QUALITATIVE ASSESSMENT FOR CHILDREN

WITH AUTISTIC SPECTRUM DISORDER

till 8 years of age

PhDr. Lenka Dzidova

Shumua Al Amal Support Team

.

QUALITATIVE ASSESSMENT FOR CHILDREN
WITH AUTISTIC SPECTRUM DISORDER
till 8 years of age

by

PhDr. Lenka Dzidova

and
Shumua Al Amal Support Team

Dammam 2008 2008

Shumua Al Amal Complex for Special Education and Rehabilitation

Post Office Box 66682

Dammam 31586, Eastern province, KSA
www.shumua.net

Copyright 2008 Shumua Al Amal Complex

All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system or transmitted, in any form by any means, electronic, mechanical, photocopying,
recording, or otherwise, without the prior written permission of the publisher.

Printed in KSA

Qualitative Assessment includes Assessment Forms and Working Sheets.

66682 .
31586

.
Shumua Al Amal provided various support activities and facilities including valuable
support and assistance to produce these documents and best possible format. The following
persons where the main participants who deserve special thanks for their proffesional
help:

Othman A. Al Dobaikhi support of this project;

BS Sadeya Nasser Al Haddad arrangement and translation of Arabic version, reminders

and suggestions, collaboration on the project;

Robert Kaleta, M.A. illustration, photography and design;

Neglaa Hosni Abdul Hameed, M.D. translation;

Members of female autistic section preparation practices and tools;

Parents who agreed with publication of the photograph theirs children.

.

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 CONTENTS

About Author 3

Preface 4

Self-care 10
Gross And Fine Motor 13

Sensory Perception 18

Communication Skills 31

How To Use This Assessment 34

How To Prepare an Individual Plan 36

A Motivation 37

Type of an Assistance 40

How To Write the Observation 42

Bibliography 45

3
4
10
13
18
31
34
36
37
40
42
45

-2-
 ABOUT AUTHOR

PhDr. Lenka Dzidova, Doctor of Philosophy in Special Education in Palacky University -

Czech Republic, Master degree in Education of Children with Special Needs, she has
Certificate of approval to perform an occupation in the health service without professional
supervisory in the branch Clinical Speech Specialist from Ministry of Health of the Czech
Republic, she is Member of Association of Clinical Speech Therapists in the Czech
Republic, Supervisor of Autistic department in Shumua Al Amal KSA.She has worked
as Specialist and Consultant in Neurological Diagnostic Centre for Infants, Center for
Early Intervention Care, Rehabilitation Centre for Severely Handicapped Children, School
for Children with Special Needs, Rehabilitation Spa for adults, in Private General Practice
and Charity Organization for 15 years. She is Lector of courses: Macaton, TEACCH
program, Neuropsychological Approach to Autism, Myofunctional Therapy etc. She is
author of books: Language Intervention Strategies in Frontal Syndrome and Swimming
Preparation of Blind.

PU .



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15 SPA

." " " " .

-3-
 PREFACE

The quality of education for children with

Autistic Spectrum Disorder depends mainly
on how the teachers, parents and others
understand the characteristic of this disorder
and how well they are able to adapt the
environment and style of communication
towards this handicap. The main condition
is theoretical education and practical
training of everyone who is involved in
teaching and caring for these children.

To make this help effective it is necessary

to build it on the qualitative assessment of
individual abilities of each child. Person
who wouldnt follow detailed assessment
when making individual care plan takes a
chance to make expectations too high or too
low. Childs IQ also plays an important
part, as well as level of autism, other
associated disabilities - for example ADHD,
age. We also have to bear in mind the
individuality and uniqueness of each child .
and his learning speed.

There had been many books and articles

written about autism, about diagnostic
methods, behavioral problems and
programmes for care plans. But teachers and
parents need to know how to start working
with a child, what abilities and knowledge
should a child have according to his age and .
what the child needs to know before starting
any education.

During work with autistic children one

needs to have theoretical education as well
as an assessment of all skills which a child .
should manage gradually according to his
age.

According to author the previously published and

described types of assessments were insufficient
when it comes to extent, parts devoted to
fine motor skills were missing as well as
parts for gross motor skills, senses etc. .

-4-
Individual skills were ranged in accordance
with its difficulty but not with details and
they were not accompanied by photographs
and sets of pictures to clarify the text. The
chosen activities were often not applicable .
for children with autism but otherwise
handicapped kids. It was often difficult for
teachers to choose what activity is important .
for a child because these previous
assessments were without details and partial
only.

This book was originated as a response to a

longlasting request for description of
completed qualitative assessment for
autistic children with respect to normal .
psychomotoric development and with
special attention to details.

After detailed study of foreign researches

and surveys and also the longterm
experiences of this book's author and her "
assistants the Qualitative Assessment For ." 8
Children With Autistic Spectrum Disorders
Till 8 Years Old was developed. This
Assessment was made, authorized, verified )
and gradually applied during work with 57 57
autistic children of this age group which (
were assigned to this programme for more .
than two years.

This qualitative approach has its

protagonists as well as opponents and it's
obvious the success lies in hands of a
teacher how well she understands,
chooses, interprets and uses the gained
knowledge in practice. That's why the text is .
completed by detailed instructions to fulfill
the tasks and to record obtained results in
the range of Individual Plan or Observation .
After Semester. Complete picture
attachments are not missing for each
activity of Fine Motor Skills and Gross
Motor Skills. The largest part is devoted to
the photo attachment of the working sheets.

-5-
The text is written with respect towards
Arabic culture, habits, education and needs
and made in unique English-Arabic version. .
This form was chosen to enable access to
information for specialists from other
countries, for common people to check the
results of this Assessment who use only one
from these two languages, for education in .
various international centers etc.

The translation from English into Arabic is

loose to grasp the thoughts so it is not
literal. The authors did not use the official .
form of Arabic language but local language
which is easily understood by children and
is used in pre-school facilities, families. It's .
down to a teacher to adjust the language
regarding to each child.

Pictures from this Qualitative Assessment

can not be used during practical learning,
otherwise the results would not be accurate.
The results of this Assessment serve to
create individual plan of education for each
child. The Assessment doesn't serve for
daily usage. There is an advantage when
different educational facilities use the same .
type of assessment in such case the
assessment doesn't need to be repeated
during child's transfer from one facility into
another.

Qualitative Assessment is not a diagnostic

method but positive or negative results
arising from the assessment should be an
appeal for further diagnostic investigation in .
specialized facility.

Author and her assistants hope this book

will fulfill its mission and will make a good
guide not only for parents and teachers but
also for other people who are interested to
provide quality work with autistic children .
and for people who need to orientate
themselves in this subject.

