Bonnie's Blog

Autism: Unraviling the Mystery

CNN is going to be offering a full day of programing about autism on Wednesday, April 2nd.  They have a number of articles and videos up on their website: Autism: Unraviling the Mystery.

Films about Autism

I wanted to share two upcoming films about autism.  The first:  Beautiful Son follows a family as they explore alternative treatments for their young son.  The second:  Autism:  The Musical celebrates the participation of older children with autism in a creative endeavor.

Susanne with the Durham County Autism Society   recommended Beautiful Son, the story of Beau a young child with autism. From their website:  " In BEAUTIFUL SON, Don and Julianne take us on their journey through the landscape of this debilitating neurological disorder as they attempt to recover Beau from autism. Along the way, through their research and personal interaction with various medical professionals, Don and Julianne come to believe the establishment has little to offer apart from advice of “good parenting” and behavioral therapy. Desperate to find help, they stumble upon a community of doctors and parents who are experimenting with alternative treatments and who are, they believe, successfully recovering some kids from autism.

This movie will be showing on Saturday, April 5th at 2:00 PM as part of the Full Frame Documentary Series

that will be showing in downtown Durham at the Carolina Theater.  Susanne saw this movie and met the filmmaker at the NAA conference this past November in Atlanta.  Susanne says: "This movie was fabulous and very moving.  I highly recommend, so if there is any way you can get over to see it please do try and see this film."

On Tuesday, March 25th, HBO will be premiering:  Autism:  The Musical.  I saw this a few months ago when it played at the Carolina Theater in Durham and it was excellent.

From  Docurama Films   (where you can preorder the DVD):  "AUTISM: THE MUSICAL follows the extraordinary acting coach Elaine Hall, five children with autism, and their parents as they heroically mount a full-length original stage production. Through trial and error, tears and laughter, these incredible families learn to communicate their feelings in song and performance, finding solace and joy in the act of creating."    

Speech vs. Language

Kristine wrote:  "This really got me to thinking and comparing this to speech v. language. I have been personally struggling a lot with when to address the SPEECH issues and when to address communication issues- and can they be done concurrently....if, for example, a child has both autism (communication probs) and verbal apraxia (speech issues). Comparing it to your separating the composition from the writing- would this be the same as separating the speech and communication? And if so, what would be the logistics of that in therapy (and, more generally, in play, activities, school, etc...?"

Excellent point Kristine.  I think it is a very similar issue.  Content vs. clarity.  And I think the big picture is content (language/composition).  Without content, the clarity (articulation/handwriting) doesn't really matter.  So in day-to-day life I would focus primarily on language.  Creating an atmosphere of facilitation and acceptance for whatever communication the child produces.  And for children with limited communication, our demands/expectations regarding clarity may actually limit their communication efforts.  As their language develops, the focus can than shift to articulation.  What you can do is model back correct articulation without making demands on the child changing what they are saying.  So when the child says "tookie"  you can say "Oh you want a cookie.  Here is a cookie."   In speech therapy sessions, the therapist may focus on both, although not necessarily at the same time.
 

Handwriting vs. technology

Kristen asks:  "I work at The Hill Center in Durham where we follow a research-based methodology for individualized instruction. Handwriting is a component for our younger students who are in need. We are also beginning to consider and incorporate various technologies in our instructional practices. With the increasing onslaught of technology to facilitate handwriting and written expression, should the focus on fine motor skill development take a different route in the schools? How important is the focus on traditional handwriting vs. instruction on use of technological supports (keyboarding, voice-recognition software, etc.)?

Even in this age of increasing technology, there is still a place for learning to write by hand.  Although not as necessary as it once was, it certainly makes getting through school and managing adult life easier.  In school, math is better done by hand, and it is very helpful if students can write down legible assignments, write brief messages, and take some notes.  Except in rare situations, where a student demonstrates severe dysgraphia (dysfunction in written language - particularly mechanics), my goal is for students to be able to comfortably and legibly write one page in a reasonable amount of time.  For longer assignments, the use of technology is totally appropriate.

It is also very helpful for students who are struggling to separate handwriting from composition.  Therefore while developing the student's handwriting skills (practicing letter formation, etc.), composition writing can be done through the use of technology or by dictating to a scribe.

It should be noted that many of the foundations for handwriting should have been established before elementary school.  The foundations for writing start young:

Infancy:  Spending daily time on the stomach, with weight bearing on hands and ultimately crawling on hands and knees helps develop the arches of the hand which supports the eventual development of a mature pencil grip.

Preschool: Children establish a dominant hand and achieve separation of the two sides of the hand (skilled and support).  Children learn to draw horizontal, vertical and finally diagonal lines, as well as basic shapes, providing a foundation for forming letters.  Working at an easel helps support mature grip development, as does working with simple tools such as tongs or tweezers.

Kindergarten: This is the time to begin systematic instruction of printing paying careful attention to children learning correct formation. Handwriting Without Tears is the program we usually use at Emerge.  Most programs begin with upper case letters first, as they are generally easier to form.  Some children will benefit from the use of a molded pencil grip if they have not developed adequate foundations.

First Grade:  Continued instruction in letter formation, with greater focus on the lower case letters.

End of Second/Third Grade:  Systematic instruction of cursive handwriting.  Many children will be faster and more fluid with cursive.  A program like Making It Legible  can be very useful for helping children to develop self monitoring skills.

What is Proprioception?

Anna wrote: My question is regarding proprioceptive dysfunction.  Can a child with sensory processing dysfunction benefit from deep pressure massages like Reflexiology? What about Aromatherapy?

Before I answer, let me give a little education regarding proprioception and proprioceptive dysfunction.

What is Proprioception? Proprioception refers to the internal and automatic awareness of where our bodies are in space and how we are moving.  Receptors in our muscles, tendons and joints send this information to the brain where it is integrated and forms the basis for body awareness, schema and organized movement

What does Proprioceptive Dysfunction look like: If a child is underresponsive to proprioceptive input they may:

• Be a sensory seeker: on the move, crashing into things, bouncing, bumping, jumping, risk taker, thrill seeker
• Have a poor body schema: invade others space, bump into others accidentally, demonstrate poor grading of movement, use too much force, break toys inadvertently
• Demonstrate poor motor planning (dyspraxia):  have difficulty  learning motor skills, motor skills may be poorly coordinated, have difficulty drawing, writing, dressing, hopping, skipping, jumping rope, riding a bike, etc.

What do you do? In therapy we typically start with activities that provide intensive proprioceptive and deep touch pressure input in an effort to reach a threshold within the child's brain where the input is being perceived.  The adaptive motor responses a child makes sets up a feedback loop so that learning occurs.  We help parents set up sensory diets at home to meet their child's proprioceptive needs.

So, what about reflexology and aromatherapy? While some parents may be interested in pursuing alternative therapies for their child(ren), these two are unlikely to address proprioceptive needs, because activation of proprioceptors requires movement and weight bearing.  We do support parents is exploring alternative therapies, if they are interested, as these therapies can have a place in supporting a child whose developmental course is stressed by sensory integration dysfunction.  During our summer program Staying Cool, for children with anxiety we have made comfort pillows, scented with essential oils selected by the children.  One child we worked with was very sensitive to odors, with offending odors making him sick to his stomach.  Our short term solution was a scented bandana that he wore around his neck and could smell to over ride any offending odors.