I was able to identify a child who was suspected to have disabilities and setbacks in the sense

of comprehension and communication. Said child has been receiving therapy and has received
confirmation of the fact that she is indeed disabled. However, no specific diagnosis has been
made as her disabilities are still in its beginning stages and requires further evaluation. I was able
to interview her parents who wished to stay anonymous as they are still understanding and
coping with their child’s condition and hope that their interview will help shed light on similar
cases.

I was able to observe the child at her home throughout the interview period and was able to
note certain traits that were later explained by her parents. The child, currently five years old,
seemed generally quiet, withdrawn, shying away from strangers and unable to discern emotions
directed towards her. She had a certain way or order of doing things and tended to exhibit
discomfort when her usual way of doing things were disrupted. She is also unable to voice out
her needs and frustrations. She also seems aloof and detached from her surroundings, tending to
also quickly losing interest in any interaction she establishes.

Her parents had had suspicions about her disability when she was 18 months old and came to
realise the discrepancy between her behaviour and other children’s as she was not as developed
and interactive as other children during their play time. She seemed to withdraw herself and was
not able to elicit similar emotions, expressions or ways of playing as her peers. Her parents were
quick to realise as they began noticing her disability as they compared home videos of her and
her brother around the same age. They noticed how she had trouble taking simple instructions
and her inability to organise herself in productive play when she did not receive specific
directions. When asked about how her condition has affected immediate family members and
their main frustrations encompassed the difficulty to communicate with her. Her usual ways of
communicating include tugging at a trusted adult and taking them in the direction of what she
desires to have or do. She has a very limited vocabulary of one to two words that she rarely uses
and gets frustrated when not understood, resulting in tantrums and confusion for both parties.
This has caused frustration to her parents as they feel helpless in certain scenarios and feeling
inadequate, being unable to do much for her. Otherwise, her brother gets quite frustrated when
playing with their as she not only is unable to communicate her style of playing but also seems
indifferent to his cues and emotions while they play. She also disengages halfway, losing interest
hence causing rifts with her brother who is also of young age. This als rings true for her peer
interaction where at time she does approach them to play, quickly losing interest. However, she
does look to her peers and watches intently their actions, attempting t replicate them without any
further action after she no longer engages with the situation she observes. Furthermore, her
grandparents who are tasked at caring for her at times find it difficult to do so as they are unable
to understand what she needs and generally wind up at a dead end of tantrums. Her tantrums can
be detected only by her parents even before the begin and prevented by distracting her with
cartoons or activities she enjoys.
 In addition to relationships being subtly difficult to maintain because of her communication
barrier she also seems to experience difficulties when tasked with activities such as shape sorting
or colour matching. Her ability to handle a shape slotting toy is limited to the arrangement of
said toys where the shapes have to be arranged in a certain and specific manner for her to be able
to correctly organise and slot it into the respective cut outs of the shape. However, she is not able
to identify colours or name them even when repeatedly presented in the same sequence. In
regards to my query of whether or not her muscle usage is delayed, her parents explained that she
is able to pick up small things, push buttons with her index fingers but is unable to use her whole
arm to pick up slightly heavier or larger things. Speaking further about her ability in self
sustaining, she does allow to be undressed, cleaned and dressed however is not able to do so
alone and requires assistance. She is also not trained to trigger adults when she requires to use
the toilet nor is she able to clean herself after. She tends to rely on diapers or certain cues noticed
only by her parents to take her to relieve herself. Her parents mentioned trying to train her to use
the lavatory on her own but were unable to do so as she seemed very distressed when they
attempted to do so. There were also incidents of soiling herself when her parents tried taking off
her diapers hoping for her to ask to use the toilet on her own accord. Hence, they have delayed
toilet training until they deem her ready for it.

