Pervasive
Developmental
Disability
Autism & it’s
Intervention
By: Prof. Mallika Banerjee
Dept. of Psychology,
University of Calcutta
What is Developmental Disability
•is attributable to a mental or combination of
mental and physical impairments;
•is manifested before age 22;
•is likely to continue indefinitely;
•results in substantial functional three or more of
the following areas of major life activity
The areas
self-care
receptive and expressive language
learning
mobility
self-direction
capacity for independent living
economic sufficiency.
DEVELOPMENTAL DISABILITY
PERVASIVE
DEVELOPMENTAL
DISORDER
1) Autism
2) Asperger
3) Retts’
4) Childhood
Disintegrative
Behaviour
5) PDD NOS
OTHER
DEVELOPMENTAL
DISORDER
1) Mental Retardation
2) Specific Learning
Disability
3) Other acquired Disorder
Autism :Historical Aspects
•Leo Kanner first identified autism in 1943 when he described 11
self-absorbed children who had "autistic disturbances of affect
contact."
•At first, autism was thought to be an attachment disorder resulting
from poor parenting. This has been proved to be a myth.
•Most specialists now view autism as a brain disorder that makes it
difficult for the person to process and respond to the world.
•Therefore, many scientists believe that, at least in some individuals,
autism may be genetic
AUTISM
A
lone even with others
U
nusual play
T
widdle and twirl object
I
ndifference to other people
S
trange movements and mannerism
M ost have a learning disability
OTHER SPECIAL CHARACTERISTICS
I nappropriate social behaviour
S peech impaired or absent
O bsessive routins and rituals
L ack of normal eye-contact
A nxious and distressed by change
T antrums and disruptive behaviour
E cho words in a meaningless way
S ometimes possess a special talent
What is Autism?
• Autism is the most common of a group of conditions
called pervasive developmental disorders (PDDs).
• PDDs involve delays in many areas of childhood
development.
• The first signs of autism are usually noticed around
the age of three.
•Autism is three to four times more likely to
affect boys than girls.
•Autism occurs in individuals of all levels of
intelligence. Approximately 75 percent are of
low intelligence while 10 percent may
demonstrate high intelligence in specific
areas such as math.
Some more information
• Autism begins at early childhood and persists
throughout adulthood affecting three crucial areas of
development:
• verbal and nonverbal communication
• social interaction
• creative or imaginative play.
The very early symptoms of autism
• Does not babble, point, or make meaningful gestures by 1
year of age.
• Does not speak one word by 16 months.
• Does not combine two words by 2 years.
• Does not respond to name.
• Loses language or social skills.
Having any of these five symptoms leads the parent and
professionals to have further evaluations for the child by a
multidisciplinary team that may include a neurologist,
psychologist, developmental pediatrician, speech/language
therapist, learning consultant, or other professionals
knowledgeable about autism.
Is there a single cause for
autistic symptomology?
The triad
Social impairments
Communication
impairments
Autism
Restricted
interests
Language Impairment
• All children with autism display some degree of
language impairment.
• About one-third of children with autism never
develop speech and remain mute throughout
life.
• Mutism with severe delay or total lack of speech
development.
• If speech is present atypical or deviant behavior
in terms of various aspects of spoken language
are seen as the following:
• Voice, articulation and prosodic abnormalities
seen as:
• poor and inappropriate pitch, loudness and
quality,
• misarticulations,
• inappropriate rate and rhythm in speech.
• Stereotyped and repetitive use of
language such as
• echolalia,
• use of stock phrases on few topics
only,
• repeated questions etc.
• Pronoun difficulties as in the confusion with
pronouns, pronominal reversal as in the use of
'you' for 'I'.
• Atypical vocabulary development seen as patchy
acquisition of vocabulary on a single or a few
topics.
• Ex. Names of objects, fascination with alphabet,
date, numbers, etc. Example: a. A child could
come out with names of 18 eatables at a stretch. b.
Recitation of Sanskrit slokas.
• Idiosyncratic use of words as in the use of
utterances the meaning of which is obscure to
others indicating communicative failures.
