Wednesday Live: High Functioning Autism vs Low Functioning | Q&A

Child is high functioning autism. And why you want to, why you want to make the distinction is because, number one, you're scared that, you know, your, your child actually cannot go to school. Right. Cannot go to like mainstream school. And that's why low functioning autism, low functioning autism will go towards like norm special schools. Yeah. So once you get the diagnosis of like how the degree of autism your child has, and then next thing you would think, oh, is he high or low functioning? And usually what that really means is just that are they able to, how well they are able to function? And there are a few things that you can actually look towards. Like number one is about the daily activities. Are they able to go to the toilet independently? Are they able to, you know, get dressed themselves? Are they able to, you know, eat, drink, whatever? Okay. And I just want to set a line here and tell you guys what is actually the lowest function I've seen for autism. And I'm not saying that this is a, this is the definition of low functioning autism, but I'm telling you that this is how low it can go. All right? And at any time you can just ask me any questions about your child or anything right here. Right. And so the lowest functioning autistic child I've seen are children who are autistic, number one, like being diagnosed with that through like doctors and whatever. And also they have a low iq, right? Academically, they're, they're not as well functioning as other children. And the lowest function I've seen was actually like bed bound. Meaning, like they're lying on the bed 24 7, you know, like, and they need to be fed through like a tube and all that kind of stuff. And it's more than just like just low functioning. It's just a bunch of serious things all tied in together, you know, like, might be really, really bad sensory disorders, some type of cerebral palsy. Sorry if I'm mispronouncing it right now, it's too early for me. And just what we call mental retardation and all that kind of stuff right now. It's called like cognitive disorder or something. Because mental retardation sounds too bad in the current society is just we cannot say that kind of stuff anymore without making people uncomfortable about it. Right? So that's the lowest function I've ever seen. Like they cannot eat, they cannot go toilet themselves, they cannot move much, they cannot even talk. That's non verbal. So you would ask, a lot of parents would say, hey, my child is non verbal. Does it mean that it's low Functioning well, not really. Not really. Okay. It really depends on, on how we should look at it, how we should look at it, how we should define it. I always say that if your child can, we should always try to put him into or her into a mainstream school. The reason why this is the case is because last time I saw a mother, I'm laughing now because now it's okay. But before, it wasn't that good. I mean, the child wasn't that behind on speech and language, but he was put into like a special needs class 24 7. Not 24, seven, like seven days, five days a week. And he was like, just mingling with children who were a lot less capable than he was. So therefore what was happening was that his environment was very bad for his development. So if right now, the things that you have to think about right now is, oh, does my child? Can my child actually cope with like, mainstream? And usually you would know after like three years of kindergarten, right? And a lot of, I guess the opposite is more so true when a lot of parents actually put their children into mainstream, mainstream primary schools without them being able to catch up, right? So that's why a lot of people are saying, oh, there's a golden age of therapy, which is between like three to six. And that's because, oh, that's the three years that you can use to catch up to get into mainstream primary school. Because a lot of countries, including Hong Kong, Indonesia, whatever, once you're into primary school, your. What's that called? The syllabus, you can't go back, you know, you got to catch up. If you can't catch up to the syllabus, it won't, it won't do, right? So anyone, to be honest, how I've seen it now is that anyone who can catch up towards a mainstream syllabus within those three years, oh, we're like, oh, he's high functioning, he's fine. All right? But if someone cannot within those three years again, then, oh, they're low functioning. Okay? So I really believe now that this has become a norm of the social norm of how it is right now with, like, education. And I think it's pretty bad, to be honest. Okay. And I'm saying this as in, like, if your child cannot conform within those three years and catch up, then people will look down on them. Right? So does it mean that the lower, high functioning, like, literally not really. So what can we do about it? Right, what can we do about it? What can we think? Okay, you have to have a think process as A parent to think about what's the best for a child. Okay? The first thing is not to think about the future too much. I think it's very hard, especially if you've labeled your child as low functioning. There's a lot of things that in our minds that cannot happen. And as a therapist and when I see low functioning autism on my assessment sheet, like when people get referred over and I take a look, boom, it's like low functioning. And then my mind would be like, oh, non verbal, has a lot of stimming, you know, like they would spin on the floor, they would hit me, they would bite me. They might be a little aggressive as well or something. And I would also know that they probably don't know how to write. They probably have a lot of sensory issues. I need to be careful about these things. These are just probably what would happen most probably in my mind when I see low functioning, when I see high functioning on the sheet, I'm like, okay, this guy, you should like talk in full sentences. And because he's high functioning, his IQ should be fine. So he's pretty smart with everything, he understands it, but he just doesn't want to talk to you or something, right? But the more I do, the more I work, right after I have these like stereotypical things in my mind, right? I've realized that it's actually not the case. It's actually not the case, okay? And this is totally not informal, okay? Just if you don't quote me on this, all right, I'm just sharing my experience. Is that lower, low functioning, odd ASD children, they might seem like they're like non