The need in the community

In every society, some individuals are intellectually challenged for one reason or another. This could result from problems experienced during birth, a genetic disorder, a severe illness, or an accident affecting the brain.

In South Africa, it is estimated that four out of every thousand individuals live with some intellectual disability. Some may have just a mild impairment and can still receive mainstream education. Others can receive training to handle specific tasks within their capability.

However, it is crucial that each intellectually challenged child receives specialised teaching, therapy, and care to progress and develop to their fullest potential. With the correct treatment, it is often surprising to what extent a child can progress. But without the proper training and environment, the child usually becomes introverted and withdrawn and may even regress in their development.

It is also essential that the parents and extended family receive guidance, advice, and support in coping with and managing the situation. This can only be provided by those with in–depth training and experience in this field.

The Cheré Botha School was established specifically to assist children who are intellectually challenged, particularly those with Down’s Syndrome or Autism, and their families.

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Autism

What is Autism Spectrum Disorder?

AUTISM SPECTRUM DISORDER, ASD

A person with ASD can be compared with a South-African in a foreign country like Germany. This person might look like others, however he does not understand everything and cannot easily predict what will happen next.

Autism always influences the following:

  • How a person communicates and how he/she interacts with others;
  • How a person behaves and acts.

With regards to Autism, we can expect any of the following behaviour:

  • Problems and challenges with The person might struggle to express himself/herself or to understand communication from someone else. The reason for this is for instance because the person with ASD struggles to process language or to comprehend abstract concepts or because he/she understands language very literally.
  • Problems with other people may exist because people with ASD struggle to “read situations”, due to “context blindness” (can’t “see” what is going on) and “theory of mind blindness” (they struggle to understand what others think or feel). Because they struggle to understand situations, they also have difficulty in predicting what will happen next. They can then also be quite anxious as well, because they do not know what to expect.
  • Problems with anxiety due to factors like context blindness and theory of mind blindness. They therefore often like routines/rituals (to do something in a specific way) because they then know what is going to happen they feel more in control and thus they feel safe. People with ASD therefore be upset by change because they then don’t know what is going to happen. This uncertainty can trigger a tantrum.
  • Problems due to Sensory difficulties:
    • They can be overly sensitive and for example close their ears or refuse to eat crunchy or noisy food.
    • They can be very insensitive and for instance put their music on very loudly or they can have a high pain threshold.
    • They might be sensory seeking and for example make sounds.
    • They might feel a sensory overload and experience a meltdown. Meltdowns might look like a tantrum, but where tantrums are a form of manipulation aimed at getting something, a meltdowns occur without the person wanting to get something.
    • They can “get stuck” or fixate on certain sensory input. For example they will listen to the same music over and over again, or only want to play with a specific toy.

HOW DO WE HELP SOMEONE WITH SID OR ASD:

  • Visual aids. Language can be supported with visual aids and demonstrations.   Language can disappear but visual aids are always there and constantly delivers the same message. For example a child who is holding the “Sit” card while sitting on his/her chair, constantly gets the message that he/she must sit and the child who is often shown the Makaton sign by an adult repeatedly receives the message, even at a distance,  without the adult needing to shout to be heard.  
  • Repetition of verbal instructions can lead to an auditory overload and problems with processing language can negatively influence comprehension and the execution of instructions.
  • Use First this, then that cards because then the child, for example, knows that the task will not continue forever. Working for a reward may also help the child to be motivated.
  • Schedules help to create predictability and the learner can see how he is  progressing with the tasks as he removes the cards when he “schedules”.  When a card is removed from the schedule, it is put in the Finished box: it also implies that the schedule (and not the staff member) has indicated that the activity is no longer available, even if the child has enjoyed the activity and even if he did not want to put it away.
  • Predictability lowers anxiety. Because of challenges with context blindness and theory of mind blindness, ASD learners can experience anxiety. Help them to work out what will happen next by, for example, referring to their schedule or by, for example, reminding them that Mom has fetched them from school every day and that she will fetch them again this afternoon.  
  • Use visual prompts and flow charts to facilitate independence, for example a visuals / pictures about hand-washing next to the wash-basin.
  • Use a timer and assist the learners with reading and using it so that they can, for example see that their work time is almost over or that there is still a lot of time left to play with a toy. The end of an activity will then not be such a surprise or it will not feel as if work will be going on forever.
  • A structured environment helps to create predictability and a feeling of being safe. The child, for example, knows where to look if he wants to check how to write a word because the words are always put up in the same place in class or he would feel less intimidated by his class-mate because he knows that a certain part of the table is marked for his use and that the classmate is not allowed to put things on his side of the table.
  • Use low arousal. Talk with a relaxed and normal tone of voice, without begging or making the child feel that you are not in control. If you scream or use intimidating hand-gestures, you can expect the learners to be aroused and on edge and more difficult to work with.

