What not to say

I read this post here about things not to say to an autism parent. Here's MY list (in no particular order):

1. Autism is [or isn't] caused by _______. (The truth is NO one knows really what causes or triggers autism. There's so many varying kinds of autism- no two kids are exactly the same on the spectrum and/ or when the symptoms started).

2. I understand. (The truth is, unless you have a kid with special needs [or work REGULARLY with them], you probably don't get it. And even then differing special needs have differing needs, autism has its own needs again with each kid being a little different).

3. She just needs to apply herself more or she can't do that. Let my child say what she can and cannot do. She'll let you know.

4. Like Rainman? [My internal response: No, not like freaking Rainman.]

5. God knew you could handle this.

6. You really need to control your child.

7. Are you sure she has autism?

8. You should try ________ (therapy, medication, etc).

9. It doesn't matter if she's learning as long as she's happy (this is one from her teacher who I wanted to punch right in the taco).

10. If you had faith in god, autism would go away.

11. It's just a phase. [Internal response: this is one freaking long phase].

12. Aren't you worried that one of your other kids could someday exhibit autism?

13. She just needs to be medicated.

14. How dare you medicate her!

15. You just don't know how to discipline your child.

16. Could you take your child out? She's disturbing everyone.

17. If you thought she could have a meltdown, why did you bring her?

18. She should be in a special class.

19. She's too smart to be autistic.

20. Why isn't she doing ______ yet?

21. Oh she has autism. That must be so hard on you. [No shit, Sherlock.].

22. She just needs a good spanking.

23. Girls don't have autism.

24. Why do you have so many kids when your eldest has autism?














At the end of the day though. I will say in this post that I am strangely grateful for my daughter Bridgette, who just happens to have autism. She is bright, funny, compassionate. I've learned more about loving people unconditionally from her than I could have learned in a lifetime. She is one amazing girl. She's made so much progress in such little time. I sincerely hope that she knows that she can be whatever she wants to be when she grows up, just like any other child. Autism doesn't limit her, but rather other people's perceptions of autism. Never make any assumptions on any child- they all grow and develop differently. Autism even more so. Because autism is the ability to think differently. Without filters. Without judgement. Without any negative conceptions. The differences are sometimes frightening to those who don't understand it, but if looked upon as simply being can be a beautiful thing.

Social Strategies

This is one of those things I for sure wanted to work on with my Bridgette. And we've made slow but good progress.

Before many of her interactions were very one-sided and she had pretty much no ability to answer the simplest question. I think it was a matter of her not understanding that was her chance to say the answer (the pattern of interchange between two people) at times rather than her not knowing the answer (which sometimes I know is the case too). It still is something she needs to work on but it's more that she has to learn to interact better with her peers.

So I'm reviewing some strategies that I found in this book.

* Group social therapy: This works really well. Unfortunately, my insurance (I don't know about others') won't pay for pure group social therapy. So we've found windows by doing group PT/ OT and sometimes I sneak in 2 of my girls getting speech at the same time. It helps to break down the rules of socializing that kids usually learn automatically. Anything abstract (like feelings, thoughts, friendships) should be introduced by visual cues and hands on stuff. For feelings products lessons I highly recommend this:























Source
and Dr Seuss' Many Colored Days.
Friends- I recommend "Since we're friends"

Be sure that any group therapy that the social skills are reinforced at home. I know that practice really helps my Bridgette.

I think the skills that Bridgette has the hardest time with is keeping eye contact and keeping an appropriate distance/ volume.

* Modeling. I know a lot of the social skills she's learned through watching my husband and I. And her sisters. We are generous with praise when she's getting it (even just a bit) because that's what she thrives on.

* Opportunities to play with friends. We make great use of time at the park or in the play room with our friends.

* Social skills games. Use a game board and use cards for questions/ cues you'd like kids to work on. All of my kids love this game. (Like we'll ask her about her favorite subjects; or her favorite shows; who do you know that _______; you are told not to do ____, what should you do?; or _____ needs help because they are sad, what can you do to help?; what should you do if someone teases you). The list of questions/ cues can go on and on.

* Make social stories (we do this a lot when we're going to have big changes and it helps a lot).

* Narrating life. It's fun to hear her say what she's doing and why.

* Learning coping strategies. For my Bridgette the best coping strategies are that she can do deep breathing (like yoga) or she can ask for pressure. We started with her just using her words to say how she feels and why. She's gotten really far with this.

* We're still trying to teach her how to deal with bullying. It hasn't been a big problem so far with her. I think it's because she's confident in herself and knows she's different and embraces it. She knows that she has a better long term memory than other kids. She knows that she just loves people no matter what, and she doesn't get her feelings hurt very easily.

