Today was a dentist day. Now, in spite of being over-sensitive to just about everything, I am good with going to the dentist. As a child, I had a great dentist who told me to focus on something else while he worked on my teeth. I did so and got through the procedure without too much discomfort. It was a good lesson.
But I didn't generalize on it until much later. I was in the midst of a home remodeling project and hammered my thumb instead of the nail :{ I was dramatically in pain. A friend told me I was a wuss, and that I should focus my attention on something else until the pain died down. I did it, and miracle of miracles, it worked. How did he know that and I didn't. He had played sports. I had not. Sensory kids don't.do.sports because it's noisy and you get bumped a lot. And that's the point of this post sensory kids naturally react differently to pain, bumps and sounds and they avoid activities like sports where kids get so many life lessons, including "think about something else".
If Zoey is playing in the sprinkler and gets water in her face, she can focus on it with discomfort, or she can shift her attention outward to something else, like the sprinkler itself, her chest or her hands. If Martin is standing next to an alarm that sounds for several seconds, he can bring his attention back into his body (and his hands over his ears) and in that way stay grounded.
This particular lesson is a game changer, and here's why. Our brain operates with great efficiency, always trying to guess what to be ready for. If I focus on sensory discomforts, the brain says, "That's what she wants to pay attention to", and so it prioritizes the brain's focus to discomforts. On the other hand, if I am able to ignore the discomfort, and focus on something else, discomfort loses priority. What a concept. Discomfort loses priority, and we don't attend to it. What a great lesson for our kids!
By the way the circuitry that processes priorities is in the right anterior insular cortex (rAI). It feeds priorities to the anterior cingulate cortex (ACC) which takes action: behaviors, motor and emotional reactions and cognitive redirection. ....but that's a post for another day.
Showing posts with label Tactile. Show all posts
Showing posts with label Tactile. Show all posts
Tuesday, August 16, 2016
Monday, June 27, 2016
My latest book, Hands-On Activities for Children with Autism and Sensory Disorders is available through my publisher, PESI.com, and at Amazon. It has all new interventions and focuses on sensory, especially multi-sensory, activities. Topics include Environmental Enrichment for children with autism, sensory enrichment for all children, and aerobics for the classroom. It's great stuff. Check it out!
As I begin to work on my next book: self-regulation strategies for the Pre-K to grade 2, I'll be previewing topics in my blog posts. So stay tuned for lots of great new material!
Teresa
As I begin to work on my next book: self-regulation strategies for the Pre-K to grade 2, I'll be previewing topics in my blog posts. So stay tuned for lots of great new material!
Teresa
Monday, January 19, 2009
Imitation as therapy
Last week, a colleague passed along the book, "Mirror Neurons and the Evolution of Brain and Language", by editors Stamenov and Gallese. Mirror neurons exist in specific regions in the brain and have a unique mission: learn how to copy someone else's movements as a way of learning to do something new. For a child this might be: take a lid off of a jar, play hopscotch, or hopefully, for one of my clients, brush your teeth.
Alicia, a 5 year old girl with autism, refuses to let mom brush her teeth (without a big fight). Mom and I want to desensitize her mouth a bit, so that she more readily accepts brushing. I put a glove on my hand and played games with Alicia while she was swinging. I managed to touch her mouth, and even get a finger onto her gum without too much of a struggle. But she was done with the game long before I managed to massage her gums.
During the next session, after playing our game for a few minutes, I guided her fingers to her teeth. I touched my teeth with my fingers and asked her to touch hers. To make this easier for her to understand, we moved to chairs in front of the mirror and kept practicing touching teeth, then gums. Alicia "got it" and her mom, who had been watching, felt comfortable with following through with the game. It's too early to say, but we have hopes that Alicia will learn to desensitize her own mouth, and then learn to brush her own teeth. Whew.
Alicia, a 5 year old girl with autism, refuses to let mom brush her teeth (without a big fight). Mom and I want to desensitize her mouth a bit, so that she more readily accepts brushing. I put a glove on my hand and played games with Alicia while she was swinging. I managed to touch her mouth, and even get a finger onto her gum without too much of a struggle. But she was done with the game long before I managed to massage her gums.
