An Under-Served Population - amtamassage.org · An under-served population . ... – Unusual and/or repetitive use of language ... tone of voice, facial expressions) – Lack of empathy

Bodywork for ASD An Under-Served Population

Bodywork for Autism Spectrum Disorders

An under-served population

www.comingthroughthefog.com

An autism recovery story

WHAT IS AUTISM?

• Neurobiological developmental disorder

• WHAT ARE AUTISM SPECTRUM DISORDERS?

• Autism* Tourette/Rhett Syndrome • *Pervasive Developmental Disorder (PDD)*Asperger’s(AS)

• *ADD/ADHD

AUTISM CHECKLIST General

◦ Repetitive behaviors ◦ Obsessive interest in certain things ◦ Avoidance of eye contact with people ◦ Repetitive rocking, twirling, etc.

As a baby ◦ Unresponsive to people ◦ Tendency to focus on one item for a long period of time ◦ Low sensitivity to pain ◦ High sensitivity to sound, touch, etc. ◦ Resistance to being touched (especially to being hugged)

As an infant ◦ Slow start to speaking ◦ Refers to themselves by name vs. “me” or “I”

AUTISM CHECKLIST • By one year old

– Not responding to their name – Lack of happy expressions – Lack of babbling – Problems establishing eye contact – Staring for a long time at items which aren’t moving

AUTISM CHECKLIST • As a child

– Difficulty making friends – Difficulty starting or carrying on conversations – Lack of imaginative play – Unusual and/or repetitive use of language – Difficulties with social interactions – Difficulties with communication (verbal and non-verbal) – Desire to adhere to certain routines – Failure to respond to their name – Difficulties determining what others think or feel – Difficulties interpreting social cues (e.g., tone of voice, facial expressions) – Lack of empathy – Self-abusive actions (biting, head-banging) – Difficulties playing with other children – Often speaks about the same topics over and over again

Signs of Autism in Puberty

• Regression of skills and or behaviors • Onset of puberty • Increased demands on the sensory system • The hidden curriculum

Associated Medical Conditions

• Seizure Disorder • Sleep dysfunction • Gastrointestinal issues • PICA (eating things that are not food) • SPD

DIAGNOSIS

What is Sensory Processing Disorder?

–Takes in information

– Integrates and filters information

– Processes the information

What is Sensory Integration?

–Disorder occurs when the information is misprocessed, leaving the body misinformed

SPD, (Sensory Processing Disorder)

SMD – Sensory Modulation Disorder

SDD – Sensory Discrimination Disorder

SBMD – Sensory Based Motor Disorder

The Eight Senses

Vestibular System – State of balance

Function • Input from body movement

• “ties us to the ground”

Malfunction • over-registers, under-registers or a combination of both

Proprioceptive System – Body awareness

Function • Location and space

Malfunction • Results in limits in motor skills

Tactile System – Sense of touch

Function • Responsible for exploration,

learning and discrimination

• Defense from harm

Malfunction • High tolerance for pain

• Sensory-seekers, craving

deep pressure

Auditory System – Auditory

Function • Interprets speech

• Sounds of the environment

Malfunction • “Superhearing”

Visual System – Sense of sight

Function • Visual stimuli

Malfunction • Hyperfocus on objects like T.V.

• Others, craving more stimulation,

will stare for hours at an object

Olfactory System – Sense of smell

Function • Interprets the envirnoment by

smell, alerting the body of

harmful odors

Malfunction • “Picky eaters”

Gustatory System – Sense of taste

Function • Interprets food by taste

Malfunction • Creates eating difficulties

Interoception

• The sense of internal organ function

• The sense responsible for detecting internal regulation responses such as respiration, hunger, heart rate, and the need for digestive elimination.

Projected trial artwork reprinted with permission from Sue V. Kratz, OTR, BCP, Special Therapies, Inc.

Creating a Sensory Environment

Ask the right questions – The Health Intake Form What triggers the child? What calms the child? Frontloading Tool to diffuse a meltdown

Creating a Sensory Environment Additional Strategies

• Organize predictable environment • Simple rule, clearly defined • Observe child and note what triggers, what

calms • Note how long they can sustain during

treatment

Creating a Sensory Environment Visual Clues and Reminders

FRONTLOADING

Children with autism don’t like change Transitions are problematic

FRONTLOADING is: Give advance notice for changes in routine,

personnel, or environment

Shutdown

• Build up the child that is shutting down • Play classical music • Smell lemon wedges • Peppermint essential oil • Play “Head, Shoulders, Knee’s and Toes” game

How To Diffuse a Meltdown

• Remove demands, lower stimulation • Slow down and lower your voice • If possible move child to safe area • If child allows touch and is receptive, calm

with deep pressure or rhythmic patterns • If not, back off and give child ample space to

rebound

HIDDEN CURRICULUM

• Precautions for massage and bodywork techniques

General Applications for Body Work

• Can’t endure sitting or standing for long periods

• Figure out how long the child can sustain • Allow for breaks in session • Variety of working areas • Remember they are literal people • Front load – prior, during and after session • Auditory listening

Applications for Autism

Upledger - CST Reiki – energy work Visceral Manipulation Manual Lymphatic Drainage Swedish Massage Deep Tissue/NMT/TrP

Upledger CranioSacral Therapy

• Improves sensory motor and mental dysfunction

• Increased membrane movement and the subsequent enhanced fluid motion is a primary focus of CST

• Craniosacral technique uses the bones of the skull to make corrections to the structures below

• Improves brain function

REIKI

• Reiki is a form of energy healing that centers on the manipulation of “ki”, the Japanese version of “chi”.

• “Rei” mean spirit in Japanese, so Reiki literally means Spirit Life Force.

• Children with autism can have tactile issues. • How do you facilitate therapy on a child who

can’t be touched?

Visceral Manipulation

• It assists functional and structural imbalances throughout the body

• It evaluates and treats the dynamics of motion and suspension in relation to organs, membranes, fascia, and ligaments.

It increases proprioceptive communication within the body. • Sensory differences in vestibular and proprioception common

for ASD • GIT issues and associated fascia restrictions common for ASD

Manual Lymphatic Drainage

• A hands on method of lymphatic drainage

• A little bit goes a long way • Make sure you can feel the fluid movement, if not refer to

someone with more training • First session open the subclavian, note post Treatment signs • Many will have difficult post treatment response. • Most have poor circulatory systems -

Swedish Massage /Bodywork

• Many OT supports similar to bodywork

techniques • Many massage tools look exactly like sensory

tools • Touch therapy is known to reduce behaviors in

children on the spectrum • Heightened state of sympathetic response,

bodywork stimulates parasympathetic

Deep Tissue, Rolfing, Neuromuscular and Triggerpoint

• “Warning Hidden Curriculum”

• When, and is it appropriate to use these techniques

• Established trust relationship

• Other less evasive techniques have not been successful

• Caution – literal thinkers

Creating a Sensory Environment

Weighted blanket or weighted stuffed animal

Creating a Sensory Environment

Interactive Hands On Exercises

• Energy/energy exchange • Tactile response • Sensory overload activity

BRAIN ANATOMY • Neurotypical Brain vs. The Autistic Brain

• Cosmosmagazine.com

BRAIN ANATOMY

medicaldaily.com

BRAIN ANATOMY

Case studies Results in my office

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Tami A. Goldstein, WLMT, CST

Available for CranioSacral Therapy, Continuing Education Courses, Speaking and Advocacy services.

[email protected]

(608) 931-9488