verbal, they don't understand much, they're stimming, they're in their own world, they cannot, you know, a lot of them would be like tiptoeing or whatever or like, you know, aggressive and stuff. But the thing is, like, if you get to know them longer, they actually know certain stuff, right? And they actually can learn pretty fast. And to be honest, if a low functioning autism, if you've taught someone for long enough, you will see the merits and you will see that actually you can do something about it. And to be totally honest with you, low functioning, high functioning, both of them are as rigid as, you know, as each other. It's just that how they react to the world is a little different, okay? And you don't even know. You can't even check if someone is like of high IQ or low IQ correctly if they have autism, you know what I'm saying? So a lot of The IQ tests. I remember last time a parent came to me with an IQ test for the child and she was saying, oh, yeah, yeah, yeah, this kid, he's autistic, but his IQ is okay. Look, look at his verbal reasoning score. Look at his whatever score. And they were using. I forgot, it's called ravens or something. Right? I mean, if you've done it before with your child, you've heard of it. So ravens is actually not that great because you need to have a certain level of language prowess to actually do well on it. Right. So I always thought that it was not very valid on children with autism because they don't really think in language. If they're non verbal, then how do you know how they think? The thing is, you just don't know. Bethel says hi. Hi, Bethel, how are you? How are you doing? Yeah, ask me anything you want anytime. Okay. I'm just sharing about high functioning and low functioning. Okay, so let's say that your child is low functioning or like being regarded as low functioning. And how should you teach a low functioning child? Actually, to be honest, high and low, there isn't much of a difference when you teach them. And the reason I say this is because they're just as rigid as each other. I've seen the highest functioning children who are on the other end of the spectrum. They are very rigid. And you would think that, hey, man, the visual cues wouldn't work for high functioning smart kids. As for the low ones, but it's not true. So if any time you need to always use visual cues, like pictures, always use it. It's always helpful to use pictures. And dude, everyone uses visual cues, even for us adults, like signs and stuff. When we're driving, we're looking at signs. When teaching, just in general, children with autism, whether low or high, remember to use visual cues because. Because we're using their rigidness against them. All right, so is there anything distinctive between teaching low and high? Okay, so low functioning, what you have to be careful of is that they're usually pretty scared. They're scared people, right? They're easily aggressive because they get scared and intimidated very easily. And their animal instincts kick in and they become like fight or flight and they start screaming and shouting and like closing their ears. Right? And they start kicking you. So I'm just like using low function as like a broad term. I don't mean that they're low functioning at all. I don't believe that. But just in the general sense of how like the society views them, I'm just going to Call them low functioning. Okay. Yeah. So if you're watching this, please don't like take this the wrong way. I really don't think, you know, it's. Right now in our society we don't have a tool that can actually like do it correctly because you. We're just using our standards on them, right? So these children who are pretty non verbal, have like huge sensory issues, are usually very scared. Okay. Especially those who have been through a lot of therapy before. You know, like it's very easy for them to. Whatever you do, they become very defensive. Right. So how do you tackle that? Well, first of all, you need a. It's like, it's like a tug of war, right? You cannot pull them too hard. The more you want to teach them, the more they resist. And I remember the first ever actually, wait, the third kid of the third ever client I had was a low functioning autism. And the therapist came in the report and said, oh, he cannot do these things. He cannot talk. And finally we finally got him to sign a few stuff, right? And like sign language, like gestures and stuff and finally got him to play like scooter just to get rid of his stimming. And the thing is, like, it really took a long time because, you know, he wasn't reactive to a lot of therapy. So the key to doing like low functioning, low functioning is to really see what's happening, see what they want, see what they're scared, avoid it. And then teach them systematically, like really systematically, like chop it into such small chunks that they cannot fail. And Bethel asks, my son is two years next week. He loves to watch tv. But when I teach him, he don't care to learn, but get upset when I turn off the tv. What should I do? Right, so use the TV as Bethel use the TV as a way of rewarding. Okay, so turn it off and then instantly turn it back on so that you show that you're the person in charge of the tv. And then number two is like when you do that, slowly increase intervals between you turning on and off the tv. All right? And once he knows to wait and doesn't get mad when you turn off the tv. And then you can like teach him stuff in between. All right? Teach him stuff in between the TV breaks. So you can actually just turn off and then tell him to do some stuff. And then you can actually do stuff in between. This takes some time to actually do it. Don't just turn it off and then just tell them to do stuff. Turn it off, turn it on, instantly increase it incrementally like 5 seconds, 10 seconds, and then turn back on. Lynn says, hey, Lynn, what's up? Lynn says, raven is always doing good with our children because they're mostly visual. That's why they perform better. Yeah, I agree as well. But, you know, there's just a few things that I don't think is, you know, like, I don't know, like for, for instance, Raven, there are some parts that, you know, I believe require verbal reasoning. Right. And I, I. And it doesn't, like how to say it's not, it's not like, functional. You know what I'm saying? Like, yeah, I can think about how, like the next. Yeah. You know, like, I. Neither do I. You know, like, you know, what's the functional purpose of knowing if the child knows what's the next sequence of like three triangles moving? Right. I