BECOMING A THERA-PARENTS

BECOMING A THERA-PARENTS

This switch to the virtual world- a world with laptops, Google calendars, and multiple conference calls hasn’t been easy for anyone. For our children on the spectrum, our staff wondered what would come of this switch. Would the children respond to video calls? Would they learn new skills? Would they even recognize us? Online learning had never been tried, and now when we were, it was the entire school- all 30 teachers and children, being put in this virtual boat together.Little did we know that there were more people aboard this boat, ones who were helping us teachers row back and forth, and keeping us steering ahead. Our parents and families have truly been a guiding force during this pandemic. They have taken this change in their stride, and helped keep our metaphorical boat, full of interventions, moving. As teachers taught through the screen and got creative with digital assignments and activities, parents and caregivers became our hands and ears and navigated their child towards acquiring goals through prompting and corrective feedback.It has not been easy, for families, by any means. In the times of work from home, parents and caregivers have doubled up as homemakers and breadwinners. They are doing it all- and now they were extending their job description to include behavioral, speech and occupational therapy! We realized, early on, that our ACE TheraParents (therapist-parents!) would need guidance from us just as much as we would need from them. Call it a blessing in disguise, but this virtual space really brought therapist and families together, working in collaboration, for our children with autism.Parent training is a big part of our program at ACE. We started with webinars that went over generating child responses to instructions, navigating challenging behaviors, building communication etc. These were helpful, but rather generic. Slowly, as the students’ programs developed, parents requested meetings and/or specific trainings. These individualized catch-ups really got our boat into a higher gear, as our parents clarified doubts and gave their inputs to better the implementation of the program. A communication program was run with items around the house most familiar to the child, a mathematics program involved counting items present in multiples like glasses and ice cream sticks, and a program on mask toleration was combined with delivering items to different members around the house! Therapist interventions were honed and perfected by our dedicated caregivers in a way that our students were mastering goals faster and with higher applicability.This online space has liberated us from the four walls of the school campus and allowed us to enter the homes of our students through the virtual window. Not only have we gotten a better understanding of how our children with autism thrive in their natural environment, but we have also seen them quickly generalize the skills learned to their homes and communities. None of this would have been possible without our parents, who have now become therapists in their own right!

Neetika Thapan,
Junior Programme Specialist


THERAPISTS TO TELE-THERAPISTS1

THERAPISTS TO TELE-THERAPISTS

Applied behavior analysis (ABA) interventions are the standard of care for individuals with autism spec¬trum disorders (ASD). Typically delivered in-person, ABA interventions can increase adaptive skills and decrease maladaptive behaviors in individuals with ASD, including behaviors that may be dangerous to themselves and others.The coronavirus disease of 2019 (COVID-19) pandemic and measures imposed to curtail its spread have created unprecedented challenges to the continuity of care for our learners with ASD. Providers had to thoughtfully consider if, and how, to continue ABA services when in-person delivery carried a genuine risk to themselves, their staff, their clients, and caregivers. The whole world including the schools, organizations, and individual practitioners had to shift their practice to a virtual service delivery model keeping those considerations in mind. This new normal made it essential for us to maintain a commitment to providing evidence-based practices in our set-up at Autism Centre for Excellence (ACE) as well.When implementing services via Telehealth, we had to ensure that we are using the basic principles of Applied Behavior Analysis (ABA) and its practical application and using technology in teaching. While we were well versed with the former, implementing the latter was a herculean task for us. It wasn’t that we didn’t use technology before but using it as a sole medium to provide services was something that was a learning process for us therapists as well.One of the initial factors that we had to consider when starting the telehealth services was accessibility to technology. Our telehealth modalities were determined by the child’s current needs as well as families’ accessibility to technology. We had to be cognizant of the fact that not every family will have a spare device and high-speed internet for the learners’ sessions. We planned our sessions based on the availability of the device. For some students, we could start the sessions on zoom/ google meet on their laptops and for some, we had to use other mediums like WhatsApp © video calls. Our session planning, the stimuli we used, and our lesson plans were based on what modality of technology we were using for the virtual sessions.In addition to that, we therapists also had to prepare ourselves for using technology for the virtual sessions. Most of us left our work laptops at school on the last day because none of us imagined that we wouldn’t return for six months or more. A lot of us had to upgrade our internet plans to accommodate hours of zoom calls and virtual sessions.A major adjustment that therapists had to make was in terms of making our online programs and activities personalized and fun for our learners. All of us learned about various features of Microsoft PowerPoint and Zoom, the applications we’ve always used. Using hyperlinks on PowerPoint and whiteboard and breakout rooms on Zoom made our presentations and sessions more interactive and learner-friendly. We also learned about the wonderful resource- Boom cards and made our lesson activities on it. We knew our learners were missing going outdoors, so we tried using virtual tours to different places and it was a big hit with the children.Telehealth and virtual sessions have taken teachers’ multitasking skills to another level. At any given point in time, we have our PowerPoint presentations, YouTube videos, Boom cards, Token boards’tab open and we keep switching between the applications during the same sessions. That said, nothing can compare the in-person therapy and the joy of playing with the kids and being able to hug and tickle them.

