What is autism?WHY IS IT SO HARD TO DEFINE?

Does autism come from the Brain, the Mind or the Body?

-The terms Brain and Mind are sometimes used interchangeably

-Sometimes people forget that Body is attached to the Brain and therefore Mind

-Some believe it is a disorder (stemming from genetic or birth defect),

-Some believe it is a disease (stemming from environmental or viral causes).

-Some believe it is simply a difference (a natural, normal variant in humans)

-Additionally, autism is a spectrum, impacting individuals to different degrees

Symptoms of autism Social-interaction difficulties

Communication challenges

Repetitive behaviors

Anxiety

Irritability

Focus and attention issues

Control issues

Lack Theory of Mind

Self stimulatory behavior

Gut issues

So what is autism? Autism is all of the above.

Autism involves the body, brain and minds of individual people. Sometimes there are clear genetic tendencies, and sometimes there are clear environmental causes, and sometimes all of us can be somewhat on the spectrum.

The symptoms we see in those with an autism diagnosis can be obstacles for a good quality of life.

What does this mean therapeutically?

Therapy is treatment intended to relieve or heal a disorder.

As a therapist (or parent), you are in a position to make decisions about how you intend to relieve (compensate) or heal (remediate) autism.

Many therapists and settings are focused on compensation of symptoms (ex. Social skills, structured teaching, shaping, modifying and extinguishing behavior)

Pathways Treatment Center focusses on remediation

Remediation of autism Remediation is the correction of something that is not functioning correctly What does remediation of autism mean? Organization of the body, brain and mind.

Is remediation an option for autism? Yes. It requires a lot of work.

Is remediation “measurable”? Not easily.

Is it quick? No and requires that the parents are highly involved, motivated and supported.

Is it worth it? Absolutely

What do we know about brains of people with autism?

Brains of people who have autism have some important anatomical and functional differences from brains of people who do not have that diagnosis.

There is an increasing body of research being done into these differences.

There is not a specific area of the brain that is “not working” but the synchronicity and connectivity of neural pathways are different.

What do we know about minds of people with autism?

-confusion

-difficulty focusing

-overwhelmed

-disconnected

-stuck in thought

-afraid of change

-misunderstanding

- chaotic

Philosophy Minds are the activity of the brain

Minds develop via experiences and relationships

The wiring of your brain can change your mind

Your mind can change the physiology of your brain

Your experiences and relationships happen with your body

Your mind develops via experiences and relationships

Its all connected

Neuro Plasticity the capacity of the brain to create new neural connections and grow new neural connections in response to thoughts (mind), experiences and relationships

This capacity of the brain continues throughout a lifespan

Some of my Therapy Heroes

Dr. Svelana Masgutova

Dr. Steven Gutstein Dr. Daniel Siegel

Dr. Siegel’s Hand model

Consider how information comes into the body

Sensory information enters the body and is transmitted via sensory nerves to the central nervous system

Early in development specific motor patterns occur in reaction to the sensory input and are called Primitive Reflexes

As the baby grows and develops these Primitive Reflexes integrate into the brain and serve as basis for many necessary functions of the brain.

Primitive Reflexes Reflex:

◦ A muscle reaction that happens automatically in response to a certain type of sensory stimulation

◦ Neuro-sensory-motor reflex circuits◦ Automatic, unconscious, and constant – guaranteeing stability for the nervous

system in stress and distress

Mediated by the BRAINSTEM and CEREBELLUM

The movements are innate, not volitional and are expressed by every individual

Emerging as early as 11-12wks gestation.

Emergence, Activation, maturation, and

integration.

The Purpose of Reflex Patterns Survival and protection/ genetically encoded system programed to spur on development

Fundamental neurological building blocks for all learned movement and skills

Crucial for development of the brain and many cognitive and intellectual processes

Protection, survival, growth and development

Vygotsky“The first infant movements do not disappear, they continue to work in union with higher nervous formations”

In other words, primitive reflexes do not become “inhibited”, they integrate.

