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Autism is something that affects different children in different ways. Some of the sensory integration issues can be quite unique while others are complaints that seem to weave a common thread for children on the spectrum. This case is about a six-year-old boy who had emergency surgery at three years old for hydrocephalus (water on the brain.) He also had febrile seizures at 13 months. At 15 to 18 months he began to experience speech regression. So the child in addition to being diagnosed with autism also cause the history of hydrocephalus and seizures. Presently his speech is limited to mostly 1 to 2 word phrases. He tends to pull the parents toward what he wants to express himself. It has been determined that his issues are more expressive and receptive. This means that he can understand more than he can say. He is in diapers.
These parents met me at a statewide conference that I spoke at over the summer. They live approximately 2 hours away. Those of you that know me, know that I am not a big fan of distance type treatments. The reason for this is that there is less quality control as more and more of the therapies and exercises are pushed off toward the home. Even parents that treat with me locally and are giving home exercises will tend to make errors in these exercises when we periodically check to see if they were being performed correctly. Fortunately, when someone is treating locally the error only continues for a few days before we catch it not weeks or months. If you understand the concept of plasticity and that we can make changes in the brain, then you understand the changes can be made both in a positive and negative fashion. These children as a group have delicate nervous systems and tend to overreact to various stimuli. So it is important to do the right stimulation at the appropriate time and in the appropriate order for that particular child. The last thing that anyone wants to do is make any of these children worse. For children that are simply doing the functional medicine approach to autism spectrum disorders, the distance treatments are something that can be done in a quality fashion. For those using functional neurology and Hemispheric Integration Therapy the issue of quality becomes more significant. Functional neurology and Hemispheric Integration Therapy also have the risk of over stimulation, as well as doing the wrong stimulation at the wrong time. Therefore, there are many aspects that can be done inappropriately.
However, this family is a great family. Two loving and hard-working parents with two loving and very supportive grandparents desiring to help this child. So I explained to them why I do not like to do a distance programs as I stated above. But I could see the concern, love and dedication that this family showed for this child. I explained to them that with a distance program, progress would probably be slower and they would have to be more patient. The fact that the risk of over stimulation is possible would cause me to give them a slightly watered-down program compared to what we would do in office. This family was disciplined and dedicated and wanted to proceed. They also had not pursued any biomedical options. So we first suggested the basics, a probiotic, a multivitamin and essential fatty acids. I explained to them some of the biomedical aspects such as leaky gut, food sensitivities and the like.
On this child’s first visit he had considerable hyperactivity, he displayed some screaming and patterns. I explained to the parents that with this type of treatment, the more that the child can do with regard to the therapy and stimulations, the more he will progress. That is to say that if we cannot get any cooperation from the child in performing certain types of activities then his progress would be limited. We can always begin with passive activities in which the child does not have to cooperate or participate much; however, even these activities still require some cooperation from the child. I demonstrated a few techniques that they should be trying at home. This was done in the office with myself and supervision. This child’s level of cooperation was not the best and to be quite honest this was going to be something difficult. However, I could see that this family had a wonderful mix of love and discipline. I thought that they would be able to find a way to get the child to perform the activities. After all, nobody knows the child as well of the family. No one knows how to motivate the child as well as the family.
The child recently presented after approximately 6 weeks of treatment. He was not hyperactive in the consultation. He did not scream throughout the entire consultation. He was fairly cooperative. The parents observed he was keeping his clothes on more. One of the child sensory issues is that he does not like to have clothes on. On his last visit, it was reported that the child allowed a family friend to hold him for over five minutes. That is the first time that this has been accomplished. His coordination is improving. His eating habits are improving. He is able to repeat words more appropriately. He is having fewer tantrums. One of the most obvious examples of this is getting a haircut. Apparently, once even approaching the barbershop, he would begin screaming and flailing. His last haircut he went fairly smoothly to the surprise of both his father and the barber. Is it the feeling of the clippers that the child does not like? Is it the sound of the clippers that the child is not like? Is there too much noise in the barbershop? We really don’t know. What we do know is that this child is making improvements with regard to his sensory integration issues and this is affecting his normal daily activities.
How far can we get with this child? Only time will tell, however, he is young, he has a great family and support group, and he is improving. Again, I repeat, the more the child can do, the better chance we have of helping him. So as he becomes more cooperative and is able to follow more instructions, this will put more tools into play that we can use to augment his progress. So, right now I am hopeful. A child getting a haircut, a small thing but a big thing. I am often asked questions such as “ when can a child begin Hemispheric Integration Therapy” or “We don’t live in Tampa can we still do H.I.T or functional medicine interventions at a distance?” I hope this gives everyone a feel for those answers.
