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An Initiative of National Trust
for the Welfare of Persons with Autism, Cerebral Palsy,
Mental Retardation & Multiple Disabilities
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Advice from Expert Team

Good Practices Guidelines for Parents:

For many families Autism services are difficult to access; often because they may not be available where you live and many times because the few service that may exist are over-subscribed.

We have listed some broad 'tips' that you may find are applicable to your situation. We have also included advice that you can give your child's teacher since we are aware of the lack of special educators who may have training in Autism specific strategies.

Some things you could do…

Accept your child as he or she is. Do not insist on 'making your child normal'. At present, there is no cure for Autism, hence as parents/caregiver your role should be that of a guide, facilitator who nurtures and enables the child to gain his autonomy and lead a fulfilling life.

Do not change therapists frequently. Developmental issues cannot be treated like infections. Children take a long time to get adjusted to a intervention/therapist and start showing any progress. Frequent changes will not only delay the process but also confuse the child.

Remember that results from therapy takes time to bring the change. While a child spends one to three hours with a therapist, s/he spends the remaining 21 hours with you.

Remember that if you learn what the teacher or therapist is doing; you can do the same thing at home so that it becomes a 'home-based intervention' in your child's real-life setting, with you as the therapist.

Be creative so that things you learn can be incorporated in your child's daily routine

Therapies conducted behind close doors should be discouraged. It is essential for parents to be informed about the methods the therapist is using with their child, what they can do at home and when to follow- up. If the therapist does require one to one with the child behind close doors then a one way glass door or any other method should be used for parents to be able to silently observe.

At home, do not be over-protective of your child. That is, do not complete tasks for your child. Let your child learn by trial and error. E.g. let him try to eat by himself even if he makes a mess!

Do not compare your child with other children.

Do not talk or discuss your child's problems to others in front of him (even if you think she/he doesn't understand); may children with Autism understand more than they can speak.

Do not pressurize him to talk but encourage him to listen and participate.

It is preferable to avoid excessive exposure to TV and other electronic media, as this will tend to make the child more solitary and lose out on opportunities to learn social and communicative skills.

Try and get as many family members to help, siblings are often motivated and motivating!

Developing a good structured daily routine will help your child settle into predictable routines.

There are a number of books and manuals that are very helpful in carrying out intervention; here are a few of them.


Information is key…

Get accurate information

Try and connect with other families who have children with Autism

Become member of a parent group or a societies which supports parents with children with Autism

Bring family members on board who are empathetic and can help.

Organize your life so that needs of all family members are met

Remember it is very important to take time off from caring for your child and allocate some time for rest, relaxation, entertainment, and pursuing your own hobbies and interests

Try to maintain your social and personal life; do not isolate yourself from your family, relatives and friends

Be prepared to explain the child's problem to others in simple terms so that they can understand

It is very often helpful and may give you relief to discuss your worries, problems, and difficulties with somebody whom you trust.

It is not healthy for the child to be engaged in 'therapy' all the time. Both the children and families need rest, relaxation and entertainment like anyone else.

Learn what works best for you , your child and your family

Reaching out to your community leaders for guidance can often give you support from unexpected areas.

Find out what the child has learnt to do first. Then move on to what s/he needs to be taught.


Though we are going to try and give you information on this website; there are a number of web resources that provide accurate, scientific and up-to-date information on ASD. Visiting these sites and learning more about ASD may help you to understand more about this disorder. Here are a few


First Signs (www.firstsigns .org)

Autism Society (www.autism-society .org)

Research Autism (http://researchautism.net)

The National Autistic Society (www.autism.org.uk)

Autism speaks (www.autismspeaks.org)


Action for Autism (www.autism-india.org)

Autism Society of India (http://www.autismsocietyofindia.org)

Helping your child with socialization:

Children with Autism lack an ability to relate, interact and respond to people around them. However, it is possible to teach them these skills through systematic, step-by-step, repetitive inputs.

Basic behaviours that require training are simple social behaviours such as: look, take, give, show, come, go, bring, and point.

These are activities which enhance joint attention, (that is, the child and mother focusing their attention on the same object and then doing something together - for example, both focusing attention on a rattle, then mother shaking the rattle and giving it child, then child shaking the rattle (with or without mother's help) and giving it to mother on her request, when she gestures and says 'give"). Other joint attention activities that can come later are mother pointing and child following direction of pointing, child following mother's direction of gaze. With some practice, assistance, encouragement, prompting, and praise these joint attention activities can be taught to the child. This helps the child to become more and more socially alert and aware, and to take greater interest in people and their activities, and responding to them appropriately.