mean, and first of all, they need to know that they're triangles anyways. Right. And, and, and so on. So I don't know why it's become like a thing that we use to determine the fate of a certain human being. You know, it's just not cool. Right? Yeah, Bethel, you got it. So you try out first. Right? Don't make your child angry and pissed off. All right? And I would also tell you to, like, get some snacks on the way, just so that in between, when you switch it off, just before he gets angry, go ahead and give him some snacks so that he doesn't burst. Right. That should be, that should work. So tell us back what happens after you try it. All right. Because we're here every Monday, Wednesday, Friday, maybe you're in the U.S. the timing is a little different, but usually the day before at 10pm so it's Wednesday now. I think it's actually Tuesday in the U.S. right. Anyways, so I'm going back to talking about high functioning, low functioning again. So I did talk about low functioning. Oh. You really need to chop the things up into very small pieces, no matter the age. Okay. Because they're, to me, it feels like they're always very scared. Okay. So whatever you do, and especially if your child has gone through a lot of therapy, they know your tricks, even if they don't. Cannot talk. Well, you know, they really know. You know, you try to prompt, they're already like, ah, and they're running away or something like that. Right. Whereas a high functioning, they're seeking for your prompts because they know that if they just copy what you say, they will get what they want to some extent. So it's a little different there. But at the end of the day, what I really want to talk about this life is to not think of them as high or low functioning, but as individual human being. Think about what's going on. High functioning, low functioning is just a label for us. When we see it on the diagnosis sheet, we're like, dude, so, okay, this is potentially what I'm dealing with. I should get ready for my assessment. That's what it means for me when I see low functioning autism paired with sensory disorder, highly whatever has trouble with going to the toilet. All these stuff on the report, it just gets me ready. Doesn't mean it should be shackles for the parent or the child to think that, oh, I'm destined to be like this, right? And then we. And then the therapist in the staff room, they'll be like, oh, my God. My case today is a low functioning, ah, oh my God. And stuff like that. Right? But it's just for people like us to like, just chit chat between each other and have like, common vocab between. Just to know. Just to get each other to know what's going on. Right? Okay, so how about like higher functioning autistic children? Right? So these children are. Should be. Should be doing much better on the Ravens test in terms of language. They're on the. They're on the better side. But the thing is they cannot use it correctly. And Lynn says, well, people are likely to. Likely are likely judging the child with high functioning autism by the child's appearance. Kind of dilemma for parents as well, though, the child threw tantrums and went stimming. Then they would say, ah, low functioning. Yeah, pretty much that. Yeah, I really think so too. Like, the amount of stimming doesn't determine high or low function. Stimming is across the whole spectrum. And by the way, we, us adults, we all stim, right? We just know when to stim or not, right? I shake my legs a lot and I actually got called out by my supervisor before, which is crazy, you know, like, they were like, hey, Ming, stop shaking your legs during session. It's very distracting. I stim as well. Am I low functioning? I don't know. Maybe I am, maybe I'm not. Maybe I'm on the spectrum. Who knows? High functioning is more like doing good on IQ tests. If they do a language test on them, they're pretty okay. They can answer some questions. But you know, still, verbal reasoning is kind of meh. And academically they're totally fine. They're like, very good. They're like hyperlexia. They can read really well. They know all the rules and all that kind of stuff, right. They, they can speak in very long sentences. But the biggest problem with them, with them, I'm labeling them now, I'm generalizing, is that they have a problem with using the language correctly. Okay. And children on the spectrum will get to this point anyways, like, if you keep on doing therapy, right? If you keep on like teaching them language, you'll get to a point where they need to use non literal language which they don't really understand and which children who are high functioning can't really deal with it. Right. So what is non literal language, you might ask me? And what it is really is just like figure of speech, right? So for instance, if we say, like, it's raining cats and dogs, children who I've taught someone, like raining cats and dogs, they really don't understand what it means as a figure of speech, right? It's just too, they're too literal. They're too literal. So for instance, if I'm saying I'm sweating like a dog, they would say like, no, you're not a dog, you're human. Something like that. Okay? So these are also the challenges that you would face for high functioning. Okay. For low functioning, your. Your tasks would be like, for them to start talking and, and start to like, respond correctly and respond appropriately instead of running away, you know, Excuse me, my nose is very, like, itchy. Yeah. So, yeah, for both of them, stimming is going to be a problem. And I might as well just talk a little bit more about stimming, about what I learned. Right? So when we're always trying to do stimming, we're like, try to treat stimming the wrong way to do it, the actual wrong way to do it. And it's backed by research, actually more on the ABA side, not on the speech side, because I'm a speech therapist. Right. But to be honest, speech therapists, we don't really care about stimming. We're all about communicating. If you go to a speech therapist and you say, oh, it does a lot of stimming won't care. Because to be honest, if you can communicate, if your child can communicate, no matter how low or high functioning, we don't care as long as it's effective. We're like, okay, that's good enough. But if you're talking about stimming, it's more on the behavioral side, then what should we do about it? Well, you have to find a replacement for it. You got to find A replacement. And I've only seen it successful a few times, right? Where, you know, we can actually find someone, something that is