Sunday, July 24, 2011

Book Review: Songames for Sensory Processing by Aubrey Lande. MS, OTR, Bob Wiz, Lois Hickman



Songames for Sensory Processing: 25 Therapist-Created Musical Activities for Improving Fine and Gross Motor Skills, Muscle Strength & Rhythmicity.
by Aubrey Lande. MS, OTR, Bob Wiz, Lois Hickman & Friends.

It's no secret that music can provide excellent therapy for children with special needs and this book is designed to support teachers and therapists in that endeavor.

At eighty pages, it's a short book but it covers a lot of ground. It's colourful and full of pictures of happy kids - and it comes with two CDs with 25 "songs" on them.

The book is divided into five "circle forms" which despite a page and half of explanation, seem to be just "broad topic areas" to me.
  • Balance Circle Form
  • Message Circle Form
  • Bob's Circle Form
  • Lori's Circle Form
  • Aubrey's Circle Form
The songs on the CDs are all good and very professionally done and the book contains their lyrics and suggestions for their actions. In fact, the musical element of the book was far better quality than I was expecting.

Unfortunately, I found that because I wasn't personally familiar with the activities, The book didn't provide enough direction for me to do any. All of the pictures in the book are of kids enjoying themselves doing other things but there's nothing to show the activity itself.

By way of example, the Musical Chairs game (with which I am very familiar) has a picture of a blue chair on pink background. That's it. The picture tells me nothing. The text is all about variations on the game - all exciting stuff but it doesn't actually tell people how to play the game.

I also think that I would have expected the book to be full of "warnings" about how to gently introduce music to children with sensory needs but I really didn't see any.

If you are a therapist or teacher and you're familiar with the games but need ideas for sensory-friendly variations, then this book provides some great ideas and good music. If you don't know the games however, this book won't teach you any.

Songames for Sensory Processing: 25 Therapist-Created Musical Activities for Improving Fine and Gross Motor Skills, Muscle Strength & Rhythmicity is available on Amazon.

Honesty Clause: I was provided with a review copy of this book at no charge.

Sunday, July 17, 2011

Empathy and Perceived Empathy

Yes, it's another "empathy post". I'm sorry if you're getting sick of them. I'll be on a different topic soon.

Today I just wanted to say a few words about the perception of empathy.

Right now, my mother is in hospital. Her hospitalisation was sudden and unexpected but she is ok. I've checked. I've received an email from my father and my wife rang him later during the day.

I'm happily convinced that everything is fine and that for the immediate future her main priority should be rest.

She lives too far away for a "quick visit" and I haven't contacted her directly yet. Unless I hear of changes in her condition, I'm best off giving her time to heal.

No doubt once she comes out she'll rouse on me for not having gone to panic stations and talked to her directly. The thing is that I can't do anything and chances are that I'll end up calling during her nap time.

Does that make me less empathetic?

Some would say yes but I think that sometimes I put more thought into the physical well-being of people than I do towards self-serving information gathering exercises.

It doesn't mean that I'm not worried or that I don't care.

The perception of this empathy by others however is different altogether. Other people think that unless I'm waking her up and asking her how she is, then I don't care. She has doctors and nurses doing that already - and I've spoken to them. They're better qualified to give me a rundown on her condition.

Addendum: I wrote this post a few days ago but have been too busy to post it. I've since spoken to my mother a couple of times and she's home and getting better.

Monday, July 11, 2011

Overcoming Sleep Issues


The is post is part of Best of the Best, Edition 8: Sleep Issues & Bedtime and Special Needs Kids. If you check the above link on about July 14, you'll find a whole host of similar articles by other authors.

Sleep issues are very common for children and adults with Aspergers Sydnrome. I've talked about these before but last time it was a bit of a "scientific" post. This time, I want to be more practical. I want to look at why children with Aspergers Syndrome and Autism have sleep difficulties and what you as parents can do to improve their sleep.


Some Reasons for Sleep Issues
First of all, I want to look at some reasons why sleep may be difficult for children (and adults) with aspergers sydnrome;

The Sleep Ritual
Like many aspergers activities, sleep is a matter of ritual. If you get the ritual wrong, or out of order, then sleep can become much more difficult. The aspie can stress over the ritual instead of sleeping. A case in point is my youngest son (7.5). One part of his ritual concerns dessert and should a parent send him to bed without any, trouble is sure to follow.

