November 29, 2012

Stimming Issues in Autism

Award Winning Non-Fiction Blogs - BlogCatalog Blog DirectoryThere are a lot of unique challenges that come with living with a non-verbal, severely-autistic person. One of them is vocal stimming, such as incessant humming, whistling, echolalia (repeating words or phrases), moaning and/or shrieking.

Primary reason for vocal stimming in autism is rooted in self-soothing attempts to calm an overactive nervous system. Imagine how you’d feel after seven cups of coffee. That’s how some autistic people feel all day, everyday. And they can’t tell you. Nor can they process what is happening. To mitigate this hyper-arousal, the autistic person may actively vocalize to physically release calming endorphins.

Other times, vocalizations can be rooted in pain or discomfort. You can discern reasons for stimming by knowing baseline of the autistic person. For example, if the person stims in the absence of others, it’s not for attention, it’s a coping mechanism.

Remember if an autistic person normally vocalizes a few hours a day, but suddenly the pitch, duration and tone changes, as if in distress, consider underlying infection and look for signs and symptoms of an illness. Or a minor cut or scrape on body that is stinging or itching. Treating an underlying medical issue often resolves the sudden dramatic increase in vocalizations.

To mitigate chronic vocal stimming try music therapy. For instance, if my son’s vocalizations become too loud, and seem rooted in boredom, we place an IPOD on with soft music playing. This re-directs his brain from being stuck on internally driven sound and offers him a soothing external auditory input.

Other types of stimming include visual, tactile, vestibular, gustatory and olfactory stimming. Here are some examples seen in my severely-autistic son:

Visual: He often sits on his back on his bed and stares at a map on the ceiling. Other times he fixates on trees blowing in the wind. This seems to calm his overactive mind. He loves stripes and geometric patterns. Also loves to fixate on colors red, blue, black, white and green.

Tactile: He sometimes taps drums, taps his pillow, taps his legs or taps on people when they are too close to him. The tapping can be hard and misconstrued as an outburst or aggression by those who don’t understand tactile stimming in autism. Another tactile stim my son has is rubbing his fingers together or grabbing hold of someone’s hand or arm tightly. Sometimes he’ll pinch you, so you have to re-direct his hands. He is also obsessed with rubbing his hands over rugs, grass and artificial turf. I recall once he rubbed hand on a carpet that had a staple in it. Ouch. This triggered self-injury. So be careful what they use for tactile sensory needs is safe. An oral tactile example rooted in presenting as hypo-sensitive while eating is seen when he swallows food whole. To avoid the dangers of this sensory behavior, we mince or puree most foods and then switch back to whole foods when he’s out of this “phase.” This can switch back and forth several times in one day.

Vestibular: He bounces on his bed daily. Sometimes he bounces on trampoline. This of course requires close supervision. When he sits he may rock or cross his legs and move one foot up and down. He also likes to be on swings. And ride in cars.

Gustatory: Chews on a sensory tube daily. We have to frequently check and toss tubing if he rips it with teeth to avoid aspiration. An Olfactory component of gustatory is when he holds food or saliva in mouth (also can be a sign of oral sensory defensiveness if he isn’t in mood for particular texture, SMELL, temperature or taste of food he’s offered). A simple remedy is to offer a different food (like slipping a strong smelling, salty, crunchy cracker in mouth to get him chewing) or get him to take a drink to encourage him to swallow. What is a strong smelling cracker? Any cracker with flavoring, as opposed to, let’s say, a saltine cracker. If that doesn’t work, you have to gently scrape out food with a toothbrush, re-direct him to another room or activity and try feeding later.

A daily sensory diet is critical for severely-autistic individuals, especially those who can’t communicate their needs. Sadly, some people don’t get it. For instance, I had to recently fire a new nurse for getting angry at my son for doing things he can’t control and which he uses to self-soothe. The nurse thought he was doing things “for attention” despite the fact my son does these things when he doesn’t think anyone is looking. The key to treating autism is learning the individual and doing things for them are that are known to help.

It can be time consuming. Some people aren’t cut out to work with autistic individuals. They become easily frustrated are too lazy or inconvenienced by the demands to implement therapeutic interventions. That’s fine. They should find another job. To work well with an autistic person who requires constant support, one must have good observational skills, be willing to learn, work hard, be creative and have empathy for and patience with the autistic person.

I have met many people who have a natural ability to help autistic people. And they remain a critical part of any team of individuals working to better the lives of the severely-autistic child or adult. 

November 26, 2012

Dogs Sensitive to Autism

Award Winning Non-Fiction Blogs - BlogCatalog Blog DirectoryEver since childhood, dogs have been my favorite animal.  And last week, I was reminded why. As I was walking our property with my autistic son, Jamey, the neighbor’s curious chocolate Lab followed along the fence and watched us. Round and round the property we went, and whenever Jamey would pause, start slapping his thighs or hips, the Lab would bark at him, as if saying, “Hey buddy, don’t do that!” Naturally, our dogs became jealous and barked back at her, as if saying, “Back off girlie, that’s our guy!”

Given dogs are so perceptive, wouldn’t it be super if one could train dogs to be self-injurious behavior dogs in the same way there are seizure dogs? Australian Cattle Dogs would be perfect. They’re solid, smart, tough dogs, bred to herd all types of cattle.
Later that afternoon, as we sat on swing for vestibular therapy, Jamey again started slapping his thighs. Suddenly, one of our Cattle Dogs jumped on the swing and began licking Jamey’s thigh, hands and fingers. Immediately, Jamey stopped hitting himself and began petting the dog. Though I watched closely— in fear he might start slapping the dog— Jamey is more sensitive and smarter than he seems. Even when the dog nibbled hard, but playfully on his hands, he only laughed. The dog’s action re-directed Jamey to stop hitting, laugh and get up and begin walking around patio. No doubt, Jamey senses the unconditional love and attention of his dogs. They adore him.
Even assertive dogs we’ve passed on walks over the years have often paused, ceased barking and studied Jamey. I believe dogs see something special in Jamey that is unseen by an untrained human mind and eye. This explains why so many professionals who haven’t spent time with Jamey, never understand who he is or how to help him.  Pretentious people, filled with presumptive thoughts, are incapable of understanding Jamey. Subsequently, they rely on speculation, suspicion and remain stupefied. Not so with dogs. They could care less about impressing anyone with a fancy working title. Nor are they caught up in self-importance. They are there for one reason: “to love and be loved”. Hidden in this simple phrase we also find: friend, companion, loyal, trustworthy, helper, protector and comforter.

According to Stanley Coren, professor of psychology at University of British Colombia, “In the same manner that young humans show empathy and understanding of the emotions of others, so do dogs. Furthermore, we appear to have bred our dogs so that they not only show empathy, but also sympathy, which is a desire to comfort others who might be in emotional distress.” This echoes observations of how little children (Jamey has a special bond with his young niece and nephew) and most dogs react around Jamey, and how Jamey seems consoled by their presence. If only dogs could talk! I wonder what they’d tell us. My guess would be to love Jamey unconditionally. To never give up on him, in the same way dogs expect humans to never give up on them— especially when sick, aging or injured. 

Article on animals helping people with autism:

Kim Oakley