My son Advaith was diagnosed with Autism Spectrum Disorder (ASD) and ADHD when he was 2.4 years old. At that stage, he was non-verbal and would communicate by pulling my hand towards his desired objects. He was diagnosed with ASD at National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, and the doctors suggested Applied Behaviour Analysis (ABA).
ABA is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviours to a meaningful degree. The doctors explained to me that for maximum benefit, the mother should partake with the therapist in the interventions for the child. We enrolled him for ABA when he was 2.5 years old. His therapist introduced him to sign language.
As I was a co-therapist for him, I started practising sign language at home. After one month of ABA, he started communicating for his needs independently using signs.
He started vocalising with first sounds while communicating. His therapist then asked me to fade signs and focus on sounds. So, we started to focus on words for communication. This put immense pressure on Advaith, and the result was a regression of speech and incessant crying during sessions.
After eight months of ABA, Advaith stopped cooperating with his therapist and would be continuously crying. Even though they tried different techniques to keep his interest levels, it was not helping him. Hence, we discontinued ABA from that centre and I continued at home with the help of a certified ABA therapist. Advaith was communicating using sign language and he was using 12 to 15 signs at that stage.
I was finding it difficult to manage everything alone as I had to manage household chores as well as take care of my elder son. This made me realise that I needed a support system.
This was when I enrolled him at Bubbles Center for Autism, a special education school in Bengaluru. But I realised that no one was able to understand his signs at school. In Bubbles, they follow Structured Teaching Method and Picture exchange communication system (PECS) for communication. I did my practical sessions at Bubbles and understood the importance of picture support.
Ms Sarbani Mallick, the founder of Bubbles, emphasised the need to create a stimulating environment for communication. The school conducted open houses for parent-school interaction evert month, and Ms Mallick guided all parents to work on communication skills as autism is mainly a communication disorder.
I introduced PECS at home. I created two picture cards of his favourite food and stuck them on my kitchen wall. In the beginning, I was giving him hand-to-hand prompts to pick up cards and hand them over to me (or another communication partner). I would hide his favourite food items to use the cards effectively. Within a week, he started using those two cards independently.
Then I introduced other pictures like milk, juice, music, one after another. When he started communicating with all the pictures from the strip, I fixed them in a big file in different pages.
On the left side of the file, I attached an ‘I want’ strip. Again, I taught him to pick the picture and use it with the ‘I want’ strip. At that time, I was using only ten pictures. After a month, he started communicating using the strips. He was trying to label words while communicating. Then I introduced a small file with small-sized pictures.
I arranged food items, toys, places to go to, actions, and feelings on different pages. Advaith was using that file for his communication with different people.
Then I attended a workshop about ‘Avaz’ at Bubbles with Dr Preeja Balan. By then, Advaith was able to use the iPad for watching his favourite rhymes and for doing activities.
Avaz is a picture and text-based application for children with Autism, Cerebral Palsy and Down Syndrome. It aims to help them learn, articulate and communicate with the help of simple and practical guidance tools for parents and educators.
So under Dr Preeja’s guidance, I started with Avaz Lite, that was a free version for seven days. I added his PECS pictures for better understanding and was showing him how to communicate using them.
Advaith was very happy to hear real voices on the iPad while using Avaz. The fact that someone was talking for him served as motivation. After observing his interest, we decided to buy ‘Avaz India’.
After buying it, I clicked pictures from his PECS file and uploaded them on the app. I began encouraging Advaith to use Avaz to fulfil his communication needs.
In the beginning, I was always with him to ensure that he used it effectively. In his mind, the communication concept was clear from sign language. So the only challenge was a transition from PECS file to iPad. He was getting immediate responses from me when he communicated with Avaz.
At present, he uses Avaz for communicating his food requests (including ordering food from restaurants), actions like swimming, horse riding, skating, scooter ride and cycling, for his favourite rhymes, favourite places to go to, his toys, etc. When he experiences a sensory overload, he asks for horse riding or scooter ride. Then I realised that those two activities help him keep calm.
He is able to initiate interactions and is more connected with family and friends through Avaz. Advaith was a child with a high level of anxiety and Avaz helped him communicate his difficulties.
I am using Avaz for creating visual schedules as well. This helped keep him calm, and we were able to find many of his strengths as well.
Advaith is excellent in different sports activities like horse riding, swimming, cycling, badminton, basketball and rollerskating. Advaith won two gold medals in the Roller Skating Competitions conducted by Karnataka Disability Department in 2017 and 2018. He participated in Special Olympics Bharat Karnataka in November 2017 and won the silver medal.
Advantages of Avaz
- Everyone can understand what he is communicating. It works across various languages like English, Hindi, Malayalam, Marathi, Kannada.
- Communicating with voice helps to stimulate speech.
- Anxiety has reduced because he can express his feelings.
- It is easy to create folders and to put pictures. They have provided symbols for all nouns, verbs, adjectives, preposition. We can use our own pictures also, according to the kid’s understanding level.
- Avaz can be used to teach number concepts, typing, adjectives, prepositions and to build comprehension.
Know more about the app here.
(Written by Smrithy Rajesh)
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