Many parents and professionals are confused about unusual behaviors, generally referred to as “stims,” which are usually associated with autism. These “stims,” in fact, exist to varying degrees with many children and adults, some of whom have various developmental issues and some of whom are considered “typical.” During the past year, many parents of typical children have become concerned their child may fit into the autism spectrum, and a surprising number of normal adults are wondering if they fit into the spectrum as well. That being said, there are many children being permitted—and even encouraged—to engage in what are actually Debilitating Sensory Addictions (DSAs) which do need to be addressed. It’s important to understand what is, and is not, of concern.

Over ten years ago I coined the term DSA, or Debilitating Sensory Addictions, to identify most of what was being referred to as “stims” in children on the autism spectrum. These included developmentally harmful sensory behaviors which may occur in a broad range of children with developmental issues. I incorporated debilitating into the term to indicate that these behaviors are in fact debilitating, as in undermining and impairing development. In addition, these behaviors are addictive. The more the individual engages in the behavior, the stronger the addiction to the behavior becomes, and the more inclined they become to developing sensory and other addictions. The foundation of these behaviors is sensory dysfunction or delayed/underdeveloped sensory function. 

Debilitating Sensory Addictions, although primarily seen in children on the autism spectrum, exist within the broad range of children with delayed development. This is particularly true for those with significant sensory issues. DSAs begin as a form of self-soothing or self-arousal behaviors. They originate around a “broken,” underdeveloped, or abnormal sensory channel and/or a lack of ability or opportunity to engage and interact appropriately with their environment, people, or toys. This was seen very graphically visiting state institutions for those with developmental issues back in the sixties and early seventies. The institutions were filled with “autistic” individuals who had entered after having been labeled or identified as having Down syndrome, cerebral palsy, or brain injuries, etc. The DSAs exhibited by these institutionalized children were often much more extreme than what we observe today in even the most severely involved autistic children. These children were, sadly, models of what can develop in permitted and untreated DSAs. 

DSAs can involve any and all sensory channels and can incorporate more than one at a time. The most common DSAs involve vision and hearing. The most prevalent visual issues, in both children on the spectrum and others with developmental issues, is the delayed or slow development of central vision. Peripheral vision is the first vision that develops in all children. Peripheral vision picks up edges and movement. Most people know that babies are attracted to black and white images with sharp edges and to things that move.* These are things that they can see as opposed to things involving their central, or detail, vision. Most young children are far sighted, meaning they do not see things that are up close well. As they use this central vision more and more it generally improves. If, however, this development is delayed, the central vision may not improve. Delays to central vision development can occur when a child learns to play with their peripheral vision in such a way as to become aroused by this play. This can include waving their hands and objects in front of their eyes or lining up objects and flipping pages. It can also include, once they become mobile, moving around a room looking at the edges of the walls, ceiling, and floor, as well as other objects.

Often the first thing that is apparent with a child on the spectrum is the lack of eye contact. The reality is that it goes way beyond lack of eye contact, to not actually looking directly at many things, since they look peripherally. If you watch a typical person as they look around their environment, you will notice—unless they are thinking—that they look directly at faces or objects of significance. This is as opposed to a child or individual with hyper-peripheral vision and hypo-central vision who rarely look directly at anything and instead look rather absent, which they often are.

One of the common characteristics of those “on the spectrum” is the apparent inability to read expressions. I would propose that many, if not most, of those on the spectrum with this issue simply have underdeveloped central vision. They have learned to look at the periphery of the face (the hair that is sticking up or the edge of the ear), rather than the face itself. If you are not looking at the face, you are not seeing or reading the expression on the face.

DSAs related to hearing or auditory processing issues involve manipulating sound, from producing repetitive sounds with toys, to simply tapping or banging, to various forms of vocal repetitions of sounds, words, phrases, or songs. Also included is covering or batting at the ears to block or modify sounds. 

As mentioned, all sensory channels can be involved in DSAs and can involve more than one sensory channel at a time. As an example, children can engage in hand/mouth DSAs that involve the senses of taste, touch, smell, and in some cases even hearing, all simultaneously. The DSAs involving many sensory channels are often the most difficult to resolve.

