CONTEXTBLINDNESS, TEORI MENJELASKAN PERILAKU AUTISME

Saya mendapatkan banyak sekali orang tua yang bingung saat mendapatkan

buah hatinya menerima diagnosa autisme. Serasa dunia runtuh dan panik ingin

mendapatkan terapi yang menyembuhkan, apapun itu, asalkan ananda bisa menjadi normal

kembali. Wow …wow…. mestinya kita justru memahami dahulu apa arti autisme itu, dan

memahami karakteristik anak agar kita mampu menghadapinya. Karena autisme adalah gangguan yang parah yang akan disandangnya seumur hidup. Ia tidak dapat disembuhkan namun dapat kita bantu agar kondisinya lebih baik dan agar ia mampu menyandang masalahnya itu.

Untuk itu, sudah banyak sekali teori yang dibangun orang untuk menjelaskan bagaimana sesungguhnya perilaku autisme itu.

Apa yang disebut teori untuk sebuah diagnosa adalah jika mampu:

1)      menjelaskan bahwa gejala yang ditampilkan hanya khas dari diagnosa itu;

2)      dapat digunakan untuk membedakan antara diagnosa yang satu dengan diagnosa yang lainnya. 

Ada tiga teori yang dikembangkan oleh ahli-ahli neuropsikologi namun ketiga teori ternyata gagal dibuktikan untuk menjelaskan bahwa gejala yang ditampilkan itu adalah gejala khas dari autisme.

Teori-teori itu adalah:

1)      Theory of mind test, yaitu kemampuan membaca pikiran orang lain untuk membuktikan bahwa ketidak mampuan itu karena kegagalan autisme dalam mengembangkan emosi sosialnya. Dasar pemikiran tes ini adalah bahwa karena penyandang autisme mempunyai keterbatasan pada perkembangan emosi sosialnya, ia juga akan mempunyai kelemahan pada membaca emosi orang lain. Emosi orang lain akan dibuktikan dengan pikiran orang lain sebagai reaksi dari sebuah aksi dari tindakan orang lain. Tes yang terkenal adalah tes Sally and Ane. Saat dilakukan tes, ternyata pada kelompok yang mempunyai inteligensi rendah baik autisme maupun non-autisme sama-sama tidak bisa membaca pikiran orang lain. Sebaliknya pada autisme yang mempunyai inteligensi tinggi, ia justru bisa meliwati dan berhasil lulus dalam tes. Hal ini  yang seharusnya menggunakan emosi sosial namun ia bisa lulus tes karena  menggunakan logika. Karena itu theory of mind test tidak bisa digunakan untuk mendeteksi autisme.

2)       Weak Central Coherence test, berasumsi bahwa karena kemampuan pandang ruang (visual spatial) yang terbatas maka para autisme mengalami kelemahan pada test test pemecahan masalah. Tetapi ternyata test ini tidak bisa membedakan anak-anak autisme yang berinteligensi rendah dengan non-autism berinteligensi rendah. Sehingga test ini tidak bisa digunakan untuk menjelaskan perilaku autism spectrum disorder.

3)      Executive function test. Test ini berasumsi bahwa anak-anak autism spectrum disorder mempunyai kelemahan pada sistem perencanaan gerak (perilaku) yang disebabkan karena pusat pengatur perilaku (pusat fungsi eksekutif) nya mengalami gangguan. Ternyata masalah fungsi eksekutif tidak hanya terjadi pada autisme saja, juga pada ADHD.

Sekalipun ketiga tes itu sudah gagal, namun masih bisa digunakan untuk menjelaskan mengapa seorang penyandang Asperger yang cerdas dengan inteligensi yang tinggi mengalami kesulitan dalam berbagai pelajaran yang membutuhkan kreativitas berpikir atau logika analisa dan pemecahan masalah. Hal ini disebab karena pada Asperger mengalami masalah pada central cohenrence yang berfungsi pada melihat konteks global, pemecahan masalah, dan logika analisa. Dan dapat dijelaskan bahwa kecerdasan Asperger lebih banyak didukung oleh tingginya kemampuan mengumpulkan informasi bukan pada logika analisa.

Dengan gagalnya ketiga tes itu ternyata sekarang dikembangkan sebuah tes yang mampu mengatasi kekurangan ketiga tes itu, yaitu CONTEXTBLINDNESS.

ContexTblindness dikembangkan oleh berbagai penelitian dalam bidang teori kognitif. Salah satu yang mengembangkan adalah tim yang diketuai Prof Uta Frith dari Inggris, seorang ahli autisme yang sangat terkenal.

