Autism is the second most prevalent neurodevelopmental disorder today among children. In recent years Israel has become a major hub for studies on the topic and also the second most important country after the US in implementing the DIR - Developmental, Individual-differences & Relationship-based model – that searches to understand the child’s development and provide the kind of support and intervention that helps the children to reach their fullest potential.
With regard to World Autism Awareness Day 2016 on April 2, we talked to Ayelet Haas from the Jerusalem Variety Center (JVC). The JVC aims to allow children with special needs and their families equal opportunities in the future, through developmental treatments and educational and social activities and is an important actor for the DIR model in Israel. Mrs. Haas is a Developmental Psychologist at the Variety Center and works with children, amongst others from Arab and Ultra-Orthodox Jewish families. In a phone interview she shared with us one of her experiences.
A couple of years ago 2 year young Khalid* came to the Variety Center with his mother. His mother had noticed different developmental and behavioural problems of the little boy. His language development was behind children of his age; he mostly enjoyed watching repetitive movements such as the washing machine or wheels, was very picky with food and did not play or interact with other children. Many times he did not even react when she called him or respond to any other (non-)verbal communication. His main interest in a ball for instance, was related to its shape and visual appearance rather than to its possibilities as a tool for playing games with other children.
The mother, a paediatrician herself, heard about the JVC at a conference in Jerusalem’s Hadassah Hospital and contacted the Center. At first Mrs. Haas suggested to guide the therapeutic staff in Khalid’s Palestinian hometown so the mother did not have to travel all the way to Jerusalem for each treatment session. However, the mother preferred her son to be treated directly by the staff at the Variety Center that is specialised in the DIR model.
The DIR model provides a framework that helps clinicians, parents and educators conduct comprehensive assessments and develop educational and/or intervention programmes tailored to the unique challenges and strengths of each child. In previous conventional approaches it was believed that autistic children are not able to or not interested in building up and maintaining relationships and the focus was put on teaching them daily useful skills without paying attention to the causes of their behaviour. The DIR model concentrates on involving the natural surroundings, especially the child’s parents, and developing significant interpersonal relations of the child in the intervention and working on the gaps in their neurodevelopmental system through continuous stimulation, specifically adapted to the child.
While Khalid was way ahead of his age in his visual skills his auditory, speaking and motoric capacities were rather weak. With the help of a multi-disciplinary team that included amongst others an occupational therapist and a speech therapist Mrs. Haas developed a tailored treatment programme for Khalid. His mother quit her job in order to ensure constant interaction between them at home. Focusing on his strengths while slowly improving his weak sides in her daily interactions with him, he developed a very strong bond with her and also felt increasingly self-confident. His two older sisters and also his father were included in the analysis and the treatment.
After a few months Khalid improved his spoken Arabic remarkably, started interacting closely with his parents and sisters and even with other children. He found a friend amongst the other children at the JVC. He soon also went to a regular kindergarten. His mother found a good kindergarten in their hometown where the staff was willing to invest time and effort in the stimulation and inclusion of Khalid. The kindergarten teachers were guided by Mrs. Haas and the mother and kindergarten assistant brought her short movies of Khalid’s interaction with other children for the continuous analysis of his development.
Mrs. Haas was especially amazed that Khalid quickly understood that she did not speak Arabic. He thus adapted his communication with her - focusing on gestures, facial expressions and eye contact. This did not only prove his understanding of the - for him - rather complex language situation and his ability to comprehend the emotional components of the interaction but also his social skills to adapt to it. Based on Khalid’s case a new programme for Arabic speaking kids was developed at the Variety Center.
His mother introduced the DIR model in the medical facilities of her Palestinian hometown and translated the main book on the topic into Arabic. She and Mrs. Haas are still in touch. Khalid is today seven years old, attends a regular school, has many friends and fields of interest, fully communicates and enjoys interpersonal relations. He just started learning French.
*Name changed by editor.
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