You are not covered!

Usually this is an information blog, however, when I look back what happened to me today I decided I needed to write about this experience.

When I did my doctorate thesis, I did it on the difference in special education in the US vs Oman. This unfortunately is another slap in the face for Omani parents with special needs children or children with learning problems.

My son had an appointment this morning with Dr. Laura Do Vale, one of the leading psychologists in Muscat for children with learning disabilities and for children with other handicaps.  While I am a Dr. in educational psychology, I choose not to assess my own children. So my son’s pediatrician had recommended Dr. Laura.

We are covered by one of the largest insurance company in Oman- however when I went into the clinic they informed me that educational testing, IQ testing and behavior therapy are not covered under his medical insurance. Needless to say, I was shocked.

Then I started to think about the autistic children, children with ADHD and other conditions that need these services. Most children with autism as well as children with severe ADHD need bi-weekly behavior therapies. I was wondering if other parents were having the same problem with their insurance companies.  I asked some parents at the center, they said absolutely these services are not covered with their insurance plan. Either they have to take them to government hospitals or pay large sums of money at private hospitals and clinics.

In the United States, most HMOs or insurance companies are paying for psychological services for children that have been diagnosed with a learning difficulty or a handicap?  It is very frustrating to parents in Oman that this service is not being covered by insurance companies in the Sultanate. It is another step backwards for special education in Oman.

The insurance companies here need to look at the situation for special education students and cover this part of their medical. This is a very imperative part of the success of a child with learning disabilities and most important for an autistic child. The child needs mass sessions of behavior therapy and the parents need the guidance of a experience child psychologist.

Activites for special education children

Here's some good and fun activities suggestions for autistic children, However, most of these activities can be used for all special education children.

1. You could play with him in a swimming pool. Make a splashing game or a kick game. Get some simple pool toys or beach toys like beach ball, floating rings, etc. Sing a song so he could swim with the beat and feel relax. Remember to keep a good eye on the child while in a pool.

2. In a class, you could print out some pictures of eating, sports, going to the bathroom, sleep and everything that may happen in his daily life. Let him make a schedule for himself, he should like this activity, because children with autism take constant schedules very seriously. And if the schedule they followed everyday is broken, it will ruin their day badly.

3. Big tupperware items filled with rice or beans will be fun, you can put little toys in them and have the autistic child put his hand into the rice or beans to find them. The game could make a mess, but they would love it.

4. Sensory play is widely suggested, too. You could take the child to a children's museum if there's one nearby. Commonly, there will be something that could interests the child.

5. Structured activities with a clear start, middle and end are always good for children with autism because they like rules, organization and structure. Gymanasitics is a common game that autistic children do well at since there is less reliance on language(children with autism often have little communication skills) but a lot of motor movement and imitation.

6. If music can calm the child down, you can introduce different instruments to him, with some music playing gently in the background. You can let him beat a drum and learn different rhythms.

7. There are some therapeutic horse riding groups that you can participate in, children can learn to feed and take care of horses in their lessons.

8. Every child with autism is different, you should find out his likes and dislikes and continue to do the things he seems to enjoy.

Learning difficulties vs Mental retardation

To be considered mentally retarded (MR), a person's general intellectual functioning is well below average. People with this diagnosis have an intelligence quotient (IQ) of around 70 or less. People with mental retardation also have a significant impairment in the ability to handle the demands of daily living. This condition clearly has an impact on learning, communication, self-help skills, and social skills, during play or in a work setting. The degree of difficulty can range from mild to moderate to profound. According to federal government statistics, about 1 out of every 100 people is mentally retarded, although some place this figure as high as 3 percent. Mental retardation is slightly more common in males than in females. It occurs in people of all racial, ethnic, educational, and economic backgrounds.

In contrast, a learning disability (LD) is regarded as a disorder in one or more of the processes involved in understanding and using spoken or written language. Learning disabilities show up in different ways in different individuals. They can have problems with visual perception (understanding or remembering what they see), which can make activities like reading letters or copying shapes very difficult. Or they can have problems with auditory perception (understanding or remembering what they hear) or using language to tell or write a story. A learning disability can cause difficulties in math, reading, writing, or spelling. Some people with a learning disability have organizational problems that can affect school or work.

People with learning disabilities generally have average or above-average intelligence. Their learning disability, however, creates a gap between ability and performance. They tend not to do well in environments that aren't suited to their learning style, but they can learn very well when taught appropriately. Learning disabilities often run in families. Fifteen percent of the U.S. population, or some 39 million Americans, have some form of learning disability. About 50 percent of all public-school students in special education have learning disabilities.


LD and MR are two distinctly separate conditions, and the terms are absolutely not interchangeable. If tests scores suggest that your son has a verbal IQ (that is, his ability to use and understand language) of 105, that's right in the middle of the average range. You say, "in all other areas his IQ is a 66." This might mean that his non-verbal skills, (that is, his eye-hand coordination and his visual perception) are extremely weak. This much of gap between verbal and performance IQs (the two major parts of an IQ test) suggests that at some point your son experienced a trauma to his brain that affected the centers that control non-verbal skills. So "by the numbers" he functions like someone with mental retardation in the visual perceptual areas. His verbal intelligence is clearly in the average range. If you blend these two scores together, you would get an overall IQ that would be in or close to the cut-off for mental retardation.