-6-
Qualitative Assessment is divided into three .
books. First one has its theoretical and
practical part. Second book contains
Assessment forms, blank forms for
Individual Plan and Observation After .
Semester and Appendixes. Third book
contains working sheets and pictures which
can be cut out if needed.

FIRST BOOK

Theoretical part of the first book contains

chapters of Self-care, Gross And Fine
Motor, Sensory Perception and .
Communication Skills these subjects were
chosen by the authors for detailed analytic
description because these are often missed .
or not having the needed attention.

Self-care part contains detailed work

management in the programmes ABA or ABA
TEACCH simply because there were
frequent questions from parents and .
teachers regarding the correct technique. .
This part refers to the appendixes of the
second book.

Gross and Fine Motor part explain certain

rules in the motoric development which .
needs to be considered. It's always
necessary to find out the baseline for further .
practical activities. The individual stages of
practice can not be left out or changed over.
This part also describes the most frequent
problems of motoric development. The final
part is devoted to movement stereotypes, .
theories of why they appear and prognosis
of their removal.

Communication part is described in details

out of experience with often not suitable
start of speech therapy and practice without
really understanding a child. Authors often
mention typical language regress of autistic
children, also the use of alternative type of
communication, differences between verbal .

-7-
and nonverbal communications and in
which case is a child ready to begin
successful speech therapy.

The practical part of the first book is set :

up from chapters How To Use This "
Assessment, How To Prepare An " "
Individual Plan with a reference to the " "
appendixes of the second book, "A ."
Motivation", Type Of Assistance again
with reference to the second book, How To
Write The Observation with same
reference once again to the second book.

Author find it very important to place in

here chapters Motivation and Type Of " " " "
Assistance whose use is necessary for .
practice of individual skills.

SECOND BOOK

Second book contains Assessment forms of: "" :

Self-care which was differentiated 3 1,5 )
according to age (for children 1.5-3 years ( 8 3
and 3-8 years old), there are also chapters of :
Fine Motor Skills, Gross Motor Skills,
Sensory Perception, Cognitive Skills,
Communication Skills, Academic
Skills, Other Skills. All skills are
arranged by difficulty starting with the
easiest and ending with the most difficult.
The book contains also Appendixes .
involving Self-care: Sequence At Dressing,
Recording Sheet For Self-care, TEACCH-
Sequence Of Self-care.

There are also Appendixes with

photographs for the parts Fine Motor Skills,
Gross Motor Skills and Sensory Perception.
The part Cognitive Skills has larger .
Appendixes: the Macaton, introduces the "" :
most common signs used for skills " .""
Response To Orders and Understanding "
Verbs, other appendixes are Movements .
During The Song Lets Go My Friends, .
photo Appendix for Cognitive Skills and . " "
"Recording Sheet for Type of Assistance".
Assessment of Communication Skills

-8-
provides also photo Appendix Story Of
The House. Other skills in Assessment are .
accompanied by the Appendix "TEACCH -
Organization Of Places". Final chapter of
the second book contains blank form for
"Individual Plan" and blank form for
"Observation After Semester".

THIRD BOOK

Third book contains Appendixes of

"Cognitive Skills", "Communication Skills",
"Academic Skills" and "TEACCH Cards".
First three appendixes are made of working
sheets and labeled by the name of each skill,
these working sheets contain pictures that
can be cut out if needed. Last Appendix is .
made for setting up daily schedule
according to each individual activity in the
TEACCH programme.

-9-
SELF-CARE
When a child has a problem for example
with toilet training, eating and so on it is
necessary to prepare for him special
program of teaching him these skills.
Psychologist will work up this plan in terms ABA
of ABA program. Teacher or parent teachs
the child according to this program and .
psychologists advices.
There are some rules for self-care training
which we have to take into account before :
initiation:
v every skill has to be analysed on v
individual steps in sequence to be )
easily practiced by the child (see ;(A
Appendix A);
v individual steps have to be suitable for v
childs age (e.g. we teach children less 3 : )
than age 3 to only move toothbrush in
the mouth without refusal but older
children have to learn cleaning front,
lower and upper teeth completely); .(
v we start with providing some effective v
help for the child within training; .
v we have to prepare particular schedule . v
with individual sequential steps.

SHEDULE OF SELF-CARE SKILLS

We have to prepare schedule with

individual steps appropriate for childs age
and put it on noticeable place inside the (... :)
room (e.g. bathroom, dining room).We
continue in accordance with this sequence
every day and we should not leave out or
reverse any step. We write every day which
of helps we used. For achievement of
success we have to use same plan at home .
and in kindergarten.
First three days we provide to child physical
help (i.e. our hands catch his hands and do
together with the child all steps from .
beginning to the end).

- 10 -
Then we write these types of help (i.e.
physical help = P) into the schedule (see ) ""
Appendix B1, B2). (
) (B2, B1-
Fourth day we repeat all these steps with
physical help but the child has to do the last
one independently. We write type of help
= again (all physical = P, one independent )
I). =
= ( .
If we are sure that the child does the last
step independently then we can give him
next day chance to do last 2 steps
independently. We continue and the next
day give him physical help up to last 3 steps
and so on. All the time we proceed with our
help from the end to beginning up to
achievement of independence. .
Sometimes the child can do all steps
independently only one from them not (e.g. ) :
wash hands with a soap). In this case we (
have to choose some of help for this child ) :
(e.g. we can start to help him with verbal
help, if is this help insufficient we can
offer to him attention help, next imitation, (.
up to physical help).
This schedule helps other people who work
with the child. They can teach the child in .
the same way as parent or teacher (e.g.
teacher is sick, mother is at work). It
shows us which step is difficult for child
and how we can help him. The child learns
more quickly then before according to this
organization and mother or teacher
remember this sequence and should not
work spontaneously.


.
This method is initially difficult due to large
a quantity details. However we can observe
later that the child acquires all new activities
faster because he understands organization .
and sequence.

- 11 -
Programs ABA and TEACCH are focused on ABA TEACCH
organization and sequence of self-care skills.
Different between these programs is that ABA
ABA depends on choosing of suitable type
of help and time for changes this help. . TEACCH
TEACCH is based on using of visual help. )
(real objects, pictures, words) for sequence (
of individual steps (see Appendix C). ) .(C

Some of parents or teachers dont know

which program to use for their child. It
depends on the child and level of his )
abilities (as visual attention, gross and fine
motor skills, problematic behavior caused
by sensory needs, cognitive skills and so (.
on).

- 12 -
GROSS AND FINE MOTOR
The development of gross and fine motor is
always linked to the mental development.
If the child controls his body, walks, grips
or drops the objects on purpose then he
developes his functional intelligence. After
reaching of certain level of motor
development and cognitive skills, the child
is ready to start communicating. If the child )
is not able to imitate a gross movement then (
he is not able to imitate fine movements of .
articulatory apparatus (put out the tongue,
blow) and his development of the speech
will not continue successfully.

