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INTRODUCTION

In Bangladesh, the general attitude towards autism is mostly negative and it is seen as a social barrier. Even today, autism is considered a God-given curse and children with ASDs are taken as possessed by the Devil. Also bad parenting is accused: mothers going out to work still get the blame. As such the demands of living with a person with autism are great, and families frequently experience high levels of stress. The uniqueness of each individual with autism makes the experience of living with autism different for each family. There is no alternative but to live with autism for such families; but the concern is how better this living can be made. Recognizing and preparing for the challenges that are in store will make a tremendous difference to all involved, including parents, siblings, grandparents, extended family, and friends. AWF wants to promote autism awareness in the society and turn it suitable for living for the autistic children. AWF also wants to prepare families with some of the basic knowledge and working knowledge they may need to provide what their dear ones need.

Autism affects children of all races and nationalities, but certain factors increase a child’s risk. Day by day increase autistic children in Bangladesh.Autism is burden for a country.It is threaten for the country like Bangladesh.The center and educational institution are not available for autistic children in Bangladesh. Autism is a brain disorder that often makes it hard to communicate with and relate to others. With autism, the different areas of the brain fail to work together.

Autism is a lifelong developmental disability that prevents individuals from properly understanding what they see, hear and otherwise sense. This results in severe problems relating to social relationship, communication and behavior. [Autism is a Spectrum Disorder, which means that condition has wide ranging degrees of severity.] This is also a condition called Asperger Syndrome, which is a form of autism used to describe people at the higher functioning end of the Autism Spectrum. Here are some most important links of Autism: Autism is a physical condition linked to abnormal biology and chemistry in the brain. The exact causes of these abnormalities remain unknown, but this is a very active area of research. There are probably combinations of factors that lead to autism. Genetic factors seem to be important. For example, identical twins are much more likely than fraternal twins or siblings to both have autism. Similarly, language abnormalities are more common in relatives of autistic children. Chromosomal abnormalities and other nervous system (neurological) problems are also more common in families with autism. A number of other possible causes have been suspected, but not proven. They involve:

• Diet
• Digestive tract changes
• Mercury poisoning
• The body’s inability to properly use vitamins and minerals
• Vaccine sensitivity

Autism is one of a group of serious developmental problems called autism spectrum disorders (ASD) that appear in early childhood — usually before age 3. Though symptoms and severity vary all autism disorders affect a child’s ability to communicate and interact with others. The number of children diagnosed with autism appears to be rising. It’s not clear whether this is due to better detection and reporting of autism, a real increase in the number of cases or both. While there is no cure for autism, intensive, early treatment can make a big difference in the lives of many children with the disorder.

OBJECTIVES

• To know about Autism Welfare Foundation.

• To pinpoint about their present activities.

• To cluster information about autism.

• To inquiry about characteristics, cause, sign and symptom of autism etc.

• To know about communication problem

• To collect information about the activities of AWF regarding the development of communication skill for children with autism.

• How they get academic support through their behavior

• How to manage adult children with ASD (Autism Spectrum Disorder) and adult vocational activity.

• To know the level /criteria of child according to the classroom basis.

• To gather knowledge about autism.

• To identify the main problems in developmental domains of autistic children.

• To get idea about the teaching and training methods used in AWF.

TYPES OF AUTISM

These are the most common disorders, all presenting in a somewhat similar manner, but having slight variations:

Autistic Disorder

As stated above, and defined by the Autism Society of America (ASA): “Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults with autism typically show difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities.

Autism is one of five disorders that falls under the umbrella of Pervasive Developmental Disorders (PDD), a category of neurological disorders characterized by “severe and pervasive impairment in several areas of development.”

Pervasive Developmental Disorder (P.D.D)

Pervasive Developmental Disorder Also called “Atypical Autism.” Children with this disorder have many of the same characteristics of Autism, but not all the criteria associated with Autism.

Asperger’s Disorder

Children with this disorder do not have the usual language barriers associated with Autism and are generally very intelligent. However, they do tend to struggle with social interactions, and can fixate on a particular object or subject they take an interest in, and talk about it constantly.

Retts Disorder

Retts is rather similar to Autism, but presents only in girls. The children begin to develop on target, but then begin losing some communication abilities. The symptoms of Retts can begin to occu.

Causes of Autism

Autism has no single, known cause. Given the complexity of the disease, the range of autistic disorders and the fact that no two children with autism are alike, there are likely many causes. Scientists aren’t certain what causes autism, but it’s likely that both genetics and environment play a role. Researchers have identified a number of genes associated with the disorder. Studies of people with autism have found irregularities in several regions of the brain. Other studies suggest that people with autism have abnormal levels of serotonin or other neurotransmitters in the brain. These abnormalities suggest that autism could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how neurons communicate with each other. While these findings are intriguing, they are preliminary and require further study. The theory that parental practices are responsible for autism has now been disproved. These may include:

• Genetic problems- A number of genes appear to be involved in autism. Some may make a child more susceptible to the disorder; others affect brain development or the way brain cells communicate. Still others may determine the severity of symptoms. Each problem in genes may account for a small number of cases, but taken together, the influence of genes may be substantial. Some genetic problems seem to be inherited, whereas others happen spontaneously.
• Environmental factors- Many health problems are due to both genetic and environmental factors, and this is likely the case with autism as well. Researchers are currently exploring whether viral infections and air pollutants, for example, play a role in triggering autism.

Other cause

• Prenatal environment

• Infectious processes

• Environmental agents

• Other maternal conditions

• Other in utero

• Perinatal environment

• Postnatal environment—

• Mercury

• Vaccines

• Thiomersal

• MMR vaccine

• Autoimmune disease

• Viral infection

• Excessive hygiene

• Oxidative stress

• Amygdala neurons

• Locus coeruleus–noradrenergic system

• Lack of Vitamin D

• Lead

• Leaky gut syndrome

• Paracetamol

• Rain

• Refrigerator mother

Charecteristics of Autism

Each individual with an autism spectrum disorder (ASD) is unique and may demonstrate markedly different behaviors and skills. The following information provides an overview of some of the common characteristics seen in children with ASD.

1.Speech

Speech is likely to develop much more slowly than is the norm. Speech may remain absent, or appear in the small child and vanish by the age of four. Speech may include peculiar patterns or intonations.

2.Social Interaction

Most often noticeable is the failure to form social bonds. The child who has ASD may not follow the parents or other children around the house – or may cling to them. He may not go to others for comfort when hurt. The autistic child often avoids eye contact, resists being picked up, and does not seem to “tune in” to the world around him/her.

3.Sensory Differences

The child with ASD may not react the same way to a variety of environmental stimuli. He may not respond to cold or heat or over-respond. The child may exhibit hypersensitivity to light, noises, touch, smells, and tastes.

4.Peak Skills

The child who has ASD may have strong peak skills in areas such as computations in math, drawing, music, or memory of data, whether trivial or important. At the same time, he may not be able to discuss the weather, understand time, or easily comprehend what he has read.

5.Play

A child with ASD may not initiate play with other children. The child may prefer to be left alone. There is a lack of imitation of other children’s or adult’s actions.

6.Need for Sameness and Routine

Such a child may throw a tantrum that lasts for hours because the seating was changed in the family car. Or he may engage in stereotyped behavior, such as flicking or flapping a hand, lining up toys, drawing the same picture, or seeking repeatedly to do what he is unable to do at the time.

7.Behavioral Problems

Children with autism spectrum disorders can be very passive or hyperactive. They may also demonstrate obsessive interests in objects or activities. Aggression towards others or themselves is a possibility, especially when frustrated. Generally, people with ASD prefer to maintain certain routines and may respond negatively when a routine is changed or disrupted.

8.Management of a Child who has Autism Spectrum Disorder

The management of a child with ASD falls into two areas:

1) Providing understanding, training, and consultation for parents, teachers, and service providers as they seek to deal with the child’s atypical and problematic behavior, and

2) Providing a highly structured environment, including trained personnel, in which the child, adolescent, or young adult can learn.

Other Characteristics include:

• No fear of danger.

• Over or under sensitivity to pain.

• May avoid eye contact with you.

• May prefer to be by him/herself.

• Has difficulty expressing what they want or need – may then try to use gestures.

• May echo words or phrases.

• May have inappropriate attachments to objects.

• May spin his/herself or objects.

• Prolonged repetitive play.

• May insist on things/routines always being the same.

• May exhibit inappropriate laughing (laughing when not appropriate to the situation).

• May display tantrums for no apparent reason.

• May avoid cuddling.

• May exhibit self injurious behavior when upset i.e. biting selves or banging heads.

• An overall difficulty interacting with others.

Sign of Autism

There are three distinctive behaviors that characterize autism. Autistic children have difficulties with social interaction, problems with verbal and nonverbal communication, and repetitive behaviors or narrow, obsessive interests. These behaviors can range in impact from mild to disabling.

The hallmark feature of autism is impaired social interaction. Parents are usually the first to notice symptoms of autism in their child. As early as infancy, a baby with autism may be unresponsive to people or focus intently on one item to the exclusion of others for long periods of time. A child with autism may appear to develop normally and then withdraw and become indifferent to social engagement.

Children with autism may fail to respond to their name and often avoid eye contact with other people. They have difficulty interpreting what others are thinking or feeling because they can’t understand social cues, such as tone of voice or facial expressions, and don’t watch other people’s faces for clues about appropriate behavior. They lack empathy. Many children with autism engage in repetitive movements such as rocking and twirling, or in self-abusive behavior such as biting or head-banging.

They also tend to start speaking later than other children and may refer to themselves by name instead of “I” or “me.” Children with autism don’t know how to play interactively with other children. Some speak in a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Many children with autism have a reduced sensitivity to pain, but are abnormally sensitive to sound, touch, or other sensory stimulation. These unusual reactions may contribute to behavioral symptoms such as a resistance to being cuddled or hugged.

Children with autism appear to have a higher than normal risk for certain co-existing conditions, including fragile X syndrome (which causes mental retardation), tuberous sclerosis (in which tumors grow on the brain), epileptic seizures, Tourette syndrome, learning disabilities, and attention deficit disorder. For reasons that are still unclear, about 20 to 30 percent of children with autism develop epilepsy by the time they reach adulthood. While people with schizophrenia may show some autistic-like behavior, their symptoms usually do not appear until the late teens or early adulthood. Most people with schizophrenia also have hallucinations and delusions, which are not found in autism.

Symptoms of Autism

For many children, autism symptoms improve with treatment and with age. Some children with autism grow up to lead normal or near-normal lives. Children whose language skills regress early in life, usually before the age of 3, appear to be at risk of developing epilepsy or seizure-like brain activity. During adolescence, some children with autism may become depressed or experience behavioral problems. Parents of these children should be ready to adjust treatment for their child as needed. The symptoms may vary from moderate to severe.

