Designing for specially abled

Socially Responsible Design Special Needs

I Deepankar Gupta of UG-PD:2015-19 would like to thank our course leader and Module tutor Pranay Mangrati, for guiding and supporting us throughout this module.

I would also like to acknowledge following people without which this project wouldn’t have been completed: Dr. Mansoor alam, ICD Delhi; Nina Cherla, Elena Konstantinidi, The Music therapy Trust ; Dr. Prabal Yadav, Margshree clinic; and Entire Staff, Faculty and Children of Udaan Ngo .

I am thankful to my college, Pearl Academy for providing me with all the facilities.

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Topic Special Needs Autism Types of Autism PDD-NOS Causes of Autism Redefined Autism as per DSM-5 Hyper Active senses Hypoactive senses Famous Personalities suffering from autism Autism Clinic Visits Visit to Udaan Case Studies Design Brief Ideation /Brainstorming Re-Defined Brief Conceptualisation, Iterations, Prototyping Initial Form explorations Plug “n� Play: About the game Emphasis on Skills Approximate Cost Structure About Age group 6-10 years old.

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Children with special needs are the one who have a disability or combination of difficulties that hinders the growth and learning ability of a child resulting in requiring clinical assistance .

Special need children could be those who have: Mental Retardation, which causes them to develop more slowly than other children. Speech and Language Impairment, such as a problem expressing themselves or understanding others. Physical Disability, such as vision problem, cerebral palsy, or other conditions. Learning Disabilities, which distort messages from their senses. Emotional Disabilities, such as antisocial or other behavioral problems.

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Special needs can be categorized under six broad heads: Genetic and Chromosomal Condition: • Genetic disorders • Single gene disorders • Chromosomal disorder • Down’s syndrome • Angelman syndrome • Sotos syndrome • Cystic Fibrosis • Fragile X

Social Communication Disorders • Autism • Asperger's Syndrome • Deficit attention motor control and Perception • Attention deficit hyperactivity Disorder • Selective Mutism

Mobility and Muscular Disorder • Cerebral Palsy • Muscular Dystrophy • Hypermobility

Neurological Disorders • SPD • Epilepsy • Mylagic encephalomyelitis • Tourett’s syndrome

Special Education needs • Dyslexia • Dyscalculia • Dysgraphia

Mobility and Muscular Disorder • Cerebral Palsy • Muscular Dystrophy • Hypermobility

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“Autism is not a disability ,it is just a different ability�

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Autism can be defined as a neurobiological disorder that affects the mental, physical and social growth of an individual. It is called as an spectrum disorder because symptoms of autism keep changing from time to time and individual to individual.

Some people are mildly impaired with the symptoms ,while others could be severely disabled. According to the Centers for disease Control and Prevention (CDC) around 1/68 children have some form of ASD. It can be spotted within first two years of life if a child shows: • Repetitive behavior and limited interests or activities • Difficulty in communicating .

• Poor social behavior and interactions These are primary symptoms that a child shows.There are other symptoms also that could be observed in people suffering with ASD.

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AUTISTIC BRAIN

10 Img source: Pinterest.com,2017

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Very little or no eye contact.

Resistance to being held or touched.

Tends to get too close when speaking to someone (lack of personal space).

Responds to social interactions, but does not initiate them.

Does not generally share observations or experiences with others.

Difficulty understanding jokes, figures of speech or sarcasm.

Difficulty reading facial expressions and body language.

Difficulty understanding the rules of conversation.

Difficulty understanding group interactions.

Aversion to answering questions about themselves.

Gives spontaneous comments which seem to have no connection to the current conversation.

Makes honest, but inappropriate observations.

Seems unable to understand another’s feelings.

Prefers to be alone, aloof or overly-friendly.

Difficulty maintaining friendships.

Finds it easier to socialize with people that are older or younger, rather than peers of their own age.

Unaware of/disinterested in what is going on around them.

Talks excessively about one or two topics (dinosaurs, movies, etc.).

Overly trusting or unable to read the motives behinds peoples’ actions.

Minimal acknowledgement of others.

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By 6 months, no social smiles or other warm, joyful expressions directed at people By 6 months, limited or no eye contact By 9 months, no sharing of vocal sounds, smiles or other nonverbal communication By 12 months, no babbling By 12 months, no use of gestures to communicate (e.g. pointing, reaching, waving etc.)

By 12 months, no response to name when called By 16 months, no words By 24 months, no meaningful, two-word phrases Any loss of any previously acquired speech, babbling or social skills

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Applied Behavioral analysis(ABA) Verbal/ Speech Therapy(VT) Occupational Therapy(OT) Developmental and individual differences relationship (DIR) Relationship development intervention (RDI) Cognitive Behaviour Therapy(CBT) Music Therapy Sports therapy Physiotherapy Art Therapy Yoga Therapy

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ABA therapy ABA (Applied behavior Analysis) is one of the most researched intervention for autism ,and has been in application for more than 50 years in medical field. It’s role is to teach children communication,play,social,academic,self-care,work and community living skills. ABA uses a three step process that includes stimulus - action- reaction: 1. An antecedent, which is a verbal or physical stimulus such as a command or request. This may come from the environment or from another person, or be internal to the subject 2. A resulting behavior, which is the subject’s (or in this case, the child’s) response or lack of response 3. A consequence, which depends on the behavior. The consequence can include positive reinforcement of the desired behavior, or no reaction for the incorrect response.

ABA has an highly structured curriculum .Through ABA a therapist may break down skills into small component parts through repetition, reinforcement, and encouragement, helping a child learn them. A therapist observes a child’s abilities and defines what would benefit him ,even when a child is not interested in learning particular skill. It’s the role of the therapist to analyze the importance of the skill, for example, if a child is not interested in greeting others or in learning toilet training, an ABA therapist might focus on those skills anyway, because she recognizes their long-term value long before a child can.

Success is measured by direct observation and data collection and analysis – all critical components of ABA. If the child isn’t making satisfactory progress, adjustments are made.

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Verbal/ Speech Therapy(VT) Speech therapy is also one of the most important applied therapy that teaches non-vocal children to communicate purposefully. Children learn how we use words functionally – to get a desired response. It’s not enough for a child to know that a cookie is called a cookie or to point to a cookie that he wants. VT seeks to move children beyond labeling, a first step of learning language, and gesturing to vocalizing their requests – “I want a cookie.”

Autism is usually evident before age 3, and language delays can be recognised as early as 18 months of age.In some cases, autism can be identified as early 10 to 12 months of age so sooner the therapy is started the better it would be.

It could help in dealing with following problems • Articulation disorders: some children have trouble saying some sounds or words correctly. For example, ‘run’ might sound like ‘won’ or ‘say’ might sound like ‘thay’. Lisps are a common articulation disorder.

• Fluency disorders: some children repeat some sounds or have trouble saying complete words. For example, the word ‘story’ might come out sounding ‘st..st..story’. A stutter (or stammer) is a common fluency disorder.

• Resonance or voice disorders: some children talk in a way which makes it difficult for people to understand them – as if they have a cold or are talking through their nose. Some individuals on the autism spectrum speak in a high-pitched voice or use robotic-like speech.

• Language disorders: some children find it very difficult to understand what people are saying to them as they don’t understand the meaning of words. Some children have trouble making themselves understood as they find it difficult to put words into sentences correctly.

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Occupational therapy Occupational therapy is a client centred therapy which is concerned with promoting health and well being through occupation. Occupation means the activities children are supposed to do,expected to do and want to do.

An Occupational therapist focusses on increasing the levels of: • • • •

Attention Spans and Arousal Levels Sensory and Processing Skills Fine gross and Motor skills and Activities of daily living , also called self-help or self-care activities. These activities include everyday tasks such as dressing, self-feeding, bathing, laundry, and / or meal preparation. Acquirement of daily activities are very crucial for an autistic kid as it would help him make independent in future.