These are just a few of the suggestions. I'm sure there's more out there, but that's what we've tried and what's worked.

Do you understand?

Some tips for developing better comprehension through conversation (nothing groundbreaking- just good reminders).

Tip #1: Build in time for rich conversation in your home
* Turn off the cell phones, tv, and close your laptops when you have time for a "real conversation"
* Set the tone by reminding your child to bring something "to the table" to share.
*Keep meal time talk relaxing & pleasant.
* Remember to chose worlds that enrich your child's vocabulary: The potatoes are "delectable" instead of "good". During a TV show: Why was the policeman "reluctant" to go into the house?
* Make connections from your own experience: "That happened to me in the 4th grade..."
* Extend one-word or phrase answers by modeling the use of complete sentences and correct grammar. Language is refined & improved by example!
* Ask "why" and "how" questions requiring more than "yes" or "no" responses.
* Use starters like these to extend your child's language: Tell me more...; Why do you think that is?; how did that happen?

Tip #2 Encourage sophisticated vocabulary use at home.

* Choose a "word of the week" from vocabulary lists, independent reading, or tv shows. Choose words that are unfamiliar and/ or unused in your child's conversation and post on the refrigerator. Use the word in conversation as much as possible.
* Write vocabulary words on strips of scrap paper or index cards. Ask your child to sort words, after you read each. He might sort by meaning, by part of speech, by relationships (igloo, tent, huts are all shelters... endangered, vulnerable, jeopardized could describe the rainforest.) Just make sure there's an "oddball" category for words that don't fit into categories. The object of the activity is to discuss and debate ways of sorting words and explore meanings, not to find the "right or wrong" answer.
* Incorporate varied sentence structure and more specific and varied verbs & adjectives into your conversation. Instead of "the wind is blowing hard", say "the trees are swaying in the wind"
* Play "what is, what it's not" with chosen vocabulary words. Plan examples of situations that do or don't describe the word's use to help you child think and make choices.

Tip #3: Make comprehension, writing, & fluency practice relevant & fun!
* Have your child select tv shows for the day and write a persuasive essay to why she should be allowed to watch that show.
* Start a "book club" that only has the members in your family; or just you and your child. Read the same book (together and independently). Highlight interesting words, discuss characters, predict and confirm actions and events. Enjoy the shared reading experience!
* Choose your child's favorite song and ask her to rewrite the lyrics to perform for the family. Rhythm and rhyme support fluency! (This would be a great fun activity for the whole family to do for a family talent show night or something similar).
* Encourage emails, postcards, or letters written to friends and family members.
* Record your child reading a passage and replay so that he can listen. Repeat the activity and challenge him to improve phrasing and expression.
* When YOU read aloud to your child, remember that tone and expression help convey meaning. Model conversational speed, phrasing, and intonation.
* Clip out a current news story or articles from a magazine and cut the paragraphs apart. Ask child to read the paragraphs and put them in order.
* Find an editorial and ask your child to highlight or underline facts in one color and opinions in another.

Sensory 101: Part 2

Click here for part 1.

This is more a list of situations and solutions of how to deal with solutions depending on if the child is hypersensitive or hypo-sensitive. These situations may also apply to power struggles with terrible 2's/ 3's.











SITUATION:
Waking up/ Rise & Shine
Over-Reactive child: Wakes up already overloaded. Family feels like they are walking on egg shells. Easily startles & wakes irritable, especially when startled by loud noises. May have difficulty transitioning out of bed to avoid "starting the day." Helpful equipment: gradual alarm clock rug placed on floor by bed; sun blocking blinds; time timer; visual schedule; calming background music. Helpful Strategies: Joint compressions; wall pushes; firm hug; brushing program; allow time to complete morning routine; use visual timer; quiet voice limit.
Under-Reactive child (which is part of hypo-sensitive): This child refuses to get out of bed or is extremely challenging to wake up & motivate in the morning. They are hard to wake up, often hit the snooze button several times, and can sleep through alarm. Helpful equipment: traditional alarm clock with bell or buzzer [not music]; dizzy disc/ sit & spin; therapy ball; trampoline. Helpful strategies: Alerting activities like jumping on trampoline; shower int he morning to "wake up"; leave blinds open so room is brightly lit; regulate sleep cycle; use loud upbeat music to wake up during morning routine; implement morning exercise routine.
Sensory Seeker (which is also part of hypo-sensitive): This is the family alarm clock. Helpful equipment: weighted hat; visual schedule/ chore/ activities child is allowed to do in morning. Helpful strategies: heavy work activities; chore list; joint compressions/ brushing program.