Communication problems may include:

• Cannot start or maintain a social conversation
• Communicates with gestures instead of words
• Develops language slowly or not at all
• Does not adjust gaze to look at objects that others are looking at
• Does not refer to self correctly (for example, says “you want water” when the child means “I want water”)
• Does not point to direct others’ attention to objects (occurs in the first 14 months of life)
• Repeats words or memorized passages, such as commercials
• Uses nonsense rhyming\

Social interaction:

• Does not make friends
• Does not play interactive games
• Is withdrawn
• May not respond to eye contact or smiles, or may avoid eye contact
• May treat others as if they are objects
• Prefers to spend time alone, rather than with others
• Shows a lack of empathy

Response to sensory information:

• Does not startle at loud noises
• Has heightened or low senses of sight, hearing, touch, smell, or taste
• May find normal noises painful and hold hands over ears
• May withdraw from physical contact because it is overstimulating or overwhelming
• Rubs surfaces, mouths or licks objects
• Seems to have a heightened or low response to pain

Play:

• Doesn’t imitate the actions of others
• Prefers solitary or ritualistic play
• Shows little pretend or imaginative play

Behaviors:

• “Acts up” with intense tantrums
• Gets stuck on a single topic or task (perseveration)
• Has a short attention span
• Has very narrow interests
• Is overactive or very passive
• Shows aggression to others or self
• Shows a strong need for sameness
• Uses repetitive body movements

Risk Factor of Autism

Autism affects children of all races and nationalities, but certain factors increase a child’s risk. They include:

• Child’s sex-Boys are three to four times more likely to develop autism than girls are.
• Family history- Families who have one child with autism have an increased risk of having another child with the disorder. It’s also not uncommon for the parents or relatives of an autistic child to have minor problems with social or communication skills themselves or to engage in certain autistic behaviors.
• Other disorders- Children with certain medical conditions have a higher than normal risk of having autism. These conditions include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; the neurological disorder Tourette syndrome; and epilepsy, which causes seizures.
• Parents’ ages- Having an older father (being 40 or older) may increase a child’s risk of autism. There may also be a connection between children being born to older mothers and autism, but more research is necessary.

Tests and diagnosis

Autism varies widely in its severity and symptoms and may go unrecognized, especially in mildly affected children or when it is masked by more debilitating handicaps. Doctors rely on a core group of behaviors to alert them to the possibility of a diagnosis of autism.

These behaviors are:

* impaired ability to make friends with peers

* impaired ability to initiate or sustain a conversation with others

* absence or impairment of imaginative and social play

* stereotyped, repetitive, or unusual use of language

* restricted patterns of interest that are abnormal in intensity or focus

* preoccupation with certain objects or subjects

* inflexible adherence to specific routines or rituals

Doctors will often use a questionnaire or other screening instrument to gather information about a child’s development and behavior. Some screening instruments rely solely on parent observations; others rely on a combination of parent and doctor observations. If screening instruments indicate the possibility of autism, doctors will ask for a more comprehensive evaluation. Autism is a complex disorder. A comprehensive evaluation requires a multidisciplinary team including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who diagnose children with ASDs. The team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. Because hearing problems can cause behaviors that could be mistaken for autism, children with delayed speech development should also have their hearing tested. After a thorough evaluation, the team usually meets with parents to explain the results of the evaluation and present the diagnosis. Children with some symptoms of autism, but not enough to be diagnosed with classical autism are often diagnosed with PDD-NOS. Children with autistic behaviors but well-developed language skills are often diagnosed with Asperger syndrome. Children who develop normally and then suddenly deteriorate between the ages of 3 to 10 years and show marked autistic behaviors may be diagnosed with childhood disintegrative disorder. Girls with autistic symptoms may be suffering from Rett syndrome, a sex-linked genetic disorder characterized by social withdrawal, regressed language skills, and hand wringing.

Diagnostic criteria for autism

For a child to be diagnosed with autism, he or she must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment. To be diagnosed with autism, a child must have six or more of the following symptoms and two or more of those symptoms must fall under the social skills category.

Social skills

• Has difficulty with nonverbal behaviors, such as making eye contact, making facial expressions or using gestures
• Has difficulty forming friendships with peers and seems to prefer playing alone
• Doesn’t share experiences or emotions with other people, such as sharing achievements or pointing out objects or other interests
• Appears unaware of others’ feelings

Communication skills

• Starts talking later than age 2 and has other developmental delays by 30 months, and doesn’t make an attempt to communicate with gestures or miming
• Can’t start a conversation or keep one going
• May repeat words or phrases verbatim, but doesn’t understand how to use them
• Doesn’t play make-believe or doesn’t imitate the behavior of adults when playing

Behavior

• Develops interests in objects or topics that are abnormal in intensity or focus
• Performs repetitive movements, such as rocking, spinning or hand-flapping
• Becomes disturbed at the slightest change in routines or rituals
• May be fascinated by parts of an object, such as the spinning wheels of a toy car

Treatment

There is no cure for autism. Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement. The ideal treatment plan coordinates therapies and interventions that target the core symptoms of autism: impaired social interaction, problems with verbal and nonverbal communication, and obsessive or repetitive routines and interests. Most professionals agree that the earlier the intervention, the better.

• Educational/behavioral interventions: Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills. Family counseling for the parents and siblings of children with autism often helps families cope with the particular challenges of living with an autistic child.

• Medications: Doctors often prescribe an antidepressant medication to handle symptoms of anxiety, depression, or obsessive-compulsive disorder. Anti-psychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more of the anticonvulsant drugs. Stimulant drugs, such as those used for children with attention deficit disorder (ADD), are sometimes used effectively to help decrease impulsivity and hyperactivity.

• Other therapies: There are a number of controversial therapies or interventions available for autistic children, but few, if any, are supported by scientific studies. Parents should use caution before adopting any of these treatments.

Location, Extension and Accessibility of the study area

Dhaka is the capital of Bangladesh and the principal city of Dhaka Division. Dhaka is a megacity and one of the major cities of South Asia. Located on the banks of the Buriganga River, Dhaka, along with its metropolitan area, had a population of over 16 million in 2011, making it the largest city in Bangladesh.^{<href=”#cite_note-BangladeshStatPock2008-1″>[2]} It is the 9th largest city in the world^{<href=”#cite_note-5″>[6]} and also 28th among the most densely populated cities in the world. Dhaka is known as the City of Mosques and with 400,000 cycle rickshaws running on its streets every day, the city is also described as the Rickshaw Capital of the World.

Dhaka is located in central Bangladesh at 23°42?0?N 90°22?30?E, on the eastern banks of the Buriganga River. The city lies on the lower reaches of the Ganges Delta and covers a total area of 360 square kilometres (140 sq mi). It consists of eight principal thanas –Lalbagh, Kotwali, Sutrapur, Ramna, Motijheel, Paltan, Dhanmondi, Mohammadpur, Tejgaon – and 16 auxiliary thanas – Gulshan, Mirpur, Pallabi, Shah Ali, Turaag, Sabujbagh, Dhaka Cantonment, Demra, Hazaribagh, Shyampur, Badda, Kafrul, Kamrangir char, Khilgaon and Uttara. In total the city has 130 wards and 725 mohallas.^{<href=”#cite_note-Dhaka-31″>[32]} Dhaka district has an area of 1463.60 square kilometres (565 sq mi); and is bounded by the districts of Gazipur, Tangail, Munshiganj, Rajbari, Narayanganj, Manikganj. Tropical vegetation and moist soils characterize the land, which is flat and close to sea level. This leaves Dhaka susceptible to flooding during the monsoon seasons owing to heavy rainfall and cyclones.

Introduction

Name of the Organization:

‘Autism Welfare Foundation’ institution located in Dhaka.

13/38,Shakhertak,

Road No:4,Mohammadpur,

Dhaka-1207.

Back ground of the Organization:

Autism welfare foundation was established on April 4, 2004. It is non-profitable, non-government, voluntary welfare organization aiming to train and educate the autistic children to perform their maximum strengths and interests and making them able to support themselves.AWF is dedicated to increase public awareness about autism.

The training and education centre of AWF provides intensive training and education for autistic children and adults. This training and education centre emphasizes on a highly structured program where teacher and student ratio is 1:1. This program also gives emphasis on social, communication, behavioral and functional skills.

The foundation also runs a vocational training center for students above 10 years of age. Other activities like secretarial job, work in cafeteria, gardening etc are also performed by them.

1. Area of Work : ASD, PDD

2. Geographical Coverage of Operation : Dhaka, Bangladesh

3. Sources of Funds : Students’ tuition and donation from

Members and parents of the students,

Donation private companies occasionally.

AWF Organizational Profile

1. Name of the Organization : Autism Welfare Foundation

2. Founder/ Chairperson : Dr. Rownak Hafiz, MBBS, DCH

3. Address : House No. 38/40, Road No. 04

Block-Kha, Pisciculture Housing Society (Sekhertek), Mohammadpur, Dhaka-1207

: Telephone: +88 028121759

: Fax: +88 028121759

: E-mail: rownak_awf@yahoo.com

: Website: www.awfbd.com

4. Established in : 2004

5. Registered Under : Society’s Registration Act with registration of Joint Stock Company

6. Registration no : S-3821 (610/2004)

Objectives of the Organization:

AWF is dedicated to increase public awareness about autism. The Training and Education Center of AWF provides intensive training and education for autistic children and adolescents. This training and education center emphasizes a highly structured program where teacher student ration is 1:1.

This program also gives emphasis on communication skill, behavior and functional academics.

The foundation also funds a vocational training center for students above 10 years old. Other adult activities are secretarial jobs, work in cafeteria, gardening etc.

Organizational Structure:

Autism welfare foundation was established on April 4, 2004. It is non-profitable, non-government, voluntary welfare organization aiming to train and educate the autistic children to perform their maximum strengths and interests and making them able to support themselves.AWF is dedicated to increase public awareness about autism.Their main activities are in the institutional level.

The Organigational structure are given below:

Chairperson

Tregear

Organizational members

Co-ordinator

Class Incharge

Teachers

Staffing pattern of the Organization:

Autism welfare foundation is non-profitable, non-government, voluntary welfare organization aiming to train and educate the autistic children to perform their maximum strengths and interests and making them able to support themselves.The doctors, Psychologist, Therapist, Co-ordinator, Class Incharge, Teachers and third and forth classes workers work here.All of them are works are finished with their own responsibility.

Table 01: The staffing pattern of the Organization is given following:

Principal	01
Consultant	01
No. of Teachers	52
No. of Psychologist	01
No. of Occupational Therapist	01
No. of Office Staff	02
No. of Attendant	15
No of Guard & Peon	03

Regular Activities of AWF

1.Outing

2.Report presentation

3.Member’s meeting

4.Group Discussion session

5.Participating various common national & international events

Description of participants

Training and present activities of the Organization:

Training

They have provided training to several of their staff as well as undergraduates, masters and PhD from home and abroad.

present activities of the Organization:

• Creates mass awareness among parents, professionals, social worker, and general public for better understanding for autism

• Offers diagnosis and assessment of autistic children

• Runs education and training center

• Runs Early Intervention Program for children below the age of 5

• Runs Adult Activity Program and Vocational Training Program for older children and adolescents with autism

• Arranges Teacher Training Program

• Arranges Parent Training Program

• Arranges Parent-Teacher Workshop

• Arranges seminars, workshop

• Offers package program for autistic children and adolescents from different areas of Bangladesh who are unable to attend the Training Centre of AWF

• Provide outing program for students of AWF for improving social behavior

• Publishes News Letter

• Integrates more able autistic children into normal school.

• Offer free services for poor autistic children

Description about the works:

1) Running Education & Training Program:

Educating children with autism is a challenge for both parents and teachers. These children are individuals first and foremost with unique strengths and weaknesses. Some may be of average to above-average intelligence, while others may be below average. Academic goals need to be tailored to that individual’s intellectual ability and functioning level. Understanding this reality, AWF started an education and training center named “Kanon”. The aim of this school is to provide a safe and secure learning environment for students with autistic spectrum disorders. In order to provide a high-quality and relevant education for children and young adults with autism, a combined program including education and training has been introduced. AWF has its own course and curriculum to provide education of these autistic children. An Individualized Education Plan (IEP) is prepared on the basis of functional assessments. Currently, the School has Eleven sections in which around 148 children aged 3 – 15 are placed in two shifts (morning & day) depending on their abilities, needs, and chronological age. In the early years the emphasis is on developing communication, as well as building basic interaction skills, pre-reading and writing skills and concept building. Concepts are taught in one-on-one

Sessions, while group activities are used to develop social skills. Alongside, the child’s abilities to work independently and interpret instructions in a general environment are developed and strengthened. Gradually, the children learn independent work behaviors that enable them to learn vocational skills. Children, who are ready, move on to mainstream classrooms. The school combines group activities and one-on-one teaching, as well as music therapy, computer and sensory integration.

