References & Links
For the last few years, we have been aware that, while Intensive Interaction is extremely successful when practised with some children and adults on the spectrum, there are other individuals, whose attention it is difficult to engage. For example, it is counterproductive to work with a child who has visual hypersensitivity if you are wearing a jazzy Tshirt, which triggers visual processing difficulties. Spurred on by the new diagnostic tool, DSM 5, which includes sensory deficits in its criteria for autism, we have been combining Intensive Interaction with paying Attention to Sensory Deficits, addressing the hypo and hypersensitivities that were triggering behavioural distress. We encourage practitioners to be on the lookout for visual, auditory, proprioceptive and emotional hypersensitivity problems and to take steps to meet the distress they are triggering.
For example, a child may be sensitive to bright light, certain colours or patterns. These cause distortions that make incoming visual information difficult to process, which may not only affect vision but also mood, balance and even sleep disturbance. (Not all sleep problems are likely to relate to visual processing). Irlen Syndrome as it is known, can be painful. It can be alleviated by using tinted lenses or coloured lighting, cutting out the frequency that is triggering distress.. Similarly, Auditory processing difficulties, (certain frequencies, loud noises, overlapping speech, even dogs barking), can be addressed by using Acoustic Noise Reduction Headphones (not the same as ear-muffs). Proprioceptive processing problems (indicated by jumping, running, banging self, climbing) can be helped by increasing physical input. Particularly helpful is a trampoline. Input needs to be regular, 3 or 4 times a day.
Each child has different sensitivities, depending where the nerves in the brain are failing to link up in the usual fashion during development.
In order to reduce overloading the processing system and consequent sensory chaos, we need to scale down those inputs to which the individual's brain is hyper (over)sensitive and increase those to which it is hypo(under)sensitive, as well as communicating through non-verbal signals that the brain can easily recognise. Stress levels are reduced and the brain starts to function more effectively. Although not every child will be able to respond positively, it is always worth exploring these options. We cannot assess how able a child is until we have addressed their sensory processing problems.
Responsive Communication gives voice to the success of combining the use of body language to communicate with attention to sensory deficits.
If the individual screws up their eyes in bright light, shows preference or dislike for certain colours, reacts badly to, or fixates on bold patterns they almost certainly have Scotopic sensitivity or Irlen syndrome. Wear plain muted block colours. Paint walls calm colours. Do not clutter walls with pictures/ornaments. Explore use of Coloured light bulbs, Dimmer switches, Peaked caps, Grey Sunglasses (where the problem is caused by intensity of light rather than colour or pattern.)
Many children on the spectrum have problems with sound - loud sound, particular sounds, sudden sounds, certain frequencies in certain voices, complex sounds (especially overlapping speech.) Where speech is used, speak quietly. For many it helps to support speech with simple gesture. Designed for helicopter pilots so they can hear each other over the engine noise, BOSE Quiet Comfort 15 Acoustic Noise Reduction Headphones (Amazon) cut down on distant sound while allowing close up conversation. They can be very effective helping children to cope and attend in noisy environments such as school, mealtimes, supermarkets, etc.
Balance, Boundary and Proprioceptive Distortions
A common problem is under-sensitivity to messages from the body's muscles and joints to the brain telling it what the body is doing. In an effort to overcome this, children and adults will give themselves strong physical inputs (rocking, jumping, bouncing, climbing, hitting themselves) so that at least they have some idea of what they are doing. We can help by also giving strong physical inputs. Explore use of: Trampoline, Pogo Stick, Swing, Space Hopper, Climbing frame, Wall or Bars, Ridged Insoles, Astroturf, Weights, Weighted clothes, Carrying rucksack or shopping bags with books or drink cans in them, Weighted blankets, Compression vests/stockings, SQUEASE vest, Vibration and firm Massage, Manual pressure. (Inputs need to be frequent, topping up with short sessions several times a day to make any real difference.) Boundary Problems are allied to Proprioceptive difficulties, the person finds it hard to know where they stop and the outside world starts. They may tap objects to communicate. Tap back.
Recent and Upcoming Work
The text of this page is available for modification and reuse under the terms of the Creative Commons Attribution-Sharealike 3.0 Unported Licenseand the GNU Free Documentation License (unversioned, with no invariant sections, front-cover texts, or back-cover texts).