autism care norway nepal


Parent Child Teaching Program (PCTP)

The Parent Child Training Program (PCTP) was started on the philosophy that parents can be the best teachers for their children when they are given proper inputs, guidance and support. This support and guidance along with theoretical and practical knowledge about teaching and behavioral management techniques are included in PCTP.


1) Every child with autism can improve and be helped to lead a dignified and meaningful life with consistent and appropriate intervention.

2) A child is better understood by his/her parents, when the parents know how to use appropriate teaching strategies with their children, they can be the ideal people to help the children learn and grow.

3) When the parents know appropriate methods to teach their children they are empowered to take an active role in shaping their child's and family's future.

4) When parents are taught strategies of relating to and educating their children, the parent child interaction becomes more meaningful, productive and enjoyable for both parent and the child.

1) To help parents understand Autism, understand their child, the unique ways in which their child thinks and learn.
2) To increase parents ability to effectively interact with and teach their children.
3) To help the child progress through the teaching of essential skills.
4) To empower parents, help them create a support system and subsequently reduce stress levels and improve overall family well being.

Where to start:
At the beginning of the Programme our special educator completes a brief assessment for each child which serves as a guide for beginning to plan activities for teaching the child. Additionally our trainer work closely with mothers to plan and implement their teaching.

The PCTP is a part of Autismcare Nepal's day care centre, so the mothers also take ideas by watching the teachers, staffs and parents. The PCTP families become a part of ACN and participate in events and activities at the center such as picnics, outings, festival celebrations, annual day and awareness campaign, so there is always someone around to help generate ideas and give support.

The PCTP follows the same structure every day as order and predictability are important for children with autism, so it is necessary to have a routine that is followed consistently. Also it is important for the mothers to be prepared and organized before session begins so that the child does not have to wait.

The first two weeks of the Programme are focused on understanding autism. There are detailed lectures given on autism, communication, the principles of behaviour and its modification, structured teaching and thereby the actual time that the mothers will work with the children will be much shorter to begin with, and will gradually increase as the session progresses. In the first two weeks of the Programme, the trainer will lead all group activities, whilst the mothers will be given strategies to begin work with their child in a way that both mother and child enjoy and look forward to the interaction in one on one sessions.

By around the third week of the Programme a timetable is set up whereby mothers are given charge of the group sessions during the week. For example, one of them will be doing the morning activity and another one may be doing the music time. In this way all the mothers have a chance to plan and implement activities for all the children not just their own, and learning to anticipate and deal with the different needs of the children which will help them to be prepared if similar needs ever arise in their children in the future.

The sessions begin in the morning from 10:30 and ends up by 2-2:30. The day begins with assembly time, group activity focusing on gross and fine motor skills, one on one sessions as well as a snack time and ends with music time. After music time the children have a break while mothers sit with the trainer for a discussion and feedback on the day's activities. Explanations of what is done during each section are as follows:


What happens during assembly time?
This is the first thing that happens each morning. It starts with prayer and some sets of exercises. Then the children are shown the calendar to cross yesterday and circle today. Also they are given a card showing the day of the week written on it and given an instruction to put it in a day card box. Then attendance is taken calling every child's name and having them either say " present" or raise their hands( dependent on whether or not the child uses speech). Then it is time to look at the "thing of the day" which means a covered box with some interesting toys encouraging the children to attend jointly. After assembly time the children go to the play area and the class is set up for physical group activity.

What is the child's learning during assembly time?

Assembly time helps the children prepare themselves for the day. It introduces the concept of a structured school day and helps them to gather together before beginning their work. The exercises allow them to practice gross motor and imitation skills. Days of the week gives the practical knowledge of what day it is as well as information about time. Every day has a name, they follow a structured order i.e Tuesday always comes after Monday. Taking attendance helps them to acknowledge their classmates and notice whether everyone is at school or not. Attendance also teaches them to respond to their name being called. The "thing of the day" encourages  joint attention, waiting for their turn to play with the " thing of the day" and giving back an interesting toy once their turn is over.

What happens during the group activities ?
After assembly It's time for physical or sitting group activities. The sitting group activity focuses on fine motor skills while the physical group activity focuses on gross motor skills. Each child gets a turn to participate in the activity.

  What is the child learning the group activities?
* The activity for fine motor skills usually takes place at the table and teaches fine motor skills through things like cutting, coloring, pasting, folding and activities to     enhance fine motor skills like playing with beans, sand etc.
* The activity for gross motor skills teaches gross motor skills through activities like jumping, crawling, catching and throwing ball etc.
* The children learn to wait for their turn.
* The children learn that sometimes we do things alone and sometimes we do things in a group. This teaches important social interaction skills.
* Having a schedule where the child ticks his own name helps him self regulate and control impulses.

