Tag Archives: autism

May I Have Your Undivided Attention? Fidget Spinners

 

Let’s just install ceiling fans in every classroom.

Ban Fidget Spinners with Bob Doman of NACDFidget spinners—what a wonderful invention—as though our children need something else to distract them. Let’s give children mini ceiling fans to carry around to help them pay attention—what a great idea! If spinning things help children concentrate, let’s just install ceiling fans in every classroom.

I have been arguing against giving kids on the Autism Spectrum fidgets for years. Do some kids on the spectrum like and want fidgets? Absolutely—they’re addicted to them. A fidget feeds their sensory addictions and helps keep them seated in their classroom chair when what is being presented quite possibly doesn’t fit them and goes on way past their auditory attention span. You attend to what you can process and if the input doesn’t fit your ability to process the information or what is being presented doesn’t match your knowledge/educational base, then you don’t pay attention to it (sadly this describes most children in most classrooms). Unfortunately, the operational definition of educational inclusion for children with developmental problems has really just come down to the kids sitting in desks and not making a fuss while surrounded by typical children. The special needs children then leave the classroom for a resource room where the instruction is hopefully more targeted and appropriate for the child. So, enter the fidget. The theory is that the fidgets help the children on the spectrum pay attention and avoid being distracted. As far as I know, there has been no good research to substantiate this, but I would suspect that if the research were directed at whether a fidget would keep a child sitting for longer periods the results would quite likely be positive. If, however, the study was testing whether the children learned more or if it helped their sensory issues, I believe the answer would be no. There has, however, been extensive research on the effects of any and all distractions while driving (paying attention) and the conclusion is that they are all bad. Try driving and watching your fidget spinner spin. You can give it another twirl if it stops and tell me if it makes you a safer driver.

One of the first things we recommend parents who have children on the spectrum do for their children who engage in visual DSAs (Debilitating Sensory Addictive behaviors), is to remove or a least not turn on any ceiling fans. As most parents with children on the spectrum with visual issues know, the kids will stare at ceiling fans endlessly if given the opportunity. None of these parents will tell you that their child is paying better attention or is more present while staring at the fan. The fan takes them away—it doesn’t help them focus or concentrate. Most visual stims or DSAs involve the child playing with and stimming with their peripheral vision. Your peripheral vision picks up movement and edges, both of which are stimulated in a negative fashion by ceiling fans, fidgets, waving fingers, staring at edges, etc. Fidget spinners not only distract with the visual aspect, but also with an audio and a tactile component—they hum and vibrate while they spin. So let’s have the child’s brain distracted with extraneous visual, auditory and tactile garbage and simultaneously help build a new addiction.

I’m sure to hear from “professionals” out there, particularly occupational therapists who just discovered that children have sensory issues, but having worked with Autistic children for fifty years and having learned how to help normalize their sensory issues, I am confident that feeding their addictions is not in their best interest in the long term. If the motivation and goal is to keep them content, in their seats and quiet at the cost of their development, then. . .

Now, enter the logic that begins with the erroneous premise that if fidgets help kids on the Spectrum pay attention, then perhaps they will help typical kids pay attention. Sadly many, if not most, children have successfully learned not to pay attention already and the last thing they need is another distraction. Parents and teachers often mistake the child looking in your general direction and apparently listening as attending. At best, we often mistake listening for paying attention. Listening is something you do when you’re watching your favorite sporting event and the game is tied with seconds to go and someone talks to you about the weather. Listening is something you do when you’re talking to someone on the phone while you’re checking your email. Ask the child who appears to be “listening” to repeat the last sentence of something you just said or read to them. When we talk about learning we are talking about changing the brain and to change the brain we need to put in specific appropriate input with sufficient frequency, intensity and duration. Of the three components, intensity is the most important. Intensity means focus and focus means that I have your undivided attention. We need to help teach children to focus and give undivided attention, otherwise parents and teachers are largely talking to themselves.

