May 3, 2008
Azri: The caged boy of Sanglang
Since I read the news about the caged boy of Sanglang, I’ve been wanting to write something concerning him. Initially, I was overwhelmed by this case: a 15-year-old boy locked up for his safety; a non-verbal boy who does not recognize his family.
What can I do about it?
There’s nothing I can do about it.
But I kept thinking about this case. I finally realized that it is my responsibility to put some thought into this case.
Isn’t that what I came to the US for?
To learn how to help children, like Azri, back home.
Even if I cannot come up with an intervention that will fix everything for him, I should at least come up with some initial steps to understand his situation. And hopefully from that, develop some intervention ideas that might improve his quality of life. Being locked up in a cage and tied to the house is no way to live.
First of all, it is difficult to come up with ideas when my only guide is a news article that is 300+ words long. I’ll have to make assumptions and guesses along the way.
I suspect Azri has severe mental retardation, perhaps severe autism too. Some initial questions that I have for the family are:
- Tell me about his childhood.
- What does he like to do?
- What is his favorite food? Favorite music? Favorite tv show? Favorite person to be with?
- What is his daily routine like?
- What can he do independently?
- What makes him happy?
- What upsets him?
- Does he try to communicate?
- How does he communicate? Gesture? Make sounds?
Since his most challenging behavior right now is running away from home, I’ll start from there.
Challenging behavior: Running away from home
There are many questions that his family will have to answer to help me understand his running away behavior. For example:
- When did he start running away from home?
- Where does he normally run to?
- Is there a specific time of the day that he usually runs off?
- Does he always run off if he gets the chance?
- Has there been a time that he didn’t run off when he had the chance? If yes, what was happening then?
- How does he react when he is caught after running off? Does he look upset that he’s caught? Does he look happy?
Without answers to the questions above, here is my best guess as to why he runs away from home:
He is locked in his house all day, so he wants to get out.
But when he runs away from home, he endangers his life;
So, he is locked in the house all day.
It is a vicious cycle.
Without answers to the questions above and having very limited information to guide my intervention, I suggest the following to break the vicious cycle:
1. Instead of locking Azri home the whole day, his family members could take him to a safe and enclosed field, such as a school football field, and let him run, or maybe even run with him. Thirty to 45 minutes of intense running will be good for him. It will burn off some of his extra energy. The exercise might also calm him down, which may help him sleep at night.
and
2. His family members could take him out for a long walk around his kampung (neighborhood) every evening. If there is a place that he seems to like or is always running off to, I suggest walking to and spending some time at that place. Perhaps a walk to a nearby park to watch the kids in the area play. Or a walk to the pasar malam (night market). Or a walk to a nearby grocery store.
If this intervention works, I predict that slowly and surely he will stop running away because he knows that he gets his time out of the house, so he doesn’t need to run off. Eventually, I hope that he will no longer have to be caged in the house and he would be able to freely move around the house without being tied down.
Initially during both the morning run and evening walk, if he has a tendency to run off, a few more people could be involved, so that they can help get a hold of him before he runs off. In time, only one person will need to be with him during the morning runs and evening walks.
Functional communication skills: Picture cards, photos or objects
In a response to Azri’s case, a medical doctor suggested that Azri be provided speech therapy. Since he is still nonverbal at 15 years old, I am doubtful that speech therapy will help.
I would try using picture or photo cards instead. For example, teach him to point to a photo that shows food items, when he wants to eat. Point to a photo of football field, when he wants to go for a run or walk.
If photos or picture cards are too complex, maybe he can learn to use objects. Point to a shoe, when he wants to go out. Point to food items, when he wants to eat. Point to a glass, when he wants to drink.
Self help skills: Toilet training
Lastly, I think it is very important to give toilet training a try. Unless it is a medical condition, most children with developmental disabilities, even those with severe autism and mental retardation, can learn to use the toilet. When I reflect back on the kids at NASOM, I don’t remember any of the teenagers there using adult diapers. And some of them had severe autism too.
The family members can set up a schedule to bring Azri to the toilet every hour or so. In time, they will learn what his toilet routine is like and most accidents will be prevented. If possible, Azri can be taught to go to the toilet on his own. If he likes his walks, maybe he could be taught to first go to the toilet before going out for his walks (positive reinforcement).
Because Azri is only fifteen years old, if he’s not toilet trained now, he will have many years ahead of him where he will be dependent on diapers. Besides being very expensive, diapers are extremely uncomfortable in the hot and humid Malaysian weather. Being toilet trained will greatly improve his quality of life.
Thursday April 17, 2008
The caged boy of Sanglang
By SIRA HABIBU
ALOR STAR: Fifteen-year-old Azri Azmi has been living in a cage in his kampung house for five years.
His parents had no choice but to confine him in an enclosed space for his own safety.
Azmi Aziz, 55, said his hyperactive son would run helter-skelter if allowed to roam free.
“He would simply run anywhere, oblivious even to danger of oncoming traffic.
“There were times he almost jumped into the river near our home. When he runs out of the house, we need at least five or six people to catch him and take him home,” said Azmi at his house in Kampung Kuala Sanglang yesterday.
Azmi said he had taken his son to see doctors.
“The doctor gave him sleeping pills as he has trouble sleeping at night. But even after taking the pills, he could not sleep until 2am or 3am,” he said.
Azmi said Azri was physically normal except for a slightly deformed left hand.
“But he can’t talk. He does not even recognise his own family members,” he said, adding that Azri was his sixth child. Azmi, a fishmonger, had seven children aged between 13 and 30.
Azmi said his wife Jam Wahab, 51, could not control Azri anymore, as he was physically stronger.
“Azri has been incontrollable ever since he was four. When he turned 10, we had no choice but to cage him,” he said.
Jam said they would sometimes allow Azri to sit in the living area.
“But we have to tie him to the wall, otherwise he will run out of the house,” she said.
Jerlun MP Datuk Mukhriz Mahathir visited the boy at his home yesterday.
“The family is getting Welfare Department aid. But it is not enough, as the boy needs three or four disposable diapers a day,” he said.
Meanwhile, Shah Alam-based Nuri Cergas Sdn Bhd managing director Khusairi Wahijan donated two weeks supply of diapers and RM700 to the family.