An Occupational Therapy (OT) will apply a sensory checklist on children to determine sensory processing difficulties and will accordingly form a plan (sensory Diet) for these children. Sensory Diet is a planned, personalized schedule of sensory activities for a child which helps them to better handle their activities of daily living. It will help the child function well at school, and at home, so that they can learn, socialize, eat meals with family and friends without stress and struggle. By providing a sensory diet, one can over a period retrain the brain to process sensory information from sensory receptors in a more typical way, which will promote self-regulation of activity, focus, and mood.

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Occupational therapy Occupational therapy is a client centred therapy which is concerned with promoting health and well being through occupation. Occupation means the activities children are supposed to do,expected to do and want to do.

An Occupational therapist focusses on increasing the levels of: • • • •

Attention Spans and Arousal Levels Sensory and Processing Skills Fine gross and Motor skills and Activities of daily living , also called self-help or self-care activities. These activities include everyday tasks such as dressing, self-feeding, bathing, laundry, and / or meal preparation. Acquirement of daily activities are very crucial for an autistic kid as it would help him make independent in future.

An Occupational Therapy (OT) will apply a sensory checklist on children to determine sensory processing difficulties and will accordingly form a plan (sensory Diet) for these children. Sensory Diet is a planned, personalized schedule of sensory activities for a child which helps them to better handle their activities of daily living. It will help the child function well at school, and at home, so that they can learn, socialize, eat meals with family and friends without stress and struggle. By providing a sensory diet, one can over a period retrain the brain to process sensory information from sensory receptors in a more typical way, which will promote self-regulation of activity, focus, and mood.

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DIR therapy (also called floortime therapy) Development Individual Difference Relationship may look like a complex but simply it is the It is a way to understand our children and each other that builds connections, understanding, love, communication, and engagement. Through this approach, the true potential of each person can be discovered. The DIR model is also a framework that helps clinicians, parents and educators conduct comprehensive assessments and develop educational and/or intervention programs tailored to the unique challenges and strengths of each child.

Floortime, ideally takes place in a calm environment. This can be at home or in a professional setting. Formal treatment sessions range from two to five hours a day. They include training for parents and caregivers as well as interaction with the child. Therapists encourage families to use Floortime principals in their daily lives.

As children mature, therapists and parents tailor the strategies to match a child’s developing interests and higher levels of interaction. For example, instead of playing with toy trucks, parents can engage with model airplanes or even ideas and academic fields of special interest to their child.

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Developmental levels in DIR therapy Level 1: Shared Attention/Regulation and Interest in the World Level 2: Engagement/Forming Relationships Level 3: Two-Way, Purposeful Interactions with Gestures/Intentional Two-Way Communication Level 4: Two-Way, Purposeful Problem-Solving Interactions/Development of Complex Sense of Self Level 5: Elaborating Ideas/Representational Capacity and Elaboration of Symbolic Thinking Level 6: Building Bridges Between Ideas/Emotional Thinking Level 7: Multi-Cause, Comparative, and Triangular Thinking (Grade School Children) Level 8: Emotionally Differentiated Gray-Area Thinking (Grade School Children) Level 9: Intermittent Reflective Thinking, a Stable Sense of Self, and an Internal Standard (Grade School Children)

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RDI therapy RDI therapy is a family-centered approach to treat autism focusing on defined emotional and social objectives meant to establish more meaningful relationships. It includes the ability to form an emotional bond and share experiences.

Goals are set to develop skills related to interpersonal engagement, such as empathy and overall motivation to engage with others. RDI breaks its various objectives down into step-by-step paths adults use to prompt development, such as building eye contact or back-and-forth communication.

Six objectives of RDI therapy to develop are : • Emotional Referencing: Ability to learn from the emotional and subjective experience of others.

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Social Coordination: Ability to behave and successfully participate in social relationships

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Declarative Language: Ability to use verbal and non verbal communicative interactions and share feelings and perceptions with others.

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Flexible Thinking: Ability to adapt to a circumstances and the plans

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Relational Informational processing: Ability to put things into context and sole problems that lack easy solutions.

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Foresight and hindsight : Ability to anticipate future possibilities based on past experiences.

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Cognitive Behavioural Therapy CBT is a short term goal oriented form of psychotherapy that aims to change the negative patterns of thinking and the way a patient feels about himself, his abilities, and her future. Therapy requires to get in touch with the thoughts and feelings of patient and learn to modify them when they are dysfunctional. Cognitive behavioral therapy aims to define the triggers of particular behaviors, so that a child starts to recognize those moments himself.

CBT is based on the recognition that cognitions, or automatic thoughts, lead to emotional difficulties. Automatic thoughts are spontaneous interpretations of events.

These impressions are susceptible to distortion, such as unfounded assumptions about yourself (or others), a situation, or the future. An unhealthy internal dialog could prevent an individual from working toward an aggressive goal, working to develop productive new habits, or generally take calculated risks. CBT helps with concerns 21 common to autism, such as being overly fearful or anxious.

Music Therapy Music therapy is an effective and proven method where music is used as an intervention to accomplish the therapeutic goals .Its goal is to address physical, cognitive and social needs of special individuals .It is a fast growing research based field in which a certified music therapist applied interventions to address non-music goals with their clients.

Music therapy• Encourages social interactions • Is adaptable to ASD people of any level • Is multi-modal and engages across multiple domains such as (motor, communication,cognitive,etc) • Is adaptable to other therapies such as ABA ,DIR,Cognitive behavourial and more.

• Is motivating and paced as per child.

Music is beyond verbal or non verbal communication. Once a child starts enjoying it he becomes open to the instruments he plays, the songs he listens to, the hand movements and the body movements, that largely affects his mental growth. Many children develop a good singing over the time and even talk in musical language.

Although music is good way to treat autism but still in some cases it doesn't works at all .There are children who are not able to develop any taste in music even after 3-4 sessions. In those cases child is referred for other therapies that could prove even more useful.

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Sports Therapy Sports therapy is an umbrella term which includes physical based activities like swimming, aquatic therapy,Bicyling, Skating,Football,Handball ,Weightlifting. Children with multiple disorders can be benifitted from the exercise, energy release, and pure enjoyment of playing sports. Special needs children are sometimes discouraged because of the fear of injury by the parents and guardian. But importance of physical activity lies on same scale of importance just like for other kids.

Participation in sports can help instill a sense of self-confidence, improve skills, help to improve executive functioning of the brain, in relationship building and working as part of a team. It also helps in weight management.

The benefits of regular physical activity can be • • • • • • • • • •

Better overall fitness Improved cognitive benefits Better control of weight Healthier bone density Better emotional and psychological health Improved social skills Improved motor skills Improved self-esteem Reduced risk for diseases such as diabetes Reduced risk for some types of cancers

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Physiotherapy Physiotherapist play a crucial role while providing a customized programe to a child suffering from autism who has a difficulty with functional movement, balance and motor skills. Areas of intervention for a physiotherapist are : •

Gross Motor Skills – using large muscles for sitting, standing, walking, running, etc.

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Balance/Coordination Skills – involves the brain, bones, and muscles in a coordinated effort for smooth movement; for example, as in climbing stairs, jumping, etc.

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Strengthening – building muscle for support and endurance; for example, to walk for a distance without becoming tired.

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Functional Mobility/Motor Planning – moving through space, day to day, for independence and efficiency; for example, to climb onto the rocking chair and make it rock back and forth.

Bobath (Neuro-developmental) Therapy emphasizes on observation and analysis of the child’s current functional skill performance and the identification of therapy goals. Neuro-developmental therapy (NDT) aims for active participation and practice of relevant functional skills. It also influence muscle tone and improves postural alignment by specific handling techniques.

Children learn through play so the physical therapists use child-friendly, specially chosen toys and activities to motivate and encourage their students or patients to participate in therapy. Typically one will find balls, swings, and slides in a pediatric therapy gym. Children are encouraged to have fun while they work hard to accomplish the tasks their therapists set for them.

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Art Therapy Art therapy is a unique form of treatment for autism, as it helps mitigate symptom, while also channeling autistic behaviors into an expressive, creative outlet. It promotes communication, emotional growth and sensory integration while also fostering social interaction in a fun setting.

It can address following situations : • Sensory processing disorder Art therapy is ideally suited for addressing sensory processing disorder (SPD), a pervasive problem in autism which contributes to a great deal of difficult emotions and behaviors, yet is too often overlooked.