Contextblindness lebih banyak digunakan oleh psikologi pendidikan dan orthopedagogi, dan kini tengah diusung keliling dunia untuk disosialisasikan oleh Peter Vermuelen seorang orthopedagog ahli autisme dari Belgia.

Ketiga teori untuk menjelaskan perilaku autisme di atas yang diharapkan mampu digunakan sebagai alat diagnosa autism, kini ketiga teori ini digabung menjadi satu, dinamakan Contextblindness.

Kini dapat dikatakan bahwa semua anggota Autism Spectrum Disorder adalah seorang individu yang mengalami masalah dalam konteks (contextblindness).

Context blindness can be defined as the lack of spontaneous use of context when giving meaning, especially to vague and ambiguous stimuli. (Vermeulen, 2009).

Gangguan konteks

-          Missing the point (kehilangan point dalam konteks global)

-          less contextual sensitivity (tidak sensitif terhadap situasi sesuai dengan konteksnya)

-          literal understanding  (pemahaman yang harafiah)

-          masalah dalam pemahaman komunikasi nonverbal dan bahasa kiasan

-          masalah dalam problem solving atau pemecahan masalah

-          masalah dalam komunikasi

-          kekakuan berpikir

Diharapkan dengan memahami contextblindness pada penyandang autisme maka penanganan autisme akan lebih ramah. Jika seseorang anak mempunyai gejala mirip autisme jika tidak mengalami masalah dalam konteks maka ia tidak lagi disebut sebagai autisme dan memerlukan strategi pendidikan serta penanganan yang berbeda.

Hingga saat ini di Indonesia,  pendiagnosisan autisme masih menggunakan DSM IV-TR (sekalipun bukan gold standard for diagnostics) – dan belum memperhatikan masalah contexblindness, dengan begitu bisa kita perkirakan bahwa persoalan kesalahan diagnosa pada anak-anak masih akan terus berjalan.

http://www.cmcgc.com/media/handouts/101103/230_Peter_Vermeulen.pdf
http://aquila.usm.edu/cgi/viewcontent.cgi?article=1026&context=honors_theses

http://eprints.gold.ac.uk/2560/1/hill_devrev04_GRO.pdf

LATE SPEECH AND GIFTED CHILDREN

Summary

Gifted Children often identified as being gifted when they begin to talk much earlier than

their peers. However, there is lesser known group of gifted children who display their

intelligence in every other way apart from speech. These children are gifted late talkers.

This factsheet covers the characteristics that these children share and offers support

and advice to parents of gifted late talkers.

Introduction

Around 15% of 2 year olds are developmentally delayed with their speech ability. Of that

15%, a small minority are Gifted Late Talkers. These children are displaying a Specific

Language Impairment and this is the term that health professionals and speech therapists

will use to describe this form of speech delay. These children have an excellent

understanding of speech, but have difficulty expressing themselves using language. Very

little is known about exactly why these bright children experience speech delay. Gifted

Late Talkers are essentially developing asynchronously. Their intellectual development is

much more advanced than their chronological age and speech ability.

Their speech can take years to develop; most do not speak intelligibly until they are 3.5 or much older (can

be up to the age of around 6-7).

Characteristics of Gifted Late Talkers

·         Boys are 3 times as likely as girls to have speech delay
Strong family history of late talking

·         Exceptional memory

·         Excellent understanding

·         Communicate well using other means

·         Mischievous

·         Long concentration span when engaged in activities that interest them

·         Personal quirks

·         Independent

·         Like music (although not always the usual nursery rhymes- they tend to prefer more

·         complex sounds)

·         Interested in mechanics/engineering and how everything works

·         Extremely curious

·         Affectionate

·         Very good at puzzles

·         Highly active, enjoys physical play and time outdoors

·         May have problems sleeping and ‘switching off’

·         Pick up on conversations and responds accordingly (non-verbally) from a very early age

·         Late to potty train

Only What Interests Them

Einstein, the most famous late talking genius:

‘Ignored whatever bored him, making no attempt to master it; but if something caught his interest, he embraced it with the purposeful concentration of a watchmaker.’

Similarly, gifted late talking children are often unwilling to participate in any obvious attempts to practice speech as it bores and frustrates them. These same children surprise their parents when they are absorbed in a task that interests them for much longer than their peers are able to concentrate. The key to engaging gifted late talkers into practicing speech is to get involved in what interests them. These children are often quirky and obsessed with particular things. Playing with your child whist they are absorbed in what fascinates them is an ideal time to incorporate conversation; to begin with, this will be one-sided!

Keen Observers

These children are excellent observers of day to day life. They are absorbing and evaluating their surroundings and those around them. One school of thought regarding the reason why gifted children talk late is the belief that these children are absorbing and processing far more than they are physically able to communicate via speech.

