The Doris Duan-Young Autism Center: Building the steps for success for children of determination

Marina Loukas, Administrative Director

Could you share some details on the therapies currently available at The Doris Duan-Young Autism Center (DDY)? How could DDY make a difference in the lives of children with autism?

Located in Dubai Healthcare City, The Doris Duan-Young Autism Center (DDY) is one of the most reputable, specialised therapeutic service providers in the field of autism and a wide range of other developmental disorders. DDY is a trusted and innovative leader which is exemplified in our multidisciplinary team approach and throughout all of our comprehensive services: Applied Behaviour Analysis; Verbal Behaviour Milestones Assessment and Placement Programme (VB-MAPP); In-Depth Individual Functional Assessment; Speech and Language Therapy Services and Assessment; Occupational Therapy Services and Assessment; Physical Therapy Services and Assessment; Individualised Intervention (Behavior, Speech-Language, Occupational Therapy, Physical Therapy) Plans; Parent and Caregiver Training; School Teacher Training; Camps during off-school sessions; Psychological assessment.

In the 8-year journey of DDY, we have witnessed the challenges and obstacles that families and children with disabilities face and we have worked hand in hand with them to improve the quality of their lives. We enable parents to participate in their child’s treatment by attending parent education sessions in the centre. We organise social outings in the community to provide them the opportunity to develop social skills and access to different activities and experiences. At DDY, we believe in providing a holistic treatment approach by incorporating all aspects of a child’s life in their treatment plan.

At DDY, we live by our motto, expertise that cares, through our evidence-based interventions.

- Dr Ben Hadj Hassine, Chief Executive Officer

Inas Ktaech, Clinical Director and BCBA

How is autism spectrum disorder diagnosed? Will you be able to customise therapies based on the levels of autism?

Autism Spectrum Disorder (ASD) is a neurodevelopment disorder which can be detected and diagnosed by observing the client; interviewing the client (if applicable); screening tools administered by a qualified professional; and interviewing parents, teachers or caregivers.

The development screening tools necessary for an Autism diagnosis can be the following:

● Ages and stages questionnaires (ASQ)

● Autism Diagnostic Interview — Revised (ADI-R)

● Autism Diagnostic Observation Schedule (ADOS)

● Autism Spectrum Rating Scales (ASRS)

● Childhood Autism Rating Scale (CARS)

● Gilliam Autism Rating Scale (GARS)

● Social Communication Questionnaire (SCQ)

When it comes to customising ABA therapy based on the child’s level of diagnosis, DDY uses standardised assessments to develop individual goals. These assessment tools are The Verbal Behavior Milestones Assessment and Placement Programme (VB-MAPP), The Assessment of Basic Language and Learning Skills (ABLLS-S), The Assessment of Functional Living Skills (AFLS) etc. In addition, each client is provided with a multidisciplinary team, which include speech and language therapy, occupational therapy and/or physical therapy in order to teach skills based on their individual needs.

What are the various interventions that have been found to be useful in the treatment of autism?

DDY encourages the use of evidence-based interventions while choosing a therapy option for your child with autism. Applied Behavior Analysis (ABA) is one of the most widely used forms of therapy to treat autism. This therapy focuses on reinforcing positive behaviours while decreasing negative, or unwanted, behaviours.

In addition to ABA therapy, speech -language therapy, occupational therapy, Cognitive Behavioral Therapy (CBT), social skills training, parent/caregiver training, vocational and daily living skills training, are all useful in the treatment of autism. The best intervention for your child is to use a multidisciplinary approach, ensuring that these types of therapies and training are used in combination of one another based on your child’s needs.

Radwa Rizk, Case Manager and ABA Therapist

What are the key benefits of ABA therapy?

Key value of ABA lies in its evidence-based, results. ABA has effective behavioral strategies that help reduce challenging/ undesired behaviours. Additionally, ABA focuses on improving the social skills that many children with autism lack.

ABA training can be individualised for each client, using a variety of behavioral strategies and focusing on their needs. The benefit of the ABA approach is that it breaks down skills into small steps. Then, by using reinforcement strategies, the child gains control over each of those steps. The ABA therapist gathers data during each session to measure progress.

Ghina Saab, Learning Support Assistant Supervisor and BCaBA

What are the latest challenges and solutions within the classroom for children of determination during the pandemic?

Wearing face masks is a concern for some children of determination. Additionally, we faced some challenges in teaching social skills while following social distancing measures. However, we have been able to deal with these challenges using innovative strategies such as social stories and visual rules about the importance of face makes, which helped desensitise children gradually to accept face masks.

We also managed to inculcate various social skills while maintaining social distancing. We encouraged them to identify a peer and have a short conversation with the peer from a distance, role play with therapist, watch video models and listen to social stories. At the centre, our children are trained to frequently wash hands and sanitise.

How important is parent-teacher collaboration for improved learning outcome in children with autism?

Collaboration between teacher and parents is very important in generalising academic and social skills to the child’s environment. For instance, math targets such as measurement, shapes, and counting, can be integrated in child’s home environment through cooking, playing or during family outings. Parents can always dedicate reading time to revisit the same books read in the class. Teacher and parents’ communication can help parents develop child’s language skills. For example, children can retell events happened in school through pictures posted on the school app. Consistency in setting a routine at home can also help children have a more productive day at school.

Guendolyn Logronio, Head of Speech Department

What are the unique treatment approaches for childhood apraxia of speech (CAS)?

Childhood Apraxia of Speech is a motor speech disorder characterised by difficulty to plan, sequence and/ or coordinate volitional movements for speech sounds production in the absence of any muscle weakness.

Common manifestation of CAS include but is not limited to: inconsistent speech sound errors; significant difficulties in producing longer multisyllabic word and word shapes; and prosodic errors like intonation, stress pattern, loudness variations, and rhythm.

There are several approaches available in the treatment of CAS. We, at DDY, firmly believe that there is not one single approach or programme that is most appropriate for the treatment of CAS. Instead, CAS treatment programme is a combination of different approaches and techniques that addresses the unique strengths and needs of the child and uses the principles of motor learning. And as the child progresses, the approaches and techniques may change over time.

Our speech-language therapists/ pathologists are trained in the following approaches: DTTC (Dynamic Tactile and Temporal Cueing); Prompts for Restructuring Oral Muscular Phonetic Target (PROMPT); Oral Placement Therapy Speech Clarity (Sensory approach); and the use of both high tech and low tech AAC device/s.