• Failure to respond to the communication of others
and failure to initiate (spontaneously) and sustain
communication
indicating
problems
with
interpersonal two-way communication.
• Semantic and conceptual difficulties as in "case in
concrete" use of learnt words and concepts,
difficulties
with
conceptualization
and
comprehension of heard language, etc.
• Abnormalities in the use of nonverbal
communication as seen in the poverty of
facial expressions and gestures as
pointing and showing, impaired emotion
recognition and expression, etc.
• Morpho syntactic and Pragmatic Errors
telegraphic speech, poor PNG markers,
poor
comprehension,
imaginary
observation.
SOCIAL SYMPTOMS
•IMPAIRMENT IN USE OF EYE GAZE,
•FACIAL EXPRESSION, BODY POSTURES
AND GESTURES.
•DEFICITS IN JOINT ATTENTION SKILLS.
•LACK OF IMMITATION.
•LACK OF DRIVE FOR SOCIAL
ENGAGEMENT
•LACK OF INITIATION IN INTERACTION
•LACK OF RELATING TO PEOPLE
SENSORY INTEGRATION DYSFUCTION
IT CAN BE DEFINED AS INABILITY OF THE BRAIN TO
CORRECTLY PROCESS INFORMATION BROUGHT IN BY THE
SENSES.
CHILDREN WITH SENSORY INTEGERATION DYSFUNCTION
MAY BE HYPERACTIVE OR HYPOACTIVE.
THE SYMPTOMS OF SENSORY INTEGRATION
DYSFUNCTION CAN BE SUBDIVIDED INTO VARIOUS
DOMAINS:
VESTIBULAR
SYMPTOMS:
HYPO- THE NEED FOR ROCKING, SWINGING AND SPINNING.
HYPER- DIFFICULTIES IN ACTIVITIES, WHICH INCLUDE
MOVEMENT, SPORT,DIFFICULTIES IN STOPPING QUICKLY OR
DURING AN ACTIVITY.
PROPRIOCEPTIVE
HYPO: PROXIMITY- STANDING TOO CLOSE TO OTHERS, NOT
KNOWING PERSONAL BODY SPACE, NAVIGATING ROOMS
AVOIDING OBSTRUCTIONS, BUMPING INTO PEOPLE.
HYPER – DIFFICULTIES IN FINE MOTOR SKILLS,
MANIPULATING SMALL OBJECTS.
SMELL (ALFACTORY)
HYPO- NO SENSE OF SMELL, FAIL TO NOTICE EXTREME
ODOURS.
HYPER- TOILETING PROBLEM, DISLIKES SHAMPOOS AND
PERFUMES.
VISION
HYPO- MAY SEE THINGS IN DARK, CONCENTRATE ON
PERIPHERAL VISION COZ CENTRAL VISION IS BLURRED.
HYPER- DISTORTED VISION, FRAGMENTATION OF IMAGES,
FOCUSING ON PART THAN ON WHOLE.
HEARING
HYPO – HEARING CONVERSATION OR SOUND WHICH
OTHERS CANNOT HEAR (BELOW AUDIBLE DB)
HYPER - CAN’T TOLERATE SOUNDS IN WHICH OTHER’S
HAVE NO DIFFICULTY.
TOUCH
HYPO-
HOLDS OTHERS TIGHTLY, HAS HIGH PAIN THRESHOLD,
SELF HARMING, ENJOYS HAEVY OBJECTS ON TOP OF THEM.
HYPER- TOUCH IS PAINFUL, DISLIKES BRUSHING AND
WASHING HAIR. LIKES CERTAIN TEXTURE OF CLOTH.
Emotional expression of Autistic
children
•Typically, autistic children do not show any
need for affection or contact with anyone
•They do not understand others’ emotions
properly
•Can’t express their own emotion in a
sociable way.
•Have characteristic ways of showing
physical affection toward parents, caregivers
and/or adults.
