Friday, 13 July 2012

Autism and Vestibular Issues

Thought I would address this issue for multiple, it is a very active problem for both of our boys, and two, because I am pretty sure that it is something that the population in general does not understand about kids on the spectrum.  Vestibular issues in autism include both hypo and hypersensitivity.  A perfect example of hypersensitivity is Jack.  A perfect example of hyposensitivity is Nathan.  This is one of the main issues they work on in OT. All of Jack's gross motor delays (for which md's had recommended PT) have turned out to be more sensory related than due to physical inability.  See below:

Vestibular System: The vestibular system refers to structures within the inner ear (the semi-circular canals) that detect movement and changes in the position of the head. For example, the vestibular system tells you when your head is upright or tilted (even with your eyes closed). Dysfunction within this system may manifest itself in two different ways. Some children may be hypersensitive to vestibular stimulation and have fearful reactions to ordinary movement activities (e.g., swings, slides, ramps, inclines). They may also have trouble learning to climb or descend stairs or hills; and they may be apprehensive walking or crawling on uneven or unstable surfaces. As a result, they seem fearful in space. In general, these children appear clumsy. On the other extreme, the child may actively seek very intense sensory experiences such as excessive body whirling, jumping, and/or spinning. This type of child demonstrates signs of a hypo-reactive vestibular system; that is, they are trying continuously to sti mulate their vestibular systems.

So Jack has loved to WATCH things spinning since infanthood....blades of grass, propellers, pinwheels, fans, you name it.  But spinning HIM?  Yeah, no.  He likes to spin slowly, but as the speed picks up he goes into a complete panic, although this has improved significantly with his OT.  Back and forth swinging has been, for the most, part fine.  He wouldn't go on slides independently for a LONG time, he still takes the stairs two feet at a time, he is very very hesitant about trying new activities.  His sensory issues have affected his desire to color, use playdoh, cut with scissors- and this in turn has caused hand weakness because he has resisted doing what most kids his age do to increase this strength.  This is something else he works on in OT.  He definitely has an impaired sense of his place in space....falls out of his chair frequently, drops his cup multiple times at every meal (thank god for sippy cups), trips all the time, and will not ride a bike unless we "buckle his seat belt", as this makes him feel more secure.  So these are things we are working on.

Yesterday our day care provider was sick, so John and I took shifts...he took the morning, and worked the afternoon and vice versa.  I got to take the boys to the playground, which really is an OT experience for both of them.  I chose to take them to a playground that has tire swings because this is a really good way to stimulate the vestibular system (and yes, I do choose activities based on that).  He loves the tire swing, but cries every time he starts using it, until his little system can regulate a bit more.  It went pretty quickly yesterday and he tolerated amazing amounts of "unruly", side to side and spinning movement.  It was so neat to see.  Almost all kids on the spectrum LOVE to swing.  Both of my boys have always been those kids who can sit in the swing the entire time they are at the playground.  It is soothing, and gives both of them input that they crave.  I guess you can think of it as a more highly evolved way of "rocking" (if you think of this "typical" characteristic of autism).I have to bargain with Jack to get him to climb, or try monkey bars, or go down the slide.

So after this experience, I decided we were going to be brave.  Last night Jack and I met some friends at the local carnival.  I went knowing that he might refuse to go on any rides, and that all of the stimulation could cause a meltdown.  And he definitely had some moments, especially when we first got noisy, so many lights, so many different places to look.  This is why I made sure we went in a one-on-one situation.  I was able to get him to focus on one thing at a time, and for the most part it worked.  Except with the dragon ride....

He did find several rides that had propellers on them- spinning bears with propeller hats, helicopters, and he was up for these as long as mommy went with him.  And he even did a few little car rides by himself.  He cried at the beginning of most of the first rides, but calmed down and even enjoyed it after awhile.  If you look at the picture below to the right you will see that he found an "excellent" piece of grass on our walk to the carnival grounds- great propeller shape.  He carried it everywhere, totally brought back memories!

On our way out, he freaked for a Diego doll (deluxe blow-up of course) and I caved.  Hey, it wasn't a plane or a sea creature, so I'm gonna encourage it!  When we got home, he wanted to give Diego a snack and then brush his teeth.  Went in about 10 minutes later and found him like this!  So sweet....

This morning while eating his daily peach, he lost his first tooth!  And that was the first one to come in too!  Getting so big!

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