Alternative Interventions in Autism

 Sensory Integration Therapy

Sensory Integration is the process through which the brain organizes and interprets external stimuli such as movement, touch, smell, sight and sound. Autistic children often exhibit symptoms of sensory integration abnormalities, typically sensory defensiveness - overreaction to sensory exposures. This makes it difficult for them to process information brought in through the senses. Children can have mild, moderate or severe sensory processing deficits manifesting in either increased ( hypersensitivity ) or decreased (hyposensitivity) to touch, sound, movement, etc… For example, a hypersensitive child may avoid being touched whereas a hyposensitive child will seek the stimulation of feeling objects and may enjoy being in tight places. The sensory channels autistic children tend to have the greatest problems with are tactile and auditory.

The goal of sensory integration therapy is to facilitate the development of the nervous system's ability to process sensory input in a more typical way. Through integration, the brain pulls together sensory messages and forms coherent information upon which to act . SIT uses neurosensory and neuromotor exercises to improve the brain's ability to repair itself. When successful, it can improve attention, concentration, listening, comprehension, balance, coordination and impulsivity control in some children.

The evaluation and treatment of basic sensory integrative processes in the autistic child are usually performed by an occupational and/or physical therapist. A specific program will be planned to provide sensory stimulation to the child, often in conjunction with purposeful muscle activities, to improve how the brain processes and organizes sensory information. The therapy often requires activities that consist of full body movements utilizing different types of equipment. It is believed that SIT does not teach higher-level skills, but enhances the sensory processing abilities thus allowing the child to acquire them.

In addition to the external senses people are very aware of, there are several internal sensory channels, including the vestibular channel which provide the brain information about which way is up through the motion of little rocks in our inner ears, and the proprioceptive channel, which informs the brain about where various parts of the body are located. Occupational therapists have learned that in some children stimulation of the vestibular and proprioceptive channels, through activities like jumping on the trampoline, rolling around on the ground, and doing hard work with the muscles, can help normalize external sensory processing abnormalities. 

Systemic Desensitization 

Systematic desensitization is a type of behavioral therapy used in the field of psychology to help effectively overcome phobias and other anxiety disorders. More specifically, it is a type of Pavlovian therapy / classical conditioning therapy. To begin the process of systematic desensitization, one must first be taught relaxation skills in order to control fear and anxiety responses to specific phobias. Once the individual has been taught these skills, he or she must use them to react towards and overcome situations in an established hierarchy of fears. The goal of this process is that an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy. Systematic desensitization is sometimes called graduated exposure therapy.

Prior to exposure, the therapist teaches the patient cognitive strategies to cope with anxiety. This is necessary because it provides the patient with a means of controlling their fear, rather than letting it build until it becomes unbearable. Relaxation training, such as meditation, is one type of coping strategy. Another means of relaxation is cognitive reappraisal of imagined outcomes. The therapist might encourage subjects to examine what they imagine happening when exposed to the phobic object, allowing them to recognize their catastrophic visions and contrast them with the actual outcome.

The second component of systematic desensitization is gradual exposure to the feared objects or situations. The therapist would begin by asking their patient to develop a fear hierarchy, listing the relative unpleasantness of various types of exposure. For example, seeing a picture of a snake in a newspaper might be rated 5 of 100, while having several live snakes crawling on one’s neck would be the most fearful experience possible. Once the patient had practiced their relaxation technique, the therapist would then present them with the photograph, and help them calm down. They would then present increasingly unpleasant situations: a poster of a snake, a small snake in a box in the other room, a snake in a clear box in view, touching the snake, etc. At each step in the progression, the patient is desensitized to the phobia through the use of the coping technique. They realize that nothing bad happens to them, and the fear gradually extinguishes.

Progressive desensitization has been shown effective in helping autistic children habituate to certain sensations and noises. Gradual change works because the child can feel in control during the process. As change occurs without negative consequence, the child can gain confidence and start to cognitively reframe their reactions to a stimulus. This leads to reduced fear reactions and helps to stop the positive feedback loops that otherwise build.


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