Summary
•Autism is not a single condition but rather
there is a spectrum of conditions
•The core behavioural features observed in
autism are actually relatively independent &
each can be observed in isolation – related
conditions (e.g. PLI) may reflect expression
of just one of these features
•Autism is apparently increasing in
prevalence – this is likely due to advances in
understanding/diagnosis rather than a true
increase
Differential Diagnosis
MENTAL RETARDATION
Appearance – Strikingly intelligent physiognomic
of Autistic

Early Skill Performance

Memory – Excellent Rote Memory

Spatial Ability

Motor and Manual Ability

Special Ability – Idiot Savant Performance
CHILDHOOD SCHIZOPHRENIA
 Onset & Course – CS
follow an initial course of
normal development
than CA
•
CA innate
•
Course lifelong in
case of CA in
comparison to CS.
 Health & Appearance –
CS poor health from
birth – contrast to CA
 EEG – CS considerably
high abnormality in
comparison to CA
 Physical Responsiveness –
Impaired in CA in
comparison to CS
 Autistic aloneness –
failing to adjust with
others – in both emotional
and postural aspects.
 Preservation of sameness
is common to autistic than
CS
•Hallucination is common to CS but not CA
•Motor performance better in CA than CS
•Language impaired in CA – not in CS
•Idiot savant performance
•Personal Orientation – CS realizes that he is confused –
disoriented but CA is unoriented.
•Conditionability – Conditioning hard to establish with CA, C
conditioned easily.
•Twin – both monozygotic and dyzygotic, more in autism than
in schizophrenic.
•Family Background – Low divorce rate, high educational
background- dramatically different in CS Family Mental
RETT’S Disorder
 Apparently normal
psychomotor and other
physical development upto
5 months after birth.
 Stereotyped hand
movements
 Loss of social engagement
early in the course.
 Severely impaired
expressive and receptive
language
• Unlike Autistic
 Deceleration of head growth
between 5 to 48 months.9
 Loss of previously acquired
purposeful handskills bet
ages 5 –30 months
 Appearance of poorly
coordinated gait or trunk
movements
 Severe psychomotor
retardation
ASPERGER’s Disorder
• Marked impairment in the use of multiple nonverbal behaviours
  Lack of social and emotional reciprocity
  Lacks in eye-contact, socially approved facial expression, body
posture and gesture to regulate social and emotional interaction.
  Failure to develop peer relationship.
  Lack of spontaneous seeking to share enjoyment, interest and
achievements with other people.
  Restricted, repetitive and stereotyped pattern of behaviour.
  Apparently inflexible adherence to specific, non-functional
routines and rituals
  Stereotyped and repetitive motor mannerism (hand flapping etc.)
UNLIKE AUTISM
No clinically significant general delay in
•
•
•
•
•
language
No clinically significant general delay in
No clinically significant general delay
in self
help and adaptive behaviour (other than
social interaction).
CHILDHOOD DISINTEGRATIVE
BEHAVIOUR
• Apparently normal
development up to
2years of age.
 
Qualitative
impairment in
communication, both
verbal and non-verbal
 
Restricted,
repetitive, and
stereotyped pattern of
behaviour
 
Motor stereotype
and mannerism
• UNLIKE AUTISM

Clinically
significant loss of
previously acquired
skills, viz, language,
social, bowel and/or
bladder control, play,
motor skills etc. before
age 10 years.
•
"Theory of Mind" (TOM)
"Theory of Mind" (TOM)
•TOM is a specific ability to read the
Intentions, Beliefs, Feelings, Emotions and
desires of others from their external
behaviour .
TOM proposes that all humans are, by
nature, mind-reader, i.e., can interpret
other’s mind in terms of theoretical
concepts of intentional states such as own
beliefs and desires.
In recent years, the phrase
"theory of mind" has more
commonly been used to refer to
a specific cognitive capacity:
the ability to understand that
others have beliefs, desires and
intentions that are different
from one's own.
ToM for AUTISTIC INDIV.
Theory of mind refers to the notion that many
autistic individuals do not understand that other
people have their own
plans, thoughts, and points of view.
Furthermore, it appears that they have difficulty
understanding other people's
beliefs, attitudes, and emotions.
Autistic people see others as
extensions of themselves because they
do not have a coherent, independent
self that "separates" them from other
people. Hence, they instinctively
expect others to perceive, think, feel,
sense and behave like them.