We can often equate the degree of DSAs and the degree to which individuals are or are not present with the global degree of developmental delay or the placement on the spectrum

One of the significant effects of DSAs is the child’s lack of connection to their environment or to being present. We incorrectly equate learning almost exclusively with being taught, but the reality is that most of what we learn—and what permits us to interact with our environment and the people in it—relates to the degree to which we are simply present. Those engaged in DSAs are to varying degrees not present.

Perseveration—stuck on repeat

A subtle form of DSAs involves perseveration. Perseveration involves wanting, needing, and essentially being addicted to specific input. Videos, commercials, books, and songs all have the potential of becoming perseverative addictions, or DSAs. If permitted, children will watch the same video over and over, or the same piece of a video over and over,** or want to hear the same book or song over and over. They do this to the point at which they have it memorized and beyond, because they are literally addicted to it. This type of DSA is of particular concern because the child can eventually watch the video, recite the line, or play the song in their head over and over; and although not displaying an overt DSA, they are simply not present. Many parents who are trying to get their child’s attention feel as though their child’s mind is someplace else. This is because their child’s mind is somewhere else; they are watching their video clip or repeating their sound bite in their mind. They are not present.

The greater the DSAs, the less present and connected are the individuals and the greater the impact on global development

The role of neuroplasticity is very relevant to DSAs. Essentially all development occurs because of neuroplasticity, which essentially means that the input the brain receives and how we use our brains determines how our brains become wired and develop. To trigger neuroplasticity, the more specific the input (stimulation) and the greater the frequency, intensity, and duration of the input (stimulation), the greater the impact on the brain and thus the more the brain is trained or developed in that direction. Typically, we perceive learning and stimulation as a good thing and work to utilize the components of neuroplasticity to maximize learning. If, however, we look at DSAs, they tend to occur with very repetitious specificity–high frequency, often with great intensity and extended duration—the model that changes the brain. Unfortunately, in the case of DSAs the change is all negative; it triggers neuroplasticity, but with harmful outcomes. If the DSA involves a “broken” undeveloped sensory channel, it tends to perpetuate and unfortunately strengthen what is “broken” and simultaneously wire the brain for more addictive behaviors. If the brain is focused on this intense input, it simultaneously diminishes the “normal” appropriate input that leads to “normal” development.

Sensory/developmental imbalance and sequential processing

In typical development, changes across the sensory and functional areas are balanced. DSAs and sensory issues tend not to be balanced, meaning unequal. As such, the overall development is imbalanced. A very significant related factor is found in auditory and visual sequential processing. This refers to the number of sequential pieces we can hear or see. This is typically measured in digit spans. If I said a number sequence to you at one second intervals, such as 5-2- 7- 3- 9-0-8 and if you could repeat it, that would give you an auditory digit span of seven, which is normal for most adults. This would be a measure of your auditory processing, or short-term memory, which equates with how much you process of what is said to you. Hearing a list of numbers and repeating them backwards, a reverse auditory digit span, would be a measure of your working memory, which is now being referred to as the new IQ and is the foundation of executive function. Executive function is what permits us to have self -control, inhibit inappropriate behaviors, plan, organize, set goals, problem solve, prioritize–all functions that are challenging for many on the spectrum. Typically, auditory sequential processing develops at about ¾ of a digit a year from birth to about 9 years of age. For most children this growth of processing—including short term and working memory—expands simply by people talking to the child and the child being present and listening. If the child is not present, it significantly impairs this development with global impact, affecting all aspects of typical development, most notably the ability to understand language, to think in words, to develop language, and to think conceptually. 

Essentially, we think in either words or pictures. Thinking in words is called conceptualization and thinking in pictures is called visualization. Because of not being present and other issues, many children with DSAs do not develop auditory processing well and lag behind, often dramatically, in learning to think well in words. Simultaneously, the ability to think in pictures, to visualize, keeps getting stronger, creating a greater and greater imbalance. This is often the root cause of the lack of language development and maturity in children on the spectrum. Often behavior outbursts occur because what is happening in real time does not fit the picture in the child’s mind, and their inability to think in words inhibits their ability to think their way through the situation.