Gifted late talkers are highly intelligent and very capable; consequently, they are able to amuse themselves quite well without the need to participate in ‘baby play’ or ‘baby talk’. What interests them is not necessarily what most toddlers find fascinating. Many late talking gifted children tend to enjoy ‘grown up toys’ such as household appliances, computers or mobile phones!

Speech Therapy and Gifted Children

It is very common for gifted late talkers to be non-compliant during speech therapy sessions as they are very aware of why they have been brought there and the characteristic gifted personality trait of stubbornness becomes more apparent than ever. During a speech therapy session, it is not uncommon for the gifted child to categorically refuse to participate in any attempts made by the therapist to engage the child and even initially bond with them! It is a good idea to speak to the speech therapist prior to a therapy session and tell them about your gifted child; in particular what they are interested in and what makes them happy. Rather than the brightly coloured toys strategically placed on the floor, the gifted late talker may instead be fascinated by the stapler or phone on the therapist’s desk! In which case, it may work best for the therapist to initially bond with your child by sharing his/her interest and build up trust. Once this rapport has been established, it is far easier to follow speech therapy exercises (although they still may require tweaking to suit the gifted child’s abilities and interests or your child could again refuse to participate).

Practical Speech Therapy Strategies to Help your Child Develop Speech:

OWLing- Observe, Wait, Listen to what your child is saying

MMA- Match, Model and Add More language

Share the Moment- get down to your child’s level and mimic their actions. Use this time

participate in their chosen form of communication, acknowledge their methods and use of

communication and build up experiences and practice from there.

How Else Can Parents Help?

Play

Studies have shown that children make good progress with speech when they are able to see their parent’s faces and read their expressions. It is essential that the child is engaged and challenged, but at the same time is happy and secure. As with any activity for gifted children, it is important to consider what interests your child and then try to incorporate speech into that particular activity. A running commentary by a parent whilst your child is engaged in a task, including plenty of encouragement and high praise works well without being too obvious an attempt at cajoling a resistant child into talking. Quick responses to any sounds made by your will also encourage your child to experiment with making more complex sounds eventually.

Although it is impossible to be absolutely certain what goes through the minds of these gifted late talkers, judging from their ingenuity in other areas and their incredible memory, it is easy to conclude that they are capable of complex and analytical thought patterns. Such children require varied and increased amounts of activities in comparison to other children their ag

Perfectionism and Speech Delay

As ‘gifted’ children, this group of late talkers are highly prone to perfectionism. A perfectionist late talker can be easily put off imperfect attempts at speech and may even categorically refuse to participate in speech therapy as needing therapy is an admission that they are ‘imperfect’ and need help to do something that other children can do with apparent ease. Gifted perfectionists tend to place an enormous amount of pressure on themselves to achieve the impossible. In the case of Gifted Late Talking Perfectionists, these children are facing the enormous pressure of trying to communicate highly intelligent thought and observations within the restrictions of being a 2/3 year old!

To help late talker with a perfectionist streak requires a subtle approach by parents. Parents who desperately wish for their children to start speaking ‘normally’ may inadvertently thwart their child’s initial attempts by being overly enthusiastic. Do pay close attention to what your child is looking at when they are making a sound as this may well be their attempt at naming an object, and do resist the temptation to put words into their mouths before they have made a sound as this will put a gifted late talker off talking.

It is advised that parents do not attempt to correct the pronunciation of what little words their child does attempt. At this stage, it is important to encourage your child to make as many sounds as possible and not to worry about ‘perfect’ speech. For example if your child says ‘Dooda’ instead of ‘Water’ or ‘Baba’ instead of ‘Spider’, answer or respond to their attempt at speaking and talk about the topic, but do not make them feel as though they have said the wrong word.

Patience is Key!

Patience is essential to parenting a gifted late talker, as is a strong belief in your child’s abilities and intelligence. Your child is unique and cannot and should not be pigeon-holed into set parameters.

Please do not be discouraged that they have not reached their milestone in talking when they

should. Avoid comparisons to other children who are speaking fluently and clearly from an earlyage. Instead, encourage your child’s interests and stay positive in order to avoid your child picking up on any anxieties you may have regarding their speech delay.

This group of late talking gifted children will talk when and where they are ready and not when it suits those around them! There are no physical or intellectual barriers to speech for this group of children. The only thing holding them back is a developmental delay which will improve with time, encouragement and patience.

For further advice and support, you may wish to book a Telephone Consultation with an NAGC Education Consultant. Parents of Gifted Late Talkers have found this service invaluable as NAGC is often the only place where someone really understands these fascinating and complex children.

http://www.potentialplusuk.org/file_upload/factsheets/447P65%20Late%20Speech%20and%20Gifted%20Children.pdf