There are certain rules in the motor :

development:
v gradual control of particular parts of v
the body while growing of the child: :
from the head to the heel (the )
child raises his head, neck,
lumbar region while sitting, later ;(
he crawls on his knees, finally he
stands on his feet);
from the center of body to the )
periphery (the movements of
upper limbs start from shoulder
to the wrist and fingers, the
movements of lower limbs start ;(
at hip joints and continue to the
feet);
from the side of little finger of
the palm to the thumb while )
keeping active hold (the child
holds the object in the whole .(
palms, later between thumb and
other fingers, then between
thumb and index finger).
v alternative interdigitation of : v
neuromotor functions: the child
reaches a certain level of perfection and
then he goes back to the previous way to
be able to overcome actual performance
and progress to higher level. This
occasional regression means chance .
given by nature to the child to be able to
strengthen his abilities to get ready for
further development.

- 13 -
v functional assymmetry: gradual : v
specialization of right and left side of : )
the body on higher level (e.g. smaller
child uses both hands for drawing, later
he uses right hand only and his drawing (
is better than previously).
v individualization: every child is unique : v
with an individual way of growth, every
child is different and has specific )
characters since being born up to the . (
adulthood (we cannot compare one child
with another because they cannot be the
same).
v self-regulation: the development is a : v
process of the advancement to higher : )
level while the progress in each field is
not smooth and steady (e.g. the child (
can sit, crawl but he has problem with .
walking). We can see variations that are
driven by the child himself while getting
to higher level.

MOTOR DEVELOPMENT AND

LEVEL OF MOTOR

In practice we may see various

developments of the motor as well as
various levels of motor abilities: :
v the motor development is late and it is v
first reason for concern. Abnormal in the .
first year of life are hypertonia
(increased muscular tension) or
hypotonia (decreased muscular tension).
The parents do physiotherapy with some .
children on the basis of recommendation
of the neurologist.
v incoordination of fine and gross motor. . v
The walk of children is unsteady, they
often fall, they have problems with the
change of the posture, keeping the : )
balance etc. (e.g. the children at the age
of four have marked troubles with the
riding of the tricycle or bicycle.

- 14 -
 At preschool age they have problems
such as gripping a pen, manipulation
with fine objects, construction of cubes,
self-care activities such as buttoning up, ...
use of cutlery... They are anxious while
doing some activities such as walking .(..
on the bench, walking downstairs etc.).
Incoordination is attached to the .
dysfunction of the cerebellum.

v good motor development is in contrast v

with the development of speech and .
other mental abilities.We can see this at )(
children with ASD who are mute. These
children are very skillful, they manage
the self-care well. The level of their 2 1
motor abilities at the age of four .
corresponds to the norm but other skills
are at the level of 1 to 2 year old child.

v the motor development and motor level v

is slower in many fields. The abilities
are not developed equally but the motor : )
development is in accord with other .(
functional skills of child (e.g. a child
walks late, he listens to orders late and
he speaks words late too).

v the motor development is unequal. v

Children manage some of skills in
accordance with the norm but they have :
problems with the other skills. For
example they don't have problems with
movements such as eating with a spoon,
getting dressed, riding a bicycle, but
they do show marked difficulty while
learning new skills. Some children write )
numbers and letters novely, build cubes, .(
take an alarm oclock into parts and put
together these parts again but on the
other hand they fail in simpler
developmental activities such as eating
with spoon, stringing beads or cube
construction etc.

- 15 -
Concerning the level of motor activity,
some children are passive, slow, they react
with a longer latency, they like roll over,
lounging. On the contrary, the others are
hyperactive, impulsive with sharp
movements. Their impatience causes : )
inaccuracy and incorrect motor performance .(
(e.g. spilling of liquids, tripping).

ABNORMAL MOVEMENTS :

There are repetitive movements and

stereotypes at children with ASD. Those are
often pivotal for the diagnosis. We can .
observe shaking or flapping movements of
hands in front of the face of the child that is
fascinated by that. Long-lasting stereotypes
appear while the child is nervous as means
of comfort. These movements can also serve
to spend childrens free time and they may .
also be the only activity that can be used by
children to spend their free time. Many
children accompany stereotypes with the )
objects manipulation (turning toy-cars, .(
longish objects shaking, small objects
spilling).

In accordance to the existing theories, the

reason for the stereotypes may be: :
v keeping mental balance when the child v
is bored (e.g. body swinging); ;( )
v filter to reduce a lot of stimuli from v
outside when the child is overloaded )
with them (e.g. runnig away and ;(
back);
v to reduce anxiety and tension when the v
child is stressed or excited joyfully ;( )
(jumps, shaking movements of
hands);
v learned behavior (the child gets more v
attention while making stereotypes or it
may help to avoid the demand by
showing this behavior); ;(
v chemical processes in brain (the ) v
behavior is used on purpose in an effort
to reach a chemical status in brain that is
caused by this way of behavior and that
is pleasant for the child or the child is
dependent on it e.g. head-banging...). .(

- 16 -
 It is possible to interrupt some stereotype
behavior by diversion of childs attention to .
another activity.

Stereotypes tend to reduce with the increase .

of age. We may often speak about reflective
behavior that is controlled by lower brain ) :
structures (e.g. a child shakes or rotates a (
spoon). The children learn to work
independently step by step and they ) :
concentrate on the basic doing (e.g. we (
teach the child imitate movement with
spoon and use it). Then these activities
move into the control of upper brain
structures and the stereotypes are less ) : (
common, sometimes they completely .
disappear (e.g. if the child can use a spoon
his stereotypes will be less frequent).
Practice of functional abilities such as self- .
care skills, fine motor skills, writing and so
on also helps to improve.

Motor jerks (e.g. grimaces, blinking, jerky )

movements of limbs) are not suggestible
by the will and they do not disappear while (
diverting an attention. Their suppression is
temporary only, the reaction to this is just
escalation of the eigenstress (e.g. if the child
has unusual movements with hand and we ) :
bind his hand with a string his motor jerks
will more marked like before).
(.

At some particularities such as tiptoeing is

important orthopedical care and special
exercises (e.g. barefoot walking on various )
bottoms, gripping objects with toes, imprint
coloured, feet imprint into the plasticine,
walking on the bench, across the obstacle,
feet massage etc.).
(.

- 17 -
SENSORY PERCEPTION
We can observe some special behavior of
children with ASD often but this behavior
isnt related to typical problems in social
behavior, communication and imagination.
We can call these manifestations
perceptional disturbances. .

Perception is the process which a person

obtains information from the environment
by senses and its related nervous centers. .

Senses are organ's systems that make

possible to obtain an information from the : )
external (e.g. we can hear a car) and internal .(( )
environment (e.g. we are hungry).