• Visual skills Art therapy widely affects the visual skills of a child. Expressing feelings and ideas through images is very natural for such people and can be a welcome relief from the daily struggle to use words effectively.

• Develop choosing options ability in child's mind • Developing communication skills 25

Yoga Therapy Children suffering from ASD have neurological drawbacks that separates them from the existing community. Recently yoga has become a topic of interest for the therapists and the studies have shown that it can have significant benefits.

1. Increased Social and communication skills : The studies have indicated that yoga may offer benefits as an effective tool to increase imitation, cognitive skills and social-communicative behaviors in children with ASD. In addition, children exhibited increased skills in eye contact, sitting tolerance, non-verbal communication and receptive communication skills (taken from Radhakrishnan, S., 2010).

The ability to understand ones actions and imitate those actions are directly correlated to the development of social-communication skills.Practicing yoga includes breathing strategies,it helps children to learn the poses and breathing through imitating the actions and behaviors of the adult. This also supports children’s ability to sustain joint attention, something that can be a challenge for children with ASD. 2. Awareness and Expression of Emotions: Yoga can also help in bringing more awareness to children’s emotions and how they are feeling. Providing an outlet for children with ASD to express their emotions gives them the message that it’s OK to feel these emotions and when express constructively can support them in feeling better emotionally.

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3. Reduced anxiety: Many children with ASD experience heightened levels of anxiety. This can significantly affect their sleep, mood, behavior and health. Due to difficulty with communication, sensory integration deficits and a variety of other challenges, children with ASD can be in a constant state of anxiousness. This state of anxiousness if often referred to as the fight/flight mode.

Calming their nervous systems and releasing tension in their minds and bodies supports better sleep, digestion, mood, behavior and overall health and well-being.

4. Increased Body Awareness: By teaching and identifying body parts through yoga and movement of the body, children can develop a greater sense of body awareness. Poses that provide proprioceptive and vestibular input also support body awareness. Directional concepts taught in yoga such as up and down and left and right are also helpful concepts in developing a greater sense of body awareness.

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Autism can be divide into five parts : 1. Asperger's Disorder: 2. Kanner’s Syndrome 3. Pervasive Development Disorder –NOS(Not otherwise specified) 4. Rett’s Syndrome 5. Childhood disintegrative disorder

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Asperger Syndrome (AS) is a neurobiological disorder on the higher-functioning end of the autism spectrum. An individual’s symptoms can range from mild to severe. People with Asperger syndrome generally develop spoken language in the same way as typically developing children, but have a tough time with social communication. These difficulties that become more obvious as they get older and social expectations rise.; Because people with Asperger syndrome are often very intelligent - but "quirky" - the disorder is sometimes nicknamed "geek syndrome" or "little professor syndrome."

Following the symptoms of Asperger's Disorder : • • • • • • •

Problems with social skills: Children with Asperger syndrome generally have difficulty interacting with others and often are awkward in social situations. They generally do not make friends easily.

Restricted or repetitive behaviours: Children with this condition may develop odd, repetitive movements, such as hand wringing or finger twisting.

Unusual preoccupations or rituals: A child with Asperger syndrome may develop rituals that he or she refuses to alter, such as getting dressed in a specific order.

Communication difficulties: People with Asperger syndrome may not make eye contact when speaking with someone. They may have trouble using facial expressions and gestures, and understanding body language. They also tend to have problems understanding language in context.

Limited range of interests: A child with Asperger syndrome may develop an intense, almost obsessive, interest in a few areas, such as sports statistics, weather or maps.

Coordination problems: The movements of children with Asperger syndrome may seem clumsy or awkward.

Skilled or talented: Many children with Asperger syndrome are exceptionally talented or skilled in a particular area, such as music or maths.

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"Pervasive Developmental Disorder Not Otherwise Specified" is a mouthful of words that, until 2013, were used to describe individuals who didn't fully fit the criteria for other specific diagnoses but are nevertheless autistic.

PDD-NOS can have following subgroups : • A high-functioning group (around 25 percent) whose symptoms largely overlap with that of Asperger syndrome, but who differ in terms of having a lag in language development and mild cognitive impairment. (Asperger syndrome does not generally involve speech delay or cognitive impairment).

• A second group (around 25 percent) whose symptoms more closely resemble those of autistic disorder, but do not fully meet all its diagnostic signs and symptoms.

• A third group (around 50 percent) who meet all the diagnostic criteria for autistic disorder, but whose stereotypical and repetitive behaviors are noticeably mild.

Child suffering from PDD-NOS will exhibit following symptoms : • • • • • •

Uneven skill development (motor, sensory, visual-spatial organizational, cognitive, social, academic, behavioral) Poorly developed speech and language comprehension skills Difficulty with transitions Deficits in nonverbal and/or verbal communication Increased or decreased sensitivities to taste, sight, sound, smell and/or touch Perseverative (repetitive or ritualistic) behaviors (i.e., opening and closing doors repeatedly or switching a light on and off ) 30

A lot of research has been done and is still going on to find the exact cause of Autism. It is still a big question that what causes autism. Upon analyzing several mothers some points were extracted which may give a vague idea about the cause of Autism.

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Rubella (German measles) in the pregnant mother Tuberous sclerosis (a rare genetic disorder that causes benign tumors to grow in the brain as well as in other vital organs) Fragile X syndrome (the most common inherited form of intellectual disability) Encephalitis (brain inflammation) Untreated phenylketonuria (PKU) – when the body lacks an enzyme needed for normal metabolism

Other potential causes could be the toxins in environment including pesticides and heavy metals such as mercury. Radiations and Information technology is also referred to as a cause that hinders the development .

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33 Img source: DSM.uk.org,2013

Prior 2013 Autism has a very broad category of sub-disorders, people diagnosed on the autism spectrum were assigned a specific diagnostic category. They might have been given a diagnosis of Asperger syndrome, autistic disorder, or PDD-NOS (short for pervasive developmental disorder not otherwise specified). In rare circumstances, they might even received a diagnosis of Rett syndrome or childhood disintegrative disorder.

After release of DSM-5 in 2013 ,terms like Asperger syndrome, PDD-NOS, childhood disintegrative disorder, and autistic disorder completely disappeared.

Retts Syndrome was completely eliminated from autism.

DSM-5 unlike DSM-4 describes autism as a single spectrum disorder.It has defined a set of criteria's in the areas of social communication, behavior, flexibility, and sensory sensitivity.If one has symptoms on this spectrum, the person would be declared autistic.

Autism is a very wide spectrum, distinguishing from a Classic Autism to Asperger's sometimes become quite difficult .To solve that issue DSM-5 has introduced three levels .

Level 1:Requiring Support Level 2:Requiring Substantial Support Level 3:Requiring Very Substantial Support

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35 Img source: DSM.uk.org,2013

People on Autism spectrum have difficulty in processing everyday information. The child's reactions can easily be interpreted as wilful misbehavior. Along with this will frequently be difficulties in movement, coordination and sensing where one's body is in a given space, leading to clumsiness and difficulty with tasks such as dressing.

Sensory Overload happens when brain is not able to process multiple stimuli’s at one time. It is quite common for a normal human being also ,but in case of autism this problem can turn into extreme cases.

The are problems with sensory integration, as the nervous system has difficulty receiving, filtering, organizing and making use of sensory information is commonly known as Sensory Integration Dysfunction.

There are 7 senses in Autistic kid. These are-Vision, Auditory, Tactile, Taste,Smell, Vestibular and Proprioceptor.

There senses might be hyper-active or hypo-active at anytime in a day.

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Hyper vision Hyper vision means that the vision of autistic kids is very acute. For example, they notice the tiniest pieces of fluff on the carpet, complain about ‘moths (air particles) flying’, dislike bright lights, look down most of the time and may be frightened by sharp flashes of light. Under fluorescent lights such children can see a 60-cycle flickering: the whole room pulsates on and off.