What is Cerbral Palsy

Cerebral palsy (CP) is a disorder that affects muscle tone, movement, and motor skills (the ability to move in a coordinated and purposeful way). Cerebral palsy can also lead to other health issues, including vision, hearing, and speech problems, and learning disabilities.

CP is usually caused by brain damage that occurs before or during a child's birth, or during the first 3 to 5 years of a child's life. There is no cure for CP, but treatment, therapy, special equipment, and, in some cases, surgery can help a child who is living with the condition.

About Cerebral Palsy

Cerebral palsy is one of the most common congenital (existing before birth or at birth) disorders of childhood.
The three types of CP are:

1. spastic cerebral palsy — causes stiffness and movement difficulties
2. athetoid cerebral palsy — leads to involuntary and uncontrolled movements
3. ataxic cerebral palsy — causes a disturbed sense of balance and depth perception

Cerebral palsy affects muscle control and coordination, so even simple movements — like standing still — are difficult. Other vital functions that also involve motor skills and muscles — such as breathing, bladder and bowel control, eating, and learning — may also be affected when a child has CP. Cerebral palsy does not get worse over time.

Causes of Cerebral Palsy

The exact causes of most cases of CP are unknown, but many are the result of problems during pregnancy in which the brain is either damaged or doesn't develop normally. This can be due to infections, maternal health problems, or something else that interferes with normal brain development. Problems during labor and delivery can cause CP in some cases.

Premature babies — particularly those who weigh less than 3.3 pounds (1,510 grams) — have a higher risk of CP than babies that are carried full-term, as are other low birth weight babies and multiple births, such as twins and triplets.

Brain damage in infancy or early childhood can also lead to CP. A baby or toddler might suffer this damage because of lead poisoning, bacterial meningitis, malnutrition, being shaken as an infant (shaken baby syndrome), or being in a car accident while not properly restrained.

Diagnosing Cerebral Palsy

CP may be diagnosed very early in an infant known to be at risk for developing the condition because of premature birth or other health problems. Doctors, such as pediatricians and developmental and neurological specialists, usually follow these kids closely from birth so that they can identify and address any developmental delays or problems with muscle function that might indicate CP.

In a baby carried to term with no other obvious risk factors for CP, it may be difficult to diagnose the disorder in the first year of life. Often doctors aren't able to diagnose CP until they see a delay in normal developmental milestones (such as reaching for toys by 4 months or sitting up by 7 months), which can be a sign of CP.
Abnormal muscle tone, poorly coordinated movements, and the persistence of infant reflexes beyond the age at which they are expected to disappear also can be signs. If these developmental milestones are only mildly delayed, the diagnosis of CP may not be made until the child is a toddler.

Preventing Cerebral Palsy

In many cases the causes of CP are unknown, so there's no way to prevent it. But if you're having a baby, you can take steps to ensure a healthy pregnancy and carry the baby to term, thus lowering the risk that your baby will have CP.

Before becoming pregnant, it's important to maintain a healthy diet and make sure that any medical problems are managed properly. As soon as you know you're pregnant, proper prenatal medical care is vital. If you are taking any medications, review these with your doctor and clarify if there are any side effects that can cause birth defects.

Controlling diabetes, anemia, hypertension, seizures, and nutritional deficiencies during pregnancy can help prevent some premature births and, as a result, some cases of cerebral palsy.
Once your baby is born you can lower the risk of brain damage, which could lead to CP. Never shake an infant, as this can lead to shaken baby syndrome and brain damage. If you're riding in a car, make sure your baby is properly strapped into an infant car seat that's correctly installed — if an accident occurs, the baby will be as protected as possible.

Be aware of lead exposure in your house, as lead poisoning can lead to brain damage. Remember to have your child get his or her immunizations on time — these shots protect against serious infections, some of which can cause brain damage resulting in CP.

How Cerebral Palsy Affects Development

Kids with CP have varying degrees of physical disability. Some have only mild impairment, while others are severely affected.

Associated medical problems may include visual impairment or blindness, hearing loss, food aspiration (the sucking of food or fluid into the lungs), gastroesophageal reflux (spitting up), speech problems, drooling, tooth decay, sleep disorders, osteoporosis (weak, brittle bones), and behavior problems.

Seizures, speech and communication problems, and mental retardation are also common among kids with the severe form of CP. Many have problems that may require ongoing therapy and devices such as braces or wheelchairs.

Treatment of Cerebral Palsy

Currently there's no cure for cerebral palsy, but a variety of resources and therapies can provide help and improve the quality of life for kids with CP.

