Design for Social Responsibility- Game Design

DESIGN AND SOCIAL RESPONSIBILITY Special needs Anvi Mathur (Product Design-L2)

Student Name: Anvi Mathur Course: BA (Hons.) Product Design Cohort: 2015-2019 Module Name: Design and Social Responsibility Module Leader: Pranay Mangrati Module Tutor: Pranay Mangrati

Module Duration: One Month Module Credits: 30

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ACKNOWLEDGEMENT oI, Anvi Mathur of UG -PD:2015 -19 would like to thank our course leader Pranay Mangrati and module tutor Srishti Bajaj for guiding and supporting us through this module.

oI, would also like to acknowledge friends ,family and the labour who helped me throughout the process of the project.

oAt last I would like to acknowledge all the organisations that allowed us to visit and provided us with all the information.

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PROJECT BRIEF To design a “Tangible product” for a user with special needs. The product should be contextually designed keeping in mind the environment. This is not a special category only catering to people with special needs. The aim is to make people with special needs not to feel alienated, minority or distinguishable. This is a fundamental condition of good design. If an environment is accessible, usable, convenient and a pleasure to use, everyone benefits. By considering the diverse needs and abilities of all throughout the design process, inclusive design/universal design creates products, services and environments that meet people’s needs. Simply put, universal design is good design.

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WHAT ARE SPECIAL NEEDS? Any kind of difficulties (such as a physical, mental, emotional, behavioural, or learning disability or impairment) that causes an individual to require additional or specialized services or accommodations (such as in education or recreation) are known as special needs.

An individual with special needs may need help in one or more of the following areas: oCommunication oMovement oSelf-care oDecision-making A ‘Learning Difficulty’ is where a child: Has significantly greater difficulty in learning than the majority of children of the same age. Has a disability which prevents or hinders them from making use of the educational facilities of a kind generally provided for children of the same age in schools; or under compulsory school age and falls within the definition above or would do so if special education provision was not made for them.

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Picture credits: lakecountyohio

Types of special needs Types of special needs include: oAutism oADHD oCerebral palsy oDown syndrome oEmotional disturbance oEpilepsy oReading and learning disabilities oIntellectual disabilities oPervasive developmental disorder (PDD) oSpeech and language impairments oSpina bifida oTraumatic brain injury oVisual impairments 6

ISSUES RELATED TO SPECIAL NEEDS MEDICAL ISSUES oMedical issues for children include serious conditions like cancer and heart defects, muscular dystrophy and cystic fibrosis. It also includes chronic conditions like asthma and diabetes; congenital conditions like cerebral palsy and dwarfism; and health threats like food allergies and obesity. oChildren with medical issues may require numerous tests, long hospital stays, expensive equipment, and accommodations for disabilities. Your family may have to deal with frequent crises, uncertainty, and worry. In any case, establishing a good support system is very important.

BEHAVORIAL ISSUES oChildren with behaviour issues may not respond to traditional discipline. Diagnoses like ADHD, fetal alcohol spectrum disorder (FASD), dysfunction of sensory integration, and Tourette's syndrome require specialized strategies that are tailored to their specific needs. oIf these strategies are not developed and used, kids with behaviour issues can throw their families into chaos. It also increases the risk for problems at school. As a parent, you will need to be flexible, creative, and patient.

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DEVELOPMENTAL ISSUES oDevelopmental disabilities are some of the most devastating for a family to deal with. This can change your visions of the future and provide immediate difficulties in caring for and educating your child. Diagnoses like autism, Down syndrome, and intellectual disabilities often cause children to be removed from the mainstream. Quite often, parents become fierce advocates to make sure their children receive the services, therapy, schooling, and inclusion they need and deserve

LEARNING ISSUES oChildren with learning disabilities like dyslexia and auditory processing disorder (APD) struggle with schoolwork regardless of their intellectual abilities. They require specialized learning strategies to meet their potential and avoid self-esteem problems and behavioural difficulties. oParents of learning-challenged kids need to be persistent. This includes working with your child at home as well as teachers and schools to ensure they get all the help they need.

MENTAL HEALTH ISSUES Realizing that your child suffers from anxiety or depression or has attachment difficulties can be unexpected.

Again, every child will be different, yet these can leave your family dealing with a roller coaster of mood swings, crises, and defiance.

It's important that parents find the right professionals to help. You will also need to make decisions about therapy, medications, and, possibly, hospitalization. The consequences of missed clues and wrong guesses can be significant.

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ADHD Attention-deficit hyperactivity disorder is a biological condition that makes it hard for many children to sit still and concentrate.

ADHD is a cluster of difficulties that involve the self management system of the brain.

There are various areas of the brain that control your child’s ability to concentrate and “hit the brakes.” These areas may be less active and develop more slowly in kids with ADHD. The best evidence for this occurs in the front part of our brain, or the frontal lobe. This can upset the balance of certain brain chemicals. It can also explain why your child may have more trouble socially than his peers.

TYPES OF ADHD: oADHD, Predominantly Hyperactive-Impulsive Presentation: Kids who have this type of ADHD have symptoms of hyperactivity and feel the need to move constantly. They also struggle with impulse control. oADHD, Predominantly Inattentive Presentation: Kids who have this type of ADHD have difficulty paying attention. They’re easily distracted but don’t have issues with impulsivity or hyperactivity. This is sometimes referred to as attention-deficit disorder (or ADD). oADHD, Combined Presentation: This is the most common type of ADHD. Kids who have it show all of the symptoms described above.

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CAUSES OF ADHD oGenes and heredity: Studies show that ADHD runs in families—meaning it may be genetic. If a child is diagnosed with ADHD, there is a significant chance that the parent had it too, even if never been diagnosed. As many as 35% of children with ADHD have a parent or sibling who also has the disorder. oDifferences in the brain: Certain areas of the brain may develop at a slower pace or be less active in kids with ADHD. Johns Hopkins Medicine reports that kids with ADHD also may have lower levels of a brain chemical called dopamine that helps to regulate mood, movement and attention. oEnvironmental factors: Prenatal exposure to alcohol and cigarette smoke could increase the chances of getting ADHD, says the National Institute of Mental Health. So does exposure to high levels of lead during infancy and early childhood. There’s no evidence that sugar or food additives cause ADHD. oBrain injury: Traumatic brain injury (TBI) is a lot less common than ADHD. But ADHD-like symptoms are sometimes present in the relatively small number of kids who have TBI. Recent studies show high rates of attention problems in acquired brain injuries (such as concussion and brain tumours).

SYMPTOMS OF ADHD oSigns of Inattention oSigns of impulsiveness oSigns of hyperactivity 10

VISUAL IMPAIRMENT A vision impairment refers to when you lose part or all of your ability to see (vision).

The World Health Organization (WHO) classifies visual impairment based on two factors: the visual acuity, or the clarity of vision, and the visual fields, the area from which you are able to perceive visual information, while your eyes are in a stationary position and you are looking straight at an object.

Three Types of Vision Impairments oLow visual acuity, also known as moderate visual impairment, is a visual acuity between 20/70 and 20/400 with your best corrected vision, or a visual field of no more than 20 degrees. oBlindness is a visual acuity of 20/400 or worse with your best corrected vision, or a visual field of no more than 10 degrees.

oLegal blindness in the United States is a visual acuity of 20/200 or worse with your best corrected vision, or a visual field of no more than 20 degrees.

Causes of Vision Impairment oGlaucoma oCataracts oTrachoma oDiabetic retinopathy oAmblyopia, or the lack of use of an eye in

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Autism Autism spectrum disorders (ASD) are characterized by social-interaction difficulties, communication challenges and a tendency to engage in repetitive behaviours.

Basic symptoms of autism are often accompanied by other medical conditions and challenges.

The children are born apparently normal, but then begin to deteriorate by the age of 1 to 2 years. The main features start appearing before 36 months of age. These children may have some speech developmental and social interactive regression, usually around 18 months of age. The Diagnosis of childhood autism must meet the specific DSM IV criteria and will therefore present with poor eye contact, pervasive ignoring, language delay, and other features.

Per definition, these children will have a severe impairment in speech, communication, or social interaction. Many of them will be completely non-verbal and “in their own world.”

ASD now includes various conditions as listed: • Autistic disorder (classic autism).

• Asperger’s disorder (Asperger syndrome).

• Pervasive developmental disorder not otherwise specified (PDDNOS).

• Childhood disintegrative disorder (CDD).

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MINDSET OF AUTISTIC CHILDREN THEORY OF MIND Difficulty explaining own Behaviors Difficulty understanding emotions Difficulty predicting the behavior or emotional state of others Problems understanding perspective of others Problems inferring the intentions of other Lack of understanding that behavior impacts how others think and/or feel Problems with joint attention and other social conventions Problems differentiating Fiction from Fact Picture credits: autismtopics.org 13

CAUSES OF AUTISM The causes seem related to genetic predisposition triggered by pollution affecting the mother (high contamination found in breast milk) or the child after birth through air / food / water / insecticides / pesticides / heavy metal exposure in drugs and daily use chemicals and household goods.

According to Dr. Allam, Institute of Child Development, the radiations from the IT sector are also a major cause of autism.

The maximum number of autistic people are in Bangalore within India and in America around the world since these are the IT hubs.

Picture credits: dealwithautism 14

SOCIAL CHALLENGES oTypically developing infants are social by nature. They gaze at faces, turn toward voices, grasp a finger and even smile by 2 to 3 months of age. o

By contrast, most children who develop autism have difficulty engaging in the give-and-take of everyday human interactions.

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By 8 to 10 months of age, many infants who go on to develop autism are showing some symptoms such as failure to respond to their names, reduced interest in people and delayed babbling.

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By toddlerhood, many children with autism have difficulty playing social games, don’t imitate the actions of others and prefer to play alone. They may fail to seek comfort or respond to parents' displays of anger or affection in typical ways.

oPeople with autism have difficulty in regulating emotions. This can take the form of seemingly “immature” behaviour such as crying or having outbursts in inappropriate situations. It can also lead to disruptive and physically aggressive behaviour. The tendency to “lose control” may be particularly pronounced in unfamiliar, overwhelming or frustrating situations. Frustration can also result in self-injurious behaviours such as head banging, hair pulling or self-biting.

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COMMUNICATION CHALLENGES By contrast, young children with autism tend to be delayed in babbling and speaking and learning to use gestures. Some infants who later develop autism coo and babble during the first few months of life before losing these communicative behaviours.

Others experience significant language delays and don’t begin to speak until much later. With therapy, however, most people with autism do learn to use spoken language and all can learn to communicate.