Hyper hearing Individuals suffering from hyper hearing usually get affected easily by mild sounds.They are generally very light sleepers and are frightened by unpredictable sounds like telephone ringing or baby crying or thunderstorms ,crowds and get terrified by haircuts. Sometimes hyperauditory children make repetitive noises to block out other disturbing sounds.

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Olfactory Hypersensitivities Children with this disorder cannot tolerate how people or objects smell. They run from smells, move away from people and insist on wearing the same clothes all the time. For some, the smell or taste of any food is too strong, and they reject it no matter how hungry they are. They are usually poor eaters, gag/vomit easily and eat only certain foods.

Hyper Tactility Children with ASD are hypersensitive to different textures.Slightest touch can give them a panic attack. Many individuals refuse to wear certain clothes, as they cannot tolerate the texture on their skin. Some children with hypertactility overreact to heat/cold, avoid wearing shoes, avoid getting ‘messy’ and dislike food of certain texture.

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Vestibular Hypersensitivities Children with this hypersensitivity experiences difficulties in changing directions and walking or crawling on uneven or unstable surfaces. They are poor at sports. They feel disoriented after spinning, jumping or running and often express fear and anxiety of having their feet leave the ground.

Proprioceptive hypersensitivity Individuals who have this disorder might hold their bodies in odd positions, and might have difficulty manipulating small objects. They might flint their hands and also tend to harm themselves .

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Hypo vision Children with Hypovision experience trouble figuring out where objects are, as they see just outlines, then they may walk around objects running their hand around the edges so they can recognize what it is. Having entered an unfamiliar room they have to walk around it touching everything before they settle down. Often they sit for hours moving fingers or objects in front of the eyes.

Hypo hearing Children with Hypo hearing may crave for sounds, they enjoy hearing sounds no matter if it is a siren noise or a guitar music. They often create sounds themselves to stimulate their hearing – banging doors, tapping things, tearing or crumpling paper in the hand, making loud rhythmic sounds. These type of children are best suited for the music therapy as they develop a good taste in music and may talk also in phonetics.

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Hypo taste/smell Individuals with hypotaste/hyposmell chew and smell everything they can get (e.g. grass, play dough). They mouth and licks objects, play with faeces, eat mixed food (for instance, sweet and sour) and regurgitate.

Hypo Tactility ASD child suffering from hypo tactility may not feel skin as part of their body, instead they may seek joy in hurting themselves. They like pressure, tight clothes, often crawl under heavy objects. They hug tightly and enjoy rough and tumble play.

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Vestibular Hyposensitivity's Children with vestibular hyposensitivity enjoy and seek all sorts of movement and can spin or swing for a long time without being dizzy or nauseated. People with vestibular hyposensitivity often rock forth and back or move in circles while rocking their body.

Proprioceptive Hyposensitivity Those with proprioceptive hyposensitivity have difficulty knowing where their bodies are in space and are often unaware of their own body sensations, for example, they do not feel hunger. Children with hypo proprioceptive system appear floppy, often lean against people, furniture and walls. They bump into objects and people, stumble frequently and have tendency to fall. They have a weak grasp and drop things.

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Normal Brain

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Asperger's Brain

45 Img source: Cyndimccoy.facebook.com,2015

46 Img source: Autism Speaks, 2009

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Albert Einstein

Andy Warhol

Nicole Tesla

Thomas Jefferson

Temple Gardin

Bill Gates

Steve Jobs

Charles Darwin

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Continua Kids Centre of Neurotheraphy in differently abled kids

50 Img source: Continua.com,2017

Physiotherapy

Yoga

Art

Therapies Provided Autism cannot be cured completely but there are several therapies provided by continua that have helped in curing ASD up to some extent.

One of the most effective therapy recommended by the institution is the Music therapy. It has shown drastic changes in many cases.

Music Theraphy

Sports Therapy

ABA therapy

Aquatic

Occupational

Speech Therapy 51 Img source: Continua.com,2017

Therapists

JOSE ALOR(Clinical Music Therapist)

NINA CHERLA (Regional Director Clinical Music Therapist) IN PARTNERSHIP WITH

The Music Therapy Trust is a private, nonprofit making NGO and a unique example of collective philanthropy in India. The Trust introduced the first Postgraduate Diploma in Music Therapy to train Indian and Nepalese musicians to receive a clinical qualification, employment and career development in the music therapy profession.

Aim of the trust is to : • to build partnerships to increase the provision of music therapy in the community • to improve awareness of disability and the benefits which music therapy can bring • to provide lasting benefits to hundreds of children and adults who are marginalised due to communication difficulties, disability or poverty, irrespective of their gender, economic status, race or religion.

52 ELENA KONSTANTINIDI Clinical Music Therapist)

Img source: TMTT.com, 2017

Interaction with Nina Cherla (Regional Director Clinical Music Therapist) 14th September,2017 Thursday Music therapy has proved quite effective since its inception . Interaction with Nina Cherla helped us to broaden our perspective about this technique and how it works in different scenarios.

• There are three primary ways to treat a child with ASD when he enters the music therapy clinic.

1. Meeting : with the child to know his problems and evaluating possible solutions 2. Matching : When a therapist plays a music child also joins in if he is interested , now child may sing or play any instrument so the therapist has to make sure he matches with the musical tone of child so that he doesn't feel secluded.

3. Mirroring: When a tone is played by the therapist ,child acts responds to it and his response is recorded and therapist tries to replicate the actions that a child does.For example if a child howls after listening to a song ,the therapist may also howl and make him feel that someone is with him .This helps in developing social connections •

Therapy is designed exclusively for a child depending on his needs , requirements and recorded responses.

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A technique called as the ISO principle is applied here . Through this approach the therapist tries to match upto the emotional state of the child. If a child is depressed or sad then slow beats are created to interact with the child and vice versa. The core idea is to connect with the child spiritually ,not evasively.

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Musical Instruments are played according to the sensory activeness of the child. If a child is hyperactive , instruments like drums or banjo will be played in order to expel energy from body. If a child is hypo active to music ,the procedure will be different. The child will be introduced to instruments like piano or violin and further depending on the interest of child he is introduced to moderate instruments like guitar and shakers.

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Throughout the therapy interaction with the child takes place in songs format and child is also asked to do the same.

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Each session starts with a hello song and ends with a goodbye song.

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Children are also taught how to put things in place after use.

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Music therapy Assessment report is filled after every three sessions with the child

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Institute for child development,

Institute for child development (ICD) is a non profit organization that works exclusively with special need children. It deals with Neurodevelopmental Disorder and Neuromuscular Diseases e.g. High risk infants, Children with Brain Injury, and Developmental Disabilities, etc.

Malviya Nagar Delhi

55 Img source: ICD.com, 2017

Interaction with Dr. Mansoor Alam(Consultant in Early Intervention and Developmental Paediatrics) 16th September,2017 Saturday Dr. Mansoor Alam is a very experienced professional working in field of autism and other disorders related to child growth development. It was a great experience meeting Dr. Alam.

Around 15 children visiting ICD are suffering from ASD. Due to lack of time we concluded our interview in these few questions:

-Can you tell us in medical terms about autism ?

Autism, briefly can be described as wrong wiring of nerves in the brain or a neurobiological disorder. About 1/89 have autism in India .There are three symptoms we check for autism; -Socially and Emotionally poor, -Poor communication, unable to speak verbally or through actions, -Repetitive behaviour.. An extreame case of autism will exhibit all these symptoms. Autism as a term is not new. People earlier were used to call these kids as playful or over active. Now a days a definition has turned them into a mentally retarded kid with lack of social awareness. People don’t accept them as a part of society and don’t treat them the way they should be.

-What are the levels of autism?

Autism is an spectrum disorder. It has three levels: Mild, Moderate and Severe. Children with mild autism can continue with the schooling and can communicate verbally. In the case of moderate autism, a child may not be able to go to school and communication would be poor. He might be able to respond but not able to express his needs or desires.In case of severe autism ,child lacks completely in terms of communication, behaviourally and shows repetitive actions.

-What do you think could be the cause for autism?