If we want to be proactive and improve focus and attention, we need to do a better job of targeting the input to fit the child. Teaching algebra to a child who still is struggling with basic math isn’t going to work. Speaking in paragraphs to a child who has difficulty following a two- or three-step direction doesn’t work. Making many children sit in a chair and attend for more than ten minutes without letting them get up and move around a bit generally doesn’t work either. We need to pay attention to the individual and teach to their knowledge level so they have some context within which to associate the information. We need to be aware of the child’s processing ability (short –term and working memory) and target the structure of the input to fit them. We need to provide educational environments as free of extraneous distractions as possible—not contribute to them—and we need to focus upon the neurodevelopmental foundation and help build the child’s ability to learn, communicate and function.

Many children across the county are learning not to attend, not be present and sadly are learning that learning itself isn’t fun, isn’t exciting and that it doesn’t work for them.

Ban Fidget Spinners!

—Bob

April is Autism Awareness Month

NACD Autism Awareness MonthIt’s Autism Awareness Month, so let’s talk about ASD (Autism Spectrum Disorder) and awareness.

They say you are what you eat. They should also say you are what you attend to and can process. What you perceive, the quality of what goes into your brain through your sensory channels, what you pay attention to and how much of it you can process essentially determines what and how much you learn. In turn, it determines how you can think, what you know, how you develop and ultimately your quality of life.

One way to gauge the level or degree of involvement of those on the autism spectrum is to look at what they give their attention to, their overall level of awareness and the degree to which they are present and engaged. As we look at individuals with sensory issues, which is generally how we refer to those on the spectrum internally at NACD, we start with observation and understanding that individual for the purpose of providing strategies to improve specific and global function.

We can observe virtually any child, watch what they are paying attention to and see how much they are attending to what is happening around them. This gives us a fair sense of what and how much they are learning and developing and what issues need to be addressed. Everyone essentially attends to what is meaningful to us and ignores what isn’t. We can observe any number of children who are on the autism spectrum or who have developmental delays, look at their behavior and develop insight as to their needs. For example, if there is a child staring at a ceiling fan rotating over and over, or a child who is in the corner waving their hands in front of their face and making repetitious sounds, or a child sitting quietly sucking on and smelling their fingers, or a child who is pacing around the room, relatively oblivious to anyone or anything going on in the room, then we know we have children who are essentially not present, not learning and not developing. We could also observe other children who are trying to get our attention, or are going around the room investigating and getting into things, looking at this and that, touching or banging things, knocking things over—children who are much more present and are learning and developing at a much higher rate. The varying degrees of a child’s involvement and of being present is essentially a representation of their level of severity and where they are on the spectrum.

The first group of children are not only not learning, they are engaging in behaviors that are making them more and more isolated, further delaying the normal development of their sensory channels and teaching their brains to ignore more and more of what is in their world. For their brains, the meaningless is meaningful and significant to their brains, while what should be meaningful is essentially meaningless. The exploring child is looking for meaning, for significance and that child’s brain will continue to do this with every new opportunity. The degree to which any child is inquisitive, attending to the right things (be it making eye contact because they know there is something to learn from observing your face and listening to your words, or looking at the people and things in their environment and interacting with that environment), the more present they are, the better and higher their level of function, the more and faster they are learning and developing.

Neuroplasticity, that thing which permits the brain to change and develop, occurs through input. It does not simply develop because we are getting older. The quality and quantity of the input the child’s brain receives determines not only how rapidly the child develops, but also how they develop. Good input generates good change and development, while bad input produces negative changes to the brain and impairs development.

Awareness, being present, is that which determines the direction and rate of development. For any child with a developmental delay, normalizing sensory function, redirecting them when they are “stimming” or engaging in DSAs (Debilitating Sensory Addictions or sensory addictive behaviors) and providing them with as much specific, appropriate, targeted input as possible is the formula that can produce the desired results and foster development. Positive neuroplasticity occurs when we provide the child with specific, targeted input that is delivered with sufficient frequency, intensity and duration.

