THE EFFECTS OF MULTIDISPENSARY PROGRAM ON CHILDREN WITH AUTISM

The aim of the present work is to evaluate the role of multidispensary program in improvement of children with autism. The sample of the study was 15 autistic children. The children were subjected (before and after the program) to evaluation of motor skills, languages behaviour, social skills, and life skills. There was a significant important change in motor skills, language skills, and social skills after the program. The nature of autistic spectrum disorder has significant implications for approaches to education and intervention.


INTRODUCTION
imaginative play and a pattern of repetitive serotypical behaviour, and interest. (1)e onset of the autism starts in the first years of life, disrupt diverse developmental processes, and is often associated with mental retardation.This condition differs from primary mental retardation and flow in the language and other development disorders in that the behavioral features and patterns of development are observed in multiple areas, highly distinctive, and not simply manifestations of developmental delay. (2)tism like most other behaviour system, seems to be etiologically heterogeneous disorder. (3)Although a link between autism Bull High Inst Public Health Vol.37 No. 4 [2007]   and environmental exposure is plausible, little evidence exists to support associations with specific environmental exposures.In rare situation autism is strongly associated with agents that cause birth defects. (3)eschool Physicians and family care providers have primary role in assisting families to identify the needs of their children in order to obtain appropriate supports. (5)aching children with autism can be the most challenging to preschool teachers because of the complexity of their brain disorder.The child life is affected, in the areas of communication and language, social, and play skills activities of daily living, self regulation behaviors, and no sensory improvement. (7)eschool teachers and programs should provides two dimensions of quality for best practice approach.Process quality is the materials learning opportunities, safety routines, interactions, and activities.
Structural quality is the size of the group education and training of the staff. (8)

THE AIM OF THE PRESENT WORK
Is to evaluate the efficacy of multidispensary program in improvement of autistic children.

MATERIAL AND METHODS
The study was conducted between diagnosis was confirmed using specific test. (9)All the sample was subjected to the following: 1. Motor evaluation test with the following subdivision, (10) Gross motor evaluation.
Fine motor evaluation.
Body image.
2. Language evaluation test. (11) Observation checklist to assess the social skills (7) and self care skills.
4. Behaviour test. (12)jectives of the program 1. Improvement of life skills in autistic children.
2. Improvement of motor skills in autistic children.
3. Development of social skills and language skills.

II-Development of social skills which include:
1-learn how to wear and remove clothes.
2-Learn how to care of himself/herself.

III-Development of motor skills
1-Development of gross motor skills.

RESULTS
Table (1) shows the main demographic features of the sample as regional age, sex, socioeconomic status, family history of autism, and consanguinity.

DISCUSSION
Autism is a communication disorder characterized by a child's inability to relate to the world physically and emotionally. (2)ese children are usually hypersensitive to environmental stimuli and seem to be withdrown into the inside world.Only they have Autistic children need special and individualized care from their parents and caregivers. (2,3)udies from the 1980s and early 1990s reported a prevalence of 4 to 10 per 10,000 children approximately.Recent studies have reported much higher prevalences of 30 to 50 per 10,000 children. (5)A large body of research has demonstrated substantial progress in response to specific intervention techniques in relatively short periods of time (several months) in many specific areas, including social skills, language acquisition, numercal communications, and reductions in challenging behaviors. (13)he consensus across program is generally strong concerning the need for: The goal of autism speech language therapy should be to improve useful communication is a realistic goal.For others, the goal may be gestured communication skills.Other children may have the goal of communicating by many of a symbol system such as picture boards.(17) A large percentage of people with autism doesn't use language functionally that is, to communicate basic needs and wants even those who speak will likely have difficulties with the pragmatic or social use of language, which includes understating social uses, and understanding ageappropriate humor.Whither a child is more verbal or has a large vocabulary speech and language therapy can be a valuable piece of therapy.(18)

CONCLUSIONS
The nature of autistic spectrum disorders has significant implications for approaches to education and intervention.
Children on the autism spectrum develop most successfully and rapidly when their special social, educational, and biomedical needs are met within on individualized program.

RECOMMENDATIONS
Autism and the pervasive developmental disorders are neuropsychiatric disorders characterized by patterns of delay and deviance in the development of social communicative and cognitive skills.Autism is characterized by impairment in reciprocal social interaction, impairment in verbal and non-verbal communication, lack of education lays the foundation for individuals to develop fully.It contributes to their communities in ways that foster economic growth, social stability, and prosperity.Child development experts and brain researchers continually studied a durance of an understanding of the magnitude and critical nature of learning during preschool period. (4)Current research supports the need for early identification of children with autism spectrum disorders and the provision of appropriate education at program.
November 2006 and June 2007 on 15 children (6♀ and 11♂) referred to educational center in the Kindergarten Collage diagnosed as autism.The Bull High Inst Public Health Vol.37 No.4 [2007]

I-Development of social skills which include 1 - 3 -
Several materials were used according to the type of training such as balls, tools casate, toys with some clothes, shoes,…, ect.The main components of the program Readiness for learning which include.a-Visual communications.b-Increase attention span.c-Follow simple orders.2-Learn simple social skills a-Knock the door.b-Say good bye.Play in groups.a-Play with one or two adults.b-Play in regular way.c-Wait the turn.

2 -
Development of fine motor skills.May 2007 then the children resubjected to the preview evolution tests (post test).The results were tabulated and statistical analyses were carried out using relevant statistical tests to compare the pre and post results.(13) early entry into an intervention programs; active engagement in intensive instructional equivalent of a full school day including services that may be offered in different sites, for a minimum of 5 days a week with full year programming, use of planned teaching opportunities, organized around relatively brief periods of time for the young children. (14)Difficulties with social relationships and interactions have been one of the hallmarks of autism and efforts to understand the nature of difficulties in autism, and to find effective treatment, have driven research and clinical and educational practice for the post 40 years. (15)By definitions, children with autism demonstrate impairments in relationship to peers, the use of non-verbal communicative behaviors within their social exchanges, the use of initiation, and symbolic or drastic play. (15)Our study revealed significant Improvement in social and life skill in autistic children after the program.Although the basic motor skills of children with autism are often reported to be an area of relation strength, numerous studies also provide evidence that motor problems may sometimes be quite significant-specific defects which have been reported, such as hypotonia and in coordination. (16)Developmental modes of communication and speech in young children with autism are a primary focus of many interventions but the development of receptive language abilities has generally received for loss targeted attention. (17)Steven and Kairtym, 2006 investigate the clinical efficacy of a computertraining program for teaching-used comprehensive skills to young non-verbaland minimally verbal children with autism.(18)

Table ( 4): The results of languages evaluation before and after the program Skills Mean of pre-test Mean of post-test % Change Test
* Significant