The puzzle consists of many small pieces in different shapes and sizes, but six-year-old Joshua Law was not daunted at all. He calmly overturned the box of puzzle pieces and proceeded to put it together. When his father, Law Cheok Maan, joined him, Joshua assured him he didn’t need help.
Law was happy to allow Joshua to work out the puzzle at his own pace, as father and son chatted amiably.
It has taken a lot of hard work and perseverance for Joshua and Law to arrive at this stage.
Five years ago, a family friend who is a paediatric neurologist noticed that Joshua had speech delay, made poor eye contact and showed other signs of autism. She advised Law and his wife Dr Choy Sook Kuen to screen him.
“We took him for screening, and he was diagnosed with pervasive developmental delay, which is a symptom of Autism Spectrum Disorder,” recalls Law, 43.
That marks the beginning of their journey in helping Joshua overcome his challenges.
They began by learning about autism – they attended conferences on autism abroad, read up and researched the subject and consulted with doctors and therapists in and out of the country.
The father-of-two who trained as a lawyer had by then embarked on pursuing his belief in education – he had started a Montessori preschool, The Treetop House School in Ampang, Kuala Lumpur, with a pioneer batch of seven children which included his eldest son Aaron.
“Going into education was a way to connect with families, to build lives. It was something I was passionate about,” says Law. But Joshua’s diagnosis literally put Law and Dr Choy through a “baptism of fire”.
They were placed on a five-month waiting list to get Joshua screened in a hospital in Singapore. They also quickly realised services for autistic children were under-supplied and fragmented here. In May 2010, they attended the Defeat Autism Now conference in the United States, where they listened and spoke to experts, therapists and other parents of autistic children.
Combining his passion as an educationist with his wife’s medical knowledge, they began identifying strategies to help Joshua.
One of the first things they did was to practise biomedical intervention; blood tests had revealed high mercury toxicity, a long list of allergens and other biomedical imbalances.
“We found out that he was allergic to seafood, eggs and cranberries,” says Law. They put Joshua on a gluten-and-casein-free diet and recommended supplements.
The also found a therapy that suited them – Relationship Development Intervention (RDI), a programme based on a model of dynamic intelligence developed by Dr Steven Gutstein to help autistic children interact and build social relationships.
“I believe in RDI because I believe in parental involvement and embedded intervention,” says Law who started Joshua on RDI two years ago. Using RDI techniques, they helped Joshua with issues such as poor eye contact and resistance to change in routine.
‘When Joshua was young, he was fascinated with anything with numbers. So, he’d carry a clock around with him. When we were working on his eye contact, we had to reduce his dependence on these objects and get him to look at us when he talked to us. We did these exercises daily until he overcame his pain of making direct eye contact.
“He didn’t like changes, and so we’d create obstacle courses for him. It’s play-related and relationship-centred. We’d upload videos of these sessions and our RDI guide would help us out,” says Law, who worked with their US-based RDI guide via teleconferencing. RDI is now available in Malaysia.
The other effective intervention for Joshua was sensory integration therapy, which addresses the child’s difficulty in processing and integrating sensory information.
“What was powerful was we brought the sensory integration right into the classroom level. In Montessori, the materials are sensorial and the programme is inclusive and individualised. That integration was a moment of enlightenment for us,” says Law who built a sensory integration room in Tree Top House school which has enabled them to incorporate Joshua’s therapy into his daily school curriculum.
About 10% of Tree Top House school’s children have special needs.
Joshua also has weekly speech and occupational therapy.
“Within a year of us starting the intervention, we could see Joshua blossoming. He used to have delayed speech but now he has achieved 99th percentile in his verbal and communication skills,” says Law.
Joshua has come a long way since his diagnosis, and has overcome many of his challenges. In most respects, he is like his peers although his father says there are still issues they need to work on. He is also fortunate because his parents were able and willing to commit their resources, energy and time in seeking intervention for him.
The family’s experiences with Joshua have given Law insights on some best practices and approaches.
“It’s important to nurture the child’s intrinsic motivation. For a child like Joshua, it’s very difficult for him to write, to form the right sentences or to go into a chaotic room. He has to structure his planning to execute some function.
“We need to nurture his intrinsic motivation so he has the will power to overcome his obstacles. It’s hard for parents to stand out of the way so he tries on his own,” shares Law.
He says there are different therapies available for special needs children, but what’s crucial is the delivery system.
“It’s the guide that is important – the person who calms the child and makes the world fun and come alive. The guide is not necessarily the therapist, it can be a parent or someone else.
“We need to coax the kid out. In this world, a child with autism and other learning differences are considered outsiders and we have to think of ways to make the world a fun place so that they want to open the door and come in. That is my guiding principle.”
Law also believes in embedded intervention, rather than therapy-driven intervention.
“We have to intervene in our day-to-day living. Parents must observe and understand what is the appropriate challenge for the child at a particular milestone. When there is opportunity and motivation, parents can intervene.
“A therapy-led intervention is costly, and there isn’t enough time spent with the child. Sometimes, a child is not ready for therapy but has to go ahead because the session has been paid for. So, it’s hard to be child-led in a therapy setting.”
Law and Dr Choy are keen advocates because they have seen how effective intervention has benefited Joshua.
“We saw that it works when parents are involved and the whole ecosystem is integrated and focused – from the home to the school, to the community.
“My wife and I want to be advocates in the education sector. We realised that we have the resources but we need the infrastructure,” says Law.
Law and Dr Choy established Oasis Place, a one-stop centre for multi-disciplinary intervention services for special needs children. They offer various therapies and bring in experts who conduct short courses. Like Tree Top House School, Oasis Place is a top-tiered facility.
“We are committed to building the community. We want to start a parents’ support groups called Family Voices so families have an outlet. In Asia, it’s much harder to set up a parents’ group because we are not an open society. There is shame, and families would rather hide and stay silent. Denial is the worst. We want to encourage early intervention. Parent involvement is the most important and cost effective. So, we need to share our knowledge,” he says.
The couple have also started thinking about special needs children beyond the schooling age and how to include them in the community.
“We also started Edu Village for the post-school segment where young adults with learning differences can learn life skills. It’s a complex of shophouses in Segambut, Kuala Lumpur. We plan to start social enterprises that young adults can run, including teens who are not academically inclined,” says Law.
Law Cheok Maan can be contacted at email@example.com