There have been a lot of research to find about the causes of autism but till date nothing concrete could be said about it. One of the probable cause that has came out to be is the Genetic imbalance of chromosomes also known as Fragile X syndrome.One part of X chromosome has defective piece that appears pinched and fragile when viewed under microscope. It is one of the reason for the mental retardation. Other causes could be allergies like- GF or Gluten free and Cystic Fibrosis or CF. -Can autism be cured completely ?

No it cannot be. If a doctor advertises that he would cure it completely then he is just marketing something fraud. It can be said that mild autism can be cured upto an extent but it cannot be outgrown completely.

-Where in Delhi has been seen maximum cases of autism?

According to our survey conducted in 2015 in areas of delhi –Pitampura, Punjabi Bagh, Dwarka, Nehru Place and Rajori, maximum cases were from Dwarka. In india according to the survey of IHO maximum number of cases of autism have been found in Bangalore and in world it is America(NYC). These results in someway points toward the tech cities which can be connected to the factor of harmful radiations .It could be considered as a cause of autism.

Dr. Alam also provide us with a brochure that contained the details about autism and its nuances. The visit to the clinic gave us a better understanding about ASD that was beneficial in our later stages.

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Margshree is a clinic founded by Dr. Praval Yadav (special educator) .It deals with intervention therapies like Occupation Therapies, Special Education, Remedial education and Play therapy.

Margshree Multidisciplinary Clinic E-104, Basement, opp Mahagun Morpheus, Near Ramagya School, Sec 50 Noida - 201301, Uttar Pradesh 57 Img source: Margshree.com,2017

Interaction with Dr. Praval Yadav (Special Educator) 20th September,2017 Wednesday It was our second interaction with a child specialist and a educator. He dealt with the educational aspect of autism where an unconventional approach is required to stabilize and teach the child . He dealt with the age groups of 3years to 18 years old children where each session is for 45-60 minutes. Maximum of 10 sessions and at least 7 are necessary for detection of some improvements in a child. Also the sessions must be repetitive and at least four tmes a week.(120hrs) Various Approaches he tried while teaching a child were: • • •

Massages on the back to calm baby in order to increase concentration.

He plays jingles and poems on phone in baground when a child starts crying.

Tries to motivate the child constantly, no matter how hard a child cries or looks uninterested to work. According to him this technique actually works after a long period of time a sessions with child as he starts realizing that he has to finish a task anyways .

His academic approach includes following steps: -Reading -Writing -Associating -Identification -Classification -Vocal Language interaction.

He also informed us about the PECS programme of visual identification and the Theory of Mind

58 Img source: Facebook.com,2017

Story building Technique Children on spectrum of ASD majorly lack in development of social and behavioural skills .

If a child has some repetitive behaviour like spitting or crying or slapping himself ,a story is created around that problem and targeted in such a way that it reaches to the unconscious mind of the child which he might stop after some time./987 Process includes: 1. Creation of a story(that targets a unsocial behaviour) 2. Visuals Shown: Creation of different characters around the target behaviour 3. Story Session: In the session different characters talk about the behaviour exhibited by that person indirectly and make him feel guilty that he does that.

It may not be effective in less time but according to Doctor Praval results have shown that it has helped to stop a targeted behaviour up to some extent in some cases .

59 Img source: Self Clicked

Observation of a 5 year old girl suffering from Acute Autism at clinic who has came for her fifth session with doctor.

• • • •

• •

She was constantly trying escape from work.

She was crying for whole time ,the minute she started the session.

She wanted top go home and wasn’t interested in any activity but was forced to complete .

Because of this she jumped off from seat and ran out of the room multiple times.

She was constantly urging to stay with his mother.

She was quiet for around 3-4 minutes while playing a matching game and again started to cry .

Chair for children suffering from cerebral 60 palsy Img source: Self Clicked

Application of Toys and Games

Different types of toys were used in therapy .According to doctor, toys also depend on the behaviour of child .If a child is hypersensitive he may be given smiley balls to control his anguish and if a child is hyposensitive he may be given some hard tactile texture based toys .

Other toys include match making toys, LEGO blocks, and stress balls and electric toys that make sound and glow.

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62 Img source: Self Clicked

Theory of mind refers to the ability to understand the desires, intentions and beliefs of others, and is a skill that develops between 3 and 5 years of age in typically developing children.

Theory of mind refers to the notion that many autistic individuals do not understand that other people have their own plans, thoughts, and points of view. Furthermore, it appears that they have difficulty understanding other people's beliefs, attitudes, and emotions.

By not understanding that other people think differently than themselves, many autistic individuals may have problems relating socially and communicating to other people. That is, they may not be able to anticipate what others will say or do in various situations. In addition, they may have difficulty understanding that their peers or classmates even have thoughts and emotions, and may thus appear to be self-centered, eccentric, or uncaring.

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PECS programme Picture Exchange Communication System Developed by Andrew S. Bondy, Ph.D. & Lori Frost, M.S., CCC/SLP

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What is PECS ?

PECS (Picture exchange Communication System) is a unique augmentative/alternative communicative package developed specially for autistic kids worldwide. PECS does not require complex or expensive materials. It was created with families, educators, and resident care providers in mind, so is readily used in a range of settings.

PECS has been successful with individuals of all ages demonstrating a variety of communicative, cognitive and physical difficulties. Some learners using PECS also develop speech. Others may transition to a voice output system.

Picture Chart 65 Img Source :Pinterest.com,2017

The Six Phases of the Picture Exchange Communication System Are: PECS PHASE I: How to Communicate The child with autism learns to exchange single pictures for items or activities they really want.

PECS PHASE II: Distance and Persistence Still using single pictures, the child with autism learn to generalize this new skill by using it in different places, with different people and across distances. They are also taught to be more persistent communicators.

Phases of PECS programme

PECS PHASE III: Picture Discrimination The child with autism learns to select from two or more pictures to ask for their favorite things. These are placed in a communication book, a ring binder with Velcro strips where pictures are stored and easily removed for communication.

PECS PHASE IV: Sentence Structure The child with autism learns to construct simple sentences on a detachable sentence strip using an "I want" picture followed by a picture of the item being requested.

PECS PHASE V: Answering Questions The child with autism learns to use PECS to answer the question, "What do you want?"

PECS PHASE VI: Commenting Now the child with autism is taught to comment in response to questions such as, What do you see?, What do you hear? and What is it? They learn to make up sentences starting with I see, I hear, I feel, It is a, etc.

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Interaction with Anonymous Parent at Marg Shree Clinic

Paediatrics the picture became clearer and efforts began to cure this disorder. Medicines were ineffective so they started sending the kid to therapy classes such as Occupational Therapy(OT) , ADL(activities of daily life) , Speech Therapy and physiotherapy. According to her mother therapies have helped her child to grow in five years to such a extent that he is able to communicate his thoughts clearly, can walk properly ,respond to what is asked and behaves properly in public. His ability to hold stuff like bag or simple objects have also grown .

‘It was quite disappointing to know that government is not doing any thing for these kids’-said her mother.

But the biggest con that her mother considers is that the therapy centres have merely become a funds collecting centre. They were effective earlier but now the results have decreased. Earlier she was use to come to this clinic thrice a week but now she comes twice a week as she believe that the centre is not that good now as it was used to be.

Living with an autistic kid means devoting whole life for him .“Going for market to buy something feels like a useless task instead that time could have been spent with Lakshya ,teaching and playing with him” says her mother.

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68 Img source: Self Clicked

UDAAN is the main activity centre of a non profit trust: Foundation for Spastic and Mentally Handicapped Persons (FSMHP)ÂŽ. It was registered as Trust in April 1994, and with the Ministry of Social Justice & Empowerment (PWD Act), Govt. of India in March 2000. FSMHP-UDAAN started 20 years ago from the drawing room of its founder trustees, and by sheer determination and dedication, has achieved National and International level recognition for its work with Neurodevelopmentally delayed disorders in children: the most difficult group to manage.

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In a group of five people we visited to the Noida center of Udaan NGO. Our aim was to extract as much information as possible and also volunteer . Next few slides contain daily analysis and observations conducted for 5 days between 40 students 5 teachers and other staff members.

