Complementing Treatments of Autism
Needed qualification for receiving water therapy
- Being a male
- At least 80CM of Height
- Cognitive development abilities of up to at least 3 Years
- Not afraid of water
- Have been poddy trained
Necessary conditions for school education services
- Participate in at least one of the center’s group classes (peer peers who have weaknesses like a child) to learn the basics of the relationship.
- Have one of the following two conditions: A) Children who have reached the age of 7 and do not have aggression, sensory problems or autistic ecstasy. B) Children who have reached the ABA level in individual skills and have the minimum. These conditions include: 4-word speech, self-help skills, interest in communication and interaction, cognition at the age of 3
About school Education
Autism is a disorder that is affecting more and more children. The first step in diagnosing autism is to provide a comprehensive rehabilitation and individual program for a child with autism spectrum disorder. These programs are developed according to each child’s strengths and weaknesses and according to the Applied Behavior Analysis (ABA) method.
Upon successful completion of the ABA course, the child will be directed to a working group for autistic children. Group activities have different levels and children will be placed in these groups according to their abilities. In these groups, the child is usually introduced to a set of social, cognitive, and emotional skills. The educational programs of these group activities are determined in such a way that the child is systematically and purposefully acquainted with what is going on in social environments and can experience the rules and regulations of a larger group such as preschool with his peers. At this time, the child will be ready to enter the second preschool and can start school. In school education, we help children learn a simple and understandable structure, understand the teacher’s instructions, and accept the stability and patterns created. Of course, the combination of these trainings (ABA and group training and school education) will increase the independence of our autistic child in the school environment.
Necessary conditions for the child to provide toilet training services
- Be at least 2.5 years old.
- Have instructions.
- Conditioning has happened to him.
- Cognitive growth is at least 2 years.
- Have the ability to squat and maintain balance.
- Have no digestive problems (such as constipation).
- Have a word or ability to point out his or her requests to others.
- Know the concept of wet and dry.
The family system is the most important part of a child’s environment that plays a central role in his or her developmental outcomes. In this system, parents play a very key role. They can facilitate their child’s developmental process or inadvertently take it out of the normal course. Numerous studies show that behavioral problems (such as snoring, hyperactivity, aggression, physical conflict, self-harm, or others) are high in children with autism spectrum disorders. These behavioral problems often interfere with the child’s family life, educational and social adjustment, and are a major obstacle to the child’s achievement of educational and social goals. On the other hand, parent-child interactions provide important social context for the development of problematic behaviors or adaptive behaviors in children with a range of autistic disorders. Accordingly, teaching parenting skills to parents in a way that they can act as one of their child’s treatment rings can be of great benefit to the child. Because parents are the ones who spend the most time with the child, by teaching them the necessary skills, they can take an important step in the treatment of the child and reduce the cost of treatment. One of the programs designed to improve parent-child interactions and reduce children’s behavioral problems is the “Parent-Child Interaction Treatment” package.
Parent-child interaction treatment package
This package is designed by Eyberg and colleagues in the United States for children aged 2 to 7 years with behavioral problems. In this program, there are two stages: the child-centered interaction phase and the parent-centered interaction phase.
The first stage of child-centered therapy or interaction is similar to play therapy. Because the child directs the game and the parents provide the necessary support in an effort to improve the parent-child relationship. At this point, the therapist specifically teaches the parents that in the game, through the skills of admiration, parents are also taught to refrain from asking questions, criticizing, and giving orders. Because it takes the game out of the child’s hands. Parents are also asked to play with their child on a one-to-one basis for 5 to 10 minutes each day as a homework assignment and to use the skills they are learning.
In the second stage, in addition to the parents continuing to use the skills of the first stage, they learn skills to increase obedience and appropriate behaviors and reduce the child’s inappropriate behaviors. The therapist teaches parents how to give effective instructions and apply different consequences to the child’s obedience or non-obedience. At this stage, all members of the family network, especially parents, should show similar responses to the child’s behavior and strictly avoid monotony. Otherwise, the treatment process will be disrupted.
