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Autism Spectrum Disorder (ASD), also known as pervasive developmental disorder, is a complex neurodevelopment phenomenon characterized by impairments in social interaction and communication, restricted repertoire of interests and stereotyped activities. ASD in “spectrum condition” affect individuals differently and in varying degrees. The manifestations of ASD may be hyperactivity, delayed learning of language, difficulty in making eye contact or holding a conversation, difficulties in activities of daily living, narrow and intense interests, poor motor skills and sensory sensitivities etc. and might follow one, few or many of these behaviours, or many others besides. Studies and evidences reveal that the incidence and prevalence of Autism is increasing day by day, once considered rare. It is estimated that 1 to 1.5 per cent of children between ages of three and nine in India are affected by Autism. Kerala is no exception. Taking this into account NIPMR established the Regional Autism Rehabilitation Centre on the 4thof August,2018.

 

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RARRC functions with the following objectives and goals

OBJECTIVE:

  1. To successfully integrate children with Autism into the community through a holistic approach of intervention & therapies.
  2. To create and promote social awareness about Autism Spectrum Disorders.
  3. To provide the needs of autistic children and their families in availing high-quality services for comprehensive diagnosis, assessment, evidence-based personalised appropriate interventions, development of personalised and structured care plan, continuous assessment of co-morbidities, family education and support, empowerment of family, monitoring and management.
  4. To promote training in ASD for professionals.
  5. To carryout and promote research and studies on ASD.

 

GOALS

  • Early identification through comprehensive diagnostic assessment
  • Extend services based on individual developmental needs
  • Enhance communication skills and socialisation.
  • Provide support to families through counselling, parental education etc .
  • Provide opportunities for recreations and games.
  • Equip the child for appropriate education.

SERVICES OFFERED

  • Medical Services

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NIPMR provides the services of a Developmental Paediatrician, Physical Medicine and Rehabilitation Specialist and E. N. T who provide comprehensive medical assessment and management, acknowledges and responds to developmental and behavioural concerns as early as possible. The medical team plays an active part in a multidisciplinary evidence-based diagnostic and assessment process and assists to identify a key worker for families for an autism spectrum disorder and require significant intervention and support.

  • Physiotherapy

Many children with ASD will experience difficulties with their motor skills and capabilities in addition to behavioural, sensory and emotional difficulties. The role of a physiotherapist is to help children who have difficulty in functional movements, poor balance and challenges moving through environment successfully. Some children with ASD have low muscle tone, poor balance and co-ordination. The Physiotherapist after detailed assessment helps them in such situations by implementing a treatment plan to improve the child’s overall functioning in daily living.

BENEFITS OF EXERCISE IN AUTISM:

  • It will help to improve motor skills, essential for weight management, improve social skills, improve mental health and decrease stereotypical behaviour
  • Improve self-regulation
  • Decrease aggression
  • Increase academic responses
  • Appropriate motor behaviour

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EXERCISES FOR AUTISTIC CHILDREN

  1. EXERCISES TO IMPROVE MUSCLE TONE
  • Strengthening exercise using dumb bells
  • Dumb bell press on the floor
  • Row on knees
  • Standing dumb bell press
  1. STRENGTHENING ABDOMINAL MUSCLES
  • Leg raise
  • Curl ups
  • Physio ball exercises
  1. EXERCISES TO IMPROVE BALANCE AND CO-ORDINATIONBall throwing
  • Ball throwing
  • Balance board
  • Ladder exercise
  1. EXERCISES TO REDUCE OBESITY AND TO IMPROVE CARDIOVASCULAR FITNESS
  • Cycling
  • Treadmill
  • Floor exercises

Occupational Therapy

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Occupational therapists help children with autism perform better in school, home, and social environment. Occupational therapy intervention focusses specifically on helping children integrate their sensory systems and initiate and sustain purposeful play. Occupational therapy also supports parents and helps them to be more effective, reinforcing the already good work they do.

 

Developmental Therapy

A developmental therapist is responsible for providing developmental therapy including ongoing developmental assessments to young children and support for families in home based settings. Early intervention for high risk and at risk children who may have developmental delays are the main focus. Early intervention improves and enhances the development of a child with developmental delays, special needs or other concerns. It provides assistance and support to empower families of these children. It lays a foundation that will improve the life of the child and offer greater oppurtunities

 

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Developmental therapists help identify the early markers of ASD features in young children using various developmental scales or tools. They help initiate early stimulation programme for ASD features or developmental delay suspected children to achieve their normal developmental milestones. ASD intervention mainly focusses on improving their social behaviour, daily routines, attention skills and play activities. The department also conducts awareness classes, community programmes, counselling for parents and care takers etc.

 

Speech Therapy

 

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Speech Language Pathologist plays a central role in the screening, assessment, diagnosis and treatment of Autism Spectrum Disorder. Therapists aim at developing independence and self-advocacy of individuals with ASD by ensuring each individual has a functional communication system and by supporting communication in different social settings. Goals are set based on assessment data that target core deficits in ASD and focus on initiating spontaneous communication in functional activities, engaging in reciprocal communication, interaction and generalising gains across activities.

