Services in our center....
ITTA Center offer a range of courses and training about the Autism and ABA Therapy. If you are interested in our courses and trainings please check the calendar for the upcoming courses or contact our offices in Tirana and Durres.
Our aim, as experienced psychologists and business coaches, is to apply a scientific approach using proven psychological expertise to acquire outstanding talent and to enhance individual and team performance across industry sectors.
We work with individuals and teams to ensure that your organisation is healthy, diverse and motivated leading your business toward greater innovation, enhanced staff well-being and increased productivity and profitability
There are a variety of screeners that pediatricians or other practitioners might employ as a first step to learning if a child might have autism, before beginning a formal evaluation. Some are questionnaires that parents fill out and others are assessments done by clinicians. The Modified Checklist for Autism in Toddlers, or M-CHAT, is one questionnaire that is used to identify red flags. The M-CHAT asks questions about behaviors that might indicate autism, but Dr. Epstein warns that the test purposefully “casts a very broad net,” so it often flags children who may or may not be autistic. Similar scales include the Childhood Autism Rating Scale and the Ages and Stages Questionnaire, which is more of a basic developmental screener.
The Screening Tool for Autism in Toddlers and Young Children, or STAT, is another screener that probes for autism symptom behaviors in more detail than the other screeners mentioned, but is still intended to be used as a tool to catch children who are candidates for further evaluation. Screener results alone should never be considered a diagnosis.
If a screener indicates that a child may have autism spectrum disorder, the child should receive a comprehensive evaluation from someone trained in diagnosing autism.
This evaluation will often begin with a diagnostic instrument such as the Autism Diagnostic Observation Schedule, or the ADOS-2. The ADOS is a test with different modules to accommodate a range of children. There is a version for toddlers that is play-based. For kids older than thirty months, there are modules that include more conversation, according to the child’s language level.
This isn’t the kind of test where there are right answers. The purpose of the ADOS is to evaluate the social skills and repetitive behaviors the child displays during the test. This means the evaluator is paying attention to things like if the child asks for help when he needs it, gives other people a chance to speak, and follows along with changes of subject.
The Communication and Symbolic Behavior Scales (CSBS) is another good diagnostic instrument for toddlers and young children. This play-based instrument is also backed by research, but is used less than the ADOS, which covers a broader age range.
Speech Disorders, Language Disorders, and Feeding Disorders
A speech disorder refers to a problem with the actual production of sounds. A language disorder refers to a problem understanding or putting words together to communicate ideas.
Speech disorders include:
Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can't understand what's being said.
Fluency disorders: problems such as stuttering, in which the flow of speech is interrupted by abnormal stoppages, partial-word repetitions ("b-b-boy"), or prolonging sounds and syllables (sssssnake).
Resonance or voice disorders: problems with the pitch, volume, or quality of the voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort for a child when speaking.
Language disorders can be either receptive or expressive:
- Receptive disorders: difficulties understanding or processing language.
- Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.
- Cognitive-communication disorders: difficulty with communication skills that involve memory, attention, perception, organization, regulation, and problem solving.
- Dysphagia/oral feeding disorders are disorders in the way someone eats or drinks, including problems with chewing, swallowing, coughing, gagging, and refusing foods.
In speech-language therapy, an SLP (Speech-language pathologists) will work with a child one-on-one, in a small group, or directly in a classroom to overcome difficulties involved with a specific disorder.
Therapists use a variety of strategies, including:
- Language intervention activities:
- The SLP will interact with a child by playing and talking, using pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct vocabulary and grammar and use repetition exercises to build language skills.
- Articulation therapy:
Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables in words and sentences for a child, often during play activities. The level of play is age-appropriate and related to the child's specific needs. The SLP will physically show the child how to make certain sounds, such as the "r" sound, and may demonstrate how to move the tongue to produce specific sounds.
- Oral-motor/feeding and swallowing therapy:
The SLP may use a variety of oral exercises — including facial massage and various tongue, lip, and jaw exercises — to strengthen the muscles of the mouth for eating, drinking, and swallowing. The SLP may also introduce different food textures and temperatures to increase a child's oral awareness during eating and swallowing.
When Is Therapy Needed?
Kids might need speech-language therapy for a variety of reasons, including, but not limited to:
- hearing impairments
- cognitive (intellectual, thinking) or other developmental delays
- weak oral muscles
- chronic hoarseness
- birth defects such as cleft lip or cleft palate
- motor planning problems
- articulation problems
- fluency disorders
- respiratory problems (breathing disorders)
- feeding and swallowing disorders
- traumatic brain injury
Therapy should begin as soon as possible. Children enrolled in therapy early (before they're 5 years old) tend to have better outcomes than those who begin therapy later.
This does not mean that older kids can't make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be changed.
Helping Your Child
Speech-language experts agree that parental involvement is crucial to the success of a child's progress in speech or language therapy.
Parents are an extremely important part of their child's therapy program and help determine whether it is a success. Kids who complete the program quickest and with the longest-lasting results are those whose parents have been involved.
Ask our therapist for suggestions on how you can help your child. For instance, it's important to help your child do the at-home stimulation activities that the SLP suggests to ensure continued progress and carry-over of newly learned skills.
The process of overcoming a speech or language disorder can take some time and effort, so it's important that all family members be patient and understanding with the child.
What is DIR®?
DIR is the Developmental, Individual-differences, & Relationship-based model (pronounced saying each letter as an initialism: D.I.R.). It was developed by Dr. Stanley Greenspan to provide a foundational framework for understanding human development. It explains the critical role of social-emotional development starting at birth and continuing throughout the lifespan. It also provides a framework for understanding how each person individually perceives and interacts with the world differently. The model highlights the power of relationships and emotional connections to fuel development. Through a deep understanding of the "D" and the "I" we can use the "R" to promote healthy development and to help every child and person reach their fullest potential.
DIR® is rooted in the science of human development and can sound very technical at times. However, it is also very simple. It is a pathway to promote healthy development in a respectful manner that builds connections, understanding, love, communication, and engagement.
DIRFloortime® (Floortime) is the application of the DIR model into practice.
While the DIR model helps us understand and promote the positive development of all children, DIR and DIRFloortime are most commonly utilized with children with educational, social-emotional, mental health, and/or developmental challenges. DIRFloortime has become most widely known as an approach to support children with with Autism Spectrum Disorders (ASD). You can read more about DIR and ASD in many books including "Engaging Autism" and "The Child with Special Needs" by Drs Greenspan and Wieder.
The objectives of the DIR® Model are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing exclusively on skills and isolated behaviors.
The “D” describes development from the perspective of the individual, where they are and where they are headed. Understanding the unique developmental process means allowing space for each person to be respected and guided in his or her own personal developmental journey.
The "I" describes the unique ways each person takes in, regulates, responds to, and comprehends the world around them.
The “R” describes how relationships fuel our development. Humans are social beings and relationships are a key to our human development. DIR harnesses the key affective (emotional) aspect of these relationships to promote development.
Understanding DIR can help us promote healthy development in all children, but it is especially powerful in helping children on the autism spectrum or with other developmental or emotional challenges
ABA therapy is effective for a variety of conditions related to autism
The autism therapists at ITTA Center provide customized therapy for individuals with autism and related disorders in Tirana and Durres in Albania.
Getting the right diagnosis can assist in achieving the most progress.