Using Visual Schedules

We have come to the third strategy that was discussed in our poster presentation which was recently presented at the 4th NECIC in Sibu, Sarawak. We shared three strategies on how to increase predictability, prepare children for change and teach them coping strategies. The first two strategies that we shared in our previous blogs entries were social stories and video modelling. These visual strategies also serve as communication tools when explaining to our children about upcoming changes and expected behaviours. Below is a review of the third strategy. 

Strategy: Visual Schedule 

What it is

Pictures or symbols that represent expected activity or changes 

Pictures are arranged in one consistent sequence 

Variety of visual schedules 

First Then Board 

Calendar 

Task Schedule 

How to use it

Simplify and individualize visuals according to your child’s need 

Use consistent visuals when teaching new skills 

Pictures can be substituted with words if your child has reading comprehension 

When to use it

This is a useful strategy to increase predictability and understanding routine. 

To teach specific skills with multiple steps First Then Board (ex. First, eat. Then, watch T.V.) 

• Task Schedule (school and classroom, community outings, new skills/routines, etc.) 
• Calendars: Daily Routine (Waking up and then going to bed) 
• Weekly Calendar (public holidays, doctor visit, play dates) 
• Monthly Calendar (longer school holidays, vacation, daddy away for work 

Implementation 

Teach child to understand visuals by pairing visuals with items or activity. Introduce First-Then Board to teach child to tolerate and understand transitions. Gradually increase level of difficulty – easy transitions to difficult transitions. Increase the number of visuals and transitions. For example a schedule board with 3 – 4 steps within a play session. 

Introduce and explain the whole schedule with your child prior to the routine/event. Then show your child the visual of the current step before executing it. Once the step is done, show the child the visual board, and label the end of the particular step by removing the visual card. Repeat the same for the following steps. 

You can include a “FINISH” visual to indicate the end of the event or the routine. Consistently pairing the correct visual with specific step/activity is important for child to understand and learn predictability through the schedule. Involve your child when altering the visual schedule in case of changes in the routine. 

The strategies that we have shared with you over the past few weeks have worked very well with our children who are on the Autism Spectrum. However, we’ve also found that the strategies work well for typical developing children, especially visual learners. Continue to experiment with each strategy and you may find that for your child, one strategy may work better than the others. At the end of the day, you know your child best. So, do what works for your child! 

Written By 

Huey Sien 

Senior Consultant, EAP Malaysia

Dads.

The Needs of Fathers of Children with Disabilities

I recently read the above article, written by Sir Barry Carpenter, a dedicated and a proud father of Katie Carpenter. Sir Barry gave an inspirational speech and performed the song “Sing a Rainbow” with Katie during the recent NECIC in Sibu. Sir Barry brought many powerful messages for professionals in Malaysia; the importance of early intervention, being flexible and creative, about fathers of children with special needs and many more.

Huey Sien and I attended the 'Meet the Expert Session' during the conference, and listened to three respected fathers: Associate Prof. Koay Teng Leong, Sir Barry Carpenter and Dr Lim Boon Hock, as they shared their experiences and perspectives in bringing up a child with special needs.

They shared their marvellous journey, from struggling and finding resources, to relocating just to find support for their child, to how much they appreciate the help from their wife, family and wonderful people they met. And for the first time in my career, I listened to a father who shared how he felt when he received the news that his child is different.

It was indeed a good wake up call for me when they emphasized the father's role in bringing up children with special needs. Sir Barry had reminded us that Dads are different from Moms.

“We don’t do coffee mornings, we don’t share our feelings as openly as women do”, and of course, men are different from women! And I think men often only say what is really important and needed to be said."

Then I realised that’s why it is less likely to hear Dad’s complain when I conduct team meetings on weekdays during office hours. When Sir Barry mentioned that men hold day jobs, it also made me realize why I rarely get both parents to attend our fortnightly meetings. It is easy to take parents’ efforts to show up at meetings simply as part of the routine. He pointed out to the professionals that we have to be “Flexible and Creative” when working with families.

Since that very inspirational morning, I realised that I have somewhat been neglecting the silent yet important partner of the team. Since then, I have been listening and learning so much more, from both the fathers and the mothers of the children that I am working with. So here are some tips to my fellow professionals in this field of therapy.

Dads know what we are doing, even though we don’t see them often.
I recently found out that one of the father's at our centre reads our session notes the the minute he comes back from work daily.  He’ll try out any new game that his son has learned on that day!

