Saturday, June 18, 2005

Autism Spectrum Disorder and sensory communication

Ideas on Autism: Building sensory communication with your child
Kerstin Potter MS OTR
Would you let a stranger spend several hours with your child, communicating values, distracting them from homework, creating separation and distance from family? Even worse, would you let a stranger into your child's bedroom?
Sensory Preferences:Jessica is four and likes to rock; if not involved in other things, she sits in a corner holding her favorite toy and sways back and forth. Billy is three and likes smells; rather than greeting a person by making eye contact, he will reach for the clothing and sniff it. When Jamie, five years old, is asked to attend to a table-top activity, he responds by flapping his wrists and waving his arms. Luis, at six, can't stand to be touched; if another child brushes against him, he throws himself into a beanbag chair and covers himself with a blanket.
Why are these children doing such unusual things? While parents and experts agree that many of our children with Autism-related conditions show unusual behavior, there are various interpretations as to why. Some will call these behaviors "maladaptive" and will aim to eliminate them through behavior training. Some believe that the child is seeking attention, and will ignore them. Professionals using a sensory processing/integration approach, however, interpret the behaviors as a language which children use to communicate their wants and needs to those around them. If we can learn this language, we can start building new ways of communicating with our children.
Each of us has a unique way of taking in sensory information from the world around us and from within our bodies, so that we can interpret what is going on, and relate to the world. As babies, most of us enjoyed the touch and smells of our parents, and the sensation of movement as we were being rocked or driven in a car. We loved feeling our limbs move and spent hours kicking our legs in the air. We then added the ability focus on sounds around us, distinguishing voices, recognizing music, and knowing to ignore background noises. While we could always see, we gradually used our vision more effectively to identify the world out of reach, - people, toys, and the exciting sights on a stroll to the park. This last sensation, vision, proved to be so good at providing important information that we focused on this more and more, using vision as our primary conscious means of learning about the world. Therefore, visual input became a priority; eye contact became essential for communication, recognizing letters for learning, and watching our step for safety.
Children with Autism have their own priorities. They may prefer the sense of smell over vision, like Billy, who would rather smell than look at a person. Or, like Jessica, they would much rather rock back and forth than attend to what is being said, since the sensation of body movement really feels good to them. While this may look unusual to the outsider, it provides us the opportunity to understand our children better. As parents and teachers, we need to recognize these behaviors as expressions of preferred sensory channels, and use them to build our communication, in other words, develop our skills at speaking "Sensorish". The child is saying to you: "This is my language; this is how I relate to the world."
What you can do:
How can you use "Sensorish" to communicate?First, sharpen your observation to recognize the preferred channel. What arouses your child's interest? What does she do to comfort herself? We already identified that Billy's channel is the sense of smell, and Jessica's the feeling of movement. Here are some other examples: A child who likes to hop up and down may need some trampoline time with you, a child who scratches or hits himself may ask to be held closely or be massaged.
Once you have identified the preferred sensation, there are two ways in which you can begin to use this, by "switching channels", or by "coupling channels": By "switching channels", you may move your communication to the child's preferred channel. If Billy would rather smell than look, let's provide him with interesting smells when you play with him. You can use different aromatic essences, creams, magic markers with fruit smells, or add aromas to toys by spraying them with essential oils, etc. (of course, check out any allergies before using this, and use only if the child is not mouthing toys). You may be surprised by your child's level of interest, attention span, and motivation to participate in play with you.
By "coupling channels", we describe the process by which you combine the child's preferred channel with another channel. If Jessica would rather rock than listen, let's combine the two. Tell her stories, or sing songs, while she is in your lap in a rocking chair, or in a swing. Gradually, you may find that you can reduce some of the movement, and she may show more interest in just listening.
Now that you know what sensory input "turns your child on", you may also use sensory activities as a reward for a difficult task, for example, application of special skin cream after washing hands independently. And finally, you may choose to just spend some special one-on-one time with your child engaging in activities in the sensory language that you both understand.
Sensory Diet:While vision appears to have become the dominant "sensory channel" in our society, it is important to remember that we continue to use all of our other senses. In fact, it is essential that we all get a balanced "sensory diet" every day. For instance if we sit still all day long in front of a computer, we will feel the need to stretch and "feed ourselves" the sensation of limb movement through a brisk walk of work-out in the gym. On the other hand, if we take in too much of a particular sensation, such as the overwhelming visual stimuli of rush hour traffic, we may have to - once we get into the driveway - digest the experience by closing our eyes and tuning everything out.
Children with Autism often live with an imbalance in sensory diet. Because of the unique way their nervous systems identify and interpret sensation, they may react differently to sensory experiences than you would expect. Jamie, whom we met at the beginning of this article, may not be getting in enough sensation to keep him in an alert state. When he is confronted with a task that requires attention, he may flap his wrists and wave his arms to "wake himself up". Luis, whom we also met earlier, perceives being touched lightly on the shoulder as very irritating, and even threatening – more sensation all at once than he can handle. The intensity of this experience is comparable to our hearing chalk squeak on the blackboard – it stops us in our tracks and we will do anything to make it go away! If we watch our children carefully, we can find clues as to what they have figured out to balance their sensory diets. Some have ways of alerting themselves, so that they can be ready to interact. Some have identified ways of "make it go away", and to calm themselves down. Unfortunately, many of these behaviors appear unusual to the outsider and are disruptive to other children, and some are even harmful (such as head banging, or pulling hair). Therefore, based on the clues they give us, we need to offer our children alternate means of providing themselves the sensory input they need to balance their diet.
What you can do:Observe what your child does when he gets upset or overwhelmed, identify the sensory channel that works for your child, and think of ways to provide the desired "sensory food". Let's look at some examples by starting with Luis and Jamie:
We have heard that Luis likes to throw himself in a bean bag chair when he is touched. Aha! Now we know it is the deep pressure sensation that helps Luis "erase" the bad feeling of the initial touch! We can now provide that sensation in more appropriate ways; through deep bear hugs, by teaching him how to "rub himself down" using a terry cloth, or by providing a heavy "comfort jacket".
Jamie, as we have observed, likes to flap his wrists and wave his arms when he is asked to do table-top work. Now we know that pressure and movement to the joints makes him feel more alert. We can offer him squeezable toys, such as stuffed animals or balls, provide play dough or thera-putty, or ask him to help with household activities that involve pushing or pulling heavy objects, such as setting up furniture, pulling a garden cart, or taking the garbage can to the curb.
Here are some other examples:Does your child bang her hands against her ears? She may be overwhelmed with sounds and benefit from ear muffs that block out noises. Does he run into a corner and hide his face? He may need a quiet area, such as a refrigerator box with pillows, to "regroup". Does he pull at his hair? He may need intensified tactile sensation, such as a body rub or a "brushing down".
SummaryIn this article, we have looked at using sensation as a way to increase our communication with our children. Identifying the preferred sensory channel can help us develop skills in "Sensorish". By either "switching channels" or "coupling channels", we may discover new ways to make contact. By observing a child's reactions to overwhelming stimuli, we can help him develop safe and effective coping mechanisms.
In summary, our children are giving us clues all the time; we just need to learn to read them! By opening our eyes to the world of sensory communication, it is hoped that this article has provided some ideas to help you and your child understand each other in new ways