Receptor is a cell, a group of cells or organ :( )

whose function is: :
v detecting condition (e.g. we cannot read ) v
letters in dark room but our eyes are (
OK) and changes (e.g. we feel cold )
because outside is snow and we arent
dressed well, but we are OK not sick) (
from the external and internal .
environment
v inform about them higher nerve centers v
- especially brain
v direct response (e.g. in first case our ) v
eyes will react by dilatation of pupils, in
the second case we will have goose-
skin). .(
Receptors respond to certain specific ) (
stimulus and change it into nerve impulse
which travels to the specific region of brain
or spinal cord where there the stimuli are
further analyzed, associated, they may be
perceived or they may automatically invoke .
an answer reflex.
A human organism registers except a classic
five senses (vision, hearing, touch, smell, ) (
taste) also pain, change in temperature,
movement (such as stretch, pressure or
vibration), monitor body position, force of
gravity, balance and row of other that we
may not perceive knowingly but they are .
necessary to his correct function.
- 18 -
A special sense is localized in a special
sense organ: :
v vision from receptors in the eye v
v hearing from receptors in the internal v
ear
v smell from receptors in the upper nasal v
cavities.
v taste from the tongue receptors v
v balance from receptors in the internal v
ear
A general sense are: :
v touch, pressure, temperature and pain v
from receptor in the skin and internal
organs .
v sense of position from receptors in the v
muscles, tendons and joints. .

Inclusion of sensory perception into

assessment is important for differentiation
and understanding of causes, that are
connected with typical behavior of children
and according to these causes it is possible .
to help and easily choose a suitable
therapy.

We can observe anxious up to panic

reactions, avoidance behavior, outbreaks of
anger and shouting, strong expression of
displeasure and so on. The child exhibits
unusual, repetitive or not meaningful
response to visual, auditory (hearing), .
tactile (touch), olfactory (smell), gustatory
(taste), kinesthetic (movement) stimuli. The
child's behavior differs from high levels of
activity and responsiveness to low levels.
Children aim to increase of sensory
stimulation or its reduction so they feel .
more comfortable. These typical behavior
differences cause by sensory needs.

Children with autistic spectrum disorder

have dissimilarities in: :
v the special way of perception . v
v hypersensitiveness or hyposensitiveness v
of sensation .
v unusual interest up to fascination of v
specific sensory stimuli. .

Hyposensitivity is reduced by pedagogical

- 19 -
practises. .
Hypersensitivity is loosed mostly with age

spontaneously. Various behavioral
techniques help to reduce it (work of
psychologist). .

Self-stimulatory activities may be utilized

such as resource of motivation.

)VISION (eye sight ) (

Children with autistic spectrum disorder

show varying degree of abnormality in eye .
contact.

They often can't use sight in common way

although they haven't associated any
specific eye defect. A way of their
observation can be different. We can notice
that a child holding an object close to his
eyes and scrutinizing it carefully may give
the impression that the child has poor .
vision. Some children hold objects close
others at arm's length. A number prefer to .
hold the objects on the periphery of their
visual fields. .

For children with ASD it is very difficult to

make eye contact with most people. They
make better eye contact with familiar people
than with unfamiliar people. They will
make eye contact fairly regularly but
usually only briefly and only when they .
want something.

Typical eye contact has problems with

overshooting, losing the target, finding
objects again and difficulty in changing
direction. Child's sight is often accompanied
by squinting, inattentiveness, fixed staring.

.

Watching the child's eyes as they follow the

object and their movements with a
stabilized head (children try to move the ) (
head instead of the eyes) in different .
directions is important for choice of
adequate practises. Some of children can't .

- 20 -
recognize an object by sight but they can
recognize it by using other sense.

Children may be fascinated with color

patterns, lights, smooth objects, shapes, the
configuration of letters and numbers, to
objects with a strong horizontal axis such as
long flexible string, belt, rubber band or .
blade of grass. Other preferred objects that .
can be wiggled.

We have to get the result from the

assessment at the preparation of individual
plan and adapt the environment of the child .
and individual practises in the appropriate
manner.

We can make practises for hyposensitive

child with different kind of lights for
example in dark room. Lights are located on
walls or suspend from ceiling, blinking and
moving lights. We can begin teach a child
to watch slow movements like e.g. bubbles,
falling objects inside long tubes and step by
step moving objects with sounds and lights
at the same time and so on. .

During work with hypersensitive child it is

important not to change lighting, use
subdued lights, avoid of blinking stimuli or
utilize other senses (recognition of subjects )
by sounds, touch, smell) at training. (...

We can utilize a self-stimulatory activities )

to motivation, work with colored pieces of (
glass, with pour materials, sandglass, work
with magnifying glass, magnetic boards
filled with tiny iron filings, magnets, hidden
pictures and so on (see Appendix F). ).
.(F () ...

HEARING (auditory system) ( )

For children with autistic spectrum disorder

it is typical that they don't respond to very
strong stimuli and another time they
respond to very faint stimulus. For example
child doesn't respond to call his name but he .
clearly respond to jingle on TV or water running.

- 21 -
One of the first things parents may notice
about their autistic child is that he doesn't
respond to sound in the usual way. Some of
children hear only when aren't occupied
with someone's else at the same time. .
Another respond to every even unnecessary
sound in their surroundings.

Hearing is basic for language development.

Auditory requirements consist of analyzing :
the different parameters of sound, such as .
duration, late auditory response, frequency
or tone, intensity, sequence.

Hearing of the children with autistic

spectrum disorder appears to be selective
hearing. Some of autistic children are
hypersensitive to low sounds (drum,
vacuum cleaner...), while others are set off .
by higher pitched sounds (whistle, the cry of
a particular baby and so on).

As autistic children grow up, some discover

that covering their ears works not only as a
portable soundproof barrier to offensive
sounds, but can also help create a buffer
between themselves and new unfamiliar
things they don't want to pay attention too. .
Covering of ears may happen in all
situations that they evoke anxiety. Child
covers his ears even if be no fear of any
hearing stimulus but he feels someway in
danger.

Hyposensitiveness improves with natural

development about third year of age. The
problem is quality of reaction to speech. We
can utilize sound's toys, rhythmic exercises,
longer songs and so on. .

Hypersensitiveness reduces with age.

During a work with child it is important to
lower tone and eliminate sounds as possible
from his surroundings. When a child is able .
to regulate loudness himself he will tolerate .
also loud stimuli. Also methods for
structuring the environment around the
child in a way that minimizes his need to .
cover his ears or use other avoidance behaviors.

- 22 -
We can utilize self-stimulatory activities for )
training of rhymes, songs, with sound toys, (
recognition of subjects according to their
characteristic sounds and so on. .

