Incorporating
Sensory Integration into your Autism Program
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Children
and adults with autism spectrum disorders, be they mildly or severely
challenged, have one or more of their senses affected to the extent that it
interferes with their ability to learn and process information from the world
around them. Often, the sense of hearing is the most affected, but vision,
touch, taste, smell, balance (vestibular), and awareness of their body in space
(proprioception) can all function abnormally in the person with autism.
Therefore, I am a strong proponent of sensory integration (SI) as a must-have
therapy for this population.
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Most
school systems have an occupational therapist (OT) who can assess the child's
needs, set up a daily "diet" plan, and provide sensory treatment to a
child. It is just common sense that sensory integration activities such as
relaxing deep pressure, swinging, visual tools, and other strategies be
components of any good autism program. These activities help the child's
nervous system calm down so the child can be more receptive to learning. They
can also help reduce hyperactivity, tantrums, and repetitive stimming, or rev
up a lagging system in a child who is hypo-sensitive. SI assures that a child
is at optimal levels of attention and readiness to benefit from other
intervention programs, such as behavorial, educational, speech, or social
skills programs.
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To
be effective, sensory activities must be done every day. I still encounter
parents and some professionals who believe that it doesn't work, precisely
because the activities have to be repeated on a daily basis. Would you question
whether or not eyeglasses worked because they had to be used every day? Another
example is using medication to improve behaviors. Medication has to be taken
every day in order for it to be effective. The same holds true for sensory
activities.
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ABA
(Applied Behavior Analysis) techniques are the core of many good autism
programs. Research clearly shows that a good ABA program using discrete trial
is very effective for teaching language to young children with A5D. The best
ABA programs carried out today are more flexible than the original Lovaas
method, where most of the activities were done while the child was seated at a
table. Newer programs have a greater variety of activities, and teaching often
takes place in more natural settings. However, even well-trained ABA
professionals are frequently bewildered about how to incorporate SI into their
behavior-based program. In my opinion, their problem stems from their viewing
SI (or any adjunct therapy program) as separate and apart from the ABA program.
Therapies for children with autism are interrelated. We can't work just on
behavior, or just on social skills, or just on sensory. The progress achieved
in one area will affect functioning in another, and all need to be integrated
into a whole to achieve maximum benefits. To use a visual analogy: a good ABA
program is like a Christmas tree. It is the framework, the foundation, the base
of a child's therapeutic program. Because of the differences manifested by
people on the spectrum, other adjunct programs are often needed in addition to
ABA, like sensory integration, dietary intervention, social skills training, or
language therapy. These services are the ornaments on the tree, which render
each tree unique, beautiful, and specific to one child's needs and level of
functioning.
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There
are several easy ways to combine sensory integration with a young child's
behavior-based program. Try doing some discrete trials while the child receives
soothing pressure. One child I knew learned best when he lay across a beanbag
chair, and another bag was placed on top of him, sandwich style. The pressure
calmed his nervous system and made him ready for learning. Try slow swinging -
ten to twelve times a minute - during the lesson. Swinging helps stimulate
language and is why a growing number of speech and occupational therapists hold
joint therapy sessions to improve learning. To help a fidgety child sit still
and attend to his lesson, try a weighted vest. The vest is most effective if
the child wears it for twenty minutes and then takes it off for twenty minutes.
This prevents habituation. Conversely, rev up a slower sensory system so that
learning can happen by doing a drill while a child jumps on a trampoline, or by
using a vibrating chair pad.
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Some
of the children with the most severe autism function like a TV with bad
reception. Visual and auditory perception fade in and out depending on the
strength of the signal. In the most severe cases, visual auditory information
is scrambled, rendering the child unable to decipher what he sees or hears at
any given moment. Recent brain scan dies show that the brain circuits that
perceive complex sounds are normal. Sensory integration activities may help
unscramble the child's perception and enable information to get through - a
prerequisite for any type of learning.
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While
sensory challenges often lessen over time, and especially as a result of SI
treatment, we must acknowledge the detrimental effects that sensory impairments
have on the ability of children with ASD to benefit from any treatment, and
plan accordingly. Sensory integration should be an Important part of any
treatment program for a person with ASD.
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Temple
Grandin "The Way I See It: A Personal Look at Autism &
Asperger's" (2011)
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