Category Archives: Developmental Disorder

泛自闭症障碍 (Autism Spectrum Disorder)

一个蛮常出现的情况,就是大人要是有些什么心理问题,就会被说成“抑郁症”(或“忧郁”),不管他的症状是闷闷不乐,竭斯底里,情绪高昂,自杀念头,出现幻觉,嫉妒心强,时好时坏…… 所以很多时候问当事人或其家属他有什么问题的时候,最常出现的答案,就是“抑郁症”(往往仔细问过症状后,其与“抑郁症”风马牛不相及!)

而孩子呢?这种情况也是有的,只是一般他们会被标签的是“自闭”(或“过动”,其次),不管他的症状是安静,闷闷不乐,不爱社交,过动,不听话,无法沟通,爱说谎,智力偏低,生活无法自理… 情况不严重的时候,就被称为“有点自闭”…

根据DSM-V (Diagnostic and Statistical Manual of Mental Disorder, 美国精神协会的精神障碍与统计手册,第五版),自闭症(现在已改称Autism Spectrum Disorder, 泛自闭症障碍*,本文继续简称自闭症)从孩提早期,与他人的接触在一定程度上影响了患者几乎每个方面的功能。 社会关系从轻度损害到几乎完全缺乏互动。 有些可能只是减少分享,而一些患者则完全不能主动接触他人或回应他人。 他们说话的时候,倾向于不用一些大多数人常用的身体信号,比如 眼神接触,手势,微笑和点头。 自闭症患者难以在各种不同的社交情景中调整他们的行为; 他们可能缺乏对其他人的兴趣,并且几乎没有朋友。

重复和狭小的专注点是他们的活动和兴趣的特征。 他们不喜欢/抵抗日常微小的变化(比如每天午饭点一样的菜,或不停地重复已经回答的问题。)他们可能被一些动态(如旋转)或微小物体所着迷。 对刺激(疼痛,巨响,极端温度)的反应可能过于微弱或过度。 一些非常专注于感官体验:他们对特定的视觉动态或特定气味着迷,有些或者恐惧或拒绝特定的声音或特定物体表面的触觉。 他们可能使用怪异的言语或表现出刻板的行为,例如拍手,身体摇摆或像回音般重复他人的话(echolalia)。

自闭症最主要是从沟通社交机体行为这三方面来判断,有可能伴随或不伴随智力缺陷,伴随或不伴随语言缺陷。

*Autism Spectrum Disorder, 泛自闭症障碍,或自闭症系列障碍,表达了自闭症的多元性。

马来西亚自闭障碍的干预训练中心

Intervention Programmes for Autism in Malaysia

It just happened that I was doing a brief research on the internet and among my friends who are in the field, so here is some information that might be useful to those who are looking for early intervention programmes for children diagnosed with Autism. (It is up-to-date on April 2016, within Klang Valley only).

I’d advise to take your child and visit the centre, get a feel of how it’s like on a typical day, on top of enquiring what they offer and how they charge. If possible, bring someone who knows a bit more in the field!