Stim is short for stimulation—a misnomer

We generally perceive stimulation as a good thing, and perhaps, therefore, many tend to think of stims as being good and to be permitted, if not encouraged. But, as stated previously, stims/DSAs are providing the brain with negative input which is detrimental to development. DSAs deprive the individual the means to engage and interact with their environment and produce “bad” brain wiring. My grandfather liked to use the saying “Call an ace an ace.” If we are going to address and fix debilitating sensory additions, let’s start by calling them what they are: DSAs.

Attention, inattention, distraction, and fidgeting—good, bad or ???

What is fidgeting? I correlate fidgeting with the issue of DSA’s obstructing the individual’s ability to be present. If a child or adult is actively engaged in behaviors to varying degrees that prevent them from being present, then I would classify the behavior as a DSA. There is a disturbing tendency to see many (and tragically in some cases, most) children as needing more sensory input. Quite to the contrary. The reality is the need to teach the child, and their brain, to focus, to filter, and to ignore extraneous, disruptive input. To believe that many children in a classroom need additional sensory stimulation is ludicrous. Twenty plus children are in a classroom, with all of them breathing, moving, squirming, mumbling, and talking, while other children move down the hallways, trucks go past outside, and planes flying overhead. All the while, they are supposed to be attending to their teacher or their work. The problem is not children being deprived of sensory input; it’s children being overloaded by sensory input and learning how to tune it out, not tune into it. The more distractions, the tougher it is for the child to learn how to filter and attend. When you were going to school, would you have had a better time attending to your work in a library or in the gym during a basketball game? The few who need a thing to occupy part of their brain while they are learning to filter and focus does not justify teaching others to be distracted and dependent and even addicted to inappropriate actions or mechanisms.

For a small percentage of children and adults, the intention and function of a behavior, such as tapping a foot or a finger to help maintain focus, could be considered a short term needed mechanism, although identifying and addressing the underlying issue or issues is to be preferred. The need for fidgeting may exist because of some residual sensory deficit, such as hyper-peripheral visual distractions or residual figure ground issues; but if the result is better attention and the individual being more present, then, while not to be encouraged, it is fine. Fidgets can also be the reflection of being “wired” from a poor or individually inappropriate diet, from present anxiety or nervousness, or from a residual behavior resulting from previous anxiety. Sometimes it might not even have any direct sensory association at all. But encouraging otherwise typically developing children to adopt such behaviors is counter to healthy normal development.

It is vital to look at all these actions and behaviors that have been lumped together as stims from the perspective of the individual. Most of these behaviors have underlying sensory issues which need to be identified and developed. If understood as addictions, it becomes obvious that we need to do all that we can in order to reduce and eliminate them as much as possible. This process typically involves redirection, elimination of any tools that facilitate DSAs, and appropriate engagement for as much of the waking day as possible. If one of the net results of DSAs is prevention of the individual from being present and engaged, then we need to do everything we can to keep them present and engaged. Sensory channels that are underdeveloped, or which have developed improperly, need to be treated. If sequential processing, short-term memory, working memory, and executive function work together to be the foundation which permits us to learn, develop, to think, and function in society, we need to actively and specifically work to develop these incredibly important functions.

Every person is unique. One of the things I taught both of my sons when they were young and perceptive enough to be able to observe the differences between and oddities of their friends and classmates, was that if you met someone and you did not think they were “weird,” it only meant you didn’t know them well enough. We are all “weird” if you look closely enough, which is rather synonymous with different and unique. That is a good thing and bodes well for the perpetuation of our species. Often labels and terms can cause more harm than good. When we can be definitive, we need to be. When we can identify issues as specific to the individual, we need to. Lumping children together with similar symptoms, and often perceiving these symptoms as pervasive, tends to imply that these symptoms are just part of who and what they are and thus to accept it. Having worked with thousands of individuals with DSAs over fifty years, the most important lesson learned is that each child is unique and complex—and needs to be perceived as such. Doing so is the first important step in helping them do and be what their innate potential would permit them to be. Understanding these associated pieces which are distinctive to the individual leads to creating the necessary tools and the ability to treat each child appropriately so that we can unlock their innate potential.

