World Autism Awareness Day 2026 Autism and humanity : Every life has value

Dr Yumnam Sana Devi
How to support Children with Autism at Home?
We all are aware that Autism Spectrum Disorder (ASD) /Autism is a Neurodevelopmental disorder with two core features of deficits in social-communication and restricted- repetitive behavior/interests. A child with ASD will gradually gain the skills that he lacks through the brain development and training. No two children have same level of deficits and functioning because of heterogenous nature of the disorder itself. Hence long term outcome depends on major factors like intelligence, speech and language level, presence of co-morbidities, response to intervention and extent of family’s home based interventions.
ASD management is essentially a multidisciplinary approach comprising of Psychiatrist, Pediatrician, Neurologist, Speech and Language Pathologist, Clinical Psychologist, Occupational Therapist, Special Educator and Psychiatric Social Worker. Mostly, therapist training will be a time limited center oriented therapy.  Hence sustenance and generalisability of those learnt skills will depend on the extent of home based practices.  Every caregiver will accept the fact that irrespective of the age or child developmental condition, the family has maximum contact time with child, with numerous opportunities to train the child in natural settings. Providing training in a familiar environment makes the learning process a stress free for children which allows more frequent and consistent intervention which are crucial for achieving a target skills.
 Caregivers are encouraged to take active roles and become equal partners in the treatment of ASD. Home based activities that are effective for children with ASD are as follows
1. Speech therapy at home
* Communication strategies: Teaching non-verbal communication methods like attending skills- maintaining eye contact, looking at the person’s face; shared attention task; pointing; imitation skills (mirror game)
* Interactive Language Play: reading stories together, singing songs, or playing games that require simple responses
2. Behavior therapy at home
* Applied Behavior Analysis (ABA) principles to be followed i.e structured interventions for developing a positive behavior through a reward system. To simplify it every positive behavior should be followed by a reward (verbal praise, hug, favorite object). However visible result is expected only when the above pattern are practiced consistently  for most of the day.
* Tailored Activities: Activities should be designed to integrate seamlessly into daily routines, helping children learn functional skills like brushing teeth, dressing, or engaging in social interactions with family members
3. Occupational Therapy at home:
* Sensory Integration: Sensory-friendly activities tailored to the child’s specific needs, such as tactile play with different textures or listening to calming music, which help in managing sensory sensitivities
* Daily Living Skills : Work on skills necessary for daily living, such as eating with utensils, using the bathroom independently, and managing simple chores, which are crucial for building self-reliance. These are dependent on development level of motor skills for which different activities to be practice consistently
I. Gross motor activities: walking, running, jumping, hopping, crawling
II. Fine motor activities : Dough/clay modeling, grain sorting, peg board games ,colouring, cut and paste activities
* Optimising home environment for therapy
a) Structuring the physical space : Designating specific areas for therapy can help establish routines and minimize distractions, making therapy sessions more effective.
Dedicated Therapy Area: Set up a particular part of the home for therapy sessions. This area should be quiet, well-lit, and free from unnecessary distractions. It helps the child associate this space with learning and therapy.
Sensory-Friendly Modifications: For children sensitive to sensory overload, it’s important to control environmental factors such as light, sound, and textures. Use soft lighting, minimize ambient noise, and include comfortable seating arrangements that accommodate sensory needs.
Organized and Accessible Materials: Keep therapy tools and materials organized and within easy reach. Use clear, labeled containers and shelves at an appropriate height for the child to access independently when appropriate.
b) Creating a Supportive Atmosphere
Visual Schedules and Labels: Use visual schedules and labels around the home to provide predictability and structure, which can reduce anxiety and help children understand what to expect throughout the day.
c) Incorporating Flexibility and Comfort
Flexible Learning Areas : Some children may benefit from having options regarding where they learn. Having a primary area for structured activities is important, but also consider creating spaces where the child can engage in more relaxed or creative play. This approach can help facilitate learning through comfort and choice.
Personalization : Personalize the therapy space with items that the child finds comforting or engaging, such as favorite colors, characters, or themes. This personal touch can make the therapy area feel safe and inviting, enhancing the child’s willingness to engage in therapy activities.
* General principles of training:
1. Training should occur every day.
2. Training should also be integrated into the daily routine rather than have only a specific "therapy time". If therapy is done only at a specific time, place or by a person, chances are that child might avoid or get upset when approaching the training session. When the family members are not able to spend extra time with their child due to some reasons, integrating training in to the daily activity is extremely beneficial.
3. All the family members should be involved in training. Child will benefit from different activities with the family members. Training of a child with ASD requires tremendous energy and patience; hence the burden has to be shared amongst all the family members.
4. Training should largely be pleasurable for the child and the family.
5. Child should be immediately and consistently reinforced (social or material) upon completion of the task.
6. Tasks and reinforcers used in the training should be varied to maintain child’s interests.
7. Tasks should be planned keeping child’s strengths and likes in mind. E.g visual daily schedule
* Practical Tips for Parents
Engaging children with autism in therapeutic activities at home requires creativity, consistency, and patience. Here are practical, easy-to-implement tips for parents that facilitate effective therapy sessions and encourage active participation.
a) Establish a Routine: Consistency is a key in autism therapy. Establishing a regular schedule for therapeutic activities helps create a sense of security and predictability. Set Clear Expectations: Use visual schedules or timers to outline the day’s activities, helping the child understand what to expect and when to expect it. Routine Before Flexibility: Once a stable routine is established, gradually introduce small changes to help the child adapt to new situations while maintaining a sense of structure.
(To be contd)