My wife will often say; "You don't have dessert every night" but that's not true. In his mind, it's an accepted part of the ritual. In his mind, he DOES have dessert every night. Though at least we've mandated "eating your dinner" first. If we break this ritual, he will stress over the lack of dessert. It might seem like a small thing but it's enough to keep him awake.

This puts us into a positive parenting dilemma. Is giving him dessert really "giving in" to him? Sometimes it is but sometimes it's just a case of picking your battles. Is dessert unhealthy? Are we encouraging unhealthy rituals? Perhaps... but then, maybe if we could come up with a healthier dessert, such as fruit, it would be less of a problem. In any case, a small dessert is not as unhealthy as lack of sleep.


Constant Thinking (No brain quiet)
Aspies have a lot of trouble calming their brains. We tend to think over things, solve problems and allow our minds to wander into excessive detail on our special interests. When I was younger, I'd lie in bed and code computer programs. I'd wake up in the morning with reams of code and amazing solutions in my head but I'd suffer from lack of sleep. Talking to my older son (10.5), he designs lego creations in his head while he's attempting to fall asleep. Of course it's obvious - if you're using that much brainpower, you're not going to fall asleep. Aspie brains tend to seize quiet time and use it to its full potential.

If this is your issue, then you need to find a way of removing that quiet time. Have your child do a regular activity when going to bed. It needs to be something which can occupy their thoughts but must be in one direction only (ie: computer games are out). Watching television in bed is one option, though it's probably not the best habit. Listening to quiet music or audio books is better and reading books or comics is best of all.

If your child is concentrating on the story, they won't be stewing over other things. There's a good chance that they will fall asleep while reading. That's good. At least they've fallen asleep.


Reviewing
Even when aspies aren't actually dreaming up new concepts, they're busy reviewing the events and conundrums of the day. Some aspies are word-based, some are picture-based and some, like me, tend to be more events-based. I find that I play back whole conversations over and over again looking for hidden meanings, gestures, tones etc. All of the stuff that I didn't notice during the actual conversation. After all, I did "take it all in". I just couldn't process it during the conversation. Word and picture based aspies will also tend to review their day using their preferred mental facilities.

Again, the solution for this problem is to remove the quiet time. Don't let your aspie use sleep-time to reflect on their day. Give them a certain time for that before bed but make sure that once they're in bed, they are mentally occupied.


Compounding the problem
It's clear that sleep is a problem for people with aspergers on normal days but there are a few things which can really compound the problem;

Extraordinary Stress
A stressed child will find sleep even more difficult. Lots of things can cause stress, deviation from routine, sensory issues and day-to-day problems. You need to communicate with your child regularly to find what things stress them out.


Social Problems
The more social problems a person has, the more time they'll need to spend reviewing their day. Sometimes it's better as a parent to spend some time before bed putting their social problems to rest. Then, when it's time for them to sleep, distract them with a book.


Medications
Many stimulant medications (most notably ritalin/concerta) have side effects which reduce the patient's ability to sleep. If the medication is still active in a child's body, it will prevent sleep. Check the dose and the time it takes to wear off. If you've given your child a tablet later than usual, don't expect them to fall asleep at the normal time. In fact, if the medication is still in your child's body, don't send them to bed. You'll only make the bedroom into a place of frustration.

You can counter these medications with a natural product called Melatonin but don't automatically assume that "natural" means safe. Melatonin can cause irritability and may have other side-effects too.


Food
There are lots of side effects from food including allergies and discomfort. Some foods such as chocolate and soft drinks have a stimulant effect which keeps kids awake and some foods, particularly those which are high in carbohydrates will cause the body to spend the night processing it rather than relaxing.

The evening meal should really be consumed about four hours before bedtime but today's busy lifestyle means that it's often only a matter of minutes between the meal and sleep. Don't forget too that lying down after a big meal can create reflux problems (and the acid in reflux can damage a child's teeth while they are asleep).


