Autism

1. Autism

2. Definition • A neurodevelopmental disorder that affects the way a person communicates and relates to people around them. • Triad of impairments in social interaction, social communication and imagination.

3. Autism Spectrum Disorder • Classic Autism • Asperger Syndrome generally thought to be at the milder end of this spectrum. • Childhood Disintegrative Disorder typically occurs later than autism and involves a more dramatic loss of skills. • Rett Syndrome have increasing problems with movement, coordination and communication that may affect their ability to use their hands, communicate and walk. • Pervasive Developmental Disorder individuals with this disorder share same signs and symptoms of autism but do not meet all of the criteria for diagnosis

4. Interesting Facts • Children grown up isolated from humans said to be raised by the animals in the woods (Heflin, L.J and Alaimo, D.(2007) • There is a story about Peter aged 12 who never learns to speak even when he was given advantage. However he loves music and would hum tunes he heard.

5. Causes • may be attributed to a metabolic condition, viral bacterial infection or genetic basis • result of variation in conditions that occur before, during or after birth may affect brain development • imbalance of certain chemicals in the brain e.g. exposure to some toxins or chemicals during pregnancy could affect the child

6. Characteristics • Speech Development • Delayed • Absent • Present and later disappears • Social Interaction • Practices ego-centric play • Prefers isolation • Avoids eye-contact Skills Strengths: Drawing, music, mathematics, remembering data Weaknesses: Unable to understand content and concepts like time and weather Behavioural Problems Shows signs of hyperactivity or the opposite Obsessive interest in a particular object or event May turn aggressive and throw tantrum Stereotyped behaviours (e.g. flapping his/her hands, lining up toys) • Sensory Differences • Reacts to noises, lighting, temperatures, touch, as well as certain tastes and smells

7. Prevalence • With an estimated of 4 million people living in Singapore, about 24,000 individuals are diagnosed with autism • 5,472 of them are children below the age of 19 years • Approximately 216 new cases of children diagnosed with autism annually Source: Autism Resource Centre (Singapore), 2012

8. Assessment • INTERVENTION IN SINGAPORE • Early Detection • Occurs in an "ad-hoc" manner in healthcare facilities preschools / kindergartens. • medical checkups / vaccinations / observation in schools. • Results in delayed detection of developmental disabilities thus affect the time a child starts receiving intervention. • Use of Health Booklet • Source: MCYS Chapter 2 Early Intervention • indicates a screening gap between 18 months and 3 years which is crucial in a child's developmental years.

9. Assessment Admission Process to Intervention Programmes • Example 1, WeCan EIP (Autism Resource Centre Singapore): • Referral > Initial Screening > Placement • Example 2, Centre for Enabled Living (CEL): • Referral > Case Manager > Designated or preferred EIPIC centre

10. Assessment Intervention programmes for children with autism (Singapore) • Autism Resource Centre (WeCan Early Intervention Programme) Source: http://www.wecaneip.com/arc/web/aboutwecaneip/ Criteria: -Children 18 months to 6 years - Priority for Singapore Citizens Intervention Model: - Emphasise on work habits, self-regulation, social and communication skills. - Individualised Educational Plan (IEP) with specific goal for every child. - Aims to improve the abilities to learn and chances for improved future.

11. Assessment • Eden Children's Centre Source: http://www.autismsg.org/autism/index.html Criteria: Children 2 years to 6 years old Singapore Citizen / Permanent Resident Intervention Model: - "mixture of Applied Behaviour Analysis (ABA) strategies and Structured Teaching (TEACCH) principles" (Autism Association Singapore, 2009) - IEP based on Needs Assessment and an Occupational Therapy Assessment - Emphasise on Language, Social, Behavioural, Cognitive, Adaptive Living and Motor Skills

12. Assessment • Autism Behavioural Intervention Center for Children (BICC) Criteria - 3 to 8 years Intervention Model: - Analysis Behaviour Methods - Diagnostic report - Psychological Assessment - Screening - Therapy - Reinforce positive behaviours, expressive language and functional skills Source: http://www.autismbicc.com.sg/

13. Technologies • Electronic devices e.g. iPad, iPhone • Learning aids e.g. pencil grips, visual timers • and visual schedules • Lack of Assistive Technology for children with ASD in Singapore • WHY? • More Emphasis Placed on Physically Disabled • Lack of AT Suppliers • Lack of Collaboration between MOE & MCYS

14. Services

15. Services (continued)

16. Local Service Providers • Autism Association of Singapore • Autism Resource Centre • Autism Partnership • Learn Different • Metacognition Learning and Development • Centre

