What in my world is with this body? Connecting children to their means for engaging the world around them

Think about your body...  During this presentation, be your body  Think about where all your parts are and what they are doing  What’s up and what’s down? (where are you in space)  What’s touching you? (clothing, chair, jewelry, hair, something in your hands)  Are you motionless or moving, and if so, what is moving?  During this presentation, be your body  Think about where all your parts are and what they are doing  What’s up and what’s down? (where are you in space)  What’s touching you? (clothing, chair, jewelry, hair, something in your hands)  Are you motionless or moving, and if so, what is moving?

Starting Points WHAT IS: AUTISM? OCCUPATIONAL THERAPY? SENSORY INTEGRATION? AUTISM? OCCUPATIONAL THERAPY? SENSORY INTEGRATION?

For this discussion:  AUTISM  not to focus on diagnosis or presence/absence of specific symptoms  focus on performance of everyday activities such as play, school, and social activities  impact of apparent disconnect with children and their bodies during engagement in activities  AUTISM  not to focus on diagnosis or presence/absence of specific symptoms  focus on performance of everyday activities such as play, school, and social activities  impact of apparent disconnect with children and their bodies during engagement in activities

What is Occupational Therapy?  The ‘doing’ therapy  Everyday activities as the means (i.e. therapeutic tool) and the ends (intended outcome is successful performance) of treatment  Focus on Occupations: the substance of one’s daily life - you are what you do  Activity analysis and breaking down activities  The ‘doing’ therapy  Everyday activities as the means (i.e. therapeutic tool) and the ends (intended outcome is successful performance) of treatment  Focus on Occupations: the substance of one’s daily life - you are what you do  Activity analysis and breaking down activities

What exactly do those OT people do? APPEARANCES  Have a really cool job  Show up, play with the kids for a while, get them wound up, and then leave  Sit in front of a computer, looking busy  Have a really cool job  Show up, play with the kids for a while, get them wound up, and then leave  Sit in front of a computer, looking busy

What exactly do those OT people do? REALITY  Have a really cool job  Show up, play with the kids for a while, get them wound up, and then leave  Sit in front of a computer, looking busy  Have a really cool job  Show up, play with the kids for a while, get them wound up, and then leave  Sit in front of a computer, looking busy

REALITY (cont.)  Help the goofy, awkward, and uncoordinated to be less so  Break down activities and grade tasks to a student’s ability level to allow for success/failure  Use activities as a means to develop skills needed to participate more fully in the classroom and on the playground  Help the goofy, awkward, and uncoordinated to be less so  Break down activities and grade tasks to a student’s ability level to allow for success/failure  Use activities as a means to develop skills needed to participate more fully in the classroom and on the playground

Getting your hands dirty ACTIVITY EXAMPLE ‘Tie-Dye’ Butterflies Activity Analysis Grading the Activity Promoting Success Activity as a Means and End ‘Tie-Dye’ Butterflies Activity Analysis Grading the Activity Promoting Success Activity as a Means and End

REALITY (cont.)  LAUSD - focus on sensory-motor skills  Assessment - answering the question:  How goofy, awkward, or uncoordinated?  Consultation and Collaboration  SEAGULL method - Not preferred approach  Support Service - “How can we help you?”  Paperwork and Documentation  Sitting in front of a computer, trying to look busy  LAUSD - focus on sensory-motor skills  Assessment - answering the question:  How goofy, awkward, or uncoordinated?  Consultation and Collaboration  SEAGULL method - Not preferred approach  Support Service - “How can we help you?”  Paperwork and Documentation  Sitting in front of a computer, trying to look busy

REALITY (cont.)  Promoting change to improve performance  Person and Abilities - difficult to change in short term, possibility of success to be determined, might not change  Activities and Environs - change more feasible, potential for immediate success, range of possibilities is greater  Promoting change to improve performance  Person and Abilities - difficult to change in short term, possibility of success to be determined, might not change  Activities and Environs - change more feasible, potential for immediate success, range of possibilities is greater

CASE STUDY: Forrest Gump Eligibility: Mental Retardation (IQ < 80) Areas of Strength: Speed (“magic legs”), eye-hand coordination, loyalty, perserverance Areas of Weakness: Cognitive, speech (tone), social skills Impact of Disability: Tormented by peers, referred to as “the local idiot” Supports: A caring Momma, some clever sayings, Lieutenant Dan (1-to-1) Eligibility: Mental Retardation (IQ < 80) Areas of Strength: Speed (“magic legs”), eye-hand coordination, loyalty, perserverance Areas of Weakness: Cognitive, speech (tone), social skills Impact of Disability: Tormented by peers, referred to as “the local idiot” Supports: A caring Momma, some clever sayings, Lieutenant Dan (1-to-1)

Forrest Gump: ACTIVITIES & ENVIRONMENT  Graduated University of Alabama “after 5 years of playing football”  In army, medal of honor winner and ping-pong champion  Shrimpin’ boat captain and owner of Bubba-Gump shrimp company (following hurricane)  Best friend of Bubba, Husband of Jenny, Father of little Forrest  Graduated University of Alabama “after 5 years of playing football”  In army, medal of honor winner and ping-pong champion  Shrimpin’ boat captain and owner of Bubba-Gump shrimp company (following hurricane)  Best friend of Bubba, Husband of Jenny, Father of little Forrest

