Guest Author - Bonnie Sayers
OT For Children with Autism, Special Needs & Typical is a 45 minute DVD with Occupational Therapist Britt Collins. There are three children profiled. Two boys are on the autism spectrum with one typical girl. All three children are 5 ½ years of age. The setting for the DVD is outdoors and appears to be a nice spacious backyard. There are numerous activities for exploration within the session with a few I had never seen before. The objects utilized were in vibrant colors with pillows and blue mats for the ground.
There are nine sections in OT For Children with Autism, Special Needs & Typical. The first half of these chapters seemed to last much longer than the remaining ones with more observations for the viewer to gain an understanding of the OT sessions. The chapters are as follows:
1. Tactile Dysfunction
2. Proprioceptive Dysfunction
3. Gravitational Dysfunction
4. Vestibular Dysfunction
5. Oral Motor
6. Auditory Processing
7. Visual Motor
8. Motor Planning
9. Organization of Behavior
Although it was not mentioned in the DVD I believe not every child with autism or other disabilities has issues with all these listed, so an OT session will not implement all these strategies. This outside setting is something my family has never experienced in ten years of therapies and living with autism with two children. There were techniques and terms I was not familiar with and activities I am interested in exploring with my youngest child Matthew.
Britt does mention at the start of the DVD that Occupational Therapy is on an individual basis and that you need to see an OT before starting. You should not force the sensory systems and follow a trial and error method. Assessments, funding and suggestions on where to buy items shown were not discussed in the DVD. A few times I missed what Britt said and wished that there was some visual text at the bottom of the screen for the key words and specific terminology to help guide the novice parent.
In Tactile Dysfunction Britt has a child play with shaving cream. She explains that kids who do not like to have tags in their clothing or cannot tolerate walking barefoot in grass are tactile defensive. She said to provide a controlled environment with guidelines for the child to follow. The boy was sitting on the blue mat with the shaving cream and started with his hands. It looked like Brit wrote out some letters with the cream and the boy started to smear the cream around. As long as the parent allows it let the kid get messy, suggests Britt. When using glue, shaving cream or other non-edible items make sure there is constant supervision.
Tactile Processing can be with a plastic container filled with beans and hiding a favorite toy inside, the child can move on to place their feet in the tub of beans and explore other parts of their body besides hands. One boy was sitting in a container of rice. Next the brushing protocol was observed with the explanation that a trained OT needs to do this. It was suggested that parents can get trained in brushing, but it was not expanded on how long this process takes or websites to learn more about brushing. Britt said you can follow up with joint compression as it desensitizes kids.
In Proprioceptive Dysfunction Britt showed deep pressure activities by squishing the boy on the blue mat. She squeezed his head and while singing a song asked the child if he wanted more. She said this helps calm him down by increasing his body awareness. This is about force of movement and how one moves in space. There was a body pillow utilized and pillows for squishing. Britt indicated that even if a child is using the pillows to place on someone else they are still getting deep pressure from the experience.
There was this colorful barrel that was used for the children to climb into and then pillows were placed inside as well and it was used as a tunnel in other activities. They played peek-a-boo as well. Britt shared how continuous input allows children to tolerate new activities through motor planning. The child can organize his behavior and receive verbal prompts while crawling through a stretchy tunnel. This material looked very similar to the body sox that are used for spacial awareness.
Gravitational Insecurity is a term I have never heard before and after viewing the DVD I am not really sure I have a full grasp on an explanation of the term. The boy cannot jump or stand on one foot, so they did balancing on these colorful stepping stones, while still barefoot. A google search states it is a fear of movement. There was an obstacle course consisting of hula hoops, balance beam, barrel, ball and other items. It was mentioned to make this a team effort and have parents learn new skills. The kids can even go upside down on the ball or the matt and walk backwards.
Vestibular Dysfunction has to do with inner ear being out of balance. Kids might trip a lot. They did some spinning back and forth on swings, which helps them tolerate movement. Britt explains that you need to spin in both directions to avoid dizziness. They can swing on their side or on their stomachs. A trampoline can be used as well.
With Oral Motor Britt used party favors for blowing and spinning. The child can bite the toy for input in the mouth. Kids who need oral motor have issues with feeding and textures of the food and may have drooling problems or difficulties with brushing their teeth. An electric toothbrush for kids can help them tolerate new things. A chewy tube can be worn on the wrist so they can chew this instead of their clothing or other objects. Oral motor defensiveness means they have weak muscles around the mouth.
In the Auditory Processing segment, Britt explained how it is best to give the child a moment to process a verbal request before repeating it again. She then went on to suggest using a physical prompt like hand over hand when repeating a request. I learned long ago at a conference to count fifteen seconds when making a request or asking a question to someone on the autism spectrum. I always felt that was a great tip to pass on. It was also suggested to give warnings before finishing an activity like a 5 minute and then 2 minute warning that an activity is ending. They can learn to complete a task and sequencing.
For Visual Motor the kids jumped on the trampoline and tried to catch a ball. This is an advanced skill that not many children will be able to complete. The bright hula hoops were used for learning visual perception by having the kids toss bean bags into the hoops that were placed in various spots on the grass.
Motor Planning uses all systems for an obstacle course. This can be done in a classroom setting, at the playground or outside as demonstrated. Deep pressure for joints helps organize oneself. The obstacle course in a sequence formed in a circle helps the children learn to do activities.
Organization of Behavior showed calming activities like deep breathing and blowing out. This is to do before homework, dinner, a difficult task or where there is an increase in anxiety. It could even be done before bed. Here is where Britt talked about focusing on one activity and to decrease stimuli.
Britt ended the DVD by saying to do your own research on Sensory Integration. I felt that the DVD was similar to observing an OT session in the same room or through a two-way mirror. There was limited explanations with no pointing the viewer into the next direction on how to obtain therapy services or what an actual session would cover and how long it would typically last and how often. These could easily be generalized and cover the terms in more depth with a list of websites to gain more insights and a few shops on where to buy the items that were utilized in the therapy.
Britt did not really expand on the differences between hyper and hypo responsiveness. Hypo means theyneed more input and hyper means they do not want stimulation. Several years ago my son Matthew received school based OT at an LAUSD clinic. The therapist always had him swinging and I could tell that it was too much. A few times Matthew threw up as she was swinging him. It was clear the OT was not in tune with his needs and we stopped therapy.
Britt did mention that typical kids can benefit from the activities too, but did not expand on that and give the pros and cons of combining sessions with more than one child. It would have been nice to get a sense of how long children can benefit from receiving OT and the difference from clinic based and school based OT. Viewers could have benefited from an accompanying booklet or pamphlet.
Watch Trailer of DVD
Play therapy used for kids who react adversely to stimuli - Orlando Sentinel, November 2007
Seamless Socks - tootsies.com
Fun and Function - Affordable Resources For Therapeutic Play & Education
Abilitations - products used in an Extreme Home Make over episode
Sensory Processing Disorder
Interview with Lorna Jean King - on sensory integration
Floor Time Basics
Helping the child with autism self regulate
Educational Autism Tips for Families 71 page resourceful ebook for families entering the school system with a recent autism diagnosis. Find out what issues take place over the course of a school day and meet these challenges head on.