Autism Therapy: comprehension

definition of comprehension: An understanding of the meaning of spoken or written communication.

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American Journal of Speech-Language Pathology, by Drager, KDR, Postal VJ, Carrolus L., Castellano M., Gagliano C., and Glynn J., published in 2006, summarized Jun 18, 2007

Aided language modeling (ALM) may help preschoolers with autism learn to communicate.

ALM involves teaching children new symbols through play. This study was designed to test whether ALM can help children with autism learn new symbols. The authors studied two preschool-aged children who used few words and found that ALM therapy was able to teach them to use more symbols. The children learned to understand more symbols and to express their needs better using symbols. In general, the children were better at understanding symbols than they were at using symbols.


J Autism Dev Disord., by Eldevik, S., Eikeseth S., Jahr E., and Smith T., published in 2006, summarized Nov 15, 2006

Ten to 20 hours per week of one-on-one behavioral therapy can benefit mentally retarded children with autism. The therapy was more effective than mixed therapies in a mainstream kindergarten class.
Behavioral therapies such as applied behavioral analysis (ABA) in which children are treated one-on-one for 40 hours per week over a period of two years have been shown to be effective treatments for autism. Sometimes, however, parents want to reduce the amount of time spent in behavioral therapy in order to reduce stress on the child or to allow them time to interact with peers. This study compares the outcomes of 2 groups of children who were autistic and mentally retarded. One group of 13 boys received 10-20 hours per week of one-on-one behavior therapy. A second group of 15 boys received 2 or more of the following therapies: alternative communication; applied behavioral analysis (ABA); sensory motor therapy, or Division TEACCH in a mainstream kindergarten classroom. After two years the group receiving one-on-one behavioral therapy had larger gains in intellect, language comprehension, and behavior than did the group receiving mixed therapies. There were no differences between the two groups in daily living, socialization, or non-verbal intelligence skills.


J Autism Dev Disord., by Grela, BG, and McLaughlin KS, published in 2006, summarized Nov 15, 2006

Focused stimulation can be effective for children who do not enjoy adult-directed therapies and for children with strong IQ and expressive language skills, but weak language comprehension skills.

Therapies designed to treat children with language difficulties often rely on an adult leader who chooses activities and materials. In contrast, with focused stimulation, the child directs the activities and the adult follows the childâ??s lead. The adult gives the child many models of the language goal, but does not require an answer from the child. Rather the child learns from observing and listening. In this study the authors trained the parents of a 3 ½ year old child with autism how to provide focused stimulation. The language skill targeted was for the child to identify actions performed by a character (â??What is X doing?â?). Before treatment, the child could identify the character but not the action. After 6 weeks of treatment, the child successfully named the action 80% of the time. The parents reported that the child also could apply the new skill to language targets he had not practiced (generalization).


Journal of Autism and Developmental Disorders, by Rogers, SJ, published in 2000, summarized Oct 21, 2006

This article reviews research showing that the socialization of children with autism can be improved through several different means, and these methods are described. The author begins by pointing out that social difficulties are among the most troubling features of autism, and that improved social skills lead to better use and comprehension of language. In order to improve social skills, several approaches are used. The successful tools for preschoolers with autism are: parents imitating a child's play, pivotal response training, visual cueing, peer-mediated techniques, peer tutoring, social stories, and applied behavior analysis (ABA). The successful tools for school-aged children with autism are the same as for preschoolers, but self-management strategies and video-modeling techniques also work well. For adolescents, the successful tools are: object-initiated interactions, self-management strategies, peer-mediated techniques, and social skills groups. The author concludes that that more research is required to determine which methods are best at which ages.


