LANGUAGE IN INDIA

Intervention in Autism Spectrum Disorders - A SLP'S GUIDE

Shyamala Chengappa, Ph.D., Anna S.K., MASLP., and
Akanksha Gupta, M.Sc. (SLP)

INTRODUCTION

Autism is a brain disorder that typically affects a person's ability to communicate, form relationship with others, and respond appropriately to the environment. Some people with autism are relatively high functioning, with speech and intelligence intact. Others are mentally retarded, mute, or have serious language delays. For some autism makes them feel closed off and shut down; others seem locked into repetitive behaviors and rigid patterns of thinking.

Autism emerges in childhood; it affects about 1 or 2 people in every 1000 and is 3-4 times more common in boys than in girls (National Autistic Society, 2001).There are a number of conditions which share similarities with autism, and are now considered as sub categories under the title " Autistic Spectrum disorder" or ASD (Wing & Gould,1979).

Autism is an 'umbrella' term and it encompasses that group of children, who present triad of impairments in,

• Reciprocal social interaction
• Verbal and nonverbal communication, and have
• Restricted range of imaginative activities (Wing, 1988)

Hence, a number of classification systems adequately and appropriately tried to classify them depending on their characteristic features. 2 widely used systems are:

1. DSM IV classification (APA, 1994)
2. ICD 10 classification (WHO, 1987)

They have classified various disorders under autism as Autism, Asperger's syndrome, Childhood disintegrative disorder, Rett's disorder, PDD - NOS/ Atypical autism, Pervasive developmental disorder and many more.

NEED FOR A RESOURCE MANUAL

Currently there is no cure for autism, but behavior can be positively intervened and treatments exists which may reduce challenges associated with the disability. Some treatments have research studies that support their efficacy; others may not (Gilberg et al , 2000). Many professionals have agreed that individuals with ASD respond well to highly structured, specialized education programs, tailored to the individual's needs. (Mauk, 1993; Campbell et al., 1996)

There are many publications of treatment programs, management guidelines, intervention strategies schedule that can be seen in vast literature available on this topic. However most are geared towards western population, and quite often not directly implementable in the Indian context. More importantly, they are simply not accessible to the general professional population.

Thus there is a clear need for a management resource that can be used by the speech language pathologist, when dealing with an individual with ASD, in the Indian context. Numerous researches have proposed that the primary disability in ASD individual is their communication deficit (Parson, 1985). Hence this manual was focused to address the communication domain in ASD, especially the language deficits, and to meet the needs of SLPs.

REVIEW OF LITERATURE

SPECIFIC LANGUAGE INTERVENTION

There are various specific treatment techniques that have been utilized with ASD clients. Some of them are:

1. Auditory Integration Therapy (AIT):

It is based on the belief that autism is auditory dysfunction disorder including inattention, hypo or hyper sensitivity to sounds and central auditory processing (ASHA 1994). AIT intends to reduce some of these auditory problems. One of the most frequently reported benefits of AIT are that is causes reduction in the sound sensitivity as well as better listening and comprehension skills.

2. Visually Cued Instruction:

It has been found that the children with autism have superior ability to encode visuo- spatial information than auditory information. Thus visual aids could be used for teaching more than the auditory cues.

3. Picture Exchange Communication:

It is a training program for children with ASD to acquire functional communication skills. Here they are taught to give a picture of a desired item to the communicative partner in exchange of an item, thus initiating communicative act for a concrete outcome within a social context.

4. Augmentative and Alternative communication in ASD:

Language programs have come to include alternative means of communication such as signs, abstract shaped plastic symbols, written communication boards, and even computer consoles. Signing probably has been used most commonly as an alternative communication system. (Schuler, 1985)

AIM

The aim of this study is to develop a comprehensive treatment resource manual for language deficits in ASD clients that is intended to provide,

• A means by which the client communication deficit can be profiled.
• A resource from which the SLP can plan client- specific therapy as per the clinical profile presented by the client.

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