Management and Intervention of the Children with ASD at Home Environment in a Developing Country

Background:

After assessing the child with ASD (Autism Spectrum Disorder) parents try to intervene the behavioral issue but most of the time parents do not know the proper way of ASD management. The Institute of Paediatric Neurodisorder and Autism (IPNA) in Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, initiated home visit program for 35 Children with ASD who were admitted at IPNA Autism School in 2016. Home visit conducted by a team (at least two members must visit the child’s home). This team consisted by: Paediatric Neurologist, Educational Psychologist, Head Teacher, Autism Instructor/Teacher, Counselor, Autism Teacher, Assistant Autism Teacher

Objectives:

Short term :

For Parents: Observed how parents dealt with child’s behavior, Which types of methods and materials were followed by parents at home.For Children: Child’s relationship with their family members, How they expressed own need at home and which place or task child liked most.

Aims:

For Parents: How they constructed work environment for child, How they built up materials and manage the child in future.For Children: How the child improved own self skill (ADL-Activities of Daily Living), How they coped/ shared own experience of emotion with others.

Methods:

Using semi-structured demographic questionnaires for observation/systematic observation (coding system), observer can give some intervention to the parents so that they can improve their management skills or how to deal with their ASD child. Each member of the team fill up Questionnaire developed by specialist team of IPNA Autism School and must deliver an evaluation report with the consultation of the expert team. For this purposes the child’s activities of daily living (ADL), play, sharing and intimacy others information were taken. Duration: 1^st Home Visit: June 2016, 1^st Follow-up Home Visit: June 2017

Results:

Both home (1^st and 2^nd ) visit showed a clear structured improvement and involvement of the parents. Though a few numbers of parents didn’t start to use each material utterly but most of the parents commenced the few PECS (Picture Exchange Communication System) item for some task. Comparison between two years improvement graphical representation shows that parents give a lot of effort on outing and self help activities (toileting, eating, and dressing) but structure routine and materials are not used enough. Parents commented that they need more technical structured training on making material and PECS item. IPNA Autism School home visit team also showed some pictured routine which were used in classroom and conduct some 1:1 task in front of the parents. Home visit is one kind of intervention technique that parents and other caregivers can use to help their children when professional services and school are not available.

Conclusions:

The strategies by the home visit team gave parents skills that improved how they interacted with their children and dealt with challenging behaviors. The goal was for the parents to help foster their children’s communication and, when possible, their language skills. The emphasis was on skills that the parents and their children could use daily as they participated in activities at home and play.