier on, CaregiverAsia collaborated with The Colourful Mind to produce an article that sheds light on the journey of children with Autism Spectrum Disorder (ASD). As a continuation, this article describes the types of intervention for children with ASD, together with fun activities that parents can engage with their children while staying at home.

Types of Intervention for Children with ASD

Current treatments include pharmacological therapies and various complementary therapies including diet modifications, vitamin therapy, occupational therapy, speech and language therapy and behavioral and developmental approaches. The main types of interventions are as follows:

Applied Behavior Analysis

ABA therapy helps to develop new skills, shape and refine previously learned skills. It is a scientifically validated approach used to understand learning and behavior. This approach looks at the function of the behavior and the environment in which it occurs. These factors are taken into consideration when devising plans to replace less-desirable behaviors with favorable and functional ones.

TEACCH

TEACCH uses a method called “Structured TEACCHing.” This is based on the unique learning needs of people with ASD, including strengths in visual information processing and difficulties with social communication, attention and executive function. Structured TEACCHing provides strategies and tools (e.g. Visual and/or written information to supplement verbal communication) for teachers to use in the classroom. These help students with ASD to achieve educational and therapeutic goals.

Speech Therapy

Speech-language therapy addresses challenges with language and communication. It can help people with autism improve their verbal, nonverbal, and social communication. The overall goal is to help the person communicate in more useful and functional ways (e.g. Making clearer speech sounds, Understanding body language).

Occupational Therapy

Occupational therapy (OT) helps children with ASD work on cognitive, physical, social, and motor skills. The goal is to improve everyday skills which allow them to become more independent and participate in a wide range of activities.

For children with ASD, OT programs often focus on play skills, learning strategies, and self-care. OT strategies can also help to manage sensory issues.

What does The Colourful Mind practice?

The Colourful Mind is a behavioral intervention center that adopts naturalistic approaches (naturalistic Applied Behavior Analysis (ABA)) for children with developmental delays and learning difficulties. An experienced team of case managers and behavior therapists work closely with parents and teachers to achieve lasting behavioral, emotional and educational breakthroughs by applying the principles of ABA and other teaching methods (e.g Teaching Interaction and Social Thinking™) . The team also works closely with schools on how to implement strategies to empower teachers to manage students with Special Education Needs (SEN).

The Colourful Mind also believes that even though Applied Behavior Analysis is the core methodology of how therapy sessions are run, the team has also learned to ‘mix and match’ different types of interventions according to the child’s needs. This has allowed them to be more creative in the way they manage the various behaviors of children with special needs and has resulted in more effective outcomes in their learning journeys.

Advice from The Colourful Mind based on first-hand experiences in terms of treatment methods:

• As there is no evidence for dietary types of treatment, such treatments are not advised.
• The main interventions listed above have overlapping and similar ways to manage children with special needs. There is no intervention that is more effective or works better than another, as long as interventions are customized according to individual needs.
• It is important to have a holistic and continuous support from all stakeholders outside of the intervention realm - Parents, school teachers and the community.

How can parents support their children in overcoming the challenges they encounter?

Be consistent

Children with ASD have a hard time applying what they’ve learned in one setting (such as the therapist’s office or school) to others, including the home (generalizing). For example, your child may be communicating more in school (due to the use of visual aids adopted during class time), but may have difficulties doing so at home. Creating consistency in your child’s environment is the best way to reinforce learning. Find out what your child’s therapists are doing and how they are carrying it out. You may want to discuss with them if you can continue their techniques at home.

Start with a schedule

Children with ASD tend to do best when they have a highly-structured schedule or routine so that they know what to expect next or even how their day looks like before they can get their playtime. Set up a schedule for your child, with regular times for meals, therapy, school, and bedtime. If there is an unavoidable schedule change, prepare your child for it in advance (e.g. visual aids, verbal priming).

Reward good behavior

Positive reinforcement can go a long way with children with ASD, so make an effort to “catch them doing something good.” Praise them when they act appropriately or learn a new skill, being very specific about what behavior they’re being praised for. Also look for other ways to reward them for good behavior, such as giving them a sticker or letting them play with a favorite toy.

Create a home safety zone

Carve out a private space in your home where your child can relax, feel secure, and be safe. This will involve organizing and setting boundaries in ways your child can understand. Visual cues can be helpful (colored tape marking areas that are off limits, labeling items in the house with pictures). You may also need to safety proof the house, particularly if your child is prone to self-injurious behaviors.