The children have unlimited potential. Our lack of knowledge and the application of that knowledge is the causative factor which limits the outcomes.

*Some children on the spectrum demonstrate an exceptional ability to identify numbers, letters, and words and even to be able to read at an early age, which appears to be the result 

of an early attraction to the edges of numbers and letters. 

** YouTube has made some children on the spectrum tablet navigation experts, as they are driven to pursue their addictions to specific videos.

Reprinted by permission of The NACD Foundation, Volume 36 No.1, 2023 ©NACD

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by Bob Doman

Who would have thought that one of the potentially most harmful “tools” available to our children was something as educational and entertaining as YouTube? For many children and young adults with developmental issues, it is.

Our work at the National Association for Child Development involves working with the whole child and all aspects of their development. From sleep and diet, to reading and cognition, to social function and behavior, to how they spend their day and how they entertain themselves. Our job is essentially to see where all the pieces are, how they are fitting together or not, and how to work with the family and the child to maximize the child’s function and potential.

We work internationally with the full range of children. From those with severe brain injuries, to those on the autism spectrum, to genetic issues such as Down syndrome, to learning and attention problems, as well as “typical” and talented children. Working with this broad range of children provides us with an opportunity to gain many insights, not the least of which are what tools can be used to our benefit or that can become harmful. For many children, particularly, but not exclusively those with developmental issues, YouTube can have a negative to devastating effect on their global function, wellbeing, and development.

When the iPad first came out, I heralded it, and still do, as both a tremendous developmental and educational tool and source of entertainment. For many children with developmental issues, we finally had an instrument that served as an entire portable toy box and toolbox, an instrument that taught them everything from cause and effect and how to isolate and use their index finger, to how to speak (NACD Apraxia apps) and to think (NACD Cognition Coach apps), therapeutic videos, and an almost endless list of educational and entertaining content and access to a world’s worth of information.

For many parents of our lower functioning children, having something that their child could engage with all by themselves was a godsend. Not many children are going to sit by themselves and entertain themselves putting rings on a post. With the tens of thousands of apps for young children, it was a fairly easy task to find apps that the child enjoyed and to follow a progression of apps that push and follow the child’s development. For an educator and a developmentalist, the iPad and subsequent tablets are certainly some of the greatest inventions ever.

One of the amazing effects of the iPad was how quickly children learned how to use it, and not only use it, but navigate and control it. I have been amazed to watch children with severe handicaps and typical kids as young as two and three navigate and find everything they want on their device, often better than their parents. This facility of children to navigate has, however, created some unintended issues.

For many children one of the favorite and most preferred functions of the iPad is to use it as a vehicle to watch YouTube videos. How some children who can’t even read are able to navigate and find specific videos is rather amazing, but many do it and they do it well.

I first became aware of the issue with YouTube with our children on the autism spectrum. Many of these children have a tendency to get stuck on specific things, with videos being at the top of the list and with music coming in a close second. For more than forty years, I have been hearing parents tell me that their autistic child would watch the same video over and over. Not over and over like four or five times, but over and over like many hundreds of times. I was also hearing of children who, if they had control of a VCR or disc player, would keep rewinding and watching little snippets of the video over and over. What we came to realize was that the children memorized these videos or snippets and would get a huge endorphin rush every time what they anticipated happening did in fact happen. Quite simply, they became addicted to the video or their favorite parts of the video. Why else watch it over and over and over again? In some cases, the addiction was so strong that there was nothing, including eating, that the child would voluntarily do over feeding their video addiction. As it turns out, the iPad and YouTube provided the perfect pairing for creating and feeding the children’s addictions.