Many nonverbal or nearly nonverbal children and adults learn to use communication systems such as pictures (image at left), sign language, electronic word processors or even speech-generating devices. oSome have difficulty combining words into meaningful sentences. They may speak only single words or repeat the same phrase over and over. Some go through a stage where they repeat what they hear verbatim (echolalia). o Some children and adults with autism tend to carry on monologues on a favourite subject, giving others little chance to comment. In other words, the ordinary “give and take” of conversation proves difficult. o inability to understand body language, tone of voice and expressions that aren’t meant to be taken literally. For example, even an adult with autism might interpret a sarcastic “Oh, that's just great!” as meaning it really is great. oConversely, someone affected by autism may not exhibit typical body language. Facial expressions, movements and gestures may not match what they are saying. Their tone of voice may fail to reflect their feelings. Some use a high-pitched sing-song or a flat, robot-like voice. This can make it difficult for others know what they want and need. This failed communication, in turn, can lead to frustration and inappropriate behaviour (such as screaming or grabbing) on the part of the person with autism.

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REPETITIVE BEHAVIOURS oCommon repetitive behaviours include i.

Hand-flapping

ii.

Rocking

iii.

Jumping and twirling,

iv.

Arranging and rearranging objects, and

v.

Repeating sounds, words, or phrases.

vi.

Sometimes the repetitive behaviour is self-stimulating, such as wiggling fingers in front of the eyes.

oThe tendency to engage in a restricted range of activities can be seen in the way that many children with autism play with toys. Some spend hours lining up toys in a specific way instead of using them for pretend play. Similarly, some adults are preoccupied with having household or other objects in a fixed order or place. It can prove extremely upsetting if someone or something disrupts the order. oRepetitive behaviours can take the form of intense preoccupations, or obsessions. These extreme interests can prove all the more unusual for their content (e.g. fans, vacuum cleaners or toilets) or depth of knowledge (e.g. knowing and repeating astonishingly detailed information about Thomas the Tank Engine or astronomy). Older children and adults with autism may develop tremendous interest in numbers, symbols, dates or science topics.

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DIAGNOSIS o Autism spectrum disorder (ASD) diagnosis is often a two-stage process: i.

The first stage involves general developmental Screening during well-child check-ups with a paediatrician.

ii.

The second stage involves a thorough Comprehensive diagnostic evaluation by a team of doctors .

o Children with autism spectrum disorder Autism spectrum disorder (ASD) can usually be reliably diagnosed by age 2.

Early intervention can reduce or prevent the more severe disabilities associated with Autism spectrum disorder (ASD).

Early intervention may also improve your child’s language, communication and everyday functional skills.

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PREVELANCE OF AUTISM o The CDC survey found that around 1 in 110 children has Autism spectrum disorder (ASD). Boys face about four to five times higher risk than girls. oEstimated prevalence 1.12 [INCLEN study, unpublished data].

oThe incidence of Autism spectrum disorder in males 1:42 whereas in females it about 1:189. oThis makes that every 1 in 68 children is diagnosed with Autism spectrum disorder.

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CLINICAL FEATURES OF AUTISM Spinning

Repetitive behavior (perseverance)

No speech

Balancing, e.g. standing on a fence

Flapping hands

Behavior that is aggressive to others

Walking on tiptoes

Lack of interaction with other children

Lack of eye contact

Extreme dislike of touching certain textures

Self-injurious behaviour

Desire to keep objects in a certain physical pattern

Lack of interest in toys

Desire to follow set patterns of behavior/Interaction

Dislike of being touched

Treating other people as if they were inanimate objects

Non-speech vocalizations

Delayed echolalia: repeating something heard at an earlier time

Preoccupation with hands

Confusion between the pronouns “I” and “You”

Lack of response to people

Echolalia: speech consisting of literally repeating something heard

Extreme dislike of certain foods

Either extremely passive behaviour or extremely nervous, active behaviour

Delayed development of speech

When picked up, offering no “help” (“feels like lifting a sack of potatoes”)

Extreme dislike of certain sounds

“Islets of competence”, areas where the child has normal or even advanced competence. Typical examples include drawing skill, musical skill, arithmetic, calendar arithmetic, memory skills, perfect pitch 20

SIGNS AND SYMPTOMS â?–RESTRICTRCTIVE/ REPETITIVE BEHAVIOURS MAY INCLUDE: oRepeating certain behaviours or having unusual behaviours oHaving overly focused interests, such as with moving parts of objects oHaving a long lasting interest in certain topics, such as numbers, details or facts. â?–SOCIAL COMMUNICATION/INTERACTION BEHAVIOURS INCLUDE: oGetting upset by a slight change in routine or being placed in a new or overly stimulating setting oMaking little or inconsistent eye contact

oHaving a tendency to look at and listen to other people less often oRarely sharing enjoyment of objects or activities by pointing or showing things to others oResponding in an unusual way when others show anger, distress or affection oFailing to, o being slow to, respond to someone calling their name or other verbal attempts to gain attention oHaving difficulties with the back and forth of conversations oOften talking at length about a favourite subject without noticing that others are not interested or without giving others a chance to respond 21

oRepeating words or phrases that they hear, a behaviour called echolalia. oUsing words that seem odd, out of place, or have a special meaning known only to those familiar with that person’s way of communicating. oHaving facial expressions, movements, and gestures that do not match with what is being said oHaving an unusual tone of voice that may sound sing-song or flat and robot-like oHaving trouble understanding another person’s point of view or being unable to predict or understand other people’s action.

Children with ASD may have other problems, such as being very sensitive to light, noise, clothing or temperature. They may also experience sleep problems, digestion problems and irritability.

Picture credits: Wordpresscom

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CONDITIONS ASSOCIATED TO ASD oSensory problems : Many children with ASD either overreact or under react to certain sights, sounds, smells, textures, and tastes.

For example, some may: i.

Dislike or show discomfort from a light touch or the feel of clothes on their skin

ii.

Experience pain from certain sounds, like a vacuum cleaner, a ringing telephone, or a sudden storm; sometimes they will cover their ears and scream.

iii.

Have no reaction to intense cold or pain.

oSleep problems : Children with ASD tend to have problems falling asleep or staying asleep, or have other sleep problems. These problems make it harder for them to pay attention, reduce their ability to function, and lead to poor behaviour. oIntellectual disability : Many children with ASD have some degree of intellectual disability. When tested, some areas of ability may be normal, while others—especially cognitive (thinking) and language abilities—may be relatively weak.

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oSeizures : One out of four children with ASD have seizures, often starting either in early childhood or during the teen years. Sometimes lack of sleep or high fever can trigger a seizure. oFragile X syndrome : Fragile X syndrome is a genetic disorder and is the most common form of inheritance. An Intellectual disability, causing symptoms similar to ASD. Since this disorder is inherited, children with ASD should be checked for Fragile X, especially if the parents want to have more children. oTuberous sclerosis : Tuberous sclerosis is a rare genetic disorder that causes noncancerous tumours to grow in the brain and other vital organs.

Tuberous sclerosis occurs in 1 to 4% of people with ASD. oGastrointestinal problems : Some parents of children with ASD report that their child has frequent gastrointestinal (GI) or digestion problems, including stomach pain, diarrhoea, constipation, acid reflux, vomiting, or bloating. oCo-occurring mental disorders: Children with ASD can also develop mental disorders such as anxiety disorders, Attention Deficit Hyperactivity Disorder (ADHD), or depression.

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STRENGTHS AND ABILITIES oHaving above average intelligence. According to the CDC reports, 46% of ASD children have above average intelligence oBeing able to learn things in detail and remember information for long period of time oBeing strong visual or auditory learners oExcelling in math, science, music, game, art, computers.

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26 Picture credits: Pinimgcom

LEVELS OF ASD oThe DSM-5, published in May 2013, is the official publication of the American Psychiatric Association, unlike the DSM-IV, defines autism as a single “spectrum disorder,” with a set of criteria describing symptoms in the areas of social communication, behaviour, flexibility, and sensory sensitivity. oHere are the three levels, as described in the DSM:

Level 1: “Requiring Support”- MILD A person who is able to speak in full sentences and engages in communication but whose to-and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful.

Inflexibility of behaviour causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence.

Level 2: “Requiring Substantial Support”MODERATE A person who speaks in simple sentences, whose interaction is limited to narrow special interests, and who has markedly odd nonverbal communication.

Inflexibility of behaviour, difficulty coping with change, or other restricted/repetitive behaviours appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts.

Distress and/or difficulty changing focus or action.

Level 3: “Requiring Very Substantial Support”- SEVERE A person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches.

Inflexibility of behaviour, extreme difficulty coping with change, or other restricted/repetitive behaviours markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action.

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7 SENSES IN ASD Receptors over bodies develop sensory stimuli which is then processed and organised by the central nervous system. Autistic people often have difficulty processing sensory information. This may make an individual stressed or anxious. Some may even feel physical pain.

Autistic people are â?–Sight: The ability to see. oDifficulty maintaining eye contact oHas trouble copying information from one place or page to another oStruggles keeping place while reading oHas a hard time tracking a moving object oGets tired with reading or homework oExhibits characteristics of dyslexia, reversing words or letters when copying oDifficulty judging space and distance

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â?–Hearing: The ability to hear sounds. oMay be extremely sensitive to auditory input and appear stressed or anxious oCovers their ears when they are exposed to sudden or loud noises oHave difficulty determining where a sound is coming from oDistracted by seemingly normal background noises, not able to filter them out oEither some delay or confusion when following verbal directions oMay have normal hearing but has difficulty organising, interpreting or remembering auditory input

â?–Touch: The sense of pressure perceptions on the skin, the tactile system oBothered clothing, socks, certain materials oTouching things constantly oAvoids groups of other children, may fear unexpected touch oAvoids outdoor play, may dislike the wind on their skin oDifficulty in holding a pencil or using scissors oDislikes finger painting and using glue or clay oMay walk on their toes

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❖Taste: The ability to taste sweet, salt, sour and bitter oFussy or picky eater, preferring to eat foods with familiar tastes and textures oOnly eats “soft” or pureed food from the age of 2, may gag with textured food oHas difficulty with sucking, chewing and swallowing oFearful of going to the dentist or having dental work done

oDislikes or complaints about toothpaste and mouthwash oMay like, taste or chew on inedible objects from toddler years oComplains or reacts adversely to smells

❖Smell: The ability to distinguish odours. oSensitive to even typically pleasant or normal smells, causing stress or anxiety oRefuses to eat certain foods due to their smell oBothered by typical household or cooking scents, perfumes or aftershaves oDetermines whether he or she likes someone as a result of how they smell

oExcessively smelling when introduced to objects, people or places oUses smell to interact with objects oSeeks strong odours

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â?–Proprioception: The perception of body awareness in space. oApplies too much pressure when writing or coluring oAppears too rough when touching other children or animals oAppears clumsy, uncoordinated and have difficulty performing everyday activities oMay enjoy tight clothing or lots of layers

oAlways full of energy, on the go, loud and active oWalks with heavy feet, sounds like stomping oFidgeting when seated

â?–Vestibular: the perception of balance or acceleration. oFear of heights oDifficulty sitting still, always moving and seeking movement oDislike tilting their heads or being upside down oAppear to be clumsy and lack typical motor movement coordination

oHas difficulty riding a bake, jumping, hopping or balancing on one foot oCan be a thrill seeker at times and does not see risk or danger oRocking or spinning excessively

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THERAPIES FOR AUTISM oVerbal therapy oApplied Behaviour Analysis (ABA) oOccupational Therapy (OT) oMusic therapy oRelationship Development Intervention (RDI) oDevelopmental Individual-difference Relationship-based model (DIR) oCognitive Behaviour Therapy

oArt Therapy oYoga Therapy oPhysiotherapy oAquatic Therapy oSports Therapy oActivities of Daily Living (ADL) therapy 32

VERBAL THERAPY Verbal (speech and language) therapists observe, analyse, interpret and treat problems of speech, language, voice, communication and auditory processing when the disorder is a consequence of cerebral palsy, hypoxic brain injury or autism.