A total of 57 teachers, 1 psychologist, and 1 occupational therapist are engaged in conducting the education courses through the education center where 138 autistic children are enrolling every year. As the education program is highly structured, the teacher, student ratio is 1:1.

AWF is also running two pre-normal class called “Nayantara” & “Malati” where the students are taught national course curriculum, aiming to enroll them in normal school. A total of 14 students have already been admitted to normal school in last 4

View With Charts And Images  

 

INTRODUCTION

In Bangladesh, the general
attitude towards autism is mostly negative and it is seen as a social barrier.
Even today, autism is considered a God-given curse and children with ASDs are
taken as possessed by the Devil. Also bad parenting is accused: mothers going
out to work still get the blame. As such the demands of living with a person
with autism are great, and families frequently experience high levels of
stress. The uniqueness of each individual with autism makes the experience of
living with autism different for each family. There is no alternative but to
live with autism for such families; but the concern is how better this living
can be made. Recognizing and preparing for the challenges that are in store
will make a tremendous difference to all involved, including parents, siblings,
grandparents, extended family, and friends. AWF wants to promote autism awareness in the society and turn it
suitable for living for the autistic children. AWF also wants to prepare families with
some of the basic knowledge and working knowledge they may need to provide what
their dear ones need.

Autism affects children of all races and nationalities, but certain
factors increase a child’s risk.
Day by day increase autistic children in Bangladesh.Autism is burden for a
country.It is threaten for the country like Bangladesh.The center and
educational institution are not available for  autistic children in Bangladesh. Autism
is a brain disorder that often makes it hard to communicate with and relate to
others. With autism, the different areas of the brain fail to work together.

Autism is a life long developmental
disability that prevents individuals from properly understanding what they see,
hear and otherwise sense. This results in severe problems relating to social
relationship, communication and behavior. [Autism is a Spectrum Disorder, which
means that condition has wide ranging degrees of severity.] This is also a
condition called Asperger Syndrome, which is a form of autism used to describe
people at the higher functioning end of the Autism Spectrum. Here are
some most important links of Autism: Autism is a physical condition linked to abnormal biology and
chemistry in the brain. The exact causes of these abnormalities remain unknown,
but this is a very active area of research. There are probably combinations of
factors that lead to autism. Genetic factors seem to be important. For example,
identical twins are much more likely than fraternal twins or siblings to both
have autism. Similarly, language abnormalities are more common in relatives of
autistic children. Chromosomal abnormalities and other nervous system
(neurological) problems are also more common in families with autism. A number
of other possible causes have been suspected, but not proven. They involve:

• Diet
• Digestive
  tract changes
• Mercury
  poisoning
• The
  body’s inability to properly use vitamins and minerals
• Vaccine
  sensitivity

Autism is one of a group of serious developmental problems called
autism spectrum disorders (ASD) that appear in early childhood — usually before
age 3. Though symptoms and severity vary all autism disorders affect a child’s ability to communicate and
interact with others. The number of children diagnosed with autism appears to
be rising. It’s not clear whether this is due to better detection and reporting
of autism, a real increase in the number of cases or both. While there is no
cure for autism, intensive, early treatment can make a big difference in the
lives of many children with the disorder.

OBJECTIVES

To know about Autism Welfare Foundation.

To pinpoint about their present activities.

To cluster information about autism.

To inquiry about characteristics, cause, sign
and symptom of autism etc.

To know about communication problem

To collect information about the activities of
AWF regarding the development of communication skill for children with autism.

How they get academic support through their
behavior

How to manage adult children with ASD (Autism
Spectrum Disorder) and adult vocational activity.

To know the level /criteria of child according
to the classroom basis.

To gather knowledge about autism.

To identify the main problems in developmental
domains of autistic children. 

To get idea about the teaching and training
methods used in AWF.

TYPES OF AUTISM

These are the most common disorders, all
presenting in a somewhat similar manner, but having slight variations:

Autistic
Disorder

As stated
above, and defined by the Autism Society of America (ASA): “Autism is a
complex developmental disability that typically appears during the first three
years of life and is the result of a neurological disorder that affects the
normal functioning of the brain, impacting development in the areas of social
interaction and communication skills. Both children and adults with autism
typically show difficulties in verbal and non-verbal communication, social
interactions, and leisure or play activities.

Autism is one of five disorders that falls under
the umbrella of Pervasive Developmental Disorders (PDD), a category of
neurological disorders characterized by “severe and pervasive impairment in
several areas of development.”

Pervasive
Developmental Disorder (P.D.D)

 Pervasive Developmental Disorder Also
called “Atypical Autism.” Children with this disorder have many of
the same characteristics of Autism, but not all the criteria associated with
Autism.

Asperger’s
Disorder

 Children
with this disorder do not have the usual language barriers associated with
Autism and are generally very intelligent. However, they do tend to struggle
with social interactions, and can fixate on a particular object or subject they
take an interest in, and talk about it constantly.

Retts
Disorder

 Retts is
rather similar to Autism, but presents only in girls. The children begin to
develop on target, but then begin losing some communication abilities. The
symptoms of Retts can begin to occu.

Causes of Autism

Autism has
no single, known cause. Given the complexity of the disease, the range of
autistic disorders and the fact that no two children with autism are alike,
there are likely many causes. Scientists aren’t certain what causes autism, but
it’s likely that both genetics and environment play a role. Researchers have
identified a number of genes associated with the disorder. Studies of people
with autism have found irregularities in several regions of the brain. Other
studies suggest that people with autism have abnormal levels of serotonin or
other neurotransmitters in the brain. These abnormalities suggest that autism
could result from the disruption of normal brain development early in fetal
development caused by defects in genes that control brain growth and that
regulate how neurons communicate with each other. While these findings are
intriguing, they are preliminary and require further study. The theory that
parental practices are responsible for autism has now been disproved. These may
include:

• Genetic
  problems– A number of genes appear to be
  involved in autism. Some may make a child more susceptible to the
  disorder; others affect brain development or the way brain cells
  communicate. Still others may determine the severity of symptoms. Each
  problem in genes may account for a small number of cases, but taken
  together, the influence of genes may be substantial. Some genetic problems
  seem to be inherited, whereas others happen spontaneously.
• Environmental
  factors- Many health problems are due to both genetic and
  environmental factors, and this is likely the case with autism as well.
  Researchers are currently exploring whether viral infections and air
  pollutants, for example, play a role in triggering autism.

• Other Cause

ü  Prenatal environment

ü  Infectious processes

ü  Environmental agents

ü 
Other maternal conditions

ü 
Other in utero

ü  Perinatal environment

ü  Postnatal environment—

ü  Mercury

ü  Vaccines

ü  Thiomersal

ü  MMR vaccine

ü  Autoimmune disease

ü  Viral infection

ü  Excessive hygiene

ü  Oxidative stress

ü  Amygdala neurons

ü  Locus coeruleus–noradrenergic system

ü  Lack of Vitamin D

ü 
Lead

ü 
Leaky gut syndrome

ü 
Paracetamol

ü 
Rain

ü  Refrigerator
mother

Charecteristics of
Autism

Each individual with an autism spectrum disorder (ASD) is
unique and may demonstrate markedly different behaviors and skills. The following information
provides an overview of some of the common characteristics seen in children with ASD.

1.Speech

Speech is likely to develop much more slowly than is the
norm. Speech may remain absent, or appear in the small child and vanish by the age of four. Speech
may include peculiar patterns or intonations.

2.Social
Interaction

Most often noticeable is the failure to form social bonds.
The child who has ASD may not follow the parents or other children around the house – or may
cling to them. He may not go to others for comfort when hurt. The autistic
child often avoids eye contact,
resists being picked up, and does not seem to “tune in” to the world around
him/her.

3.Sensory
Differences

The child with ASD may not react the same way to a variety
of environmental stimuli. He may not respond to cold or heat or over-respond.
The child may exhibit hypersensitivity to light, noises,
touch, smells, and tastes.

4.Peak
Skills

The child who has ASD may have strong peak skills in areas
such as computations in math, drawing, music, or memory of data, whether trivial or important. At
the same time, he may not be able to discuss the weather, understand time, or
easily comprehend what he has read.

5.Play

A child with ASD may not initiate play with other
children. The child may prefer to be left alone. There is a lack of imitation of other
children’s or adult’s actions.

 

6.Need
for Sameness and Routine

Such a child may throw a tantrum that lasts for hours
because the seating was changed in the family car. Or he may engage in stereotyped behavior, such as
flicking or flapping a hand, lining up toys, drawing the same picture, or
seeking repeatedly to
do what he is unable to do at the time.

7.Behavioral
Problems

Children with autism spectrum disorders can be very
passive or hyperactive. They may also demonstrate obsessive interests in objects or activities.
Aggression towards others or themselves is a possibility, especially when
frustrated. Generally, people with ASD prefer to maintain certain routines and
may respond negatively when a routine is changed or disrupted.

8.Management
of a Child who has Autism Spectrum Disorder

The management of a child with ASD falls into two areas:

1) Providing understanding, training, and consultation for
parents, teachers, and service providers as they seek to deal with the child’s atypical and
problematic behavior, and

2) Providing a highly structured environment, including
trained personnel, in which the child, adolescent, or young adult can learn.

Other
Characteristics include:

• No fear of danger.
• Over or under sensitivity to pain.
• May avoid eye contact with you.
• May prefer to be by him/herself.
• Has difficulty expressing what they want or need – may then try to
  use gestures.
• May echo words or phrases.
• May have inappropriate attachments to objects.
• May spin his/herself or objects.
• Prolonged repetitive play.
• May insist on things/routines always being the same.
• May exhibit inappropriate laughing (laughing when not appropriate to
  the situation).
• May display tantrums for no apparent reason.
• May avoid cuddling.
• May exhibit self injurious behavior when upset i.e. biting selves or
  banging heads.
• An overall difficulty interacting with others.

Sign of Autism

Children with autism may fail to respond to their name and often avoid eye
contact with other people. They have difficulty interpreting what others are
thinking or feeling because they can’t understand social cues, such as tone of
voice or facial expressions, and don’t watch other people’s faces for clues
about appropriate behavior. They lack empathy. Many children with autism engage
in repetitive movements such as rocking and twirling, or in self-abusive
behavior such as biting or head-banging.

 They also tend to start speaking later than
other children and may refer to themselves by name instead of “I” or “me.”
Children with autism don’t know how to play interactively with other children.
Some speak in a sing-song voice about a narrow range of favorite topics, with
little regard for the interests of the person to whom they are speaking.

Many children with autism have a
reduced sensitivity to pain, but are abnormally sensitive to sound, touch, or
other sensory stimulation. These unusual reactions may contribute to behavioral
symptoms such as a resistance to being cuddled or hugged.

Children with autism appear to
have a higher than normal risk for certain co-existing conditions, including
fragile X syndrome (which causes mental retardation), tuberous sclerosis (in
which tumors grow on the brain), epileptic seizures, Tourette syndrome,
learning disabilities, and attention deficit disorder. For reasons that are
still unclear, about 20 to 30 percent of children with autism develop epilepsy
by the time they reach adulthood. While people with schizophrenia may show some
autistic-like behavior, their symptoms usually do not appear until the late
teens or early adulthood. Most people with schizophrenia also have
hallucinations and delusions, which are not found in autism.

Symptoms of Autism

For many
children, autism symptoms improve with treatment and with age. Some children
with autism grow up to lead normal or near-normal lives. Children whose
language skills regress early in life, usually before the age of 3, appear to
be at risk of developing epilepsy or seizure-like brain activity. During
adolescence, some children with autism may become depressed or experience
behavioral problems. Parents of these children should be ready to adjust
treatment for their child as needed. The symptoms may vary from moderate to
severe.