INTERVENTION
• Behaviour Modelling
- LOVAAS Technique
- Applied behaviour Analysis
- TEACCH
- Higashi
- Dietary Therapy
Recent trend
• Sensory Integration & Praxis
• Speech Therapy
• Emotional Stimulation
• Dance – Movement Therapy
• Health & Sex Education
• Play Therapy
• Music Therapy
Sensory Therapy & Praxis
Sensory Integration
• SI is an innate neurobiological
process by which the brain organizes
and interprets sensory inputs from
different modalities.
 SI is both “a neurological process
and a theory of the relationship
between neurological process and
behavior.”
SI Therapy
•
SI impairment – successful integration of
sensory input requires treatment
 This treatment is comprised of
vestibular, proprioceptive, tactile,
visual and auditory stimulation,
developed over the last 30 years
by Dr. A. Jean Ayres.
Motor Deficits in ASD
• Gross motor delays
• Unusual postures, clumsiness, and motor
planning problems
• Motor abnormalities, especially organization
and sequencing of movements
• Difficulties with preparation phases for
movement patterns
• Difficulties with imitation
• Praxis is the neurological process by which
cognition directs motor action; motor or
action planning is that intermediary process
which bridges ideation and motor execution
to enable adaptive interactions with the
physical world. (Ayres, 1985)
Types of SI
•Tactile
- Various Brushing Technique
- Cushion sandwich.
- Vibration from a hand-held device.
Proprioception Jumping, Riding a swing.
Vestibular
Riding a static cycle.
Ground Tunnel Activities.
Walking on a stepper/walker.
•Visual
- Attending to visual specific
visual patterns.
Auditory
- Auditory Integration Therapy
Speech & Language
Therapy
• Self Talk
• Parallel talk
• Improving eye contact (eye to eye, nose to
nose, finger to nose, finger to finger).
• To follow simple commands
• Auditory training
• To follow complex commands (to follow two
part commands)
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•
•
•
•
•
Big and small concept
Left & right concept
Colour concept
Body parts concepts
Imitation of vocal behaviors
Imitation of body movement (gross &
fine).
• Sentence elongation (ami bhat khabo,
ami ekhon bhat khabo, ami ekhon
garam bhat khabo, ami ekhon garam
bhat ar manso khabo)
• Yes/ No options
• Understanding questions
• Ask questions
• Comprehension of stories
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•
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Two step, three step and four step stories
Action words (who, when, where and why)
Verb play (eso, jao, khao etc.)
Request assistance
Request informatives (what?)
Name of objects
Defining objects in terms of functions
Offers resistance (ma nebe)
•
•
•
•
•
•
•
•
Justifies own action (tumi ki korcho?)
Problem Solving
Situational talk
Question and answers (random)
Topic maintainence
Story telling
Develop semantics
Talk about experiences
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•
•
Sequencing
Before/after
Why/because
Comprehension of a passage/story/event
Turn taking
Socialization
Share ideas/suggestions
Give / take (dao/nao)
• Picture description
• Complex sentence formation
• Complex story following questiuon
and answer
• Abstract ideas
• Providing sufficient information (Brush
& paste etc)
• Explanations
•
•
•
•
•
•
•
•
How concepts
Many/single
Tense concept
Verb form
Story telling
Emotional speech
Continuation of a topic (tarpar)
Make sentences
•
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•
Repair strategies
Imaginative talk
Make sentences (complex) two word
Use of opposites
Use of preposition
Use of conjunctions
What happens then (tahole ki hobe?)
Comprehend a question – simple/complex
•
•
•
•
•
•
Reinforcement schedule
Time concept
Age concept
Money concept
Why questions?
Past event description (recent/very
recent/past/too past)
• Sense of humour
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•
•
•
•
•
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•
Tea making
Daily routines
Good or bad concept
Rules (to obey)
Missing information
Appropriate behavior
Angry situations
Empty/full
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Pronouns (ami/ amra etc.)