As I further inquired her parents about her health and food habits they clarified that she is
overall a healthy child. However, she has been receiving treatment for eczema and periodically
gets aggravated when her eczema worsens due to certain allergic reactions or the weather. She is
a fully vaccinated child with no history of any chronic illnesses. As for food habits, she is
deemed a picky eater and does not feed herself unless the foods presented to her are her
favourite. Aside from matters of physical health, I also enquired after how her parents are
attempting to help her with the disabilities they have noticed. Initially, at an attempt to allow her
the space to grow and experiment with common situations, hoping to see changes, her parents
enrolled her into a Montessori programme. However, she faced difficulties in terms of interacting
and coping with the activities provided there. She was at times very distressed at the end of the
day for she was unable to interact or complete anything. Her parents also felt that their decision
to put her into a programme that did no good opted to take her out of it. They mentioned
enrolling her into a primary intervention programme, otherwise known as Permata Kurnia where
she receives a specially tailored academic training, skill training and curated help as needed. Her
parents have also attempted to assign her to a child therapist and reported to see their child open
up during these sessions and believe that more sessions will be of help. As for progress, her
parents felt more has to be done for her in terms of therapy and intervention to see better and
more progress. When asked about their plans when she graduates from the primary intervention
programme, her parents mentioned being still unsure citing the lack of evaluation done and
diagnosis arrived at. They believe a decisive diagnosis has to be made before they move on with
future plans but are open to sending to a special needs institution if need be and if she will
benefit from the choice.

Based on the very informative interview with her parents, I was able to analyse said situations
and possibly understand how minute factors would impact her behaviour and emotions
differently. In her case I believe the fixes or solutions lie in seeing situations and conditions
through her lens and accommodating to that instead of attempting to force her into readily
available moulds of how other children operate as that only brings frustration, worsened by the
lack of ability to communicate ending in a task or mission unfulfilled. I believe the most
effective ways to intervene and assist her with her disability is to ease the process of her
communicating allowing her to understand her situations whilst making her a part of the decision
making process.

Her parents should let the child know the next course of activity for example letting her know
that she has to brush her teeth in five minutes after watching her cartoon. This allows for her to
wind down and understand what is going to happen next, removing the anxiety of a suddenly
changing course of action that results in tantrums. As the child seems to have difficulty
comprehending large concepts, her parents can opt for visual timers on devices or even
hourglasses to ease her understanding. This also applies to giving instructions, where the
instructions should be concise and concrete. Furthermore, she should be given choices, allowing
her to be part of the process, for example asking her whether she would like to eat in the kitchen
or outdoors. This allows her to feel as though she made those choices. Otherwise, to help her
understand that good behaviour will be rewarded parents should acknowledge her ability to
comply to instructions and follow through with any promised privileges as discussed. This tells
her exactly what she needs to do and a promise of an incentive later on.

As language difficulty is a prominent part of the problem for her, more interactive and
interesting activities or toys should be used to incentivise and irk her to learn. As an example,
using Velcro alphabets or word cards that can be placed to matching pictures or colours will help
keep her focused and intrigued, making the learning process more inclusive to her. Same goes to
toys like puzzles. As her parents mentioned difficulty for her to comply to instructions and
progress throughout the day, a schedule that is more visual would be a good day to alert her on
her daily expectations. To allow easy transition and reduce tantrums when she transitions from
one activity to another, she can also be allowed to bring with her a “transition” item to her next
activity. For instance when she needs to leave the car to her therapist appointment, allowing her
to bring her favourite toy or accessory will give her a sense of security, ensuring lesser distress.
As her parents also mentioned frequent tantrums, I believe it is important that problematic
behaviour is not fussed over instead redirected. For instance, when they find her throwing
tantrums, they could show her how to calm down with breathing, modelled to her or even
showing her items that may pique her interest instead of blatantly saying “No!”
 In a nutshell, I believe the child and her parents are still coping with the discoveries they make
daily about her varied needs and hope that they will be able to provide and care for her in a way
that suits her best.

References

1. International Board of Credentialing and Continuing Education Standards, IBCCES

(n.d.).
15 Behaviour Strategies for Autistic Children.
https://ibcces.org/blog/2016/07/15/behavior-strategies/

2. Centres for Disease Control and Prevention, CDC (n.d.).

Autism Spectrum Disorders (ASD).
https://www.cdc.gov/ncbddd/autism/signs.html