TOUCH (tactile system) ( )

Tactile information sense is one of first

senses the child establishes to make contact
with surrounding. This information
accompanies him all life and offers him rich
background to cognition of world. Tactile
functions and motor planning are closely
linked. Tactile functions are a sensitive .
indicator of central nervous system
functions.

Sensitivity to touch varies with the number

of touch receptors in different areas. They
are especially numerous and close together
in the tips of the fingers and the toes. The
lips and the tip of the tongue also contain
many of these receptors and are very
sensitive to touch. Other areas, such as the
back of the hand and the back of the neck, .
have fewer receptors and are less sensitive
to touch.

Some children with autistic spectrum

disorder don't like other people touching
them because they can perceive hold behind
shoulder like squeezing. They don't tolerate
touches that are unpredictable. Some of
children don't like hygienic activities like
nail cutting, hear combing and so on. Even .
though the nails do have a sense of touch
like hair, they can be cut without causing
any pain, because we are cutting dead cells.

Children with autistic spectrum disorder

may prefer to touch smooth object,
including blanket edges, nylon stockings,
smooth wooden surfaces, plastic material
and so on. Preference for something like a
satiny-edge blanket is normal for a child
under four, but this behavior begins to .
bother parents as the child grows older and
the blanket becomes a decrepit and the child
bear it with him everywhere.

- 23 -
 Touch sense is very important for mental
functions. For example child learns by
, touch how to compare between sizes and so
on and the information is the base of .
intellectual operations.

Appropriate activities for hyposensitive

child are: work with color changing touch
board that is sensitive on warmth, imprint
hand on forming material, work with
finger's colors, changing hot and cold
materials, work with baker's dough, water,
with different materials (such as textile )
material, cotton wool, sponge, threads,
toothpicks, skewers, sand, stones). (..

At work with hypersensitive child we can

: use living activities such as cooking,
sewing, work with potter's wheel, cleaning .
and so on.

We can utilize a self-stimulatory activities

such as searching some toys without visual
control, recognition of subjects by touching,
compare of materials for example by
fineness, by kind of material (wood, metal, :
plastic), suitable are creative activities
(work with glue, scissors, colors, brushes,
stamps). For children that enjoy press on
surface of the body it is very effective to use .
body massage.

)SMELL (olfaction, olfactory system

This sense helps to detect gases and other

harmful substance in the environment and
helps to warn of spoiled food. Smells can
trigger memories and other psychological )
response (e.g. fear, aversion, release). .(...

The receptors for smell are located in the

nasal cavity. The nose is not responsible for
smell only. The interpretation of smell is
closely related to the sense of taste, but a
greater variety of dissolved chemicals can .
be detected by smell than by taste.

The smell of foods is important in

stimulating appetite. When a child has a

- 24 -
common cold, food often seems tasteless
and unappetizing because nasal congestion .
reduces ability to smell the food.

When we pinch our nose we will have

problem with distinguish one food from the
other, because the blocked-up nose cannot ( )
work with the tongue and the tongue can
only distinguish sweet foods from bitter, .
salt or sour tastes. The olfactory receptors
deteriorate with age and food may become .
less appealing.

Some practises for distinguish subjects by

smell (for example flowers, washing )
powder, vinegar, coffee, tea, cheese, fruits,
mint, cinnamon, vanilla, blow out candle, (
perfume, smoking mixture, smoke.) are
very appropriate when child likes smell. We
can use aromatherapy in the education .
program too.

TASTE (a gustation, a gustatory system) ( )

The sense of taste involves receptors in the

tongue. Receptors for four basic tastes are
localized in different regions. Sweet tastes
are at the tip of the tongue, salty tastes are at
the anterior sides of the tongue, sour tastes
are located laterally on the tongue; bitter
tastes are at the posterior part of the tongue.
Other tastes are a combination of these four
with additional smell sensations. .

These tastes are very sensitive to contact. A

baby will learn to distinguish different
surfaces by using his mouth and tongue.
The earliest form of play is that everything
goes into the mouth. Inserting subjects into
the mouth belong to natural development.
This behavior steps back at healthy children 15
after 15. months of age slowly. About .
second year of age this behavior detects
only sporadically.

It is interesting that many children with

autistic spectrum disorder don't pass
through the oral stage of exploring subjects. .
On the other hand some of children with

- 25 -
autistic spectrum disorder are fascinated by .
gustatory and tactile perception in much
later age yet. They persist in this stage far
longer than other children.

One reason is that their development is :

often slower, and so they are slower to leave
this stage. Second, these children tend to
remain oriented by their senses, even after
they develop more sophisticated means of
exploring objects. Some researchers have .
suggested that whatever is neurologically
insult with autistic children causes them to
pay too much attention to proximal or
near, sensory information, such as taste and .
touch, and to little attention to distal
senses, such as seeing and hearing.

We can use the following practises in our

education program that are based on
distinguish the kind of food according to :
their:
taste e.g. fruits-vegetables, such as -
banana, strawberry, apple, lemon, tomato,
pepper, cucumber, ginger; ..
form e.g. chips, one piece of grapes, -
sunflower seed, walnut, cherry tomato, leaf
of mint, okra, strawberry, biscuit, small
piece of Arabic bread; .
consistence e.g. mixed-crispy-soft, such
as yogurt, mustard, ketchup, custard, chips,
corn flakes, popcorn, biscuit, cake, hard-
boiled egg, cucumber, banana and so on. .

We can use the similar practises on drinks

e.g. thick-thin, such as yogurt's drink, pear :
juice, strawberry juice, water, milk, tea,
acid-sweet such as lemon, kiwi, apple,
grape juice, pear, strawberry, carrot, mango
juice. .

Psychologist solves eating problems such as

refusing or preference of certain foods or
drinks, loss of appetite and so on by the help
of behavioral techniques.
.

- 26 -
SENSE OF BALANCE, MOVEMENT
AND POSITION

This system is in the inner ear and it makes

possible to sensation of movement and
balance and his receptors are located in .
muscles, tendons and joints. They transmit
the impulses that help in appraisal one's
position and changes in the locations of .
body parts in relation to each other. They .
also inform the brain of the amount of
muscle contraction and tendon tension.

Information received by these receptors is

needed for the coordination of muscles and
is important in such activities as walking,
running, body posture and more
complicated skills. The cerebellum is a .
main coordinating center for these impulses.

The information provides also the stability " "

of the visual image in an accord with
movements of the head and body. The
combination of information from the extra
ocular muscles, the vestibular apparatus and
the visual field enables the person to tell .
whether his eyes are moving, his head is
moving, or the visual field itself is moving.

The vestibular system enables the organism " "

to detect motion, especially acceleration and .
deceleration and the earths gravitational pull
also.