Communication problems may include:

• Cannot
  start or maintain a social conversation
• Communicates
  with gestures instead of words
• Develops
  language slowly or not at all
• Does not
  adjust gaze to look at objects that others are looking at
• Does not
  refer to self correctly (for example, says “you want water” when
  the child means “I want water”)
• Does not
  point to direct others’ attention to objects (occurs in the first 14
  months of life)
• Repeats
  words or memorized passages, such as commercials
• Uses
  nonsense rhyming

Social interaction:

• Does not
  make friends
• Does not
  play interactive games
• Is
  withdrawn
• May not
  respond to eye contact or smiles, or may avoid eye contact
• May treat
  others as if they are objects
• Prefers
  to spend time alone, rather than with others
• Shows a
  lack of empathy

 

Response to sensory information:

• Does not
  startle at loud noises
• Has
  heightened or low senses of sight, hearing, touch, smell, or taste
• May find
  normal noises painful and hold hands over ears
• May
  withdraw from physical contact because it is overstimulating or
  overwhelming
• Rubs
  surfaces, mouths or licks objects
• Seems to
  have a heightened or low response to pain

Play:

• Doesn’t
  imitate the actions of others
• Prefers
  solitary or ritualistic play
• Shows
  little pretend or imaginative play

Behaviors:

• “Acts
  up” with intense tantrums
• Gets
  stuck on a single topic or task (perseveration)
• Has a
  short attention span
• Has very
  narrow interests
• Is
  overactive or very passive
• Shows
  aggression to others or self
• Shows a
  strong need for sameness
• Uses
  repetitive body movements

Risk Factor of Autism

Autism affects children of all races and nationalities, but certain
factors increase a child’s risk. They include:

• Child’s sex– Boys are
  three to four times more likely to develop autism than girls are.
• Family
  history–
  Families who have one child with autism have an increased risk of having
  another child with the disorder. It’s also not uncommon for the parents or
  relatives of an autistic child to have minor problems with social or
  communication skills themselves or to engage in certain autistic
  behaviors.
• Other
  disorders–
  Children with certain medical conditions have a higher than normal risk of
  having autism. These conditions include fragile X syndrome, an inherited
  disorder that causes intellectual problems; tuberous sclerosis, a
  condition in which benign tumors develop in the brain; the neurological
  disorder Tourette syndrome; and epilepsy, which causes seizures.
• Parents’
  ages–
  Having an older father (being 40 or older) may increase a child’s risk of
  autism. There may also be a connection between children being born to
  older mothers and autism, but more research is necessary.

Tests  and  diagnosis

Autism
varies widely in its severity and symptoms and may go unrecognized, especially in mildly
affected children or when it is masked by more debilitating handicaps. Doctors
rely on a core group of behaviors to alert them to the possibility of a
diagnosis of autism.

Diagnostic criteria for autism

For a child to be diagnosed with autism, he
or she must meet the symptom criteria spelled out in the Diagnostic and
Statistical Manual of Mental Disorders (DSM). This manual is published by the
American Psychiatric Association and is used by mental health providers to
diagnose mental conditions and by insurance companies to reimburse for
treatment. To be diagnosed with autism, a child must have six or more of the following symptoms and two
or more of those symptoms must fall under the social skills category.

Social skills

• Has
  difficulty with nonverbal behaviors, such as making eye contact, making
  facial expressions or using gestures
• Has
  difficulty forming friendships with peers and seems to prefer playing
  alone
• Doesn’t
  share experiences or emotions with other people, such as sharing
  achievements or pointing out objects or other interests
• Appears
  unaware of others’ feelings

Communication skills

• Starts
  talking later than age 2 and has other developmental delays by 30 months,
  and doesn’t make an attempt to communicate with gestures or miming
• Can’t
  start a conversation or keep one going
• May
  repeat words or phrases verbatim, but doesn’t understand how to use them
• Doesn’t
  play make-believe or doesn’t imitate the behavior of adults when playing

Behavior

• Develops
  interests in objects or topics that are abnormal in intensity or focus
• Performs
  repetitive movements, such as rocking, spinning or hand-flapping
• Becomes
  disturbed at the slightest change in routines or rituals
• May be
  fascinated by parts of an object, such as the spinning wheels of a toy car

Treatment

There is no
cure for autism. Therapies and behavioral interventions are designed to remedy
specific symptoms and can bring about substantial improvement. The ideal
treatment plan coordinates therapies and interventions that target the core
symptoms of autism: impaired social interaction, problems with verbal and
nonverbal communication, and obsessive or repetitive routines and interests.
Most professionals agree that the earlier the intervention, the better.

* Educational/behavioral
interventions: Therapists use highly structured and intensive
skill-oriented training sessions to help children develop social and language
skills. Family counseling for the parents and siblings of children with autism
often helps families cope with the particular challenges of living with an
autistic child.

* Medications:
Doctors often prescribe an antidepressant medication to handle symptoms of
anxiety, depression, or obsessive-compulsive disorder. Anti-psychotic
medications are used to treat severe behavioral problems. Seizures can be
treated with one or more of the anticonvulsant drugs. Stimulant drugs, such as
those used for children with attention deficit disorder (ADD), are sometimes
used effectively to help decrease impulsivity and hyperactivity.

* Other
therapies: There are a number of controversial therapies or
interventions available for autistic children, but few, if any, are supported
by scientific studies. Parents should use caution before adopting any of these
treatments.

 Location, Extension and Accessibility of the
study area

Dhaka  is
the capital of Bangladesh
and the principal city of Dhaka Division. Dhaka is a megacity and
one of the major cities of South Asia. Located on the banks of the Buriganga
River, Dhaka, along with its metropolitan
area, had a population of over 16 million in 2011, making it the largest
city in Bangladesh.^[2]
It is the 9th largest
city in the world^[6] and also
28th among the most densely populated
cities in the world. Dhaka is known as the City of Mosques and with 400,000 cycle
rickshaws running on its streets every day, the city is also described as
the Rickshaw Capital of the World.

Dhaka
is located in central Bangladesh at 23°42?0?N 90°22?30?E,
on the eastern banks of the Buriganga
River. The city lies on the lower reaches of the Ganges
Delta and covers a total area of 360 square kilometres
(140 sq mi). It consists of eight principal thanas –Lalbagh,
Kotwali, Sutrapur, Ramna, Motijheel, Paltan, Dhanmondi,
Mohammadpur, Tejgaon – and 16
auxiliary thanas – Gulshan, Mirpur,
Pallabi, Shah
Ali, Turaag, Sabujbagh,
Dhaka
Cantonment, Demra,
Hazaribagh,
Shyampur, Badda, Kafrul, Kamrangir
char, Khilgaon
and Uttara. In total the city has 130 wards and 725 mohallas.^[32]
Dhaka district has an area of 1463.60 square kilometres
(565 sq mi); and is bounded by the districts of Gazipur,
Tangail,
Munshiganj, Rajbari,
Narayanganj, Manikganj. Tropical
vegetation and moist soils characterize the land, which is flat and close to
sea level. This leaves Dhaka susceptible to flooding during the monsoon seasons
owing to heavy rainfall and cyclones.

Introduction

 

Name of the Organization:

‘Autism Welfare
Foundation’institution located in Dhaka.

13/38,Shakhertak,

Road No:4,Mohammadpur,

Dhaka-1207.

 Back
ground of the Organization:

Autism welfare foundation was established on April 4, 2004. It is
non-profitable, non-government, voluntary welfare organization aiming to train
and educate the autistic children to perform their maximum strengths and
interests and making them able to support themselves.AWF is dedicated to
increase public awareness about autism.

The training and education centre of AWF provides intensive training and
education for autistic children and adults. This training and education centre
emphasizes on a highly structured program where teacher and student ratio is
1:1. This program also gives emphasis on social, communication, behavioral and
functional skills.

The foundation also runs a vocational training center for students above
10 years of age. Other activities like secretarial job, work in cafeteria,
gardening etc are also performed by them.

1. Area
of
Work
:  ASD, PDD

2. Geographical
Coverage of Operation
 :  Dhaka,
Bangladesh

3. Sources of
Funds
:  Students’ tuition and
donation from  

 
members and parents of the students,  

Donation private companies occasionally.

AWF Organizational
Profile

1.
Name of the Organization  
:   Autism Welfare
Foundation

2.
Founder/ Chairperson  
: Dr. Rownak
Hafiz, MBBS, DCH

:    E-mail: rownak_awf@yahoo.com

:    Website: www.awfbd.com

4.
Established
in  
   : 2004

5.
Registered
Under
: Society’s Registration Act with registration of Joint Stock Company

6. Registration
no
: S-3821
(610/2004)

Objectives of the
Organization:

AWF is dedicated to increase
public awareness about autism. The Training and Education Center of AWF
provides intensive training and education for autistic children and
adolescents. This training and education center emphasizes a highly structured
program where teacher student ration is 1:1.

This program also gives emphasis
on communication skill, behavior and functional academics.

The foundation also funds a
vocational training center for students above 10 years old. Other adult
activities are secretarial jobs, work in cafeteria, gardening etc.

 Organizational Structure:

 

Autism welfare foundation was established on April 4, 2004. It is
non-profitable, non-government, voluntary welfare organization aiming to train
and educate the autistic children to perform their maximum strengths and
interests and making them able to support themselves.AWF is dedicated to
increase public awareness about autism.Their main activities
are in the institutional level.

The Organigational structure are given below:

Chairperson

Tregear

Organizational members

Co-ordinator

Class Incharge

Teachers

Staffing pattern of the Organization:

Autism welfare foundation  is
non-profitable, non-government, voluntary welfare organization aiming to train
and educate the autistic children to perform their maximum strengths and
interests and making them able to support themselves.The
doctors, Psychologist, Therapist,
Co-ordinator, Class Incharge, Teachers and third and forth classes workers work
here.All of them are works are finished with their own responsibility.

Table 01: The staffing pattern of the
Organigation is given following:

Principal	01
Consultant	01
No. of Teachers	52
No. of Psychologist	01
No. of Occupational Therapist	01
No. of Office Staff	02
No. of Attendant	15
No of Guard & Peon	03

Regular Activities of AWF

Description of participants

 Training
and present activities of the Organization:

 

Training

They have provided training to several of their
staff as well as undergraduates, masters and PhD from home and abroad.

present activities of the Organization:

Creates
mass awareness among parents, professionals, social worker, and general public
for better understanding for autism

Offers
diagnosis and assessment of autistic children

Runs
education and training centre

Runs Early
Intervention Program for children below the age of 5

Runs Adult
Activity Program and Vocational Training Program for older children and
adolescents with autism

Arranges
Teacher Training Program

Arranges
Parent Training Program

Arranges
Parent-Teacher Workshop

Arranges seminars, workshop

Offers
package program for autistic children and adolescents from different areas of
Bangladesh who are unable to attend the Training Centre of AWF

Provide
outing program for students of AWF for improving social behavior

Publishes
News Letter

Integrates
more able autistic children into normal school.

Offer free
services for poor autistic children

Description about the works:

1) Running Education & Training Program:

Educating children with autism is
a challenge for both parents and teachers. These children are individuals first
and foremost with unique strengths and weaknesses. Some may be of average to
above-average intelligence, while others may be below average. Academic goals
need to be tailored to that individual’s intellectual ability and functioning
level. Understanding this reality, AWF started an education and training center
named “Kanon”. The aim of this school is to provide a safe and secure learning
environment for students with autistic spectrum disorders. In order to provide
a high-quality and relevant education for children and young adults with
autism, a combined program including education and training has been
introduced. AWF has its own course and curriculum to provide education of these
autistic children.  An Individualized Education Plan (IEP) is prepared on
the basis of functional assessments. Currently, the School has Eleven sections
in which around 148  children aged 3 – 15 are placed in two shifts
(morning & day) depending on their abilities, needs, and chronological age.
In the early years the emphasis is on developing communication, as well as
building basic interaction skills, pre-reading and writing skills and concept
building. Concepts are taught in one-on-one

sessions, while group
activities are used to develop social skills. Alongside, the child’s abilities
to work independently and interpret instructions in a general environment are
developed and strengthened. Gradually, the children learn independent work
behaviors that enable them to learn vocational skills. Children, who are ready,
move on to mainstream classrooms. The school combines group activities and
one-on-one teaching, as well as music therapy, computer and sensory
integration.

