Autism and Therapy

Autism and Therapy

What is autism? WHY IS IT SO HARD TO DEFINE? Does autism come from the Brain, the Mind or the Body? -The terms Brain and Mind are sometimes used interchangeably -Sometimes people forget that Body is attached to the Brain and therefore Mind -Some believe it is a disorder (stemming from genetic or birth defect), -Some believe it is a disease (stemming from environmental or viral causes).

-Some believe it is simply a difference (a natural, normal variant in humans) -Additionally, autism is a spectrum, impacting individuals to different degrees Symptoms of autism Social-interaction difficulties Communication challenges Repetitive behaviors Anxiety Irritability

Focus and attention issues Control issues Lack Theory of Mind Self stimulatory behavior Gut issues So what is autism? Autism is all of the above.

Autism involves the body, brain and minds of individual people. Sometimes there are clear genetic tendencies, and sometimes there are clear environmental causes, and sometimes all of us can be somewhat on the spectrum. The symptoms we see in those with an autism diagnosis can be obstacles for a good quality of life. What does this mean therapeutically?

Therapy is treatment intended to relieve or heal a disorder. As a therapist (or parent), you are in a position to make decisions about how you intend to relieve (compensate) or heal (remediate) autism. Many therapists and settings are focused on compensation of symptoms (ex. Social skills, structured teaching, shaping, modifying and extinguishing behavior) Pathways Treatment Center focusses on remediation Remediation of autism Remediation is the correction of something that is not functioning correctly

What does remediation of autism mean? Organization of the body, brain and mind. Is remediation an option for autism? Yes. It requires a lot of work. Is remediation measurable? Not easily. Is it quick? No and requires that the parents are highly involved, motivated and supported. Is it worth it? Absolutely What do we know about brains of people with autism? Brains of people who have autism have some important anatomical and functional differences

from brains of people who do not have that diagnosis. There is an increasing body of research being done into these differences. There is not a specific area of the brain that is not working but the synchronicity and connectivity of neural pathways are different. What do we know about minds of people with autism? -confusion

-difficulty focusing -overwhelmed -disconnected -stuck in thought -afraid of change -misunderstanding - chaotic Philosophy

Minds are the activity of the brain Minds develop via experiences and relationships The wiring of your brain can change your mind Your mind can change the physiology of your brain Your experiences and relationships happen with your body Your mind develops via experiences and relationships Its all connected Neuro Plasticity

the capacity of the brain to create new neural connections and grow new neural connections in response to thoughts (mind), experiences and relationships This capacity of the brain continues throughout a lifespan Some of my Therapy Heroes Dr. Svelana Masgutova

Dr. Steven Gutstein Dr. Daniel Siegel Dr. Siegels Hand model Consider how information comes into the body Sensory information enters the body and is transmitted via sensory nerves to the central

nervous system Early in development specific motor patterns occur in reaction to the sensory input and are called Primitive Reflexes As the baby grows and develops these Primitive Reflexes integrate into the brain and serve as basis for many necessary functions of the brain. Primitive Reflexes Reflex: A muscle reaction that happens automatically in response to a certain type of

sensory stimulation Neuro-sensory-motor reflex circuits Automatic, unconscious, and constant guaranteeing stability for the nervous system in stress and distress Mediated by the BRAINSTEM and CEREBELLUM The movements are innate, not volitional and are expressed by every individual Emerging as early as 11-12wks gestation.

Emergence, Activation, maturation, and integration. The Purpose of Reflex Patterns Survival and protection/ genetically encoded system programed to spur on development Fundamental neurological building blocks for all learned movement and skills Crucial for development of the brain and many cognitive and intellectual processes Protection, survival, growth and development

Vygotsky The first infant movements do not disappear, they continue to work in union with higher nervous formations In other words, primitive reflexes do not become inhibited, they integrate. The integration is very important for development of the brain and therefore the mind. What if the reflexes do not

integrate? Physical, emotional and cognitive functioning will likely be impacted. People with labels such as: Autism, Dyslexia, ADHD, LD, apraxia, Aspergers, Downs Syndrome, sensory processing disorder, and speech and language disorder are very likely to have nonintegrated reflexes Integration of Primitive Reflexes Serves as a way to organize and stabilize what is occurring in the brainstem and lower limbic system

Establishes positive protection so that the brain can develop and mature The Reticular Activating System is a part of your brainstem. It acts as a customizable filter which adapts to sensory information delivered from the sensory neurons Many people with autism have RAS filtering problems, delivering too much or too little information to the brain The Brain is an Experience Dependent Organ If the information from the sensory and motor input from the body is unreliable or different, the

wiring of that brain will be different and unreliable Brains that are unreliable have a difficult time experiencing the world and relationships in a regular way The mind builds on the structure of the brain is also based on experience and relationships MNRI Masgutova Neuro-Sensory-Motor Reflex Integration Russian Psychologist, Svetlana Masgutova. Techniques and exercises developed with the goal of maximizing positive protection in order to

facilitate restoration and maturation of the primary movement systems. Combining what we know about how the body works biomechanically (contraction and extension principles)..with how we understand the brain to work neurologically What does MNRI look like? It is hands on work with the body and face Specific sensory input along with the correct motor movement to re-pattern primary reflexes Other parts of MNRI are about releasing tendons and muscles that are in protection and delivery of specific touch into the tactile system

The Oral Facial part of MNRI is about activation and integration of the cranial nerves and is directly applicable for eating, talking and auditory processing The Mind and Autism If the RAS of people with autism is not properly functioning, that person will have over or under reactions to sensory input Based on that experience, the person is likely to be put into a state of fight/flight/freeze Being in that state limits the brains ability to use its higher order thinking abilities Being in that state also creates high states of emotion for both that person and those around

that person This impacts relationships, communication and experience based learning Relationship Development Intervention (RDI) Developed by Steven Gutstein and his wife Rachelle Sheeley, Child Psychologists in Houston, TX A parent training model that uses consultation to address the core thinking, learning, communication and relationship issues common in people who have autism RDI is about helping parents to use communication, trust and engagement to restore a guiding

relationship and expose the child to dynamic thinking processes Static Thinking The vast majority of mind differences in people with autism revolve around relative strengths in static thinking and relative deficits in dynamic thinking. Static thinking involves mental processes that are predictable, patterned, routine, and unchanging in nature. Static thinking can be simplistic (watching the same video again and again) to very complex in nature (What day of the week was November 28, 1798?) Doing things repetitively, screen time, using chunks of language and having a hard time with

change is symptomatic of too much static thinking Dynamic Thinking Dynamic thinking is often thought of as common sense. It is non-patterned, context dependent, co-regulatory and un-predictable It typically develops without people targeting work on it Having conversations, working with others, having friendships, managing multiple things at the same time are examples of dynamic thinking abilities People with autism typically have difficulties around these non-measurable processes, making

them slippery concepts in therapy What does RDI look like? Consultants meet with parents and provide education about autism and dynamic learning Concepts include things like how to use communication to help the child with pre-requisites of experience based learning Pre-requisites include: engagement, feeling safe in relationship, building trust, communication, reciprocity, internal motivation and competency, paying attention. Parents are given a goal to work towards with the help of the Consultant. Parents video tape

their work and then problem solve as a team Does this fit into a SpeechLanguage Pathology model? It is all related, body, brain, mind and communication. Communication and thinking, relationships and learning are impossible to separate. Parents want and need to be involved in the therapeutic process if remediation will be possible. The setting in which you work will likely dictate what kinds of work you are able to use.

My website is: www.pathwaystreatmentcenter.org Email: [email protected]

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