The skills of “parent-child interaction therapy” are taught in the weekly sessions of the center through educational sessions and direct guidance (practice) of parents during the interaction with the child. Numerous studies have been performed on the effectiveness of this program in reducing the behavioral problems of children with ADHD / Attention Deficit Hyperactivity Disorder, Facial Disorder, Mental Retardation, and Spectrum Disorders with High Performance. The results indicate that this treatment program is useful in reducing the behavioral problems of children with these disorders and increasing the positive interaction between parent and child. The program has recently entered the country and conducted a study on its effectiveness in reducing the behavioral problems of children with high-performance autistic spectrum disorders and reducing parental stress in their mothers, at the Center for Organizing Treatment and Rehabilitation of Autistic Disorders and the Department of Psychology at Shahid Beheshti University. It has been done (Hatamzadeh et al., 2009). The results and reports of parents indicate the positive effects of this program in reducing behavioral problems and improving parent-child interactions.
Early interventions in children with autism spectrum disorders fall into two broad categories: “parental intervention interventions” and “treatment interventions by specialists.” In the first group, parents, with the help of an experienced therapist, learn the principles and methods of behavior change so that they can act as the primary controllers for their children. With the entry of parents into treatment programs, the effectiveness of treatment interventions by specialists also increases. Because parents spend more time with their children. Also, if the intervention is presented in different situations (such as home and training center) and by different people (such as parents and different educators), it will be more effective.
There are two logical reasons for parental intervention:
First, parents are the main source of information about their children, and professionals can benefit from this knowledge. Because children with autism are so close together, it is important to know these differences in order to coordinate the treatment of each child.
Second, parents can be a factor in the treatment (not just the therapist). Because by changing the parent-child relationship, there can be fundamental changes in the symptoms of the disease. So the overall goal of Parental Therapy Interventions is to teach parents the different parenting skills that a child with special needs demands. One of these programs is the “Little Bird Package”.
Little Bird Package
“Little Bird Package” is taken from the “Early Bird Program” of the British National Association, which uses the “Tich”, “Spell”, “Pax”, “Hann” and “Star” approaches. The program is offered to parents of preschool children with autistic disorders for three and a half months.
The first workshop will be held in the presence of the children’s parents. During this workshop, parents become familiar with the structure and content of the course. Participants’ expectations are then reviewed during the course. At the end of the workshop, parental suggestions are collected to be considered throughout the course.
After the workshop, group meetings or home visits are held once a week (alternately). In group meetings attended by mothers, program specialists and assistants at the center, the content of the program is taught, mothers are encouraged to share their experiences and find solutions to the problems they raise. They are then given homework to practice what they have learned over the course of a week.
During the home visit, a video of the mother’s education and her interaction with her child is filmed. These films are shown in the first part of the group sessions, and mothers are encouraged to express their views on the films.
Content of group sessions: Group sessions begin with a study of the signs and characteristics of autistic disorders, and mothers learn why their child’s development and behavior are different. Then, the metaphor of “Ice Mountain” and the “Star” approach to behavior analysis are explained. Using these techniques, parents learn how to analyze their child’s behavioral behaviors and triggers, as well as how to encourage appropriate behaviors. In this way, parents learn how to manage their child and implement it.
Early intervention, parental education, and support are three important elements that enable parents to make the right changes in their child. Therefore, in the “Little Bird Package”, mothers learn together and the benefits of group meetings with individual support are gathered together with the parents during the home visits of the “Little Bird Package” specialists.
Thirty families participated in the preliminary assessment of the Early Intervention of the National Autism Association of England, eighteen of whom participated in the program and twelve families did not receive the program.
As a result of the training, significant changes were made in the rate of adaptive performance of children, which was assessed on a wild scale. The severity of the symptoms of autism, which was measured by the degree of autism in children, also decreased.
In one of them, it was given that educating mothers with this program reduces behavioral problems and increases children’s communication, sensory and cognitive skills (Bagherian, Pour Etemad, Khoshabi and Heydari, 2008). In another study, maternal education with a “small bird pack” was associated with a reduction in parental stress and an increase in their general health (Khorramabadi, Pour-Etemad, Mazaheri and Dehghani, 2008).
It was with the support of these studies that parental education with the “Little Bird Package” became one of the main programs of the Center for the Treatment and Rehabilitation of Autistic Disorders.