Noticing their responses which are feeble at first, and strengthening these responses by doing this again and again will help them to understand social cues and respond appropriately to these cues, and thereby improve their reciprocal and spontaneous social behaviours.

Another good method is through caregiver - child games. There are plenty of these games in each culture, and child needs to be engaged through these plays and games. Simplest of games are tickling, peek-a-boo, and gentle swinging on the legs with a lullaby. Initially child may remain indifferent, but with repeated attempts and modifying the approach, which works best with a given child, child slowly starts responding and starts enjoying these activities and games.

These mutually enjoyable playful games and activities are often very effective to make the child respond, seek out and interact with people. Once the child enjoys these simple activities one could move and to more elaborate - clap-clap game, run and catch, throw ball and catch, kick ball back and forth, "I am coming…I am coming….I have come!!" game, father pretending to be elephant and giving a savaari(ride) to child with mother being the mahout, train game etc.

Similarly, interactive games involving sand, water, play materials, household utensils, are often liked by children. Later, one could introduce turn-taking games (hide and seek, "you first, I next, father last") and rule-based games (you are out!!)

Sometimes child may appear indifferent and not paying attention, but he may be still listening, and comes up with the behaviour unexpectedly!

Careful natural observation of the child will help in deciding what the child wants and then one can organize new activities around it. In other word, child's choice for activity is recognized, and given importance.

Child can be given many choices, and then depending on the child's preference, one can go ahead with interactive activities. It is also possible to convert child's solitary activities into interactive ones. Suppose child is interested in ball. Parents repeatedly say ball? And give it only when the child gives some indication verbally or by gesture that he wants it.

For older children with good verbal skills, there are a number of methods that can be employed to teach them what to do and what not to do in different situations. One method is to tell the child clear do's and don'ts, making the child rehearse these and monitoring and role-play the situation and giving them the feedback. This requires a lot of animation on the part of parents, so that messages are clearly conveyed. Another method is to build simple stories around the situation, going over the story and then create mock situations for practice. Later, child's behaviours in real-life situations are observed and appropriately reinforced.

Many of these skills can be taught as a part of interaction in their daily routine, in other words incidental teaching.

Self-help skills Training:

From a very a early age, it is very important to encourage, teach and train these children in taking care of themselves in their daily activities, so that they become more and more independent as they grow older.

This can start with simple things such as drinking from a cup, and eating by self. Later, toilet indication, undressing, dressing, brushing, toilet training, grooming skills, bathing skills, simple household chores can be the focus of training.

It is a good strategy to select a few targets in different areas at a time that the child is capable of learning and then move further once the child has learnt these. How to make children respond to our efforts to teach and train? Parents often get disappointed when there is a child who does not seem to care when they tell him/her to do something.

Behaviour modification methods to build new skills are very useful here. These are modelling or imitation (showing how), physical prompting with fading (holding the child's hand and doing the required task - hand on hand technique.

Later gradually reducing the support), shaping (simplifying the task and then gradually making it more and more identical to the goal), backward chaining (when the activity is complex, breaking it into many small steps and teaching them one by one, beginning with the last step first; example for drinking from a cup, give the cup to hand, then picking cup from table, and so on). Noticing the child's efforts to learn, however small and feeble they are, and praising immediately in a manner that child understands, will help the child to remember and learn faster (rewarding or reinforcing).

Communication and language
  • Communication and language is one of the core problems that these children face - but can be improved with appropriate training/therapy/intervention
  • Communication means exchange of messages, intentions, thoughts, information etc between people - a two-way process - shared understanding
  • Non-verbal (gestures, vocalizations, and body language) and verbal (language and speech, written)
  • Non-verbal - involves understanding others' gestures and body language, and expressing through gestures and body language
  • Verbal - involves understanding others' speech, reading, and expressing through words, phrases and sentences, and writing
  • Reception first, expression later
  • Start early; focus on gestures accompanied by simple words
  • Talk and play while feeding, dressing, bathing, etc. Give running commentary. Keep it simple and relevant to activities
  • Let the child watch the way you speak by getting attention and look at face
  • Make it two-way: Listen to noises and sounds, take interest and imitate his/her sounds - parallel vocalization
  • Use gestures, body language and facial expressions to help clarify the meaning
  • Name the objects that are in the child's focus of attention repeatedly
  • Rhymes, lullabies, songs are useful media
  • Using mirror to promote imitation
  • Do not unduly pressurize or force
  • Notice and take pleasure in utterances, vocalizations, and words
  • Try to figure out the meaning of child's utterances and rephrase
  • Recording and playing may help some children
  • Using pictures to communicate
  • Recognizing, naming, describing, relating experiences
  • Mini-conversations around ongoing activities
  • Question with answer in end in different tone
  • Written language
Cognitive skills

Cognition means to know, and children with ASD need inputs to understand their surrounding so that they can learn to deal effectively with their environment.