A total of 57 teachers, 1
psychologist, and 1 occupational therapist are engaged in conducting the
education courses through the education center where 138 autistic children are
enrolling every year. As the education program is highly structured, the
teacher, student ratio is 1:1.

AWF is also running two pre-normal class called “Nayantara” &
“Malati” where the students are taught national course curriculum,
aiming to enroll them in normal school. A total of 14 students have already
been admitted to normal school in last 4 years and this year 2 students are
ready to go.

Table 02: Number of Students & Teachers in
AWF

Year	Shift	Number of Students	Number of Teachers
2004	Morning	44	23
2005	Morning	58	34
2006	Morning	60	45
	Day	50
2007	Morning	61	52
	Day	54
2008	Morning	63	57
	Day	60
	Vocational	3

 

2) Social skill development: 

 The most important barrier the
family comes across in every day situation is poor social skill of their
autistic children. AWF arranges many social skills program besides
classroom based social skill training. For example, students go for
shopping, or eat in restaurants, visit parks, zoos etc twice a month. Students
participate in different cultural programs. AWF arranges a handicrafts fair
twice every year which enhances the social skill of each student in AWF.

3) Vocational
training program: 

 AWF runs a vocational training
program named “Krishnochura” where there are 20 students aged 15
years and above, whom are directly involved for making potteries, products
adorning block prints and boutique, candles, bag-making, necklaces etc. for
selling purposes. About 16 students are given hand on training to make them
independently work for vocational products.

 

4) AWF also runs a cafeteria:

Where students work for preparing different food items, serving them to
customers, washing dishes, involve in exchanging and counting money. All 148
students of Kanan take snacks in cafeteria during snack time and eat in a group
which increases their social skills.

5)Distant package program:

 AWF offers distant package programs for autistic
children, adolescents and their families from all
over Bangladesh who cannot avail any teaching program or schooling for
their children. Home based programs are given for autistic children in package
program and guidelines are given regarding different techniques
and strategies for enhancing communication and play skills for
children who come from distant areas. Parents also come for regular follow-up.
AWF extends services for package program for 4 children per day for 4 days a
week.

 

 Parents as co-therapists: 

Specialty of AWF’s education training program
is that we include parents of autistic children directly in our program by:

1. Extensive interview
from parents while making IEP for each student 

2. Regular counseling and interaction with parents when needed

3. Classroom visits are compulsory for parents every year

4. Home visits are done by teachers

5. Including parents in many programs of AWF.

Training and workshop:

Throughout the year, AWF arranges training program for parents and
teachers by extensively explaining them the strategies
of teaching techniques of autistic children so that
they can successfully apply it to their child/student.

AWF Services offered :

Assessments

(a) Diagnostic Assessments

Autism Welfare Foundation (AWF) knows
that Autism is treatable. Children do not “outgrow” autism, but
studies show that early diagnosis and intervention lead to significantly
improved outcomes. Screening and diagnostic assessments are made here following
detailed observations of and interactions with the child, as well as
comprehensive interviews with family members. Internationally standardized
diagnostic criteria (DSM 4 TR) and a variety of standardized screening /
diagnostic instruments including Checklist for Autism in Toddlers – Modified
(M-CHAT), Psychological Assessment are administered here. Determining related
disorders and differentiating ASD from other disorders is part of this process.
The parents are provided information on autism and services necessary to start
intervention from AWF.

(b)Functional Assessments

Autism is marked by the
development of an uneven profile of skills. Functional assessments provide an
insight into the current level of performance of the child in various skill
areas such as motor, speech, communication, imitation, cognition and activities
of daily living. The assessment is made over multiple sessions through a series
of direct work sessions with the child, observation and discussion with the
family.

(c) Occupational and Sensory Assessment

A detailed assessment is made
based on a sensory profile questionnaire which addresses all the sensory
systems in depth. A comprehensive evaluation of the child is done using
observation and feedback from parents. The assessment provides a base for all
subsequent interventions for the child.

(d) Follow Up

After a child is diagnosed,
the child can begin benefiting from one of the many specialized intervention
approaches to treatment and education. In this case, follow-up service is very
important since these children need regular follow-up. So AWF has also a
provision of follow-up services to the Children so that parents can bring their
children at AWF clinic as per given schedule.

(e) Distant Package Program for Out Station Families

Patients living outside of
Dhaka city can not attend the clinic regularly. For them, AWF extend their
services outside of Dhaka city. Outstation families often visit AWF and receive
an intensive program of observation, counseling, work sessions with the child.
Depending on their duration of stay and where families so require, assessments
and curriculum planning may also be carried out. Because the characteristics
and behaviors of people with autism vary so widely, the individualized nature
of these programs is particularly crucial, and parents are encouraged to stay
in touch with AWF to make modifications and implement additional skills. Till
now about 1600 patients have already received the services under outdoor
package services.

A table is shown below giving the

Number of patient receiving outdoor service in package:

 Table
03:
Number of outdoor package patients

Year	New Patient	Old Patient	Total	Station of the patient
2004	100	200	300	Dhaka & Out side of Dhaka
2005	500	300	800
2006	74	145	219
2007	120	225	345
2008	148	200	348

MORNING SHIFT ROUTEIN

DAY	8.00-8.20	8.20-8.40	8.40-9.10	9.10-9.30	9.30-10.10	10.10-10.30	10.30-10.50	10.50-11.20	11.20-12.00	12.00-12.25	12.25-12.30
SUNDAY	Jateo sanget	Suvo sokal	Communication	Lakha pora	Tiffen	Berote	Aso Neja Kore	Aso Chobe Ake	Khala dula	Gun nar asor	chute
MONDAY	Jateo sanget	Suvo sokal	Communication	Lakha pora	Tiffen	Berote	Aso Neja Kore	Aso Chobe Ake	Exercise	Gun nar asor	chute
TUESDAY	Jateo sanget	Suvo sokal	Communication	Lakha pora	Tiffen	Berote	Aso Neja Kore	Aso Chobe Ake	Exercise	Dance class	chute
WEDNESDAY	Jateo sanget	Suvo sokal	Communication	Lakha pora	Tiffen	Berote	Aso Neja Kore	Karegore Shekha	Exercise	Golpo Bola	chute
THURSDAY	Jateo sanget	Suvo sokal	Communication	Lakha pora	Tiffen	Berote	Outing, shopping or extra curricular activities.

DAY SHIFT ROUTEIN

DAY	1.00-1.20	1.20-1.40	1.40-2.10	2.10-2.30	2.30-3.10	3.10-3.30	3.30-3.50	3.50-4.15	4.15-4.55	4.55-5.25	5.25-5.30
SUNDAY	Jateo sanget	Exchange Greeting	Communication	Lakha pora	Tiffen	Berote	Aso Neja Kore	Aso Chobe Ake	Khala dula	Gun nar asor	chute
MONDAY	Jateo sanget	Exchange Greeting	Communication	Lakha pora	Tiffen	Berote	Aso Neja Kore	Aso Chobe Ake	Exercise	Gun nar asor	chute
TUESDAY	Jateo sanget	Exchange Greeting	Communication	Lakha pora	Tiffen	Berote	Aso Neja Kore	Aso Chobe Ake	Exercise	Dance class	chute
WEDNESDAY	Jateo sanget	Exchange Greeting	Communication	Lakha pora	Tiffen	Berote	Aso Neja Kore	Karegore Shekha	Exercise	Golpo Bola	chute
THURSDAY	Jateo sanget	Exchange Greeting	Communication	Lakha pora	Tiffen	Berote	Outing, shopping or extra curricular activities.

 

 

v  Off day-Friday and Saterday

My Activities Of Morning Shift:

The school established by Autism
Welfare Foundation is a dream land of the small lovely kids who can be called
as angels.Iam very fortunate because I have been associated witn the Institute
for one month with this kids.Ihad know previous knowledge on autism or autistic
children.What I knew was that Autism is mental retardation.Here I have come to
across a lot of lovely kids,looking handsome but who  are self centered or introvert.They do not
share their joys and sorrow and feeling with others.The teachers of this school
are dedicated.They  do lot for this
school.So far Iam concerned because of their help Ican perform my duties
properly.With in few days I could get attached with the children. AWF children
can perform ADL routein.

AWF started an education and
training center named “Kanon”
and I
worked in their educational program as a vocational teacher.I have analysis 4 students between 4  different class in morning shift and I have
collect the information from this 4 parents.I finished my internship work by 30 days.My shedule time is 8:00a.m to
12:30p.m.At first I signature my attendence khata then I attend in assembly and
help for PT my fixed class student.When finished assembly then I go to class
room.Then I participate shuvu sokal with student by flash card  and help their communication.Then start
reading and writing.Then start tiffin hour this time I go to cafeteria with
children Where students work for
preparing different food items, serving them to customers, washing dishes,
involve in exchanging and counting money then they return in
classroom and they rest sometimes this time they wash their hands.Then I help
their own work and help drawing picture.Next start play And then they
participate singing class and sometimes story telling, dance class, vocational
training and golpobola.Then last 5 minutes I prepared  children for going home and when ring the
bell they are hand over their gardian.

My Activities Of Day Shift

AWF started an education and
training center named “Kanon”
and I
worked in their educational program.I have analysis 4 students between 4 different class
in day shift

and
I have collect the information from this 4 parents.I finished my internship work by 30 days.

My shedule time is 1:00p.m to 5:30p.m.At first
I signature my attendence khata then I attend in assembly and help for PT my
fixed class student.When finished assembly then I go to class room.Then I
participate exchange greeting  with
student by flash card  and help their
communication.Then start reading and writing.Then start tiffin hour this time I
go to cafeteria with children
Where students work for preparing different food items, serving them to
customers, washing dishes, involve in exchanging and counting money then they return in classroom and they rest sometimes this time
they wash their hands.Then I help their own work and help drawing picture.Next
start play And then they participate singing class and sometimes story telling,
dance class, vocational training and golpobola.Then last 5 minutes I prepared  children for going home and when ring the
bell they are hand over their gardian.

Follow this routine  I finished my work  and this 
work  complete by30 days.

 

 
Case Study-1 

Name:Avishak Sharkar Fathers Name: Aset Ranjon
Sharkar

Gender: Boy Fathers
Occupation: Business man

 Age: 4+  Mothers Name: Noboneta Pal  

Class: Rojone gondha(Morning)  Mothers Occupation: House Wife

 Blood Group:A+ Economic Status:Higher
class

Past History:

 Avishak mother has no complication during
pregnancy period but he get bain injury fall in sofa then he was senceless. Poor
eye contact and no speech,hyporactive,No response when calling name.

INTERVIEW QUESTION

 

1.Any problem
during fetus?

-NO 

2.Any problem
during delivery?

– No

3.When you
understand your baby is autistic?

-During 2 years old

4.What
are the problem present in your child now?

-Poor eye contact, Restless,Lack of
attention, Talking inabilities, Communication problem,can not talk,hyper
active.

5. What are the like &
dislike of child?

 
Like:

–
Favourate
place-Fathers university,

–
Favourate
food- Chicken,fish, egg,milk.

–
Favourate
person-House tutor

–
Favourate
toy-lipstick, pen seizer, body lotion,car.

 Dislike:

–
Unknown
person,crowd area.

6.Can your child perform any
creative work?

-No

7.How your child spent his most of
the time at home?

