Structured teaching

Introduction

A wide range of behavioral and educational interventions is available to treat various aspects of Autism. Most of them are based on assessment of current level of functioning in all major areas (sensory, motor, cognitive, ADLs, academic etc.) and accordingly teach the age appropriate skills. These measures include development of core skills by modified applied behavior analysis (ABA), enhancement of sensory inputs by sensory integration and management of routine tasks by structured teaching.

Autism and Expectancy Factor

Autistic children have difficulty in communication and social adaptation. This leads to inability to express themselves and poor understanding. This often leads to increased anxiety level and tendency to remain withdrawn and develop non functional routines and stereotypic behaviors. Problems faced due to lack of expectancy factor by children and their parents are tempertantrums, difficulty in learning, increased anxiety levels, lack of organization, narrow interest and aloofness.

Visual Structure Support – A solution!

it is a methodological and scientific approach to provide structure to develop predictability in their life, in short and simple facilitated manner. This includes:

• What to do?
• How much to do?
• Where to do?
• When am I finished?
• When to do?
• What’s next?

How does it help?

Autistic children are good visual learners. This strength is utilized by the visual structure support which reduces the burden of instructing each task repeatedly. This in turn provides clarity to the child regarding the parental expectations, hence facilitates organization. The child becomes more independent and more calmed. He /she develops different ways to communicate.

How to implement?

Environmental Supports include

• Minimized auditory and visual distraction
• Proper seating arrangement of the child
• Minimized clutters in the environment
• Using furniture to provide the boundary in the working area like shelves, almirahs, bookshelves, table, chair etc
• Provision of proper light in the room

Visual schedules

• Has three levels: Object, Picture, Word label
• Should be in either left to right or top to bottom sequence
• Initially introduce two visual cards in the schedule and gradually one can increase the number of cards
• Use physical prompts to guide the child with minimal verbal prompts as the verbal prompts are more difficult to fade out.

Making ‘to do lists’

• Activities: Should have clear start and finish
• Activities are designed as follows:
• Cognitive skills: concept of putting in, sorting, matching, 1:1 correspondence, number concept
• Play and leisure: construction, cause and effect, assembly, sensory based.
• Social skills: wait, parallel, turn taking, sharing
• Communication skills: asking, initiating, sustaining.

Source: Patient Information Booklet for Autism. Developed by AIIMS, New Delhi