Perception of position of body and

movements in the space is another from
basic skills that are formed from early
childhood. Child checks where he can reach
around himself by hands for example during
play with hanging toys and it is a basic
visuo-motoric experience. The child .
acquires other experiences that relate to this
visuo-motoric experience such as crawling,
climbing, walking and running.

When the child can control his body and

perceive own movements in the space his
collisions with surroundings will decrease.
He perceives his body parts even if he may .
not know their name for a long time yet.
- 27 -
The child associates the space to himself: on
me, close to me, far way, above )
me....Coordination of the sight and motor .(...
experiences includes all afferent
components, sense of position, sense of
body movement, surface sensation. The : .
child learns step by step for example:
distinguish the both half of body, manage
fine motor movements at drawing and
writing in limited space and so on. He can .
determine any point on his body where
somebody or something touched him.

When the child hasn't created a precise

perception about himself and his limbs he
cannot create a plan of movement in the
space, he cannot put hands into the sleeves
at dress, he is clumsy at washing, combing .
and so on.

There are appropriate activities for

hyposensitive child: :
v to change the position from the sitting v
position on legs to kneeling position
always when a child reaches on some
toys or pictures that are placed on the
wall overhead, in the middle or on the .
left and on the right with keeping his
body balance;
v to transfer and sort of balls according to v
their colors from a box placed on the .
chair into the boxes placed on the floor
with utilization of walking;
v insertion of cubes into the car during its . v
movement on the floor;
v to catch objects swinging or stretching v
on the spring and hanging from ceiling; .
v gross motor activities such as throwing v
the objects into the openings, walking
on a bench, walking over obstacles, .
crawling under obstacles, going on four
into tunnel...
At work with hypersensitive child we can
use games such as recognition and naming
of body parts of a child, imitation of
movements, puppet show, songs with
movements, tracing a body with a pencil on .
the paper, forming figures with plasticine,

- 28 -
draw figures, compose figures from
magnets on the magnetic board, :
decomposition and arrangement of the toys ..
in relation to something for example toy-
cars go in line on a trip and park on free
parking place or two trains have the same
sequence of wagons

We can utilize also self-stimulatory

activities like motivation of some of .(... )
requested activities (merry-go-round,
swings).

SENSE OF HUNGER, THIRST, COLD,

WARMTH, PAIN

Receptors for cold and warmth are located

in the skin, receptors for pain we can find in
the skin, muscles and joints and in the most .
internal organs.

The skin is important because it covers and

protects the human body. The sensitivity of
the skin to pain is not the same in all parts
of the body. On our fingernails, pain
sensitivity is low. Our head is very sensitive
to pain. Hair gives protection against .
excessive heat, cold and shock. On our arms .
and legs, there is medium sensitivity. Two
pathways transmit pain to the CNS. One is
for acute, sharp pain, and the other is for
slow, chronic pain. Reactions to pain may .
also be abnormal; some children with ASD
have high tolerance to pain.

When we are too cold the skin contracts to

try to keep the heat in, and the skin rises up.
That is when we see goose-pimples. The .
deepest layer of skin is made up of a fatty
tissue which protects us against cold and .
from injury. The skin is soft and stretchy
due to sebum, an oily substance produced
by the sebaceous glands

- 29 -
We feel hungry and thirsty when we need
to eat or drink because our body has
exhausted its reserves. When the stomach is
empty and there is a shortage of nutritive
substance in the blood, the hypothalamus in .
the brain causes the sensation of hunger.
Similarly, then the level of water in the
body is too low, the hypothalamus (part of
brain that sends instructions to the
endocrine glands) signals to the hormone- : )
producing gland to release a hormone.
These are special chemical substance which, (
when absorbed by the blood, send messages .
throughout the body (for example when the
level of water in the body is low - a message
to the kidneys to absorb more water). Water
taste receptors are mainly in the throat and
may help to regulate water balance.

Children with ASD cannot perceive cold,

warmth, hunger or thirst often. Displaced .
threshold of pain is very usual in terms of
hyposensitivity or hypersensitivity.
Hyposensitivity can be one of the factors of
self-injury behavior. Hypersensitivity can .
lead to hysterical response. If a child cannot
perceive cold, warmth, hunger or thirst he : )
has to follow the rules and not feelings.
.(

SENSORY ADAPTATION
When sensory receptors are exposed to a
continuous stimulus, receptors often adjust
themselves so that the sensation becomes
less acute. The term for this phenomenon is :
sensory adaptation. For example, if we
immerse our hand in very warm water, it .
may be uncomfortable. However, if we
leave our hand there, soon the water will
feel less shot. Receptors adept at different :
rates. Those for warmth, cold, light pressure
adept rapidly. In contrast, those for pain do
not adept. The sensations from the slow
pain fibers tend to increase over time. This .
variation in receptors allows us to save
energy by not responding to unimportant
st imuli while a lways heed ing t he
war nings of pain.

- 30 -
COMMUNICATION SKILLS :
Communication is: :
v something happen between people v
v exchange of symbols (gestures, facial ) v
expression, pictures, real objects, but (
usually are it words),
v the aim is to invoke interesting effect ) v
(to give somebody attention and it leads .(
to exchange of the information).

During second year of life most children use

words that non related people also
understand. But at this time autistic children
have not developed the speech in this way.
These children can learn from 5 to 10 words 10 5
which they use for some time and then the
words disappear from their vocabulary. So
primary the speech is not impaired (because .
the child has an ability to speak and learn
the language) but the ability to understand
the meaning of the words for the
communication is impaired.

When continual repeating of words without

a context and it does not lead to any
progress the child stops using these words
because he is not able to understand the
reason of their usage. Many autistic children .
become mute after this first stage.

Some children with ASD begin to repeat

what they hear from other people around
them after the period of stagnation or after
the speech appears belatedly. This period of
repeating lasts for months or years on the
contrary to other children. Many children
understand a written word better than a
spoken word. The written word is slower
and more persisting than the spoken one. .
These children have a time to process this
information.

Children can have a good vocabulary

especially words which describe objects or
activities which they can see and hear. But : )
children do not understand these words in " "
context or other uses (e.g. the child run to " "
the door because understanding the word "

- 31 -
 out We go out. But he also runs to .("" "
the door when he hears Today we do not
go out, or Take it out from cabinet).

The frustration from dysfunctional

communication is very common for autistic
children and it is the most common cause of
aggressive behavior. In therapy we use such .
way of communication that the child
manage to be dependent the least. .

People often suppose that an alternative way

of the communication (by gestures, objects, : )
photos, pictures, pictograms or . (
communication boards and so on) can stop :
the development of the speech. But this
supposition is mistaken because:
v children with ASD have problem not v
only with speech but also with all forms : )
of communication (e.g. pointing at ;(...
objects, gesticulation, facial
expression);
v they understand many words less than . v
we suppose.