SID and ASD can occur either in isolation or in combination with other learning and developmental challenges and can include the diagnoses indicated on the diagram below.

Education (including parenting), should promote independence and the learning of new skills.

All children should:

  • Learn to listen to their educators (parents and teachers) and accept their authority and rules. This also means that the child needs to accept that they can’t always do or have what they want. The, “First this, then that” rule would be a good place to start.
  • Learn to develop self-control.
  • Learn to wait for what they want and learn to understand that, “No” and “Not now” are acceptable answers.
  • Understand that their behaviour has consequences and then learn to think ahead about the consequences of their behaviour and to plan for what they want to have so that they can plan to achieve their goals, just like successful adults who work according to a plan.
  • Learn to work together as a member of a team.

A child’s successful functioning as an adult will be influenced to a large extent by the learning and development of the above skills. Play (NOT on a screen or device) can help to develop many of these skills. Playing with someone else can also be very good for development, especially if there is adult supervision to ensure that play is safe and fair.

Our Partners

Severe Intellectual Disability

SEVERE INTELLECTUAL DISABILITY (ID)

A person with an SID often behaves like a person who is much younger. A 16 year old SID child can, for example, behave like a 6 year old child, even though he has the body, physical strength and the desires of a 16 year old, he does not have the insight and understanding of a 16 year old.

A person can be described as being intellectually disabled if he experiences difficulties with regard to:

  • The learning of new material. Steps in a process must be broken down even further and more practice will be required to learn something. It will probably also be forgotten much sooner.
  • The application of information that has already been mastered. A person with SID will experience difficulties with applying familiar concepts in a new way. While a person with SID may, with practice, be able to bake a chocolate cake, it is unlikely that he will be able to bake a vanilla cake unless someone specifically teaches him to do so and he practices it, even though the basic principles of baking a cake remain the same. In contrast, a person who does not have an SID will possibly be able to work out for himself how to bake a vanilla cake even though he has not specifically been taught to do so.

Apart from the above information, other difficulties often occur together with SID. This can include the following, namely:

  • Poor concentration or a short attention span, with or without hyperactivity. Poor concentration or a short attention span without hyperactivity can imply that the person can be passive with the result that behaviour which would be obvious to others may not occur spontaneously with them. A person with poor concentration and who is more passive can, for example, make coffee and leave to coffee jar open or leave the fridge open after taking the milk out and may then also not return the milk to the fridge, almost as if they did not think about what the next logical step in the process would be. A person with poor concentration or a short attention span with hyperactivity can experience difficulties or can cause difficulties for others because they exhibit certain behaviours without thinking of the consequences. A person with poor concentration and who is very active can, for example, place a mug of coffee on the edge of the table and then bump it over when they turn around too quickly, almost as if they did not think of the consequences of their rushed behaviour and that they do not think that it would have been safer if they had put the coffee in the middle of the table instead of on the edge of the table.
  • Because of impaired insight and impulsivity, behavioural problems such as destructiveness, aggressive outbursts, unreasonableness, etc. can also occur. When such a person for example, becomes angry they may throw a phone and only later come to regret it while a person who has good insight will realise beforehand that the phone will break if it is thrown and will therefore not throw the phone even if they are very upset about what the person on the phone is saying.
  • Low muscle tone which means that the person will look wilted or limp. This can give rise to clumsiness, with the associated breaking of objects, falling and getting hurt, a tendency to slouch instead of sitting, etc. Low muscle tone can also lead to drooling, messy eating, etc. A person with low muscle tone will tend to avoid physical exercise, which implies that they will be more unfit, which implies that their muscle tone will probably deteriorate instead of improve.
  • Damage due to well-meant efforts to help which is aggravated by poor insight. For example, instead of not forcing a cupboard door closed they may force the door and break the hinge in the process whereas a person with better insight would probably have checked to see what is preventing the door from closing and remove it instead of merely pressing harder to close the door.