-make sound in table, aimless walk
in room to room,watch tv.

  8.Which activity is enjoyable
for your baby?

  -watch tv advetise,music and when
same age friend come in home.

  9. Which activity is irritable for your
child?

-While chid hear any loud sound,
hungry,physically illness.

10.How your child express about toileting?

-By pulling others hand if he need.

11. Have any special quality is
enjoyable for other?

-No.

12.Have any problem during sleep?

-No

 13.How child spent his lazy time?

-watching tv program especially add.

14.How your child communicate with
other?

– By pulling others hand he
communicates with them.

15.When your child disturb you how
you control your child?

-By body massage,recite,singing.

Comments:

Avishak is inactive.He want live alone for
behaviour problem.Always he caught his own ear.He can not speak He dont
tolerate any type of loud sound.When he goes to crowed place then he start
crying.He likes school teacher. His autism level is severe.

Case Study-2

Name:Sahil siddiqe   Fathers
Name: Golam Mowlla Siddique

Gender: Boy   Fathers Occupation: Service holder and
Business
man

 Age: 3+  Mothers Name: Sammemun-Nessa

Class: Rojone gondha(Day)  Mothers
Occupation: House Wife

Blood Group:o+  Economic Status:Higher class

Past History:

Pregnancy period is complicated.He
was stubborn for outing.Poor eye contact and no
speech,hyperactive,unstedy,fickle-minded.impatience

INTERVIEW QUESTION:

 

1.Any problem
during fetus?

-First baby
abortion and  when second baby conceved
then create hormonal problem.

2.Any problem
during delivery?

– Cezar in 8th
month

3.When you
understand your baby is autistic?

-During 2 years 21 days old

4.What
are the problem present in your child now?

-Poor eye contact, Restless,Lack of
attention, ,can not response,hyper active,Delay speech.

5. What are the like &
dislike of child?

 
Like:

–
Favourate
place-Shesu park,Shopping Mall,tour

–
Favourate
food- All kind of sweet food,oilly food

–
Favourate
person-Father,mother,All school teachers and friend

–
 Favourate toy-Puzzel,ball

Dislike:

–
Unknown
person,crowd area.

6.Can your child perform any
creative work?

-No

7.How your child spent his most of
the time at home?

– watch tv – NXM channel.play with toys
in play ground

  8.Which activity is enjoyable
for your baby?

  -play with cousin and maid
servent,raceing  and touching game  Ringa Renga,Pupil game.

  9. Which activity is irritable for your
child?

-When dont hear his speech.

10.How your child express about
toileting?

-Self dependent.

11. Have any special quality is
enjoyable for other?

-No.

12.Have any problem during sleep?

-No

 13.How child spent his lazy time?

-watching tv program especiallyNXMchannel.

14.How your child communicate with
other?

-By speech.

15.When your child disturb you how
you control your child?

– By singing and story telling.

Comments:

 Sahil is
active for all type of activities. He want live 
togethert with teacher. Always he 
can not tolerate unknown person He can speak all type of word.Now he
share his toy with other. He likes school teacher.His autism level is mild.He
is captain in class and he follow all command and help and encourage his friend
for work.

Case Study-3

Name:Abid-Ur-Rahman
Abir Fathers Name:Ahmed Mamunur
Rashid

 
Gender: Boy Fathers Occupation:Govt.empolyee

Age: 6+
Mothers Name: Mehnaj Nasrin.

Class:
Rangon(Morning) Mothers Occupations:Housewife

 
Economic Status: Higher class

 

Past History:

Poor eye contact and no
speech,hyporactive,No response when calling name.

High fever age is 9 month this time
convulsion occur. self stimulates behaviour

INTERVIEW QUESTION:

1.Any problem
during fetus?

-NO

2.Any problem
during delivery?

– No

3.When you
understand your baby is autistic?

 
-During 1 years old

4.What are the problem present in
your child now?

-Speech problem,no eye contact,no
toilet training,no expression,do not respone any command,self stimulates
behaviour.

5.What are the like & dislike of
child?

Like:

–
Favourate
place-Shishu Park,Chinese resturent

–
Favourate
food- Fried- Choccolate,Fruits,Chicken,rich food,sweet Favourate
person-Father,Mother,mama, mame.

–
 Favourate toy- ball,puzzles.

 Dislike:

 
-Discipline.

 

6.Can your child perform any
creative work?

-No

 

7.How your child spent his most of
the time at home?

-Playing with father,stay
alone,fight his sister.

8.Which activity is enjoyable for
your baby?

-make fun,listening song.

9. Which activity is irritable for
your child?

-While take any decision aganist his
command.

 

10.How your child express about
toileting?

-Maintain a specefic time for
toileting.

11.Have any special quality is
enjoyable for other?

-No.

 

12.Have any problem during sleep?

– Sometimes he wake up at midnight.

 

13.How child spent his lazy time?

-sitting alone

14.How your child communicate with
other?

– 
Sometimes by pulling others hand he communicates with them.

15.When your child disturb you how
you control your child?

-By singing,recite, pupil game.

Comments:

Abir do not always attend in school.He likes see
any kind of books and picture. He likes chocklateb run. He likes class teacher
than his mother.He can cycleing by help.He done work by  commad. He is absent minded. Riem can not
speak. His autism level is moderate.

 

Case Study-4

Name:SK
Arib Rayhan  Fathers Name:Sk Zakir Hossain

  Gender:
Boy   Fathers
Occupation: Business man

Age: 3yr and 9 months Mothers
Name: Saifun Jahin .

Class:
Rangon(Day) Mothers
Occupations:Housewife  

Blood Group:o+ Economic Status: Higher class

 

Past
History:

Speech delay,Learning
disorder,Attention sicking behaviour,Insecure feeling,sleep disorder,Bed
wetting,Mood disorder,Over sensitive,Intellectual disabilities, Behaviour
disorder,Communication deficiency,Temper tentraum,

INTERVIEW
QUESTION:

1.Any problem
during fetus?

-Mother have
dibetics mellitus during pregnancy period.

 2. Any problem during delivery?

– Blueish
apperance at birth for this reason prescribe antibitic.

3.When you understand your baby is
autistic?

  -During
one half years.

4.What are the problem present in your child now?

– Mood disorder.Hyperactive,He is
not interested in school and any kind of work ,attention sicking behaviour.

5.What are the like & dislike of
child?

Like:

–
Favourate
place-Own house,Play ground,Open place,Wonderland,Shopping mall.

–
Favourate
food- Chanachur,sauce,soft drink,mango juice,chips

–
Favourate
person-Father,Mother,Khala,Khalu,Nanu

–
 Favourate toy- ball,puzzles.jumping,running,play
with water.

 Dislike:

 
-Discipline.

 

6.Can your child perform any
creative work?

-No

 

7.How your child spent his most of
the time at home?

-Watching tv,play with water,sometimes
play with toys.

8.Which activity is enjoyable for
your baby?

-Play with father and
mother,music(robindro sanget)

9. Which activity is irritable for
your child?

-With out any reason he lay down in
floor,Throwing object,

10.How your child express about
toileting?

– By pulling others hand if he need.

11.Have any special quality is
enjoyable for other?

-No.

 

12.Have any problem during sleep?

– Late night sleep and wake up at
midnight

 

13.How child spent his lazy time?

-Play with water and toy.

14.How your child communicate with
other?

– 
Sometimes by pulling others hand  and speak own language.

15.When your child disturb you how
you control your child?

-By singing,recite, sometimes givee
punishment,telling story

 Comments:

Arib follow teachers command.Now he
likes book. he has aggressive behaviour. Sometimes he heat other and sometimes
he can not understand his problem.

 

Case Study-5

 

Name: Sabab   Fathers
Name:Qazi Assaduzzaman

Gender: Boy   Fathers Occupation:Service
holder
Age: 10
Mothers Name:Samoli aktar

 Class: Malote(Morning) Mothers Occupations:
Housewife

Blood Group:AB+ Economic Status: Higher class

 

 

Past
History:

Do not sleep at night,Restless,He
heat in wall,absence eye contact,Inattentive .He has aggressive behaviour. he
heat and bite other.

 

INTERVIEW QUESTION:

 

1.Any problem
during fetus?

-Pressure

2.Any problem
during delivery?

– oxygen
problem.

  3.When you understand your
baby is autistic?

-During 4 years old.

4.What are the problem present in
your child now?

-Speech elay, poor eye contact,slike
playing alone,do not understand anything,do not respone any command,sieeping
problem,aggresive behaviour,Bite other person.

 

5.What are the like & dislike of
child?

Like:

–
Favourate
place-Shesu park,swiming pool.

–
 Favourate food-All type of food

–
Favourate
person-Father,Mother

–
Favourate
toy-fan,skeletal,lighting, pellow

Dislike:

– 
Discipline.

 

6.Can your child perform any
creative work?

-Art in computer.

 7.How your child spent his most of the time at
home?

-Art. sitting alone.

8.Which activity is enjoyable for
your baby?

-Like to roam,stand over bridgeand
train journey

 9. Which activity is irritable for your child?

-Hot weather.

10.How your child express about
toileting?

– Maintain toileting.

11.Have any special quality is
enjoyable for other?

-Art.

12.Have any problem during sleep?

-Incomplete sleep,late night sleep.

13.How child spent his lazy time?

-sit alone. 

14.How your child communicate with
other?

– He communicates with other by
calling.

15.When your child disturb you how
you control your child?

-By love,break concentretion,

Comments:

Sabab is regular student in school.He has lack
of interest in work.Excess demand in food. He do not want to work.He has eye
problem.Last 2 years he can not speech. He learn by KG syllabus.Glucoma problem
in his eye always he is laughing with out any reason.

Case Study-6

 

Name:
Arafat Hasan Amlan Fathers
Name:kamrul Hasan Gender:
Boy Fathers
Occupation: Real State Business

 Age: 9+ Mothers
Name:Moyna

 Class: Malote(Day) Mothers
Occupations:House Wife

Blood Group:B+ Economic Status: Middle higherclass

Past History:

Sezerian and
over weight baby.  No toilet training, Repetative behaviour,

 

INTERVIEW QUESTION:

 

1.Any problem
during fetus?

-NO

2.Any problem
during delivery?

– Sezerian and
over weight baby.

3.When you understand your baby is
autistic?

-During 4.5 years old

  4.What are the problem present
in your child now?

– Repetative behaviour, social
interaction problem ,behaviour problem.

5.What are the like & dislike of
child?

Like:

–
Favourate
place- Grand father house

–
Favourate
food- All type of spicy food.

–
Favourate
person-Nanu, father, mother

–
Favourate
Toy-Ball

 Dislike:

 – Outdoor game.

6.Can your child perform any
creative work?

-Vocational work,study.

 

7.How your child spent his most of
the time at home?

-Play with brother,study,watch tv.

 8.Which activity is enjoyable for your
baby?

-Listening song, shoping mall,shesu
park.

9. Which activity is irritable for
your child?

-While take any decision aganist his
command.

10.How your child express about
toileting?

-Maintain toileting.

11.Have any special quality is
enjoyable for other?

-Any type of block and puzzel can
matching.

12.Have any problem during sleep?

-No.

 

13.How child spent his lazy time?

-Study,watch tv.

14.How your child communicate with
other?

– Use word

15.When your child disturb you how
you control your child?

– By leave his  alone

Comments:

Amlans main problem is repetative
behaviour.Every time message his hand and clean the hand. He is regular
student.He  makes many peculiar sound
such as ‘’ta ta
ta ta’’ .He learn by KG syllabus.Sometimes he is
continue laughing with out reason.

Case Study-7

 

Name: Esam Fathers
Name:Mahather Mohammad
Gender: Boy  Fathers
Occupation: Banker

 Age: 5+ Mothers
Name:Rowson Akhter

 
Class: Paddo (Morning)
Mothers Occupations: Housewife

Blood
Group:A+  Economic Status: Higher class

Past History:

High raise
fever at 7th day after delivery.Speech problem,sudden aggressive behavior,sudden beating any one.