Simplest examples of cognitive skills are physical concepts such as size, shape, consistency, temperature (hot/cold), colour, quantity (more/less), etc. Sorting, arranging, classifying activities enhance concept formation.

Other concepts child has to master are directions (up/down, right /left,) relationships between objects (inside/outside, under/above) time (now/later, night/day, yesterday/tomorrow, day, date etc), distance (near/far). Later they need to learn readiness or pre-academic skills such as scribbling, drawing, colouring, copying.

This is followed by scholastic skills of reading, writing, spelling and arithmetic. It is preferable not to force the child into any activity; alternatively; one can try different methods and find out which approach suits the child best (individualization of approaches). Some children may do better with computer-based learning.

  • Few hours of play home, baby nursery, or Anganwadi center, when they are very young is useful.
  • Can and should go to school at an appropriate age
  • There are laws that ensure that no child is excluded from schooling - this is called inclusive education
  • Having a dialogue with the school before putting the child to school and later to follow-up how are things going in school is necessary.
  • Expectations about what child learns can be worked out.
  • It is possible to develop peer support with some effort by the school
  • Open schooling (nios.org) is another alternative that might suit, at a later stage.
Problem behaviour(s)

Sometimes individuals with ASD develop problem behaviours. Some common examples are aggression, self-injury, hyperactivity, and sexually inappropriate behaviours.

Studying the patterns - how it started, where, when and with whom it occurs, and when it is not present, what happens after the behaviour- otherwise called as functional analysis - will help in understanding the roots of problem and how to help the individual overcome the problem.

Sometimes these behaviours serve some purpose - for example, trying to communicate something, getting frustrated because s/he can't make others understand, and developing his/her own methods of doing so.

Behaviour Modification techniques are often very useful in minimizing these problems. Some examples are as follows:

  • Time structuring and Activity scheduling (predictable and organized sequence of activities in a day at appropriate times; care must be taken that the schedule is realistic and fulfils all the needs of the individual. Whenever possible, individual should have a say in the preparation of the schedule)
  • Attention-enhancing tasks
  • Disregarding (attend to the child, but completely ignore the behaviour),
  • Ignoring (ignore the behaviour and child),
  • Differential reinforcement ('catch' the child when s/he is showing appropriate behaviour and attend/praise/reward),
  • Antecedent management (taking pre-emptive steps to prevent the behaviour from occurring),
  • Limit setting (clear instructions about what is allowed what is not allowed and following it through),
  • Graded exposure / desensitization (gradual exposure to the situations that the child is scared of, so that the child slowly overcomes the fear),
  • Time-out (putting the child in a boring place without attention till s/he cools down).

Many times these problem behaviours result from faulty parent-child interaction patterns. These can be identified and changed, so that behaviour decreases. Improving the skills of the child also helps the child to give up problem behaviours.

On Therapies:

National Trust does not recommend therapies like HBOT, Chelaton, Stem cell Therapy since there are no conclusive scientific evidence as yet in proving their efficacy in treating conditions of Autism

Therapeutic Hysterectomy

Parents of young girls with Autism are often in a dilemma on how to keep their daughters safe. Some doctors may recommend a hysterectomy or taking out the womb in a surgical procedure. However this is against the rights of the woman and should be avoided unless the individual makes a decision based on the facts. Hence if your daughter with Autism is able to understand and discuss the issue and feels she would like this operation (having understood all the consequences); she should be given this option.

However for the more severely affected individuals who are not able to understand the seriousness of such a surgery, it is preferable to use other methods to teach her how to keep safe; work with a special educator and use social stories to teach her how to say 'no' if approached in a threatening way and make sure your daughter knows the safe persons and places that she can go to in case she feels she is at risk.

  Autism Spectrum Disorders or ASD is commonly called Autism Neuro- typical: A term used for people who do not have Autism or ASD  
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