Clarification (amake bolte hobe to)
Play a story (bandhu ke story bole/ han/ ki story)
Face reading
Telephone conversation
Synonyms/hyponymy
Agent+action (phal – khabo, -kinbo/ katbo)
Picture – before+after (lathi marche-age/pore)
Listening story+’wh’ questions+answers+ask
questions/give answers
• Sequesnce – story
• Jumbled words into story-sentences into
story
• Today/yesterday/tomorrow concept
• Environmental awareness
• Regulations (janala keno thake)
• Cause+effect (brishti+kada)
• Categorization
• Word making
•
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•
•
Fill in the gaps
Gender
Sentence variations
Association and
• ORO-MOTOR EXERCISES
Oromotor Exercises + Sensory
Integration Training
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•
•
•
Tongue Exercises
Lip Exercises
Oro-motor co-ordination Training
Muscle Training
Stress Training
Isometric & Isotonic Exercises
Emotional expression of Autistic
children
• Typically, autistic children do not show
any need for affection or contact with anyone
• They do not understand others’ emotions
properly
• Can’t express their own emotion in a sociable
way.
• Have characteristic ways of showing physical
affection toward parents, caregivers and
others.
Training
Researchers showed that autistic children
can properly express their emotion under
exposure of proper affective stimulation.
Through training children are stimulated to
respond to stimuli that normally gives rise to
pleasant stimulation and discouraged from
responding emotionally to stimuli that give
rise to the unpleasant emotions.
Dance/Movement Therapy
Dance / Movement Therapy
is defined by the American
Dance Therapy Association
as “the psychotherapeutic
use of movement as a
process that furthers the
• emotional,
• cognitive,
• social and
• physical integration of the
individual.”
• Body Attitude: • Body Awareness:
• Body Coordination: • Body Reflex
• Gestalt
• Interactional Synchrony:
• Kinesphere :• Kinesthetic Memory
• Movement Vocabulary:
• Phrasing
• Spatial Awareness:• Expressional Aspect:-
Play Therapy
•Play therapy was originally conceived as a tool
for providing psychotherapy to young people
coping with trauma, anxiety and mental illness.
In that context, play becomes a way for children
to act out their feelings and find coping
mechanisms.
Stages of Play Therapy – Sensori-motor stage
• This stage normally develops during 6 to 8 months of age.
With the aim of facilitating social interaction and
communication and developing sensori-motor skills,
arrangement of simple games like: ball throwing and sand
play have arranged.
• A scientific Sand Pool with coloured balls and toys kept
hidden under the sand and children would be motivated to
search them, different shapes of spoons and sieves have
been kept for sand poring. Thus the child has to explore at
first object of his primary interest and then gradually
expected to turn to culture specific social interests. After
primary fulfillment of sensation with sand, a ball pool
would be provided.
• Thus the the aim of sensori-motor stage is to facilitate
whole body interaction, to reduce behavioral problems, to
develop eye contact, joint attention &object permanence.
Organizational/ Constructive play• This type of play occurs from 6 to 9 months of age when
the child has developed strategies for examining the
surrounding world
• In autistic children to develop the strategies for
understanding the world beyond their “glass shell” this
stage has structured with some items, which would
encourage them to take interest in the outer world,e.g.,
modeling with plasticine, block building, form boards of
different shapes and colours, two and three piece puzzles,
colour pyramid
• Thus, the aim of this stage is to improve concentration,
stimulate creativity, provide self-sufficiency in specific and
shared attention, eye contact communication and social
interaction, in general.
Functional Play
• The third stage is of functional play. This play normally dominates
from the age 9 months to12 months. Play items at this stage are used
intentionally, according to their functions.
• Important part of the functional play is to acquaint them with the
different objects and their functions.
• This process has been started with identification of the body parts and
their functions followed by identification of different fruits, vegetables,
transports, cooking utensils, furniture, along with their functions.
Finally, the situation has been structured in such a way that the
children can be provided with a male and a female doll and learnt to
describe their attire. Human models of different relations with different
ages and imaginative figure like fairy have been introduced as per the
capacity of the child.
• Thus the aim of this stage is to help the children to know about their
surrounding and to imitate object-oriented behaviors of others.
Pretend play• The final stage in structured play is pretend play. This type of play is a
valuable opening to the emotional and cognitive universe.
