The World Through Their Eyes

Angela WoodwardPatient Family Liaison

Integrative Pediatrics of Ohio, Allen T. Lewis, MDwww.integrativepediatricsofohio.com

Goal for Today

Learn some facts about Autism andAutism Spectrum Disorders in order to:

1. Show compassion, understanding and support towards affected individuals

2. Better serve and care for children who are affected

3. Be prepared and informed

Today’s Discussion� The Incidence of Autism and ASD� Parents and Disclosure � The Autism Spectrum – What it is?� Characteristics of Autism and ASD� Understanding Sensory Dysfunction� Social Difficulties� Safety Concerns� Tips for Safety� Tips for Quality of Experience� Meltdowns� What Parents Want

Incidence of Autism Spectrum Disorder

� Fastest growing developmental disability in the US

� Over 2 million in the US, over tens of millions worldwide

� 2014 – CDC reports 1 out of 68 children, (1 out 42 boys)

� Considered an Epidemic, increasing rapidly� Currently the CDC website reports that

1 out of 6 children (3 – 17 yrs) have 1 or more developmental disabilities

Rates of Increase

Parents and Disclosure

� Some will tell you up front

� Some will know but will not tell you

� Some will be unaware or in denial

The Autism Spectrum

The Autism Spectrum (ASD) is a group of complex disorders of brain development characterized by difficulties with:

1. Social Interaction2. Verbal and Non -verbal Communication3. Repetitive Behaviors

Includes Autism, Aspergers, PDD/PDD -NOS(some consider ADD/ADHD to be on the cusp)

The Autism Spectrum

In addition to difficulties with:1. Social Interaction2. Verbal and Non -verbal Communication3. Repetitive Behaviors

Some may also have difficulties with:1. Intellectual Abilities2. Motor Coordination3. Attention and Focus4. Physical Health (Sleep/GI/Allergies)5. Sensory Processing

Social Interaction Difficulties1. Failure to respond to name

2. Reduced interest in people

3. Difficulty playing social games

4. Preference to play alone

5. Failure to seek comfort

6. Failure to respond to anger or affection

7. Difficulty understanding what others think or feel

8. Difficulty understanding social cues

9. Difficulty regulating emotions

Communication Difficulties1. Difficulty putting words into sentences2. May repeat phrases over and over3. May only repeat what they hear (echolalia)

4. May have large vocabularies but can’t sustain a conversation

5. May talk about a favorite subject and not let other s talk

6. May only be able to speak at an adult level7. Inability to understand sarcasm, slang or humor8. Inability to read facial expressions or body

language9. Inability to exhibit different facial expressions, voice

fluctuations, body language

Repetitive Behaviors1. Hand-flapping, rocking, jumping, twirling2. Arranging & rearranging objects3. Lining up objects4. Repeating sounds, words or phrases5. Repeating same activity over and over6. Intense preoccupations/obsessions (fans,

exit signs)7. Extreme interest/fixation of topics

(dinosaurs, trains, letters, numbers, movies, animals, science)

8. Difficulty adjusting to change

What is Sensory Integration?

How we process what we:See Hear

Touch Smell Taste

Traffic Light — Traffic JamEx: Processing Landscape vs. Soundscape

The majority of children on the Autism Spectrum hav e Sensory Integration problems.

Sensory Integration Dysfunction� Hyper-Sensitivity (over-sensitive)

Sensitive to sound, light, smells, textures, flavor sSome Signs: Hands over ears, covering face, squintin g, won’t touch certain things, won’t eat certain textures, p roblems with clothes/coats/shoes/socks/tags/stickers

• Chuck E. Cheese / Black Friday Shopping

� Hypo -Sensitivity (under-sensitive)Lack of sensitivity to pain/injuries, lack of atten tion to environment, people or things, lack of dizzinessSome Signs: Spinning without falling down, non-respo nsive or delayed response to people/sounds/alarms/stimuli, l ow fear, low or no response to injury

Sensory Issues and Programs

� Hyper-Sensitivity (over-sensitive)Sound (vacuums, mowers, flushing, yelling/cheering, music programs, crying, florescent lighting-vibration)

Light (indoor vs. outdoor)

Smell (perfumes, hand sanitizer, soaps, paints, lacquers)

Touch (child won’t touch play-dough, project items, pelts , sand)

� Hypo -Sensitivity (under-sensitive)Awareness (child gets to an area that is not safe and is unresponsive to risks or your instruction to stop)

Injuries (child is injured and does not respond to alert you )

What Might You See?� Poor eye contact� Difficulty mixing with other children� Toe-walking� Self-stimulatory or repetitive behaviors� Poor transitioning or rigidity� Poor tolerance to change� Easily agitated or upset, possible tantrums� Anxiety and fears (bees - common extreme fear)� Problems sitting still� Tics (involuntary movements or sounds)� OCD – Fixations on topics, objects or rituals� Covering of the ears� Gastrointestinal issues� Sensory Integration Issues

Social Difficulties – What to Do?� Sometimes we have to go where they are

� Relate to their interests

� Remember they may have trouble reading our emotions, facial expressions, body language

� Be specific, watch sarcasm and abstract thought. See how they communicate.

Additional Things to Note� Non-verbal Children Understand Us

� Children who are not very expressive of emotions still have very strong feelings

� Autism Spectrum Disorders have MANY different faces

� Children with ASDs are very smart and learn to care for and express themselves in many ways when we can’t help them.

Safety Concerns

� Runners� Allergies (food/inhalant)� Hypo -sensitivity – unresponsive to injury/pain� Seizures� Asthma� PICA – eating non -food items

Safety Tips� Questionnaires & good program descriptions � Disclose snacks that will be served prior� Watch snack sharing� Colored name tags (allergies, runner, sensory)� Buddy system when walking somewhere� Pictures to accompany rules – keep posted� Be specific when you explain rules� Have enough people � Check kids over for injuries� Immediate contact number for parent� Keep exit doors closed

Quality of Experience Tips� Watch perfumes, lotions, hand sanitizer, paint� Provide a schedule with pictures� Try having a routine, if more than one day� Try to keep leaders the same� Minimize loud sounds when possible� Have a “Quiet/Safe” place for meltdowns� Watch bullying� Be aware of bathroom location and access� Sensory Toys (provide or ask parents if

needed)

A word about MeltdownsTry to see the world through their eyes:

Consider:� Changes� Sensory Overloads (Therapist Example)

Don’t become the sensory overload yourself. Remember Slow, Silly, Shhhh

What a Parent Wants

� They want their child to be safe.

� They want their child to be treated fairly and well.

� They want their child to have a fun and memorable experience (they really want their child to enjoy this world, rather than be overwhelmed by it).

The Amazing Opportunity

Parks and Recreation professionals have anamazing opportunity to make a difference

in the life of a child with Autism Spectrum Disorder.