Inner Circle: Filling the void in care for children on the spectrum

On a bright Spring day in 2016, Muntasir Hossain was born to Ikram Hossain and Zeba Mumtahina (pseudonyms). As the firstborn in the family, Muntasir was always showered with attention and affection. His parents were eager to see him reciprocate all this love and grow up gracefully, just like every other toddler.  But something was off.

Muntasir started having issues with eating, maintaining eye contact and struggled to pick on instructions. When consulted with a developmental paediatrician at the then Apollo Hospital (now Evercare Hospital), his parents were told that he might have "some sort of autism" and were advised to look for other options for him.

To better understand what sort of autism Mohsin might have, Ikram tried out all the child development centres in the city, but nothing was of help.

"The services at each centre were horrible and extremely commercial. Poor diagnosis, not up-to-the-mark environment and the lack of expertise everywhere," said Ikram.

Then in 2018, Ikram took Muntasir to the Autism Recovery Network (ARN) in Singapore where he was diagnosed with mild to moderate level autism. ARN suggested Ikram consult with Inner Circle, an affiliation of ARN. Since then, Muntasir has been associated with the Inner Circle.

Muntasir is now seven years old and in much better shape. On any given week, he takes about 36 hours of therapy at Inner Circle. Ikram says Muntasir's eye contact issues are almost fully resolved. He has also gotten better at picking up instructions.

"Autism has a comprehensive spectrum. Children can have one or multiple developmental concerns, like attention deficit disorder, sensory-processing deficits, communication disorders, etc. 

So, we must diagnose these concerns precisely and provide necessary supporting services," said Tania Huda, Head of Business Operations of Inner Circle.

Inner Circle Private Limited (ICPL) is a social enterprise of the Sajida Foundation. They have been offering individualised therapy and counselling programmes to children with special needs. These provide significant learning opportunities and benefits to the children.

About 3,00,000 children are affected by autism in Bangladesh. One in every 94 male children, and one in every 150 female children, are estimated to suffer from autism spectrum disorder, according to the National Library of Medicine.

The founder, Onaiza Owais, initiated Inner Circle back in 2017 with only three therapists and four children. 

She wanted to address the lack of resources for children with special needs, especially those who required Applied Behaviour Analysis-Verbal Behaviour (ABA-VB) Therapy, which was unavailable in Bangladesh. People had to go abroad to avail the service. 

Hence, to provide high quality treatment, Onaiza formed Inner Circle in collaboration with Autism Recovery Network, a leading ABA service provider in Singapore. And within just a year, Inner Circle grew into a team of 11 therapists, while the number of their clients rose to 38.

To date, the organisation has served more than 200 clients through internationally accredited in-house therapists, counsellors, psychiatrists, clinical psychologists and supervisors. 

Inner Circle works specifically with children between the ages of two and 14. Photo : Courtesy

Apart from ABA-VB Therapy, they offer other services like Speech and Language Therapy (SLT), Occupational Therapy (OT), Social Thinking Class, Counselling Sessions, Clinical Testing and more.

Early intervention in autism care

Inner Circle works specifically with children between the ages of two and 14. 

Usually, all symptoms related to developmental concerns appear between 18 to 36 months of age. Once symptoms arise, the primary healthcare provider's awareness and skills play vital roles to ensure early intervention, which can change and guide the course of a child's life on the autism spectrum.

At present, Inner Circle has an in-house child and adolescent psychiatrist to help diagnose and provide medical consultation along with therapy. The therapy sessions are continued until they graduate.

"When children graduate from our programme, it means that they have maximised their ability and are now ready to get back to their regular lives. However, autism is not a disease and hence there is no cure for it with medicine. 

People with autism function differently such that they process various sensory inputs differently," explained Huda.

According to her, understanding this is the most important first step in accommodating children and adults with autism as well as getting prepared to be their lifelong support system as parents or guardians. 

"It doesn't get any easier for parents though. That is why early interventions are always encouraged for enhancing the quality of life," she further said.

In 2017, Inner Circle set up its first office at Banani. In the following year, they relocated to Gulshan. Their current office is an 8,500 square feet of colourful space equipped with all the modern facilities and amenities. All the therapy sessions are conducted there. During the pandemic, the organisation arranged many online counselling facilities.

Recently, Inner Circle has introduced mental health counselling for parents as well.

Photo : Courtesy

The journey of a parent of a newly diagnosed child with special needs is not an easy one. Parents have to muster abundant acceptance, patience and courage. The parents may experience breakdowns and burnout. Counselling for them is nearly as important as counselling their child.

All the services provided by Inner Circle are customised as per the needs of each individual. Hence, the prices of the services greatly vary.

Huda admitted that services like this are usually expensive and the majority of their clients belong to the higher and upper-middle-class societies. 

However, aligned with the core vision of the Sajida Foundation – which thrives to ensure quality health, happiness and dignity for all – Inner Circle has plans to make the services affordable and accessible for people of all socioeconomic classes.