Asperger Help

By Dwayne Pickels
TRIBUNE-REVIEW
Monday, March 29, 2004
In a therapy room filled with toys, tools of the trade, 3 1/2-year-old Ben bounced on a ball and grinned at his mother, Jodi Yanan.
Kelly Meeder, licensed assistant occupational therapist, was amazed.
"I am so proud of you today," Meeder said. "Ben, this is a banner day for you."
Before he began treatment, Ben did not like his feet to leave the ground.
"Swinging was an issue," said Yanan, of Ardara, North Huntingdon Township.
Ben, who is autistic, has also been diagnosed with sensory integration dysfunction. His therapy includes weekly visits to the Allegheny Valley Institute for the Development of Learning in New Kensington.
Sensory integration is simply the organization of the senses allowing one to accurately interpret a situation and respond appropriately. If it does not develop normally, sensory integration is disordered, causing a bit of a "traffic jam" in the brain. Learning, development or behavior problems may occur.
Sensory dysfunction can affect all of the senses, and may or may not accompany autism. Children or adolescents may find certain sounds -- the noise of fire alarms, the buzz from overhead fluorescent lights -- unbearable. They may resist physical affection. Intolerance of certain food textures may limit what they will eat. Their play may be rigid, rather than spontaneous. Some children may be unusually active, while others may express little interest in activity.
They may play roughly with peers, possibly because they cannot accurately judge where their own bodies are in relation to others. They may hum constantly, in an effort to block out other noises and help them organize their thoughts. They may rock or spin or jump.
Things most of us take for granted -- brushing our teeth, getting our hair cut, stepping up onto curbs, ignoring annoying clothing tags -- may overwhelm them.
At what point should parents seek help? "When you sit back and realize your entire day is planned around (anticipating) your child's needs," said Susie Oresic, coordinator of occupational therapy at Children's Hospital of Pittsburgh.
With older children, she said, academic problems might be a symptom. If other potential culprits -- hearing impairment, low intelligence, vision problems -- have been ruled out, the problem might be organizing information.
Oresic believes more children are being diagnosed with the disorder largely because physicians are getting better at diagnosing it.
"We're not lumping them into (the category of) mental retardation," she said.
An evaluation can test children's visual perception, eye-hand coordination and motor planning.
"It's a very hard diagnosis to explain to parents," Oresic said. "There is no blood work, no 'aha' moment, but at least they know they are not alone."
EARLY INTERVENTION
According to the nonprofit Sensory Integration International, as many as 30 percent of school-age children have a learning disability. The majority are likely to have sensory integration problems, according to some research.
The syndrome affects far more boys than girls, although no reason has been determined.
Those are the children Rebecca Moyes hoped to reach when she opened the institute last June. It offers therapeutic services for a variety of childhood learning disabilities.
The institute is sponsoring a workshop April 2 at Futules' Harmar House, 1321 Freeport Road, Cheswick, for parents, educators and professionals, to address working with children with sensory dysfunction in the school and home.
Occupational therapist Ronna Hockbein recalled how Ben used to hide under a table and run from her when she provided in-home therapy.
These days, Yanan said, tantrums are almost a thing of the past. "He is so much calmer," she said.
Ben was flagged early by a pediatrician, his mother said. When his speech was not developing at 12 months, the doctor recommended therapy. At his 2-year-old checkup, sensory issues were discussed. Ben was seen by a development specialist, diagnosed and began occupational therapy.
Ben likes the feel of different textures -- mud, water, shaving cream -- on his skin. But certain food textures, including meat, can bother him. And he dreads getting his hair cut.
He and John Green Jr., 5, who also has autism and sensory dysfunction, have both benefited from a dietary change. Some autistic children seem to interact better with their peers and families when they follow a gluten- and casein-free diet.
John, said his mother, Marla Green, of Lower Burrell, is easily "set off" by certain noises, like vacuum cleaners and loud vehicles.
He also finds haircuts traumatic. "It takes him 15 to 20 minutes to calm down afterward," his mother said. "It takes him to the brink."
He has had some problems with fine-motor issues. But he is learning life skills, she said, and is better at dressing himself and holding a pencil.
"He's more focused," she added.
Marla Green is preparing a booklet to help her son's teachers when he begins kindergarten next year. "For John to succeed," she said, "his team needs to be on the same page."
He attends a typical preschool program. "We are hoping he can hold his own," his mother said. "If not, we will by all means get him a
(classroom aide)."
CHANGING BEHAVIOR
Earlier, Hockbein had applied shaving cream to John's legs and feet, as part of touch therapy. He and Ben took turns lying across and rolling around on a huge inflatable pillow. Ben slapped the pillow to show Hockbein he wanted to be lifted onto it.
"He normally doesn't like this," she said.
Working with Meeder, he identified animals on a wooden puzzle, and imitated the sounds they make.
"More animals," he told Meeder.
Ben, who sometimes fears strangers, turned to a visitor and instructed, "Away."
Meeder and Hockbein both have children with sensory dysfunction. Meeder recalls shopping trips lasting for hours, as her son traced the letters on license plates of cars in the parking lot.
"As a parent," Meeder said, "you educate your pediatrician, your therapists."
Moyes, a former teacher, added, "We really feel that parents and educators and professionals need training in this field."
Teachers can learn what sounds or activities can agitate children in their classrooms. Sometimes allowing "movement breaks," or letting children leave class before or after the halls become crowded, can make for a smoother school day.
Hockbein's son could glance at a clock and know when a school bell was about to ring, and raise a hood to cover his ears.
One of Meeder's son's teachers stuffed newspaper into an intercom system, to muffle the noise and reduce static.
Some children have eye-hand coordination problems, or trouble with perception of movement.
Their brains can perceive an action, "but they can't execute the movement," Meeder said.
With some kids, the smell of a shampoo, exhaust fumes or cleaning fluids can aggravate them.
Others have trouble with transitions, simply coming inside from outside, or putting a coat on or off.
Parents have to become detectives, Hockbein said, and determine the roots of certain behavior. "These behaviors always seem random, but they are never random," she said.
With early intervention, a child's prognosis can be good.
"Every single child has his own recommendation that will work for him," said Oresic. "It's definitely very individualized."