The disorder of communication appears in

nonverbal area (understanding) and verbal .( ) ( )
area (speaking).

In nonverbal area we observe if the child is

able to use gestures and understand them,
how long is his eye contact, if he can point
at object which he is interested in, if he can
look at a given direction, how he show an
approval and disapproval. It is also
important how the child can express his
needs and desires or if we have to guess
what he needs. We take notice how much he
understands the facial expressions of other " ") " .
people, if he responses to orders, ("
understands prohibitions. (see Assessment
Cognitive skills, Other skills)

- 32 -
In verbal area we find out if the child is
able to communicate in sentences, by words
or if he produces only sounds. It is
important is how many words he uses in
ordinary speech and how he understand the
words he uses. We observe if he repeats
some words or sentences just after called
and if he repeats it immediately or
belatedly. We notice if the child speaks ) .
about himself in a correct way, if he calls (" " " "
objects and activities, if he can answer
questions, lead a conversation and what
about, if his conversation has a sense
relative to the situation. (see Assessment
Communication skills, Other skills)

Speech therapy is more effective for

children with certain level of cognitive
skills. A child can start speech therapy if
he can listen to orders, match pictures with
the same pictures, imitate movements, his 10
attention has to be minimal 10 minutes, his . 3
visual attention has to be longer than 3 sec.

Only basic finding of speech level in this

assessment can be made by teacher or
parents. Special investigation must be
perform by speech therapist.
.

- 33 -
HOW TO USE THIS
ASSESSMENT
v We should read this assessment in v
details before usage. .

v We have to know the childs age for v

selection of suitable part of this : )
assessment (e.g. for children younger
than 3 years of age we cannot use the .( 3
part of Assessment Academic skills).

v We ask mother what her child likes and . v

what he doesnt like. We can utilize this
information for motivation of the child. .

v Teacher has to work with the child v

himself without mother because a lot of
children are interested in mother only, .
not in activities.

v We should choose places which are v

suitable for certain activities (e.g. quite :)
place for sensory perception, a bathroom
for self-care, place for playing). .(...

There is a difference between the :

assessment and the teaching of the child: we
can work with the child on the floor if he
refuses to sit on the chair during the
assessment but we require him to sit in a : )
special place for an activity when teaching .(
him (e.g. place for individual work).

v We prepare activities which we want to v

use with a child on the same day. .

v We must change these activities during : )v

the day (e.g. fine motor activities, self-
care, cognitive skills, sensory) so the (
child does not get bored. .

v Some children refuse to work v

repeatedly. If we cannot change his
behavior or find the reason we continue
with other skills or the following part of .
Assessment.

- 34 -
v We have to repeat these skills the v
following day to be sure that the child is
or isnt able to do these activities (e.g. : )
he fails in activity give me 1 real object 2 1
from 2 because he likes color of these
objects or some of these objects are .(...
close to his hand or he isnt in a good
mood).

v We have three weeks for completion of v

this Assessment and during fourth week
we work up the individual plan .
according to ascertained data.

v Tasks are ranged from easy to difficult v

in agreement with ordinary development
in this Assessment. If the child cannot
do a task inside 1 group we don't : )
continue in the same group because
following tasks are more difficult (e.g. .(...
in groups: colors, sizes, shapes,
pictures).

v When the child cannot do a task we v

have to help him with some type of
assistance. A child needs help at the
beginning and following days he should
do this task without help. If he can do
this task minimally three times
independently we write in the .
Assessment that he can do it without
help.

We provide the family with the results of

this Assessment when we invite them. We
give these results to family inside Individual .
plan and we keep this Assessment form with
us.

We can repeat this Assessment after one

year to see the differences between the
beginning and the present time. This
information is important for family as well. .

- 35 -
HOW TO PREPARE AN
INDIVIDUAL PLAN
We prepare individual plan after we finish
the Assessment. We must write all the .
results in the Individual plan.

We record all the information about what

the child is able to do himself, with help or
isnt able to do on the right side of blank
form. Then we write what he is able to do
with help and isnt able to do on the left side
of blank form as a plan for future in line .
with his capabilities and his age.

One part of the blank form is about

observation of the teacher where she can
write about strengths of the child, about his
mood, what kind of skills he likes and
dislike, about his behavior etc. .

We have to teach child one semester as

minimum to see good results of this plan
and this individual plan is assigned for this
period but some children need more time
(all year) as compared to other children who .
manage these skills faster.

Sometimes we dont use certain parts of the ):

Assessment (e.g. communication skills,
academic skills for the mute child or a child 3(
less than 3 years old) then we take these
parts of this Individual plan out. .

We attach other blank forms into this plan

(for speech therapist = speech, occupation
= therapist = occupation and psychologist ) =
behavior) because they are often members =
of the team. = (.

After finishing this plan we invite the family

to inform them about the results and explain
the plan to them (see Appendix M). ) .(M

- 36 -
A MOTIVATION
Reward and punishment are among the most
common means to regulate behavior. .

We use a reward for a child when we teach

him new skills or fix old skills. We give
him this motivation after the required .
behavior.

There are various types of rewards: :

v concrete reward (sweets, food, toys, )v
fine motor activities, gross motor
activities, stickers); ;(...
v social reward (smile, caress, hug, )v
kiss); ;(...
v verbal reward (well, yes, bravo, )v
excellent, good job). (...

Concrete rewards: :
If the child understands the relationship
between convenient behavior and the
reward only little or doesnt understand we
have to use a reward which he likes for a
long time every day. In this case the usage
of some sweets is more effective. Initially
we give it to the child after advisable .
behavior and later we extend the period
between advisable behavior and giving the
reward .

Giving sweets we have to be careful not to

reward with such sweets which are in
violation with a special diet or can be
detrimental to the childs health (e.g. some
children have allergy to chocolate..). The :)
sweet also will stop being the reward when ( ...
the child does not want it. .

Another concrete reward could be also the

music, the vibration or the most liked
objects, pictures, stickers and so on that
mean fulfilled task and the satisfaction of .
the adult. A stickers system implies to the
child how long he will wait for the privilege
or reward and what the effects of his )
advisable behavior are (certain number of (
stickers can mean the concrete reward).

- 37 -
We use this method for children who
understand waiting and like stickers.
.
This is effective mainly for fulfillment of
single tasks when we need a child to
continue doing without constantly control .
him. But this is not effective if a child uses
same objects, stickers or pictures in other
activities.

Social and verbal rewards: :

We combine every concrete reward with

social or verbal recognition (smile, caress,
well). As soon as a child understands ( .. )
social or verbal recognition we should
reduce the concrete rewards. The
recognition is not effective if the child does
not understand it or it is unpleasant for him )
(e.g. the caress can felt painful, the .(
recognition can be perceived as an
unpleasant).