SITUATION:
Getting dressed
Over-reactive child: Refuses to get dressed and can have adverse response to getting dressed. Can go through many outfits in the morning. No clothes "feel right." Tantrums over getting dressed. Helpful Equipment: calming music CD; environmental adaptations. Helpful Strategies: let child pick out clothes; put on clear undies and socks night before so body is already used to these; may need to accept changing outfits; use bear hug vest/ lycra clothing; take them shopping with you; pick your battles.
Under-reactive child: Decreased initiation to get dressed & will often lose focus. Clothes & appearance are disheveled. Helpful Equipment: upbeat music; therapy ball/ trampoline/ sit-n-spin. Helpful strategies: Shower with towel rub to alert & get ready for dressing; dressing schedule with timer; lay out clothes night before; use massager prior to getting dressed or rub lotion on skin.
Sensory Seeker: These kids are in constant motion, making dressing a challenge as they don't stay still. May have difficulty fastening clothes because don't have precise control to manage fasteners. Disheveled appearance. Helpful Equipment: time timer; visual supports. Helpful strategies: child needs to engage in movement activity prior to getting dressed; clothes picked out night before & let them help pick out outfit.

SITUATION:
Grooming
Over-reactive child: Adverse reactions; refuses to participate; fight/ flight response; anxiety. Helpful equipment: Soft terry face towel; natural flavored toothpaste. Helpful strategies: Use firm pressure with warm water; use toothbrush with soft bristles, no flavored toothpaste, warm water to brush teeth; wet brush with warm water and comb through hair apply pressure to head & body
Under-reactive child: Unaware of messy appearance; doesn't do thorough job of completing grooming activities. Helpful equipment: cinnamon or mint flavored toothpaste; battery operated toothbrush. Helpful Strategies: Wash face using cold water to alert/ wake up; battery powered toothbrush with mint/ cinnamon toothpaste.
Sensory seeker: Makes a mess- toothpaste/ water everywhere; distracted by moving water. Helpful equipment: time timer; grooming schedule; therapist ball. Helpful strategies: set timer and have child brush til timer sounds; use schedule to stay on task.

SITUATION:
Breakfast
Over-reactive child: refuses to eat; has meltdown over eating. Helpful equipment: weighted lap pad; chair hug; proper positioning in chair. Helpful strategies: avoid smells or place calming scent in environment; may need to eat later; eat in alternative environment away from smells of morning.
Under-reactive: may take long time to complete meal. may exhibit disinterest in breakfast, prefer same foods every day, or have trouble finishing meal. may overstuff self or not eat due to difficulty discriminating feelings of fullness or hunger. Helpful equipment: spices; therapy ball; chair hug. Helpful strategies: spice up food and use strong flavors; drink through straw.
Sensory seeker: Easily distracted by themselves, environment, and their need to move. Have difficulty staying seated during meal. Their busy is so busy that they may not even stop & realize they're hungry. Rush through a meal. Helpful Equipment: intense flavors; spices; provide crunchy & chewy food for breakfast. Helpful strategies: Sit on therapy ball; weighted utensils; weighted lap pad; bungee cord on chair; tennis balls on bottom of 2 legs of chair allow for movement during eating; quiet environment to eat to avoid distraction stimuli such as TV.

SITUATION
Car or bus ride
Over-reactive child: May get car sick; can become irritable, overloaded, hyperactive. Helpful equipment: weighted animal/ lap pad; weighted hat; fidgets; sun glasses; ear phones; doodle pro/ coloring book. Helpful strategies: sit at front of bus; car pool so there are less kids; listen to music through head phones.
Under-reactive: difficult to transition into vehicle. Helpful strategy: sit at back of bus.
Sensory seeker: gets out of seat belt & moves around; bouncing up & down; makes loud noises; touchy hands; feet up on seat or kick back of seat. Helpful equipment: weighted animal/ lap pad; weighted hat. Helpful strategies: use lap belt; keep child occupied in vehicle.