Different kinds of therapy can help them achieve maximum potential in growth and development. As soon as CP is diagnosed, a child can begin therapy for movement, learning, speech, hearing, and social and emotional development.

In addition, medication, surgery, or braces can help improve muscle function. Surgery can help repair dislocated hips and scoliosis (curvature of the spine), which are common problems associated with CP. Severe muscle spasticity can sometimes be helped with medication taken by mouth or administered via a pump (the baclofen pump) implanted under the skin.

A team of professionals will be needed to work with you to meet your child's medical needs. That team may include therapists, psychologists, educators, nurses, and social workers..

Listen

How Cerebral Palsy Affects Development

Kids with CP have varying degrees of physical disability. Some have only mild impairment, while others are severely affected.
Associated medical problems may include visual impairment or blindness, hearing loss, food aspiration (the sucking of food or fluid into the lungs), gastroesophageal reflux (spitting up), speech problems, drooling, tooth decay, sleep disorders, osteoporosis (weak, brittle bones), and behavior problems.
Seizures, speech and communication problems, and mental retardation are also common among kids with the severe form of CP. Many have problems that may require ongoing therapy and devices such as braces or wheelchairs.

Treatment of Cerebral Palsy

Currently there's no cure for cerebral palsy, but a variety of resources and therapies can provide help and improve the quality of life for kids with CP.
Different kinds of therapy can help them achieve maximum potential in growth and development. As soon as CP is diagnosed, a child can begin therapy for movement, learning, speech, hearing, and social and emotional development.
In addition, medication, surgery, or braces can help improve muscle function. Surgery can help repair dislocated hips and scoliosis (curvature of the spine), which are common problems associated with CP. Severe muscle spasticity can sometimes be helped with medication taken by mouth or administered via a pump (the baclofen pump) implanted under the skin.
A team of professionals will work with you to meet your child's medical needs. That team may include therapists, psychologists, educators, nurses, and social workers.
Many resources are available to help and support you in caring for your child. Talk to your doctor about finding those in your area.
Reviewed by: Steven J. Bachrach, MD
Date reviewed: April 2009

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What is meant by the term "Mental Retardation""?

Mental retardation is a term that was once commonly used to describe someone who learns and develops more slowly than other kids. But it’s not used as much anymore. (However unfortunately,  it is still widely used in the Middle East)
Instead, you might hear terms like “intellectual disability” or “developmental delay.” But all these words mean basically the same thing. Someone who has this kind of problem will have trouble learning and functioning in everyday life. This person could be 10 years old, but might not talk or write as well as a typical 10-year-old. He or she also is usually slower to learn other skills, like how to get dressed or how to act around other people.
But having an intellectual disability doesn’t mean a person can’t learn. Ask anyone who knows and loves a person with an intellectual disability! Some kids with autism, Down syndrome, or cerebral palsy may be described as having an intellectual disability, yet they often have a great capacity to learn and become quite capable kids.
Just like other health problems, an intellectual disability can be mild (smaller) or major (bigger). The bigger the disability the more trouble someone will have learning and becoming an independent person.

What Causes Intellectual Disabilities?

Intellectual disabilities happen because the brain gets injured or a problem prevents the brain from developing normally. These problems can happen during pregnancy, during the baby’s birth, or after the baby is born. Many times, though, doctors don’t know the cause.
Here are some problems that can cause intellectual disabilities:

• There’s a problem with the baby’s genes, which are in every cell and determine how the body will develop. (Genes are inherited from both parents, so a baby might receive genes that are abnormal or the genes might change while the baby is developing.)
• There’s a problem during the pregnancy. Sometimes, the mother might get an illness or infection that can harm the baby. Taking certain medicines while pregnant can cause problems for the baby. Drinking alcohol or taking illegal drugs can also damage a baby’s developing brain.
• During childbirth, the baby doesn’t get enough oxygen.
• The baby is born way too early.
• After being born, the baby gets a serious brain infection.
• Any time in life, a serious head injury can hurt the brain and cause intellectual disabilities. Some of these disabilities are temporary and others can be permanent.

Doctors figure out that someone has an intellectual disability by testing how well the person thinks and solves problems. If a problem is spotted, doctors and other professionals can work with the family to decide what type of help is needed.

Schooling

During school, a student with an intellectual disability will probably need help. Some students have aides that stay with them during the school day. They may be in special classes or get other services to help them learn and develop.
Someone with an intellectual disability often gets help in learning “life skills.” Life skills are the skills people need to take care of themselves as they get older, such as how to cook a meal or ride a public bus to get to work. Adults with intellectual disabilities often have jobs and learn to live independently or in a group home.
Students with intellectual disabilities want to develop their skills to the best of their abilities. They want to go to school, play, and feel support from loving families and good friends.
If you can’t think of anything, just say, “hi.” It’s a little word that could make that person’s day.