HOW DO WE HELP SOMEONE WITH SID OR ASD:

  • Visual aids. Language can be supported with visual aids and demonstrations.   Language can disappear but visual aids are always there and constantly delivers the same message. For example a child who is holding the “Sit” card while sitting on his/her chair, constantly gets the message that he/she must sit and the child who is often shown the Makaton sign by an adult repeatedly receives the message, even at a distance,  without the adult needing to shout to be heard.  
  • Repetition of verbal instructions can lead to an auditory overload and problems with processing language can negatively influence comprehension and the execution of instructions.
  • Use First this, then that cards because then the child, for example, knows that the task will not continue forever. Working for a reward may also help the child to be motivated.
  • Schedules help to create predictability and the learner can see how he is  progressing with the tasks as he removes the cards when he “schedules”.  When a card is removed from the schedule, it is put in the Finished box: it also implies that the schedule (and not the staff member) has indicated that the activity is no longer available, even if the child has enjoyed the activity and even if he did not want to put it away.
  • Predictability lowers anxiety. Because of challenges with context blindness and theory of mind blindness, ASD learners can experience anxiety. Help them to work out what will happen next by, for example, referring to their schedule or by, for example, reminding them that Mom has fetched them from school every day and that she will fetch them again this afternoon.  
  • Use visual prompts and flow charts to facilitate independence, for example a visuals / pictures about hand-washing next to the wash-basin.
  • Use a timer and assist the learners with reading and using it so that they can, for example see that their work time is almost over or that there is still a lot of time left to play with a toy. The end of an activity will then not be such a surprise or it will not feel as if work will be going on forever.
  • A structured environment helps to create predictability and a feeling of being safe. The child, for example, knows where to look if he wants to check how to write a word because the words are always put up in the same place in class or he would feel less intimidated by his class-mate because he knows that a certain part of the table is marked for his use and that the classmate is not allowed to put things on his side of the table.
  • Use low arousal. Talk with a relaxed and normal tone of voice, without begging or making the child feel that you are not in control. If you scream or use intimidating hand-gestures, you can expect the learners to be aroused and on edge and more difficult to work with.

SID and ASD can occur either in isolation or in combination with other learning and developmental challenges and can include the diagnoses indicated on the diagram below.

Education (including parenting), should promote independence and the learning of new skills.

All children should:

  • Learn to listen to their educators (parents and teachers) and accept their authority and rules. This also means that the child needs to accept that they can’t always do or have what they want. The, “First this, then that” rule would be a good place to start.
  • Learn to develop self-control.
  • Learn to wait for what they want and learn to understand that, “No” and “Not now” are acceptable answers.
  • Understand that their behaviour has consequences and then learn to think ahead about the consequences of their behaviour and to plan for what they want to have so that they can plan to achieve their goals, just like successful adults who work according to a plan.
  • Learn to work together as a member of a team.

A child’s successful functioning as an adult will be influenced to a large extent by the learning and development of the above skills. Play (NOT on a screen or device) can help to develop many of these skills. Playing with someone else can also be very good for development, especially if there is adult supervision to ensure that play is safe and fair.

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