SITUATION
Bath
* Contrary to popular opinion, it's not necessary to bathe kids everyday unless there are medical or sanitary reasons to do so. Rather than bathe, use a washcloth or wet wipes (which can be kept warm in a warmer) to zap any dirty areas daily, and schedule unavoidable bath time for one or more days each week consistently.
* Use large sponge or loofah sponge and rub firmly to decrease defensiveness.
* Before bath, do resistive exercises or activities that provide deep proprioceptive input.
* Have bath water drawn before having child undress. Make transition from undressing to getting into tub as quick & smooth as possible. Keep bath temp warm & have them dress while still in bathroom.
* If child dislikes having his/her face or body washed, encourage them to do it themselves. Self-imposed touch produces less defensive reaction.
* Use fragrance-free soap, as well as sensitive skin brands.
* Use tub toys, soap paints, and bubble baths for them to play with & keep occupied.
* For showers, use a hand-held nozzle. Let child control direction & force of water. This can be especially helpful washing for kids who are afraid of a big shower.
* Use a large towel & quickly & firmly wrap child in it. Avoid exposure of wet skin to air.
* Provide deep-touch toweling to extremities, hands and feet to decrease defensiveness. If child will tolerate, provide firm massage, using lotion to avoid skin irritation.
* Some kids who dislike the bath, will go into the shower with no/ less problems.

SITUATION
Bedtime
Establish a consistent routine- I've heard suggested no tv/ computer time for 60 mins prior to bedtime. Suggested calming activities:
* Rocking/ swinging
* Dim lights, use small space. Use only for quiet time like reading or regaining composure when upset. Not for punishment or it will lose its effectiveness.
* Relaxing scents such as lavender or vanilla.
* Oral input- try fruit or jello. Or drinking something through a straw.
* Wrap snugly in blanket or towel. Ask child if they want you to press more or less firmly.
* When reading to your child, give him bear hugs.
* Warm pajamas in dryer before going to bed. This may provide neutral warmth to help body calm for sleep.
* Tell your child you'll stay with him for 10 mins and once time is up, leave room. Set a timer if it's helpful.
* Turn on calming music for child.

SITUATION
Dining out
* Choose 1 or 2 familiar restaurants to master before attempting new places
* Call ahead & order food to avoid a wait if you like
* Make sure child has something of his/ her own.
* Ask for drinks right away. Ask waiter to bring out kids' food first if it's ready before adults'.
* Ask server to bring extra napkins
* Bring objects to keep waiting kid occupied. (koosh balls, cars, etc)
* Bring weighted lap pad if helpful

SITUATION
Doctor/ Dentist visit- trip to doctor/ dentist can be stressful & traumatic experience for some kids. Here's some suggestions to decrease anxiety:
* Let your kids wear sunglasses
* Bring fidget toys to keep hands busy & entertained
* Use deep pressure or massage to calm child before appointment. Allow them to wear weighted lap pad or x-ray apron while sitting in dentist chair.
* Ask if child can bring own toothpaste from home to dentist if they're sensitive to tastes & smells.
* Create social story with child so they know what to expect or read them book about trips to doctor/ dentist.
* If orally defensive, do oral motor stimulation to "wake up" their mouth muscles & decrease sensitivity before visit.
* To diminish amount of time spent in waiting room, call ahead to see if office is on schedule or arrange to be first visit of the day.
* Warn child before any procedure. Choose words carefully to not frighten them. Like we say that shots will sting instead of hurt. We explain shots are medicine to keep them healthy.
* It may help to bring along your kid to one of your other kids' or your own doctor visits so they can see observe the environment/ equipment. We used the same tactic for blood draws too. I have to get blood draws frequently for anemia tests, so I've taken my kids in with me so they can see it's no big deal.

Sensory 101: Part 1

First entry: Sensory 101 for kids. Good stuff to know.

I want to start with there are different kinds of senses:

We know the more normal ones: hearing, taste, smell, touch, and sight... but do you know?

*The Near Senses: These are hidden senses that we're not aware and are the earliest senses built in utero. This is the foundation for all other development: proprioceptive & vestibular.

*Proprioception [aka body awareness]: The receptors are located in the muscles, tendons, ligaments, and joints. Imagine kids who don't know where they are [or their body parts are] in space. Things that help this area are deep pressure touch or heavy work.

*Vestibular [balance sense]: The receptors are located in the inner ear. It tells us about movement, gravity, and balance. It tells us the speed and direction of movement. These kids are usually sensitive to spinning.

Both the proprioceptive and vestibular sense influence how we move in our environment.

Every move we make begins with the input of sensory input info. Brain processes this info and reacts to it with motor response. If the info received is faulty, then the motor skills will be negatively affected. These motor skills are observed in kids' behavior and tells us about their sensory processing.

Some kids are considered out-of-sync. That is because their ability to modulate sensory input (in the brain), to decide automatically what to pay attention to and what to ignore, is impaired. Kids who are overly sensitive to stimuli need less input then a typical child... and kids who are under sensitive need more input then a typical child.

