Sensory Processing Responses to Comforting Touch in Children with Autism

Transcription

1 Sensory Processing Responses to Comforting Touch in Children with Autism RP 302 Saturday, April 5, :00-9:00 AM AOTA Conference, Baltimore, MD Guy L. McCormack, PhD, OTR/L,FAOTA

2 Comforting Touch The concept of physical touch in caring has not been well articulated in the literature. The concept of physical touch in caring is a complex phenomenon having meanings in several different dimensions such as promoting physical and emotional comfort in normally developing children.

3 Goals of the Presentation Goal 1 To describe differences in the response to comforting touch in children with autism and normally developing children. Goal 2 Describe the methods, procedures and results of the study and evidence to support the findings of the study Goal 3 Discuss successful strategies for soothing children with autism and for normally developing children. Goal 4 Discuss examples of Interventions that are promising for future Occupational Therapy Practice

4 Observed Differences Children with Autism Normally Developing Children

5 Attachment Theory Attachment or early bond between child and parent is a factor in how child responds to trauma. Hippocampal and Amygdala volume has been assessed from magnetic resonance images. The Hippocampus helps to regulate responses to stress.

6 Methodology This study used a randomized quasiexperimental design and the Comfort Questionnaire to compare mothers selfreports of children with autism (N = 25) to mothers reports of typically developing children (N = 26).

7 Analysis of Data We used T-test analyses to determine significant differences between the two groups in relation to methods of providing comfort, and response to physical contact. The hypothesis was evaluated as a two-tail analysis, allowing for a Type 1 error rate of.05. The Pearson Product-Moment Correlation Coefficient (r) examined patterns of correlation between soothability measures and ratios of favored or resistance to physical contact.

8 Results The procedures mothers used to comfort children with autism and normally developing children were different. Mothers of children with autism reported more difficulty in comforting their children and found visual and auditory stimuli worked best. Mothers of typically developing children reported more success in soothing by using comforting touch.

9 Discussion How practitioners use touch to comfort children with Autism raises many clinical and ethical issues. Can forms of touch be a successful method of providing a relaxation response in children with Autism?

10 Imaging Studies Showing Hypoperfusion in Temporal Lobes in Children with Autism Spectrum Disorder

11 Children with sensory processing disorders have over growth of brain s white matter which is essential for perceiving, thinking and learning. Trouble with Emotional regulation and Attention Elysa Marco, MD UCSF

12 Associated Regions of the Brain Contributing to Sensory Processing Disorders

13 Non-Verbal Behavior The language of children with autism is their behavior. Rather than tell a practitioner how they feel, they may act it out.

14 Engaging Attention Early Intervention seems to improve the ability to develop language skills. It integrate tactile and verbal expression in activities.

15 Enriched Environments and Sensory Input Promotes Dendritic Growth.

16 Early Intervention Studies Symbolic play- One object represents another object. Divided attention between object and person Fessenden,M (2012). Early intervention could help Autistic children to speak. Scientific American.com

17 Light Touch Massage Removes Biochemical Substances in Soft Tissues: Vasopressin Levels Reduced Rapport MH, Schettler, Bresee,C (2010). A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic-Pituitary Adrenal and Immune Function in Normal Individuals. J. of Alternative and Complementary Medicine 16,10 pp

18 Touch Stimulation and the Insula

19 Qigong Massage Program Occupational therapists can help families understand that children with autism have unique styles of sensory processing that influence their behavior in the parentchild relationship. Silva, L.M., Schalock, M & Gabrielse, K. (2011). Early intervention for Autism with a parent-delivered qigong Massage Program: A randomized controlled trial. AJOT,65,

20 Loewy, J., Stewart, K., Dassler, A (2013). The Effects of Music on Vital Signs, Feeding and Sleep in Premature Infants. Beth Israel Medical Center, N.Y.,N.Y. Music is processed globally in the brain. Elements such as rhythm affect physiological and developmental functions.

21 Auditory Processing and the Nucleus Basalis Gatekeeper-relays signals to the auditory system to other regions of the brain. Main subcortical source of cortical acetylcholine (Ach) which is associated with speed and strength of synaptic connections. Acetylcholine accelerates Activity-dependent neuroplasticity & developmental epochs.

22 Therapeutic Applications Children with Autism become socially engaged when they mouth words & rhythms.

23 Studies on Stress and Telomere Length UCSF scientist Elissa Epel, PhD, showed a link between psychological stress and Telomere length. Life Style Changes Stress management Diet Exercise Increased Social support

24 Excess Stress & Cortisol Levels Studies show mothers of children with autism have high levels of stress. Impaired cognitive performance Lowered immunity and inflammatory responses in the body, slowed wound healing, and other health consequences.

25 Meditation Matters Imaging studies show neuroplasticity causes thickness in the Insula and Orbital Frontal Lobes after mediation.

26 Kirtan Kriya 12 Minute Protocol Sa Ta Na Ma Chant out loud for 2 minutes Chant in a whisper for 2 minutes Chant in silence for 4 minutes Chant in a whisper for 2 minutes Chant out loud for 2 minutes

27 Telomerase Activity Meditation increased telomerase by 43% Lavretsky H1, Epel ES, Siddarth P, Nazarian N, Cyr NS, Khalsa DS, Lin J, Blackburn E, Irwin MR.(2013). A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: effects on mental health, cognition, and telomerase activity.

28 OT Areas of Occupation Rest and Sleep in OTPF Rest induces a relaxed state and renewed interest in engagement. Sleep preparation- establishing sleep patterns Sleep Participation- sustaining a sleep state without interruption.

29 Nedergaard and Colleagues of Rochester University The main detoxifying system in the brain consists of the cerebrospinal fluid (CSF) that is produced by filtration through the brain arteries into the surrounding spaces, and circulates among the brain structures. Researchers found that the space inside the brains increased by 60 percent during sleep.

30 Neuroplasticity We have known for over 10 years that the brain is capable of change. Neuroplasticity is an important part of how human humans have evolved to adapt.