- Mental Health
Sensory Enrichment as a Creative Method for Addressing Autism
Alternative Therapies Give Hope for Autism Spectrum Disorders
The two major challenges identified by psychiatrists and psychologists which are faced by children and adults who live with an Autism Spectrum Disorder (ASD) are social and communication/language ability. Both of those challenges make much of what we consider everyday life hurdles for them to overcome compared to the general population. Social connections become important when a child starts attending school and comes into contact with other children. The ability to socialize is then important throughout life in higher education, interpersonal relationships, and a career. Communication is vitally important for expressing basic needs, getting needs met,and clear understanding in relationships. Impairments in language and psychosocial functioning may inhibit gainful employment or independent living.
Other symptoms or signs of ASD are inflexible living patterns which are more intense and rigid than those seen with Obssessive-Compulsive Disorder symptoms, for instance. For those with ASD there is such aversion to change that the individual cannot break out of an aggressive insistence on repetitive patterns of living that interferes with eating, sleeping, education, employment, and social interaction. This rigidity is pervasive across all aspects of life. The interest range of the individual becomes so restricted and focused that without intervention there is no appropriate development through the normal stages of the life cycle. Broadening the individual's life experiences can help break cyclical, repetitive patterns of behavior allowing an increase in social skills and effective communication. Traditional treatment for the symptoms of autism consists of speech therapy, strict behavior therapy, behavior modification, motor skills, role-play, and play therapy.
While those treatment options address the social and communication challenges they do not get at the heart of the disorder. The core diagnostic issues of ASD revolve around functional impairment in relating to the environment through the senses. One adult client confided to me that she wasn't diagnosed with ASD until her sons were pre-teens and had been diagnosed with ASD first. She began to relate her difficulty with sensory stimulation such as sounds and smells, which is typical of ASD. Having massage therapy was difficult for her, for instance, since she could not tolerate the sound of the therapists hands rubbing across the sheets near her ears or around her head; the sound was magnified and too intense. Physical touch was not unpleasant for her, but her sense of hearing was ultra-heightened. On the other hand the sensory symptoms experienced by each of her sons varied per child uniquely, indicating that sensory reception and interpretation by the brain will differ for each individual although the main criteria for the disorder are similar.
Standard and Alternative Therapies
In an effort to improve therapeutic experiences and to increase positive outcomes, alternative healthcare providers began experimenting with natural means of addressing the sensory symptoms. The most effective method was to address each sense separately. and for a specified period of time. The justification for doing so is that one of the mechanisms in autism is a faulty feedback loop which does not gate out most environmental stimuli, but allows too much stimulation to the brain and nervous system. The brain attempts to process all the incoming information, but becomes overburdened, and the individual is affected to the point of overload. This can cause the individual to shut down and lose the ability to address what should be normal, everyday life circumstances. There is an inability to focus on one sensation at a time, one stimulus at a time, or one thought at a time. It may be the reason that those who live with ASD are incapable of socializing appropriately; they are busy dealing with the internal responses to the overload of external stimuli which cause an inability to focus or attend to a conversation. Thus, perseverating on a repetitive movement of idea is more comforting. They may be unable to communicate with others due to the chronic sensations with which they are having to cope. Coping becomes almost impossible without ingrained coping mechanisms or faulty ingrained coping mechanisms. This can lead to an odd personality presentation because the individual is attempting to shut out all the incoming data, and attempting to appear "normal".
In an effort to reconcile the individual to the environment s/he can be directed to focus on one piece of environmental information at a time. The following are suggestions provided per sensory organ. I recommend that the sensory focus be maintained for about 5 minutes per task, but not longer. Switching from one sensory task to another over a period of 20-30 minutes is most effective.