GUNJAN GUJRAL,
BCBAJUNIOR PROGRAMME SPECIALIST


TRANSITIONAL EXPRESSION: ON FIELD TO ON SCREEN

TRANSITIONAL EXPRESSION: ON FIELD TO ON SCREEN

As we all know, Covid has spread globally and has had a challenging impact on all of us in some way or the other.At Autism Centre for Excellence, wefollow intensive one on one therapy and we never could have imagined that we could teach virtually to our children on the spectrum. Initially, the transition from offline to online teaching felt so foreign. As a therapist, it was definitely very challenging to navigate through this new reality, managing our curriculum and teaching protocols.We work on a wide range of skills from those required for early intervention to working on vocational skills. Our work does not involve disseminating work or assignments but working on core skills like simply attending and increasing in-seat of the child.It was a very different learning experience for me as a therapist, exploring different and creative ways to teach the kids and helping them understand the concept. There were not many apps that focused on the learning of children with special needs. Either the apps had too much information or did not match the skill set of the child. The apps were generic, and we needed something more individualized.It was imperative to create a safe virtual learning space for the kid and help them understand and develop a virtual social presence. Here at ACE, we follow Applied Behavior Analysis (ABA) therapy whichfocuses on principles that bring about meaningful and positive change in behaviors. Its major goalis to increase behaviors that are helpful and decrease behaviors that can interfere or affect learning of the child.Since each child with Autism is unique and gifted with their own abilities and skill set, we design specific protocols and programs for each child catering to their needs. Our initial challenge was to figure out the transition from the one on one in-person therapy to virtual one on one sessions. We began with learning and implementing how to set up the telehealth sessions for our students, from parent training to working on increasing the in-seat and attending towards screen to pandemic specific goals, we worked on all.The sessions in the home setting worked in our favor in the aspect that we planned our programs and activitiesaround house hold things to make it easier and accessible for parents. There are so many opportunities at our homes for practical learning throughout the day that helps a child to generalize the learning, to different contexts. We had counting programs during practical activities like cooking or with vegetables, problem solving and life skill tasks such as sorting house hold items, pairing socks, spreading or folding clothes and cleaning things.This pandemic has been difficult but working with parents and the caregivers as a team on a virtual setup has totally made it possible for us and we surely ACE’d it, seeing our students’progress so beautifully!

Supreet Batra,
Classroom Manager.