*Note: Parents should also take note of the following when engaging with them in programs that they want to run at home (e.g. teaching them how to trace):

What are my child’s strengths – and his or her weaknesses?

What behaviors are causing the most problems? - What important skills is my child lacking?

How does my child learn best – through seeing, listening, or doing?

What does my child enjoy – and how can those activities be used to bolster learning?

Resources for parents to receive support

It is important for parents who are caring for children with special needs to have their mental wellness constantly taken care of. Parents can receive self-care via the following ways:

• ASD Support Groups. Joining an ASD support group is a great way to meet other families dealing with the same challenges. Parents can share information, get advice, and rely on one another for emotional support. Being around others in the same boat and sharing their experiences can go a long way towards reducing the isolation many parents feel after receiving a child’s diagnosis.
• Respite care. Every parent needs a break now and then. For parents coping with the added stress of learning how to manage the challenges of a child with ASD, this is especially true. In respite care, another caregiver (e.g. another family member or even online learning sessions) takes over temporarily, giving them a break for a few hours, days, or even weeks. 

How can members of the public help parents manage children with special needs without being intrusive?

There are many types of disruptive behaviors. The general public may not have a clue on why the parent or caregiver is having a hard time managing the child or why the child would behave in such a disruptive manner. In short, people always get confused with the difference between a Meltdown and  a disruptive behavior e.g. throwing tantrums. In accordance with the National Autistic Society, a ‘Meltdown’ is an intense response to the overwhelming situation the child is in. It happens when someone becomes completely overwhelmed by their current situation and temporarily loses behavioral control.  This loss of control can be expressed verbally (e.g. shouting, screaming, crying), physically (e.g. kicking, lashing out, biting) or in both ways. Hence, do not be too quick to judge at first glance.

While there is no correct approach to assist the child, members of the public are recommended to take the following actions:

If there is a caregiver present:

• Show empathy and patience, be calm and kind in your response
• Let the parents or caregivers take the lead (they might have better knowledge on how to deal with the situation)
• Offer help or support to the parents or caregivers (to make things easier for them during the stressful and tense situation).
• Always maintain a calm voice and speak at a slower pace

If the caregiver is not present:

• Give the child time and space to calm down.
• Observe from a distance that the child is safe.
• Gently approach the child and ask if he or she needs help.
• Always reassure him/her in a calm manner with gentle words or reminders (e.g. It's okay, I am here to help you).
• Never touch the child as it may escalate the situation.
• Look for the nearest help point or call the authorities for help (e.g. security guard of a mall, nearby police station, should his/her parents are still not within sight after a period of time).

Fun activities to engage the children while at home

Experiment - Float or Sink

Suitable for children aged 3 to 6

Materials:

1. A container
2. Water
3. Any items from around the house small enough to fit into the container of water

Instructions:

1. Fill the container with water till it is half-full.
2. Place the object you have gathered from around the house into the container of water.
3. Observe if the item floats or sinks.

Optional: Parents can explain why some things float while others sink by showing the children a video.

Under the Sea

Suitable for children aged 3 to 6

Materials:

1. White Crayon
2. Water color (or any types of paint that is diluted)
3. Container of water
4. Drawing papers
5. Marker
6. Color pencil

Instructions:

1. Using the white crayon, draw out curvy lines across the drawing paper.
2. Paint over the paper with shades of blue and set it to dry.
3. On another sheet of paper, draw shapes.
4. Once done with drawing, decorate them with colors and patterns.
5. Cut the shapes out and combine 2 shapes together to form different sea creatures.
6. When the painted drawing paper has dried, paste the sea creatures onto the paper.

Don't Get Zapped!

Suitable for children aged 7 to 12 years

Materials: Red string (or any colour that is visible), scissors, tape, a hallway, timer (optional)

Instructions:

1. Transform simple strings into a string laser maze obstacle course that’ll have your spy kids twisting & turning their way to avoid being zapped!
2. Cut string or streamers long enough to fit from wall to wall of the hallway.
3. Tape the string diagonally, horizontally, and vertically all down the hallway.
4. Let your children find a way through the maze without touching any of the “lasers.” (Parents can also participate together)
5. Optional: There can be different stages of difficulties by simply adding more strings across the walls. A timer can also be set to see who manages to go through the laser wall the fastest!

