Dr Remilekun Durojaiye has been a physiotherapist for over three decades. She obtained her Diploma in Physiotherapy from Bristol Royal Infirmary (now the University of the West of England), Bristol, England in 1988. She also has a Masters in Physical Therapy from The University of Health Sciences, The Chicago Medical School, Chicago, USA (now Rosalind Franklin University of Medicine and Sciences) in 1993 and Doctorate in Physical Therapy from the Alabama State University, Alabama, USA in 2009. She is a Certified in Biofeedback for the Pelvic Floor and she has worked in various settings during the course of her career including but not limited to pelvic rehabilitation, orthopedics and pediatrics (children of special needs). Our correspondent, Olutayo Irantiola, engaged her in commemoration of the World Autism Awareness Day on April 2, 2019.
PDC: What is Autism Spectrum Disorder?
DRD: Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. According to the Centers for Disease Control. A serious developmental disorder that impairs the ability to communicate and interact. More than 100 thousand Autistic cases are reported annually in Nigeria.
PDC: At what age do we start to notice children with ASD?
DRD: Most screening tools should not be done before the age of 18 months. Not easily diagnosed before the age of 2 years. There are more autistic male than females.
PDC: What are the causes of ASD?
DRD: There is no known single cause, but it is generally known to be due to abnormalities in the brains structure and function.
PDC: What are the symptoms of ASD?
DRD: ASD may have a number of effects on a person’s social interaction and communication, including: adoption of unusual speech patterns, such as using a robot-like tone; avoiding eye contact with others; not babbling or cooing to parents as an infant; not responding to their name and late development of speech skills. Others are having difficulty with maintaining conversation; frequently repeating phrases; apparent difficulty in understanding feelings and expressing their own.
In addition to impaired communication, a person with autism may also display repetitive or unusual behaviors. Examples of these are- becoming so invested in a topic that it seems to consume them, such as cars, train timetables, or planes; becoming preoccupied with objects, such as a toy or household object; engaging in repetitive motions, such as rocking side to side and lining up or arranging toys or objects in very orderly ways
People with autism thrive on routine, and the ability to predict the outcomes of certain behaviors and places. A break in routine or exposure to loud, overstimulating environments can overwhelm a person with ASD, leading to outbursts of anger, frustration, distress, or sadness.
PDC: The theme for the 2019 is “Assistive Technologies, Active Participation”, what are the technological ways through which we can help a child with ASD?
DRD: There are various forms of Assistive Technologies that can be used for autistic children. There are explained below-
Low-Tech AT tools are often characterized as tools that do not need batteries or electricity to operate. These are commonly found in a multisensory, differentiated classroom as “accommodations” and require little-to-no training to operate. Some low tech AT tools are; a pencil grip, slant board, communication boards, flash cards, use of icons/pictures/symbols, social stories or velcro sneakers.
Mid/High-tech AT tools require a bit more training as they may be battery-operated and add a level of specialization that low-tech tools might otherwise not. An example of a mid-tech AT support could be a multiple-message voice output device like a Big Mack (switch), audio books(read aloud programs), screen magnifiers, video modeling and computers, phones or ipads. Some of these are not readily available in this environment.
PDC: Part of what has been noted with children with ASD are unique talents, unique social interaction amongst others, does this mean that they are not properly managed that’s why it’s considered to be a disorder?
DRD: Around 1 in every 10 people with autism exhibits signs of savant syndrome, although this condition might also occur in people with other developmental conditions or nervous system injuries.
Savant syndrome occurs when a person demonstrates extraordinary abilities in a particular field, such as playing a musical instrument, calculating extremely complex sums at high speed, reading two pages of a book simultaneously, or being able to memorize vast amounts of knowledge.
PDC: What are the various behavioral treatments and interventions that will help an autistic child?
DRD: There a variety of behavioral interventions that can be implemented, such as ABA, floor time to name a few.
ABA aims to increase desirable behaviors and reduce harmful or isolating ones by using positive reinforcement.
Floortime: This involves parents joining children in the play area and building relationships. ABA therapies might also use floortime to support treatment and vice versa. Parents let the children lead the game, allowing the child’s strengths to develop. Resources for evaluation and treatment include: https://www.nobelovagradani.org/ and https://asktoks.com/
PDC: How do we ensure that there uniqueness become meaningful addition to the world?
DRD: It is important as mentioned above that to know the child, treatment plans are individualized. Intervention cannot be a one size fits all approach. This is why parents need to do their due diligence is finding qualified staff, not the person who says they can work with the child and charges very little, that’s a red flag right there.
PDC: Are there policies to help people with ASD in Nigeria from being stigmatized or discriminated against?
DRD: Nigeria just signed it’s disabilities act on January 23, 2019. https://reliefweb.int/report/nigeria/nigeria-passes-disability-rights-law
PDC: What are your advice for parents with autistic children?
DRD: Once you have a definitive diagnosis, it is important to implement treatment and the whole family must be involved in their care as they don’t do well with change.