Some children have disorders such as hyperactivity, insomnia, self-stimulation and aggression that disrupt the learning process. These children are monitored by a pediatric psychiatrist and, if necessary, receive medication at the same time as other treatments.
The most traditional teaching methods in working with autistic children were often based on auditory instruction. But autism is a spectrum with a great variety of needs and abilities in different children, and not all children in this group benefit from verbal education. Therefore, they miss the opportunity to learn and teach, which is due to the difficulty in analyzing the meaning of abstract auditory information. But this problem is solved in visual training. Also, these children have difficulty understanding communication, and this affects language acquisition; But using the visual system strengthens the child’s understanding of communication in his environment and can facilitate speech. PECS is an image-based alternative communication system developed in 1985 by Bundy and Frost and is an effective way to help people with disabilities who are diagnosed with autism spectrum disorders and related disabilities. In this way, it is not necessary to teach prerequisite behaviors, and it is a relatively simple and inexpensive method, and its most important advantage is that it can facilitate speech. Also, due to the special features of this method, such as the ability to generalize and start communication by the child, this method is a useful intervention strategy and now the use of this method to minimize communication skills problems in these people is expanding. , Has shown the effectiveness of this method in increasing communication skills and reducing behavioral problems.
Different stage of PECS
This system has six phases Phase (1): Starts with an encouraging object for the child. First, when the child wants to take it, the image of the object with the help of the assistant instructor in the hands of the instructor sitting in front of the child; The instructor smiles at the object and immediately gives it to the child. At the end of this phase, the child takes a picture from the table and gets what he wants.
Phase (2): The instructor gradually moves away from the child and the distance between the image and the child increases. At the end of this phase, the child alone is able to take the image of the stimulus object and go to the instructor and exchange. In this phase, the child practices insistence.
Phase (3): Teaches the child a clean learning between images. This phase begins with two images, one of which is the desired object and the other is the image of an unpleasant or neutral object. At the end of this phase, the child is able to select the desired item from the communication book and exchange it between 15-20 pictures.
Phase (4): In this phase, the size of the images is reduced, and the child learns to use the phrase “I want” along with the desired item to request and paste the desired item next to this phrase in the sentence bar and the sentence bar. Exchange with the coach. At the end of this phase, the child will be able to make longer sentences using the conjunction “and”.
Phase (5): In this phase the child learns to ask the direct question “What do you want?” Respond through pictures and at the end of the phase generalize this to all daily activities.
Phase (6): At this stage, in addition to the request, the child can comment and ask questions such as “What do you see?” And “What do you have?” Reply with a “I see” card or “I have” or similar phrases. At the end of this phase, these skills are generalized to daily activities.
After these phases, children begin to apply concepts in language (such as adjectives, verbs, the concept of place, and time), and gradually objective reinforcers give way to secondary rewards. It should be noted that in all these phases, at the beginning of the phase, physical assistance was needed to help the teacher to acquire the necessary skills. Also, in all phases, in order to increase the generalization of the role of the coach and the continuous coaching assistant, they are transferred together.
Evaluation plan and preparation of individual treatment plan by treatment group
Greetings and Regards,
In order to increase the quality of medical services for children with autism, the plan to evaluate and develop a treatment plan for each child by a team of experts was presented to the esteemed deputy director of rehabilitation of the Welfare Organization. In this plan, each child’s treatment plan is developed under the supervision and consultation of a psychologist, occupational therapist, speech therapist, parents, educator, and, if necessary, the therapist or physician. And the child is evaluated by an expert other than the programmer.
It should be noted that this method of programming and evaluation has long been practiced in reputable centers of developed countries (eg, the Center for Autism in California). But in our country, due to various difficulties such as the lack of autism experts, the costs and the 4 have not been applicable until recently. Fortunately, after raising this issue in the esteemed Deputy of Rehabilitation of the Welfare Organization and holding several expert meetings, the last of which was on 7/24/2012 in our center and with the presence of: ladies Dr. Salehi, Dr. Radfar, Dr. Khoshabi, Dr. Amiri, Dr. Alagband Rad from the Child and Adolescent Psychiatric Association, Dr. Mansouri from the Rehabilitation Deputy of the Welfare Organization, Dr. Chimeh from the Autism Center of Bahara and Dr. Pouraatmad from the Center for the Organization of Treatment and Rehabilitation of Autistic Disorders, this project was approved in all autism centers inthe country.
