Anuradha H S*, Shanthalaksmi K**, Lakshman***
Consultant Adolescent Pediatrician (IMRHC), Manipal Teen Clinic, IMRHC*, Founder and Secretary, IMRHC **, Consultant Psychiatrist, IMRHC***
Autism spectrum disorders (ASD) have been found throughout the world in families of all racial, ethnic and social backgrounds. It occurs in approximately twelve of every ten thousand births and is several times more common in boys than in girls1, Autism is a severe, lifelong, pervasive developmental disorder, identifiable by the presence of the following three characteristics:
  • Significant impairment in the development of social relatedness
  • Significant impairment in verbal and non-verbal communication
  • Unique patterns of behavior (e.g., preoccupation with certain objects or parts of objects, routines, and interests; distress over changes in seemingly trivial aspects of the environment; and an insistence on maintaining sameness)

Integrated Multipurpose Recreation and hobby center (IMRHC), Bangalore, is a voluntary organization, which was founded 35 years ago with the aim of helping children with disability. It has strived to identify the hidden talents in these children and channelise them to achieve high standards at both national and international level.

IMRHC has always taken up challenges of adolescent school dropouts with multifarious problems. In this category, autism has been the focus of attention.

Over the last 10 years, there has been an increase in the rate of dropouts especially the autistic adolescents from special schools. The reason for this is lack of proper early intervention and training programs that are individualized or structured to suit the autistic child. The result is an autistic adolescent who has multiple behavior problems and no prevocational, social or communication skills that would help him/her to take up independent/semi-independent living. However, with a structured program incorporating use of creative arts can go a long way in rehabilitating an adolescent with autism despite the delayed intervention.

Objective: Role of hobby and recreation in training an adolescent with autism case report of a 12 year old adolescent boy with autism.

Review of literature: Problem Behaviors are often a source of exclusion for many autistic people. Hence, behavior modification forms the basis for any intervention program for the autistic. One of the programs that have been very successful is the TEACCH program2. It is a complete program of services for autistic people that makes use of several techniques, of several methods in various combinations depending upon the individual person's needs and emerging capabilities.

Methods: Our subject was a 12 year old boy, who had been diagnosed to have childhood autism at the age of 3 years. He had attended a special school till he was 12 years old, following which, he was sent home due to behavioral problems. At the time of admission, he was re-assessed by a team of pediatrician, psychiatrist, psychologist and special educator and diagnosed to have autism based on the DSM IV Criteria 3.
  • His behavioral problems included
  • Poor eye contact
  • Severe echolalia
  • Obsessive behavior
  • Ritualistic behavior
  • Hyperactivity

Apart from these unwanted behaviors, the adolescent boy was found to be highly skilled and accurate in repetitive activities. After determining the boy's abilities, a special program was designed using two creative arts, namely- Traditional Mysore painting art and Janur Art. Two teachers who were experts in these arts were recruited who coordinated with our special educator to teach these skills to the autistic boy.

Results: Over a period of 6 months, the adolescent was able to master the craft and at the same time, there was a marked reduction in hyperactivity, echolalia, improvement in eye contact and better socialization.
The outlined behavioral strategies, can be creatively executed when caring for children and adolescents with ASD. The most important part is the preparation and plan devised in collaboration with the family prior to the visit. Every child with ASD is unique, and implementation needs to be individualized with different combinations of techniques for each child and family 2. The concept of "forewarned is forearmed" is key to effective strategies. The schools should develop effective pre-vocational skills for adolescents with autism and aim for achieving an independent living.

The keynote to achieving success in these children is a multi-faceted and in depth approach on part of therapists and the transformation of caregivers from despairing individuals into co-operative and concerned people, thus ensuring that transfer of learning takes place. A combination of factors like networking, enriched atmosphere, informal set-up, personal attention and intuitive application of learning principles have been responsible for the positive results.
References :
  1. Special education monographs No.4, Students with Autism, Special Education and Provincial Schools Branch, April 1990 Ontario.
  2. E.Schopler, J. Olley, "Comprehensive Educational Services for autistic children, the TEACCH Model", in Handbook of School Psychology, Wiley 1982.
  3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., rev. Washington, D.C. : American Psychiatric Association, 1987.
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