more, that is as fun as stimming that replaces it. One of them is like a child was playing. Like, instead of flapping their hands, we taught them to play drums, right? Instead of squeezing their own hands, we gave them something to squeeze upon. Instead of eye cornering, we taught them to watch something. And it doesn't really work all the time because the more time they're able to stim, the harder the behavior actually becomes to like, get rid of. And to some extent, right? I'm not like, don't quote me on this again. This is not backed by any type of research. I'm just going to disclaim the hell out of this, right? Smoking a cigarette is what the psychologists call like oral fixation, right? So to some extent we want something between our mouths, like our lips to smoke. And that in itself is a type of stimming, I believe, you know, and it's paired, like, it's strongly paired. Especially if you're living in a country like Hong Kong. Because whenever you smoke, because you can't smoke indoors, right? So what you do is you go down and it becomes a social thing to actually smoke together and it becomes harder to break, right? So what, what, what do we do when this happens? Because your child has had a long history of doing it. Just as someone who is like, has been smoking for 20 years, they're harder to like get rid of it as opposed to someone who smoked for one month. So sorry, my cats are going crazy. So you have to find something else that can replace it, all right? And that's why, and that's why people who smoke usually have like biscuits. Have you guys watched like Constantine, the movie, you know, with like Keanu Reeves? He's trying to get rid of smoking. That's why he's just eating like biscuits, putting stuff in between his mouth to like just feel the sensation of that. So when I was in the ABA center, that's actually how it felt, right? It's like a anti addiction kind of center, to be honest. It feels like that. Okay, so getting rid of stimming the wrong way to do it is to like restrict the kid from doing it, all right? The more you don't let someone do something, the more likely they want to do it. It's just like that. I mean, like, look at Amsterdam. They banned marijuana. No, no, they allow. Sorry, they allowed marijuana. You don't see people smoking on the streets, right? But Then if you go to like the USA and some states that it's still not legal yet you see people just smoking in the park, right? Even in Hong Kong, if you know where to look, even if it's illegal, you see drug use everywhere, right? The more you like not let people do it, the more they want to do it. And another example is like, the more you don't let public drinking to happen, people just wrap their drinks around like a plastic paper bag and they start drinking, right? So for stimming, you should not restrict your kid from doing it. Instead what you should do is like, you should set a time so that they can do it for themselves. And this is for low and high functioning both. Okay? And Lynn is right, man. Like if, if someone sees autistic person do stimming, then they would instantly think, oh dude, this guy is like a, is like a low functioning for, for the general public. People think, what's a high functioning autistic person is more like an Einstein, right? Oh yeah, Einstein was like, like a speech delay as well. He was a late talker. He's also autistic, dude. Everyone's, everything's fine, dude. See? And like they're saying, oh, Jay Chow, you know, musician, the Taiwanese singer, he's also autistic. Look, look how successful he is or whatever, right? And Lynn says, what about stimming, that's getting more intense? Well, you have to understand what's the reason behind the stimming? What's behind the stimming, right? Is there, is there a trigger? So sometimes stimming has become a coping mechanism, a way to calm down, a way to make their senses come back together. And you see it when we get distressed, we get distressed. We drink. We drink a lot. Well, I don't really drink a lot, but I'm just saying that human beings in general, the stimming behavior becomes more intense because of something, right? So you need to know the reason behind why it has, why it's actually like getting intense. Is it because that they're getting more threatened? Is it because that in their mind they're thinking about something or is it because like there's an external stimulus that has made it make the sensory more like heightened? Yeah. So for me, my stimming is like to peel off the skin of my fingertips, the dead skin. So when I'm in a stressful situation, it becomes more intense, right? If you look at some videos, I do it and if you see me at an assessment when I'm talking to, like when I'm thinking Really hard about something. I also do it right for my girlfriend. She twirls her hair and bites her fingernails. So everyone has it. It will get more intense as stress increases, as external stuff increases. So how do you get rid of it? Right? So first of all, you really cannot really. Like, you need to think about another way to calm them down. So that's why, Lynn, that's why I taught the countdown, right? And to a lot of my clients. I also, I also teach the countdown for getting down to like, a more calm state. And the reason why it works, basically, which I don't know. There's no, like inside the book that doesn't say, oh, teach countdown or calm your child down. No, I've learned it from, like, I learned it from watching other therapists and trying it. Right. And watching other children. And I realized that why it works is because when you do a routine, it calms the body down. It's just as simple as that. If you do a routine that you know, it will calm them down. So for Lynn, if your child is stimming, it's getting more intense. Ask them to like count and calm down. All right, Try that. But on the side, you have to make child hyper aware of their stimming, okay. And why it's not appropriate at that time, which is the hardest thing to teach in the world. Because they think it's their right to do it. Like, you just. If you stop them from stimming, they'll probably hit you, you know, no matter high or low functioning. All right? Just the end of it. Like, if you don't let them, it's like the end of the world, right? So no matter high or low functioning, stimming is still like the most apparent thing that happens with both things, right? Then Lynn says then the counting will become new stimming. Yes, you're totally correct. But the thing is counting, you can do it mentally as well afterwards. So we're always looking for a