TO SCREEN OR TO NOT SCREEN

TO SCREEN OR TO NOT SCREENS

“The ability to learn and communicate visually and virtually can no longer be seen as optional”Each learner has a unique learning need and style. For individuals with Autism Spectrum Disorder or ASD require that little extra guidance and support. Individuals with ASD, thrive on familiarity and consistency. Due to the experience of this unprecedented moment in time,this uncertainty has led to an increase in the level of anxiety of distress. The new normal has been particularly unsettling and difficult for our learners and their respective families LUnderstanding all the complexities involved, knowing some individuals will not have the ability or capacity to engage in traditional online learning formats that are currently being offered through the Zoom/WhatsApp/Google meetplatform. It didn’t stop us from seeing the potential of this novel way of learning style method that had to be explored and bought into the daily routine of our learners and their families.The key element was to have our learner be comfortable the same way he/she was when learning new skills and having fun equally as was done in our physical set up at ACE. Our teaching style for this new e-learning had to comprise each and every nuances involved in maximization of developing and mastering current skills.With the pandemic leaving us with little time to process and prep up with new educational goals for the virtual mode, we started by gaging our learner’s existing repertoire of following instructions, if instruction following was present via the screen and simultaneously if our learners accepted us from a distance. Alongside, their ability to sit and to what degree and have regular sessions had to be taken under consideration too.Having said that, learning via technology soon started with one step at a time. This process was gradually introduced to our learners, keeping in mind the idea of remotely being available to each other. For learners, who were not habituated with screen time interaction with another person, had to be behaviorally shaped and guided to bring about a change in their notion of pre-conceived interaction. With everyday practice, of meeting us face-to-face and with increasing duration, our learners with autism, included us virtually in their everyday routine. Familiarity,had been established through the virtual mode. And it led our learners in their way of a success story.Correspondingly, instructions for every learner had to be personalized for the best possible outcome. Individuals, with a setback of not being able to understand and follow instructions were guided to respond virtually. This involved taking step by step measures and implementation, which at no cost could have been overwhelming for our learners.A sense of familiarity was well paired with the use of visual aids in the sessions. Use of visuals such as picture schedules, mini schedules and if/then cards and stickers incorporated within the session provided a structure to our learners and helped them absorb information coming their way. It motivates them to stay focused and be attentive in their e-learning process. Pictures & words put in these schedules were already A sense of familiarity was well paired with the use of visual aids in the sessions. Use of visuals such as picture schedules, mini schedules and if/then cards and stickers incorporated within the session provided a structure to our learners and helped them absorb information coming their way. It motivates them to stay focused and be attentive in their e-learning process. Pictures & words put in these schedules were already

Iris Basumatray,
Classroom Manager


THERAPISTS TO TELE-THERAPISTS

THERAPISTS TO TELE-THERAPISTS

THERAPISTS TO TELE-THERAPISTS

THERAPISTS TO TELE-THERAPISTS

Applied behavior analysis (ABA) interventions are the standard of care for individuals with autism spec¬trum disorders (ASD). Typically delivered in-person, ABA interventions can increase adaptive skills and decrease maladaptive behaviors in individuals with ASD, including behaviors that may be dangerous to themselves and others.The coronavirus disease of 2019 (COVID-19) pandemic and measures imposed to curtail its spread have created unprecedented challenges to the continuity of care for our learners with ASD. Providers had to thoughtfully consider if, and how, to continue ABA services when in-person delivery carried a genuine risk to themselves, their staff, their clients, and caregivers. The whole world including the schools, organizations, and individual practitioners had to shift their practice to a virtual service delivery model keeping those considerations in mind. This new normal made it essential for us to maintain a commitment to providing evidence-based practices in our set-up at Autism Centre for Excellence (ACE) as well.When implementing services via Telehealth, we had to ensure that we are using the basic principles of Applied Behavior Analysis (ABA) and its practical application and using technology in teaching. While we were well versed with the former, implementing the latter was a herculean task for us. It wasn’t that we didn’t use technology before but using it as a sole medium to provide services was something that was a learning process for us therapists as well.One of the initial factors that we had to consider when starting the telehealth services was accessibility to technology. Our telehealth modalities were determined by the child’s current needs as well as families’ accessibility to technology. We had to be cognizant of the fact that not every family will have a spare device and high-speed internet for the learners’ sessions. We planned our sessions based on the availability of the device. For some students, we could start the sessions on zoom/ google meet on their laptops and for some, we had to use other mediums like WhatsApp © video calls. Our session planning, the stimuli we used, and our lesson plans were based on what modality of technology we were using for the virtual sessions.In addition to that, we therapists also had to prepare ourselves for using technology for the virtual sessions. Most of us left our work laptops at school on the last day because none of us imagined that we wouldn’t return for six months or more. A lot of us had to upgrade our internet plans to accommodate hours of zoom calls and virtual sessions.A major adjustment that therapists had to make was in terms of making our online programs and activities personalized and fun for our learners. All of us learned about various features of Microsoft PowerPoint and Zoom, the applications we’ve always used. Using hyperlinks on PowerPoint and whiteboard and breakout rooms on Zoom made our presentations and sessions more interactive and learner-friendly. We also learned about the wonderful resource- Boom cards and made our lesson activities on it. We knew our learners were missing going outdoors, so we tried using virtual tours to different places and it was a big hit with the children.Telehealth and virtual sessions have taken teachers’ multitasking skills to another level. At any given point in time, we have our PowerPoint presentations, YouTube videos, Boom cards, Token boards’tab open and we keep switching between the applications during the same sessions. That said, nothing can compare the in-person therapy and the joy of playing with the kids and being able to hug and tickle them.

GUNJAN GUJRAL,
BCBAJUNIOR PROGRAMME SPECIALIST