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Collaborators: BBB Autism, ASO York Region, ASO Halton July 30, 2001
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AUTISM SOCIETY ONTARIO (YORK REGION CHAPTER) NEWSLETTER THE SENSORY INTEGRATION ISSUE |
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OUR FAVORITE LINKS (note: many of the links for this issue come from BBB Member Bernie! Thanks a million!) BBB Autism Online Support Network Sensory Integration by Cindy Hatch-RasmussenAutism and Auditory Integration Training (AIT) How can Occupational Therapy Help the Individual with Autism? Sensory Integration Resource Center Sensory Integration Dysfunction: "The Misunderstood, Misdiagnosed and Unseen Disability" Written by Sandra Nelson Sensory
Integration Dysfunction Evaluating Alternative Interventions My
Experiences with Visual Thinking Sensory Problems and Communication
Difficulties by
Temple Grandin, Ph.D.
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What are some signs of Sensory Integrative Dysfunction?
____________________________________ OUR FAVORITE SENSORY POST Hi, I thought I'd share this experience in case it effects any others families. I'll be honest I'm not a guru on this topic as my son didn't have a great many sensory issues, but on the few he did... he sure went to town on them. Sensory or Stim it could fall either way. He was extremely oral and it affected him all over the place. 1) For two years he would eat only three foods, as he couldn't stand the texture of other foods. They included French fries, grilled cheese and CHICKEN wieners. It was rather difficult to plan three meals a day around this repertoire of foods. We initiated a program within our ABA program to try a deal with this. He was going to preschool (shadowed) in the mornings and home for ABA in the afternoons, so we started having him stay for lunch at preschool before bringing him home so that we could have peer modeling to help with it. This process was slow and it took a long time upwards of over a year and a half... but it worked for us. 1st step) We picked one new food to introduce at all three meals. (We picked corn to start with) Note: he had to do the following before he was allowed to eat his preferred foods. 2nd step) All he had to do was touch this food to the outside of his bottom lip. The natural reflex is then to either scrap your lip with you top teeth or to lick it. This allowed him to slowly and gradually get used to the new taste without dealing with the offensive texture. This was continued for two weeks and over this time we increased the number of occurrences expected until it was one bite of preferred food for one touch of corn to his bottom lip. 3rd step) We stepped it up and he now had touch the food (corn) to his tongue and that was all.. then he could again have his preferred foods. This was over a little more than a week. 4th step) Now he has to do one chew of the targeted food and then he can remove it from his mouth into a napkin. Over the course of two weeks we increased the number of expected chews before removal. 5th) Now he has to take one miniscule bite of the targeted food, chew it and swallow it... for each bite of preferred food. Note: miniscule bite consisted on a tiny portion of one kernel of kern. Over the next two weeks the bite was increased until it consisted of one whole corn kernel. 6th step) This was increased to two, three, then four kernels at a time, until he could do a child size spoonful of corn. Then we increased until he could complete a child size portion of corn on his plate. 7th step) This was then put to maintenance so that the food was included in one meal a day 2 to 3 times a week. And on it went with each new food, as we progressed the time may be shorted in any step and you could stager new foods about a week apart... BUT all foods had to be put on maintenance... because if you didn't he would strike them from his list of acceptable foods and you had to start again with them. Once in a while a new food was excepted more easily and could go throw all the steps within days and others not so easily. We tried to start with foods that most children would eat and we also incorporated the school menu so that he was working on foods that were served at school anyway. While a specific food was on target we sent it with him to school each day (I didn't expect to the school to serve it daily on his account). OUTCOME: Today he will eat almost anything, when we have his friends over for lunch or dinner, it is the friend that is now the picky eater. I understand that there will be foods he will never eat or like, but isn't that true for all of us. Example: he detests tomato's, but loves anything made from tomato's i.e.: ketchup, pasta sauce etc... But we still live with one rule and I think we will always have to... he has to have one bite of anything that is served at a meal (except tomato's). He at times will still attempt to remove certain foods that he had previously liked and eaten without question i.e.: broccoli and carrots. But with the one bite rule we are able to keep this under control, and he actually finds new foods he likes sometimes that he thinks he will not... like shrimp, scalloped potatoes, Chinese noodles, rice, and salmon steaks. We recently found a way to get him to willing try and eat almost anything, and my daughter loves this as well. I bought them both their own tiny ceramic portion cup (it holds about 4 oz full), we fill it about half full with ranch salad dressing as a dip, and they will both eat any vegetable or meat if they can dip in it the dressing. That's