Reporting time : 10:00 a.m.- 3:00 p.m Reporting head : Mrs. Madhu (Institution head)

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Day 1: 14th September 2017 First day at Udaan Ngo was quite an emotional experience. We were completely new to this world inside and needed an induction about how to deal with these kids.

The main instructors of the institution were-Madhu Ma'am, Anuradha Ma'am(dealt with kids upto 12 years) and Sandeep Sir.(dealt with kids upto 22 years). We were given information about how to talk with these kids.

• • •

Some children keep on repeating sentences like – I want to go to home, I am hungry, I am so beautiful ; so we were told just to complement them and keep on forcing them to do the given task.

Children will try their level best to escape from the room but we have to stabilize them and strictly ask them to finish what they are doing.

We were instructed to help them in crafts , ADL activities, computers and other requirements

The activity assigned to me was to help in teaching computers.

Time slot for kids under 12 : 10am to 11am for children between 13-22 : 11:30am to 2 pm In computers there were three activities that a child has to finish in a day.

1. Typing: Individual is given words or sentences or paragraphs to type .It helps in increasing the recognition power and motor skills of hand.

2.

Matching: A game called , “A thousand Words” is given to a child .It has various levels of complexities from easiest shape matching to hardest of object finding. This activity helps to strengthen the memory skills and social behaviour of a child. It is an inclusive game designed for autistic children .

3.

Paint: This activity helps in exploring the world of different shapes, colours ,brushes and complex forms. A child is give a set of activity in MS.Paint- A rectangular box is given and it needs to be painted without letting the colour go outside; Screen is fill with black colour and has to be erased completely; drawing and colouring of shapes. Apart from that a child is free to explore numerous other things he likes to draw and colour.

First day was more of an introduction with the kids and staff where we observed various categories of disabilities and Levels of ASD.Few observations were: • Children with hypo vestibular disorder were pressing the keyboard keys so hard that they just came off from keyboard.

• Some children were not comfortable with the existing mouse and were unable to grip it properly.

• Children yelled and shouted randomly while working that scared us a lot.

• They showed us sigs of toilet when not interested to work.

• They get exhausted too quickly

Class cards that have to be put inside the box hung outside the class depicting the 71 respective class

Img source: Self Clicked

72 Img source: Pinterest.com,2008

Day 2 : 18th September 2017

• • • • • • •

Time table 73 Img source: Self Clicked

Day 3 : 19th September 2017

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Day, Date Year Chart 74 Img source: Self Clicked

Day 4 : 20th September 2017

•

•

• Items

Cost

Chips

10

Paneer

500

Popcorn/P epsi

600

Pizza

250

Can buy ?

Yes

•

No

Housie session in NGO

•

75 Img source: Self Clicked

Day 5 : 21st September 2017

• •

•

• •

Children Gathered for birthday celebration 76 Img source: Self Clicked

Story Telling Session Story telling session is a part of time table that happens on every alternate days .Its procedure is: 1.

2.

3.

4.

5.

A group of 5 students are given story books to select from. One book is selected and its name is pronounced and written on board.

Story starts by taking characters from book and relating it to real life.

After that keywords from story are extracted and spelled out loud and written on board.

Then once the story finishes children are given around 4-5 question .Questions are asked verbally and children have to pick they keywords from board itself to write the answer.

Children are appreciated if they write correct answers.

The aim of this exercise is to to some social and moral values to these kids in form of pictures and words .These keywords might get stuck in their brains may help them in future.

Children given story books to choose.

77 Img source: Self Clicked

Games that students play at Udaan

Ludo: Game is simplified and redesigned in such a way that it could be played by two people at same time

Shapes Learning Board: Can be played by any special need child.It uses Velcro that makes it easy to be corrected if wrong

Children with autism have a strong visual sense and lack in social communication. So the games are generally handmade and customised accordingly. For example snake and ladder is quite an extensive game ,so to reduce its time they added more ladders and reduced the snakes along with reducing the number of blocks in game.

Turn based games help in interacting with the next person they are sitting with and make friends .

Other games include shape matching and colour matching games where one has to pick up that shape and put into the given space. These are designed for small children unable to comprehend complex shapes and forms.

Blocks (Left) and Shape Box(Right) : These are generally used with small kids to for developing motor and mind skills.

Texture Bowls: Filled with sand and other 78 textures , used as skin therapy.

Img source: Self Clicked

Craft-Work at Udaan As a part of vocational training, children are taught about various crafts and art likeStitching, Wall hanging ,colouring, painting etc.

One hanging was made by us and the same was replicated by the students. The motive was to sell them for the Dussehra Mela organized by Action for Autism.

Stitching done by children

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Overall Experience at Udaan Visit to Udaan has been quite an emotional journey. It was a completely new world inside the building .We were able to sympathise with them but empathising was quite a difficult task. We cant even imagine how difficult it is for the kids when they are unable to express themselves. All we could do was to try to fulfil their needs upto the extent we could. It was just like a normal school where parents send their kids to study and take them back at afternoon.

Similar was the case with Udaan , children came with hanging school bags at 9 and studied till 3.Each day was a new experience with same activities and a strict timetable. It was a laborious job to handle 30-35 kids daily with limited number of care takers and teachers.

The aim of the institution was to make the kids feel a part of society, not the exclude from it. Children were taken for shopping, picnic , movie and to other public places.

Udaan taught that how a simple daily life activity can be so challenging for a 20 year old child and for a kid of below 5 years it’s even hard to imagine.

We had great time at Udaan while teaching ,playing, helping and partying with them. They were quite enthusiastic kids who wanted to grow and learn but due to medical constraints they weren’t able to.

So the learning was not to underestimate our skills and uniqueness because not everyone is gifted it.

80 Img source: Self Clicked

Picture Vectors for Computer Classes Children like to explore various forms and shapes in MS-Paint so we decided to gift them few vectors for practice. Teachers usually sketch on paper and colour the form which looked quite untidy and confusing .

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Case Studies Of 8 children based on observation for five days.

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Sameer Age : 12 •

One of the rare autistic kid who can communicate verbally.

•

Mildly autistic because:

i. ii. iii. iv.

He is literal in listening and processing the words of people.

Although he speaks but speaks the lines repetitively whatever you say to him.

Can express his thoughts and respond to whatever asked.

Can recognize people

• • •

Very curious and constantly asks “ why’s “ .

Talks to himself.

Gets distracted easily and needs some motivation to perform any task.

Lacks basic ethics and norms of society but curious to know about them.

Likes drinking Coke, Limca, Glucon-D, Maaza, etc.

Although he knows how to cut a paper but dosen’t until he has a mood to do so.

He was also having problem in gripping scissors and placing paper on table while making envelopes

• • • •

83 Img source: Self Clicked

Amrit Age : 18 • Calm and hardworking student of Udaan.

• Don’t get irritated and is stable for long duration in comparison to other students.

• Cognitive skills are far more better as he can relate to objects easily and has good matching skills.

• Although slow ,he can type quite easily as he has remembered the letters and can write his name with a pen.

• Beats his thighs when given too many instructions.

• Unable to comprehend complex shapes and basic figures if they are tangled.

• Colour sense is just fine as it takes time to figure out what colour is where.

84 Img source: Self Clicked

Suhani Age : 15

• Has good Colour recognition skills.

• Very interested in creating graphic artworks.

• Prefers Colouring rather than drawing –analog or digital both.

• Quite motivated while working but becomes restless after continuously working for 10 minutes.

• She has good sense of matching and relating to objects .

• Pronounces the words while matching with the picture.

• Has good typing and writing skills although she is quite slow in it.

85 Img source: Self Clicked

Saayn Age : 18

• Hard working and gets distracted easily while working.

• Has good motor skills.

• Sometimes he may be in a mood to work but sometimes he may be completely distracted and may scratch on tables and bang on the mouse.

• Can match and relate to complex figures with ease but has problem while trying out something new and complicated.

• While doing paint he was quite confused how to make a new form given to him. Although he was able to figure out what shapes to make but he wasn’t sure about how to make .

• Requires a lot of time while typing but is easily able to find letters ,type and save document.

• He responds quite well while playing a number based game like housie in comparison to his other classmates.