The therapy focuses on improving the patient’s speech, articulation, swallowing or communication with or without alternative methods. The program includes exercises to : oEnhance oral muscles, oImprove feeding and swallowing issues including problems with gathering food and sucking, chewing, or swallowing food.

oEstablish speech and language skills oTypically includes the development and improvement of communication skills. Helps to enhance social adaptation of the individual in regard to communication.

A speech therapist works with the child on the receptive (understanding) part of speech and language as well as the expressive part (talking).

Speech therapists help improve the child’s ability to speak clearly or communicate using alternative means of communication or sign language. Speech interventions often use a child’s family members and friends to reinforce the lessons learned in a therapeutic setting. This kind of indirect therapy encourages people who are in close daily contact with the child to use their new skills in conversation, learning and play.

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APPLIED BEHAVIOUR ANALYSIS (ABA) ABA uses the scientific principles of learning and motivation in order to effectively teach. It focuses on the idea that the consequences of what we do affect what we learn and what we will do in the future. ABA seeks to improve specific behaviours while demonstrating a reliable relationship between the procedures used and the change in the individual’s behaviour.

ABA uses positive reinforcement to increase more positive behaviours and social interactions and decrease inappropriate behaviours. ABA therapy is customized to an individual’s unique needs.

Picture credits: Pinimgcom 34

OCCUPATIONAL THERAPY (OT) Occupational Therapy is an art and science of facilitating and building up skills in a child to help them participate in day to day living through occupation. “Occupation� here means and includes things that children need to, want to and are expected to do.

Occupational / Sensory Integration Therapy is a method of helping people who are her oversensitive to the senses by overwhelming them with sensory experiences The overall goal of occupational therapy is to help the children under autism spectrum disorder improve his or her quality of life at home and in school. The therapist helps introduce, maintain, and improve skills so that people with autism can be as independent as possible. They will use exercise, facilitated practice, alternative strategies and adaptive equipment to promote independence.

An Occupational Therapist (OT) will help children: oAttention span and stamina level

oTransition to new activities

oSensory and processing skills

oPlay skills

oFine and gross motor skills

oNeed for personal space

oActivities of daily living (ADLs), also known as self-help skills, such as brushing teeth, dressing and toilet training; visual-perceptual skills; handwriting etc.

oAggression or other types of behaviours oInteractions between the child and caregivers

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MUSIC THERAPY Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.

Music Therapy is used to address physical, emotional, cognitive, and social needs of individuals. After assessing the strengths and needs of each child, the music Ability to alter therapist provides the indicated treatment including creating, singing, moving to, Improve your state and/or listening to music. Through musical involvement in the therapeutic of mind context, child’s' abilities are strengthened.

Music therapy also provides avenues for Reduce the communication that can be helpful to perception of those who find it difficult to express pain themselves in words.

Acts as a distracter Dopamine, feels good chemical

Meditative state. Faster beats and concentrated thinking Occupies the mind Alters patterns of pain

Brain on Music 36

RELATIONSHIP DEVELOPMENT INTERVENTION (RDI) RDI training is a therapy for autism spectrum disorder which is most effective when children start getting therapy at a young age, but it can be beneficial for people of all ages.

RDI training aims to teach children how to think flexibly and engage in social relationships with other people. Typically, RDI training begins by helping children develop relationships with their parents and other family members. It is very similar to other therapies for ASD in that it focuses on the disorder’s core deficit -- social skills and interaction.

RDI’s six objectives are: oEmotional referencing: The ability to learn from the emotional and experiences of others oSocial coordination: The ability to observe and control behaviour to enthusiastically participate in social relationships oDeclarative language: The ability to use language and non-verbal communication to express curiosity, invite interactions, share perceptions and feelings and coordinate with others. oFlexible thinking: The ability to adapt and alter plans as circumstances change oRelational information processing: The ability to put things into context and solve problems that lack clear cut solutions oForesight and hindsight: The ability to anticipate future possibilities based on past experiences

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DEVELOPMENTAL INDIVIDUAL-DIFFERENCE RELATIONSHIP-BASED MODEL (DIR) Floor time therapy derives from the Developmental Individual-difference Relationship-based model(DIR). Floor time allows parents to engage children literally at their level – by getting on the floor to play. Families can combine it with other behavioural therapies or use it as an alternative approach.

In Floor time, therapists and parents attract children through the activities each child enjoys. They enter the child's games. They follow the child's lead. Therapists teach parents how to direct their children into increasingly complex interactions. This process, called “opening and closing circles of communication,” remains central to the Floor time approach.

Floor time focusing on helping children reach six developments crucial for emotional and intellectual growth. They are: oSelf-regulation and interest in the world oIntimacy, or engagement in human relations oTwo-way communication oComplex communication oEmotional ideas oEmotional thinking

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COGNITIVE BEHAVIOUR THERAPY (CBT) Cognitive Behaviour Therapy works to change both cognitions and behaviours that are part of a mental health disorder.

CBT does not try to remove the disorder, instead it works the secondary issues related to the experience of life of an autistic person like anxiety, depression, stress, anger, bullying, social skills deficits and limited social support.

Since different people have unique cognitive and behavioural habits, thus therapist customize and prepare a tailored CBT plan to meet the strengths and needs of the induvial. Therefore, from the beginning of treatment, therapists explore their goals, passions, and values, then identify specific steps that CBT can help them make in service of that long term goal.

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ART THERAPY Art therapy is a creative method or technique used for therapy. It is a form of psychotherapy that uses medium of art as its primary mode of communication.

For a child with special needs, art can be a mode of expression, it can provide relaxation, help improve focus and give a sense of accomplishment while working creatively.

The creative process involved in artistic self-expression helps children to resolve conflicts and problems, develop interpersonal skills, manage behaviour, reduce stress, increase selfesteem and self-awareness, and achieve happiness.

In children with Autism, art therapy can improve skill to imagine and think symbolically and to recognize and respond to facial expressions. It will help in improving the fine motor skills of the child and somewhere also help in sensory integration.

Picture credits: Self clicked

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YOGA THERAPY Yoga therapy is the process of empowering individuals to moving toward improved healthy lifestyle through the practices of yoga.

Yoga is a scientific method of self transformation that will increase self awareness and engage an individual’s energy into desired goals. The aim is to reduce and dismiss inappropriate symptoms and behaviours and strengthen and emphasize appropriate behaviours.

Yoga improves the quality of life by improving the quality of sleep, provide relaxation, decrease pain, increase joint stability and strength. It helps physiologically by improving circulation, digestion, it helps regulate heart rate, respiratory rate and blood pressure. It also benefits an individual psychologically by increasing emotional stability, c2onfidence, reduces pain and anxiety, it improves the alertness of minded help overcome depression.

Yoga can help children with special needs in various ways like:

oImprove motor skills oImprove social skills and confidence oIt has calming effect on our senses and hence reduces uncontrolled repetitive behaviours and thereby cause sensory integration oCalming Attention Deficit/Hyperactivity Disorder (ADHD)

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PHYSIOTHERAPY Neuro-developmental/Neuromuscular Physiotherapy is a scientifically proven method to help promote increased mobility, strength, postural control, flexibility, coordination, balance/core stabilization, and gross motor skills of a child.

Physiotherapy emphasises on observation and analysis of the child’s current functional skill performance and the identification of therapy goals. It aims for active participation and practice of relevant functional skills. It also influence muscle tone and improves postural alignment by specific handling techniques. It may be used to help children with the following disorders: oDevelopmental Delay

oOther Neurological Disorders

oGross Motor Delay

oDevelopmental Coordination Disorder

oTorticollis

oHypotonia

oCerebral Palsy

oAcquired Brain Injury

oDeviant

oDe-conditioning from Prolonged Illness or Hospitalization

oGenetic Disorders

oPost Botox and Operative Treatment.

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AQUATIC THERAPY Aquatic Therapy is an activity with the use of water to aid in the restoration, extension, maintenance and quality of function for persons with acute, transient, or chronic disabilities, syndromes or diseases.

Aquatic therapy will consist of individual sessions of the therapist with the child, and it may include of sessions where the family members are also involved. The sessions can also be conducted in groups with multiple children and their parents.

Safety measures are taken before starting the therapy. Building a rapport with the child on land before entering into the water is necessary.

Benefits of Aquatic therapy oImprovement in Posture, Coordination, and Body Control oReduction in Improve Sensory Issues oImprove Social Skills oImprove Cognitive Functions

oHelps build impulse control and frustration tolerance Picture credits: continuakids 43

SPORTS THERAPY Exercising can benefit All children by energy release, and pure enjoyment of playing sports. Children with special needs are sometimes not encouraged to exercise due to the fear of injury. Participating in sports can help improve self-confidence, improve skills, help to improve executive functioning of the brain, in relationship building and working as part of a team. It also helps in weight management.

The benefits of regular physical activity are many: oBetter overall fitness oImproved cognitive benefits oBetter control of weight oHealthier bone density oBetter emotional and psychological health oImproved social skills oImproved motor skills oImproved self-esteem oReduced risk for diseases such as diabetes oReduced risk for some types of cancers 44

VISITS TO ORGANISATIONS

CONTINUA KIDS oWe visited Continua Kids in Sushant Lok, Gurgaon on 13.09.2017 to meet Ms. Nina Cherla, a musical therapist who deals with autistic children. oAt Continua kids, we learnt about Music therapy as well as other therapies provided over there. o

Picture credits: Self clicked

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SERVICES PROVIDED AT CONTINUA KIDS Continua Kids is a holistic centre that provides medically supervised therapies, early intervention programs and support for children with special needs.