One of the issues for many children on the autism spectrum is lack of eye contact and not being present. For many of these children their ability to visualize, think in pictures, is exceptional; and if they become addicted to a video or a specific event, they can “watch” that event over and over again in their mind. If you are visualizing, thinking in pictures, you cannot really simultaneously process what you see well enough to engage in the moment, in the real world properly or to be entirely present. As an example imagine (but don’t really do it) driving on a freeway in rush hour traffic and computing something like 379 plus 86 in your head. Most of you to complete this task would need to picture, or visualize, the numbers to do the computation. Guess what you wouldn’t be doing while completing the problem? Would you believe watching the road. The more mental ammunition these children have to visualize, often the less present and engaged they are. This issue has become exacerbated for many children because of YouTube.

YouTube is the perfect vehicle for these children. It offers an endless variety of short videos that the child can easily locate, stop, go back to their “spot,” and revisit as often as needed. Many of these kids also find related videos easily as well. One of the favorite subjects for some of the children on the spectrum is roller coasters. This has to do with the imbalance between their central and peripheral vision and an attraction to movement and edges, which roller coasters abound in. Some of the children become amazingly talented at finding roller coaster videos, of which there is an almost endless supply on YouTube. The biggest video culprit isn’t roller coasters, however, it’s music videos.

When children watch the same thing over and over, or listen to the same song over and over, or even want the same book read to them over and over, we refer to it as perseveration. (See video below.) In addition, the perseverative child will perseverate with thoughts that lead to perseverative behaviors or actions that involve the senses, often leading to DSAs—Debilitating Sensory Addictive behaviors, or “stims,” all of which are harmful.

We tend erroneously to believe that most of what we know we were “taught,” but in truth most of what our brain processes and what we learn from our world, we learn simply by being present and aware. If a child spends hours a day watching the same YouTube videos over and over and then spends great chunks of the day not really being present, but watching the same videos in their mind, then they are not present, not learning, not engaging in life, and not developing as they should.

In school it is often the quiet child who doesn’t make waves or get into trouble that gets ignored. Unfortunately, many of these children and young adults who are off getting their YouTube fix fit into the same category. Parents and caregivers are happy that these children and adults on the spectrum, or with Down syndrome, or other issues that tend to slow down and misdirect development are quiet, happy, and occupied. Tragically we have seen many children and young adults left to their own devices—pun intended—become more and more addicted to their videos, with a resulting slowing down of their development or even regressing.

Parents, beware. Excessive screen time can be a significant problem—excessive perseverative screen time can be a disaster.

Here are a couple of links to assist you in restricting access to YouTube or other apps:

• https://www.imore.com/how-restrict-siri-airdrop-and-carplay-parental-restrictions-iphone-and-ipad
• https://www.guidingtech.com/block-youtube-screen-time-iphone-ipad/
• https://support.apple.com/en-us/HT201304

Of note, fortunately I have yet to hear of any children perseverating on any of my many YouTube videos. They’re safe and educational, not fodder for perseveration, I hope!

Reprinted by permission of The NACD Foundation, Volume 33 No. 7, 2020 ©NACD

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by Bob Doman

In a previous post, I talked about getting unstuck and how to help change the picture and the minds of children who have weak auditory processing and who are strong visualizers. This combination is never more of an issue than it is with children on the autism spectrum, particularly those who are becoming teens.

Before I go any further, let me say that the combination of strong visualization, addictive behaviors (DSAs), low auditory processing, strength, and hormones is a combination you really want to do you very best to prevent.

This is an issue primarily for children who are “autistic” and generally not for others that are included on the spectrum. One of the primary, if not definitive, issues that separate those on the spectrum is auditory processing. The higher the auditory processing, generally the higher the child is on the continuum. The lower the auditory processing, the more likely we are to encounter this behavior management issue.

Let’s begin by talking a bit about auditory processing, maturity, and behavior. Simplistically you can determine auditory processing, which includes auditory short-term memory, working memory, and executive function, by measuring sequential processing. The first step in auditory sequential processing is short-term memory, which is a measure of how many pieces of auditory input (words) the child can process. If I were to test your auditory sequential processing, I could simply have you listen to a sequence of numbers said slowly and repeat them. With children we can do this as well, or have them follow different kinds of sequential verbal directions.

If I were to do a simple assessment of your auditory working memory, I could again say a sequence of numbers, but this time have you repeat them backwards. To some degree this would be a measure of your complexity of thought.