86 Img source: Self Clicked

Swastik Age : 10 years • Efficiently speaks the name of the shapes and different colours.

• Associates the colours to real life, eg:Sky blue, Grass green etc.

• He was quite patient throughout the class and worked hard to complete the given task.He had good motor skills and was able to able to type and use mouse .

• His perception of perceiving complex figured was very clear but may get confused when asked to make inscribed shapes.

• Vestibular issues as he swings to and fro while sitting and makes sounds after accomplishing a task.

• Primarily he writes in Capital Letters but when assisted he makes efforts to write in small letters also.

• He gets distracted after writing a sentence and needs a break.

• He is able to perceive shapes and complex figures and may spell the name of the object if asked to do so.

• While counting he gets confused and needs help .

• Uses Phonetics while talking or reading letters.

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Pritam Age : 18

• He is also quite calm and focussed student .

• But he gets distracted after sitting on computer for more than 10 minutes.

• Good typing skills.

• Has good motor skills and can easily hold scissors and cut paper accurately.

• Made an envelope in 10 minutes.

• Gets happy and claps after completing a task.

• His social interaction was much better in comparison to other children. He wanted people to be aware of him and often warns them if something was causing distraction to him.

88 Img source: Self Clicked

Anish Age : 18

• Good typing skills but one has to point the word constantly .

• He is able to make big size shapes but has problem while making small shapes.

• He is quite fast while match pictures and has good memory.

• Saves document in MS WORD easily without any assistance.

• Has good cognitive skills.

• Bangs fists when frustrated with work.

• He is not always in a mood to work.

• He looked afraid most of the times whenever someone approached him.

• This may be because where he was first enrolled he was treated badly and beaten up so that perception has fitted in his mind and he feels afraid when any male entity approaches him.

89 Img source: Self Clicked

Anshuman Age : 18

• Can be considered as one of the brightest child of Udaan • He can easily operate a laptop . He knows how to open internet and search on google.

• He has obsession of YouTube videos.

• He is quite intelligent but it needs a lot of efforts to put him to work.

• He loves to sketch flower and star and efficiently cuts it easily without any help.

• He doesn't likes to do origami work instead prefers sketching with bold markers.

• He can work for fifteen minutes straight without any excuse.

• He loves to talk in phonetics and watches old Hindi classic songs and may dance with them.

• The problem he has is to speak out loudly as he just whispers when asked a question or told to sing.

90 Img source: Self Clicked

Interaction with Madhu Ma'am (Head of Institution)

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Design Brief To design a “tangible product� for a user with special needs. The product should be contextually designed keeping in mind the environment. This is not a special category only catering to people with special needs.

The aim is to make people with special needs not to feel alienated, minority or distinguishable. This is a fundamental condition of good design. If an environment is accessible , usable, convenient and pleasure to use, everyone benefits. By considering the diverse need and abilities of all throughout the design process, inclusive design/universal design creates products, services and environments that meet peoples needs.

Simply put, universal design is a good design.

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Ideation/ Brainstorming

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Design Insights Any product designed for a Autistic kid or should have these features taking in consideration a normal kid also: • Easy to use: If a child has problem in operating the game then it would be a fail, although it could have some level of complexities that challenges the mind of child .

• Repetitive: Game needs to have a repetitive set of actions that leads towards the goal. This is because children with ASD tend to relax after they see or do something again and again. It helps them in calming down.

• Educational and Message giving: Game need to deliver some message such that in the end he learns something and apply it in real world. It should have connections with the things related to his daily life or surroundings.

• Social Aspect: Game can involve two or more children that could help them know each other and connect social. It could also be a single player game as well because children with ASD might not like to do so.

• Pictorial: The primary requirement of any board game designed for ASD would need to have pictures. Because these children are usually not vocal and they could easily relate through means of drawing or sketching so game needs to be pictorial.

• Multiple Levels: Game needs to have complexities in ascending order from 7-12 years .

• Sense of Achievement: In the end like regular games it should give a child a sense of achievement which would invite him to play the game again.

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Redesigned Brief To design a educative game/ object for children between ages 6-10 suffering from ASD, that can help in developing their sensory, communication and behavioural skills.

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Conceptualisation Prototyping Iterations

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Cubes of different sizes will combine together to form a word. They will stick together by the help of magnets or Velcro. Alphabets and ADL activities will be printed on the sides which have to be connected together.

A wrist band that could be worn to protect the child from biting as its not possible to stop it completely. It could be worn by a normal kid also and it would create a sound of ghungro when banged on table as a musical instrument.

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A telescopic structure that expand by the weight of ball and comes back to its original position when ball is removed. It could be used a game for relaxing a child when he is hyperactive.

A Lamp that will contain laser cuttings which will glow in dark giving a message. It can be used as bed side lamp for children.

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A board on which will contain a matching set of questions which have to be connected using a thread .

An installation made up of wooden blocks and ball bearing on a rod that revolves in Z axis . Since children with autism like repetitive actions so one can just fidget with it seeing the blocks revolve.

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Self framing story. During the story telling sessions this board can be used to complete the story told by the teacher as it would be printed in parts on the small blocks.

Board game that will help children to develop their motor skills and will teach them about numbers . A child has to insert a ball correct to the given table and whoever gets the most number of correct balls in the end wins.

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Gears: The game focusses on the motor skills of children between ages 8-12 years old. Gears will be changeable and need to be placed in such a way that all gears move.

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Initial Form Explorations

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Building blocks • The concept was to have blocks with slits in form of a puzzle on which Alphabets , Tables, Daily Activities are printed.

• A child has to join all the block creating a 3D form completing the sequence like ABCD or 2*2=4, 2*3=6 and so on .

• It would help child in learning various things and developing motor skills .

Alpha-Cube

Spoons

• The concept was to have small cubes of 5*5 cm on which alphabets will be written. A child can use it as a medium to communicate by making a word out of these blocks.

• The problem faced by children with ASD is that due to poor motor skills they are unable to grip spoon properly while eating .

• Here a cavity is created on the handle where a child can insert his hand. Once hand is inside because of the knuckles it holds firm on the hand .It will help creating a grip even when a child has hyposensitive senses.

• It could be used as a tool to express the emotions as what a child wants .

• It could be used even if a child cannot write or have poor motor and vocal skills.

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Iteration 1: Sheet sliding on board with pegs on sides

In this prototype ,the idea was to add multiple sheets and creating the process of matching shapes, numbers and forms.

On the sides of the board: 1. A peg with a hole inside will be inserted on the sided where the thread will pass connecting the figures/images.

2. There will be hole on extruded part of side from which thread will pass through.

OR On the board: 1. There will be thumb pins stuck on each image and text and then thread will be tied between them.

Side beadings

Cork board

Groove

Why it fails?

• It contains a complete sheet where images will be printed on one side and its corresponding text on other side. So remaining part of the sheet gets wasted although the purpose gets solved.

• The board contains detailing's on the groove area which need to be very precise or the sheets will not fit in.

• It requires pins to be stuck on the cork board, using which may spoil the sheet and it couldn’t be reused.

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The idea was to break the blocks into four parts on joining which complete the board. Each part will have groove on sides where the sheet slides in.

In these sketches the game has been further made as a 4 player game where thread passes from one player to another resulting in completion of a task.

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3d Model The form of board has been explored digitally.

Each form follows the same idea of sliding in sheets with a different way of placement

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Iteration 2: A foldable board of A5 or equivalent sizes which will contain single set of gameplay.

In this concept ,the idea was to make a single foldable board that will contain a single A5 size sheet. Holes will be made on the sides of board frame . It would be easy to carry and play.

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Iteration 3: Making a grid on sheet with different sizes of block that will fit together in a frame.

This prototype involves the concept of previous ideas, where individual pieces were forming a block together and making a word. Instead of making it in a 3d form of a cube there would be a single board which will have blocks of different sizes and they will fit into respective places(as shown in image) .

These blocks would be lifted by a small slit stick on the edges of each block.

A child has to figure out which block fits where and he could learn simultaneously.

Pros: • It helps in development on motor skills as child learns to fit in each block and pass through the thread from the holes of different sizes.