For those children on the lower end of the spectrum, intensive neurodevelopmental intervention is needed to help bring their developmental pieces together. For any child with lesser issues or with a developmental delay who cannot process information or coordinate movements well enough to play independently, they are at risk of getting too good at infantile sensory play, getting developmentally stuck and need intervention to rapidly develop their sensory function and processing. Every child needs attention. Every child needs specific appropriate input and opportunities to maximize their potential. As parents, educators and those assuming various roles in helping children become all they can be, we need to perceive every child as having unlimited potential and do all we can do to provide them with opportunities commensurate with that perception.

All parents should be aware of what your child is and isn’t attending to. Pay attention to how present they are and be proactive. Bring them into this world or they will go into their own. If they have a problem, don’t perceive it as a disease, let alone an incurable disease, perceive it for what it is—one of many developmental steps that you need to help them achieve on their way to achieving their unique potential.

—Bob Doman

 

 

 

 

 

 

Autism Awareness Month – Should we really be using a disease model?

Bob Doman Autism Spectrum Disorder Disease Model NACDI am opposed to labels in general and “autism” is no exception. I am also generally opposed to looking at most developmental issues as diseases and again “autism” is no exception. The label and perception of autism as a disease leads to the perception that there is or that there needs to be a cure, that there is a pharmaceutical cure—a magic pill. I have also believed, having dedicated my life to understanding how to help all people achieve their innate potentials, that our strength as a species lies in our uniqueness as individuals—in our diversity. Every child has developmental needs and the better job we do at addressing those needs, the better job we have done at helping them achieve their unique potential. With those on the spectrum, our job is not to cure, nor to merely teach them skills that we feel are commensurate with the limited potential associated with their “disease”, but to assist in the developmental process. As with all children, we need to assist in developing their sensory function, their processing ability and as much as possible provide an individualized education in a positive, supportive, “typical” environment while simultaneously celebrating their uniqueness and ability to contribute to society. I have been very privileged over the course of five decades of work with Autism Spectrum Disorder (ASD) to have assisted thousands of individuals ascend through levels of the spectrum to become happy, successful “disease-free” members of society. Our job, our role for those on the spectrum and for that matter all children, is to understand and assist them in their ascension to a full and happy life.

Eye Contact

autism_articleI just passed a billboard on the freeway that had a picture of a child and said something like (I was perhaps traveling a little fast and only caught the sign out of the corner of my eye): “Avoiding making eye contact is a sign of autism.” Really!

A child not making eye contact might be a sign that they have a visual problem, are lying, or anxious, or insecure, or even doing something terrible like visualizing and thinking. Is it true that many autistic children make poor eye contact? Yes. But do they “avoid” eye contact? No. “Avoid” implies that the child is consciously not doing something, like connecting to you. This perception harkens back to the old psychiatric perception of autism and links to the old refrigerator mother nonsense.

Autistic children who have not yet developed good central vision, and who more often than not function largely with their peripheral vision, do not make good eye contact simply because they can’t; and if you try and force many of them to look at your face, you are in fact making it very difficult for them to see you.

I hope parents of autistic children can avoid those professionals who feel that their children choose to avoid making eye contact with them.

Is Anyone Listening? Sensory/Motor Treatment for Autism

autismIn a scientific article published in Behavioral Neuroscience, May 2013, researchers at the University of California Irvine found that environmental sensory and motor enrichment serves as an effective treatment for autism. This may be the first “official” study demonstrating that sensory/motor treatment can effect change in autistic children. (I actually applied for a government grant back in 1974 to research a significantly more comprehensive developmental-sensory/motor program. It was rejected by the government because there wasn’t any research that would show that it worked—which would have been the point of the study–but the reality is that academic institutions get the funds, not the people who are out there actually making the discoveries.) Sadly, most people in the field still don’t get it. Where would we be without such open-minded people who are in possession of such wisdom? We have since been able to compare literally thousands of children within the spectrum based on the treatments they received prior to NACD’s Targeted Developmental Intervention and with TDI, using the children as their own controls. We have been fine-tuning what works for over forty years and helping these children not only progress faster, but in some cases lose those dysfunctions and behaviors that define autism.