How to choose the type of reward: :

v to ask parents what the child likes and ; v
dislikes;
v to show him a foregoing type of rewards v
and observe what interests him most. .

We have to prepare more types of foregoing

rewards especially what he likes for next
types of rewards when we notice his lack of .
interest in the previous ones. If the
motivation loses effect we have to try other .
types of reward again.

Before we start to teach a child we should

offer him a choice from 3 concrete rewards.
We give him the one he selected for a short
time. Then we use the same motivation for .
advisable behavior when we teach him.

What time we can use a reward with :

children:
v immediately, v
v gradual delay of reward. . v

- 38 -
Very small children and also handicapped
children need usually the reward .
immediately to understand a positive
reaction of an adult.

We should not reward immediately children

who understand that the reward will follow
later and who are able to look forward to it. .

A punishment has not big effect for a child.

Usage of punishment leads to the reduction
of the unsuitable behavior but similar
behavior may appears in other situation. The
theories which say that punishment is
necessary, have been overcome by more .
effective and better practices.

When a child makes a mistake we dont

warn him on his mistake but we tell him
how to do the good way. A child can not
correct his behavior if he doesnt know how
to do it well. Other reason is that some
children dont understand what is
mistake. The children with ASD have
often unsuitable behavior often and they . ""
may hear the word mistake all the time
which makes it loose its effect.

- 39 -
TYPE OF AN ASSISTANCE
The aim of our assistance work is reaching
the independence of the child. If the child
isnt able to do an activity independently or
this activity is new for him we have to use
various types of assistance during teaching
him. It isnt correct to use one type of .
assistance only.

We can use assistances: :

v physical = P: v =
to catch his hand,
to put something into his palm,
;to push his elbow
v according to example = E: v =
;to imitate
v attention = A: v =
to point at designated place,
to knock on designated place,
;snap fingers
v verbal = V: v =
to tell him go on, do it, "" " " " " " "
to tell sounds ohm, oh, " "
;to tell him no, mistake "" " "
v gesture = G: v =
to move the index finger no, ""
to move the head no, "" ""
) to change faces expression (surprise, to
;)raise eyebrows, to frown, a look of eyes (.
v without help independent = I. v =

These types of assistance are ranged in

accordance with their level from maximal to
minimal (from up to down). We find a type ) (
of assistance which is useful for the child.
We teach him to respond to following types
of assistance as well until he does a task .
independently.

It happens that the child who worked with

certain type of assistance (e.g. tell him lets ) :
go or do it) doesnt respond to this help " " (
suddenly. Then it is necessary to return one
step back on this scale (in this case snap
fingers). ) " (.

- 40 -
 If he doesnt respond to this type of help we
continue and help him with help two steps
)... before and so on (e.g. knock on designated
place). (..

The children dont use one type of

assistance for all skills but they use different ):
types of assistance for different skills (e.g.
self-care skills with physical assistance, fine
motor skills with attention assistance, some (.
of cognitive skills with verbal assistance).

We have to write the type of assistance in

Recording sheet to know what kind of
assistance we offer to the child next day.
Certain type of assistance as a gesture = G .
we dont use for self-care skills but we use " = "
this type in other skills as fine motor,
cognitive skillsand so on (see Appendix ......
J1, J2). ) .(J2 ,J1-

- 41 -
HOW TO WRITE THE
OBSERVATION
We write the observation two weeks before
the end of first semester and we repeat it
before the end of second semester. .

After first semester: we note results from :

daily observation and as an advantage is that
we describe shorter time period. The .
disadvantage is that we have to describe the
beginning of the care (e.g. a frequent : )
problematic behavior, an adaptation on
daily routine etc.). Also the results of our
care are not as significant after one semester (
as after a year.
.

After second semester: the disadvantage is :

that we describe a longer time period,
ordinarily one year. Sometimes it happens
that the child changes a teacher during this
time. The advantage is that we repeat the
Assessment and therefore we can compare .
the skills of a child at the beginning and the
end of the care.

There are 3 parts of the Observation: :

v introductory part: : v
before,
now,
v comparative part: : v
before,
a therapy,
now,
v final part: : v
a recommendation,
thanks.

Introductory part has to contain before :

and now:
v what time the program began - a month . v
and an year,

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v adaptation to daily routine (e.g. if a child : ) v
cries in the morning or at the end of a
day, if he likes or doesnt like changes,
what is his behavior when he begins (...
new activity, what is his mood etc.),
v a behavior of the child during requested v
activity,
v what the child likes and dislikes ( what ) v
kind of activities, toys, sounds, people,
places), (...
v if the child can express pleasant and v
unpleasant feelings (e.g. if the child is : )
happy or unhappy, how he feels at the (...
present, if he is tired etc.),
v what is attention of this child (e.g. how : ) v
long he can work, play, wait), .(...
v if the child is hyperactive or hypoactive v
(e.g. he runs or jumps all time, is :)
noisy- he is quite, he sleeps often), (...
v how he speaks, v
v if the child has a special behavior by v
reason of sensory needs (e.g. he covers : )
his ears, he is afraid of a loud sounds...). .(...

Comparative part has to contain before, )

during therapy (details our work) and now: : (
v description of the childs skills in the v
same succession like in this Assessment,
v how the child work according to the
v
TEACCH program or other program,
v what is the time suitable for some v
activities (e.g. some hyperactive : )
children work at morning better like
later, some children would like to sleep
in the morning and they work better (...
after breakfast),
v what kind of assistance help to the v
child,
v what kind of motivation we use (type of )v
rewards). .(

Final part contains: :

v recommendation (e.g. what kind of : )v
skills the child has to complete in next
semester, what kind of program is (
suitable for him),
v thanks (e.g. for cooperation). .(... ) v

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We write all these information in the
Observation blank. Then we invite the .
parents to inform them and explain to them .
the content of the Observation (see .(N )
Appendix N).

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 BIBLIOGRAPHY
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- 47 -
 Shumua Al -Amal
Shumua Al -Amal complex's objective is to provide all necessary services for special education
and rehabilitation under one roof, one of which is making suitable research and development
needed by the disable children and their parents. We have selected a group of highly qualified
professionals to insure proper quality and value for our customer, trainers and other users.
Our Mission
Work with the parents to limit agony and provide good level of comprehensive services to help
the child and the family to adjust and utilize available energy and resources.
Our Vision
Develop the procedure and specialized services in the field of rehabilitation and special education
and spread it as far as possible within reasonable cost.
If you have comments or suggestions please send it to us or call us we will try our best to
accommodate your request or clarify your enquiry as part of our aim for continuous
improvement on the services for our clients.

.


.


.

Othman A. Al-Dobaikhi
General Manager

Tel : 966 3 8227680

Fax : 966 3 8189787
E-mail : Othman@shumua.net

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