During the next session, after playing our game for a few minutes, I guided her fingers to her teeth. I touched my teeth with my fingers and asked her to touch hers. To make this easier for her to understand, we moved to chairs in front of the mirror and kept practicing touching teeth, then gums. Alicia "got it" and her mom, who had been watching, felt comfortable with following through with the game. It's too early to say, but we have hopes that Alicia will learn to desensitize her own mouth, and then learn to brush her own teeth. Whew.
Saturday, October 4, 2008
Another Blog
I am starting up and new blog and that will slow my activities on this blog. The new blog will cover some of the same territory, but be focused on new interventions, technologies and clients aged 12 - 99. The new blog is called Brain Tune-Ups - that's the name of my Ann Arbor clinic. The blog is at http://braintuneups.blogspot.com/
A big factor for the change is that a small flood destroyed all of my research articles on peds and autism. But the change would have come in any event, since I am shifting my practice into teens and adults away from children. The title of this blog just doesn't do justice to where my practice is heading. I will continue to work with clients whose main concerns are self regulation or the symptoms of autism and so I will continue to have material for this blog.
On the Brain Tune-Ups site, I will continue to write about Interactive Metronome, Therapeutic Listening, Samonas, stress reduction, etc. And I'll publish the results of the adult study there.
By the way, my clinic's website is http://www.braintune-ups.com/
A big factor for the change is that a small flood destroyed all of my research articles on peds and autism. But the change would have come in any event, since I am shifting my practice into teens and adults away from children. The title of this blog just doesn't do justice to where my practice is heading. I will continue to work with clients whose main concerns are self regulation or the symptoms of autism and so I will continue to have material for this blog.
On the Brain Tune-Ups site, I will continue to write about Interactive Metronome, Therapeutic Listening, Samonas, stress reduction, etc. And I'll publish the results of the adult study there.
By the way, my clinic's website is http://www.braintune-ups.com/
Sunday, January 6, 2008
Comparing AS and HFA Sensory
Here is a thought provoking article that compares the sensory status of children with Asperger syndrome (AS) with those with high functioning autism (HFA) using the Sensory Profile.
Article 1: Auditory & Attention; Tactile and Motor Planning
Article 1: Auditory & Attention; Tactile and Motor Planning
Myles, B.S., Hagiwara, T., Dunn, W., Rinner, L., Reese, M., Huggins, A., & Becker, S. (2004). Sensory issues in children with Asperger syndrome and autism. Education and Training in Developmental Disabilities, 39, 283-290.
Summary
A comparison of Sensory Profile assessments on 76 children ages 6 y 9 m to 16 y 8 m. Half were diagnosed with Asperger's syndrome, the other half with autism. There were no restrictions to the study based on intellectual capabilities. The purpose was to discover sensory differences between the 2 groups. Statistical significance was found in the areas of auditory processing, tactile processing, "modulation of sensory input affecting emotional responses and activity level" and emotional/social responses. Children with AS were more severely impacted than children with autism in all of the above areas.
The authors conclude
1. Higher rate of social/emotional behavior for children with AS may be due to greater capacity for language. They are attempting to interact and are doing a poor job.
2. The poor auditory processing skills are associated with decreased attention levels. Children with AS may hear just portions of verbal information and this create a confused message which they then try to make sense of. The authors go on to posit that this may lead to rigidity in behaviors because the children latch onto the portion of the message that they heard.
3. Children receive inaccurate tactile information causing a distortion in their body perception which in turn causes poor motor planning. The authors explain that this may thus explain poor coordination in children with AS.
My Thoughts
A previous article () classified children with autism into 4 catagories. Children with high functioning autism (HFA) do not have communication problems. This would suggest that they need to be separated into a third group for this study to make sense. Another article (hmm, have to find that one...) I read found that children with AS and HFA have similar sensory issues -- and yet there truly are differences ... I for one, want to know more.