Executive function is a mechanism related to working memory and complexity of thought. Executive function includes those things we would tend to attribute to people who function well, such as the ability to prioritize, problem solve, and have organizational skills and inhibition, which is essentially stopping yourself from doing things that you know you shouldn’t do or that are harmful for you.

The development of these pieces can be looked at relative to the digit spans I mentioned before.* If we look at the typical development of auditory processing correlated with digit spans or their equivalents, we have approximately the following picture (understanding that the range can easily be +/- 12 months or more):

Auditory forward sequence of 1 = 6-18 months

Auditory forward sequence of 2 = 18-30 months

Auditory forward sequence of 3 = 24-40 months

Auditory forward sequence of 4 = 3 yrs-5 yrs

Auditory forward sequence of 5 = 4 yrs +

Working memory starts kicking in when the forward processing is about a 4. Up until this point, working memory is very limited.

Disregarding various personality differences, when we look at the full range of children, we can to a certain degree associate the auditory processing and complexity of thought with level of maturity and behavior.

Babies 12 months and younger, who are just learning to understand and process language, are pretty easy to deal with as long as they feel fine, aren’t tired or hungry or need a diaper change. You can give them something and they can like it, or you can take something away and they might not particularly even miss it.

When processing starts getting into the 2s, life gets interesting; and we hit what has historically and aptly been called “terrible 2s.” At this point the complexity of thought generally permits the child to process/think “I want” or “I don’t want.” The complexity of thought provides no qualifiers; there is no “later” or “after” or “because.” At this level we should expect and get a lot of tantrums.

I have categorized 3s as “lock and block 3s.” The complexity of thought and lack of working memory doesn’t permit children to think through anything with any real complexity. They rely on familiar patterns and the perception of whether something feels good, feels safe, is non-threatening and fun, or if it breaks previous patterns, doesn’t feel good or safe, is in some way threatening, feels like work, or is important, or simply not fun. Children at this stage can be very intractable and react very poorly if pushed out of their comfort zones.

As we start moving into processing 4s and above, we start getting to a point where we can have some negotiating power and the kids start really using working memory. They can think through things or think their way out of things or old patterns.

I encourage everyone who works with child development and education, and particularly with those who work with special needs, to look at individuals through the lens of processing power and not chronological age. Just because a group of children are approximately the same age doesn’t mean that their functions are going to be very similar or that it is appropriate to be working on the same functions or skills. A typical group of 3-year olds could have auditory processing ranging from a two to a four or more and see the world as very different places. Certainly it is not appropriate to treat them all the same and have the same expectations for all of them. (Not to digress, but perhaps we should help all children development their processing skills. What a great idea! I’ve been trying to get the world to understand this for more than 40 years!)

Relating back to the behavior patterns discussed, imagine a six-foot tall, strong, hormone-driven, visualizing two or three year old. Imagine the tantrums your typical two or three year old might have thrown in the grocery store when you refused to buy them the candy they wanted. Now imagine them being this six-foot, hormone driven, thirteen plus year old child throwing that fit. Do you think that many of those typical two and three year olds physically resist and fight you? Yep! Do you think you would be in major trouble if your two year old were six feet tall and strong as an ox? Yep! Then think about throwing hormones into the mix. And now just think about adding the fact that autistic children are almost universally strong visualizers and probably have a very strong video in their heads as to what they want and don’t want and what should and shouldn’t be, and you have a very intractable child. Breaking or changing a low processing child’s mental picture when they lack the processing power to think their way out of a it can be extremely difficult and even dangerous.

For every parent of every young child on the spectrum, it is imperative that you understand that developing your child’s cognitive abilities needs to be at the top of the priority list. It saddens me (and certainly at times when a family brings me one of these low processing, out of control teenagers infuriates me) that millions and millions of hours and dollars are being spent, not addressing the fundamental sensory issues, DSAs/addictions, and processing power of these children, but teaching them isolated skills and to be prompt-dependent, using antiquated programs like ABA (Applied Behavior Analysis Therapy).