Aromatherapy can be delivered effectively through numerous means including diffusion into the air. The diffuser has a chamber which is filled with filtered water and a few drops of essential oil are added. The exact number of drops of oil depends upon the brand. The cool mist emitted by the unit contains tiny droplets of oil which are then dispersed into the air. Commonly used oils which calm the nervous system are lavender and ylang ylang. Oils which stimulate the senses are orange, grapefruit, and bergamot. Due to the intense nature of the oils I recommend that you start with 1 drop on a handkerchief or small square of fabric. You can waft the fabric in the air to diffuse it. Increase to 3-5 drops on the fabric and waft them around the room. After that is tolerated incorporate a mechanical diffuser. Again, start with just a drop or two and increase to 10 drops or more as tolerance is increased.
Taste is best introduced by foods or liquids that excite different taste buds. A bitter taste comes from taste buds at the back of the tongue. The sense of saltiness comes from the taste buds on the forward sides of the tongue. Sour taste is located at the back sides of the tongue. Sweet taste is located at the front of the tongue. Exciting the taste buds for a bitter sensation can be accomplished with buttermilk or sauerkraut. Salty can be elicited with potato chips, pickles, or olives. Sour tastes can be elicited with lemons. Sweet sensations can be elicited naturally with fruit or fruit juice. Lastly, a sense of savory food can be elicited with foods that normally have a high fat content such as meat or cheese, or even chocolate if it's tolerated.
In addition to the sense of taste a sense of texture can be introduced with food and liquid. Applesauce has a smooth texture, but pudding has a different type of smooth texture in that it is creamy. Potato chips have a crunchy texture. Meat is chewier than other foods. Celery introduces the sensation of crunchy and stringy. This allows the child you are working with to also use the muscles of the mouth, the tongue, and the teeth in different ways. Incorporating the teeth and mouth muscles also allows the child to opportunity to have a greater body incorporation as they come into contact with various substances.
Remember as you introduce touch to find objects or fabrics of varying textures. Smooth stones or cool, smooth spoons elicit a greater sense of comfort. Silk on the edge of blanket can cause a sense of peace of comfort. Pieces of carpet introduce the concept of roughness. Felt introduces a different type of sensation somewhere between smooth and rough. Bubble wrap introduces the sense of mechanical motion and things that "give" when pressure is applied. Soft balls can be squeezed for a sense of control over a textured object.
Since the sense of hearing may be the most sensitive for many children, begin slowly. Using headphones or earphones at low levels is helpful. Or, making the room as soundproof to interfering noise is also helpful. Introduce auditory sensation with light music or environmental sounds. Another option is to incorporate brain wave recordings to the child. Again, make certain the sound is light and at a low level. Each child will begin to favor a certain sound or style of sound whether it is music or environmentally-based. Also note the patterns that the child may be drawn to such as a drum beat, thunder, etc.
This may be a difficult task for the caregiver and the child. On the other hand, it may be simple given the sensory focus of the child. Most individuals living with ASD do not make eye contact or connect easily and comfortably with others. Obviously, eye contact is a form of social connecting, and not making eye contact obscures many social skills required to have appropriate and meaningful relationships. Those social skills are understanding when to speak or to listen during a conversation, understanding emotions, understanding that others have emotions, recognizing the emotions of another person and the potential consequences of those emotions, or ready body language.
Picture of people who are looking directly at the camera can be useful. Ask the child to look at the picture and then ask questions about the face. If it is in color ask what color the parts of the face and hair are. If the photo is black-and-white ask the child to describe shapes of facial features or the possible emotions of the person in the picture. Discuss what the most accurate responses are and then the reasons for those answers. For instance, a photo of someone who has a tear in the corner of eye might be sad. You might ask, "What is this girl feeling? She looks sad. I know this because there is a tear in the corner of her eye."
As mentioned above a sensory schedule can be followed to provide consistent administration of the tasks. Three times per day for 20-30 minutes is a good starting point. During that time you can present sensory stimuli for 5 minutes and then change to another sense. Allow the child to explore the sensory object. If attention wavers, gently bring the child's attention back to the sensory object. If you experience difficulty switching stimuli because the child becomes too focused on one task, continue with the exercise by switching anyway. Just the act of switching from one task to another can create new patterns of learned behavior and cause a shift in the need to over-attend rigidly to one object or task.