A Father’s Journey with Autism- Chapter 15


In this blog, I’ll explore early intervention therapies implemented to stabilize Simi and enhance her eye contact. These interventions aim to address developmental challenges and foster improved communication skills.

Building Stability- Strategies for Enhancing Physical Balance:
Previously, I discussed Simi’s restlessness, posing challenges in training. Seeking guidance, our therapist recommended behavioural conditioning, also known as pain therapy. She outlined the following procedure:
1. Position the child opposite you on a chair.
2. Ensure legs are hanging down.
3. Keep arms folded or holding onto the chair’s arms. Encourage the child to remain seated like this for gradually increasing durations (starting from 5 minutes, then progressing to 10, 15, up to a maximum of 30 minutes).
4. If legs lift: Apply a gentle pinch to the thigh or ankle for conditioning.
5. If hands move towards mouth: Administer conditioning at the wrist.
6. If the child attempts to leave the chair: Apply conditioning to both shoulders. This procedure aims to encourage the child’s ability to remain seated and focused over time, utilizing behavioural conditioning techniques.
Positive reinforcement needs to be given if the child accomplished the task.

All activities were conducted three times daily, each session for 1hour and meticulously recorded in a register using the following format:
• Morning Session:
• Midday Session:
• Evening Session:

This systematic approach ensured thorough documentation and tracking of Simi’s progress and interventions.

This approach aimed to enhance Simi’s focus and participation in training sessions, addressing her restlessness effectively.
The therapist regularly monitored the register, ensuring consistent adherence to the established routine. After meticulously following this routine for three months, notable improvements were observed. Simi demonstrated increased ability to sit for extended periods, enhancing stability and paving the way for the implementation of additional behavioural therapies.

A. Sharpening Focus: Cultivating Eye Contact and Receptivity:
Indeed, it’s a known fact that autistic children, like Simi in her early childhood, often struggle with maintaining eye contact, a crucial aspect of communication development. To address this, the therapist devised a procedure aimed at fostering improved eye contact. This procedure focused on gradual exposure and positive reinforcement techniques to encourage Simi’s engagement and receptivity during social interactions, vital for her developmental journey.

i. Activity with Potatoes

1. Position the child in a chair facing a table.
2. Place 5-6 small potatoes on the table alongside a large empty bowl.
3. Sit opposite the child on the other side of the table.
4. Lift a potato from the table and present it to the child, ensuring he/she see it up close.
5. Encourage the child to take the potato.
6. If there’s no response, gently guide the child’s hand towards the potato.
7. Aim to establish eye contact, guide the child to pick up the potato, and place it in the bowl.

This activity encourages engagement, eye contact, and motor skills development in a structured and supportive environment.

We used to apply the same three times in a day  and recorded in a register as per the following format:

Continuing this practice as part of our behavioural therapy sessions yielded substantial improvements in Simi’s eye contact and receptivity over 3-4 months.
While outcomes may vary for each neurodivergent child, these methods generally offer positive impact without adverse effects. Yet, the challenge lies in consistent implementation, particularly in today’s nuclear family setups. Nonetheless, dedicated commitment remains paramount for maximizing the benefits of such interventions amidst contemporary lifestyle demands.

ii. Eye Gazing/ eye matching with Child:
Another approach we implemented to enhance eye contact involved the following steps:
1. Sit facing the child in a chair.
2. Bring your face close to his/her.
3. Maintain continuous eye contact and encourage the child to reciprocate.
4. Apply conditioning if the child attempts to avert their gaze or exhibit fidgety behaviour with their eyes, legs, or hands.

This method aimed to foster sustained eye contact through focused interaction and gentle reinforcement techniques.

iii. Candle Focusing: Direct / Indirect
We employed another technique to enhance Simi’s eye contact:
Direct Focus:
1. Hold a candle.
2. Seat the child opposite you, legs dangling, arms at the sides.
3. Move the candle in various directions, counting like a clock.
4. Ensure the child’s eyes track the candle without moving their head or body.
5. If eyes stray, gently tick near them.
6. Record instances eyes in a register during a 10-minute session.

Indirect Focus:

1. Make the child sit in front of a mirror,
2. Stand behind the child holding the Candle
3. Move the candle in various directions, counting like a clock.
4. Ensure the child’s eyes track the candle through the mirror without moving his/her  head or body
5. If eyes stray, gently tick near them.
6. Record instances in a register during a 10-minute session.


The activities can be recorded in the following format for both direct & indirect separately

We fully committed to Simi’s activities, sacrificing our social life to maintain the therapy schedule. We politely asked friends to avoid visits during sessions, emphasizing our dedication to Simi’s progress.
Stay tuned for my upcoming blog, where I’ll explore the decision to have siblings when raising a neurodivergent child, reflecting on the dilemmas we encountered in our early family life. I’ll share insights into the complexities of this choice and offer firsthand experiences from our journey with autism.

TO BE CONTINUED………

Author
Srinibash Mishra