• This stage has structured with the help of a dolls’ house within which
there are separate rooms for separate purposes, with suitable furniture
according to the purpose of the room. The house has been so structured
that upto 3-4 yrs. child can enter within the camp wall.
• The child, with guided participation first learnt the details of the
rooms, he has been made aware about the family members of the
house and finally he could pretend his daily routine with the help of the
dolls. Role taking has also been facilitated. Moreover, the model dolls
of human beings as used in the previous stage, has also been included
with more variety of relationships and images.
• Thus the aim for this stage is to encourage mental representation,
appropriate social interaction and communication.
Rules to be followed in Play therapy
•Use manipulative and exploratory play to show
how to interact with objects and the environment
around
•Treat autism by engaging children in tumbling
and physical activity to develop motor skills.
•Use role-playing and social play to mimic real
life situations.
•"Social stories" and "scripting" can develop
language skills and teach social rules.
Contd….
•Let autistic children learn games from other autistic children
with integrated play
•Encourage autistic children to participate in symbolic or
pretend play allows children with autism to develop thought
flexibility.
•Engage children in functional play, where a child may provide
appropriate sound effects and reactions for a toy or everyday
object.
•Treat autism by choosing toys that will make a visual impact
•Enhance physical activity to encourage self-expression.
•Structure playtime so that there is continuity and repetition.
Use familiar objects, but introduce new materials or different
types of toys to keep activities feeling spontaneous and fun.
Music Therapy on Autism •Music therapy can be taken as a promising
approach for intervention of autistic children.
•Stephen Malloch(1999) develop this into a theory
called ‘communicative musicality’ – a theory of
basic motivation for communication in form of
musical expression.
•Improvising music therapy is gaining acceptance
as an effective way of gaining and regulating
communication with even the most recalcitrant
autistic youngsters
Health & Sex Education
Sex education for individuals with autism ranges
from health and hygiene to social skills and
dating.
•The manner and amount of detail during the
instruction will depend on the functioning level
of the person being taught and what teaching
strategies are most effective for that individual.
Training concept
•Concepts that could be included in social/sexual
training include:
•growth and development;
•modesty;
•public and private;
•respect of privacy;
•differentiating among friends, family,
acquaintances, and strangers;
•doing something about sexual feelings; and
learning about "safe" sex.
A CURRICULUM FOR HEALTH AND
SEX EDUCATION (SHEC)
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•
•
•
•
•
The following program is being made as curriculum of health
and sex education for the people with autism by which, it
could be possible for teaching age appropriate and socially
acceptable behaviors. This program is divided into 5
segments and each segment contains items related to sex and
health education.
Domain I
Biology and Personal Appearance
Domain II
Privacy/Modesty (about sexual
expression)
Domain III
Health/Hygiene/Personal Care
Domain IV
Recognition of Emotion
Domain V
Social Behaviour
Biology and Personal
Appearance
Identification of body parts including private parts
of own body
• Materials - Models of male & female, Pictures of male
&female.
• Identification of gender specific dresses (in Indian
culture).
• Materials -Pant, Shirt, dhuti, panjabi, Shaving set.
• Sari, Salwar kamiz, Frock, Skirt, Blouse,
• Ornaments like bangle, necklace, earring, bindi, hair clip
etc.
• Identification of same sex which he/she belongs and
opposite sex as well.
• Materials - Human being (adult & peer), Models of
male and female, Pictures of male and female.
• Identification of gender from different ages.
• Materials - Various pictures of male showing of
different age level, Various pictures of female showing
of different age level.
• Differentiate sex by name like Ankit is male & Ankita
is female.
• Similarities and differences in male and female.
• Materials- Model of both male & female,
Concept should be developed like, -Sameness, in terms of eye,
nose etc. apart from private body parts.
A difference in terms of private body parts and by gender specific
dresses.
• Different developmental stages of a human being.
• Materials - Male and female pictures of different stages like,
Infant, Early childhood,. Late childhood . Adult & Old age
•
•
•
•
-Identification of each stage individually.
-Understanding of younger, elder and older.
-Arranging of different stages sequentially.
-Arranging own photographs according to his/her chronological
age.
