The Autism Blog

Ask Dr. Emily- Sensory Sensitivity and Ritualized Behaviors

Welcome to the June edition of Ask Dr. Emily! We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Rastall, a clinical psychologist at Seattle Children’s Autism Center, will share insights here, on the last Friday of each month, in a question and answer format. We welcome you to send us your questions and Dr. Rastall will do her best to answer them each month. Send your questions to theautismblog@seattlechildrens.org.

 

Q: I have a 4 year old grandson, who is diagnosed with autism. He comes to stay with me every other week, and I am learning a lot about him. Ever since he learned to walk, he has a fighting fit when his diaper or pants are taken off him. I’m worried about the diaper rash that he gets as a result. He doesn’t like when anyone tries to wash or wipe him. What is going on?

A: Because you mentioned a rash, the first thing to do is to have your pediatrician assess the area and give treatment recommendations. While I can’t say specifically what might be happening in your case, I can speak to one thing that could be playing a part. Specifically, it is not uncommon for children with autism to present with sensitivities to certain sensory input. In fact, one of the diagnostic criteria for autism spectrum disorder (ASD) is what we call “sensory sensitivities.” We call the sensitivities having to do with touch, “tactile sensitivities.” Children with tactile sensitivities could be sensitive to certain types or textures of clothing, may not like water on their skin or heads, might resist clothes being put on or taken off, may dislike haircuts or teeth brushing, and/or may dislike certain textures of food in the mouth. We can think of sensory sensitivities as the “senses on steroids;” everything feels stronger and more intense than you or I might feel it. Occupational therapy can be one way of helping children with ASD learn to tolerate sensory input more effectively. Like I mentioned earlier, the first step when there is a medical concern (like a rash) is to visit your pediatrician, who can make a referrals or recommendations based on their assessment of the issue.

 

Q: My 3-year-old daughter has autism, and I’m learning more and more about her every day. I’m curious as to why she walks around objects in certain ways. For example, she will walk around a table that is pushed up against a wall or will sometimes even walk around her younger brother’s toys that are on the floor. Sometimes I try to move things so that she doesn’t have to walk around them, but then she gets upset. What’s going on here?

A: One of the diagnostic criteria for autism spectrum disorder (ASD) is what is called “ritualized behavior.” This means repetitive patterns of behavior that may or may not appear to serve a purpose. A lot of the time these patterns of behavior don’t make a lot sense to us, but they make complete sense to our kids with ASD. Other examples of rituals might include stacking papers before bedtime, eating foods or doing tasks in one order (and one order only), requiring that parents take the same route home each day, or requiring that others say things in a certain order or certain way. It’s not uncommon for kids to become upset if they are not able to complete the ritual in the way they think it should be performed. The good news is that many times, these rituals are fairly benign. However, if you are finding that rituals are taking a great deal of time and interfering significantly with daily life, talk to your pediatrician about a possible treatment options and/or referrals.

Autism and Coping Tools for Parents – Part 2: One Mom, Two Boys, Three Tools

 

Tool Time (2)

 

Courage, Intelligence, Support

When I first met Nikki, her eldest son had recently been diagnosed with autism and she was doing well adjusting. I was concerned about her though, when her youngest son started showing familiar red flags and was also diagnosed. How would she handle adjusting to the realization that both of her children were on the autism spectrum? I know for certain, it was not easy, but she made it look so as I observed her in groups, skillfully demonstrating three powerful tools for coping. I asked Nikki to share more with us and this is what she had to say.

Q: How do you define this parenting tool?

A: Courage means taking the world on when it comes to your child. Being a strong advocate for autism and using social situations to teach people about what autism looks like. Standing up for your child in school and not hiding from autism. It’s here to stay and courage means you can become a veteran and help others.

Intelligence means using your gut instinct. You knew something wasn’t quite right and you used your intelligence to get a diagnosis. Whilst you didn’t want to be right about this you were and your common sense was right so use this for future instincts. Intelligence is realizing that you know your child better than anyone and when professionals try to educate you on your child, remember that you live autism 24 x 7!

Support means taking all the help you can get. A new diagnosis is tough, no – it is brutal. It requires us as parents to become super parents overnight. If you have understanding family and friends that offer to give you a night off, or time to finish a hot drink (we’re used to cold coffee anyway right?) or to go to the store by yourself then take it. Take all the help you can. You need to look after number one and by that I mean you, not your children. There’s a reason they tell you to fit your own oxygen mask first.

Q: How did you discover this tool for parenting kids with ASD?

A: I’ve always had courage; it’s from my Mom, however this taught me a new level of courage. I also look to my “autism elders” and see that they are still managing things and that helps propel me forwards.

Common sense is something I’ve always had of course but I now have much more confidence in my gut instincts.

Support is something I have had to learn and that self-care actually became my sanity. Being around other autism moms turned my life around.

Q: How has this tool lessened your stress or made life a bit easier for you?