Stop the Bus!

Suitable for children aged 7 to 12

Materials: Paper, template (optional), pencil/pen

Instructions:

1. Each person has a piece of paper and draws on columns for these headings: Girls Name, Boys Name, Animal, Food/Drink, Place (optional: Use the template above).
2. One person recites the alphabet silently in their head, then another says “Stop the Bus” and that letter is the initial for the words in each category. e.g. Say the letter is D and the category chosen is Animal. The answers can be Dog, Donkey etc.
3. When everyone has finished, you add up their scores for that round, awarding 10 points for a unique answer (one no one else has), and 5 points for a duplicate answer (Points can be customized based on your creativity).
4. You can come up with new categories as well to play against.

*Note: If your child finds it difficult to be engaged in the activities with you, try the activities for the younger age group and slowly level up. Activities and materials can be customized based on what you can find at home. If your child doesn’t fall within the age group, they are of course welcome to try it out still, after all we believe that there is no age limit to having fun even in the simplest ways!

Contact The Colourful Mind for online sessions they are conducting.

The Colourful Mind also provides customized online sessions ranging from individual therapy to social skills and even to enrichment (e.g. music and sing along).

Contact The Colourful Mind at info@thecolourfulmind or 85180368 for more information on the range of services that they provide as well as the rates. You can also visit their website at www.thecolourfulmind.com. 

First-hand experiences from The Colourful Mind

Staff from The Colourful Mind have witnessed how far children with ASD have come in overcoming their challenges and interacting with others around them. Read their first-hand experiences to get a glimpse of the heartwarming interactions between the children and the staff.

“It is not easy, but it will be worth it”

Working with young children has always been what I aspire to do for as long as I can remember; working with children who have special needs is an opportunity that I’ve never regretted taking a leap of faith in. As a Behavioral Therapist, I would say that the most challenging part is building rapport with the child. Playing with the child seems like the easiest part of the job but what I learned all these years is that it requires quick and flexible thinking. It never fails to warm my heart when a child tries to interact with me, even if it’s looking at me in the eye for a millisecond.

- Anna Ng, Behavioral Therapist

"Let's start the journey of these children by making each interaction fun and enjoyable!"

Although guiding each child may require more patience and care, every small step that they take always puts a smile on my face. I feel that before helping them to progress, creating a fun and comfortable environment for them should be a priority. Teaching when the child is at ease and eager to engage creates a more enjoyable learning journey. Also, when the child desires to communicate with me, I have come to realize that the ways that they convey their needs are so plentiful and innovative. Sometimes, it intrigues me as the biggest messages that they want to bring across are through non-verbal ways! Whether it is through different mediums like drawings or physical gestures, that already displays a sense of trust which I wholeheartedly treasure. As I understand that embarking on a therapeutic journey with these children may be tough on them and their family, so why not make the start of this adventure fun for everyone?"

- Austin Leong, Behavioral Therapist

"What makes the children happy makes me happy."

Taking the leap of faith and going into this line of work is the best career decision I made. When I told others of my choice of job, most mentioned how they don’t think they can do the same, and that is exactly why I decided to work with children with ASD. It is definitely not easy but the experiences I’ve encountered thus far have been nothing short of rewarding. The best part of this job is watching the children grow. I have been working with a couple of children for a whole year now and watching them turn into a more confident and independent individual warms my heart. One thing that I have to constantly remind myself is that different children grow and learn differently. What works for one may or may not work for the other. So, it is very important to observe how a child learns and grows and guide them accordingly.

- Iqah, Behavioral Therapist

As evident from the above, children with special needs can integrate well into society if they receive proper intervention and support. To help them receive the required support in the long run, CaregiverAsia has launched the Extraordinary Care Program that ensures continued long-term therapy for children with integrated therapy service providers and medical escorting service with a trained caregiver, in the unfortunate event that their parents or guardians are no longer able to care for them. Do you know of a friend caring for a special needs child? Find out more about the Extraordinary Care Program below to understand how it can benefit them!

This article is written in collaboration with The Colourful Mind.

Reference:

Paul VR, Klin A, Cohen D, editors . Handbook of autism and pervasive developmental disorders. 3rd edition. Hoboken: John Wiley & Sons, Inc; 2005