INTERVIEW
QUESTION:

1.Any problem
during fetus?

-NO

2.Any problem
after delivery?

– No

3.When you
understand your baby is autistic?

-During 2.5 years old

  4.What are the problem present in
your child now?

-Speech problem,excess crying,always
carry object,hyperactive.

5.What are the like & dislike of
child?

Like:

–
Favourate
place-Any open place

–
Favourate
food- Spicy food,fruites.

–
Favourate
person-Mother,Father,Nanu

–
Favourate
toy-any object,car,ball

 Dislike:

– Crowded area.

6.Can your child perform any
creative work?

-No

7.How your child spent his most of
the time at home?

-Television watching.

8.Which activity is enjoyable for
your child?

-listening song,singing
class,roaming with parents.

9. Which activity is irritable for
your child?

-absence and missing object.

10.How your child express about
toileting?

– By pulling others hand if he need.

11.Have any special quality is
enjoyable for other?

-No.

12.Have any problem during sleep?

-No.

13.How child spent his lazy time?

-Listening song,Watching TV.

14.How your child communicate with
other?

– By pulling others hand he
communicates with them.

15.When your child disturb how you
control your child?

-By leave her alone.

Comments:

When Esam start crying then he cries
continuously. He has sensory motor problem.He do not want to stand for long
time.He has less attentive.He participate in vocational training. He is regular
student.He can not speak

Case Study-8

 

Name: Munsat Rabeb   Fathers Name: Abdul Salam

 Gender: Boy Fathers Occupation:
Banker

 Age: 9   Mothers
Name:Tahmena Akter

 
Class: Paddo (Day   Mothers
Occupations: Housewife

Blood
Group:A+ Economic
Status: Higher class

 

Past History:

High fever age is 8month this time
convulsion occur. Speech problem, hyperactive.Poor eye contact,No response,.

INTERVIEW
QUESTION:

1.Any problem
during fetus?

-NO

2.Any problem
after delivery?

– High fever age is 8month this time
convulsion occur.

3.When you
understand your baby is autistic?

 -During 2 years old

 
4.What are the problem
present in your child now?

-Speech problem, hyperactive.Poor
eye contact,No response,No toilet training,Increase stubborn,He is afraid by
any kind of sound

5.What are the like & dislike of
child?

Like:

–
Favourate
place-Shopping mall

–
Favourate
food- Spicy food,

–
 Favourate person-Mother

–
 Favourate toy-any object,car,ball

 Dislike:

– Crowded area.Sheshu park

6.Can your child perform any
creative work?

-No

7.How your child spent his most of
the time at home?

-Television watching,Play with
water.Jaring water pot.

8.Which activity is enjoyable for
your child?

– Like to roam around by rickshaw or
car.

9. Which activity is irritable for
your child?

-Make different sound.

10.How your child express about
toileting?

– By pulling others hand if he need.

11.Have any special quality is
enjoyable for other?

-No.

12.Have any problem during sleep?

-No.

13.How child spent his lazy time?

-Play with water.

14.How your child communicate with
other?

– By pulling others hand he
communicates with them.

15.When your child disturb how you
control your child?

-By leave her alone.

Comments:

He can not speak.Sometimes he can not follow
any command. he is regular student in class. He can cycleing by help.

There are no medical tests for diagnosing autism.
An accurate diagnosis must be based on observation of individual’s
communication, behavior and development levels.

Autism is a life long developmental disability known as the autism
spectrum disorders (ASDs).It is not a mental illness.The degrees of
characteristics differ from person to person, but all those affected have
impairment in social interaction, social communication and imagination. This is
referred to as a triad of impairment

		Social Communication (difficulty with verbal and non-verbal communication) Social Interaction (difficulty with social relationship) Imagination (difficulty in the development of play and imagination

Communication problem with
autism

The communication problems of autism vary,
depending upon the intellectual and social development of the individual. Some
may be unable to speak, whereas others may have rich vocabularies and are able
to talk about topics of interest in great depth. Despite this variation, the
majority of autistic individuals have little or no problem with pronunciation.
Most have difficulty effectively using language. Each person with an ASD has
different communication skills. Some people can speak well. Others can’t speak
at all or only very little. About 40% of children with an ASD do not talk at
all. About 25%–30% of children with an ASD have some words at 12 to 18 months
of age and then lose them.1 Others might speak, but not until later in
childhood.

Examples of communication issues related to ASDs:

.
Delayed speech and language skills

 Repeats words or phrases over and over
(echolalia)

 Reverses pronouns (e.g., says “me” instead
of “I”)

 Gives unrelated answers to questions

 Does not point or respond to pointing

 Uses few or no gestures (e.g., does not
wave goodbye)

 Talks in a flat, robot-like, or sing-song
voice

 Does not pretend in play (e.g., does not
pretend to “feed” a doll)

 Does not understand jokes, sarcasm, or
teasing

Stage of comminication for  autistic children

1. Own agenda stage:

  *
Low communication skill.

  *
Nothing understands.

  *
Play without toys.

 2.
Requester stage

*
Communication with symbolic way.

* Try
to gesture or sound.

*
Understanding known routine steps.

 3. Early
communicator stage

* can
meaningful communication.

*
known person with known place shown favorable behaviour.

*
Understanding known word and easy question.

 4.
Partner stage

*
Play with other child.

*
Communication do for different cause.

* Can
tell short story.

*
Understanding many word.

 

Be short  of communication

Most signs or characteristics of Autism are
evident in the areas of speech or communication (verbal and non-verbal).

• The
  child does not respond to his/her name.
• The
  child cannot explain what he/she wants.
• Language
  skills or speech are delayed.
• The
  child doesn’t follow directions.
• At
  times, the child seems to be deaf.
• The
  child seems to hear sometimes, but not others.
• The
  child doesn’t point or wave bye-bye.

• The
  child used to say a few words or babble, but now he/she doesn’t.
• The
  child throws intense or violent tantrums.
• The
  child has odd movement patterns.
• The
  child is hyperactive, uncooperative, or oppositional.
• The
  child doesn’t know how to play with toys.
• The
  child doesn’t smile when smiled at.
• The
  child has poor eye contact.
• The
  child gets “stuck” on things over and over and can’t move on to other things.
• The
  child seems to prefer to play alone.
• The
  child gets things for him/herself only.
• The child is very independent for
  his/her age.
• The child does things
  “early” compared to
  other children.
• The child seems to be in his/her
  “own world.”
• The child seems to tune people out.
• The child is not interested in other
  children.
• The child walks on his/her toes.
• The child shows unusual attachments to
  toys, objects, or schedules (i.e.,
  always holding a  string or having
  to put socks on before pants.)
• Child spends a lot of time lining
  things up or putting things in a
  certain order

 Actions of AWF concerning the development of communication
skill for children with autism.

1.Signing

2. Pictographs (line drawings)

3. Photographs and Objects

4. Picture Exchange Communication System (PECS)

5.Increase communications in different domains.

6. Increase story telling skill.

How to create self-independent of Autism child

At first autistic children should learn normal
work for daily life. This work are complete according to their age. Example-
eating , toileting, brushing , bathing wearing etc Another activities continue
besides that. Autistics children are
face different kinds of problem every step in their life. All this are toilet
training problem. eating problem and brushing problem are very critical.

1) Eating problem:

Sensory problem.

Do not want eating.

Ignore new food.

Motor planning of difficulties.

Touch sensitive.

Don’t want own hand for eating.

Many of them more eating but do not understand
quantity.

Avoid eating according to social rules.

 
Suggestion:

All family members eating together in one
place.

Find out cause of eating problem.

Removing for eating problem care about
-selection of food, identify new food and time fixing.

Make eating demand.

Happiness environment.

At first giving dislike food then gives like
food.

To identify any problem with teeth, tongue, and
throat.

Step by step moves slowly.

Consult with speech therapist and occupational
therapist.

Use flash card

2) Toilet training:

Toileting is a major problem for autistic
children in  different activities to
daily life. If a autistic child have no proper toilet training then another
activities are complete too critical. So an autistic child at first giving
toilet training then others training.

  Factor
of toilet training:

Sensory 
problem

Motor planning 
problem

Lack of communication.

Feeling of toilet is painful for autistic
children.

Don’t understand pressure of toileting.

 Suggestion:

Rule
making.

 Use
toilet sign.

Reserve record.

Ensure happiness environment for toilet
training.

Use flash card.

Teaching toilet training step by step.

Toilet training should not begin before 18th
months of age.

Beyond 4 years of age toilet training should
become a priority.

Schedule training is the easiest way to begin
toilet training.

3)Teeth brush problem:

  Teeth
brush problem are seen many autistic children. Mainly brushing problem are seen
because of sensory problem. Such as:-

Somebody dislike smell of paste, depending on
their sensitivities.

Brushing with paste creates some froth which
may feel awful.

Somebody eating froth of paste.

Don’t want opening mouth wide.

Somebody dislike toothbrush touches the gums or
the tongue.

Saliva pooling near the back of the mouth.

Physical problem.

The taste of tooth paste can also be strong and
unpleasant.

They can not brush the teeth and also cannot
wash their muscle of gum properly.

Suggestion:

Experiment with
different paste.

If no toothpaste
tolerable then try brushing his teeth with baking soda and water.

Try different kinds of brushes from soft to harder.

Use flash card.

Happiness
environment.

Imitation

Slowly touch the
brush.

 

Play in Children with Autism

n  There is no question that play is an integral
part of child development.

n  Typically, children with autism demonstrate
marked impairment in developing play skills in a socially meaningful context.

n  They also show differences in the way they
play. They may have trouble with functional play, or using toys and objects.

n  Different pattern of play development in kids
with autism:

u Repetitive and stereotyped play with toys

u Difficulties learning imitation and learning
through observation

u Difficulties with pretend play

 

Play in children with Autism is often described
as:

Play in children with autism spectrum disorders
is often solitary. They prefer to play alone.

Children with autism often lack
age-appropriate, purposeful play skills.

Lack of cooperative group play.

They have Lacking in imagination

Does not understand ‘cause and effect’

They show repetitive and stereotyped play with
toys

Difficulties learning imitation and learning
through observation.

Difficulties with pretend play.

Children with autism often exhibit atypical
play behaviors that are nonfunctional.

The child shows unusual attachments to toys and
objects.

 

Why is play difficult for children with ASD?

Several factors contribute to the lack of play

Language (communication deficits) – individuals with autism have communication
deficits. They may not understand the language or social cues of peers, or have
the ability to express their feelings effectively with others.

Social interaction (restricted and unusual interests) –
unwillingness to allow others to share experience.  Lack of understanding of thoughts, feelings
and intentions and Facial expressions.

Imagination – difficulty in understanding imaginary situations.  Often leading to repetitive, obsessive
actions that mean something only to the child.

 

Table 04: A child with autism play is different for them

 

Children without a developmental disorder	Children with a developmental disorder
n  Voluntary	n  Stereotyped
n  Spontaneous	n  Can be non-functional
n  Internally Reinforcing	n  Limited interests
n  Flexible	n  Rigid
n  Creative	n  Repetitive

 

Play is important for Children with autism

Play allows a child with autism to learn and
practice new skills in all areas.

Play provides a vehicle to interact with people
and objects in their environment.

Play builds confidence and competency.

For a child with autism learning how to play
appropriately with toys.

Most important, IT’S FUN!!!

To promote social interaction

To promote motor activity

Promote eye contact

Decrease self stimulation and bad behavior

Learn new ways of talking, listening and
communicating

Through play children also learn:

appropriate behavior

Imagination and creativity

building relationships

imitation 

Various color, texture, shape, and size

Teaching Play Skills to Children with Autism

Some ideas to enhancing play skills and
interests include:

Select a motivating toy.