A: Courage doesn’t always make life easier, as you might have to have conflict but it ultimately means progress as I continue to advocate, and that makes me happy. Common sense or my gut instinct doesn’t necessarily make my life easier but means I have the tools to not over-analyze and to realize I am right – most of the time! Support 100% makes my life easier as I allow myself to lean on those around me.

Q: Did you find that the more you used this tool, the better you got at it?

A: My courage continues to grow as my children grow. Intelligence grows as the children grow too and I learn more and more about THEIR autism. Support – yes I continue to improve on taking and giving help.

Q: What else would you like us to know about these parenting tools?

You don’t have them all on Day One of your diagnosis (and you’re not meant to!). They come with time and experience. What helps is getting to know parents of children slightly older than yours. That gives you hope and guidance.

We’d like to thank Nikki for taking time to share her coping tools with us. Many of you know her as the founder of Seattle Autism Moms, an online parent support/information group on Facebook and from her blog:  

Autism Moms of Seattle

Autism and Tea

 

Transition to Adulthood-Community Based Housing Options for Adults with Disabilities- This Month’s Autism 200 Class

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This month’s Autism 200 Series class “Transition to Adulthood-Community Based Housing Options for Adults with Disabilities” will be held Thursday, June 16, 2016, at Seattle Children’s Hospital in Wright Auditorium from 7 to 8:30 p.m. These classes are designed for parents, teachers and caregivers. The topics associated with the majority of classes are applicable to all age ranges and for a wide variety of children diagnosed with autism. This class will be led by Vicki Isett & Pam Blanton, Community Homes, inc.

Autism Re-examined: Ethical challenges in care, support, research and inclusion

Bioethics

 This year, Seattle Children’s Annual Pediatric Bioethics Conference is focused on autism. It will be held July 22 and 23 at Bell Harbor International Conference Center in Seattle.

 

 

 

 

Some of the questions to be explored include:

  • How have changes in the way we understand autism over time influenced ethical issues in diagnosis and treatment?
  • How and why do health disparities occur in diagnosis, treatment and support, and what are the impacts? How can we reduce and ultimately eliminate disparities?
  • How can we incorporate knowledge of cross-cultural differences to provide better care for children with autism and their families?
  • What are the ethical challenges in the transition from adolescence to adulthood? How can they be addressed?
  • What are some of the ethical issues in autism research? How can research findings result in more effective care and support for children with autism?

 

For more information and to register for the conference.

 

We hope to see you there!

Mindful Monday- Meditation

 

Meditation

 

No More Excuses

If you’ve told yourself you want to give meditation a try but find you have more excuses than mindful moments under your belt, here are some tips from Redbook magazine and Timothy McCall, MD:

“I don’t have time.”

You don’t need to do 10 minutes a day. Close your eyes and take a few deep breaths. Start somewhere! It’s easier if you pick a time of day and stick with it. Upon waking or at day’s end are the most common but you can meditate any time of day.

“I can’t turn my brain off.”

You don’t have to! The goal isn’t to stop thoughts. That’s impossible. Don’t fight them but also don’t dive in. Just let them pass through like traffic in the background.

“I tried it once and nothing happened.”

Not every second of a ten minute meditation needs to be deep. Even if you only get 30 seconds of that time immersed in the process, you still have benefit. Your heart rate, blood pressure, and breathing will slow and you are becoming more mindful.

Beginning Meditation Exercise

Sit comfortably but with your back straight – on the floor against a wall, in a chair, even in bed but sit upright. Have a watch or clock or phone (turn it off!) nearby.

With eyes open and a soft focus, take a few deep breaths, feeling your chest rise and fall. Breath deeply so that if someone were next to you they could hear you breathing.

Gently close your eyes and notice the sounds around you. Don’t try and block them but also don’t hyper-focus on them. Just notice them.

Notice how your body feels, scanning from head to toe. Any discomfort or tightness? Don’t block it or hyper-focus on it, just draw your attention to wherever you feel it. You may find your self taking a deep breath or repositioning yourself as you do this.

Breathe naturally and as you inhale, think “in” and as you exhale think “out”. Your mind will wander, thoughts will intrude. That’s A-OK and to be expected. Don’t try and block the thoughts, just notice them and return to “in” and “out”. Some people prefer to focus on a mantra, a word or sound that is repeated over and over. If you prefer a mantra, choose a word or sound that doesn’t have an association for you. For example, if I think “love”, I will automatically call to mind all the people I love and lost love and why we love and on and on. If I choose a non-word, a sound such as “umba”, there is no association to divert my attention.

A key component of meditation is nonjudgment so if you have thoughts or feelings such as “What’s wrong with me, I can’t do this right!” just notice them and let them pass. Remember that the first time you do anything, you are learning and it will take practice.

After a few minutes of focusing on your breath, draw your attention back to your body. Do a body scan and note how you feel.

Notice any sounds or smells.

Gently open your eyes and stretch.

Quote of the Week

“At the end of the day, let there be no excuses, no explanations, no regrets.” ― Steve Maraboli, Life, the Truth, and Being Free