Friday, November 30, 2007
Response Patterns
Here are more blocks in the foundation of self regulation. Today I am reviewing and commenting on 3 interesting pieces of research that describe response patterns in children with autism and "typical" children. The articles cover 3 different areas: sensory input, affect and joint attention (a social skill).
Article 1: Response to Tactile & Vestibular Patterns
Bar-Shalita, T., Goldstand, S., Hahn-Markowitz, J., & Parush, S. (2005). Typical children’s responsivity patterns of the tactile and vestibular systems. American Journal of Occupational Therapy, 59, 148-156.
Summary
The article describes typical 3-4 year old responses to tactile and vestibular input. There was no noted differences in gender response. There was no significant difference in responses from age 3 to age 4. Children in this study showed no sensory modulation issues. That is, they were not seekers of this input and did not appear to be hypo-reactive and/or hyper-reactive in response to the input.
Comments
The study was performed in Israel, and so is valid for that population, but in fact supports data collected from U.S. researchers including Dunn, Ayers, Blanche and others.
The article is noteworthy for the excellent review of past and current literature in the areas of sensory modulation, tactile defensiveness, and hypo- and hyper-reactivity to movement.
Article 2: Response to Mood
Begeer, S, Meerum, T. Rieffe, C., Stegge, H., & Koot, H. M. (2007). Do children with autism acknowledge the influence of mood on behaviour? Autism, 11, 503-521.
Abstract
"We tested whether children with and without high-functioning autism spectrum disorders (HFASD) differ in their understanding of the influence of mood states on behaviour. A total of 122 children with HFASD or typical development were asked to predict and explain the behaviour of story characters during hypothetical social interactions. HFASD and typically developing children predicted at equal rates that mood states likely result in similar valenced behaviour. `Explicit' descriptions were used to explain predictions more often by children with HFASD than by typically developing children. However, `implicit' and `irrelevant' descriptions elicited fewer mood references among HFASD children. Furthermore, they less often referred to the uncertainty of the influence of mood on behaviour, and less often used mood-related explanations, in particular when they had to rely on implicit information. This may indicate a rote- rather than self-generated understanding of emotions in children with HFASD. "
Article 3: Response to Novel Input on Joint Attention Skills
Gulsrud, A.C., Kasari, C., Freeman, S., & Paparella, T. (2007). Children with autism’s response to novel stimuli while participating in interventions targeting joint attention or symbolic play skills. Autism 11, 535-546.
Abstract:
"Thirty-five children diagnosed with autism were randomly assigned to either a joint attention or a symbolic play intervention. During the 5—8 week treatment, three novel probes were administered to determine mastery of joint attention skills. The probes consisted of auditory and visual stimuli, such as a loud spider crawling or a musical ball bouncing. The current study examined affect, gaze, joint attention behaviors, and verbalizations at three different time points of intervention. Results revealed that children randomized to the joint attention group were more likely to acknowledge the probe and engage in shared interactions between intervener and probe upon termination of intervention. Additionally, the joint attention group improved in the proportion of time spent sharing coordinated joint looks between intervener and probe. These results suggest that generalization of joint attention skills to a novel probe did occur for the group targeting joint attention and provides further evidence of the effectiveness of the joint attention intervention."
Other Points Made
The authors conclude that the intervention worked for these reasons:
1. It violated the established routine for the child's session.
2. The focus of the session was already on engagement with other people, and so the child was not required to do something new (beyond engaging).
3. Children in the joint attention group were becoming more adept at shifting their attention and responding with flexibility to the environment, so the surprise intervention was simply an increase in the level of challenge.
Although there was an increase in initiation and duration of joint attention there was no significant change in the child's affect, non-verbal gestures and verbalizations.
The authors note that "sustained engagement in joint attention states has been linked to language development in typical children...may be important for the language development of children with autism."
Here is a working definition for sensory modulation.
My Comments
This is a very important finding that can be applied to SI interventions in that we can add a joint attention component to activities such as a swing or a trampoline, and add a surprise element into the mix. The authors treated for 30 minutes and interjected the random stimulus during the last 2 minutes - timelines that could easily work in a typical OT session.
