WEB EXCLUSIVE: AUSTISM Q&A

What you didn’t know about the brain disorder.

In our April 2011 issue, we published two mothers’ accounts of life with autistic kids, as well as a sidebar on the condition. Here is more expert information on autism. What are the myths about autistic children? The mum did something wrong. Some cases may have clear associations like maternal infections in pregnancy or brain injury during a complicated birth, but most are not linked to any particular trigger, says Dr Chong Shang Chee, head and consultant at the Child Development Unit of the University Children’s Medical Institute in the National University Hospital (NUH). “There may be a genetic contribution in some cases, but the genetic causes are still complicated in many and under research.”

The Measles, Mumps and Rubella (MMR) vaccine caused it. It’s not true. Big studies have refuted the claims, and even scientific journals have taken the stand that there’s no link.

It can be cured. It cannot, but the functioning levels can improve significantly such that an older child with milder autism can really seem fairly normal, she says.

What kind of help is available?
Structured teaching programmes. These include Teaach, Floortime, Pivotal Response Therapy and Applied Behaviour Analysis (ABA). They help communication, learning and behaviour in autistic children, says Dr Chong.

Dr Joseph E. Morrow, Professor Emeritus and professor of psychology and behavior analysis at the California State University in Sacramento, explains how ABA works: “What we do at the beginning is an extensive behaviour assessment where we list the behaviour deficits (as compared to normal development) such as not speaking, not imitating and not socialising.

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“A typical imitation session would involve sitting across the table from a child and say ‘do this’ and clapping our hands. If the child does not do it, we would prompt the behaviour by taking their hands in ours and clap when we say ‘do this’. This would be followed by a reward to the child.

“We would continue doing this, gradually fading our prompts until the child does it at our request, and then we would fade our request. In the process, we would have various other behaviours to imitate, including vocalisations. Other deficits would be treated in a similar manner.”

Medication. Your specialist may prescribe medicine to minimise self-injuring or violent behaviour, and manage anxiety in your child.

Parent training and support These help parents deal with autistic behaviour in positive ways. The latest one is a pilot programme called Signposts for Building Better Behaviour. It trains mums and dads of kids with developmental problems (see “I want to find out more”).

What kind of improvement can I expect from therapy?
There’s no one specific approach that works for every child, says Mahesh Mythra, speech therapist at the Child Development Unit at NUH. But therapy and training, if done consistently, can increase the chances of integrating your kid into society.

Dr Morrow says published studies show intensive sessions of ABA – if done early enough and long enough – can help 30 to 40 per cent of kids achieve “normal” functioning that makes them indistinguishable from their same age peers

If my child has mild autism, or if he improves with therapy, can he attend a mainstream school?
Your developmental paediatrician or psychologist with experience will be able to advise on this, says Dr Chong. Many kids with milder autism have been able to enter mainstream schools.

But she adds that even with good support, your kid will need “adequate language skills” for schoolwork, have minimal behavioural difficulties that make engagement and attention difficult, and not be able to cope with transitions like moving from class to class or lesson to lesson.

“My baby refuses to nap. She just wants to play.” Why she does it: As your little one becomes increasingly curious of her surroundings, she may find napping a total waste of time. This can also happen when the environment is not conducive for her to sleep, says Gwendolyn Lan, principal of Baby Haven infant care centre.

How do I prepare my autistic child for adulthood?
He needs self-help skills to be independent. For example, he should know how to take public transport, count money, and care for himself, says Dr Chong. Adults with higher functioning autism can find jobs if they are trained – and some may be very successful. But they may have problems with social situations; they may get anxious or not be able to control their emotions if they’re stressed. It helps if the people around them are empathetic about their difficulties and don’t exclude them.

Useful links
Autism Association (Singapore)
is a charity under the National Council of Social Services. It offers early intervention programmes, a youth centre, and operates Eden School for those with moderate to severe autism.

Autism Resource Centre
is a non-profit organisation with information and services like assessment and diagnosis, early intervention programmes and therapy. It started Pathlight School, the first for autistic kids.

ABC Center Singapore
is the local branch of Dr Morrow’s company, Applied Behavior Consultants Inc, which was set up in 1987. It offers applied behaviour analysis services for autism and other developmental disabilities. Dr Morrow will hold a talk here in June for parents; check with the centre for details closer to the date.

Signposts for Building Better Behaviour
is an Australian programme that is now available through a partnership with KKH. It teaches parents to manage the difficult behaviour of kids aged three to 16 who have developmental problems. The programme consists of five weekly sessions. Contact KKH at www.kkh.com.sg.

You can also check out Brenda Tan’s book, Come Into My World: 31 Stories of Autism in Singapore ($18). To find out where to buy it, visit visit www.come-into-my-world.com.

Read the April 2011 issue for more expert advice and local tips to make you a better mum or dad.