CONTINUA Kids ensures that children with special needs are not hindered from achieving their full potential and get every opportunity to learn and grow, and live a meaningful and satisfied life. They wish to achieve this by providing children with a loving, empathetic and homely learning environment, by empowering their parents through guidance and support in their journey of parenting, and last but not the least, by spreading awareness in society and creating an environment of acceptance, love and equal rights for all.

Picture credits: continuakids

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MUSICAL THERAPISTS

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EFFECT OF MUSIC THERAPY ON ASD People with Autism spectrum disorder (ASD) often show interest and response to music, making it an excellent therapy for them. Music can promote relatedness, relaxation, learning, and self-expression. Music therapy addresses multiple developmental issues simultaneously. oEnable those without verbal language to communicate, participate and express themselves non-verbally. oHelps individuals with ASD identify and appropriately express their emotions. oSince music is processed in both hemispheres of the brain, it can stimulate cognitive functioning and may be used for remediation of some speech/language skills. oMusic provides concrete, multi-sensory stimulation (auditory, visual, proprioceptive, vestibular, and tactile). oThe rhythmic component of music is very organizing for the sensory systems of individuals diagnosed with autism. As a result, auditory processing and other sensory- motor, perceptual/motor, gross and fine motor skills can be enhanced through music therapy.

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TYPES OF MUSIC INSTRUMENTS USED oBrass Brass instruments are made of brass or some other metal and make sound when air is blown inside. The musician's lips must buzz, as though making a noise against the mouthpiece. Air then vibrates inside the instrument, which produces a sound.

Brass instruments include trumpet, trombone, tuba, French horn, cornet, and bugle. oPercussion Most percussion instruments make sounds when they are hit, such as a drum or a tambourine. Others are shaken, such as maracas, and still others may be rubbed, scratched, or whatever else will make the instrument vibrate and thus produce a sound.

Percussion instruments include drums, cymbals, triangle, chimes, tam-tam, glockenspiel, timpani, bells, and xylophone. oStrings Yes, the sounds of string instruments come from their strings. The strings may be plucked, as in a guitar or harp; bowed, as with a cello or a violin; or struck, as with a dulcimer. This creates a vibration that causes a unique sound.

Stringed instruments include the violin, viola, cello, bass, harp, and dulcimer. oWoodwinds Woodwind instruments produce sound when air (wind) is blown inside. Air might be blown across an edge, as with a flute; between a reed and a surface, as with a clarinet; or between two reeds, as with a bassoon. The sound happens when the air vibrates inside.

Woodwind instruments include flute, piccolo, clarinet, recorder, bassoon, and oboe.

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oKeyboard instruments Conveniently collected together as any instrument which is operated by means of a standard keyboard, the differences in operation are wide-ranging and carry obvious associations with certain of the above categories. These break down into four main types: 1.

Plucked mostly instruments emanating from the 17th/18th centuries where a series of stretched and tuned strings are plucked by a quill or plectrum (e.g. harpsichord, virginal, spinet).

2.

Struck where the strings are actually hit, either by a tangent (e.g. 17th/18th century clavichord), or hammers (e.g. piano, celesta).

3.

Aerated where the notes are activated by a column of mechanically propelled air within a series of tuned pipes (e.g. organ).

4.

Electronic where a number of effects approximating to those derived from any of the above instruments, as well as totally original sounds, can be achieved (e.g. electronic organ, synthesizer).

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OBSERVATIONS IN MUSIC THERAPY oMirroring- When a tone is played by someone and the other copies the tone after it. oMatching- When a tone is played by someone, but the other plays a different tone in continuation. oMusic generates sensation in the body. Music creates rhythm in the body. Different instruments focus on different sensory skills. oInstruments should have a nice grip, something which feels good to touch. oMusic is used to block out all surrounding sounds and disturbances. oA technique known as the Iso Principal is used. It is an approach to interactive music making where the therapist attempts to match the feelings and emotional state of the child. If the child is depresses, sad, then minor keys are played to produce a slow sound. A happy song would not be played to a sad/low person. The idea is to connect spiritually, not evasively. And vice-versa. oSome instruments need special training to be played whereas some instruments just need to be explored and tried to be played. oSoothing sounds of nature brings calmness in the mind and body. oSome Instruments are used to take energy, to let out anger and frustration.

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SERVICES oIndividual sessions last for about 30 – 40 minutes while group sessions take about 50 – 60 minutes. oSessions are conducted once a week unless the child requires or wants more frequent sessions. oEvery session is video recorded for monitoring and assessment purposes. o Assessment is done based on 3-6 month plan with reports given even 3 or 6 months.

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MARGSHREE oWe visited Margshree, an Academic set up in Sector 50, Noida on 19.09.2017. We met Prabal Sir who teaches and interacts with children with special needs. They offer congenial environment in which every child can learn. They focus on educational training of children with a cognitive approach through thought, experience, and the senses, wherein children come to them after attending normal school. They provide extra curricular activities and studies. Their method of teaching includes Reading, Writing, Language, Identification, Classification, Memory and Association. They provide minimum of 4 classes of therapy a week i.e. 120 hours/week. oMargshree provides the following services: ASSESSMENT AND DIAGNOSTIC SERVICES o Neuro developmental / Cognitive Psycho diagnostic o Psycho Educational Assessment o Developmental, OT/ Sensory Processing & Speech and Language Assessment o Educational Assessment Grade level Assessment (GLAD) Functional Assessment Vocational Assessment/ Skill Assessment o Aptitude tests o Behaviour Assessment

INTERVENTION SERVICES/ THERAPIES o Special Education o Occupational Therapy & Sensory Integration o Speech and Language Therapy o Social Skills Training o Behaviour Therapy o Remedial Education o Art based Therapy(Drama, Movement, Visual art and Music) o Play Therapy

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oPrabal sir explained us about autism and told the various methods of dealing with children with ASD. He explained us about Hyper- and Hyposensitivity in Autism.

HYPER-SENSITIVITY o o

o

o

o

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Hyper vision means that their vision is too acute. They get distracted by the tiniest pieces of fluff on the carpet, dust particles flying’, bright lights and look down most of the time.

Individuals with hyper hearing are generally very light sleepers, are frightened by sudden unpredictable sounds (for instance, telephone ringing, baby crying); they dislike thunderstorm, crowds. They often cover their ears when the noise is distracting .

Sometimes they make repetitive noises to block out other disturbing sounds.

Children with olfactory hypersensitivities cannot tolerate how people or objects smell. They run from smells, move away from people and insist on wearing the same clothes all the time. Some dislike food smell and they reject it no matter how hungry they are. They are usually poor eaters, gag/vomit easily and eat only certain foods.

Children who are hyper tactile pull away when people try to hug them, because they fear being touched. Even the slightest touch can send them into a panic attack. Washing hair or cutting nails turns into an ordeal. Many individuals refuse to wear certain clothes, as they cannot tolerate the texture on their skin. Some children with hyper tactility overreact to heat/cold, avoid wearing shoes, avoid getting ‘messy’ and dislike food of certain texture.

Children with vestibular hypersensitivity experience difficulty changing directions and walking or crawling on uneven or unstable surfaces. They are poor at sports. They feel disoriented after spinning, jumping or running and often express fear and anxiety of having their feet leave the ground.

Individuals with proprioceptive hypersensitivity hold their bodies in odd positions, and might have difficulty manipulating small objects.

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HYPO-SENSITIVITY Sometimes the senses of autistic children are in ‘hypo’, so that they do not really see, hear or feel anything. To stimulate their senses they might wave their hands around or rock forth and back or make strange noises. oChildren with hypo vision may experience trouble finding out where objects are, as they see just outlines, then they may walk around objects running their hand around the edges so they can identify what it is. These individuals are attracted to lights, they may stare at the sun or a bright light bulb. They are fascinated with reflections and bright coloured objects. Having entered an unfamiliar room they have to walk around it touching everything before they settle down. Often they sit for hours moving fingers or objects in front of the eyes. oChildren with hypo hearing may ‘seek sounds’ (hearing electric equipments or enjoying crowds, sirens and so on). They like kitchens and bathrooms since they are the noisiest in the house. They often create sounds themselves to activate their hearing – banging doors, tapping things, tearing or crumpling paper in the hand, making loud rhythmic sounds. oIndividuals with hypo taste/hypo smell chew and smell everything in their reach(e.g. grass, play dough). They licks objects, play with them and try to put everything in their mouth to get its taste. oThose with hypo tactility may not be able to feel pain or temperature. They may not feel a wound caused by a sharp object or they seem unaware of a broken bone. They are prone to self-injuries and may bite their hand or bang their head against the wall.

They like pressure, tight clothes, often crawl under heavy objects, hug tightly and enjoy rough play. oChildren with vestibular hyposensitivity enjoy all sorts of movement and can spin or swing for a long time without being dizzy.

People with vestibular hyposensitivity often rock back and forth or move in circles while rocking their body. oThose with proprioceptive hyposensitivity are often unconscious of their own body sensations, for example, they do not feel hunger. Children with hypo proprioceptive system seem floppy, often lean against people and objects. They bump into objects and people, trip frequently and have a tendency to fall. They have a weak grasping power and drop things frequently.

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THEORY OF MIND (TDM) oAccording to Prabal Sir, Autistic children have an ability to self imagine every situation, which is a part of THEORY OF MIND. Theory of Mind mentions that many autistic people do not understand other people’s thinking and point of view. They have a difficulty in understanding other people’s beliefs, attitudes and emotions. oSince the autistic individuals are not able to comprehend other people’s thoughts, they face problems relating to socially connecting to people and communicating with them. They may not be able to apprehend what others will say or do in various occasions. Furthermore, they may have difficulty in understanding their peers or friends and thus may appear to be selfcentred, peculiar or uncaring.

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MEANS OF TEACHING Prabal sir uses mainly two methods of cognitive teaching: oPECS: Picture Exchange Communication System- PECS is built on the idea that children who can't talk or write can be taught to communicate using pictures. In PECS, he draws or shows a picture to the child and tells the child to recognise and say it or match it with the written word. This helps the child to connect with the object and associate with daily life. oThe Six Phases of the Picture Exchange Communication System Are: 1.

How to Communicate: Autistic child learns to exchange single pictures for items or activities they really want.

2.

Distance and Persistence: Using single pictures, the autistic child learns to generalize this new skill by using it in different places, with different people and across distances. They are also told to be more persistent communicators.

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Picture Discrimination: The autistic child learns to select from two or more pictures to choose their favourite things. These are placed in a basket, a copy with Velcro strips where pictures are stored and easily removed for communication.