ADHD Vs Autism

ADHD Vs Autism
Basically, ADHD (completely known as Attention Deficit Hyperactivity Disorder) is when a person indulges in too much activity to the point that he can no longer focus his attention to a given object or task under normal circumstances. There is a recurrent feature of being impulsive, aside from the common inattention to other things. Impulsive and inattention are two of the most identifiable characteristics of ADHD.
Because these individuals are unable to focus on one task for a prolonged period of time, you’ll almost always notice them shifting tasks and frequently moving about. They really can’t stay in a single place for a long time or else they will become anxious or get bored. Nevertheless, you need not worry that much because if ever your child has ADHD, there’s still a big probability of him outgrowing the condition most especially when he reach the age of twenty and above.
Autism is when a person has poor or underdeveloped social skills. In this regard, the autistic person is not able to clearly interpret or distinguish body language. He is also unable to emphatize with other people. These characteristics are said to be attributed to the absence of mirror neurons in the central nervous system.
Autism is a more complex developmental disorder that affects many developmental dimensions of the individual. When at 3 years old, the child demonstrates certain significant restrictions in communication, interaction and behavior (repetitive) then most likely he is autistic. Sometimes autism surfaces at one year old and other cases even manifest early at birth (although you can’t conclude directly that it is autistic behavior unless there are several tests done). Because there are many dimensions and other variables to be considered, autism is usually very difficult to diagnose.

Autistic children have a hard time developing language. Even if they have already learned some new words, there’s still a big chance of losing such knowledge as time passes by. Autistic children practice a sense of ‘social retreat.’ This means that they are mostly introverted and don’t want to interact with other kids even at playtime. Most of them don’t even want to make eye contact at all. They also have sensory issues like when they identify certain stimuli as addictive (e.g. rotating fan blades). They also do repetitive motions like hand flapping.
It is also interesting to note that many autistic kids are found to have high IQs. Although they have this much mental capacity, they actually have built a ‘world’ of their own which is difficult to penetrate from the outside.
All in all, although both conditions are classified as developmental disorders they still differ in the following aspects:
1. Autism is a more complex problem compared to ADHD.
2. Autism has hallmark characteristics of repetitive behavior, language and sensory problems, and social retreat. ADHD is seen when the individual is impulsive, hyperactive, inattentive and easily gets bored.

Dance and Drama Therapy

Since we are in the process of bringing dance and drama therapist to Oman for our center, we would like the opportunity to explain what it is.
These therapies will help special education students improve in many different ways…
DRAMA THERAPY
Drama therapy applies techniques from theatre to the process of psychotherapeutic healing. It emerged as a field in the late 1970’s from hospital and community programs where it was first used with clients to produce plays and later was integrated with improvisation and process drama methods. The focus in drama therapy is on helping individuals grow and heal by taking on and practicing new roles.
Drama and psychology are both the study of human behavior two sides of the same coin. Psychology is the study of thoughts, emotions and behavior; drama actively analyzes and presents the thoughts, emotions and behavior of characters for an audience to see and understand. Much of dramatic literature addresses the psychological, social, and cultural conditions of humanity and, thus, serves as a natural vehicle for actually helping real people with problems more consciously address their problems.
Just as psychotherapy treats people who have difficulties with their thoughts, emotions and behavior, drama therapy uses drama processes (games, improvisation, storytelling, role play) and products (puppets, masks, plays/performances) to help people understand their thoughts and emotions better or to improve their behavior. However, unlike most types of therapy which rely purely on talking (psychoanalysis was, after all, called “the talking cure”), drama therapy relies on taking action on doing things!
The drama therapist is trained in four general areas: drama/theatre, general and abnormal psychology, psychotherapy, and drama therapy. Each of these categories involves a number of required classes, many of them experiential, where one learns by doing, practicing, getting supervisory feedback, and refining skills. In the end, the drama therapist is able to facilitate the client’s experience in a way that keeps the individual emotionally and physically safe while the individual benefits from the dramatic process.
Because there are so many forms that drama can take, drama therapy can be considered a very broad field. The metaphor we  like to use to explain this is to say there is a very big “Drama Therapy Pie” which can be cut into many smaller slices:

The Drama Therapy Pie

Depending on the goals and needs of the student, the drama therapist chooses a method (or several) that will achieve the desired combination of understanding, emotional release, and learning of new behavior. Some methods, such as drama games, improvisation, role play, developmental transformations, sociodrama and psychodrama are very process-oriented and unscripted. The work is done within the therapy session and not presented to an audience. Other methods, such as Playback Theatre, Theatre of the Oppressed, and the performance of plays are more formal and presentational, involving an audience. Puppets, masks, and rituals can be used as part of performance or as process techniques within a therapy session.
Certain techniques: drama games, improvisation, role play, sociodrama, developmental transformations, rituals, masks, puppets and some types of performances involve fictional work. The student pretends to be a character different from him or herself. This can expand the student’s role repertoire (or the number of types of roles that can be accessed for use in real life) or it can allow the student to explore a similar role to one he or she plays, but under the guise of “not-me-but-someone-like-me.” Other techniques, such as Psychodrama, Therapeutic Spiral Model, Playback Theatre, Theater of the Oppressed and autobiographical performances, allow the client to explore his or her life directly. Students will need to have good ego strength to be able to do this kind of non-fiction work because it requires an honest, searching look at oneself.
DANCE AND MOVEMENT THERAPY
Dance and movement therapy is the psychotherapeutic use of movement to promote emotional, cognitive, physical, and social integration of individual. Dance and movement therapy is practiced in mental health, rehabilitation, medical, special educational,  and in nursing homes, day care centers, disease prevention, and health promotion programs.
The dance and movement therapist focuses on movement behavior as it emerges in the therapeutic relationship. Expressive, communicative, and adaptive behaviors are used for group and individual treatment. This is excellent for therapist to use for aggressive children, it is an excellent way of integrating behavior therapy.
Body movement as the core component of dance simultaneously provides the means of assessment and the mode of intervention for dance/movement therapy. 