Use toys that are related to the child’s
INTERESTS.

Choose toys that correspond to child’s
developmental level. 

Using bubbles to create rainbow-colored visions
stimulates the autistic child’s brain.

Read books to the autistic child that have some
texture to them. Flashcards can also engage the child through the sense of
touch.

 Sing
songs and play games that allow the autistic child to interact with other
children.

Always maintain eye contact with the autistic
child.

Musical instruments are excellent toys for
children with autism.

Positive reinforcement (e.g., verbal praise)
should be implemented along with the prompting and used to reinforce the
desired play behaviors.

 

Training of play skills in AWF 

AWF give opportunity to play in both indoor and
outdoor.

AWF initially trained a child to identify play
objects and toys.

Give training to choose toys that are
interested to the child.

Give emphasis to Improve communication skill
through various type of play.

Improve their interest to the cooperative group
play through interesting game.

AWF give emphasis to Imitation activities that are
motivating for the child.

 

Behavioral issues

Autism Spectrum Disorders can lead to a wide
variety of behavioral issues emerging as a child develops.

Problem behaviors of children with autistic
spectrum disorders are the most challenging and stressful issues faced by
schools and parents.

Problem behaviors such as:

property destruction,

physical aggressiveness,

self-injury, severe tantrums and
destructiveness are major barriers to effective social and educational
development.

Such behaviors put children at risk for
exclusion and isolation from social, educational, family, and community
activities.

 

Common behaviors problem

Causes injury or harm to self, others, and/ or
property

Children with Autistic Spectrum Disorder (ASD)
exhibit a wide range of challenging behaviors:

–  
Avoiding
eye contact; averting gaze

–  
Staring at
objects excessively

–  
Flicking
fingers rapidly

–  
Unusual
eating habits (e.g., eating only one type of food)

–  
Licking,
tasting, and/or attempting to eat inedible objects

–  
Excessive
smelling or sniffing of objects

–  
Spinning
objects

–  
Rocking
back and forth; making rapid darting movements

–  
Prancing
(walking on tiptoes)

–  
Flapping
hands or fingers in front of face or at sides

–  
Making
self-stimulatory high-pitched sounds or other vocalizations

–  
Self-injurious
behaviors such as biting, slapping, hitting self; banging head.

–  
May seem
oblivious to pain

 

Common self-stimulatory behaviors:

Hand flapping

Rocking back and forth

Spinning in a circle

Finger flicking

Head banging

Staring at lights

Moving fingers in front of the eyes

Snapping fingers

Tapping ears

Scratching

Lining up toys

Spinning objects

Wheel spinning

Watching moving objects

Flicking light switches on and off

Repeating words or noises

 

Causes of Behavior Problems

 

Lack of speech and communication

Hormonal change

Puberty and adolescence change

Pain and discomfort from illness

Medication side effects

Environmental Factors

Inability to Meet Basic Needs

Sensory Impairment

Individual factors

Factors related to caregiver

Feeling upset, anxious or angry.

Some effects:

Risk of physical harm,

lack of social development leads to isolation,

skill acquisition deficits,

independent skill deficits (long term care),

family stress.

The most effective model for managing behavior
is the ABC approach:

A – Antecedent –what triggers the behavior

What usually happens before the behavior, and
may set off the behavior?

B – Behavior–what is the actual behavior that
results

What actually happens during the behavior?

C – Consequence–what happens in response to
the behavior

A behavior program can work on these 3 steps:

1. minimizing
   the triggers for a behavior,
2. shaping
   more appropriate behavior in the child, and
3. Manipulating
   the consequences to encourage more appropriate behavior.

 

Best Practices

Research suggests that early, intensive
behavioral interventions may improve outcomes for children with autism.

Integration and interpretation of Sensory
stimulation.

Ignore inappropriate behaviors

Be an effective communicative partner

Speak slowly, clearly, and specifically

Be aware of
sensory over-reaction and under-reaction

Positively
reinforce positive behaviour

Task will
become more meaningful to accomplish

Decrease anxiety

Promote independence

Do not raise your voice, grab, or threaten the
child

Provide Attention

Reinforce Instruction-Following

Teach a Better Behavior

Social interaction:

• Does not
  make friends
• Does not
  play interactive games
• Is
  withdrawn
• May not
  respond to eye contact or smiles, or may avoid eye contact
• May treat
  others as if they are objects
• Prefers
  to spend time alone, rather than with others
• Shows a
  lack of empathy

Recent
studies strongly suggest that some people have a genetic predisposition to
autism. In families with one autistic child, the risk of having a second child
with the disorder is approximately 5 percent, or one in 20. This is greater
than the risk for the general population. Researchers are looking for clues
about which genes contribute to this increased susceptibility. In some cases,
parents and other relatives of an autistic child show mild impairments in
social and communicative skills or engage in repetitive behaviors. Evidence
also suggests that some emotional disorders, such as manic depression, occur
more frequently than average in the families of people with autism.

Studies show that people who have autism can
improve significantly with proper education. Early diagnosis and intense
behavioral intervention can have a significant and lasting positive impact on
Autistic Children. Autistic children can benefit from placement in a good
educational program.

[With intense intervention, 50 percent of
children diagnosed with the disorder before the age 5 go on to attend main
stream school]

Through specially trained teachers, using
specially structured programs that emphasize individual instruction, persons
with autism can learn to function at home and in the community

 

 

Conclusion:

AWF is a very new organization.
Even though small scale research is regularly conducted by the specialists,
teachers and the parents involved with the organization. The researches mostly
concentrate on developing modified teaching techniques and also newer
indigenous version of low cost teaching aids. The organization regularly shares
the findings with the parents to deliver them the best. The foundation is
capable of conducting large scale research on Autism in Bangladesh and is in
search of financial sponsorship to exhibit that.

Autism is complexes develop mental disability that typically appears
during the first three years of life and is the result of a neurological
disorder that affects the normal functioning of the brain, impacting
development in the areas of social interaction and communication skills. Both
children and adults with autism typically show difficulties in verbal and
non-verbal communication, social interactions, and leisure or play activities.
Autism (or ASD) is a wide-spectrum disorder. It is not a mental illness. There
is wide variation in symptoms among children with autism, from mild to severe.
Autism is a life long developmental disability known as the autism spectrum
disorders (ASDs). Autism is an organic disorder affecting several areas of a
child’s development. Autism remains throughout the individual’s lifetime,
although with proper diagnosis and treatment symptoms can be lesson.

 Child playing
with puzzle Children with an ASD develop at different rates in different areas.
They may have delays in language, social, and learning skills, while their
ability to walk and move around are about the same as other children their age.
They might be very good at putting puzzles together or solving computer
problems, but they might have trouble with social activities like talking or
making friends. Children with an ASD might also learn a hard skill before they
learn an easy one.  For example, a child
might be able to read long words but not be able to tell you what sound a
“b” makes.Children
develop at their own pace, so it can be difficult to tell exactly when a child
will learn a particular skill. But, there are age-specific developmental
milestones used to measure a child’s social and emotional progress in the first
few years of life. To learn more about developmental milestones, visit “Learn
the Signs. Act Early,” a campaign designed by CDC and a coalition of partners
to teach parents, health care professionals, and child care providers about
early childhood development, including possible ”red flags” for autism spectrum
disorders. There’s no way to prevent autism. Autism can be treated, and
children can have improved language and social skills with treatments. If a child is diagnosed with
autism, talk to a child’s
doctors about creating a treatment strategy for your child. Keep in mind that
you may need to try several different treatments before finding the best
combination of therapies for your child. There are many disabled and crippled
personnel in our society. If they are properly trained, they can substantially
contribute instead of becoming burden. In developed and developing countries,
Government takes the responsibility for training and rehabilitation of them. In
Bangladesh, our Government has also taken many measures of this kind, though
not enough.

Although we have many organizations in Bangladesh which work in various fields
but there is hardly any quality training institution yet to develop exclusively
for the autistic children.

 Recommendation

 

1.GET INVOLVED

There are
many ways to get involved in the autism community. Being involved you can
educate yourself about the most appropriate treatments and resources available.
As the parent of autistic children or as a sensible citizen you can get
involved with us in any of the following ways:

Be a Member if the Foundation

You can
become a member of the foundation and work closely for the development of the
children on Autism Spectrum.

Be a Volunteer Worker

In
Bangladesh offering volunteer service to the autistic children is not a common
practice, whereas in developed countries it is a common phenomenon. As a
responsible citizen you can give part time voluntary service to autistic children
getting involved with AWF.

Reach Out to Your Local
Community

If you are
not in a state to give volunteer service to the organization you can at least
learn about autism and try to impart your knowledge to the unaware parents or
guardians of Autistic Children around your place.

Raise Voice for Autism

You know the
rights of autistic children’s are not being maintained properly in our society.
You can stand beside the autistic children where their rights are violated. You
can also be part of the movement to accomplish the rights of the autistic
children by raising your voice in favor of them wherever you can.

Attend an Event

You can keep an eye on the events
related to autism taking place around you; be it a seminar, rally, workshops,
cultural program etc. You can attend in any of such event and get involved in
the fight against autism.

 Autism
Welfare Foundation it is a non profitable foundation here many
students as like me can skilled myself by their knowledge,instruction,training
& other oppertunities.But from my point of view the  Autism Welfare Foundation
adopt some things regarding the following issues:

2. At first known the child’s like and dislikes.

3. Making friendly relation with child.

4. To know child how to learn to like.

5. Making meaningful environment for communication.

6. Give the child to way of like.

7. To actively play with child.

8. The like of object in front of child but maintain distance.

9.Both the Autism Welfare Foundation
& depertment of child devlopment & social relation can jointly work to
improve of the students knowledge about autism.

10.To devlop individual research
unit needs to involve in devloping research protocols by the student in the
field of child devlopment & social relationship.

11.Making linkage between the
institution of National Home  Economics
College & Autism Welfare
Foundation in analogous activity.

REFERENCE:

Autism welfare foundation Magazine

Autism welfare foundation-Manuals and Papers

internet wedsite-www.autism
welfare foundation.com

News letter, Autism welfare foundation
Auguest-November-2011

www.awfbd.com

Williams DL,
Goldstein G, Minshew NJ. Neuropsychologic
functioning in children with autism: further evidence for disordered complex
information-processing. Child Neuropsychol. 2006;12(4–5):279–98.

Kanner L.
Autistic disturbances of affective contact. Nerv Child. 1943;2:217–50.
Reprinted in Acta Paedopsychiatr.
1968;35(4):100–36.

Landa RJ.
Diagnosis of autism spectrum disorders in the first 3 years of life. Nat
Clin Pract Neurol. 2008;4(3):138–47. doi:10.1038/ncpneuro0731. PMID 18253102

Minshew NJ,
Williams DL. The
new neurobiology of autism: cortex, connectivity, and neuronal organization.
Arch Neurol. 2007;64(7):945–50. doi:10.1001/archneur.64.7.945.
PMID 17620483.

Jeste SS,
Nelson CA 3rd. Event related potentials in the understanding of autism spectrum
disorders: an analytical review. J Autism Dev Disord.
2009;39(3):495–510. doi:10.1007/s10803-008-0652-9.
PMID 18850262.

 CDC Data “Autism
Spectrum Disorders – Data & Statistics”. Centers for Disease Control
and Prevention. May 13, 2010.
Retrieved December 25, 2010.

Minshew NJ,
Williams DL. The
new neurobiology of autism: cortex, connectivity, and neuronal organization.
Arch Neurol. 2007;64(7):945–50. doi:10.1001/archneur.64.7.945.
PMID 17620483.

 

Autism in Bangladesh. Retrieved
February 5, 2011 from
http://www.autismiliitto.fi/projektit/bangladesh-projekti/the_prerona_project/autism_in_bangladesh.