Although the plan requires more expert supervision of a child’s treatment and will therefore have a greater financial burden for autism centers, it has two important achievements for children
- Developing a treatment plan for each child by a team of experts will enrich the program. And it is increasingly eliminating the need for children to be involved in extracurricular activities.
- The evaluation of the treatment plan by another expert adds to the validity of the next evaluation and development process.
It is hoped that with the help of experts, educators, parents and specialists in the field of autism, the implementation of this project will increase the quality of medical services for children with autism. Meanwhile, efforts have been made to ensure that this method is not financially burdensome for the family.
Autistic Disorders Treatment and Rehabilitation Center
Child and music
Research shows that children’s happy and fulfilling lives have a significant impact on their growth and learning. With the help of rhythm, sound and sound, music has a special ability to create a heart connection between human beings, and when this connection is established, it will play a significant role in guiding the child’s mind towards intelligent knowledge. The genetic system makes up man. Before him, Jean-Piaget, following in the footsteps of Maria Montessori, saw music as an innate intelligence, and before him Steiner realized that music was fundamental to intelligence, creativity, mathematical talent, and spiritual growth. In his research, Dr. Alfred Tamatis found that listening to certain sounds and music actually affects the brain in a way that enhances children’s listening and speaking skills, emotional health, social skills, and mental alertness.
The impact of music on autistic children
In using music in an autism education program, the goal of children is to free them from the lonely world in which they are trapped. Children with autism always have a positive effect on music, sound, and rhythm. Music has been shown to improve the collective behavior of these children. For autistic children, rhythmic entertainment intervention (RIA) is commonly used, which can be effective in reducing anxiety and aggressive behavior in these children. Music can also increase the ability to listen, increase the capacity for patience and attention, as well as social interactions, and reduce the symptoms of inattention. Remember that music is a fun and enjoyable activity, and children get the best education from those they love, not those who show the best technical skills.
(An Introduction to Mozart’s Influence on Children. Written by Dan Campbell)
The process of activities in music courses
* Part One: Poetry and Music Workshop
– Active listening to various pieces of Iranian and classical music
– Presenting collective suggestions and conversations about the heard piece
– Perform regular and coordinated movements with music in groups
– Understand the concept of rhythmic and melodic poetry and stories
– Preparing handicrafts in groups according to the piece of music
– Perform musical performances and symbolic games
* The second part: performing musical activities (according to the educational method of Karl Orff)
– Playing an instrument
– Singing group songs
– Familiarity with music, rhythm, sound, words, speed, rhythm, melody and various instruments
* Objectives and results
– Creating joy and happiness in children
– Creating a pleasant therapeutic and educational environment
– Strengthen cognitive areas and generalize previous learning in new situations
– Strengthen sensory-motor skills
– Strengthen visual and auditory memory
– Increase verbal skills
– Increase attention and focus
– Strengthen and increase communication skills and social interactions
– Reduce anxiety and aggressive behaviors
All exercises in the first and second part are designed and planned based on cognitive development, interests, physical abilities, as well as according to the children’s treatment-educational program.
Occupational therapy services are provided to children who, in addition to the sensory-motor items in the ABA program, need more services in the field of occupational therapy (at the discretion of the PI).
Movement and movement exercises
Movement is the result of a command coming from the brain to the muscles. Changing the length of the muscle causes the bone to stretch and move around the joint axis, resulting in the desired movement. Physical exercise strengthens the motor components (motor nerves, muscles, bones and joints).
Motor components, like anything else, become weak if not used. Motor components can also be improved, enhanced, or enhanced by motor exercises. During the developmental stages, children create their movements with various games and exercises and progress to the skill stage. Unless there are internal or external obstacles along the way, medical intervention is needed to create movement and skill. One of the treatments is to send a movement pattern from limb to brain. It is important to note that mere movement does not indicate complete motor development. Full movement is a movement that is performed delicately, with complete mastery and control, and with maturity and skill. In addition, the movement must be purposeful and interact with the environment, which also requires a healthy sensory system. Spontaneous, clichéd, and repetitive movements often do not have a significant value in a child’s development.
