In this article, SPD@Tampines’ occupational therapist Genevieve Ng, who is part of the Early Intervention Programme for Infants and Children’s (EIPIC) transdisciplinary team, shares how she develops curriculums that support children with autism and other developmental needs in maximising their participation and independence in their daily life.

Identifying the child’s needs and motivations

Children with autism generally have challenges in social communications and interactions. This means that they may find it difficult to initiate or maintain a conversation with people, and to notice and understand social cues during conversations or unwritten social expectations in various settings. In addition, children with autism also tend to work better with structure and predictability.

To develop goals for each child, the team would:

• First look out for and understand the interests and strengths of each child under their care, the areas of concerns affecting their participation in classroom routines, and the parents’ priorities,
• then develop functional goals for each child, and
• provide interventions in naturalistic classroom settings and routines such as art or snack time, and arrival and dismissal routines to meet the goals set and to improve their level of participation in class.

Helping the children cope with non-routines and disruptions

There are also times when interventions carried out may not specifically be linked to a child’s goal but is still essential to improve their engagement in class.

For example, during the COVID-19 Heightened Measures period, the constant changes to class size and sessions affected the children’s ability to participate, understand and follow the new safety measures, such as staying on one side of the classroom to maintain social distancing. There was subsequently a need for the children to carry out swab tests and vaccination.

It was all new and unfamiliar to the children and it would have caused much frustrations and confusions. Genevieve and the EIPIC team came up with social stories and visual schedules on the process of doing a swab test and vaccination to create structure and predictability for the children. The team also used medical-themed toys to role play the scenarios and de-sensitise the children to the vaccination procedure.

Using visuals to get messages across

A great way to relay information and simple instructions are through the use of visuals. This helps a child better understand how they are expected to behave or what they are required to do.

For instance, a visual schedule is used in class to display their routine for the day. Each child has their own visual schedule to follow, with activities like “arrival”, “art lesson” and “snack time” illustrated on cards and arranged in a vertical row. Every time a particular activity is completed, the child can remove that card from the schedule and move on to the next activity. The visual schedule provides the child with an overview of the day’s events, as well as a clear, structured routine to create a sense of predictability.

The iceberg analogy

Genevieve remembers the several occasions when persons with autism have been misunderstood for their intent and behaviour. One particular incident was of a student, who had a meltdown when he was not able communicate his thoughts in time.

To that, Genevieve akin that to the iceberg analogy: “What we see is only the tip of the iceberg, but there is always so much more underlying that behaviour. My hope is that society can take time to know and understand autism by simply interacting with persons with autism and getting to know them better before coming to a conclusion.“

View Genevieve’s sharing in this video.