A recent study reported that children with autism who received intensive therapy with the Early Start Denver Model (ESDM) may raise their I.Q. Forty-eight children, some as young as 18 months, were part of the study. Half of the children received ESDM and half received a community-based autism intervention. All the children improved their I.Q., however, the ESDM children also had larger improvements in listening and comprehension. ESDM was founded by Sally J. Rogers and Geraldine Dawson, who have recently published a new book, “Early Start Denver Model for Young Children with Autism: Promoting Language, Learning, and Engagement." When NY Times reporter, Tara Parker-Pope asked Dr. Rogers how ESDM was different from other therapies, Dr. Rogers explained, “First, the kids are really young. Another important fact is that the kind of intervention that is being used is different. This is a developmentally based intervention that really pays a lot of attention to the quality of relationships.”

Read original article: Raising I.Q. in Toddlers With Autism


ArtWithoutBoundaries (AWB) is more than art therapy, it also uses the ideas of Mneme Therapy. Mneme Therapy uses singing, story telling, and movement in addition to painting in a way that involves "whole-brain communication." Based in New York, each AWB therapist spends one-on-one time with a child with autism or other developmental disability. AWB intervention increases verbal skills, social skills, and comprehension.

Read original article.


Animated Speech Corporation (ASC) launched a suite of tools based on an animated tutor - Timo - who provides children with an environment to help build vocabulary, comprehension, language, story sequencing, and retelling. ASC is the creator of software-based learning tools for children with autism and other language delays. Read Original Article.



Please comment on this autism topic.

Ayurveda for Autism Spectrum Disorder

Jan 4, 2011 by sunethriayurved...

Hi everybody,

I am Dr.Prasad M, MD (Ay.), working with autistic kids from 2002 onwards. I went through the article mentioned. Let me share with you an unbiased information on the scope of Ayurveda, the age-old Indian system of Vedic medicine, in the treatment of ASD. This is based 100% on my personal experiences. Kindly see the following passages. Comments and criticisms are welcomed whole-heatedly. 

Scope of Ayurveda in Autism Spectrum Disorder

Trials with Ayurvedic medicines and treatments for their efficacy in ASD are going on at various centres in India and abroad.   The main advantage of ayurvedic medicine is that it has got a magazine of safe therapeutic preparations of various forms which are developed by continuous trials and rectifications over thousands of years.  There are many preparations like kwatha (decoction), churna (powder), arishta (self-fermented beverage), gudika (pill), ghrtha (medicated ghee), thyla (medicated vegetable fats) etc.  In recent times, many of the herbs used in Ayurveda are proven to have excellent detoxifying effect as well as free radical- scavenging potential.  The therapeutic preparations like kwatha are combinations of many herbs.  These combinations are originally developed on the basis of ayurvedic principles.  Till recent times these formulations were not given due consideration by the western scientists.  But now the picture has changed. More and more ayurvedic preparations are under their evaluation.  In Ayurveda, the compounds as well as single herbs are used for different purposes of health care like pacifying vitiated functional units called doshas, eliminating excessive toxic accumulations, providing targeted nutrients to tissues, tuning the mind-body coordination, sharpening the efficacy of sense-organs, and so on.  These prescriptions are based on personalised evaluation of different aspects like body constitution, doshik status, power of digestion and assimilation, status of bowel evacuation, physical strength, mental constitution, and etc which is done by experienced physicians.  Mind is an important factor in the healing of any ailment.  It is assumed that mind is like ghee which is held inside a pot called body.  If the ghee is hot the pot also gets warmed and if the pot is hot definitely the ghee also will be hot.  You cannot expect warm ghee in a cool pot and wise versa.  Similarly, food is given the supreme role in the healing process as well as in the maintenance of health.  It is a basic concept in Ayurveda that there is no use for any medicine if one stick on to pathya (wholesome) food (as it brings about health spontaneously) and there is no use for any medicine if one stick on to apathya (nasty) food (as there is no scope for functioning of the medicine).   In the context of autism, these assumptions are extremely important and seen exceptionally beneficial. 

The care of autism, as per ayurvedic principles, is based on the protocol of a three-step intervention

  1. detoxifying the body by regulating the agni
  2. Cleansing the dhatus (body tissues) by medicines and therapies
  3. Enhancing the mental abilities like comprehension, memory etc. by promoting the Agni.