Motor disorders in autistic children and their occupational therapy
Movement disorders are seen in some children with autism as follows
- Muscle weakness: In some of these children, muscle strength and strength are less than their peers. Soft, small, and weak muscles are the hallmarks of this condition. Weakness in the limbs can be detected in the form of weak arms and legs and in the trunk in the form of loose postures (loosening of walking, loosening of sitting and running sluggishness, etc.).
Therapeutic measures: Strengthening the muscles and motor system with the exercises and exercises that the instructor does on the child’s body or the activities and games that the instructor teaches the child and asks the child to do.
- Motion raw: lack of skill and elegance in performing motor activities. In this case, the child’s movements do not have the necessary delicacy and accuracy. In fact, the child’s movements are awkward. The use of the hands, especially the fingers, and mastery of their movements are weak.
Therapeutic measures: Reaching the normal muscle tone, stabilizing the joints and teaching the patterns of small motor units. The occupational therapist uses motor techniques (such as massage and special exercises) to correct these movement problems.
- Imbalance: Some autistic children easily lose their balance. This condition can be seen in static situations (such as sitting or standing) or in dynamic situations (such as walking or running).
Therapeutic measures: Creating and strengthening protective-balancing reactions in these children
- Delay or delay in the stages of motor development: In some of these children may be a step away from the stages of motor development (for example, crawling), or may be slower than the child’s age.
Therapeutic measures: In this case, the occupational therapist creates the movement of the abandoned stage and prepares the child to reach the stage of movement of the same age at any age.
- Deformities: In some autistic children, deformities are seen in the limbs, especially the lower limbs, such as the rotation of the toe in or out.
Therapeutic measures: Strengthening some muscles and eliminating the shortcomings created in them by giving specific exercises and activities will improve or correct.
- Muscle shortness: In most of these children, muscle shortness causes conditions such as walking on the toes.
Therapeutic measures: Muscle stretching and shortening of the shortcomings, if done with the right exercises and at the right time, will improve the child’s condition.
Sensory disorders in autistic children and their treatment measures
- Acute sensation: A number of autistic children react strongly to some or all of the sensory stimuli. For example, they hate light, they don’t pay attention to sounds. The smell, taste of food or touch is unbearable for them. Therapeutic measures: Providing sensory stimuli from the least amount to bringing the child’s senses to normal and increasing the child’s sensory tolerance, as well as advising parents to prepare a suitable environment for the child’s life.
- Feel: Some autistic children are unresponsive to some or all of the sensory stimuli, or some very intense sensory stimuli, such as a child who does not respond to pain or a child who stares at the sun or a lamp. Therapeutic measures: Provide high-intensity sensory stimuli to bring the child’s senses to normal and help to understand and recognize sensory stimuli. Also advise parents to prepare the right environment for the child’s life.
- Unbalanced feeling: Some autistic children may be involved in their inner movements rather than understanding, recognizing, and reacting to external stimuli. Like a child who suffers from itchy or red skin without external stimuli, or a cook who sits after running and listens to the sound of his heart or breathing or wheezing, or a child who constantly manipulates his eyes.
Therapeutic measures: Helping the child to understand, recognize and react to external stimuli and return the child’s attention from internal to external stimuli, as well as advising parents to prepare the appropriate environment for the child’s life.
Speech therapy services are provided to children who, in addition to the sensory items in the ABA program, need more services in the field of occupational therapy (at the discretion of the PI).
Behavioral problems (such as snoring, screaming, throwing, hitting, spitting) are very common in children with autism. One of the most common and effective treatments for behavioral problems is to teach “behavioral management” to parents in person or online. The theoretical basis of this treatment is based on the principles of learning. In this way, parents reduce the child’s behavioral problems over time by learning behavioral techniques by changing the events before and after the behavior, and at the same time teach them how to interact positively with the child and solve behavioral problems. Solve the problem.
Course duration: 10 to 12 sessions