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If you can’t eat out due to the gluten free diet, here is a restaurant review of a nice meal. Hopefully you live near one of these restaurants. http://glutenfreeislife.wordpress.com/
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Here is something I had not thought about. It is not something I do, but something someone out there might be interested in pursuing. This is an interview with a psychologist who uses hypnosis. It is very brief but for some maybe a good place to start. This seems like it might be targeted more toward adult ADDers. Here is the link http://adderworld.com/blog1/
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As usual they are not aware of Hemispheric Integration therapy but that is my job to get the word out, none the less, this is a concise intro.
http://www.mahalo.com/adhd-attention-deficit-hyperactivity-disorder
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Asperger’s Syndrome is a milder condition on the autism spectrum where the individuals are known for being highly intelligent yet have difficulty with social situations. Often as a child they are known as “Little professors” as they are smart and may show interest in scientific subjects such as dinosaurs or science fiction themes such as Star Wars. These individuals tend to be able to integrate into society fairly well as their verbal skills may be quite high and again the major deficiency relates to social interaction and social awkwardness i.e. little Johnny can’t seem to make friends. They may have difficulty with displaying appropriate sensitivity to others’ feelings. It is difficult at times for them to understand abstract concepts such as humor. Reading facial expressions and maintaining eye contact may be an issue. Usually, they show coordination difficulties and are not considered very athletic as children i.e. the goalie on the soccer team not the star forward.
This particular case relates to an adult with Asperger’s Syndrome. When someone with Asperger’s syndrome grows up they tend to be attracted to computer fields. Such was the case in this situation. The reason for this being that many times these individuals are very detail oriented and intelligent while they tend to avoid social interaction. Therefore, many computer-related jobs fit those aspects comfortably. Many computer-related jobs can be done at home on a computer without having to go to an official workplace on a daily basis. This allows them to feel accomplished at work, intellectually, while avoiding social contact with others.
The problem is that screen time, television, video games and the Internet have been shown to have negative effects on individuals that are on the autism spectrum(attention deficit disorder, attention deficit hyperactive disorder , Sensory Integration Disorders, Processing Disorders, Asperger’s Syndrome, Tourette’s syndrome , Pervasive Developmental Disorder and Autism.) This particular patient who also has attention deficit disorder relates to “being on the computer and then coming out of an almost trance like state realizing 20 hours have gone by and more than 20 tabs are open.” He also has made statements such as “now that I’m aware of the issue with screen time, I feel as if the computer screen is like kryptonite, sucking the life out of me.” In a perfect world, the best thing for this patient would be to discontinue all screen time.” The problem is he is now in his thirties and this is how he makes a living.
In a hemispheric integration model, Asperger’s Syndrome tends to be a right hemisphere deficiency. This does not mean that all Asperger’s Syndromes are a right hemisphere deficient and certainly the only way to determine this is with an appropriate functional neurological examination. In this particular case however, he did indeed have a right-sided deficiency with the basis of his issues localized to a left vestibular lesion. He in fact had played football in college. He was a running back. At first, I thought this somewhat unusual as Asperger’s patients tend not to be athletic. However, upon further questioning it was determined that the reason he was a running back was that he could not catch a ball. This then tended to fit in well with the common associations of balance issues and uncoordination with Asperger’s patients. Apparently, he was tough and determined but not the most coordinated. This was confirmed throughout the physical examination process . This was addressed with appropriate modalities relating to functional neurology and hemispheric integration therapy. These treatments were performed at the office on a regular basis during his therapy sessions.
The issue was that he had to go back home and go back to work. That meant that in this imperfect world, he would have to continue working at a job that required him to be on a computer to earn living. This was the only way he could maintain the standard of living that he was accustomed to. He may be able to make long-term changes into a field that does not require so much screen time, however in the near future that was not an option. In the hemispheric model postural muscles and proprioception are extremely important as is the side of the lesion. He did in fact work from home. This gave us a little bit more flexibility. Together we discussed what his workday was like and tried to come up with some adaptations he could make to lessen the impact of the computer screen on his condition. A treatment program at our office always involves in office treatments and what we like to term “homework” for the patient. We were able to come up with five adaptations which were helpful for him.
These were as follows:
- He was to use the mouse with his left hand.
- He was to do some core exercises for several minutes every hour as they break away from the screen.
- He was to use a standing desk.
- If he was in a sitting position he was to sit on a Swiss ball.
- He was to place the screen slightly off center to the left.
These seemingly small and insignificant changes had a considerable effect in his ability to concentrate and be productive at work as well as his overall Asperger’s condition. As always, this is an illustration of home modifications that were made on a particular case. This is not to imply that all Asperger’s Syndromes are right functional hemisphere deficiencies of left vestibular origin and should be treated and prescribed the same home modifications. These types of changes should only be done with appropriate physician supervision.
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We had our first play date at the hit autism support group in Tampa last night. We had a nice turn out and the kids interacted with each other much more than expected. The parents seemed to either play with their kids or socialize with other parents. A group of parents are going to get together and form an association of parents that are homeschooling. If you are interested, join our support group at www.hitautism.net. It was clear that most parents do not get an opportunity to get out like this. It is clearly something that is needed in this community.Thank you to all that participated. I wanted to especially Thank Planet Bounce of Lutz for supporting our group with a discounted price and their wonderful facility.
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Keeping with the education and back to school theme, here are some basic principles that should help those in need of this information
http://geniuschoice.com/topics/autism/therapy-for-adult-autism.php