  • Autism Link, Petaling Jaya (www.autism.my)
    • Using Applied Behavioural Analysis (ABA), 1:1 individually tailored
    • Parental training weekly
    • Monday – Friday (3 hours class)
    • Morning RM5500/month; Afternoon 4800/month; Full day 8500/month
    • Contact: 016-6100309 / 03-7957 0795; Email: enquiry@autism.my
    • According to a ABA therapist friend who used to work there, this centre is strongly recommendable if parents/family is financially capable.
  • Hatching, Jaya One, Petaling Jaya (www.HatchingCenter.com)
    • Modified ABA, 1:4 group (1 teacher/therapist, 4 children)
    • Workshop for parents/children monthly
    • 9am-12pm or 1pm-4pm RM1500/month; 9am-4pm RM2000/month
    • Make appointment for free pre-enrolment assessment (1 hour)
    • Contact: 011-1133 8518
  • ALRITE, USJ (www.alrite4kidz.com)
    • 3 hour or 6 hour session
    • Contact: 03- 8020 6666
    • I called up and was told that they don’t discuss the fee structures over the phone (it kind of makes me suspect …), to call up for appointment.
  • Bright Stars, Ara Damansara (www.brightstars.my)
    • Using ABA, the sun-rise programme; 1:1 or 1:2 individualised
    • 9am-12pm or 12:30pm-3:30pm, RM2900/month; 9am-3pm RM5200/month
    • Contact: 012-3222405 / 03-78590089
    • See brightstars.my/about_the_program (it appears to be the only centre that publishes their pricing online!)
  • The National Autism Society of Malaysia (NASOM) (www.nasom.org.my)
    • Many centres all over Malaysia, including one in Miri, Sarawak. One-stop assessment/diagnosis centre is at Setia Alam (603-3359 3987)
    • Star programme, 1:3
    • Monday-Friday 7.30am-12pm or 1pm-5pm (RM318/month, half day only)
    • May need to be put in waiting list but they have intake almost every month throughout the year
    • Note: The centre that I called up to enquire is Taman OUG centre (03-78317928 / 03-78327928)
  • Freelance ABA therapists
    • Usually much more affordable, so it would suit those family with financial constraint.
    • Some might be able to have sessions at home.
    • Standard, facility, materials used, quality, service might be compromised (or not!!)
    • It might be good to do a review (re-assessment) every 6 months or so to check the child’s progress
    • Where to find? Ask around!

Disclaimer: I am in no way involved in any of the abovementioned centres and their therapists, I have not personally known anyone who had used their services so I cannot guarantee their service quality and outcome. I’m only providing different options to those who might need it, feel free to add your comments or recommend other centres below.

Introducing “House Rules”

By Jodi Picoult

By Jodi Picoult

I picked up this book from the Popular RM5 Book Fiesta last year (yes, for RM5!). It is a fiction by Jodi Picoult (this is my first tasting of her book!).

The book is about a boy named Jacob Hunt, who has got Asperger’s Syndrome – the main reason I bought this book as I really want to learn more about the Syndrome. But then the second reason, is that Jacob is also brilliant in forensic analysis – this is my (hidden) interest back in the uni. Haha!

I’d say I’ve really enjoyed reading it. It gave me perspectives from different persons (including the mother who is the main caretaker, the brother who lives together, and even Jacob (how he thinks or analyzes a case for example, sometimes I’d say it all makes sense; it’s us “normal people” who are inconsistent and weird)! and some other characters as well). There’s so much details in it. I’m sure some people would find it repetitive, but this could be how living with someone with the Syndrome is like – you have to set boundaries (house rules!), be repetitive and consistent etc! So it really gives you a sense about Asperger’s Syndrome, plus a terrible murder case in which the evidence was pointing to Jacob…

Asperger Syndrome

Two of the tutors came to the mother today and said that they were unable to help the boy with his studies as his attention span is too short, he keeps get distracted.

This is a boy of 13 with Asperger Syndrome which was diagnosed when he was 6. With medication the boy still does not improve significantly after all the years. In school, he disturbs his classmates by walking around the classroom and talking to them while teachers are teaching. He also flips his books quickly (without reading them, but he likes creating that sound while flipping books), tears and folds books and papers. The teachers said he isn’t able to do any independent work, although he appears to have adequate intellectual abilities just like his classmates. Unfortunately he is never able to get seated down for a short test. The teachers don’t know what to do to help him, and he makes no friends in school due to his annoying behaviours.

Tutors were hired to assist him in school and to give tuition at home, but a few have left for the same reason as above – he’s too difficult to manage, to be helped. He can’t concentrate in studies or perhaps in “doing anything meaningful”, as how the mother termed it. He scratches himself badly, almost obsessed with this habit.

The parents are feeling helpless. If the medicine couldn’t touch him at all, what else would?

IPad Addiction

Came across this article and think it’s really worth sharing, also a very good case study reflecting the growing up environment of infants/toddlers nowadays:

‘The day I realised my toddler was addicted to the iPad’: Three-year-old William tugged at the duvet and woke his father demanding the tablet… at 4am

Some food for thought: How do we help the younger generations to develop healthy relationship with those advanced gadgets? How do we balance while using them as educational or entertaining tools (not iNanny!) but not overusing leading to obsession and/or addiction?

(To the educational psychologists and child experts: is this going to be a newly added and researched Developmental Disorder?!)