replacement. And we want to replace the new stimming into something else, right? If they can self talk themselves and self count themselves inside their minds, then the stimming will happen. But it doesn't have any adverse effect on the situation, right? So that's why it's taught like that. All right? We always have to think about how we can like fade it away. And what's the, what's the biggest problem about stimming anyways? Is that it's socially inacceptible, right? So when we do that, when we can fade it into a child's Mind then this new stimming is rather socially acceptable and they can use it to calm themselves down. Okay. And do you ever get rid of stimming? No. You just never. You can never get rid of stimming. Same as us. We can never get rid of stimming. It'll just come back in a different form. All right? Everyone needs to. Everyone needs an outlet. Okay? So that's what I'm talking about. And Lynn says. Yeah. Cannot stop or else becomes instantly aggressive. Yeah, because it's just, I mean like they've been doing it for such a long time and they wouldn't want you to like stop them. It's become a habit. So you can only change a habit or like. Yeah, you can only change it into something else. You cannot do nothing, you know, I'm saying like, it must be something else. All right? And we just. Hopefully the thing that we teach becomes more acceptable to our society. If this world had no rules, then no matter if your child was high or low functioning, it wouldn't be a problem. No one would care. All right? To some extent it's just us as like therapists, teachers, parents, caregivers. We care more because we love the kid. And when people look at them and treat them in a bad way because of the stimming, it hurts us more than them. You know, the autistic child doesn't care much. In fact, they're pretty okay with them. Like just whatever. They might know sooner or later that people are laughing at them or whatever. But at the end of the day, they care less about us. Right? And the only. Only way to make them care more about it is to like systematically teach them and tell them about the rationale behind why it's not good. Okay. And this is going to take a long time. Right? And Santi says, as my son is not really verbal. Some basic words only. Almost no stimming. What do you think with fc? Facilitating communication. Asking him to type with iPad what he wants. Right. So Santi. Yeah. If your child has no stimming, not really verbal. So there are some basic words, man. So what I would tell you to do, Ask him to type iPad what he wants. So that does. The problem is how much. How many activities or how many things that you can make him want. Santi, Right? At his age, I remember you told me that he's rather. Rather he's like 20 or something, right? Or 19. Do correct me if I'm wrong. Facilitating comic. Well, I can't even read it. Facilitate. Facilitating communication should be done on all levels. Like no matter how old your child is, 21 years old, Sandhi says. Yeah, thanks. So yeah, you need to know how many activities that he's willing to do with you. Right? You need to know what kind of things will make him talk. So first of all you have to make a list of those stuff, right? So for some children it might be like playing an iPad game, but you're already using iPad for communication, so I don't know. So what you're telling me here is that he can type, right? Write down your activities that you can do to make him talk. Might be food, might be games, might be like at the swings or whatever. So these are the things you have to do. Of course you have to facilitate communication. But from now on, at 21 years of age, Santi, you have to give more as a parent to show him what kind of language he needs to use every day. Okay. And this is just simple language facilitation. You have to talk, you have to describe everything that he sees, touches and does, but only at one word at a time. Because he's only like some basic words only. Right? So you have to expand his vocab in a non intrusive manner, know Santi. So find the activity you can do with him, which is fun, he enjoys it and then you just talk. Okay? Facilitate his language by talking like naturally, normally, but in short sentences. I hope this helps for the typing. I think no matter how you spin it, it's still unnatural because you're, you're still using an iPad for it, you know. So it's better if you expand as is vocab by you giving him the correct language forms. All right. So Lynn asked the matter is the stimming blocks her from functioning and learning. So kind of escaping behavior as well. What should I do? Yeah. So it seems like Lynn that the stimming has become a multi function thing, you know, like esteem has. Seems that it has become like that. Right. So the first thing you have to do is before you, whenever she stims. Oh, wait a minute. So first of all you have to make sure she knows when the learning time is right. And I think we've talked about this before and make sure that it's short enough so that she can do it without like stimming involved. Right? And what you can do is that you know, for the first five minutes, for the first 10 minutes, which we will implement later. Right? For first five or 10 minutes, if she can just focus and no stim, she gets more rewards, right? She gets more sausages. That's what she likes. And then later you can give her chances, right? If you do, which is aside of the task of the learning. Okay. Or her functioning. All right, let's say she goes to McDonald's later. I want to do this right. Later. Oh, what, you can't even start? Yeah, you have to block out the time to make her do the work. Right. I think you're doing this already. But, you know, tell me more. I don't understand, like, the stimming. What I wanted to do was like to give her chances about stimming and then slowly get. Get her to like. Slowly to get her to like. How to say this? Like, for instance, if she have three chances to stim, if she only uses one chance, let's say that she stimmed within a five minute time frame, then I would give her, you know, three, two sausages. Because she has two. Two chances left, right? So slowly I want her to want the three sausages, therefore, not stim. And this is a task and a goal of its own. This super ABA, this hardcore old school ABA. So chances. Oh, yeah, McDonald's. So what I wanted to do was like, once she could do it within a structured environment, I want her to try and go out and buy something on a functional level and then give her chances for stimming, right? And then she can like, buy