Privacy / Modesty (about sexual
expression) :
• Modesty:
•
Materials: Models of male & female Gender specific
dresses.
• - She/he has to understand the necessity of wearing garments and
practice these activities with the model also.
• - She/he has to close the door while dressing, undressing, toileting,
bathing and masturbating or touching his/her body parts.
• Menstruation:
– Materials A particular brand of sanitary napkin, Date calendar,
A set of flash cards depicting the use of napkin.
• Make her understand to highlight the date of every month of a
calendar.
• -Washing the inner garment twice a day during cycle for safety.
• -Demonstrate the process of sanitary napkin usage.
• Ejaculation:
• -The individual has to wash own inner garments after
ejaculation.
• -Wash the genitals properly after ejaculation. -Has to
learn to maintain privacy.
• Masturbation:
• Models of male& female, A peace of cloth, A set of
pictures showing masturbating by closing the door.
• Has to learn the touching of genitals in isolation.
•
-Covering up the nude model of own sex with a cloth
for understanding
•
-Touching of genitals in isolation.
Health/Hygiene / Personal care:
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•
•
CLEANLINESS
a. Cleanliness before and after meal:
Materials - Soap. Water Towel Napkin.
•
•
b. Cleanliness during and after toileting:
Materials - Soap.Towel Water.
•
c. Cleanliness during menstruation:
•
d. Cleanliness during ejaculation:
•
•
e. Cleanliness during cough and cold:
Materials - Napkin, Water, Basin.
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f. Brushing
Materials - Brush & paste. Mirror. Towel. Basin.
•
•
g. Cutting nails
Materials = Nail cutter , Water.
• Bathing
• Materials - soap.Towel.
• - The individual has to understand the meaning
and significance of cleanliness.
•
-These processes can be demonstrated by
role-playing
• Using of first aid:
• Materials - First aid box, Sign (+).
• -The individual has to understand when and
where to use first aid,
• -These processes can be demonstrated by roleplaying.
• Shaving:
• Materials
• A set of flash cards showing how to shave,
Shaving kit.
• The individual has to arrange the shaving process
sequentially, • Demonstrating the process to the child.
• Maintain desirable physical distance with the
stranger / family members:
• Make aware the individual about maintaining
desirable physical contact from family members
and outsiders as well.
• -The pattern of addressing style should be like
kisses on head, a pat on his backs or handshake,
warm verbal praise etc,
Recognition of Emotion:
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•
•
•
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Identification of different expression of different emotions.
Materials
– Happiness.
– Sadness.
– Fear.
– Anger.
– Disgust.
– Surprise.
Procedure:
- Has to identify the each emotion card individually,
- Has to identify emotion from different facial expression.
Social behavior:
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•
•
•
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Interaction with stranger:
Taking care of younger:
Taking care of older:
Taking care of same age:
Sharing habit:
Procedure:
-These behaviors could be taught through
role-playing.
Prerequisites
• The individual's behavioral repertoire must
be assessed in the areas of observed
• sexual expression,
• development of modesty,
• interactions with others,
• awareness and acceptance of self, and selfcare and hygiene.
Attitude toward Disability
• Disabled’ is used with caution to express the positive attitude.
•
•
•
specially abled,,
mentally challenged,
discover of ability’ and so on,
it creates little difference on the part of the distress
of the persons with disability and the parents they
have to bear in everyday life.
Attitude toward disability
Stages of Acceptance
Denial
Burgaining
Blaming
Support seeking
Depression
Acceptance
Attitude toward disability
Breaking out of the Vicious Circle
Discrimination and prejudice create
the sense of being disabled that leads
to further discrimination and
prejudice. How can this vicious circle
be broken?
It is the Empathy – Not Sympathy
•The harsh reality is that if disabled people themselves see
themselves as victims, then they will be
•treated as victims;
if they are sunk into self-pity, they will be
•perceived as pathetic;
if they are hostile towards non-disabled people,
•they will be shunned;
but if they refuse to see themselves as victims, if they
claim their own dignity, see themselves as positive and
able to contribute, they will be seen
• as positive and able to contribute.
Thank You