17. Services • Edusave Pupils Fund • Edusave Grants • Integrated Child Care Programme • (ICCP) • School-based Achievement Awards for Special Education • Schools (SAASPED)

18. Issues • Social emotional Issues • Low self-esteem • Low performance level • Constant need of emotional support • Education • A non-inclusive learning environment • Inexperienced teaching staff • Examinations at Mainstream level • Social Acceptance in Mainstream Schools • Lack of awareness and understanding for autism • among school staff or society • Difficulties in establishing friendships due to lack of • communication skills and obsessive behaviours

19. Challenges • Inability in Expressing Themselves • Inadequate opportunities to practise their communication skills • Abnormal social interaction style • Lack of Focus & Short Attention Span • Difficulty in sitting down for long period • of time • Self-regulatory movements: Moving about in • class or playing with things • Highly attuned to slight distractions in the • environment e.g. lights, noise • Pays little attention to topics/conversations • that are not of his/her interests

20. Useful Links For Local Service Providers http://web.singnet.com.sg/~liewping/service%20providers.htm For Speech Therapies & Professionals http://www.shas.org.sg/ For Devices & Technology http://www.autismspeaks.org/family-services/autism-apps

21. Summary • Children with autism need support to function as other typically developing children in turn affect their future. • Important to detect early, start intervention early and provide the support for needs of children with autism. • Use of technologies/assistive devices facilitates the learning. • There are efforts by government, special schools and intervention programme. • However, more efforts need to be implemented to help the cost of EI (Early Intervention) programmes. • To move towards inclusion in mainstream schools, training of professionals or teachers is important. • Increase awareness on autism amongst society, school staff.

22. References Autism Association (Singapore). (2009). Retrieved July 21, 2012, from http://www.autismsg.org/autism/index.html Autism Resource Centre (Singapore). (2012). Retrieved July 20, 2012, from http://www.autism.org.sg/main/index.php Heflin, L.J and Alaimo, D.(2007). Students with Autism Spectrum Disorders: Effective Instructional Practices. Upper Saddle River, NJ. : Pearson Kessick, R.(2009). Autism and diet: What you need to know. Philadelphia, PA: Jessica Kingsley Publishers Healing Thresholds (2012). Connecting community and science to heal autism. Retrieved July 21, 2012 fromhttp://autism.healingthresholds.com/therapy/visual-schedules?page=1 Shanab, N. (2010). Everyday life with autism: Simple tips for parents & educators. Visual Timer. Retrieved July 20, 2012 from http://autism-tips.com/?p=276

23. References • Heflin, L.J and Alaimo, D.(2007). Students with Autism Spectrum Disorders: Effective Instructional Practices. Upper Saddle River, NJ. : Pearson • Mesibov, G.B., Adams, L.W., & Klinger, L.G. (1997). Autism: Understanding the disorder. New York: Plenum Press. • Tinsnips. (2009). Common characteristics of children with autism spectrum disorders. Retrieved July 20, 2012, from http://www.tinsnips.org/Media/autism/CMNCHAR.pdf • Autism Resource Centre (Singapore). (2006/2007) Retrieved July 20, 2012 from http://www.wecaneip.com/arc/web/aboutwecaneip/OurApproach_IntervModels.shtml • MCYS (2012). Retrieved July 20, 2012 from http://app1.mcys.gov.sg/Portals/0/Topic/Issues/EDGD/Chapter%202%20-%20Early%20Intervention%20for%20Children%20with%20Special%20Needs.pdf • MCYS (2012). Retrieved July 21, 2012 from http://app1.mcys.gov.sg/Portals/0/Files/EM_Chapter3.pdf (Author: MCYS Year: 2012) • Autism Community (2012). Retrieved on July 21, 2012 from http://www.autism-community.com/education/assistive-technology/ • Autism Speaks (2012). Retrieved July 21, 2012 from http://www.autismspeaks.org/family-services/autism-apps • MCYS (10 March 2012). Retrieved July 21, 2012 from http://app1.mcys.gov.sg/Portals/0/Summary/pressroom/New%20Initiatives%20to%20Better%20Support%20Persons%20with%20Disabilities.pdf ( • Lim, L. and Quah, M. (2004). Educating learners with diverse abilities. • http://www.autism.org.sg/press/2012/pr120320a-mypaper-mainstream-integration.pdf • Ministry of Education (Singapore) (2012). Retrieved 21 July, 2012 from http://www.moe.edu.sg/education/special-education/schoollist/