whatever she wants according to the number of chances that she. She did it. Right? So for instance, I would give her again, like three chances or five actually. And then the moment she stims, I take one chance away and just doing functional tasks without stimming. Someone who will shadow her and hold up like a board or something just to show her it might not even need to be a board because she's so smart, I can just tell her how many chances are left, right? So someone needs to shadow her and do that kind of functional stuff. But it starts off at home with that thing. Okay. Because as you know, your child here needs to do it in a structured thing and then actually to try to generalize it in situations where it's more natural outside of home. Okay. All right, so let me go back to Santi. Santi says he enjoys baking and cooking. Great. So you can actually just spend around like half an hour an hour just teaching him how to bake and teach him the words associated with it. Just the verbs first. Okay, Santi, just very short. And don't think that. Don't think that he will reply. You just keep on talking. So let me give you an example. For instance, if you're doing baking. First of all, you need to get the dough right. Not the dough like the flour. So you take it and you say pour. Maybe that's in Indonesian, I don't know what it is. Right. You say pour and then pour. And you keep just talking, talking, talking according to what he's doing right now. And slowly he might pick it up. Okay, but right now that's how you do, like facilitation, right? You tell him what's happening right here, right now without him having to copy in the beginning. Slowly you will up your game. But start at that point and after that you might pour water, right? You also pour water. Pour, pour, and then mix, mix, mix, mix. So you have to be comfortable with. Keep on talking. All right, Sandy? And you don't need to ask questions. If he likes it, he'll know the sequence, I'm sure of it. So I'm going to go over. Nabil asks. My daughter likes spinning and watching spinning. Washing machine. Oh, it's not a question. Yeah. That's actually a very common kind of stimming across all functioning levels of, of autistic children. Right. And I had one client who loves that. And if you're watching this, you know who you are, right? He would go up to fans and he would say, fan, I want fan on. You would call if someone from out of nowhere, okay. Like if someone sees him, he's like, oh, high functioning autism. Totally don't think so. But anyways, he would go up to stuff and say like, oh, I want fans. Spin faster. Something like that. And now he's much better. Is because we stopped it early. This kid came to me when he was two and three months. We were able to stop it early, which was the earliest I was able to see a client of this caliber, you know, like, of this like functional level. And at the same time, at the beginning, I thought he was going to be low functioning because he was like crying, banging, whatever. Thank God he came early and somehow he was very receptive to our therapy. So how do you stop that kind of stimming? Right? You show him or her something that's more fun to watch and play. And when he spins, you stop him and you stop her being able to look at the washing machine. Remember, the more likely your child can do a behavior or stim, the more likely it will continue. Right. As we were talking about, stimming is a habit. The more you let them do it, the more it will happen. Okay. So to be honest, all children like to look at stuff spent when I Was a kid, I, I would look at the washing machine for a very long time. You know, does that make me autistic? Hopefully not. You know, hopefully, you know, hopefully not. So to some extent, don't let them obsess over it. All right, cool stuff. Okay, so there's a lot of fur around. Alrighty. So at this point in time, if you have more questions, please do let me know. All right, Put them in the comments. I'm watching. I'm looking at it. Thank you for all the comments and questions. So to summarize this live video a little bit, I want to also wanted to say that, you know, high or low functioning, to be honest, in my books, don't matter. Okay. Really don't matter to me. It's just the way that, you know, therapists will see your child's profile and make a decision and be, be prepared about what to have, what's happening next. I've tried seeing like a government document like, you know, those, those government assessments. It comes in to say like very low functioning. And I actually had a very good time. It was like, no tantrumships, no whatever, right? And it was easy to deal with. All right. I've also had like high functioning, high functioning autism coming to me and, and I had a very hard time, right? And this was in Indonesia. It was saying like high functioning autism diagnosed in USA came to me. Whoa, my God. It was very difficult to get them to sit down and do any work or do an assessment and to hold the ice cream in one hand and just to get them to finish stuff. So don't let those labels confuse you. Don't let it dictate how you feel about your child. Don't let people think about like that. Okay? So Veronica Lee says grandson, age 2, doesn't talk what to do with him. Hey, that's very broad, Veronica. That's super broad. But, you know, fair enough. So at this point in time, if your child, if your grandson is like at 2 years old, what to do with it is not to try to sit him down because he's only two years old, right? So what you can do. Let me just search for that video for you. You can do is actually just language facilitation, right? You, you got to be able to talk to him in a, in a way that will help him acquire language. Okay. And this helps for all children. It's just nice to have this habit. No matter if your child is autistic or not or high or low functioning, it doesn't matter. It helps if, you know, how to talk to children in a way that will help them with their. What's that called? With their language development. Okay, just let me find that video and basically you can just. To be honest, Veronica, you can just watch this playlist on YouTube. Right? Just watch this on YouTube. All right. It's a playlist of basically what I'm talking about. Cool. So how do you. So how do you even, like, do language facilitation? And this is for just now when Santi asked. You don't ask a lot of questions. You just. No problem. Veronica. Yeah. Watch it when. Send it to your daughter or your son. I don't know who is the father or mother of that grandson. Okay. But, you know, you get