Pioneering the Body and Mind

• For over 50 years, Dance/Movement Therapists have pioneered the understanding of how body and mind interact in health and in illness.
• Whether the issue is the will to live, a search for meaning or motility, or the ability to feel love for life, Dance/Movement Therapists mobilize resources from that place within where body and mind are one.

Applied Behavior Analysis (ABA)

Applied Behaviour Analysis (ABA)
What is Applied Behaviour Analysis (ABA)?
Applied behaviour analysis, commonly referred to as “ABA” is a systematic method of supporting and/or altering behaviour. It involves studying behaviour (via observation), analysing the steps involved in producing a behaviour, and then teaching or modifying these steps one at a time. The principles of behaviour therapy have been developed through more than 50 years of scientific research.
Key components of ABA are:

• A “functional analysis” of behaviour. This refers to the observation of current behaviours for their frequency as well as the antecedents and consequences of displayed behaviour
• Breaking down desired skills into manageable steps
• Teaching the steps through repeated presentation of skills (these repeated learning opportunities are sometimes referred to as “discrete trials”)
• Collecting data on behaviour to measure quantitative and qualitative changes over time

Examples of ABA applications to a child with autism:

• To teach new skills: Breaking skills into manageable steps to be taught systematically using reinforcement e.g., to teach new functional life skills, communication skills or social skills
• To increase desired behaviours: Positive reinforcement to increase behaviour e.g., rewarding a child to increase staying on-task or to increase their attempts to initiate play in a social interaction
• To reduce inappropriate behaviours: Modification of the child’s environment or redirecting the child to a more appropriate activity e.g., ignoring a tantrum and redirecting the child to a functional activity
• Generalisation of new skills: Teaching skills in various environments to ensure the new behaviour is transferred from one situation or response to several e.g., generalising compliant behaviours from the home environment to various public/ community settings