Steps can be taken, starting from when children are tiny and throughout their lives, to build and develop these basic, indispensable cognitive functions and normalize sensory issues, break addictive patterns, and develop the neurodevelopmental foundation that permits them to communicate, learn, integrate into society, and function well.

For those of you who have the low processing, hormone-driven, difficult teens, all isn’t lost; it’s just difficult, and for some very difficult. Many of you are in survival mode and need to use whatever tools are at your disposal to cope. But ultimately we must utilize all of the tools to build the processing, cognition, and maturity to move them forward.

*Assessing auditory processing with strong visualizers is a bit tricky and requires someone with experience and specific expertise. Visualizers tend to produce inflated scores that don’t necessarily reflect their true processing level.

Reprinted by permission of The NACD Foundation, Volume 31 No. 5, 2018 ©NACD

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It is hard to believe that my involvement with NACD started back in 1992, over 25 years ago.  With that said I have had the pleasure of watching many young children grow up to be highly capable adults. Some of these wonderful families are in regular contact while other times I am totally floored, when a voice from the past reaches out after many years. This last month, I heard from a wonderful Mom that I had lost contact with. I worked with her son and his brothers many years ago and am so pleased to hear that Christopher has such a wonderfully fulfilling adult life. For you moms that just need to hear that there is a wonderful future within reach, enjoy this article that Ana Grosshauser shares with us.
—Lyn Waldeck, NACD Developmentalist

What a miracle and wondrous gift to receive our firstborn child! As most new parents and family, we were thrilled! Here was a perfectly formed and beautiful child who seemed so content and peaceful.

Little did we know that this peacefulness and contentment would change so quickly.

From the second day he was born, Christopher cried almost constantly. It was difficult to console him. Breastfeeding was a challenge for him, and so was the bottle. At three weeks of age, he was diagnosed with his first ear infection. This was the beginning of three and a half years of back to back ear infections and antibiotics. Christopher was constantly fussy and crying. He never slept through the night, nor would he nap during the day. Besides the ear infections, Christopher often had bronchitis and pneumonia. He would want to be held, but then felt uncomfortable being held. It was not easy to console him. He usually had to be marched before he would settle down.

Additionally, the vaccinations seemed to make things worse. He reacted with high fever and rashes, and he cried incessantly. As a precaution, his pediatrician decided to give him a second round of vaccinations. This wreaked enormous havoc on his little body. Christopher was miserable and very sick and continued to cry incessantly. As a new mother, my heart was broken; it seemed almost impossible to make our little one smile.

The first few years passed. He babbled and said few words. At three years of age, he had a minimal vocabulary. By the time he was four years of age, the ear infections and the bronchitis/pneumonia episodes finally began to diminish. But now there were learning issues to address.

At age three, Christopher was placed in Project Launch and later, the Early Childhood programs of the school district. He was mainstreamed in the first and second grades with special aides, but there were obvious difficulties in learning, especially with the open classrooms, and the decision was made to homeschool him.

Various evaluators within the school district diagnosed Christopher as having Pervasive Developmental Disorder. In the meantime, Christopher was also taken to an independent neuropsychologist and audiologist who disputed the PDD label, and claimed instead that the difficulty in learning was the result of all the years of ear infections. She gave him a different label of ADHD and pointed me in the direction of an allergist.

Christopher was then taken to several doctors to evaluate him for allergies. Eventually he went to a Chinese doctor and homeopath for several years to treat him for candida, vaccinations, lead poisoning, allergies, and for over-usage of antibiotics.

Christopher was also taken to a DAN (Defeat Autism Now) nutritionist who put him on a strict diet. He also prescribed chelation.

At around age 7, Christopher began having facial tics. These began with the mouth. Later on, they became eye tics. Several years later, the self-stimming became more prominent. There was a lot of spinning, finger and hand flapping, and arm waving. The loud clapping began; often times it would be done right next to my ears! He made up a word and said it a million times a day. He’d “scribble” in the air with his finger. The stimming would change from one thing to another, and they included mouth noises, snapping till his fingers bled, talking to himself, and so forth. At this age, Christopher seemed to almost never get sick. But it was obvious that other things were going wrong.

