Monday, November 1, 2010

Blog #16 Vitamin M Continued......

“You were soooooo right,” Ellen enthused. Oh goodie, I thought. I love being right. Then it occurred to me that I had no idea to what she was referring.

“About what?” I queried.

“You know,” she continued. “About movement and speech. Remember that story you told me?”

I did. It was currently my favorite story about movement involving a 5-year-old boy on the autism spectrum. I will call him, Kirk. Kirk hopped from one thing to the next with limited attention or engagement. His language consisted of demands and basic observations with little conversation. If you work with or have a child with autism, you may know about the concept of closing circles of communication. Basically, you say something, the child acknowledges your opening and responds with something related to what you said and sends the conversation back to you. That is one circle.

The late Dr. Stanley Greenspan stressed the importance of closing circles of communication and developed many techniques to help improve conversational skills. The child needs to be interested enough in another person to engage and then respond appropriately to unexpected conversational gambits. An autistic conversation is more like a political debate on TV when one question is asked and another is answered. This “conversation” tends to be one-sided. Something like this:

“What did you do at school today?”

“Thomas”

“Oh, you played with Thomas?”

“No, want to play with Thomas.”

“You want to play with Thomas the tank engine. Okay, but did you have music today?

“Eat cookies.”

Etcetera.

Kirk communicated at this level with much prompting and redirection needed to have any level of conversation. The parents and speech therapist were working hard to improve the quality and complexity of the interactions. I explained to the mother that the language centers were right next to the movement centers. Parents so often concentrate directly on speech rather than working on motor skills and/or sensory function. When language is not improving, improving sensory and motor function can create a neurological foundation for better speech. It is the reason children usually walk before they talk and why boys, in particular, use movement to help them think straight.

With this little developmental tidbit in mind, the Kirk’s family headed off to Disney World. It had been a tough year and the parents decided for one day to allow Kirk to do whatever he wanted. What Kirk wanted was to go on the Disney equivalent of the roller coaster “20 times”. So, they let him.

At the end of the day, Kirk was communicating better than he ever had. He was answering questions and initiating more conversation. His parents were so excited but did not know how to sustain the gains.

Since they did not have room for a roller coaster in their living room and they could not move to Disney World, the question was what to do to get Kirk’s level of movement and sensory input way up. We talked about using Wii fit and checking in with their occupational therapist about what equipment could be installed and used at home. This was the story I told Ellen.

Ellen took her son with speech delays to a local amusement park and used the same strategy with similar results. “You should have heard him talk,” she reported. “It was unbelievable”.

Once again, I had a conversation about increasing the levels of vitamin M in a little boy. “Sometimes I think there is not enough movement in the world for him,” his mother cracked.

The difference between these two children and Colin, discussed in the previous vitamin M blog is in the type of movement. For Colin, it was direct heavy exercise while in Kirk and this young boy it was machinery moving them. While the child moving himself is generally preferable, the intense movement of a roller coaster is very stimulating to the nervous system and can also do the trick. The key is finding a way to get lots of movement into everyday life.

1 comment:

  1. Why am I not surprised?! After vit M worked so well for our son, we put our daughter on it. Our 13 month old Anna says actual words only on the go!

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