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Sentence Structure: The autistic child learns to construct simple sentences on a detachable sentence strip using an "I want" picture followed by a picture of the item being requested.

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Answering questions: The autistic child learns to answer “What do you want� by pointing at a picture.

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Commenting: The autistic child is taught to comment in response to questions.

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oMIND Language: Prabal Sir uses sign language for those autistic children who find it hard to connect spoken words to objects. The signs are usually adopted and made by the children. oUsing sign language can help the child to develop communication skills. It provides the child a way to communicate his needs by not crying or showing tantrums. This helps in eliminating stressful behaviours and promoting effective communication. oSince every child is different and has different ways of expression, different children may have different signs for expressing a common situation. oSign language is suitable since the repetition of sign in the same visual place allows the child to process and associate its meaning along with the spoken word to long term memory. oSome of the common sign language used by autistic children:

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On observing Prabal sir interacting with an autistic girl, aged 5 yrs. ,the following were observed: oHe massages on the back to calm the child and increase the concentration oHe gives numbers to her and tells her to match oPlays poems on the phone to bring her attention back oGives her paper to tear oHe sings poems for her and tells her to sing along oPlays a game where she has to put coins in holes vertically oTells her to match pictures, items, animals

The girl’s reactions/ behaviour during class: oCries to go home oSays “bye-bye” to Sir frequently to show disinterest oRuns from sir oDoesn’t want mother to go o Sits on lap of mother in class

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On observing Prabal sir interacting with an autistic boy, aged 8 yrs. , the following were observed: oMakes him do phonetics. Says the alphabet and tells the boy to repeat. oHe shows the written word and tells boy to pronounce through phonetics. For example, cat, dog, goat, sad, etc. oMakes boxes and write number in it and ask boy to re-write in boxes. oAppreciates and encourages boy by giving high five. oMake the boy count back ward.

Interaction with boy’s mother: We also spoke to the boy’s mother. She told us about how unaware of they were about autism earlier. They family didn’t know what autism was. When the boy was born, they didn’t know what the problem was, so they took him to various doctors at the age of 3 when they got to know that his brain development was slow. None of the medication provided was of any help to the boy.

Although they put him into a normal school, but after attending it for 4-5 years they realised that the school was not treating him very well and other schools were very expensive for them as their monthly fees was Rs 25,000-30,0000, so they decided to take him out of school. Instead the parents started taking him for therapy classes like speech therapy, occupational therapy classes and behaviour classes.

She informed us on how inconsiderate the government is about these special children. None of the schemes are helpful for them.

There are a lot of social problems that she goes through daily. The society doesn’t not accept such special children. She questions the intelligence of society when they autistic children “mad”. She told us that it becomes very problematic to take her child in metros, shops, parks, etc for interaction with general public as they do not understand the child’s behavioural issues and in turn make fun of them.

The family treats the boy as normally as possible and include him in all family activities and occasions.

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Activities at Margshree oMatching shapes/ animals/ objects oBlock building oDrawing and identification oDropping beads and coins in slots oCars with lights oAuditory, soft, hard toys oDifferent textures

oPicture books oStory telling: Prabal sir narrates social stories with less content and more visuals keeping a positive impact on children to emphasise on good behaviour. The stories target on good behaviour so that the children self realise the things that should be done and that should not be done.

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Toys at Margshree

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A chair designed specially for a child with Cerebral Palsy

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PARENT’S FEEDBACK ABOUT MARGSHREE

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INSTITUTE OF CHILD DEVELOPMENT oWe visited Institute of Child Development(ICD) in Malviya Nagar, New Delhi on 16.09.2017 to meet Dr. Mansoor Alam. He is a consultant in Early Intervention and Developmental Paediatrics. It is a clinical set up where there are highly trained, certified and professionally qualified doctors who analyse the children and prescribe the treatment to be given to the child. It is one of the first paediatric rehabilitation centres in India that work with children with Neurodevelopmental Disorders and Neuromuscular diseases like children with brain injury, high risk infants and developmental disabilities, etc. oICD provides high quality assessment and intervention for children with development delays, cerebral palsy, PDD (Pervasive Development Disorders), GDD(Global Development Disorders), DCD(Developmental Co-ordination Disorders), SPD(Sensory Processing Disorders), Attention Deficit Disorders, Obsessive compulsive disorder, Feeding Disorder and other behavioural and development disabilities. oAccording to Dr. Alam an early diagnosis increases the chances of normalcy through successful intervention. Although normalcy is not possible, it can prevent secondary problems like muscular contraction, deformities, behavioural problems, attention / concentration problems, writing difficulties, social-emotional problems, limitation in participation, relationship, self regulation, or poor self esteem.

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On meeting Dr. Alam, he informed us about Autism spectrum Disorder (ASD) which is an umbrella term of the following: oAutism oRett Syndrome oAsperger syndrome oChildhood Disintegrative Disorder oPDD-NOS (Pervasive Developmental Disorder Otherwise Specified) used to describe atypical autism.

Not

These five conditions include problems in using and understanding language, difficulty relating to people, difficulty with changes in routine, repetitive body movements and unusual play skills.

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PDD-NOS (Pervasive Developmental Disorder Not Otherwise Specified) PDD-NOS can coexist with a wide range of intellectual ability. Its main features are facing challenges in social and language development. Individuals with PDD-NOS can be placed in one of three subgroups: oA high-functioning group (around 25%) whose symptoms are largely similar to that of Asperger syndrome, but differ in terms of having a straggle in language development and mild cognitive impairment. (Asperger syndrome does not generally involve speech delay or cognitive impairment). oA second group (around 25%) whose symptoms more closely resemble those of autistic disorder, but do not fully meet all its diagnostic signs and symptoms. oA third group (around 50%) who meet all the diagnostic criteria for autistic disorder, but whose stereotypical and repetitive behaviours are noticeably mild.

Symptoms of PDD: oDifficulty in change in routine oIrregular skill development (motor, sensory, visual, tactile, cognitive, organizational, social, academic, behavioural) oPoor development of speech and language skills oIncreased or decreased sensitivities to taste, see, hear, smell and/or touch oPreservative (repetitive) behaviour

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ASPERGER’S SYNDROME Asperger syndrome is generally considered to be on the “high functioning” end of the spectrum. The children with AS have difficulty with social interactions and exhibit a restricted range of interests and/or repetitive behaviours. There is a delay in their Motor development, leading to clumsiness or uncoordinated motor movements. In comparison with those affected by other forms of ASD, however, those with Asperger syndrome do not have significant delays or difficulties in language or cognitive development. Some even demonstrate precocious vocabulary – often in a highly specialized field of interest.

Symptoms of Asperger: oLimited or inappropriate social interactions

o“Robotic" or repetitive speech oChallenges with nonverbal communication (gestures, facial expression, etc.)coupled with average to above average verbal skills tendency to oDiscuss self rather than others oInability to understand social/emotional issues or nonliteral phrases

oLack of eye contact or reciprocal conversation oObsession with specific, often unusual, topics oOne-sided conversations oAwkward movements and/or mannerisms 69

RETT SYNDROME Rett syndrome is a rare, severe neurological disorder that affects mostly girls. It's usually discovered in the first two years of life. Although there's no cure, early identification and treatment may help girls and families who are affected by Rett syndrome. It is mostly genetically based.

Symptoms of Rett syndrome: oSlowed growth: The brain doesn’t grow properly, and the head is usually remains small (this is known as microcephaly).

This growth becomes clearer as the child gets older. oUnregulated hand movements: Most children with Rett syndrome do not have control on the use of their hands. They tend to twist or rub their hands together. oNo language skills: Between ages 1 to 4, social and language skills start to decline. Children stop talking and can start having extreme social anxiety. They may maintain distance from or not be interested in other people, toys, and their surroundings. oProblems with muscles and coordination: This may make walking problematic. oTrouble with breathing: A child with Rett may have uncoordinated breathing and seizures, including very fast breathing (hyperventilation), forceful exhaling of air or saliva, and swallowing air.

Children with Rett syndrome also tend to become tense and irritable as they get older. They may cry or scream for long periods of time, or have long fits of laughter.

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CHILDHOOD DISINTEGRATIVE DISORDER Childhood disintegrative disorder (CDD), or Heller's syndrome, is a rare prevalent developmental disorder (PDD) which involves relapse of developmental ability in language, social function and motor skills. CDD is considered a low-functioning form of ASD. However, autism does not show the severe relapse after several years of normal development whereas children with CDD show a more dramatic loss of skills compared with children with autism.

CDD also tends to develop later than autism, and can develop very much later (up to the age of 10 years).

Symptoms Affected children show clinically significant losses of earlier acquired skills in at least two of the following: o Expressive language skills o Receptive language skills o Social skills and self-care skills o Bowel or bladder control o Play skills o Motor skills Abnormal function also occurs in at least two of: o Social interaction o Communication o Repetitive interests or behaviours

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UDAAN UDAAN is one of Delhi’s foremost Non Profit Organisation for Training, Rehabilitation and Early Medical Intervention with Integration of children with moderate to severe Autism Spectrum Disorder, Cerebral Palsy, Down Syndrome, Mental Retardation, Traumatic Brain Injury and Learning Disabilities to lead a better quality of life, and to help them return to their rightful place in society and gainful employment wherever possible. They also help and guide parents/guardians of the special children regarding diagnosis and evaluation of brain-related disabilities, home management and selection of special schools. They focus on improving the quality of life of disabled children.

VISION Their vision is to make the Spirit of Freedom fly like a free bird in spite of the disability trying to drag down the child. This is personified both in the name of our Project: UDAAN for the Disabled, and their logo.

MISSION oThey focus on providing affordable intensive one-to-one Rehabilitation and Training to children and adults with moderate to severe disabilities, especially those induced due to brain damage. oDevelop and standardize affordable evidence based medical methodologies for reversal of brain damage in disabled children with Cerebral Palsy and Autism. oSpread awareness about the newly established medical strategies to enhance the quality of life and level of employability of children with Neurodevelopmental disability, beyond what may be achieved by the best standards of recognized Rehabilitation Techniques

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TIMELINE OF UDAAN o1992 : Birth of UDAAN o1994 : Registered as Non profit trust ; Foundation for Spastic and mentally Handicapped Persons. o2000 : Recognized by Ministry of social justice, Govt of India as a project for education and training of severely multiple handicapped children. o2001 : Pioneered introduction of HBOT in brain damaged children o2006 : Initiated Biochemical testing for Children with Autism and need based dietary and micro nutrient support. o2006 : Introduced low pressure hyperbaric therapy in India to treat children with brain damage. o2007 : Organized NR2CON, an international conference covering all aspects of neurodevelopmental disabilities, attended by more than 600 delegates and presented by 7 international authorities and almost 20 national authorities as speakers. o2007 : Initiated mild HBO for children with autism o2010 : Dr. Mukherjee was awarded Hyperbaric Doctor of the year at the 7th International symposium on HBOT, California. o2012 : First Indian Doctor to complete 1st & 2nd training module of Medical Academy of Paediatric Special needs from U.S.A.