The UCI study found that providing sensory and motor input, even if not individualized to a child’s specific sensory or motor issues, leads to much better overall results than the standard treatment alone. The standard treatment included ABA (applied behavioral analysis), traditional speech therapy, occupational therapy, and social skills therapy. The researchers divided 28 autistic boys, ages 3 to 12, into two groups based on matching ages and severity of autism. The control group underwent standard therapy, and the treatment group received standard therapy along with “directed environmental enrichment.” The directed environmental enrichment included a kit of different objects that were “sensory,” but which they felt addressed common sensory-motor issues for autistic children. The kit contained essential oil fragrances for smell, squares of materials such as sandpaper and felt for touch, pieces of multi-textured materials to walk on, and items to manipulate such as a piggy bank with plastic coins for motor issues. The parents were also directed to do different exercises, such as dip their child’s hand or foot in bowls of water at varying temperatures of hot and cold, or touch the child with metal spoons that had been heated or chilled. The treatment group was directed to do two 15-30 minute sessions twice per day, with each session consisting of a few activities involving different combinations of the sensory stimulation objects and exercises. The children also listened to classical music once a day.

After six months, 69% of the parents of the treatment group children reported improvements in overall autism symptoms, compared to only 31% in the control group. Furthermore, 42% of the children in the treatment group made significant progress in social behaviors and responsiveness, compared to only 7% of the control group. The children in the treatment group also improved perception, reasoning, and other aspects of cognitive function, whereas the control group of children undergoing today’s standard treatment for autism actually had a measured decrease in cognitive function!

I actually find the results pleasantly surprising. As most of our families would testify, the amount of intervention was incredibly minimal and the intervention was neither targeted nor individualized. As we continue to learn, the more specific we can be in understanding the individual and applying very specific targeted treatment, the more effective we can be. Children with the same label can be incredibly dissimilar. I appreciate the UCI team’s work and their acknowledgement of the role of sensory/motor treatment in those within the autism spectrum and for bring this information forward. One would hope that practitioners would not now view this study and adopt the treatment regime used in this study as a model for a basis of treatment, but would open their eyes to the potential and join us in building the understanding and developing really individualized targeted programs and, based on that knowledge, to help in the development of more and better tools. Having worked with the sensory/motor issues related to autism since the late sixties, and having put information out for the public’s use for over forty years, I would hope and think that more people would be listening. This isn’t new information! It never ceases to amaze me that of the thousands of therapists and educators who view firsthand the children that work with NACD and the difference that Targeted Developmental Intervention makes, that only a handful ever want to understand what produced that change. But it only takes a few dedicated free thinkers to get involved, to help us reach a critical mass, produce a tipping point, and change perspectives and lives. I am happy to speak with or assist any researcher, therapist, physician, or educator who would like to learn more about what we have been doing for all these years and what we have found that works. After so many thousands of children from around the world and so many years of striving to understand and treat these issues better, we have actually learned a thing or two. And, as always, we are looking to help any parent who wishes to help their child.

Related Links

Original Article (PDF): Environmental Enrichment as an Effective Treatment for Autism: A Randomized Controlled Trial – Cynthia C. Woo and Michael Leon – U.C. Irvine – Behavioral Neuroscience May 2013

To learn more about NACD’s Targeted Developmental Intervention:
http://www.nacd.org/get_started/what_is_nacd.php

To learn more about NACD’s approach to treatment for autism:
http://www.nacd.org/labels/autism.php