Asperger Help

By David Noonan
Who is the sensory-sensitive child? Let's consider "Tom." When he walks into my music class, he doesn't want to be hugged or touched. Some days, he looks anxious as he makes the transition from the hall into my classroom. When I hand Tom an instrument, it often takes him a little extra time to take it from me and then figure out how to play it. If I give him more than two instruments to choose from, he becomes overwhelmed and can't make a decision. When Tom hears loud recorded or live music, he puts his hands over his ears as if he is in pain and he often blinks when the lights are too bright. He doesn't like to dance when he has to learn steps and often gets extremely frustrated when learning new movement sequences. One day, he became so frustrated during a dance activity that he "melted down," and it took a long time to calm him. Tom often complains that the tag in the back of his shirt is "itchy." He doesn't like to put his coat on in the winter and has a hard time tying his shoes. If the room is too hot or cold, he finds it difficult to focus on any musical tasks. Some days he has a lot of energy and is in constant motion. Other days he seems bored and unmotivated.
Tom scored very high on Gordon's Primary Measures of Musical Aptitude, and his IQ is within one standard deviation above the norm. He is extremely articulate. When he plays a musical instrument, he does so with enormous sensitivity, demonstrating capabilities well beyond his peers. When he moves, his motions are beautiful, thoughtful, and flowing. Tom has the potential to be a great musician. Who is Tom, and what separates him from other children? Tom has been diagnosed with Sensory Integrative Dysfunction. I do not use that term, preferring to use the term sensory challenged or sensory sensitive. The word "dysfunction" carries a heavy negative impact.
Tom is hypothetical, but for this article he typifies the characteristics of children who have sensory challenges. What defines sensory integration challenges? Our brains continually process incoming sensory input--sight, sound, touch, and smell. In addition to the more obvious senses, the brain also processes information from the vestibular system, which is located in the inner ear and processes movement and balance. Proprioception is still another sense, defined by how the muscles and joints interact in relationship to gravity. Children with sensory integration challenges have a difficult time processing everyday sensory input. The "wiring and firing" activity in the brain is such that sensations from a "normal" environment cannot be organized neurologically, and the child does not feel safe or comfortable in his or her world. Instead of their senses giving them the security they need to interact in the world, the information perceived through the senses is often inconsistent and unreliable, which leaves the child feeling insecure or frightened (Koomar, Szklut, and Cermak 1988). Often sensory issues are at the core of other disorders such as autism, attention deficit disorder, and learning disabilities. The primary purpose of this article is to assist the reader in recognizing sensory sensitivity in children and adapting the classroom environment so that the spark of music can remain alive and be nurtured. Knowledge leads to understanding, and understanding a child's behavior leads toward compassion. Understanding and compassion can result in the child's success as opposed to low self-esteem. Successfully adapting the classroom can also prevent teacher frustration, making the classroom environment more positive for both students and teachers.
Some children with sensory challenges are hypersensitive and, as a result, have an acute awareness of their environment. This challenge can also be their greatest gift. A child with a hypersensitive auditory system may score extremely well on a musical aptitude test and have great potential to be a wonderful musician, but become overwhelmed by too much auditory input. A logical adaptation is for the teacher to be aware of the volume of the live or recorded music. If you anticipate the classroom becoming too noisy, make prior arrangements with the child and give him or her a subtle, nonverbal cue to help him or her anticipate the dynamic level or arrange for the child to let you know when he or she needs to leave the environment in order to self-regulate. Hypersensitive children are often adversely affected by bright lights and poorly regulated temperatures. To adapt, cut some of the fluorescent lights and bring in floor lamps. A hypersensitive child who is too hot may fall apart simply because of the temperature. Be constantly aware of temperature extremes, and have a plan for dealing with them.
Other children with sensory challenges are undersensitive to sound, and as a result, their nervous systems may crave auditory input to remain organized. Allow these children to play a contrabass xylophone bar or other large instrument that vibrates fully. Chances are that if they are undersensitive in one area, they may be undersensitive in another. Therefore, the vibrations may allow the child to feel more secure with the incoming sensory input. For undersensitive children, it is often helpful to use consistent eye contact paired with animated facial expressions and voice. Children who present undersensitivity challenges often need a lot of input from their environment. For example, a quickly paced lesson paired with plenty of opportunities to experience many skills--moving, playing instruments, singing, and so forth--will allow the child the necessary sensory input within a structured setting. Lack of an appropriate level of stimulation may lead the child to create the necessary stimulation, which is often disruptive behavior.
