Case Background
Age: 5 years, 10 months
Location: Canada
Birth History: Preterm baby born at 7 months
Birth weight: 600 grams
Concerns Reported by Parents
Bhavtej presented with a wide range of developmental concerns, including:
1. Hyperactivity – Difficulty regulating energy, frequent headbanging, and constant movement. He exhibited a tendency to carry toy cars everywhere and struggled with sustained focus.
2. Echolalia – Repetition of words without understanding their meaning.
3. Low Listening Skills – Limited auditory engagement.
4. Poor Eye Contact – A barrier to social communication and emotional bonding.
5. Low Sitting Tolerance – Inability to sit for even short durations.
6. Lack of Comprehension – Difficulty in understanding and following verbal instructions.
7. Limited Meaningful Speech – Use of jargon and repetitive babbling without meaningful verbal output.
8. Lack of Self-Dependence – Required constant support for basic tasks such as buttoning shirts or wearing shoes.
9. Deficient Emotional Expression – Inability to express appropriate emotions in different situations.
10. Underdeveloped Social Skills – Struggled with peer interaction, game rules, and frequent tantrums, making it hard for others to engage with him.
ARULA Treatment Plan
The ARULA approach was applied with an emphasis on auditory development, parental empowerment, and daily-life-based intervention. The treatment focused on three primary objectives:
- Minimizing visual seeking and promoting auditory seeking
- Enhancing the mother's confidence and ease in delivering the interventions
- Providing structured yet flexible techniques rooted in everyday experiences
Targeted Interventions and Outcomes
1. Hyperactivity
ARULA’s behavioral regulation strategies, such as task-based redirection, helped Bhavtej manage hyperactivity. Example: Tasks like peeling boiled potatoes were introduced to redirect energy and build focus.
2. Echolalia
The parallel talk technique was used, where the parent spoke on Bhavtej’s behalf, modelling meaningful language. This was paired with intonation techniques to enrich speech rhythm and emotion.
3. Listening Skills
Incidental storytelling was used as a tool to enhance listening. Parents narrated Bhavtej’s daily activities to him, encouraging comprehension and engagement.
4. Eye Contact
Two techniques were employed:
- Mirror Technique: Mother and child sat in front of a mirror, with the child following verbal cues.
- Role Play: Bhavtej enacted various characters to build attention span and practice social interaction.
5. Sitting Tolerance
Activities were introduced based on Bhavtej’s interests, allowing him to engage willingly and progressively improve sitting tolerance without pressure.
6. Understanding of Spoken Language
Listening-focused speech enhancement was key. Repetition, slow-paced speech, and clear instruction helped Bhavtej gradually grasp verbal cues and directions.
7. Meaningful Speech
Vocabulary expansion was facilitated through the Home Tour Activity, where Bhavtej led his mother around the house, identifying and naming objects. His mother was trained to model correct speech and provide positive reinforcement.
8. Self-Dependency
Basic self-care routines were established, including washing hands, dressing, and brushing. Problem-solving activities were integrated to encourage decision-making and independence in tasks like choosing snacks or solving peer conflicts.
9. Emotional Expression
ARULA guided the parent to model emotions through voice modulation and interjections like "Oh!" and "Wow!" to help Bhavtej express and understand emotions in context.
10. Social Skills
Social interaction was nurtured through:
- Collaborative role play
- Celebratory peer activities
- Outdoor exposure to different environments and people
These settings provided Bhavtej with the opportunity to practice and internalize social norms, rules, and behaviors.
Conclusion
Bhavtej’s journey reflects the transformational impact of the ARULA method when personalized intervention is consistently applied. Through daily-life integration, empowered parenting, and auditory-focused strategies, Bhavtej made significant progress across multiple developmental domains—laying a strong foundation for communication, independence, and emotional well-being.