CASE STUDY: Stephen Hawking Eligibility: Orthopedic Impairment (ALS / Lou Gehrig’s Disease) Areas of Strength: Cognitive Areas of Weakness: All physical and motor abilities, speech Impact of Disability: Complete dependence for all ADLs and physical activities Supports: 24 hour nursing care and assistive technology Eligibility: Orthopedic Impairment (ALS / Lou Gehrig’s Disease) Areas of Strength: Cognitive Areas of Weakness: All physical and motor abilities, speech Impact of Disability: Complete dependence for all ADLs and physical activities Supports: 24 hour nursing care and assistive technology

Stephen Hawking: ACTIVITIES & ENVIRONMENT  In academia, where ideas are valued, he develops ground- breaking theories and is a brilliant scientist  He communicates with friends and colleagues and lectures to packed auditoriums on topics beyond most people’s comprehension  In his personal life, he maintains relationships including marriage  In academia, where ideas are valued, he develops ground- breaking theories and is a brilliant scientist  He communicates with friends and colleagues and lectures to packed auditoriums on topics beyond most people’s comprehension  In his personal life, he maintains relationships including marriage

REALITY (cont.)  That ‘SENSORY’ stuff  SENSORY INTEGRATION Defined: “Sensory integration is the organization of sensations for use…Our senses give us information about the physical condition of our body and the environment around us. The brain must organize all of these sensations if a person is to move and learn and behave normally” (Jean Ayres, 1979).  That ‘SENSORY’ stuff  SENSORY INTEGRATION Defined: “Sensory integration is the organization of sensations for use…Our senses give us information about the physical condition of our body and the environment around us. The brain must organize all of these sensations if a person is to move and learn and behave normally” (Jean Ayres, 1979).

Sensory Integration in Practice  Sensory Strategies - attempts to stimulate, regulate, or get a child in touch with their body in an environment to allow for improved functioning  Sensory Diets  Sensory Breaks  Alternative Behaviors  Fidget Toys  Heavy Work  So on and so forth...  Sensory Strategies - attempts to stimulate, regulate, or get a child in touch with their body in an environment to allow for improved functioning  Sensory Diets  Sensory Breaks  Alternative Behaviors  Fidget Toys  Heavy Work  So on and so forth...

Autism can be characterized by a disconnect that appears to exist between a child and his or her body What is YOUR experience with this disconnect? Have you seen it? How did it look to you? Autism can be characterized by a disconnect that appears to exist between a child and his or her body What is YOUR experience with this disconnect? Have you seen it? How did it look to you?

SENSORY INTEGRATION, OCCUPATIONAL THERAPY, and AUTISM Addressing the Disconnect by Marrying Children and Their Bodies

Introducing Children to their bodies  Providing sensory input through motor activities in a playful context  Body awareness & position (proprioception)  Moving around (vestibular)  Touching and Feeling (tactile)  Providing sensory input through motor activities in a playful context  Body awareness & position (proprioception)  Moving around (vestibular)  Touching and Feeling (tactile)

The Extended Courtship (for the more sensitive child)  Subtle introduction of child to their body “Susie, I would like you to meet your body”  Graded input, increased slowly over time, non-noxious stimuli  Not over-stimulating, limiting environmental busy-ness  Child-guided  Habituation and de-sensitization  Subtle introduction of child to their body “Susie, I would like you to meet your body”  Graded input, increased slowly over time, non-noxious stimuli  Not over-stimulating, limiting environmental busy-ness  Child-guided  Habituation and de-sensitization

The Arranged Marriage (for the child who seems unaffected)  To the point, first meeting is marriage: “Johnny, THIS IS YOUR BODY!”  Intensive input to promote a response  High level of stimulation to increase alertness, arousal, and awareness  Recognition, Registration, and Response to the stimuli is desired  To the point, first meeting is marriage: “Johnny, THIS IS YOUR BODY!”  Intensive input to promote a response  High level of stimulation to increase alertness, arousal, and awareness  Recognition, Registration, and Response to the stimuli is desired

What is your body up to just about now? SENSORY INPUT and CONNECTING WITH OUR BODIES (Activity) SENSORY INPUT and CONNECTING WITH OUR BODIES (Activity)

DEVELOPING the RELATIONSHIP  Therapeutic Activities - getting to know one’s body better so that it can be used to interact with people and the environment  Promoting Skill Development and Application - encouraging children to use their bodies in functional manner to accomplish tasks  Compensatory Strategies - filling in the gaps (OT as marriage counseling)  Therapeutic Activities - getting to know one’s body better so that it can be used to interact with people and the environment  Promoting Skill Development and Application - encouraging children to use their bodies in functional manner to accomplish tasks  Compensatory Strategies - filling in the gaps (OT as marriage counseling)

The Process in Practice Occupational Therapy in the ICAP Programs (What it looks like) Occupational Therapy in the ICAP Programs (What it looks like)

‘Til Death Do Us Part  A match-made in heaven - Me, myself, and my body  Marriage is work - continuously have to be aware, develop and practice the skills, and compensate accordingly  A match-made in heaven - Me, myself, and my body  Marriage is work - continuously have to be aware, develop and practice the skills, and compensate accordingly