Comfort
Children with Aspergers Syndrome often cite discomfort as a barrier to sleep. This can be a matter of temperature regulation or of difficulty getting comfortable due to bed linen. For example, most people love the feel of freshly laundered linen but many aspies will find the clean linen to be too "scratchy". Sometimes it's to do with the fabric softener you use and sometimes it's to do with specific scents within your detergent.

Distractions
Make sure that your child's room is free of distractions. Ideally, close the blinds against lights, remove toys and make the rest of the house reasonably quiet but not silent. Make sure that your child can't see the television from their doorway. In our case, we have to check the drawers of my son's bedside table regularly because he likes to sneak toys up into his room. If a distraction is present, your children will take advantage of it rather than sleep. Don't forget to check the stuffed animals in the bed as many modern toys will talk, laugh and writhe.

Anxiety and nightmares
Sometimes children won't sleep due to anxiety or nightmares. You might think that you're doing them a favour by not letting them watch scary television shows but you'll find that kids will quickly find alternative things to be scared of. Instead of dracula, they'll be scared of the count on Sesame street. Instead of some space alien, it will be the "spider in my room". Anxious children will always find something to be anxious about so instead of trying to block every experience from their sight, start trying to teach them about liklihood (how likely is it that a bad spider could get up here) and fiction (these things aren't real).

My mother always told me that a nightmare was just my body trying to wake me up to go to the toilet. I found that once I accepted this, I became much less disturbed. If all else fails, remember that you can provide younger children with night-lights and older children with lamps. My own nightmares mostly stopped once I had a bed lamp that I could turn on at any time to dispell the dark.


Things to do?
I've been dropping specific hints throughout this post but here are a few more general things you can try.

Return to Sender....
I think that most people are familiar with the supernanny's tactics and sometimes they work really well. It's always worth trying her tactics at the start of a new set of sleep issues, just to make sure that the issue is inability to sleep rather than sheer wilfulness.

Once you've figured out that your child can't rather than won't sleep, it's time to retire those supernanny tactics otherwise you'll start to exacerbate the bedroom issues. Instead of sleep, consider giving your child a chance to do some low thinking things (reading again). You might consider letting your child out of bed for a while too because sitting in a bed reading will make the bed linen feel too hot and could exacerbate any sensory issues.

Don't be tempted to lock your child's door (though many parents, myself included) will still try it. This won't help your child and may increase their sleep anxiety or simply, as was the case with us, result in the need to purchase a new door. We were certainly surprised that our child could throw things hard enough to put holes in the door.


Quiet before bed
It might seem like a no-brainer but having kids run around excitedly just before bed doesn't actually help them to sleep. It's a pity because "just before bed" is usually "dad time". It's the time when the "big toy" comes home from work and wants to play with the kids.

It's a shame to cut this time out because it's important bonding time so instead, make "dad time" an early priority. Dads should come home, and rumble with the kids for at least 30 minutes, then transition to slower and gentler play.

It's hard because mothers really want some "dad-time" of their own but if you can just get the kids out of the way first, you'll increase your chances.

The same goes for storybook time. Some dads like me are quite animated storytellers and give their characters all manner of accents and sound effects. This is fine but sometimes it stirs the kids up. If you can at least make rules to prevent your children from jumping around during storytime, you'll be able to make the story exciting without the consequences.

Friday, July 8, 2011

Barriers to Empathy

In case you haven't noticed, I'd like to draw your attention to an exciting new blog started by Rachel Cohen-Rottenberg (of Journeys with Autism) called Autism and Empathy.

I think this blog is going to be a great boon to the empathy debate and it's well worth bookmarking/following.

Autism and Empathy

I was reading a post there today and started a reply which (as is usual for me) got a bit too long. In any case, my fat fingers hit a wrong key and my comment disappeared, so rather that attempt to retype it there, I've decided to expand it and post it here.

The post I was responding to is called

Possessing But Not Expressing
It's written by Miranda (from Inside the Heart)

It might be worth reading before you read my response.

---

Miranda talks about how people with autism are often considered to "lack empathy" when what is really lacking is simply the "expected kind of expression".