( MAPS )

o2013 : Initiated Autism Hour, a free monthly internet based interactive conference on one important topic on Autism, conducted by a world authority, with Dr. Mukherjee on the Specialist Panel as one of the coordinators. o2013 : MB12 double blind randomized controlled clinical trial in autism affected children initiated.

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We visited the Udaan organisation in Sector 55, Noida which is owned by Jan Kalyan Trust. The school is on the 2nd floor and is run by Madhu Ma’am

Picture credits: Self clicked

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OBSERVATIONS : DAY 1 14TH SEPTEMBER 2017

This was the first day when we went and visited Udaan and met Madhu ma’am for the first time. It was a very overwhelming experiencing for us. On meeting Madhu ma’am she guided us about the children with special needs and informed us about how they treated them as normally and equally as any other child. She told us how we were supposed to interact with the children and if needed could take assistance from any of the faculties or helpers. There were three main instructors Madhu ma’am, Anuradha ma’am (dealing with children with the age up to 12 years) and Sandeep sir (dealt with children up to the age of 24).

First day we were told to help the children of age 12-24 with computers, art and crafts.

Children tried to run from the class but we as volunteers had to bring back their attention and encourage them to work and finish their work. We made them do their activities according to their time table.

On observing their actions, we understood that since most of them have a trouble in communicating, so they use sign language to express their feeling. They use some common actions for going to the washroom, ask for drinking water, showing hungry, etc.

Since we were not familiar with actions and reactions, we were a little worried and scared on the first day as we did not know how they would react to our commands. It was surprising to see them shouting, crying, yelling, hitting, biting themselves in short intervals when they were anxious, happy, sad, frustrated, etc.

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DAY, TIME AND YEAR

CHILDREN HAVE TO PICK THEIR NAME AND PUT IT IN THIS BOX ON ENTERING

EVERYONE’S NAME AND TIME TABLE IS MENTIONED

NAMES ON ENTRANCE

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OBSERVATIONS : DAY 2 18TH SEPTEMBER 2017

On this day we had to observe the children and get involved in other activities and games with the children. The observations made on the day were: We were told to help Vivan and Suhani in embroidery. We had to make designs on the cloth and then they were doing embroidery on the lines. Both of them were following the instructions quite well and they made beautiful designs. But in short intervals of time, they got distracted or bored and wanted to do something else. In frustration, they sometimes pulled the thread quite tightly in order to break the thread or started biting their hands or knuckles.

It was also observed that all children communicate differently. Some answered questions by saying words but not very clearly, some used sign language or some answered by drawing or writing different options and asking them to choose the right answers. On asking both of them about their favourite colours, they told that it was Red and Pink respectively.

During the craft class where children were given the activity of envelope making by cutting and pasting, it was noticed that some enjoyed it whereas some found it very boring. Motor skills were also not the same for all, some had an excellent grip of the scissors and were cutting along the line and vice versa. During pasting the sheets, some had problem in sticking the sheet due to stomping whereas some stamped the sheets very hard making the sheets tear.

The time duration for each class is fixed and the children have to change classes for each activity. Since all of them are of different levels of autism, some needed help in changing classes whereas some are very independent.

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OBSERVATIONS : DAY 3 19TH SEPTEMBER 2017

On the 3rd day we were the children from 9 am to 2 pm. We were told that they had Yoga classes on Tuesdays and Fridays. So we went at 9am to be part of their yoga classes. They were assessed by the teachers during yoga classes. Some of them enjoyed whereas some of them had problems in doing the asanas or staying focused. On that day they had other classes like Circle Time, Attendance, Signature and teaching Date, Month, Year.

On the third day we spent time with the small children and sat in their class with them. We interacted with Swastik (naughty and talkative yet clever), Mayank, Shikhar (destructive, uninterested, laughs, slams door), Pashu(4 years old with cerebral palsy, doesn’t say anything, claps when acted to her) Aneesh and Sarthak.

We celebrated Anuradha Ma’am’s birthday by cutting a cake and distributing sandwiches and drinks to all children and we also had.

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VISUALS MADE FOR CHILDREN TO DRAW ON PAINT

LADY BIRD

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TURTLE

CATER PILLAR Picture credits: Self illustrated 82

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CAR TREE Picture credits: Self illustrated 84

BUTTERFLY

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CAT

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OBSERVATIONS : DAY 4 20TH SEPTEMBER 2017

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Made strings with beads for Diwali

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Game Time

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OBSERVATIONS : DAY 5 21st SEPTEMBER 2017

oKept a party for all the children and took edibles for them like Samosas, Frooti tetra packs, Chocolates and chips packets.

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CASE STUDIES

SAMEER oRepetitive behaviour: Continuously talks and asks questions and repeats everything oVery curious oKnows how to do things but cannot recall things oKnows about basic tools on MS Word and Paint and knows how to use it oGets distracted and irritated easily on short intervals. Closes laptop and switches off all switches in aggression. oPossessive about belongings. oVery stubborn and wishes all his wants to be fulfilled oTries to skip things oFond of junk food and Pepsi. Didn’t do anything until he got Pepsi.

Age: 12 years

o Becomes destructive in short time intervals. Starts hitting companions while playing and complaints. oExaggerates and makes up wrong stories to seek attention. oCant understand other’s emotions 92

VIVAN MISHRA oHas good motor skills

oCan type words from seeing on a paper oInitially had problem in making space in between words, but on teaching he learnt how to put spaces oTypes really hard on keyboard oDoesn’t have control on how much pressure to put

oGood at matching colours and shapes by seeing the picture oVery fast and enthusiastic while playing on the computer oCant speak properly oRocks the chair when anxious oTries to respond when asked something by choosing the right answer when given options by writing the words or showing pictures Age: 19 years

oTries to repeat words when told to speak o Gets irritated on doing the same thing for a long time oEnthusiastic about working, always gives a “yes” for working ahead 93

AMRIT oFaces problem in making complex shapes and forms oGood matching skills oGood in typing oDoesn’t get frustrated easily oShakes hands and does hand movements in anxiety oStable for long time oDoesn’t talk, problem in language and speech

oRuns to the washroom when frustrated oDoesn’t pay much attention oLooks down always, no eye to eye contact Age: 17 years

oUses sign language to communicate oWalks away after completing work oWell groomed 94

PRITAM oPoor typing skills and very slow. Takes 7 minutes to type 5 words oGets distracted very easily and Starts laughing in time intervals oVery affectionate and friendly oGood in match the following game oPatient in paint as he patiently erases the whole screen oTries to copy others oGood motor skills oGood learner but forgets things easily oGood in art and craft and Can make envelopes fast oFollows instructions very well Age: 16 years

oTries to communicate but unable to do so oGood in stitching and making patterns

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SUHANI oWants to be called beautiful oVery girly oBites hand in anxiety and frustration oGets bored in short intervals and wants a break oDoesn’t talk but tries to repeat words when told to oGood in craft work, does very nice and clean embroidery and beading oFollows instructions very well

oUses more of actions and repetitive words to communicate with others oNeeds guidance to perform any activity oDependant to go to the washroom also Age: 14 years

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ANSHUMAN oVery inclined to music oHas sung on radio oGets distracted in classes and runs to watch music videos on the laptop oKnows how to run YouTube oTypes with both hands very fast from books oCan read out properly, usually reads in a musical tone oVery creative

oWants to do art and draw things all the time oLike to cut and create new things oAsks for A4 sheets frequently for drawing Age: 18 years

oHas a problem in distinguishing in currency oCan communicate well oMusic therapy can work for him oPossessive about his belongings 97

SWASTIK oEfficiently speaks name of shapes and colours

oAssociates colours to real life like Sky blue, grass green oKnows spelling of his name and phone number and can write it properly oPatient during classes and works throughout to complete the work oGood motor skills and was able to type well and use the mouse oHe perceived and made complex shapes and makes complex drawings very well

oVestibular issues as he swings to and fro on the chair oMakes sounds after completing a task oUsually understand words in capital letters but tries to write in small letters also in boxes oGets distracted after writing a sentence and needs a break oTries to harm people in anxiety and gets personal likes tries to pull hair, throws ball on a classmates' face

Age: 12 years

oUnderstands and knows how to identify date, time and year oCan pronounce a word after hearing it oRepeats words when not needed oWhile counting he gets confused and needs help oUses Phonetics while talking or reading.

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RUSHITA oStudied till 10th grade oStubborn and doesn’t like to follow instructions oTalks properly and has no problem in socially interacting with others oTakes care of other autistic children oHas interest in drawing, colouring and computer graphics oDoesn’t get irritated easily oVery friendly and talkative

oPampered and self centred

Age: 24 years

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NOISE SENSITIVITY IN AUTISM oHyperacusis is an increased sensitivity to sound that is found among autistic people. This means that certain noises may be uncomfortable for your child to hear. When a sound is distressing to a child, he or she may show discomfort by covering their ears, trying to turn off the source of the sound or leaving the noisy environment. oAccording to a survey, The children with autism rated sounds that were above 40 decibels as being significantly louder than the children in the other group. For reference, a normal conversation is about 50 decibels and a “library voice� whisper is around 30 decibels. This suggested that children with autism may have a reduced range of comfortable volume, meaning that sounds start being uncomfortable at a lower volume than for other children. So, it may be that children on the autism spectrum actually perceive noise to be louder than their peers.

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STRATEGIES TO HELP HYPERACUSIS oIdentify Irritants Perhaps the most important step is to identify which sounds are uncomfortable for your child. Examples may include the radio or school bell, a vacuum or the dishwasher. When your child indicates distress at the onset of a sound, make note of the cause. Also, talking to an audiologist can help you identify the type of sound sensitivities your child may have. oCreate Quiet Time Audiologists and speech-language pathologists discourage the overuse of earplugs and headphones to avoid noise sensitivities.

However, it is acknowledged that noise cancelling headphones may provide relief if a child becomes exceptionally distressed and overstimulated. Noise breaks may also be helpful (for example, going to the noisy grocery store followed by a quiet activity). oIdentify Quiet Zones Write down the places that are naturally quiet and comfortable for your child. This could be a library, art class, a church group or going for a walk.