What happens during the one-to-one time ?

This is the time the mothers have to work directly and personally with their own child. The mothers and children complete the activities that the therapist and special educator have planned prior to the session. The activities are an adaptation of different methodologies such as ABA, VBA, TEACCH, play therapy etc. It is essential that the mother has to prepare all of her materials beforehand. This creates structure and order for the child and reduces work related anxiety for the child.

What is the child learning during the one-to-one time?
This is the time to focus on communication, social and cognitive skills although the Programme will depend solely on each child's individual strengths and immediate needs. Some of the areas focused on are:

* Compliance
* Learning to sit and Attend
* Following directions
* Requesting
* Matching and Sorting
* Fine motor skill activities using structure
* Maths
* Reading
* Pre-writing and writing skills
* Other concepts such as colors, sequencing, matching

The One-to-one time has to be fun for the child. Parents will learn to come up with ways to make teaching activities more enjoyable for the child. During this time each child is working individually according to his needs and abilities. Parents are trained individually like for e.g avoid overwhelming their child by asking him/her to do more then he/she is capable of and if he/she begins to seem frustrated, make things simpler, if he/she is bored challenge him/her more.

What happens during snack time?

Snack time usually happens after one on one session. Snack time gives the child break from activities to have a snack. All children wash their hands, the snacks are lined up and the children pick out their own snack and come to sit and eat.

What is the child learning during snack time?

Snack time is important because it gives the child time to relax and have something to eat. But even though it may seem like off time, the children are still learning necessary skills. This teaches important eating habits such as washing hands before eating, eating only from their own plate/snack even when their neighbor's snack is more interesting and sitting properly. Fine motor skills are practiced when the child opens his own snack and feeds self. When the child picks up his snack from a line of snacks it helps him to learn to recognize his own snack. The child will be learning self help skills in snack time.

What happens during music time?
During music time the children and the mothers sing a number of songs and a closing song. After music time it is announced that school is finished for today  that they will see each other tomorrow or Monday if there is a weekend coming up. At the end it is important to indicate if anything out of the ordinary such as a holiday is going on the next day. This limits the child's confusion if he expects to come to school the next day.

What is the child learning during music time?
Making instruments or clapping along with a song helps the children learn rhythm. The children who who are verbal learn to sing along while the others sit  and enjoy the music. Most children with autism respond amazingly well to music. Thus music time gives them a nice, enjoyable ending to the day.

What happens during discussion time?
During discussion time the children have a break and the mothers get a chance to interact with a therapist who has watched all the sessions and give feedback on what was done well and what could be improved, as well as general behavior issues. This is also a good time for mothers to raise questions they have had when working with their children at home or to discuss specific difficulties and successes they have had. In the absence of a trained therapist, the mothers could use this time to bond and share with each other their difficulties, successes and questions as well as things they have heard or read that may be use of other parents. Sometimes the best ideas come from other parents.

"You may be thinking this all sounds very easy, but I can't even get my child to sit still for five minutes to wash his face, how will I ever get him to cooperate enough throughout 3 and 1/2 hour of school day? This is not an uncommon concern. Most of the children who enroll in the PCTP have had no previous schooling and at first have a very difficult time adjusting to the new expectations. At the beginning the PCTP rooms echo's with the sounds of crying children and exhausted mothers. But in a few weeks time, one already begins to notice a remarkable difference in the children's behavior and the mother's ability to encourage that behavior.

  A combination of things leads to this change. The first is simply that the child gets used to the structure of the day and begins to learn what is expected of him. Change is difficult for everyone and is particularly hard for a child with autism who places high importance on structure and predictability. When mothers are consistent the child is clear about what is expected and is less confused. Once the uncertainty and fear fades, the child will have an easier time adjusting to the new routine. The second is the mother's growing ability to understand her child, understand why her child is doing,  what he is doing and then developing and implementing the "what to do".

The PCTP is about understanding one`s own child, enjoying the child and helping child understand their parents and enjoy with them. This is an important foundation upon which we can help our children progress to the best of their abilities. The Programme is also about knowing that the parents are not alone. By the end of the Programme they will realize that they have friends in their group who will be there for them to share joy at every step and to remind them that " tomorrow is another day" when things are not going the way they would want them to.