People express emotion in various ways but people on the autism spectrum are often have characteristics which make interpretation of their expressions difficult. Here are three obvious ones;
  1. A monotone: A voice which in itself sometimes lacks the range of tones that others posess. That's not to suggest that people on the spectrum can't manage tones. They can. They make excellent actors, singers and readers. It's just that when they're in day-to-day conversation, they can't concentrate on everything at once and often variations in tone is one of the casualties.

  2. Facial Expression Difficulties: For example; Some people on the spectrum will grimace instead of smiling. To an NT this indicates pain rather than happiness. Conversely, many will smile when in pain.

  3. Sensory Issues: If touch is a sensory problem, then someone on the spectrum may not give hugs at times when they are most needed. In fact, when a person on the spectrum is in pain, often the thing they crave the most is to be left alone. This is (apparently) the opposite of what many NTs want at these times.
I could probably write a whole post on just those three points but I'm trying to stay on topic.

Miranda's points about posessing without expressing are great. Many people on the spectrum will feel empathy without being able to show that they can feel it.

Of course, playing devil's advocate here, I have to admit that there are some times when they don't feel it - and that's the point of this post.

Three's a good number, so again, I've identified three of those times;


1. When they can't interpret the expression
This is arguably the number one reason why people on the spectrum sometimes don't feel empathy. They don't know that there is a strong emotion present.

Just as our facial expressions and body language are often indecipherable to neurotypicals, so too, theirs is often a mystery to us.

Sure... when someone is crying, it's a no-brainer to say that they're sad. (I'm ignoring tears of happiness). Not everyone cries. Sometimes people have a "sad look" on their face. Sometimes they just interact less. People on the spectrum often interact less when they're pursuing their special interest. How exactly are we supposed to interpret this as sadness?

Then there's the "laughing on the outside while crying on the inside" reaction. I can't even go there. Just take my word for it. It exists, people do it. NT's somehow pick up on it but it's a total mystery to me. Crying = Sad and Laughing = Happy. That's the end of the cues for me.

2. When they really don't have any emotion
I'd love to skip this one and pretend that it doesn't exist but the fact is that I've spoken to many people who claim to have no feelings most of the time. Some of them are on the spectrum but I don't believe that this is a characteristic of the autism spectrum.

There are other words used to describe these states; Sociopaths for instance. I doubt that these people are truly emotionless but the fact remains that there are people for whom emotion is rare. Obviously if they don't feel emotion for themselves, how are they going to feel emotion for others (empathy)?

This brings me to an interesting side note:

Suppose that one of these emotionless people (a sociopath?) has an accident. Perhaps their pet dies. By definition, they feel no emotion about the event. For the moment, we'll just assume that this is all true.

Now suppose that a neurotypical person comes along and this person has no idea that the sociopath does not feel any emotion. If the NT finds out about the pet, they're going to feel "empathy" for the sociopath but this isn't true empathy. The NT will feel sadness and loss which isn't the same as what the sociopath is feeling.

Is it wrong?

How is NT empathy "better" than aspie empathy here? The NT has projected their own feelings onto the situation - clearly ignoring the real feelings of the pet owner.

Think about an embarrassing situation, where someone falls over or has a clothing malfunction. Perhaps I'm thinking about the guy who fell off the back of the titanic in James Cameron's movie and hit the propeller with a hilarious metallic "thunk". The aspie is clearly feeling an emotion here... humour... it might not be the same as the emotion they're supposed to feel but is projecting the wrong emotion still ... empathy?

I'll leave that for my readers to decide...

I raise this point because I find that NTs can often find empathy in a situation but personally, I need the other person to clearly show me that they have an emotion before I can empathize.


3. When the Emotion cannot be related to
This was my original point (the rest of this post grew around it).

Miranda's opening paragraph talks about her relating to embarrassment;

"If I see a person do something embarrassing, even if I don’t know them, I can still feel their embarrassment radiating off of them. Emotions just radiate from others and become my own, most of the time I don’t know the reason for their feelings. I just feel them."

I've had a lot of awkward moments in my life. Seriously. I'd be happy to talk about them. I'm not embarrassed, ashamed or whatever. My "skin" is tough and my self esteem is high enough these days to crush any feelings of embarrassment because I accept who I am - klutz and all.

I have no understanding of embarrassment and I really can't relate to the concept.

