Tuesday, August 25, 2009

Falling asleep...

An Opportunity to Observe
A few weeks ago I had the pleasure of observing a HANDLE (Holistic Approach to Neuro-Development & Learning Efficiency) evaluation done by a HANDLE practitioner with Joe, one of the special children that I work with on a regular basis.

Following an in-depth observation in his natural environment (e.g. his home) and an interview with the mom, Jessica created a treatment plan that allows for the activation and integration of all the special Joe's systems (e.g. sensory systems, immune system, digestive system etc.,) to work in unison, thus significantly improving the his ability to engage with people in his environment in an empowering manner.

Prior to the evaluation, Jessica asked Joe's mom a few questions. The questions included Joe's sleeping and eating patterns over the last few weeks. Joe's mom stated that there had been no changes in his eating and sleeping patterns, saying that he consistently sleeps through the night without any difficulty.

In the Playroom, Your Child is the Boss
Following the conversation with Joe's mom, Jessica, Joe and I entered the playroom. Upon walking into the playroom Joe immediately began to climb on my back indicating that he would like to play the game that we often play during our sessions. I first introduced Jessica to him and then decided to play his favorite game in order to show Joe that he is still the boss even though there is a new person present.

After our game, Joe became very aware of Jessica's presence in the room and started looking at her more frequently. I then decided to step to the side of the room and become an observer.

In the Playroom, Actio
ns Are Words
Jessica proceeded to set up the playroom for her evaluation. The first part of the evaluation required Joe to sit down at the table and pick one toy of his liking on the table in font of him. As Joe sat down and looked at the objects in front of him, he began to stare as if he was hypnotized. His eyes looked at Jessica; however, he seemed not to notice her as if she was not even there.

As Jessica continued to slowly explain to him what she wanted him to do, he continued to stare. He then slowly slouched over on to the table in order to support his body and finally slid off the chair onto the floor.

In a few minutes both Jessica and I heard intense snoring. Joe slept for the next two hours. Our attempts to wake him were unsuccessful. Every time we gently rocked his body or sang into his ear, he pushed us away and fell right back asleep.

Since both the HANDLE approach and the autism treatment program I am trained in teach that your child's behavior is his or her language of communication, Jessica and I discussed what Joe's behavior was communicating about the way he interacts with the world.

Interpreting Actions as Communications
Based on what we both know about the different levels of "arousal" (a state of the nervous system, describing how alert the individual feels), we realized that Joe's system was asleep. His nervous system may be described as being in a state of low arousal. This means that for his brain to stay awake, alert and focused, he must be engaged in a movement activity other wise he falls asleep. He must be "on the go" all the time in order to send signals from his muscle and joints to the brain in order to know that he exists in a physical reality.

Identifying that Joe's system was in a state of low arousal is very significant since that allowed us to design a treatment plan based on his specific needs. The treatment plan is always geared towards helping Joe achieve a level of optimal arousal (getting him into the zone of optimal functioning). This is accomplished through a set of simple exercises.

Tuning Your Program to Your Child's Systems
Knowing the level of arousal of the nervous system allows you to choose appropriate exercises for your child. For Joe, we decided to pick movements that would promote alertness (waking up) integration and organization of his brain.

On the other hand, for a child whose nervous system is on high arousal, I would recommend a series of exercises that first and foremost promote calming affects on the nervous system as opposed to an alerting one.

Identifying the specific state of the nervous system of your child is one of the foundations from which you can begin helping your child to achieve a state of balance. If you would like to learn more about the different levels of arousal and how to identify your child's specific needs you may do so by using the book called How Does Your Engine Run? by Mary Sue Williams, OTR/L.

1 comment:

  1. Rita,

    I absolutely loved reading this blog and found it tremendously helpful for me.

    For years, I've always wondered why, when I'm really active (physically or mentally), I seem to be able to run forever with lots of energy and very little sleep. I also never seem to get sick.

    From time to time, people will get concerned that I don't rest enough and that I need to slow down. Every time I do that, I start to feel tired and lethargic. It seems that the more rest I get, the more tired I feel. It's at these times that my immune system also seems the weakest. I'll catch a cold or get the flu.

    Reading what you wrote makes perfect sense to me; I feel like all the pieces have come together.

    Thank you!


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