The application of behaviour principles to learning and performance has been used as a basis of treatment on children with autism and other learning difficulties.In studies on ABA  positive outcomes were specifically noted for peer interactions, classroom behaviour, imitation, self-care, language and daily living skills.
Although behaviour therapy is a method of intervention used for children with Autism, it is also used extensively in the general community. For example, behaviour therapy techniques are used in sports psychology to motivate and train elite athletes, in the teaching of daily skills such as learning how to ride a bike or teaching a child how to brush their teeth, and in the corporate world to enhance staff performance (e.g., workplace incentives or monetary bonuses).
ABA involves the development of individualised programs based on the child’s strengths to help target their areas of difficulties. The programs are implemented in collaboration with families and all other health and/or education providers working with the child. Therapy sessions typically involve a well balanced amount of play time and table task time to develop learning, social and communication skills. The play times make therapy sessions much more fun and, therefore, more motivating for the child. Learning is generalised to various natural environments including day care, preschool or school.
ABA Techniques
The first step in any ABA program is to observe the child and develop a plan to change behaviours. The behaviours requiring modification are observed to determine the antecedents and consequences of the behaviour (i.e., what serves to reinforce or keep the behaviour going). Goals are then formulated to determine which particular behaviours will be addressed in intervention and in what order. The new behaviours will be broken down into smaller steps to teach the specific skills necessary to develop them.
A variety of techniques are used within ABA to teach these skills. Discrete trial learning, Natural Environment Training, Task Analysis, Reinforcements, Prompting and various Visual Supports are some of the techniques employed to teach a skill. Following is a brief explanation of each technique:
- Discrete trial learning is a structured method of presenting learning in systematic drills where the goal is purposefully and rapidly attaining mastery on a skill. It consists of the therapist’s presentation of an instruction, the child’s response, the consequence, and a short pause between the consequence and the next instruction.
E.g.,
Instruction ¨C “Come here”
Response ¨C Child goes to the person who gave the instruction
Consequence ¨C Child gets a hug for complying with instruction
There would then be a pause before another instruction is given.
- Natural Environment Training (NET) is a teaching technique, which uses the skills that your child has gained, often through Discrete Trial Training, and generalises them to the natural environment. The natural environment is that which the child encounters on a daily basis. Therefore, the aim is to teach the child how to learn from their natural setting in the same way that typically developing children might learn. That is, to teach the child to apply and to generalise the skills they learn so that they can successfully interact within their environment in a way that is functional, meaningful and independent.
Natural Environment Training uses the child’s interests to consolidate the skills they have learned. All skills taught in a discrete setting can be generalised to the natural environment. Indeed, many skills are taught most efficaciously within the natural environment e.g., play skills, social skills, and social language skills.
E.g., If a child is playing with a preferred toy train, then the therapist may join in play with the child and begin a conversation about the trains (eg “my favourite train is Percy”), whilst prompting the child to maintain eye contact and provide an appropriate verbal response. In this way, the child is taught how to respond to social conversation cues and how to reciprocate interest and communication. When mastered, the child can then extend their use of these skills to settings such as preschool or school where this kind of interaction helps form the basis of successful, reciprocal peer relationships.
- Task analysis refers to breaking complex behaviours down into their small components/ steps. This technique particularly helps in learning complex, chained behaviours and functional skills.
E.g., The behaviour of washing hands involves the following steps:
1. Turn tap on
2. Wet hands
3. Put soap on hands
4. Rub hands
5. Rinse hands
6. Dry hands with towel
- Reinforcement is a technique used to motive a child to learn. It has been found that reinforcers delivered immediately after a child’s appropriate response will increase the likelihood of that response. Reinforcements can be anything that may motivate a child to want to learn e.g., physical interactions such as tickles and hugs, or tangible rewards such as lollies, favourite toys, or having a break.
- Prompts are used to help children to acquire new skills during the discrete trial learning process. Prompts can be given at the same time as the instruction, during the child’s response or after the child’s incorrect response to show them the expected response.
Examples of various prompts for turning on a tap:
Verbal ¨C “Turn tap on”
Visual ¨C Show a picture of the tap
Physical ¨CTherapist’s hand over the child’s hand to assist the child to turn tap on
Demonstration/Modelling ¨C Having someone demonstrate turning the tap on
Gesture ¨C Pointing to tap
- Visual support is especially useful for individuals that are visual learners and have difficulty processing verbal and/or auditory information. Visual tools facilitate expressive language and language comprehension. They also assist individuals in understanding their social and physical environments by providing structure to explain task expectations or daily events.
What are some of the benefits of ABA?
A major strength of ABA is that it is a systematic approach. There are clear sets of expectations and tasks are broken down into small attainable parts. ABA also helps teach skills such as attention. It can help increase socially appropriate behaviour, including complex behaviours like language. ABA targets consistency in the child’s environment.
Even though ABA does not lead to a “cure” of autism, the application of ABA principles offer a reasonable probability of gains in functioning in areas such as language, play, social and self-help skills. Naturally, there is a range in the degree of treatment outcomes. Outcomes depend upon several factors including age at onset of treatment, quality of treatment, the child’s cognitive capacity and consistency in the home environment. Nonetheless, treatment is designed to bring out the child’s fullest potential, to maximise children’s functioning so that they can develop meaningful relationships with others and to take better advantage of learning opportunities in their homes, schools, and communities.
What are our philosophies regarding ABA?
At CCR we believe in a holistic approach to a child’s intervention program. We believe strongly in working in collaboration with parents and other professionals to help maximise the child’s potential. In our center, we work closely with Speech Pathologists, Occupational Therapists and Educational Psychologists to develop comprehensive and individualised programs for the child. (IEP)
At CCR we believe that treatment should be fun for children, families and therapists. It is important that therapy is a positive experience for the child. In creating a positive learning environment, the child will be more motivated to participate in therapy sessions and, therefore, to learn and develop skills taught.
At CCR we believe that parents play a pivotal role in their child’s therapy. Therefore, we would like parents to be as closely involved as possible in their child’s therapy programs e.g., we believe in training parents to work as therapists with their own child, where possible. This helps parents to gain a better understanding of their child’s skills as well as how to support their child’s daily development.
For more information: Contact 95307344
www.ccr-oman.com

Understanding Dyslexia

Dyslexia is a type of specific learning difficulty (SLD) in which the person has difficulties with language and words. The term dyslexia, although still used by some, is generally felt to be too narrow and SLD is often used to describe these learning difficulties. This is because the learning difficulties are usually broader than just reading difficulties; most children with SLD also have difficulty with spelling.
The most common characteristic is that people have difficulty reading and spelling for no apparent reason. The person may be intelligent, able to achieve well in other areas and exposed to the same education as others, but is unable to read at the expected level. Common problem areas include spelling, comprehension, reading and identification of words. Estimates vary, but up to five per cent of the population are thought to have dyslexia.
Despite intensive research, the exact causes remain unknown. While most people affected eventually learn to read, they may have severe spelling problems unless they get support and specialised education. Dyslexia isn’t a symptom of low intelligence. For example, Leonardo da Vinci and Thomas Edison – both highly intelligent and creative people – had dyslexia.
Symptoms in preschoolers
Some of the symptoms of dyslexia or SLD in a preschooler could include:

• Delayed speech.
• Problems with pronunciation.
• Problems with rhyming words and learning rhymes.
• Difficulty with learning shapes, colours and how to write their own name.
• Difficulty with retelling a story in the right order of events.