The Hypersensitive kid: the nervous system over reacts to sensory input
[note that not all of these characteristic may ring true, and sometimes kids have a mix hypo and hyper characteristics]
TOUCH: Avoids certain textures in clothing; rigid rituals in hygiene; picky eaters; avoids haircuts/ washing/ nails being trimmed; avoids messy activities; defensive about others touching body; may react aggressively to touch; likes seasonal clothes; avoids pets/ has exaggerated fear of pets; withdraws from groups/ peers; fussy about footwear; prefers deep hugs to light kisses; over-reactive to minor painful; experiences; very ticklish; walks on tiptoes/ avoids being barefoot.
VESTIBULAR: Insecure about movement/ anxious when feet are off the ground; fear of falling even on slightly elevated surface; avoids new positions that invert the head [like tilting head for hair washing]; holds onto walls; clumsy; dislikes playgrounds/ fear of climbing; becomes overly excited after movement activity; becomes car sick easily.
VISUAL: Avoids bright lights; watch everyone moving around the room; distracted by sights & movement of others; becomes uncomfortable or overwhelmed by moving objects or people; fatigue easily during visual activities.
AUDITORY: Over reacts to unexpected sounds; easily distracted by noise; holds hands over ears; cries about sounds in environment.
TASTE & SMELL: Rigid about foods [narrow menu]; won't try new things; gags easily at new smells/ tastes; bothered by cooking activities; uncooperative at family meals; refuses to eat hot or cold foods.

How to help Hyper-sensitive kids
*Put routine, structure, and predictability in homes. Warn/ talk about changes in schedule ahead of time when possible.
*Don't withhold sensory input. Instead limit unpredictable experiences and provide sensory opportunities in a predictable manner. The goal is to give them sensory opportunities while helping them not get overwhelmed.
*Know if kids do get overwhelmed the natural response is fight or flight. Try to figure out what triggered it.
*GRADUALLY broaden sensory processing experiences within acceptable rituals.

The Hypo-sensitive kid: the nervous system under reacts to sensory input
*TOUCH: Unaware of light touch; decreased reaction to pain; decreased awareness of messiness of hands/ face; messy clothes; touches people and objects constantly; unable to identify parts of body without first touching it; hurts other kids while playing.
*VESTIBULAR: Needs to keep moving in order to function/ difficulty staying in seat; rocks, jumps, shakes head, fidgets; thrill seeker; poor balance/ falls easily/ bumps into objects; decreased dizziness after spinning.
*PROPRIOCEPTIVE: Low muscle tone/ floppy body/ w-sits; weak grasp/ pushes hard w/ utensils to compensate; tends to slump over table; prefers to to rather than sit up during play; constantly leans body against supporting surface; fatigues easily during physical activities; problems w/ digestion & elimination; over stuffs mouth while eating.
*VISUAL: Doesn't notice details/ has problems seeing likeness & differences in pictures; difficulty tracking; decreased orientation of drawings; misjudging orientation of objects in environment; can't find materials on shelf/ in drawer; poor sense of direction; decreased use of concepts like before/after, up/ down, first/ second; academic difficulties- reversals when writing, poor legibility, lose place when reading.
*AUDITORY: Unaware of sources of sounds- looks around to locate; doesn't respond quickly when name is called; difficulty articulating when speaking; makes excessive noise with mouth or hands; reading difficulties related to auditory discrimination; weak vocabulary/ immature sentence structure; difficulty making rhymes/ singing in tune; problems responding to others' questions/ comments.
*TASTE & SMELL: Explore environment by smelling; craves sharp tastes; eats surprising variety of food; licks/ chews non-food objects.

How to help hypo-sensitive:
*Increase opportunities for meeting need by increasing amount and variety of sensory stimulation/ decreasing predictability of routine.
*Sometimes these kids will tell you what sensory information they need.

Why is Proprioceptive important? This kind of input into the joints and muscles results in increased body awareness- which is the foundation for all motor responses. Heavy work is good for all children w/ sensory issues because it helps organize sensory system. It calm hyper-sensitive responses and alert hypo-sensitive responses.

Strategies to help:
*social stories/ sensory stories or books about appropriate behavior.
*visual aids: time timers/ picture schedules
*incorporate heavy work and movement throughout the day (part 2 will be the list)
*positive behavior supports and positive associations w/ challenging situations
*honor kids' sensory needs
*structure, routine, and predictability!

**Parents remember to pay attention to your kids [be a detective]; anticipate responses as you figure out their triggers are; empathize; provide, routines, and predictability; have realistic expectations; and discipline.

Stay tuned for Sensory 101: Part 2!