What happens when a sensory-sensitive child has a meltdown in your classroom? In this situation, the child's nervous system gets overwhelmed and cannot organize any more input. The central nervous system must find a middle ground (Koomar, Stultz, and Cermak 1988). At that point, the child needs an opportunity to self-regulate or modulate his or her behavior. If meltdowns occur consistently in your classroom, explore the environment for causes. What happens before music class?
A typical setup for failure would be a child with sensory challenges who comes to music after physical education. This schedule would provide too much stimulation the period before and not enough time to make a transition into a potentially stimulating musical environment. Perhaps the child's schedule needs to be changed. If the schedule cannot be changed, how could you ease the transition? Here are several suggestions for extreme cases. Allow a young child to bring in a squeeze toy that doesn't make any noise. The repetitive movement of a squeeze toy may help stimulate the vestibular system and as a result help the child to better organize sensory input. I have a hammock swing in my classroom where children who have sensory challenges are allowed to go when they need to self-regulate. Again, the swinging motion stimulates the vestibular system in the same way that the squeeze toy does. You may see a child lying on the floor in an attempt to self-regulate. The pressure of their body against the floor can provide the brain with the necessary stimulation it needs at the time. The deep pressure of the floor against the body can be very calming and reassuring for an overstimulated child. Perhaps the child even needs to lie on the floor in a tent structure to help dampen visual input at that moment. In extreme cases, headphones may be necessary to eliminate auditory stimuli. When a tantrum occurs, it is important that the teacher remain calm and not get into a power struggle with the child. The child simply needs a safe container in which he or she can calm down (Aron 2002).
An extreme expression of frustration (e.g., meltdown) may also occur when children with sensory challenges are learning new steps to a dance or are engaged in any physical task that requires movement sequencing. This may be a sequence as simple as picking up an instrument and playing it. In this case, motor planning challenges are the culprit. Motor planning is the ability of the brain to organize and sequence a series of motor tasks. The child's brain simply cannot organize your plan for teaching. The resulting behaviors may appear to be disruptive and uncooperative, but they are simply adaptive--being silly, refusing to participate, or having a tantrum. When teaching sequential movement, regardless of the grade level, it is critical to employ adaptive teaching techniques. Use an icon for each sequence you teach. Present the teaching sequence in simple sentences rather than compound or complex sentences. Teach one idea at a time, and closely monitor the child's reactions. Be prepared to intervene before an escalation of disruptive behaviors occurs.
Some of the adaptations mentioned above are intrusive and could cause conflicts with other children in the class who want a toy or to swing. How do you deal with this? With younger children, I am comfortable explaining to the class that Tom sometimes gets upset and needs some extra help. I am quick to give Tom feedback regarding his own ability to self-regulate. For example, "I saw that when you picked up your squeeze toy, you began to calm down." I have seen children in a class of four-year-olds who would bring a squeeze toy to a child who was upset. This is the ideal situation: everyone is aware, compassionate, and able to offer assistance. For older children, this scenario may not work. Once self-consciousness becomes an issue, more subtle adaptations may need to be used.
Once you recognize that you have a child in your classroom with sensory challenges, you need to seek professional help. Please do not implement any of the adaptations suggested above without the support of other professionals. I highly recommend requesting the services of an occupational therapist who is trained in sensory integration, as well as consulting with the school psychologist or counselor. Working with a team will give you the support you need to develop creative solutions to a potentially frustrating situation. The results are rewarding and can often bring new depth to music teaching.
Historically, I would imagine that many of our greatest musicians presented a profile similar to Tom's. I often wonder how many children with sensory challenges who have extraordinary musical talent go undiscovered because of their "out-of-the-box" behaviors. Providing a classroom where a child with sensory challenges can thrive and continually discover the artist within is a great gift. Next time a "Tom" walks into your classroom, open your heart, embrace him, and perhaps eventually Tom the glowing musician will walk out.
References
??? Aron, E. 2002. The highly sensitive child: Helping our children thrive when the world overwhelms them. New York, NY: Broadway Books
??? Koomar, J., S. Szklut, and S. Cermak. 1988. Making sense of sensory integration (cassette recording). Boulder, CO: Belle Curve Records, Inc.
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By Liz Rose
Liz Rose is associate professor of music education and music therapy, Appalachian State University, Boone, North Carolina.