what I mean. Just go watch it if you want to. It will help you out a lot in the beginning just to know what to do. Okay. So for everyone else here, if you're watching this, thank you so much, by the way. It means a lot. Oh, your daughter, Veronica. Yeah. Show it to your daughter. All right. So good stuff. So don't think that, you know, by keeping. Keep on asking questions, keep on asking, you know, quizzing your kid will make them a better speaker. It doesn't. How it works is you need to tell them. You need to teach them by showing and telling and speaking in chunks that are comfortable to them. And this is for all children, all people, when they're learning something, put it in bite size, remember? And I realized that a lot of people, my audience are females and mothers. So I'll talk about my mother. Okay. When I'm teaching my mother how to use a gadget, I always get very, like, how to say, I always get very hasty. I think that she's very low functioning when it comes to gadgets, you know? But the thing is, I didn't teach her correctly. When I caught myself, I realized that I was being very pushy about, like, teaching her how to use her iPhone. And she's the person who would bring her iPhone to, like, the Apple Store and ask a genius how to use, how to turn off the flashlight. You know, that it's that bad. So I realized instead of, like, asking her questions and doing it really fast in front of her, which doesn't help her, I should facilitate her by showing her slowly and talking in the terms that she knows. Right. And this goes for teaching anyone anything. Okay? Anyone anything. No matter. Especially for low functioning children. All right? You have to make sure they don't become intimidated. Make sure that they know what to do, exactly what's happening, or else they're just going to scream, shout and run away. And this is the parallel to that is my mom just scolding me. Right. So you really have to be careful when you talk to someone when they don't have the knowledge to it. Yeah. So before how I would usually do it, it's like I would do it and do it for her, say it really fast, click a few times, and that's it. But I realized what I needed to do was like I needed to like slowly go through it once, you know, point to where it is and tell her what it is. And then after that, tell her to do it herself one more time and maybe ask her again to do it one more time, do it two times, Maybe she'll remember. Right. So I don't know, have this kind of mindset towards teaching your child. All right. Just teach them as if like they're an elderly who doesn't know how to use the phone. Okay. You have to be very, very patient and don't take anything for granted. Okay. So with that said, I think I'm coming down to the last few minutes of our live here. If you want to, you can just keep on asking questions. Anything is actually very welcome. Okay. And just before we get off this live, I wanted to say a few more things about like high and low functioning. All right, so I've seen high functioning children labeled high functioning children stay at that level for a long time. You know, like you would suspect that like high functioning children to like surpass and go to whatever. Okay, I've seen that happen. And I've also seen low functioning children from like 2 years old, they were like screaming, shouting, like that client of mine, right, who came to me at two and three months. In the beginning I was like, oh God, this is one of those like non verbal ones. In the end, totally fine, you know, caught up in terms of language when by the time he left me and he went to Singapore, which is like three and three months, I think pretty okay, right. I've seen it happen. So don't think that all this stuff is like set in stone is carved into their DNA or something. It's not like that. It really isn't. So I've seen before. Oh, Veronica asked, what's ABA therapy? That's Applied Behavioral Analysis. It's a long name. Basically it's a therapy that is popular and effective empirically using data for autistic children. It's pretty popular and the reason why behind it is very structured, it's very easy to understand and it uses behavioral Theories and techniques. What that really means is, for instance, if you've heard of conditioning, the Pavlov, you know, the Dog Salvating Bell experiment, It uses those principles of behavioral learning inside aba. So in the beginning, they don't let you to go in. And basically why is because it looks like they're teaching an animal. Okay. And a lot of parents aren't okay with it. But I'm not against that at all because I started off as an ABA therapist. Okay. So these therapy. These. This kind of therapy runs on for like two or three hours a day, and you need to go every day. Okay. Whereas, like, speech therapy is like once per week or twice a week, a little shorter. All right, so parting. I'm going back to my parting speech about, like, low and high functioning. Yeah. Don't be discouraged. There's always, you know, it's what people think about your child. Right. It's a. It's a label that you put on it. And Autism Spectrum disorder, they call it a spectrum for a reason, because everyone's different, number one. And number two is like, it's easier to be on the spectrum and get more insurance. That's what I believe is happening, you know, like, again, don't quote me, I'll be in big trouble. But I'm not no authority either. I'm just a guy at home with a microphone and a camera. Right. So. So Veronica asks, which do you recommend? Abr. Speech therapy. To be honest, you should totally get an assessment first, you know, for a grandchild, and then see what the psychologist or pediatrician recommends. All right. ABA therapy is more hardcore. I would say that you should try all the stuff you can do at home first before you actually try aba, I think. All right. And look for speech therapy first because they actually teach the parents what to do. Do they get upset in ABA therapy? Yeah. Yes, sometimes. Sometimes likely so. But that's why I said it's more hardcore, Right. You got to find good ones. Okay? Find good ones. I can only vouch for one. And I don't know if where you are in the world, Veronica, but I used to work in Autism Partnership. I think their service is good. After I've worked there and I've seen more therapy around the world. And aba, I think there is a clear distinction in quality. Okay. Rose says, my child is 9 years old. If she melts down, she will start singing loud until she feels okay. I know it's the way to calm her down, but is it okay to let her. Is it. I know. Is