 

Behaviour Therapy

Psychologists play an important role diagnosing ASD and helping people cope with and manage the challenges associated with the disorder. When psychologists diagnose ASD or meet with a patient with ASD for the first time, they typically perform a comprehensive evaluation. That evaluation acts as a roadmap that identifies the patient’s strengths and areas of need to help guide treatment. As patients grow, psychologists create new treatment plans to help patients and their families succeed at key transition points

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Treatments to help people with ASD manage anxiety or mood disorders such as depression. This often includes modified cognitive behavioural therapy, a method that helps individuals change negative thoughts and behaviours. Treatments to help manage sleeping and feeding problems that often coincide with ASD. Social skills groups to help people with ASD improve conversational skills, nonverbal communication and play. Individual psychotherapy and behaviour therapy to help people with autism improve behaviours and relationships and improve life skills necessary for daily life activities, education, employment, future etc. For people with more severe cognitive impairments, interventions to decrease aggression and self-injury and improve compliance. The goal of psychotherapy may not be to cure ASD, but to help people with ASD function at their best and cope with challenges. Monthly visit of Autism schools and centres are conducted for early intervention, treatment plans, awareness classes and counselling for parents, care takers and special school teachers are being carried out.

 

Dietary Services:

Children with Autism Spectrum Disorders can present with unique nutritional challenges and malnourishment. Various nutritional deficiencies are reported among people with ASD because of a variety of reasons such as narrow food preferences or specific food or texture aversions. In addition to deficiencies they are also prone to obesity due to impairments in motor function that limit physical activity as well as social impairment or rigidity to a specific routine that limits structured physical activity with peers. While food selectivity may predispose to specific nutrient defeciency it may also place a child with ASD at risk of obesity if calorie dense foods are preferred. Allergies and intolerances are also seen in children with autism thereby further reducing food intake.

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Dietician conducts a detailed nutritional assessment to look at whether the diet provides all the nutrients needed and suggests techniques to help try new foods as per personal choices, gives advice on nutritional supplements, provides helpful, practical guidance to help reduce mealtime stress and problems such as ADHD, constipation, diarrhoea, bloated stomach which are quite common in people with autism. Diet counselling, tips on menu planning, recipe modification etc are also taught to the care givers. Other activities to encourage healthy eating habits are also promoted by the Department of Dietetics which include cooking demonstrations for care givers, setting up of Nutrigarden and cooking competitions to promote healthy eating habits among children, nutrition education in autism centres in Thrissur district etc.

 

Early Intervention through outreach programmes

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Autism is much more prevalent in today’s society than parents think. With increasing numbers early detection helps a child with autism live a more normal life in society. Research has shown that early intervention can improve a child’s overall development. Children who receive apt education and support for autism at crucial developmental stages function better in society. Parents of autistic children can learn early on how to help their child improve mentally, emotionally, and physically throughout the developmental stages. Catching autism and working through it early also benefits parental relationships. The challenges of caring for an autistic child can be daunting, but with early preparation and intervention, parents can equip themselves for the road ahead emotionally and mentally.

The multi-disciplinary team at NIPMR has conducted various early intervention camps for detection of not just autism but also other developmental delays extensively across Thrissur District.

 

Model school for children over 2years of age

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Training school for autism is divided into 4 sections (Pre- Primary, Primary, Secondary I, Secondary II) categorised based on the academic performance and age of the students. Currently we are focusing on 3-12 years of age group children. Pre-Vocational & Vocational level classes will commence soon.

The school has special educators specialised in the field of autism and ayahs to take care the needs of students during the class hours. The timing of training sessions are from 10.00 am to 3.30 pm.

The training mainly focuses on child-centred approach model of education and teaching daily life skills for children with autism. Pre-vocational skill training are also a part of our curriculum .Apart from the school sessions the students get music Therapy, behaviour modification therapy, speech Therapy, physiotherapy, occupational therapy as per the needs of each student after a thorough assessment. The students are trained in group and individual sessions in the school. The training school fosters resilience and independence, enabling students to be engaged participants in community life.

 

Parental education and training

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Various training programmes are conducted for the parents to provide a means for income generation. After successfully training the caregivers of special school children, they have started a self-help group called Unarvu which successfully markets and sells paper pens. NIPMR actively supports this venture. Also various classes are conducted for caregivers by various departments.

 

Play facilities [indoor &outdoor]

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NIPMR has a state of the art exemplary sensory garden specially designed for children with sensory disabilities. A sensory garden stimulates all senses sight, touch, taste, smell and sound. The garden allows children with sensory disabilities to explore their senses without feeling overwhelmed by them. Sensory garden encourages a greater degree of interaction with nature as well as natural aspects other sensory equipments like sensory pathways, stepping stones, tunnels etc can bring additional visual, auditory and tactile stimulation. The sensory garden is extensively used by Occupational therapists, Speech therapists and Special educators.

 

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