In the distance a voice booming from loudspeakers rallied the troops, I heard the drums roll as soldiers march around the compound, then all went quiet. Suddenly a young boy’s gleeful scream pierced the quiet. An incongruous sight, a five year old boy was playing football with his father, not something I was expecting to see in an army base. As I approached, he looked at me quizzically, assessing the situation as he saw his father wai me, then ran over and gave me a surprising bear hug.
My cousin was two when he was diagnosed with autism. It affected the whole family no matter how geographically spread out we were throughout the world. Luckily he was born in Ireland where there are many specialised schools and programmes for autistic kids and his parents were financially able to provide the necessary teachers and extra programmes to further his development. Although I return to Ireland often I am only ever there for two weeks at a time, therefore it has taken a decade for me to gain his trust enough for even a hug. Every visit I have to start over again to make him feel comfortable around me. Autism is the most challenging developmental disorder in the world today. That is why I immediately had a tear in my eye when the young boy rushed up to engulf me in his arms.
Autism is a brain development disorder characterised by impaired social skills and communication, and by limited and repetitive behaviour. According to the Autism Society of America (ASA) autism is growing at a rate of 10-17 percent per year and affects an estimated 1 in 150 children worldwide _ the cause of this alarming increase is unknown. Cases of autism are higher in males (between 4 in 1 and 5 in 1) and there are no social or racial barriers. The Ministry of Public Health Thailand estimated that there were 180,000 autistic citizens in 2008.
Autism affects many parts of the brain; the cause is not yet understood. Parents usually notice signs and indications within the child’s first two years. Although early detection and development therapy can help children gain self-care, social, and communication skills, there is no known cure to date. There are no medical tests used for diagnosing autism. Diagnosis is based on observation of the individual’s communication skills, behaviour and developmental levels. This can lead to cases of other mental development problems being misclassified as autism as well as resulting in many children lacking in the proper treatment needed for their development.
Celebrity children with cases of autism such as those of Jenny McCarthy and John Travolta have led to an increase in awareness. Movies such as The Rain Man (1988) Mercury Rising (1998) Fielder’s Choice (2005) and many others have brought autism and understanding of the disorder inside our homes. HRH Princess Ubolratana Rajakanya’s son Khun Poom had autism which helped shine a spotlight on the disorder in Thailand. For the first time, this disorder was brought to mainstream attention and Thais saw that autism knew no social bounds and could affect any family. When Khun Poom died in the 2004 tsunami, Thailand mourned their loss. Princess Ubolratana Rajakanya set up the Khun Poom Jensen Foundation to help autistic children in Thailand which has resulted in many significant advances in autism treatments in Thailand.
There are various documented treatments that help autistic children; these include bio-chemical treatments based on medication, diet and vitamin supplements; neuro-sensory treatments including auditory integration therapy and sensory integration therapy; behavioural treatments and psycho-dynamic treatments such as integrated play groups, peer mentorship, visual supports, play therapy, structured teaching and interaction with animals.
In February, 2008 the Veterinary and Remount Department: Pack Squadron on the Chiang Mai-Mae Rim Road started a trial programme after learning of benefits to autistic children when interacting with animals. The programme was initially planned for a three month period, but with noticeable improvement in the children’s behaviours the programme has, and will, continue. The Pack Squadron offers programmes for two age groups with one hour classes per week. Dr. Kanchana Koonrungsesomboon of the Rajanagarindra Institute of Child Development has handpicked all of the children involved in this programme taking into consideration each child’s needs and the ability of the parents in dedication and time. The youngest student is only three and a half while the oldest is seventeen. Each class, which has ten children with varying degrees of autism, provides 40 volunteers, so children are assured a very safe learning environment. The four instructors have all received training at Rajanagarindra Institute of Child Development. Dr. Kanchana has been pleased to find that all volunteers and instructors have agreed to continue their support indefinitely. One uniform clad sergeant exposed his softer side, “I am a father. I know how tiring children are. Autistic children require a whole different level of patience and commitment. I want to help as much as I can.”
So, how does it work? How will learning how to ride help an autistic child interact better and improve their development disorder?
Looking at the smiles on the children’s faces you see one obvious advantage but there are many other benefits to this programme. While some benefits are instantaneous, others don’t take effect until off the field. Autistic children need activity and exercise as much as the next but are unable to play in team sports or participate in some other activities. Riding is both enjoyable and improves the child’s physical and mental health. Dr. Kanchana and the parents explained the main benefits that they have discovered are the children’s speaking and listening skills which are improved as they try to communicate with both their horses and soldier volunteers. While each child is flanked by three soldiers, the children are still afraid of falling off, and this means that they quickly learn to pay attention and sit still – one of the hardest conditions to overcome with autism.
The programme does not just benefit the child but also the families, as it offers them group support. Parents share stories of achievement, provide encouragement, tips and support to one another during hard and frustrating times. “The main benefit for me personally,” a mother explains, “is the understanding I receive from the other parents. Knowing that you are not alone is very important.” Every detail of the programme is documented, building up data for research. Parents fill out weekly reports on how their child’s behaviour has been at home and at school for the doctor to study. This helps the family, teacher and doctor monitor changes, work together and see what has helped the child, and will therefore be beneficial to other children. As Dr. Kanchana watches from the side of the ring she gives parents personal and useful tips. She is personally involved in every child’s case and is able to be there for them as they grow.
A five year old boy didn’t feel like riding the day I visited, he ran to the side and played with his toys. As a solider approached, and went down on his knees the boy initially didn’t acknowledge him, but after soft cajoling, the boy agreed to get back onto the horse only if he was allowed to take his badminton racquet with him. “As long as they are safe, anything that encourages their involvement is allowed.” Dr. Kanchana explained.
While usually lost in a world of their own, the children are very responsive and wave to parents with smiles on their faces as they ride along. The fact that they are enjoying an activity which is aimed just for them and in a new environment dramatically improves their quality of life. They learn to make friends, overcome fears, gain confidence, increase their participation with others and learn to love animals. Some benefits take time to manifest but over time it is noticed that the children have better concentration and better relationships with friends and family. Their teachers have found that many of the children’s handwriting have improved and that they are able to focus and pay attention for longer periods of time.
Although Thailand has moved forward quickly in the past few years with advancements in programmes for the autistic people there are still few studies on autism in Thailand. No definitive studies have been conducted in Thailand yet regarding this new form of therapy but there has been significant evidence that this programme has helped both the children and anyone that is involved with it.