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oCreate distractions When trigger noises are unavoidable, a distraction may help your child manage the invasive sound. A favourite toy, an iPad, puzzle or special bottle of bubbles may redirect your child’s attention from the distressing noise to the novelty of his or her new activity. oObserve First Before exposure to a potentially uncomfortable noise, allow your child to listen to the noise from afar. Using multiple opportunities to familiarize your child to the sound will help reduce the shock of a long exposure to a sound. oCreate Control Adjusting to certain sounds may be aided by allowing your child to feel in control of the sound. In example, if the vacuum is an unpleasant noise maker, allow your child to turn the vacuum on and off. Similarly, allowing your child to ring bells, start the dishwasher or honk the car horn may help ease his or her aversion through gradual exposure at his or her own will.

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OBSERVATION On observing a child during her speech therapy, it was found that she was uncomfortable with loud sounds. The therapist advised her parents to take her often to movie theatres and make her listen to music on a surround sound system to make her used to the high volumes.

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REMODIFIED DESIGN BRIEF To design an inclusive game/activity/product for Children, specially with the symptoms of Autism Spectrum Disorder to enhance their skills and make them sustainable in the environment.

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TARGET AUDIENCE oChildren, specially with Autism within the age group of 5-10 as children of this age group are limited to think concretelyin tangible, definite, exact and uni-directional terms based on real and concrete experiences rather than on abstractions. oDuring this age group, children analyse their environment using mental symbols. These symbols often include words and images and the child will apply these various symbols in their everyday lives as they come across different objects, events and situations. oThroughout this age group, children use appropriate logic to develop cognitive operations and apply the new thinking to different events they may encounter. Children in this age group incorporate inductive reasoning, which involves drawing conclusions from other observations in order to make a generalization.

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INSIGHTS Things done in Anxiousness: oBite Knuckles

oVisually appealing things attract them

oBite fingers

oMatch things well

oRock chairs which can make them fall

oHappy if appreciated

oPull and stretch things tightly- pull the needle tightly while oHave to be instructed and hand held to do a particular task sewing oWant to pull things

oMain favourite colours are: Red, Yellow, Blue, Pink, Green

oApply pressure very hardly

oMove hands in an unusual manner

oMusically inclined

oSome enjoy drawing and colouring

oSome pick up things fast oSome pick up things slowly oUnderstand things visually

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DESIGN INSIGHTS Any product designed for an autistic child should have these features taking in consideration a normal kid also: o Easy to use, yet challenging: If a child has a problem in operating the game then it would be a fail, although it could have some level of complexities that challenge the mind of the child.

oRepetitive: Game needs to have a repetitive set of actions that leads towards the goal. Since the children with ASD tend to relax after they see or do something again and again, repetition can help them in calming down. oEducational and Message giving: Game needs to deliver some message such that in the end the child learns something and can apply it in real world. It should have connections with the things related to his daily life or surroundings. oSocial Aspect: The game can involve two or more children or playing under the supervision of an elder that could help them know each other and connect socially. It could also be a single player game as well because children with ASD might not like to do so. oPictorial: The primary requirement of any board game designed for ASD would need to have pictures. Because these children are usually not vocal and they could easily relate through means of drawing or sketching, so the game needs to be pictorial. oMultiple levels: Game needs to have complexities in ascending order from 7-12 years. oSense of Achievement: In the end like regular games, it should give the child a sense of achievement which would invite him to play the game again.

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THINGS TO CONTROL oAnxiousness oFrustration oBoredom oNoise Sensitivity oMonotony oHarming themselves or others oIncrease concentration

oEnhance memory skills oEnhance tactile experience oPromote interaction with others oRelatable games oAppreciation required oDevelop motor skills 108

CONCEPTUALIZATION

109

GAMEPLAY This game will consist of a box with 4 openings on the top.

The board on top and the box underneath will be divided into 4 compartments based on the four seasons: Rainy, Summer, Winter and Autumn. The corresponding compartment of the season will consist of objects related to the season.

The child has to go to the box, spin the spinner and whichever season it points to, the child will put his hand inside the hole on the top of the box and take out an object and show it to everyone and guess it.

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GAMEPLAY This game comprises of a wooden picture board with grooves of shapes in it. There will be other pieces of the same shapes to fit into it which would be of the actual material to give the child a good tactile experience.

The pictures would be of everyday scenes which the child can relate to. The materials would be daily materials from the environment.

The child will have to pick up the piece, feel its material and texture and figure out where would it be fixed.

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GAMEPLAY oThis game includes a board with boxes cut out from it which follow a path. All the boxes are allotted points but the boxes that fall in the path lead to the box with the maximum point which can make the child win. The boxes where all the ball passes will lit up so that the child knows which point he attained. oThe child has to aim the direction of the ball and strike it though a bow and arrow striker.

The initial game thought of was to aim a ball and strike it to drop number of bottles lined up in front.

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GAMEPLAY oThis activity board aims at teaching the child how to lock and unlock, close and open different kinds of buttons and locks which are found in everyday objects.

This is to make the child independent so that he does not need help of others to do these day to day activities. oIn this board, there are different everyday items in which different kinds of buttons and locks are found.

The child has to identify the object and figure out which locking mechanism is used there and open and close it.

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GAMEPLAY oThis game will comprise a picture board with pictures of everyday objects starting with alphabet. E.g. A picture of an Apple at A, ball for B, etc. All the alphabetical pictures would be scrambled and will not be in any order.

There will also be a bowl of alphabets. oThe child has to pick up an alphabet from the bowl and recognize the initial alphabet of the pictures and place the letter over the picture starting with the respective alphabet. oThis game can be played by 4 players, each sitting on the side of the board.

BENEFITS OF THE GAME: oLearns spelling of words oConnects visuals with words oLearns to wait for chance oCan connect with daily objects

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GAMEPLAY oA texture carpet to enhance the tactility experience of the child.

The carpet is divided into a grid, each box having a different texture of material.

oThe child has to roll a dice which has sides naming +1, +2, +3, -1, -2 and-3. whatever option the child gets, he has to move accordingly on the mat. oEach move will provide different tactile experience to the child.

BENEFITS OF THE GAME oImproves sensory experience oHelps in learning addition and subtraction by actually taking steps oWill improve tactility

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GAMEPLAY oThis activity is based on the concept of mechanics. A metal framework with fine grid would be hung from the ceiling. Different parts of MECHANICS and screws and screwdrivers would be provided to the child. oThe child has to screw different parts in the metal framework and unscrew it. By joining different parts, the child could create interesting forms.

BENEFITS OF THE GAME oEnhancing motor skills oLearn fixtures: how to screw and unscrew things

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GAMEPLAY oA mechanical table in which two objects pop up randomly electronically. The faculty will ask to recognise a particular object.

oThe child will have to identify both of the objects and then recognize the particular object asked for. oAfter 1 round finishes, the child can press NEXT. BENEFITS OF THE GAME

1.

Identification of everyday objects 2.

3.

Speech therapy

Enhances memory skills

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GAMEPLAY This is a currency exchange game where the child has to exchange money to buy everyday items.

BENEFITS OF THE GAME 1.

Learns how to calculate and exchange money for daily items

2.

3.

Will learn about currency Enhance addition and subtraction

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GAMEPLAY This is a game in which the child has to throw the respective coloured rings into the rods. The rings would be tambourine rings that create sound on reaching. Each ring will have different number of bells to produce different intensities of sound.

BENEFITS OF THE GAME 1.

Improves focus and aiming 2.

3.

Can calculate distance Enhances attentivity

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GAMEPLAY oThis is a musical wrestling bag for the children to bang in agitation. It will have a layer of skin on the outing. There would be cushioning for avoiding harm to the child. The wrestling bag would have different amount of bells inside to give different sounds at different levels.

BENEFITS OF THE GAME 1.

Helps in letting out of anger and frustration

2.

The ringing of bells can calm the child

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FEATURES OF THE PRODUCT oThis is a tool for children who engage in sewing, stitching and embroidery. Instead of the circular rings, which cause a big problem to autistic children, this mechanism can be attached on the table. The cloth can be attached on the mechanism for the embroidery to take place. The length can be adjustable since the mechanism has telescopic structures.

BENEFITS OF THE PRODUCT 1.

Reduces the confusion caused by embroidery in ring 2.

Not harmful

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GAMEPLAY oThis table has several compartments which can be interchanged. The top tray would have grooves in a maze form to move the token. The boxes will have pictures of animal which the child will have to match with the animal token. The child has to find his way to the animal’s home. The tokens would be 3D animals. oWhen the child matches the animal to it’s house, there will be a sound of the animal as a form of appreciation to help their sound sensitivity.

BENEFIT OF THE GAME 1.

Enhance motor skills as child has to find way through the maze

2.

Child will learn about everyday animals and their surroundings 3.

Form of appreciation in the means of their sound. It will also help them in getting used to sound of animals found in the surroundings.

This game was selected for iterating further 122

FINAL CONCEPT

123

ABOUT THE GAME: GAZE-O-MAZE oGame. GAZE –O- MAZE enhances the motor skills, ability to memorize and noise sensitivity of autistic children. The game comprises ➢ Board with a maze ➢ 10 animals tokens seen in everyday environment ➢ 5 slots for placing Animal house/food in the maze ➢ Picture cards containing animal house and their food

oPlaying. The child selects an animal which is parked on the side of the maze. The child is tasked to take the animal to its house/ food through the maze. Eg. Make the dog reach the kennel/ bone from the sides where it is kept initially. There will be 10 animal tokens and 10 picture cards. There are only 5 slots on the board for the picture card, hence they can be interchanged. oSound. When the animal reaches its right destination, its home or its food, then a sound is created of the animal to show that it has reached the correct place. The sound of the animal is not created at any other point.

Since this game will be played under the supervision of an adult like the parent or teacher for giving the instruction, it will augment the relationship between the child and the parent/teacher.

Since children usually match visual things well, this game allows them to match the objects visually as well and achieve the task.

124

MOCK UPS

125

DIFFERENT MAZES

126

GAMEPLAY oWhen the child sits to play the game with the parent/ teacher, the adult instructs the child to match the animal with it’s house or food. For example, the parent may instruct the child to take the cat to the cattery or make the cat drink milk. oThe child will find the token of the animal from the all the animals parked on the side and glide its way through the maze to reach its destination. For example, the child will find the token of the cat from all the tokens parked in the side, and then slide the token throughout the maze to find the cattery/milk. oThe child may visually try to match the animal with its habitat/food. oAfter many trials and tribulations, when the child reaches the destination, there will be the sound of the animal to indicate achievement of task.

127

ANIMAL + HOUSE + FOOD LIST ANIMAL

HOUSE

FOOD

Tiger

Cave

Animals

Cow

Shed

Corn

Elephant

Jungle

Sugarcane

Deer

Grassland

Grass

Dog

Kennel

Bone

Horse

Stable

Hay

Bird

Nest

Fruit

Cat

Cattery

Milk

Sheep

Pen

Plant

Chicken

Coop

Grams, Seeds

128

FEATURES OF THE GAME Maze

Card Quality

Animal Homes/ Food

Sound Capturing

Benefits

Complex maze

Both sides are useable to give Wide variety of animals can variety be used

When the animal token reaches its destination, there is a sound produced of the animal to indicate that the task has been achieved.