The integration is very important for development of the brain and therefore the mind.

What if the reflexes do not integrate?

Physical, emotional and cognitive functioning will likely be impacted.

People with labels such as: Autism, Dyslexia, ADHD, LD, apraxia, Aspergers, Downs Syndrome, sensory processing disorder, and speech and language disorder are very likely to have non-integrated reflexes

Integration of Primitive Reflexes Serves as a way to organize and stabilize what is occurring in the brainstem and lower limbic system

Establishes “positive protection” so that the brain can develop and mature

The Reticular Activating System is a part of your brainstem. It acts as a customizable filter which adapts to sensory information delivered from the sensory neurons

Many people with autism have RAS filtering problems, delivering too much or too little information to the brain

The Brain is an Experience Dependent Organ

If the information from the sensory and motor input from the body is unreliable or different, the wiring of that brain will be different and unreliable

Brains that are unreliable have a difficult time experiencing the world and relationships in a regular way

The mind builds on the structure of the brain is also based on experience and relationships

MNRI Masgutova Neuro-Sensory-Motor Reflex Integration

Russian Psychologist, Svetlana Masgutova.

Techniques and exercises developed with the goal of maximizing positive protection in order to facilitate restoration and maturation of the primary movement systems.

Combining what we know about how the body works biomechanically (contraction and extension principles)…..with how we understand the brain to work neurologically

What does MNRI look like? It is hands on work with the body and face

Specific sensory input along with the correct motor movement to re-pattern primary reflexes

Other parts of MNRI are about releasing tendons and muscles that are in protection and delivery of specific touch into the tactile system

The Oral Facial part of MNRI is about activation and integration of the cranial nerves and is directly applicable for eating, talking and auditory processing

The Mind and Autism If the RAS of people with autism is not properly functioning, that person will have over or under reactions to sensory input

Based on that experience, the person is likely to be put into a state of “fight/flight/freeze”

Being in that state limits the brain’s ability to use its higher order thinking abilities

Being in that state also creates high states of emotion for both that person and those around that person

This impacts relationships, communication and experience based learning

Relationship Development Intervention (RDI)

Developed by Steven Gutstein and his wife Rachelle Sheeley, Child Psychologists in Houston, TX

A parent training model that uses consultation to address the core thinking, learning, communication and relationship issues common in people who have autism

RDI is about helping parents to use communication, trust and engagement to restore a guiding relationship and expose the child to dynamic thinking processes

Static Thinking The vast majority of mind differences in people with autism revolve around relative strengths in static thinking and relative deficits in dynamic thinking.

Static thinking involves mental processes that are predictable, patterned, routine, and unchanging in nature. Static thinking can be simplistic (watching the same video again and again) to very complex in nature (What day of the week was November 28, 1798?)

Doing things repetitively, screen time, using chunks of language and having a hard time with change is symptomatic of too much static thinking

Dynamic Thinking Dynamic thinking is often thought of as common sense.

It is non-patterned, context dependent, co-regulatory and un-predictable

It typically develops without people targeting work on it

Having conversations, working with others, having friendships, managing multiple things at the same time are examples of dynamic thinking abilities

People with autism typically have difficulties around these “non-measurable” processes, making them slippery concepts in therapy

What does RDI look like? Consultants meet with parents and provide education about autism and dynamic learning

Concepts include things like how to use communication to help the child with pre-requisites of experience based learning

Pre-requisites include: engagement, feeling safe in relationship, building trust, communication, reciprocity, internal motivation and competency, paying attention….

Parents are given a goal to work towards with the help of the Consultant. Parents video tape their work and then problem solve as a team

Does this fit into a Speech-Language Pathology model?

It is all related, body, brain, mind and communication.

Communication and thinking, relationships and learning are impossible to separate.

Parents want and need to be involved in the therapeutic process if remediation will be possible.

The setting in which you work will likely dictate what kinds of work you are able to use.

My website is: www.pathwaystreatmentcenter.org

Email: aecameron@aol.com