Symptoms in primary school children
Some of the symptoms in a primary school age child could include:

• Problems with reading a single word.
• Regularly confuses certain letters when writing, such as ‘d’ and ‘b’ or ‘m’ and ‘w’.
• Regularly writes words backwards, such as writing ‘pit’ when the word ‘tip’ was intended.
• Problems with grammar, such as learning prefixes or suffixes.
• Tries to avoid reading aloud in class.
• Doesn’t like reading books.
• Reads below their expected level.

Symptoms in high school children
Some of the symptoms in a high school student could include:

• Poor reading.
• Bad spelling, including different misspellings of the same word in one writing assignment.
• Difficulties with writing summaries.
• Problems with learning a foreign language.

Symptoms in adults
Some of the symptoms in an adult could include:

• Reading and spelling problems.
• Doesn’t like reading books.
• Avoids tasks that involve writing, or else gets someone else to do the writing for them.
• Better than average memory.
• Often, a greater than average spatial ability – the person may be talented in art, design, mathematics or engineering.

Phonological coding explained
Written words represent spoken words. In order to read and write, a child has to link the sound of a letter with its written symbol. This is known as phonological coding. The ability to grasp the ‘sound structure’ of words in this way is crucial to reading and writing. Learning to read and write is a slow process, because written letters have no direct and obvious correlation with their sounds. For example, you can’t guess how to pronounce the symbol ‘b’ just by looking at it – you have to rely on your memory. It is thought that dyslexia could be a problem with phonological coding. One of the early symptoms may be the child’s inability to learn or understand rhyming words.
A range of theories
The exact causes of dyslexia remain unknown, but theories include:

• Problems with phonological awareness (distinguishing the meaning of contrasting speech sounds).
• A person with poor phonological awareness has trouble with their short-term memory for spoken words, which means they tend to forget instructions or word lists.
• Problems with the visual, auditory, linguistic or neurological processes that are involved with recognizing the written word.
• Reading difficulties tend to run in families, which suggests a genetic link.

Diagnosis methods
Dyslexia or SLD can be hard to diagnose unless the problem is severe. Seek professional advice from a specialist educational psychologist if you think you or your child may have dyslexia. The evaluation may include testing a range of factors including:

• Cognitive (thinking) skills
• Memory
• Vocabulary
• Literacy skills
• Intellectual ability
• Information processing
• Psycholinguistic processing.

An evaluation by a speech pathologist may also assist.
Contributing factors
It is important to remember that not everyone who has trouble with reading and writing is dyslexic. Similarly, some of the reading and writing difficulties of someone with dyslexia may be caused or worsened by other factors. Some of the contributing factors that are taken into account during the evaluation could include:

• Health – for example, the person may have health issues that have interfered with their language development and writing ability, such as deafness or visual problems.
• Language – for example, a child from a non-English speaking background usually takes longer to master speech, reading and writing in both languages.
• Education - the person may have missed out on educational opportunities; for example, a chronic illness may have kept them out of school for long periods of time.
• Behavioral or developmental disorders – for example, the person may have attention deficit hyperactivity disorder (ADHD), which can cause learning problems.

Treatment options
There is no cure for dyslexia, but the person can benefit from specialized support, which could include:

• One-to-one tutoring from a specialist educator.
• A phonics-based reading program that teaches the link between spoken and written sounds.
• A multi-sensory approach to learning, which means using as many different senses as possible such as seeing, listening, doing and speaking.
• Arrangements with the child’s school – for example, for them to take oral instead of written tests.
• Learning via audiotape or videotape.

Where to get help

• Your doctor
• Specialist educational psychologist
• Your child’s school
• A speech pathologist.

Things to remember

• Dyslexia is characterized by difficulties with reading for no apparent reason.
• One of the early symptoms may be the child’s inability to understand rhyming words.
• Dyslexia or SLD can be hard to diagnose unless the problem is severe, so seek professional advice from a specialist educational psychologist.

Can my child have autism??

Parents want to know that their child is healthy and growing in the right ways. As their child grows,  the parents hope that their child’s language, thinking, social and emotional skills are developing exactly as they should. Parents naturally watch how their babies grow  and develop and also know what they are and aren’t able to do. But, how can parents know if their child is developing as they should?
Doctors look at the growth of a child. They compare a child’s abilities to those of other children around the same age. They look at a child’s progress in developmental areas during certain time frames, meaning physical skills, language, social skills, emotional development, and thinking skills. There are no specific deadlines for when a child should have developed certain skills. But, there are certain time periods or time frames for when a child should be able to first speak, stand, and be able to follow one- or two-word directions, and so on. These are called developmental milestones. One developmental milestone is when a child first learns to walk (the average is around 12 months; but it can happen any time from 10 to 15 months).
Parents need to know what is expected in typical or average development. There are several main skills and behaviors to look for in children around 3 months, 7 months, 1 year old and so on. Talk with your child’s doctor and learn what you should be looking for as your child grows. Write down anything that doesn’t seem right to you or that you may have questions around. Always use your judgment and follow your instincts. You know your child better than anyone. If you have a concern, get help.