A question worth asking is "If the children were engaged in an intervention aimed at increasing affect, would there have been a significant change in that area (and not in joint attention)?
Article 1: Response to Tactile & Vestibular Patterns
Bar-Shalita, T., Goldstand, S., Hahn-Markowitz, J., & Parush, S. (2005). Typical children’s responsivity patterns of the tactile and vestibular systems. American Journal of Occupational Therapy, 59, 148-156.
Summary
The article describes typical 3-4 year old responses to tactile and vestibular input. There was no noted differences in gender response. There was no significant difference in responses from age 3 to age 4. Children in this study showed no sensory modulation issues. That is, they were not seekers of this input and did not appear to be hypo-reactive and/or hyper-reactive in response to the input.
Comments
The study was performed in Israel, and so is valid for that population, but in fact supports data collected from U.S. researchers including Dunn, Ayers, Blanche and others.
The article is noteworthy for the excellent review of past and current literature in the areas of sensory modulation, tactile defensiveness, and hypo- and hyper-reactivity to movement.
Article 2: Response to Mood
Begeer, S, Meerum, T. Rieffe, C., Stegge, H., & Koot, H. M. (2007). Do children with autism acknowledge the influence of mood on behaviour? Autism, 11, 503-521.
Abstract
"We tested whether children with and without high-functioning autism spectrum disorders (HFASD) differ in their understanding of the influence of mood states on behaviour. A total of 122 children with HFASD or typical development were asked to predict and explain the behaviour of story characters during hypothetical social interactions. HFASD and typically developing children predicted at equal rates that mood states likely result in similar valenced behaviour. `Explicit' descriptions were used to explain predictions more often by children with HFASD than by typically developing children. However, `implicit' and `irrelevant' descriptions elicited fewer mood references among HFASD children. Furthermore, they less often referred to the uncertainty of the influence of mood on behaviour, and less often used mood-related explanations, in particular when they had to rely on implicit information. This may indicate a rote- rather than self-generated understanding of emotions in children with HFASD. "
Article 3: Response to Novel Input on Joint Attention Skills
Gulsrud, A.C., Kasari, C., Freeman, S., & Paparella, T. (2007). Children with autism’s response to novel stimuli while participating in interventions targeting joint attention or symbolic play skills. Autism 11, 535-546.
Abstract:
"Thirty-five children diagnosed with autism were randomly assigned to either a joint attention or a symbolic play intervention. During the 5—8 week treatment, three novel probes were administered to determine mastery of joint attention skills. The probes consisted of auditory and visual stimuli, such as a loud spider crawling or a musical ball bouncing. The current study examined affect, gaze, joint attention behaviors, and verbalizations at three different time points of intervention. Results revealed that children randomized to the joint attention group were more likely to acknowledge the probe and engage in shared interactions between intervener and probe upon termination of intervention. Additionally, the joint attention group improved in the proportion of time spent sharing coordinated joint looks between intervener and probe. These results suggest that generalization of joint attention skills to a novel probe did occur for the group targeting joint attention and provides further evidence of the effectiveness of the joint attention intervention."
Other Points Made
The authors conclude that the intervention worked for these reasons:
1. It violated the established routine for the child's session.
2. The focus of the session was already on engagement with other people, and so the child was not required to do something new (beyond engaging).
3. Children in the joint attention group were becoming more adept at shifting their attention and responding with flexibility to the environment, so the surprise intervention was simply an increase in the level of challenge.
Although there was an increase in initiation and duration of joint attention there was no significant change in the child's affect, non-verbal gestures and verbalizations.
The authors note that "sustained engagement in joint attention states has been linked to language development in typical children...
Here is a working definition for sensory modulation.
My Comments
This is a very important finding that can be applied to SI interventions in that we can add a joint attention component to activities such as a swing or a trampoline, and add a surprise element into the mix. The authors treated for 30 minutes and interjected the random stimulus during the last 2 minutes - timelines that could easily work in a typical OT session.
A question worth asking is "If the children were engaged in an intervention aimed at increasing affect, would there have been a significant change in that area (and not in joint attention)?
Subscribe to:
Posts (Atom)