a personal decision you have to make but I'm happy to let them have it when they'll eat things like asparagus, brussel sprouts, broccoli etc... 2) This one definitely falls across both sensory and stim and again is oral. My son used to grind his teeth, and he did it to the point that he ground both of his top centre two teeth away until he exposed the nerves and needed two emergency root canals done. Note: This is back at the very beginning of our home program and he displayed NO PAIN EVER about anything. His tolerance was so high I used to live in fear of internal injury and we'd never know it, because of a lack of pain as a consequence for things, he'd do anything and often hurt himself and never show or acknowledge it. (i.e.: he used to spin himself around and around until he was so dizzy he'd fall, once he fell at my in-laws onto the wooden arm on their sofa and got himself across the bridge of his nose, he was bleeding and both eyes swelled up and he was completely oblivious to it). Any way I'm getting off target in trying to explain the lack of his feeling any pain. On the issue of his grinding his teeth though this was a stim it originated from a need for sensory. Once the root canal was performed he stopped but moved on to chewing the inside of his cheek (again no pain issue), he'd be sitting in circle at preschool and you'd see blood trickle out of his mouth! I took him to the dentist and he said the inside of his mouth was like raw hamburger and he had no ideas or solutions to deal with it other than wearing a mouth guard. We opted out on this for a few reasons, it didn't treat the problem, we couldn't go through life putting guards on him, it would definitely make him stand out from his peers, and it would prohibit his speech and he definitely didn't need that. We (the team) put our heads together and came up in the end with a very simple strategy to try and tackle this. To try and give him an alternative to get the sensory he needed we would implement chewing gum. Sounds easy right.... except he would treat it like food... chew it and swallow it. So though it started as a sensory issue, it had now turned into a stim.. we took data, he only did it at times he had to be still (circle time, story reading, times he was waiting from one activity to the next) and he couldn't go longer than 5 seconds with out doing it. For someone not watching for it, it was hard to catch because on the outside it was only a slight movement of his mouth. You couldn't stick your hand in his mouth and if you gave him any verbal attention for it... it would be on the rise. So we came up with plan 2, if he could only last five seconds then we started reinforcing him at 4 seconds for not doing it. (We enlisted the help of his preschool teachers to support this as it would be a little disruptive at circle time.) We started pulling him out of circle to give him a tiny piece of candy (mini M & M, skittle etc.) Note: we only pulled him out as we couldn't give him candy in front of the other kids, it wasn't fair to them. He gradually increased the time he could go without doing it until it was extinguished. It took months. I'm happy to say this was the last destructive oral thing he did, though he did replace it with verbal oral stims to get the oral sensory he was after. But we addressed each of those the same way as the cheek chewing until they also were gone. Each was a long process... but today he only visits verbal stims once in a blue moon and always with one eye on me to see if I'm watching... it's more for attention now than anything. 3) He used to strip down naked whenever and wherever he felt like it, he especially had an issue with socks. Though I'm happy to report this was not a daily occurrence . We could be in the grocery store the bank you name it and I'd find him stripping down. This could be a long story as well but I'll make it short. To tackle it I only put him in pants that had belt loops so that I could put on a belt. (He couldn't undo a belt yet). That left his socks and his shirt. Which we addressed exactly as above, we put him on a regular reinforcement schedule for keeping his cloths on.... This one went relatively quickly except for the socks which lasted about a year. Today he stills prefers to be barefoot (as do I), but will keep socks on without an issue. So in the cold months socks are not to be removed ever and in the summer he can live in bare feet and sandals, except when doing sports, bike riding etc... and it's not a problem at all anymore. I'm sorry this ended up being so long. I don't know if this will help anyone and like I said I think these fall on the fringe they started out as a way to deal with a sensory issue and all turned into full blown stims, but though the process seemed long and slow while we were living through it, it now almost seems like a lifetime ago and he's only seven. But I will proudly tell you he is my HERO! Cindy Faria, ASO, Halton ----------------------------------- From Children's Therapy Works
How
to Learn About Sensory Integration Become an Expert on the Sensory Integration Needs of Your Child. Difficulty Level: Average Time Required: 60 minutes
Here's How:
Tips:
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ARTICLE OF THE WEEK OUR SENSORY STORY by BBB Autism Member Gabrielle >> My third son has some major sensory difficulties. He can't stand sudden, loud noises, gets "lost" in a visually stimulating environment and is tactile defensive...he can't stand a light, tickly touch at all. School fire alarms upset him so much he didn't want to attend class. He never knew when that alarm would go off. To solve the problem we asked the Principal to warn him when a fire drill was scheduled. It helped! My son has a lot of trouble concentrating in a place with too much visual stimulation. Grocery stores, sporting events and school assemblies are difficult for him. We try to avoid those situations as much as possible. When that isn't possible, we make a special effort to help him stay engaged and on task. We bring books and toys for him to concentrate on, use multiple verbal reminders to keep him on task and I will often actually put my hands firmly on his back and chest to get his attention. Since we know he has such trouble with excessively visual and auditory situations, we try to provide its opposite, calm and quiet, for him as often as possible. His room has as little in it as possible...few toys, no electronic games, books kept in a plain white box. When it is time for homework, we put him in a quiet corner with no wall decorations. He does so much better! Our son's biggest problem has been the tactile defensiveness. To him, a light, tickly touch feels like spider claws crawling on his skin. It makes him want to run away, even to the point of becoming physically violent. A year ago we tried the Willbarger Protocol with him in an effort to calm this over-sensitivity. The Protocol involved 3 parts, all of which were planned specifically for him by a trained Occupational Therapist (OT). The first was brushing. We were told to use a soft surgical brush on his back, arms and legs. At first I was skeptical about the whole idea, not sure if it would work. However, I was "converted" at our first session. My son was sitting on his bed, and as I applied the brush to his arm this normally tightly-wound little boy melted into a "bowl of contented jelly." I had never seen him like that! I wondered if I had unwittingly hypnotized him or something. This reaction continued for quite some time. It really made a difference. The second thing we were asked to do for him was joint compressions. After a brushing session, we would press his joints together a certain number of times. He really enjoyed that. He would remind us if we missed an area, or if we did the wrong number of compressions. The third part of the Protocol was a sensory diet. The OT determined where our son needed work, and gave us a list of suggested activities to add to our daily routine. Our son needed to use his large muscles, run around, and do some swinging 3 times during the day. We actually had him jump on a bed (just a mattress on the floor) 20 times every morning, run around in circles after lunch, and swing from our "Tarzan" rope in the evening. Our other children seemed to enjoy doing the sensory diet as well...jumping on the bed was a favorite. Working with the OT we discovered a few more things that helped our son feel better and focus more, and we added those things to his day. Chewing on things was comforting to him, so we packed a few gummy worms or pieces of gum with us when we attended an event that we knew would be stressful to him. He liked to be "squished," so once in a while we would make him into a sofa pillow "sandwich." We also noticed that he really enjoyed playing with extra-soft putty, like silly putty. We purchased a larger quantity of it for him, and started taking little containers of it with us. Some suppliers of "sensory objects" charge a lot of money for some of their products. Our family budget does not allow for that. We have found that a little creativity can go a long way. Instead of spending $100 for a "professional" net swing, we strung up our old hammock and got the same results. Paying $87 for a vibrating toy was too much...we got a generic "Bumble ball" at a toy store for just $3, and it did the same thing. Not everything in a catalog is that expensive...you can get some really good products cheaply if you look...but a desperate parent with a dollar store close by can do some marvelous things. Other things that we have found that are helpful: --washing dishes by hand; --swimming lessons; --letting him hang upside down from the bunk bed frame; --wrapping up in a slippery, stretchy sheet; wearing bike shorts for pajamas; and --wearing earplugs once in a while. Some things we have avoided: --NERF toys (he obsessively chews holes in anything made of foam)...those cloth-covered "water bomb" balls (dry, of course,) are great to throw around in the house without causing damage; --plastic garbage bags for storage (another thing he destroys obsessively)...we use the big hard plastic containers instead. Since each child with Sensory Integration issues is an individual with their own unique set of needs, finding someone to help you determine what those needs are, and treat them appropriately, is very important. Most schools has an OT on site who can help. You can also find a good OT at the closest children's hospital or at a private OT clinic. Often your child's regular physician can help you find someone who will help. In any case, finding the right person who can help you sort it all out is worth the investment of time, effort and financial resources.<< ______________________________ CHRIS'S CORNER by BBB Autism member Chirs
Sensory issues for the child
with autism have an enormous affect and impact on behavior,
participation, and overall moods and temperament. Therefore, it is
crucial for parents and educators to have an in depth understanding of
how the sensory system processes information. When these processes
malfunction by modulating too much or too little than adverse
manifestations occur by meltdowns, rages, defiance and an out of control
child.