Educative about animals their habitat/sounds/ things their uses/ sound they make etc

Allows smooth & easy movement of animals

Cards are removeable. They are visual representations of the habitat/food of the animal. By looking at the pictures, the child can match the animal.

Children can be taught about the animals their habitat/ food habits/ sounds they make

It proves as a motivation for children. It helps in noise sensitivity in children specially with autism. The children become acquainted of the sounds of animals in their surroundings.

Children can be made aware of different objects / things/ the sound they make by replacing the stickers at the manufacturing stage

Can be made from MDF/Plastic/ Acrylic/ Dried dense wood

Cards made from Wood/Acrylic/ Cardboard

The animal tokens would be made of melted plastic through plastic moulding.

It can be manufactured using The cards have stickers on 3 D Printing / Milling both sides depicting the machines/ Plastic Moulding animal home on one side and food on the reverse

Makes them accustomed to various sounds especially for autistic children

The base of the animal token The programme used for would be made of Delrin. making the sounds would be Arduino through RFID/SD card module with 5 receivers and 10 small chips.

129

FINAL ANIMALS TO BE USED

130

Picture card

Animal Token with square base to glide through the way

Maze

Made on Solidworks

131

Made on Solidworks

132

Made on Solidworks

133

Made on Rhinoceros

134

PROTOTYPES

135

PROTOTYPE 1 Magnetic strip on way to glide token Picture card

Animal token with metallic base to attract with magnetic strip

136

PROTOTYPE 2

This has 2 layers of mount board which have been laser cut. 2 layers have been made to give an elevation in the upper layer. The lower layer is 2mm less on all sides than the upper layer for the token to fix and glide through without coming out.

137

FINAL LAYOUT OF MAZE Upper layer Under layer

138

FINAL UPPER LAYER LAYOUT

139

FINAL UNDER LAYER LAYOUT

140

TECHNICAL DRAWINGS

141

420 mm

142

300 mm

143

PROTOTYPE 3

In this prototype the upper layer has been elevated by cutting small pieces of mount board and stuck between the base and the upper layer that has been laser cut. There will be space between the base and the upper layer for the token to fix and glide through without coming out.

144

MAKING PROCESS IN LASER CUTTING MACHINE

The 2D layout is made on Auto Cad

Command is given on Laser Cutter

The laser cutter cuts the sun board

145

PROTOTYPE 4 Grooves for token to move

Groove for picture cards

This game board is made in MDF and the grooves have been created through a milling machine.

146

Animals will be fixed in the groove and can move around the maze When the animal reaches the picture card there will be a sound of the animal to show that the animal has reached its place

Animals has to find way and reach the picture card which contains the animal house/ animal food The picture card can be interchanged

147

MAKING PROCESS IN MILLING MACHINE

Sticking the sheet of 2D layout on MDF (420*300*20mm) and cutting the negative space on a Milling Machine

148

A drill beat with four corners is attached in the milling machine to make a cut path on both the sides under the above path

The board is filleted and sanded from corners

After cutting, the paper is removed and the dust it dusted off from the spaces

After sanding, the game board will be varnished

149

A rod of Delrin is taken for making the base of animal token

The rod is turned on the lathe machine to cut into the desirable dimensions

A hole is drilled in the middle of the plastic animals for the rod to go and fix into it

150

3D VIEWS OF GAME BOARD

TOP VIEW

FRONT VIEW

PERSPECTIVE VIEW

SIDE VIEW

151

3D VIEWS OF TOKEN

TOP VIEW

FRONT VIEW

PERSPECTIVE VIEW

SIDE VIEW 152

TECHNICAL DRAWINGS

All measurements in mm 153

HORIZONTAL DIMENSIONS

All measurements in mm 154

VERTICAL DIMENSIONS

All measurements in mm 155

FINAL GAME

156

COMPONENTS OF THE GAME BOARD

Picture Cards

Animal Tokens

Game Board

157

DIFFERENT VARIABLES OF THE GAME BOARD On analysis of Children with ASD, it is advisable to keep low arousal subdued colours . A monochromatic colour scheme is preferable The evidence suggests that colour perception is almost like a reflex; an inherited understanding, not one that is learned. Due to structural abnormalities in the brain, autistic children often have difficulty in processing and integrating sensory information including visual information. People with autism often detect colours with higher intensity.

They are more sensitive to their surrounding so the world appears extraordinarily sharp to them.

In order to avoid strong visual stimuli it is important to opt for subdued, muted, broken colours. It is not advisable to go for pure, vivid and acidic colours.

There are, however, a few colours that tend to be better suited for autistic children (and likely everyone else): oThe Calm BLUE Sea

oGREEN Means Go oFresh Peeled ORANGES oPINK means Love oEarthy/ wooden colours

158

PINK

159

GREEN

160

ORANGE

161

BLUE

162

SHEESHAM WOOD

163

DARK COLOURED MDF WITH VARNISHING

164

LIGHT COLOURED MDF WITH MATTE VARNISHING

165

RED ACRYLIC BOARD

166

TOKENS

DOG

CAT

167

DEER

HORSE

TIGER

ELEPHANT 168

COW

CHICKEN

BIRD

SHEEP 169

PICTURE CARDS WITH SOUNDS 70 mm

70 mm

170

171

172

FINAL PROTOTYPE

173

ANIMAL TOKENS

174

ARDUINO The Arduino has been programmed in such a way that the token for each animal is customized and is not interchangeable.

Eg. The roar of a tiger will come when it will reach it’s den/meat. The roar will not be sounded when it touches the home/food of any other animal.

175

PROTOTYPE TESTING

5 YEAR OLD CHILD PLAYING THE GAME

176

HOW IS THE GAME HELPFUL The game will help the child develop his motor skills as he will be able to learn to control his hand movements by moving the animal counters in a definite direction/path. The game will also increase their power of memorizing things related to everyday animals that they see in their surroundings. Since the child may try to figure out the habitat/food of the animal by visually identifying the picture, it boosts their matching abilities. The sound effect would make them get used to the actual sound of the animals that they might hear on a regular basis and may find it uncomfortable. The game will thus help them in their sound sensitivity.

177

BENEFITS OF Gaze-O-Maze ENHANCING COGNITIVE SKILLS: Since the child may try to figure out the habitat/food of the animal by visually identifying the picture, it boosts their matching abilities. This helps the child to connect with the object and associate with it in their daily surroundings.

FINE MOTOR SKILLS: The game will help to develop their motor skills as he/she will be able to learn to control his/her hand movements by moving the animal token in a definite path/ direction. Holding the animal token and not being able to pull it out will improve their grip.

The game ensures that a child constantly improves on his hand and eye coordination as they have to keep track of the path to reach their destination.

ENHANCING CONCENTRATION/ ATTENTION LEVEL: While doing any task, a child needs to be attentive and autistic children need some kind of motivation to move ahead. The animal sounds which are made when they reach the goal, acts as a re-enforcement and motivates them to move to the next task.

Since the child has to wait and listen for the animal sound in the midst of surrounding sounds, they need to concentrate for identifying the sound.

ENHANCING MEMORY/ LEARNING SKILLS: The game will also increase their power of memorizing things related to everyday animals that they see in their surroundings.

By looking at the picture and hearing the sound of the animal in the game, they can memorize it and identify the animals in their real life. They can read the names of the animals, their home and food on the picture cards and memorize the spellings.

VOCAL AND SOCIAL SKILLS: Since the game will be played under the supervision of a parent/teacher for giving instruction, it will augment the relationship between children and the mentor. While playing the game, the child says the name of the animal and its home/food which enhances their vocal skills.

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HOW IS THE GAME INCLUSIVE The game is designed for children of age group 5-10 and specially helpful for the children with autism.

The game strengthens the motor skills of a child, enhances their knowledge, improves their speech and makes them aware of the sounds, habitat and food of animals in their day-to-day surroundings.

The game can be played with the entire family which helps in bonding, communication and interpersonal relationships.

Since this game is designed for all children, but fulfils the needs of children specially with autism, it is an inclusive design.

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COST STRUCTURE Cost of Prototyping in MDF: MATERIAL

Qty

COST

oMDF (420*300*20mm): oMilling oDelrin token base oAnimals oVinyl Printing oArduino software oLabour oVarnishing oCarriage:

1 1 10 10 2 sheets 1 1000 200

₹200 ₹500 ₹100 ₹150 ₹40 ₹3000 ₹1000 ₹500 ₹500

TOTAL:

₹5990

Cost of Production would be 15% of the Cost of Prototyping in a scale of producing 100 items. Thus, the cost of 1 piece would be ₹900.

Hence, producing 100 pieces would cost ₹90,000 in MDF using milling process.

180

MATERIALS AND PROCESSES MATERIAL

PROCESS

PER UNIT COST(₹)

MASS PRODUCTION COST(₹)

MDF

MILLING

700

200

PLASTIC

PLASTIC MOULDING

SHEESHAM WOOD

MILLING

900

300

PLA

3D Printing

1000

500

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WHERE ALL CAN THE GAME BE SOLD The game can be sold in the following companies that make toys for children with special needs: oFunskool oRubbabu oPlayability Toys oToys R Us o Gummy Lump oSpecial Needs Toys o Lakeshore Learning o Fun and Function o eSpecial Needs oDifferent Roads to Learning oAbility Station

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HOW IS THIS IDEA OR SOLUTION UNIQUE? By playing board games from an early age, children have opportunities to develop language, motor, communication and thinking skills in a fun way.

Benefits of Learning via Gaze-O-Maze are : o Provides hands-on and heads-on skill and knowledge development for people of all ages on all subjects. o Game elements, problems to solve, and situations to consider allow players to think through and apply what they learn. o The board itself provides a visual metaphor to help connect information. o Gaze-O-Maze: ➢ Creates an engaging atmosphere ➢ Provides a nonthreatening, playful, yet competitive environment ➢ Focuses on learning content and reinforces applied learning ➢ Points out mistakes which the child needs to learn

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oContinuakidscom. 2017. Continuakidscom. [Online]. [21 September 2017]. Available from: http://continuakids.com/therapy/music-therapy oThemusictherapytrustcom. 2017. Themusictherapytrustcom. [Online]. [21 September 2017]. Available from: http://themusictherapytrust.com/ oVerywellcom. 2017. Verywell. [Online]. [21 September 2017]. Available from: https://www.verywell.com/what-are-the-three-levels-of-autism-260233

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