Autism and PDD

Autism, Attention Deficit Hyperactive Disorder (ADHD), Pervasive Development Disorders (PDD). We hear these terms about children almost regularly now. Once mysterious and hardly spoken of, these disorders are now a main focus in around the world. Parents, doctors, and teachers are now faced with a growing number of children who have autism, ADHD, PDD and other similar disorders. If you are a parent hearing one of these “labels” associated with your child, it can be frightening. It is easy to become overwhelmed and unsure about what to do next and how it will affect your child.
So what are these disorders? What does it mean for your child? Autism is a word that covers delays or something that is unusual in a child’s development in more than one developmental area. This means there is a delay of some sort in the areas of: communication/language, social interaction, and behavior. “Pervasive” means there are delays across many areas in a child’s development, not just one.
These kinds of delays are almost always noticeable by the age of 3. Children do not become autistic or have PDD later in life. Autism or PDD can be detected and treated as early as 18 months. For instance, a child may be delayed in his speech, have a lot of difficulty with fine motor skills, and be behind in social skills, and that would be considered in the PDD category. The difference between Autism and PDD is usually in how severe the delays or abnormalities are in a child’s abilities, and how a child functions on an everyday basis.
There are many other kinds of disorders that have similar signs as Autism. Many children have mixed symptoms or may have more than one condition (for example many children with PDD usually have learning disabilities, and may also have speech delays). So getting a full evaluation and proper diagnosis from your doctor is critical. That way, you can get the services that will treat the symptoms your child has, rather than just guessing what the disorder may be.

Signs of Delays or a Disorder

There are some general signs that may mean your child has a delay in development, or has a more specific developmental disorder such as Autism or PDD.
While knowing and observing the typical developmental milestones with your child, also take note if your child displays any of the following signs associated with the possibility of having PDD or Autism.

Social and Communication

• Your child’s speech is not at the level it should be for your child’s age; or your child stops saying words they use to know or has a reverse in speech skills
• Your child’s speech has unusual patterns, such as your child repeats phrases over and over, or only repeats what is said on TV or videos
• Your child’s voice has a high pitch tone or is flat in pitch with no change
• Your child does not point at objects to show interest
• Your child has trouble expressing what she needs with words or gestures

Behavior/Personality

• Your child does not have eye contact when talking with you or others
• Your child prefers to be alone and play alone
• Your child does not like being held or cuddled
• Your child does not seem to be interested in other people
• Your child has many and unusually long temper tantrums
• Your child repeats certain actions over and over (hand gestures, movements)
• Your child has unusual interests (lining up objects, spinning objects)
• Your child has trouble adjusting to changes in routine

Sensory and Motor

• Your child is very sensitive to sounds, the way things feel, taste or look (may react very strongly to them)
• Your child likes being squeezed or hugged very tightly
• Your child runs or bumps into things a lot; is considered “clumsy”
• Your child has trouble with small motor skills such as grasping objects or holding crayons or utensils

Physical

• Your child does not crawl, walk or talk at any of the expected age ranges
• Your child’s vision or hearing does not seem normal
• Your child walks on his toes all the time

Note: These signs only show a possible delay if you see then regularly. Parents, caregivers and other adults who spend a lot of time with children are often the best observers. They can often pick up on behaviors that a doctor may not in a few minutes with a child. A child with any disorder may not show all of associated behaviors or signs. In fact, most will not, because all children are unique.

About Us

Creative Center for Rehabilitation is a private center located in the Sultanate of Oman.

Creative Center for Rehabilitation (CCR) Strives to create and environment which encourages and supports the full  growth and learning potential of children in all areas of development. The curriculum is designed to provide a balance of free choices and organized activities in a nurturing and creative setting.

The primary aim of our program is to develop the whole of the special child. We make use of a child’s natural curiosity to install the desire to learn and to make learning fun and satisfying so a child will continue to seek it out and learn.

We provide the wealth of inter-related experiences that each child needs to develop the body, mind and spirit to meet his or her optimal proformance.

Class session include language development activities, varied arts and crafts pojects, games and play materials for large and small motor skill development, sensory activities, nature and science activities, simple cooking and food preparation projects, as well as other developmental appropriate learning activities.

There is also speech and language, occupational and phyical therapies available for those children that require it.

We take students with the following conditions: (but not limited to)

1. Special Education:

• mild to moderate down syndrome
  

• mild autism
  

• mild to moderate mentally challenged children
  

• Other challenging conditions
  

Children with different learning needs:

• ADD
  

• Mild ADHD
  

• Dyslexia
  

• Other different learning needs