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There is a need to design interventions for children with Autism and lower degrees of developmental impairment, in India. These children have been traditionally grouped under „high functioning? Autism i.e. Autism and an intelligence quotient of more than 65-70. However, measuring intelligence in children younger than five years is practical in western contexts due to the availability of relevant normed scales, which are absent in India. The following case study explains a tailored intervention strategy adopted by a multidisciplinary team to improve social skills of a child (4 year 2 months, male) with Autism but relatively lower impairment. Within the multidisciplinary framework and the embedded Reciprocal Imitation Therapy (RIT), the following factors led to therapeutic improvement: 1) increase in sitting-tolerance i.e. he was able to sit for 30 minutes with a task of his choice, and five minutes with any assigned task; 2) he could make eye-contact during entire conversations; 3) the child?s potential to use imitation skills (stronger non-verbal than verbal) substantially improved, accompanied by improvement in receptive and expressive language; and 4) tthe child's interest in letters and numbers helped the intervention strategies. Within RIT, successful strategies included: modelling of appropriate behaviour; using physical prompts; giving actions as cues to elicit desired verbal responses; coupling actions with verbal responses; multiple repetitions and positive reinforcement. Findings in this study, particularly the improvements in speech and language, are supported by studies stressing on imitation as one of the predictors for development of communication in young children with Autism.
Samir Dalwai, Gitanjali Pillai and Zeenal Shah