Two excellent resources for
understanding this process as well as providing appropriate options and
interventions are, The
Out -of -Sync Child: Recognizing and Coping with Sensory Integration
Dysfunction by Carol Stock Kranowitz and Asperger
Syndrome and Sensory Issues: Practical Solutions for Making Sense of the
World by Brenda Smith Myles, PhD., also the author of Asperger
Syndrome and Difficult Moments: Practical Solutions for
Tantrums,Rage,and Meltdowns.
Asperger Syndrome and
Sensory Issues offers wonderful visual graphics (in the form of smiley
face people) as examples of the sensory gang. Explanations of each
process are presented in an easy format that is adaptable for children
as well. It also offers a 26 page chart of incidents, interpretations,
and interventions. It serves as a great tool for seeking out
explanations of the whys of behaviors.
Oftentimes communication is
the primary area of concern, but in order to communicate the child must
be in a receptive state of alertness and attention in order to
participate in communication. To achieve this the sensory load must be
at the level of modulation most appropriate for that child. With an
understanding of the sensory process, real interventions can occur and
behaviors can be understood.
Armed with this information
the child, parents, and educators can empower both the child and those
around them with the ability to "control" some of those
invasions on the sensory system and enable the child to be better
equipped and understood. By feeding the sensory system appropriately
what it needs, many negative behaviors can be eliminated. By empowering
the child with an understanding of his levels of comfort and discomfort,
he can better participate.
+++++++++++++++++++++++++++ KIDS CORNER by BBB Member Chris
Many of our kids
who have had sensory integration therapy have been exposed to playing
with sand, birdseed, beans, rocks, etc. It is important to extend
these activities at home. While always respecting the level of comfort
for your child explore things from a sensory sense and adapt according
to what your child's level is. If touching the shaving cream is too
much, put it in a Baggie and let them do it that way, eventually
working up to the actual thing. Use whipped topping for extra
enticement so they can eat it too! The possibilities are limitless!!
Ice cream, yogurt, etc. Mini trampolines, swinging, sliding, all great
activities! Sit 'n' Spin is a great toy for those twirlers of ours!
Explore auditory sounds, eventually and in controlled situations try
to introduce those forbidden ones. Try alarm clocks, your fire alarm,
etc. If attending events that are loud and over stimulating, carry
shooters ear muffs and sunglasses, hats, shirts with hoods for the
feeling of retreat. For those harrowing hair cutting sessions and hair
washings try swimming goggles. Get in tune with your own child by
being a sensory detective and OBSERVE and notice what your child is
drawn too and of course, you are probably already all too familiar to
what they aren't. Write a descriptive sensory analysis for your
child's teacher so they will be aware and anticipate these issues.
Write a story with your child about their sensory system so they can
begin to understand what is happening to them and what they can do to
control it, anticipate it or avoid it.
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POST OF THE WEEK Nervous Nellie by BBB Member Michelle >>Hi! For those of
you that were on chat last night - You know I had to leave because Brian
was nauseous. Well, When I got upstairs Brian was by the toilet looking
peaked. Danny was sick the week before so I figured Brian was coming down
with the same thing. _______________________________ Activities for Gravitational Insecurity
Activities for Tactile Defensiveness
_______________________________ A SPOONFUL OF HUMOR
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