Again, though the stages are generalised the execution will be personalised. 

The first stage is based on medicines almost completely.  Medicinal preparations like purgatives, specific formulations for de-worming, for enhancing the functions of the liver and pancreas, for enhancing the digestive fire (Agni), and for regulating the intestinal motility are used in this stage.  Certain preparations meant for squeezing out heavy metals from the tissues are also used.  Turmeric, garlic, curry leaves, etc are having this advantage. 

Second phase is mainly comprised of massages.  Traditional methods like abhyanga (hot-oil massages), udwarthana (dry powder massages), pindasweda of various types, thalapothichilpizhichil, etc are used here.  These manoeuvres improve the muscle tone, reduce hyperactivity, create better motor coordination, and normalize most of the obsessive repetitive movements.  Child sleeps well.  The bowels become more regular at this stage.  He/she will be more receptive to commands or suggestions.  The demand for sensory stimulation slows down considerably and the symptoms like increased sensitivity to certain sounds (hyperacusis) slowly disappear.  There will be oral medications parallel to the therapies and a few of these medications will be carried over to the next phase as well.  

Third stage is very specific and sold not be started before the proper completion of the first two.  This is an important point as there is a general tendency to mark the condition as mental retardation and to prescribe brain tonics and memory boosters to all autistic kids indiscriminately.

The major therapies in this stage are shirodhara (pouring of liquids like oils on the head), shirovasthi (holding of medicated oils on the head inside specially designed leather-rims), shiropichu (wetting the scalp with oil bandages), dhoopanam (fumigation with specific medicines) etc along with specific medications like kallyanakam kashayam, indukantham kashayam, gorochanadi gudika,balakanakapathradi kashayam, sidharthakam gudika etc.  Certain specific herbs like sahadevi, sankhapushpi, vacha, vishnukranthietc are also used.  Follow up is done with ghee preparations like mahakallyanaka, mahapaisachika, brahmighrtha, saraswathaghrtha, etc. 

Conclusion

It is seen that the classical ayurvedic treatment done systematically give promising results in kids diagnosed with ASD.  But it should be emphasised that the level of improvements is different from child to child.  Another important point is that these interventions are made in a corrective manner.   The child gets relieved of a lot of physical problems and tantrums.  But this will not make him/her a normal child.  Intensive training and special education are needed to put him on track and to catch up the peers.  This requires the dedicated involvement of parents, special educators, and skilled professional like occupational therapists.


Responding to visual schedules

Dec 28, 2010 by Anonymous

One of the most important things to remember is that our words disappear, visuals (pictures) do not..  We all use visuals in one form or another, calendars, post it notes, grocery lists, etc.  We all look to visuals for information for instance on the highway for a hospital, gas stations, places to eat and restrooms, divided highway ahead, merge to the right, speed limit 35 and Stop. Visual strategies though, are created with an intended focus of giving particular person information that they are not picking up naturally. If one mentions an abstract word to a group of people, they all may have a different vision of what that word means or looks like.  A picture of the correct definition puts everyone on the same page with regards to comprehending the intended meaning of the word for that purpose. For instance your child may associate “eating” with their favorite cookie so when you say “we are going to eat” they are envisioning getting their favorite cookie, when in fact you are talking about giving them an egg for breakfast.  There is confusion and probably a meltdown because they have a different view of what “eat” means.  Visuals can help take away that confusion for them as well as their expectation of getting the cookie, especially if they are looking at a picture of a plate of eggs, then they are prepared as well for eggs for breakfast, or for what “we are going to eat.”


