Tuesday, May 26, 2009

Sensory Integration and level of arousal/alertness

Imagine you have a headache and you are exhausted, or irritated. Imagine how that would impact your ability to engage with other people. In similar ways as how you are limited by your physiology imagined, children with autism who's sensory processing is compromised find it difficult to play games or engage with people until they feel a sense of comfort and ease in their own skin. All of their energy is used to regulate their body in order to just survive their environment. Since their level of arousal/alertness is in a state of imbalance, all their energy is used specifically to regain that level of balance, which leaves them unavailable to pay attention to anything other then themselves. Because of this very reason when I play with an autistic child or any child with special needs, I am first and foremost paying attention to their level of arousal.

To be able to determine your child's level of arousal all you have to do is to observe your child's behavior. I have noticed from my experience that most children with autism display a high level of arousal. This means that they are engaging in rhythmical, predictable and repetitious activities (e.g. jumping up and down, running in a circle over an over, flapping hands, making the same sounds, rocking back and forth over and over again, lining up cars, etc.). Sometimes the activity might not look like it is repetitious but if you look closely you will begin to notice that your child has put together several activities and that he/she is repeating the same sequence over and over in a very methodical manner.

Below you will find some techniques/ activities you can do to help your child achieve a state of balance when in a high state of arousal.
*These activities are only to be done if the child is open to them. A good technique to use to help a child be more receptive to these activities is to explain what you are about to do and then model it on your self or the child's favorite toy.

1. Massage
a. Deep pressure massage on hands and feet preferably with lotion.
b. Apply firm pressure with your fingers around the jaw line, which lead to the back of the ears, as well as a firm head message if possible.
2. Snuggling in a bean bag, large pillows, sleeping bag
3. Giving firm hugs to your child
4. Finger hugs and tugs
5. Wrapping your child in a blanket
6. Putting heavy object on the child (e.g. your body, weighted blankets)
7. Encourage your child to suck on a straw (e.g. preferably a "crazy straw" it has many loops)
8. Create a corner or a small space where your child can climb, hide
9. Quiet music (white noise music, earthy drum music, chanting music)
10. Reduce lighting in the room
11. Provide a vibration pillow
12. Provide the opportunity to engage in rhythmical, predictable movement such as rocking slowly back and fort, swinging slowly back and forth, rolling slowly on the floor, pushing or pulling with resistance.

The behavior that you might notice when the child is in a low state of arousal is lots of lying on the floor without movement (be careful with making conclusions too abruptly because this might be a child who is so overly aroused that moving might be too overwhelming). It can also be that the activities the child does look very unpredictable, erratic, irhythmical (e.g. a child may suddenly smash into a wall, climb on a ladder, run, lye down, then jump).

Here are some activities you can do when your child is in a low state of arousal.

1. Turning up the lights
2. Fresh cool air
3. Fast swinging
4. Spinning
5. Drink cold/iced water
6. Sitting on an unstable surface (ball, air cushion)
7. Loud fast music
8. Startle-sudden noise
9. Visually stimulation rooms (e.g. lots of bright colors, moving objects)

Some children may fluctuate from a high to a low state of arousal. So the best thing to do is pay real close attention to your child's behavior in the present moment and then do the activity that you think might best help him organize and find a state of balance. I invite you to experiment because sometimes, especially initially, you might not be able to identify the specific state your child is in so just try something and then observe what happens. Allow your self to experiment without placing any judgment on what you are doing. There is really no recipe. We are always experimenting and staying with the present moment.

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