Tuesday, 6 August 2019

Understanding Therapy in Autism -III

In the third part of our understanding therapy in autism, I will be talking about autism specific methodology. This refers to how one talks to/interacts with children on the autism spectrum. This can govern every aspect of life, all day long. Obviously this is one post that is going to stretch into several!

Several researchers and autism self-advocates have contributed considerably towards our understanding of best possible ways to interact and initiate communication among individuals on the autism spectrum. 

Three of them stand out in my mind - Eric Schopler, Gary Mesibov and Temple Grandin. The last one is an adult on the spectrum and has had a tremendous influence on the world of autism through her book "Thinking in Pictures" - a must read of people who wish to understand the spectrum better.

Eric Schopler and Gary Mesibov have been directors at Project TEACCH and are proponents of Structured Teaching. While Project TEACCH has never made waves like ABA (Applied Behavioural Analysis), it nevertheless has been around for a long time (from 1966). Several of the principles suggested by then have now been incorporated by many other methods.

I would like to dedicate this first post to the fact that most individuals on the autism spectrum are visual.

Visual supports, to the best of my knowledge, were suggested by Project TEACCH. Visual supports received much attention after Temple Grandin's "Thinking in Pictures" was published.

Individuals on the autism spectrum are visual learners. They understand what they see far better than what they hear. This applies even to the very verbal ones. Saying that the individual can now understand spoken language is just no excuse to stop visuals. Yet, this is commonly done both by parents and many professionals.

Visuals can be used in the form of picture cards to communicate, to make a schedule or to relate a social story. Visuals should not be confused with videos. Visuals are static and convey the point much better to a child on the spectrum than dynamic videos. Visuals can be line drawings, pictures or photographs.

Visual supports help:

  1. Provide predictability and thereby reduce anxiety
  2. Provide clarity to the individual
  3. Help the individual understand the sequence
  4. Reduce stress for both parent and individual
  5. Help teach language
  6. Help jog the memory 

First & Then Cards

This consists of 2 pictures in a sequence which tells the individual what he will do first and what next. This can be used to provide clarity and also to help manage difficult behaviours. By putting a preferred activity after an activity that is disliked, we can help ensure that the disliked activity is carried out. 

First eat


Then go outside


Visual Schedules

This is a pictorial schedule that tells the individual what is going to happen through the day or a part of the day. It makes the routine predictable and also helps the individual organize the sequence in which the tasks should be carried out. This can be used to indicate all the activities that the individual has to do at his workstation or it can be used to indicate his daily routine. This can also be used to indicate part of his day's routine.



 Go to school

Behaviour Support Cards
These cards are pictorial representations of expected behaviour. These can be flashed when communicating with the child, reinforcing the spoken word. For example, flash a picture of a child sitting on a chair, to indicate that you would like him to remain seated.

Image credits: www.do2learn.com