There are a whole load of emotions I can relate to and empathize with but embarrassment simply isn't one of them. Do something embarrassing in front of me and I won't empathize with your embarrassment but I will project my "amused" empathy onto you. Of course, if you react by crying, then I can share your sadness - even if I don't exactly understand what caused it.

Thursday, July 7, 2011

Article: "The Science of Autism and Orgasm" by LinZ

Adults on the spectrum: I just want to draw your attention to an article which looks at whether orgams are different for people on the spectrum.

The Science of Autism and Orgasm
by Lindsey Nebeker
and it's on the Naked Brain Inc. Blog

It's about four (short) pages long so when you get to the end of the page, make sure that you click on 2 to move to the next page.

If you want to view the article in total without the page turning, you can view it here;

on the Thinking Person's Guide to Autism blog. (This was actually where I found it).

I'm not going to spend a lot of time commenting on the article because it's well written and considered. It doesn't pick one side or another but simply looks at the cases for and against. It's already balanced.

I will point out however that while orgasms themselves may not be different, it's entirely conceivable that the people involved may experience difficulties if they are on the spectrum due to sensory issues. Remember that many people on the spectrum have major sensory issues. Tripping them would be enough to break anyone's concentration.

The article does actually mention this but I figured it was still worth a highlight.

Monday, July 4, 2011

Book Review: "The Screaming Stone" by J. P. Osterman

It's not often that I get to review fiction on this blog and it's the first time that I've been able to review young adult fiction.

From the title, you'd think that the screaming stone is a fantasy novel but its not. Although there is some talk of mythology, the main events of the book are firmly rooted in reality. It's a mystery and adventure novel with only the slightest hint of fantasy.

I found the writing style to be quite different from the breezy style of J K Rowling but J P Osterman has a long history as an English and writing teacher. She seems to have pitched the book at the early teen and older readers. At about 300 pages, the book isn't overly long and a lot happens within its pages.

While this is a mystery/adventure novel, it's a long way from the formula fiction one usually finds in young adult books on this subject such as The Three Investigators, Trixie Beldon, The Hardy Boys and Encyclopedia Brown. This is good because although I'm not against formula fiction which is great for fledgling readers, it does tend to restrict the learning of older readers. The events in the screaming stone are far less predictable and the characters are "multi-dimensional and real. It's an obvious choice for reading development in kids who enjoy mystery fiction.

The story is set in sixties America and it's mainly about two children in difficult home settings who embark on a treasure hunt through their family's past. There are lots of bits of Irish mythology and the Civil War. Being set in the days before everyone had mobile phones, GPS and the internet means that the mystery can be sustained for longer.

J P Osterman seems to have taken quite a bit of her past and put it in the story. I get the feeling the main character, Marcie, is so well drawn because she really is the author at 13.

I suppose that you're wondering why this review belongs on this blog? The character of Robbie very clearly has Aspergers syndrome. It's never explicitly stated in the book but his behaviour is obvious. He has obsessions, routines which need to be followed and at one point he even has a meltdown. Of course, Aspergers was not a diagnosed condition in the sixties and Robbie receives the sort of treatment provided to aspies in the day. In that sense, it's hard reading about a character who is misunderstood by everyone around him. Given today's tolerance and intervention, Robbie's life would have been so much easier.

Author J P osterman is no stranger to Autism and Aspergers Syndrome with two children on the spectrum. It is nice to see that she doesn't feel the need to label Robbie but simply takes him as an individual and describes him as he is. It is us, the readers, who put the label on him.

At the end of the day, its hard to say what makes the screaming stone so fascinating. Is it the mystery itself or the background and behaviour of the characters? I guess the appeal will depend upon your age and experience. Younger readers will be drawn to the mystery while older readers will find the character study more fascinating.

I'd recommend the screaming stone to the more competent readers in your family (aged 13 and upwards). It's not just a young adult book, there's a great deal in there for us "older" adults too.

The screaming stone is a great addition to the mystery genre for young adults and should effectively bridge the gap between formula fiction and adult novels.

You can read more about J. P. Osterman's other works here; http://www.jposterman.com/

You can buy the Screaming Stone from various outlets including "Infinity Publishing".


Honesty Clause: I was provided with an advance reader copy of The Screaming Stone at no cost for review purposes.