Visuals can be used to teach so much more than just schedules. I am the mother of a daughter with autism, who is now 16.  I began using visual strategies with her when she was 3.  They were affordable, I could do this myself and I did not need expensive equipment to find success.  My daughter did have speech and occupational therapy and she did have a supportive team at school.  I used visuals to teach routines, behaviors, social and academic rules, academics and the list goes on and on.  I used them mainly to teach comprehension of our very abstract language and to also teach preparation for change.  I created transition tools for moving from one environment to the next.  She had bookmarks for the rules of the library, she had another bookmark with the class rules for doing seatwork as well as a foam cutout of a lunchbox with what to do when the lunchroom gets too noisy rule.  I found the visuals were the bridge or the key to her understanding.  They need to be used consistently, and you must have patience and you cannot give up.  When my daughter looked confused, I would ask myself what it was about the situation she did not understand and then I created a visual to show her. 


My daughter is now 16, a junior in high school, and is taking honors classes and two AP college level classes.  She is fully included and was on the yearbook and school newspaper for two years.  She has a great interest in sports and so her articles involved interviewing coaches and players for the articles.  I believe the early intervention; with the use of visuals throughout the years is a major part of her success. 


I co-authored a book with Linda Hodgdon, who is well known internationally in the use of visual strategies for individuals with autism.  Linda has written two great books “Visual Strategies for Improving Communication” and “Solving Behavior Problems in Autism”.  These were my constant companions and you may find them helpful as well.   As a result of using all these visuals with my daughter over the years, I co-authored an e-book with Linda called “Practical Communication Tools for Autism-Visual Strategies for Lifelong Success”.  It is about the journey with visuals and how they worked as well as pictures of many of them with my daughter.  These can be found at www.usevisualstrategies.com


No matter what resource you use, the bottom line is to get started, be patient, consistent and to not give up trying.  You don’t need to be trained in using a “system”, use your gut instinct. I tore apart magazines for pictures and used cereal box tops for cereal choices. This was before the age of the digital camera and film was expensive, but I did take a lot of pictures as well.  I had to teach my daughter how to point and until she could.  I read her facial expressions when I placed her hand on a picture.  We did a lot of detective work and we worked through many obstacles until we got it right, but it was so worth it. Visuals have no side effects and are easy to use and affordable…best of luck


Scope of Ayurveda in ASD by Vaidya Prasad

Nov 13, 2009 by Anonymous

Trials with Ayurvedic medicines and treatments for their efficacy in ASD are going on at various centres in India and abroad. The main advantage of ayurvedic medicine is that it has got a magazine of safe therapeutic preparations of various forms which are developed by continuous trials and rectifications over thousands of years. There are many preparations like kwatha (decoction), churna (powder), arishta (self-fermented beverage), gudika (pill), ghrtha (medicated ghee), thyla (medicated vegetable fats) etc. In recent times, many of the herbs used in Ayurveda are proven to have excellent detoxifying effect as well as free radical- scavenging potential. The therapeutic preparations like kwatha are combinations of many herbs. These combinations are originally developed on the basis of ayurvedic principles. Till recent times these formulations were not given due consideration by the western scientists. But now the picture has changed. More and more ayurvedic preparations are under their evaluation. In Ayurveda, the compounds as well as single herbs are used for different purposes of health care like pacifying vitiated functional units called doshas, eliminating excessive toxic accumulations, providing targeted nutrients to tissues, tuning the mind-body coordination, sharpening the efficacy of sense-organs, and so on. These prescriptions are based on personalised evaluation of different aspects like body constitution, doshik status, power of digestion and assimilation, status of bowel evacuation, physical strength, mental constitution, and etc, which is done by experienced physicians. Mind is an important factor in the healing of any ailment. It is assumed that mind is like ghee, which is held inside a pot called body. If the ghee is hot the pot also gets warmed and if the pot is hot definitely the ghee also will be hot. You cannot expect warm ghee in a cool pot and wise versa. Similarly, food is given the supreme role in the healing process as well as in the maintenance of health. It is a basic concept in Ayurveda that there is no use for any medicine if one stick on to pathya (wholesome) food (as it brings about health spontaneously) and there is no use for any medicine if one stick on to apathya (nasty) food (as there is no scope for functioning of the medicine). In the context of autism, these assumptions are extremely important and seen exceptionally beneficial.

The care of autism, as per ayurvedic principles, is based on the protocol of a three-step intervention.