Dads often have more fun play ideas than we have. They were boys once, if you don’t know already.
We are currently teaching a child how to play bowling at our the centre. Her Dad made it more fun by taking her to play it at the actual arcade! It’s so much fun that she often doesn’t want to leave.

Dads, if you need to see them, make an appointment. They will make it. 
Sir Barry wants us to meet both parents, he emphasized parentS, if there’s any important news or results to inform. And be flexible so everyone can participate in the effort.

Dads, they don’t talk as much, but they observe, they listen and they do the background work.
Oh yes. Dad usually is the person who makes good observations and has good and rational perspective. Hence, sometimes they make good decisions because of that. Also, recently two of the children that I'm working with benefited from a resource that I received from a father.

Let’s make it easier and possible for Dads to participate.  
We need to keep checking if we have been neglecting the Father's need and input. It’s time to do some “Thinking Dad". As Sir Barry said, we need to be Flexible and Creative in our services! 

Written by

Lee Yu Ying

Consultant, EAP Malaysia

Communicating Through Video Models

Hello everyone! 

Welcome back to Part 2 of our poster presentation entitled, “Increasing Predictability and Preparing for Changes in Routine are Important for Children with Autism.” 

In the previous blog, we explained how you can use social stories to prepare your child for changes in routines. Below is another strategy on how you can communicate new information to your child,  including changes in routines and the expected behaviours, through video modelling.  

Strategy: Video Models

What:

-       Short video clips to demonstrate desired skills and coping strategies

-       Video clips of actual events to increase understanding and teach tolerance

How:

-       Mention target skills

-       Model expected behaviours towards specific situation

-       Use short and clear language

-       Clear view with minimal distractions (i.e. unnecessary object, sound or people)

-       Exaggerate desired skills

-       Have fun!

When:

-       Teach social games (Hide and seek, Tag, Musical Chairs, etc.)

-       Teach social skills (joining conversation, manners, sharing, turn taking, etc.)

-       Demonstrate advance conversation and communication skills (understanding social cues such as body language, facial expressions, teasing v. sarcasm, etc.)

-       Explaining procedures (taking a bus, boarding a plane, ordering food, etc.)

-       Introducing new environments (new school or house, etc.)

Implementation:

-       Watch video with your child

-       First, role play in familiar environment. Then, role play in target environment.

-       Reinforce child for participation

-       Repetition is important

We hope that you will find the above strategy useful. Don’t just stop after you have watched the video with your child. It’s very important to practice the desired skills with your child too. Practice, practice, practice....and have lots of fun!

Written by

Huey Sien

Senior Consultant, EAP Malaysia

What We Learned in Sibu. Part 2.

Hello! As promised, we are back with more updates from our participation in the National Early Childhood Intervention Conference. The following is an abstract of the poster presentation prepared by Yu Ying and I. In the poster, we identified three strategies to help our children cope with change. This is the first strategy.

Increasing Predictability and Preparing for Changes in Routine are Important for Children with Autism

Predictability represents a significant challenge for children with Autism. Their lack of coping skills to deal with changes often cause them stress and frustration, which may result in difficult behaviours. These behaviours have direct impact on the quality of life of our children and family. This poster presentation review three common strategies to increase predictability, prepare our children for change, and learn coping strategies.

Strategy: Social Stories (Developed by Carol Gray)

What: Helps children understand social cues and expected responses to situations

How:

-       Use simple or child’s language

-       Use clear and real pictures (drawing works too)

-       Social Story Layout

o   Description – Describe where situation occurs, who is involved, what they are doing and why

o   Perspective – Describe and explain if necessary the reactions and feelings of others in the given situation

o   Directive – State what the child is expected to do or say

o   Control (coping skills) – strategies to help child to remember what to do or how to understand the situation

-       

     Focus on teaching one specific skill per story

-       Do what works for your child

When:

-       Explaining and relieving anxiety about a situation (death, new sibling, relocation, different eating utensils, detours, etc.)

-       Explaining a routine (shower, toileting, going out, paying at the counter, haircut, etc.)

-       Teaching social skills/social language (birthday parties, greetings, conversation, handling rejections, proximity, etc.)

-       Desensitisation of fears (dentist visits, blender, new food, making mistakes, losing, etc.)

Implementation:

-       Read  Social Story together with the child

-       Role play specific skills and coping strategies (focus on one skill at a time)

-       Reinforce child for participation

-       Repetition is important

Stay tuned for the second and third strategy! 

