Therapists, What Are You Doing???

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Recently saw a young boy in our clinic with Autism. Almost turning 7 years of age. Has had therapies for years…and yet here is what I saw on our first encounter:

No eye contact. Did not respond much to his name being called. Non-verbal. Lots of attention span problems. Lots of self-stimulation including putting fingers in mouth, shaking his head, some arm flapping.

Increased stiffness in proximal / core muscles. Tip toe walking. Center of balance shifted forward with some high guarding of arms. Assistance to step up 5 to 6 inches high.

Unable to put basic shapes into shape sorter or put objects into container without help. A child lost in his surroundings.

I provided the following:

1. Assisted him into a swing and provided forward-back; side-side; rotation movements for 5 minutes. He initially resisted the different motions but was able to tolerate for 2 minutes on each movement. Immediately, smiles came out and more eye contact with the therapist was seen.

2. Assisted him off the swing with less assistance already and was able to get up to a treadmill with less help. Tolerated a 5 minute walk but with trunk bent forward by almost 60 degrees while holding onto rails.

3. Provided Functional Movement Training consisting of: (a) Rolling with max assist; (b) Crawling on hands and knees with max assist; (c) Walking on knees with max assist; (d) Bear walking even with max assist was hard so had to settle for wheelbarrow with more than 5 stops to go 15 feet forward; (e) Jump with moderate assistance and had to demo the jump.

4. Provided scooter board work: Pulling himself forward with max assist initially but was able to learn the motion and did it with minimal assist on the latter 2/3 of the course.

5. Provided gentle rocking exercises ( vertical and rolling motions ) as well as joint compression.

6. Provided barrel rolling.

7. Provided manipulatives while doing FMT. Needed max assist to grip since he liked to throw them.

Results:

Good eye contact with less stimming as evidenced by shirt collar being dry, (it was wet at start of session as he kept putting it in his mouth). Began to show more emotions in his face. More engaged with the environment. Increased willingness to explore. Muscle tone normalized. Not stiff anymore. Minimal to no tip toe. Increased weight-bearing on heels. Center of balance shifted backwards. Better trunk posture. Less head shaking and arm flapping. Increased learning in later parts of session.

By second session:

Provided almost same therapy activities to help set up a routine. This was when he blew me away:

1. Muscle tone continued to be near normal. No stiffness. Better posture and movements.

2. Almost climbed up the swing by himself. Approximated signing more for spinning. Laughed with spinning motions.

3. Very little assist to climb up the treadmill. Held on to treadmill by himself and walked with almost a straight trunk posture. Used bigger steps. Finished 5 minutes.

4. Rolled with mod assist; Crawled 2x by 15 feet on his own; Walked on knees with minimal assist; Bear walked on his own 1x 15 feet; Jumped with just verbal cues and holding hands.

5. Able to put circle in shape sorter with no help. Threw a shape out of 10 tries.

6. Able to follow cues and directions better. Pushed a barrel with a 10 pound medicine ball inside for 15 feet x 3 times without being distracted.

1 to 2 sessions was all it took to create a big change in this kid’s life. His mother pointed out a lot of things that he did for the “first” time or saw things that she thought her kid won’t be able to do. As ego building those words may sound. I am again reminded of my therapy pet peeves.

My therapy pet peeves again….

1. Why is this mother seeing this changes for the first time in her 7-year-old child with Autism, who supposed to have “lots” of therapies before???

2. Children with autism usually have great potentials if you just work on what they need, especially their sensory needs, Why would you not work on them???

3. Why would you not give them a benefit of the doubt on what they understand? Being unable to speak does not necessarily mean “dumb”.

4. Why would you not give them time to process??? Kids with autism have to fight their own brains to react to their environment in an appropriate manner.

5. Why would you even think that they are being “bad” and defiant??? They are only acting on what their bodies are trying to inappropriately tell them.

The list goes on..nothing irritates me more than other colleagues that are not willing to understand this condition called Autism and not willing to arm themselves with the tools to help these kids that are only asking for your help.

So, please, start today. Educate yourself and let us create opportunities to unleash these kids’ potentials.

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