it okay to let her do that for a long time. Is there any tricks to make her calm down in another way? Yeah. Rose, you're not alone. You're not the only mother with a child that does that. I have another mother who's going through the same thing. Okay, so first of all is to try to prevent the meltdowns. Right? Especially outside. I think it's fine if she's, like, at home. So always, always remember, prevention is always the number one thing. Always try to prevent. If you make it less likely that your child does it, then the less she does it, the less likely she will keep on doing. You know what I'm saying? You don't give her the opportunity to engage in that behavior. It will decrease by itself. Okay. That's a passive way to do it. Just try not to make her melt down. Right. So what happens when she melts down? Well, there are two things that you can do. First of all, as we talked about before, in this live, you can find a replacement behavior. A replacement behavior instead of singing. Right. And you need to find it yourself. It might be counting down. It might be whatever. But when she goes very loud, she's not listening. Right. So what your question is, is it okay to let her do it for a long time? I think it's fine if it's at home. And the trick to calm her down is I don't know enough about your kid, but usually what works. What works is to put her in a corner and then, you know, entice her with something that she likes. Usually it might be like a. It might be like an iPad or something. And then the moment that she comes out a little bit, just give it to her, you know? And there are multiple ways to, like, teach this. Okay. And the best way, I think, is to prevent it. Number one, Number two, is to teach the replacement behavior. Number number three is to controlled Lee in a controlled manner to trigger her so that you can teach her how to calm down and motivate her to calm down by herself so that she gets a certain reward, such as edibles like snacks or video time. So it's a whole new. Whole other topic grows. I will need more information about it. And to be honest, you got to do it systematically. Okay. It's going to take quite a long time to get rid of this, just to let you know. Okay. So Nabil says, what is group intervention session? Group intervention is basically just a more natural setting for intervention and what intervention means. It's just therapy. Okay? There's a group. The therapy is more natural because there's there's other people, there's peers around the child around the same age. Right. So when you have more children of the same age group together doing the same things or doing things together, it's easier to generalize towards school because the setting is similar. Okay. So I would always say that, oh, make sure that your child is okay one on one, and then by the time, like, oh, you need to go to school, try some group therapy. Try to see if they can generalize what they learned in one on one to the group setting. And then hopefully when they go to school, if you have a shadow teacher, that would be best. They will help you do continue it at school. Okay. So group therapy is cool, but you have to have children of the same age around the same ability. Alrighty. So Veronica says, do children that can't talk flap their hands to express language? And Lin, thanks for answering. Babies around 1, 2, 3 will stop flap. That's right. That's right, guys. Yeah, they should really stop flapping their hands. The baby, this one. Right by three. If not, you know, it's stimming. Okay. It's a very baby thing to do. All right. Veronica asks, do you work with families virtually? Yes, I do, actually. I do to some extent. I do some coaching over the Internet. So if you want to for an account, you can talk to me. You can private message me later. Thanks for asking, though. So, yeah, that concludes our live video. I hope you know I really liked all the. All the questions today. It was very, very good. It makes me, you know, think on my feet as well. That's very nice. And if you have any more questions, just leave them as a comment in the video if you're watching this on a replay. Okay. Oh, man, I'm so sorry. I'll message you, Veronica. Don't worry about it. It's okay. I'll message you after. I know. It's like Facebook is getting more and more complicated. You know, like, before it would be, like, pretty easy to navigate, but nowadays it's like that. Just before we leave, Nabil asked. Yeah, earlier she was doing individual sessions. Now they're about to start group sessions. Yeah, that's good. So that's always a good thing when you're transitioning from an individual to group sessions. It means that the therapist is thinking about generalizing and putting it into a more natural, naturalistic setting. All right, so with that said, thank you so much for hanging out with me. I do this every Monday, Wednesday, Friday. If you are in the U.S. that would be 10pm EST, the night before, which is like, I'm. It's Wednesday for me right now. I'm pretty sure in the US it's Tuesday. I believe I'm very bad with conver. Like, converting. Yes, I do. Veronica. I do go live on Instagram. This is my Instagram. Guys go follow me if you're not, which most of you are already. Yeah. So usually I'm live on YouTube and Facebook just because it's easier. Yeah, sometimes Lynn says sometimes on ig, it's just because I don't have enough phones, you know, like, around the place. If I had more phones, I'd totally do, like, three platforms. Right. So that's it for now. Yeah. Thank you. No, no, no, no. It's. You're very welcome. I always like to share. So I'm. I'm live every Monday, Wednesday, Friday, if you're in the U.S. or Canada or whatever, minus one day. And I'd be 10pm EST. Okay. And at the same time, if you have any questions, put it down below. Please share it so that everyone else. Parents like yourself, who want stuff to have, like, want stuff to be answered, get to watch these stuff as well. Okay. And then I might not be continuing with the live schedule like this. So it's better if you guys, like, come more often for this month because in July, I might be starting the therapy clinic at a small scale. Okay. Which means I will have less time. But anyways, thank you so much. Yeah, I'm trying my best, guys. Thank you for being so kind to me. Okay, so with that said, I'm going to leave it here. And if you guys need more help, you can always just DM me or just send me an email if you're on my email list. Okay, so that's it for today. I'll see you guys on Friday or Thursday, depending where you're living. But.