• It makes the game interactive and challenging as well.

Cons: • While making a alphabetical game it will require 26x12=312 blocks which is huge.

• Making a block each time and sticking slits on edges would make it even costlier and bulky.

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Mockup: Laser cut Mdf Board , a frame is cut first and a solid surface will be stuck on back.

Side Attachment: It has holes of different sizes where a child can pass through the thread

MDF blocks remains of the board Blocks of different sizes laser cut

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Iteration 2: Board with sheets that will slide in..

In this prototype the initial idea of sliding in sheets has been used along with the previous iteration of using blocks.

Instead of using solid blocks ,transparent acrylic glass are used. There will be total 12 blocks now which could also act as day memo or timetable when game in not in use and can be hung on wall. Each child could have one board and compete among the peers to finish the sheet first.

Pros: • The game will contain worksheets for different ages of children from 6-10 ranging with different complexity levels.

• Child could learn to concentrate for long time as he patiently connects each block.

• If a child gets board the orientation of the board could be changed as per requirement as a new game could be made by the mentor by scribbling on the blocks as they are erasable.

• Board is light weight and easy to carry as per the convenience.

• A child could learn sewing as well as he inserts thread into holes and learn to tie knots.

Cons: • The blocks still wobble while passing the thread from one hole to another.

• Only three sheets can get inside at a time as thickness is just 4mm.

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Sketches

The idea was to make a frame where slits are place and they could be rearranged together to make a series of events.

For example there would be daily routine activities scrambled on the board and a child has to arrange them in the way he follows.

This was the final idea which uses elements of previous iterations and form game which can help children build their vocal, motor , communication and social skills

Form exploration of side slits.

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Shape matching sheet

Alphabets matching

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Blocks made up of wood and acrylic glass

Hole on side slit to pass through the thread.

Layout of board

Front opening to insert sheets

Side beading to give thickness

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Plug ‘n’ Play…

Final Concept : Eliminating the individual blocks

In this concept instead of using individual blocks, the slits are placed on the edges of the upper part of the board such that no additional blocks are required to be placed on the board.

Child can easily pass through the thread without disturbing the position of the board.

Pros: • The game will contain worksheets for different ages of children from 6-10 ranging with different complexity levels.

• The game board remains stable as blocks don’t hinder the passing through of the threads.

Cons: • Now since the blocks have been removed the game remains restricted to only the sheets and not the daily memo.

• Weight of the board increases slightly as polycarbonate sheet is placed inside.

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Rendered Views

118

Dimensions of the board

Dimensions of the sheet

119

Technical Drawing

Exploded View Side slits:

Top Frame:

Polycarbonate sheet

Base Side frame

Worksheets 120

Materials Used

150 gsm A3 size sheets

MDF Board

Polycarbonate sheet

Nylon threads

121

Colour Schemes

122

Children with Autism generally rely on their visual senses to tell them what is happening since they often difficulty decoding verbal cues. Researchers have found that autistic children’s rods and cones (components of the eye) have changed due to chemical imbalances or neural deficiencies. Colours appear more vibrant to autistic children. Of the autistic children tested, 85% saw colors with greater intensity than non-autistic children. The color red for example, looks fluorescent and vibrates with intensity.

Calming Colour pallet 123

Colour Variations

124

125

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Emphasis on Skills Game is inclusively designed to improve upon the cognitive, Motor and Vocal Skills of Children. These simple skills shape a child's growth and define his standards. Children with autism have major issues with these skillset .

The age between 6-10 years is quite crucial for the improvements as therapies are most effective during this duration.-Dr.Mansoor Alam

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Cognitive Skills: Cognitive development is characterized by the way a child learns, acquires knowledge and interacts with his surrounding environment. Different cognitive skills are acquired as a child meets certain developmental milestones, but a child of any ability will benefit from activities that promote active learning. It can be encouraged by emphasizing in the areas of memory, concentration, attention and perception by incorporating simple activities into the everyday routine. •

Playing with the Alphabets is one of the ways a child can learn develop the cognitive skills. In the game a child has to match correct alphabet to the image and then to word forming a web on board. A child has to figure out which has to be connected to what.

•

Game enables a child to relate more closely to the real life as the images linked on the sheet are relevant to what he sees around him . It could also help the child to tell his guardian what he wants as this is a major drawback in the cases of children suffering from autism.

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Fine Motor Skills: There are two types of motor skills-Fine and Gross. Fine motor skills involve the small movements of muscles like picking up small objects, holding a glass etc. whereas Gross motor skills involve the use of bigger body parts like legs and arms involving movements like rolling, jumping, etc.

The primary aim of the game is to work upon the fine motor skills of an autistic kids. Irrespective of a child having an hypo or hyper receptive senses, they have poorly developed motor and coordination skills. •

They game ensures that a child constantly improve on his hand and eye coordination by choosing right hole to match the right content.

•

The games gives the liberty to learn whatever a child wants so as per the requirement one has to insert the sheet inside the cavity provided at the bottom of the board which helps him making choice (and learning for a parent what his child need) and learning how things work.

•

It also focusses on the way how children grip small things like needles and how to carry such things carefully without hurting others.

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Vocal and Social Skills: The game also focusses on breaking the communication gap between a child and peers. In case of autism this problem is seen in every 9/10 children . They have underdeveloped vocal skills because of which they have problem in communicating because of which they might get hyperactive. •

While playing the game child has to spell the word that comes into the path and then move forward to the next block; this helps the child in spelling out the names of some relevant things that he sees, feels and hears in his day to day life in the process of learning the alphabets.

•

It will also help the elders around to learn where a child requires more attention as they sit around and play together in groups.

•

As a group activity where board is given to a set of at least 2 children they can compete together to finish the game set first and can have dialogues in between the game checking out who wins first.

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Approximate Cost Analysis Sr.

Items

1.

2.

3.

4.

5.

MDF board 4mm MDF beadings Polycarbonate Sheet Paints Cartridge sheet

6.

7.

8.

9.

Nylon Threads Printing Laser Cutting • Polycarbonate sheet • MDF sheet

10.

11.

12.

Size

Qty.

Per Unit Cost (₹)

12”x8” 12”x.5” 12”x8” 400ml Pack of 25 sheets

2 6 1 4 10 Sheets

350 350 250 250 25

28 18 62 1000 250

18 15 55 700 100

2 metre A3 Size

10 10

5 8

100 80

70 50

12”x8”

1

10/min

300

300

12”x8”

1

5/min

300

300

500 500 300

400 300 200

₹ 3,438

₹ 2,500

Miscellaneous Labour Transport/ Carriage

Total Cost

Prototype (x1 pcs.) ₹

Final Product (x100 pcs.) ₹

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About age group 6-10 years and specifically why this age group?

Age group 6-10 years is very crucial time where generally therapies are started and if given intensely, can prove out to be very successful at times. This part of age frames the structure of what all strengths a child endear and what all need to be worked upon.

Intellectual Growth: • During this age group kids learn to read gradually. Children who can read aloud are encouraged to read as that helps them to develop more quickly intellectually. In case of mild autism children are generally placed between normal children and are asked to perform similar activities such that they could also grow intellectually.

• Child becomes more sophisticated in understanding the concept of time. They enjoy hearing about times past.

• By age 6, most children can count to 100. By age 9, they are beginning to learn how to multiply.

Physical Growth: • In severe cases of Autism due to hyper/ hypo active vestibular and proprioceptive senses children are unable to perform any function as they are not able to locate their body in space. Generally children of this age are restless and have patience issues.

• More physical abilities also develop. Many children can dribble a ball with one hand by age 6. Most learn how to ride a two-wheel bike. They become more skillful at skipping and catching and throwing a ball.

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Social Development: • Children on ASD spectrum generally lack in developing social skills as they are not able to comprehend things as a normal child does. It takes time to process information and respond to it and because of weak communication skills they feel left alone from the society. • Children this age become more adept at relationships, but they also may have many conflicts with their peers. • Many children are competitive, and can become argumentative and quarrelsome when they lose. This is a general feedback for a child suffering from ASD also as they might get very defensive about things they have and might get very angry if objects are taken away from them.

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