  1. detoxifying the body
  2. balancing the mind-body interaction, and coordination  and
  3. enhancing the mental abilities like comprehension, memory etc.

Again, though the stages are generalised the execution will be personalised.

The first stage is based on medicines almost completely. Medicinal preparations like purgatives, specific formulations for de-worming, for enhancing the functions of the liver and pancreas, for enhancing the digestive fire (Agni), and for regulating the intestinal motility are used in this stage. Certain preparations meant for squeezing out heavy metals from the tissues are also used. Turmeric, garlic, curry leaves, etc are having this advantage.

Second phase is mainly comprised of massages. Traditional methods like abhyanga (hot-oil massages), udwarthana (dry powder massages), pindasweda of various types, thalapothichil, pizhichil, etc are used here. These manoeuvres improve the muscle tone, reduce hyperactivity, create better motor coordination, and normalize most of the obsessive repetitive movements. Child sleeps well. The bowels become more regular at this stage. He/she will be more receptive to commands or suggestions. The demand for sensory stimulation slows down considerably and the symptoms like increased sensitivity to certain sounds (hyperacusis) slowly disappear. There will be oral medications parallel to the therapies and a few of these medications will be carried over to the next phase as well.

Third stage is very specific and sold not be started before the proper completion of the first two. This is an important point as there is a general tendency to mark the condition as mental retardation and to prescribe brain tonics and memory boosters to all autistic kids indiscriminately.

The major therapies in this stage are shirodhara (pouring of liquids like oils on the head), shirovasthi (holding of medicated oils on the head inside specially designed leather-rims), shiropichu (wetting the scalp with oil bandages), dhoopanam (fumigation with specific medicines) etc along with specific medications like kallyanakam kashayam, indukantham kashayam, gorochanadi gudika, balakanakapathradi kashayam, sidharthakam gudika etc. Certain specific herbs like sahadevi, sankhapushpi, vacha, vishnukranthi etc are also used. Follow up is done with ghee preparations like mahakallyanaka, mahapaisachika, brahmighrtha, saraswathaghrtha, etc.

It is seen that the classical ayurvedic treatment done systematically give promising results in kids diagnosed with ASD. But it should be emphasised that the level of improvements is different from child to child. Another important point is that these interventions are made in a corrective manner. The child gets relieved of a lot of physical problems and tantrums. But this will not make him/her a normal child. Intensive training and special education are needed to put him on track and to catch up the peers. This requires the dedicated involvement of parents, special educators, and skilled professional like occupational therapists.


Just around the bend...

Jul 26, 2009 by Anonymous

Summer is half over and as with people nationwide concerns regarding bugdet cuts to services, inavailability of services that are supportive of our children on the spectrum and the dangers in the community that became more apparent as they get older abound. While I am sure parents overall have concerns about their children being at risk in their community this fear is exacerbated greatly when your child is often oblivious to these dangers because of social skill and comprehension deficits. In the past few weeks I have run into two friends whose teenage sons, once a part of a special needs support group which has fallen prey to the budgetary axe, both found themselves under arrest. I could debate the circumstances but suffice it to say that this is every mothers nightmare. So what do we do when the mainstream only hear about early intervention. It is as if by some misfortune parents who have not solved this exhaustive puzzle of advocating and searching for appropriate services and therapies simply no longer exist once their child falls out of that window the public eye envisions of a child on the spectrum. Beautiful doe eyed 2, 3, 4 and 5 year olds. What happens when they become 12, 13,16, 19? when insurance companies want to deem their progress insufficient and therefore not medicallly necessary? When schools have decided thier capabilities long before they max out at age 22? When they have too often become prey for others willing to exploit their disability? I lose sleep over the thought that my son will one day find himself in a compromising situation because of his inabiility to discern dangers around him, or people who would use him, hurt him.... So that is my thought for the week. How do you as educators, clinicians and parents affect change in the lives of our preteens and teens and adults with ASD so that mothers like me will not live this nightmare?



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