Written by 

Huey Sien

Senior Consultant, EAP Malaysia

What We Learned in Sibu

On June 7, 2012, National Early Childhood Intervention Council hosted their 4^th National Early Childhood Intervention Conference in Sibu, Sarawak. The theme of this year’s conference is “Family-Centred Practices – Early Childhood Intervention and Beyond”. The national conference featured prominent speakers internationally and locally. This year, it has attracted approximately 600 delegates from all over the world. At this Sibu conference, Yu Ying and I represented EAP Malaysia and presented a poster  titled -  “Increasing Predictability and Preparing for Change in Routine are Important for Children with Autism”.

At EAP Malaysia, we are constantly looking for opportunities to enhance our skills and knowledge, especially in the area of early intervention, so that we can continue to provide quality services to our children and families. Yu Ying and I attended a pre-conference workshop, “Teacher Talk: Make language learning happen all through the day,” for three full days from the 4^th to the 6^th of June. Our instructor, Cindy Smith, is a Speech Pathologist from the Hanen Centre in Sydney, Australia. These three areas were targeted during the workshop:

1)     Encouraging language development in early childhood settings.

2)     Let language lead the way to literacy.

3)     Fostering peer interaction in early childhood settings.

We found the workshop very refreshing and most of the recommended  strategies were in-line with EAP’s approach! On the second day of the conference, Cindy also did a short presentation specifically for families of children with ASD.

The next three days, after our pre-conference workshop, were filled with many interesting and informative sessions. Yu Ying and I had so many choices and we had a hard time deciding which one to go to! To fully maximize our attendance, we decided that we will go our separate ways and attend the sessions that are most applicable to the families whom we serve. Below are some of  the sessions that we attended:

-        Self-Care for Parents by Dr. Rachel Ting

-        Keys to Understanding and Working with the Spectrum of Autism by Dr. Wendy   Lawson

-        Special Needs Children and Sexuality Education by Dr. Peter Lau

-        More than Words® by Cindy Smith

-        Sleep Problems in Infants and Toddlers by Dr. Rick Jarman

-        Television and Screen Activities – benefits & harmful effects on children by 

      Dr. Rajini Sarvananthan

-        Pre-School Inclusive Education by Associate Professor Chuang Chiung-Hui

By the end of the conference, both Yu Ying and I felt physically and mentally exhausted. However, we were also very much inspired and rejuvenated by the talks that we attended and the people whom we met. EAP Malaysia pledge to continue to bring quality services to our families and view families as the key to successful early intervention.

Yu Ying and I will be sharing our thoughts on some of the talks that we both found to be very inspiring and eye-opening. Stick around for more interesting updates on our adventures in Sibu!

Written by 
Huey Sien
Senior Consultant, EAP Malaysia

Therapist Training in Manila!

Last Friday I boarded the plane to Manila for the very first time in my life. I had always wanted to see Manila but I did not know that my first visit would be to present EAP’s Therapist Training to eighty ABA therapists. The workshop started around 8:30am in the morning with a short prayer followed by a gracious introduction of myself from Ginie, one of the Directors from TeamWorks. The workshop covered these areas: therapist responsibilities, socialization and play skills, reinforcement, discrete trials, prompting, data collection, behavioural support, generalization and preparing for a session.

I have conducted various workshops throughout my career in EAP Malaysia. There was something about this one that stood out from the rest. I was awed by the enthusiasm and the positive energy of the therapists in the room. Most of all, I was inspired by their eagerness to learn.

I would like to say a big thank you to Rodrigo, also one of the Directors from TeamWorks, and his team for making ABA therapy available and affordable to families in the Philippines. I admire Rod’s tenacity and his tireless effort in improving services for children with special needs. There is so much that we can learn from each other!

Everyone!

All good things must come to an end. During the closing of the workshop, one of the therapists asked me if I had any final advise for them. I thought to myself, “What can I tell this enthusiastic bunch of therapists?”  I told them to keep learning and continue to be open to new ideas and possibilities.  As I bid goodbyes to all the participants who came up to me and thanked me personally, I wonder if they know how much they have inspired me in this short seven hours.

p/s: Thank you to Bryan Barroma who took great care of my accommodation, drove me around, introduced me to Philippine’s food and made a special stop so that I could try the famous Cupcakes!

Written by 

Huey Sien 

Senior Consultant

EAP Malaysia

EAP Malaysia at the 9th ASEAN Leadership Forum and at the 1st ASEAN Young Leaders Dialogue

In conjunction with the ASEAN Summit, the Asian Strategy and Leadership Institute (ASLI) organized the 9^th ASEAN Leadership Forum with delegates from all the ASEAN countries as well as representation from numerous embassies.

The conference started off with a Gala Dinner which had the honour of both the Cambodian and Malaysian Prime Ministers. Interestingly, our Prime Minister, Datuk Seri Najib highlighted three main points which ASEAN needs to grow:

1) The Development of Human Capital,

2) To Develop Creativity and Innovation and

3) To Nurture the Younger Generation.

I was invited to present some of my thoughts at the ASEAN Young Leaders’ Dialogue which was on the 6^th of April 2012. Amongst many other intellectuals from the 10 ASEAN countries and a representative from the Japan embassy as well, I highlighted my observations that many of the industries concerning investments, trade and finance were represented at the conference with a lack of representation from educators, health care providers, human rights and children’s needs. In addition I observed that billions of dollars were discussed which highlights our region’s wealth and ability to provide better health care, education and social services. 

I brought up my concern for the mental health needs in our country. I explained the statistics of autism and that all our countries lack awareness, resources, research and clinically approved services.

So how can we help each other in this region? Well, here are some suggestions that we could consider in the future at EAP Malaysia:

1) To network with all the ASEAN countries

2) To have collaborative research conducted

3) To share ideas and resources

4) To have an ASEAN Autism Conference

In conclusion, in my opinion, the most powerful thing about a young leader, is the ability to dream, create and innovate without the baggage of disappointment, frustration and jadedness that sometimes years of experience does to the human spirit.

I do hope to see change in the education system and public mental health services in my lifetime.

Written by, 

Jochebed Isaacs

Director, EAP Malaysia

Autism Conference at Gleneagles: Part 2.

Question: How do I teach my teenage son about sexuality? 
(Asked at the Gleneagles Conference, 1^st April 2012)                 

Answer:

Well there are many ways to teach this but the most important point about teaching a child with autism is to:

a) Break the skill down so it is easy to learn and does not frustrate the child

b) Individualise the method of teaching to that specific child’s ability

c) Have sufficient repetition that the child is able to retain the information (this does depend on the child’s level of functioning, some children need more frequent repetition while others may not need so).

One of the methods we use at EAP Malaysia (this is a generalized suggestion but for it to be effective, it has to be individualized to your child’s level of learning).

The Private/Public Programme:

We encourage parents to teach their children from a young age to only undress in their bedroom or in the bathroom. We also encourage parents to teach their children that they need to close the door when they use the bathroom (note: please use discretion of age appropriateness for this).

As the child gets a bit older, you could teach the child about scenarios that are private and scenarios that are public. You could get the child to sort these scenarios into the Public pile and into the Private pile. You could also do this programme in a Receptive manner or in an Expressive manner.

It is important to model the right phrases in context. For example, when your child goes to the toilet, a parent could say, “Private, going to the toilet is Private!”

If your child is starting to demonstrate sexual behavior, redirect him or her to the toilet or to their bedroom and emphasize that it is Private. You could also alternatively redirect him or her to another activity. Remember: Do not give too much attention for this behavior or the child could start to do it to get attention or start to feel bad about it and to try and do it more in secret (like any other self-stimulatory behavior).

There are other strategies such as teaching the child about Genders, Personal Space & Circle of Friends (identifying the closeness of relationship each person in the child’s life has and how close that person is able to be with the child).

It is imperative that we use sufficient visual strategies such as a Social Story, a Visual Schedule and even a Visual Tokenboard.

Call us at 03-2094 0421 or email us at autismmalaysia@gmail.com if you have any questions or would like to schedule an appointment.

Written by, 

Jochebed Isaacs

Director, EAP Malaysia

Autism Conference at Gleneagles: Part 1

On the first day of the Autism Awareness month, April 1st 2012, I had the privilege of speaking on Early Detection on Autism at Gleneagles.

Among the other speakers that were there, Dr. Ng Sui Yin presented a clear summary of the various diets associated with autism. I also enjoyed listening to Jeanette Suen from Singapore present on Occupational Therapy and Autism.

I will be writing 3 more short articles related to this conference over the next week so stay tuned!






Jochebed Isaacs, 
Director, EAP Malaysia