The OCD developed. Christopher developed an obsession with the computer and his games. He could never go anywhere without caring a container full of computer game boxes. He had the same obsession with photographs. He would line them up and cover the entire family room floor with photos.

In the meantime, the homeschooling continued, but there were constant problems with inattentiveness, hyperactivity, poor short-term memory, auditory processing, sensory integration dysfunction, and manipulative behavior, among other things. The biggest challenge was that Christopher seemed to have very little curiosity or desire to learn about the world around him.

And then, one day, all of this turned around when one of the specialists seeing Christopher recommended that we look into NACD.

After researching their website, I eagerly made an appointment to take Christopher in for an evaluation. Words cannot express the excitement that I felt to FINALLY be given a ray of hope for our child. After trying so many different avenues of doctors and therapies, we were able to implement something that made complete and total sense!

With great fascination, I learned all about the neurological organization of the brain. What a relief to have the support of an astonishingly intelligent and caring group of individuals, and to know that they truly cared, along with his parents, about our child’s success! Following the program meant an enormous amount of commitment on my part, and I found it to be a huge blessing to be able to include this in our homeschooling program. This simply became such a wonderful way of life for us.

We learned so much!! How exciting it was to know that we were working towards building new connections for the brain cells! How encouraging to realize that sensory and motor pathways could be created with the proper stimulation of frequency, intensity, and duration! It made a lot more sense to me to be able to do this within the home every day instead of driving all over creation to visit various doctors and therapists.

One of the most important details that I learned was to do away with the labels and diagnoses. I personally had received about five different diagnoses for Christopher from as many well-meaning professionals. The leaders of NACD reminded me that these diagnoses didn’t matter. What was most important was building up strengths in all the different areas of development. It didn’t matter if a child had special needs, developmental delays, or special gifts. Each one had the ability to grow by leaps and bounds.

I was ecstatic to receive the support of NACD. For many years I had gone round and round in circles and felt frequently overwhelmed. It was so encouraging to feel so understood, and to have their support in writing up the program and lesson plans.

It took months and years of hard work, and we knew that Christopher’s brain was going through many positive changes. He eventually was able to establish his natural dominance. He could be touched without screaming with pain. He was able to master long digit spans easily. He became more pleased with himself and proud of his newfound abilities.

Where once he had great difficulty focusing, he was able to listen more, remembering details, as with directions. His stimming behavior diminished and eventually disappeared completely.

Discovering and learning the NACD philosophy, and then implementing it within our family was the pivotal, most important event in our lives. It has had such a tremendous and positive impact on me and my entire family. I am extremely grateful to this organization, and I carry enormous respect and gratitude for the caring individuals who help run it.

Today, Christopher is a wonderful, well-adjusted 29-year-old young man. He lives a simple life, still at home with his mom, and works part-time at Randall’s. He has an immense love for music and carries close to 50,000 songs on his iPod. Those who know him describe him as extremely friendly and talkative. He is pure joy and love. He has enormous confidence in himself and is almost always happy. He is a beautiful soul.

One day recently, his father had taken him out to eat. Christopher was in his usual happy-go-lucky mood, and his dad was having a bad day. Curiously, his father asked him, “Son, why is it you are ALWAYS so happy??” Christopher looked at him with a smile and simply said, “Because I CHOOSE to be happy!”

We are convinced that he has been sent here to teach all of us around him about love and compassion, patience and tolerance, and happiness! This, to us, his family, is the greatest measure of success.

NACD Newsletter, April 2018 ©NACD

The post Christopher Grosshauser: “I Choose to Be Happy” appeared first on NACD International | The National Association for Child Development.

When our son was about four, we took him for a consultation with a well-known pediatric neurologist. Because Ben used just a few words, made little eye contact and showed little interest in other children, the diagnosis of Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) was no surprise, yet it was still crushing to hear it. There was no “cure” for PDD-NOS the doctor said, but to cope with some of the symptoms, she recommended speech and occupational therapy, along with Applied Behavior Analysis (ABA).

Soon after receiving the diagnosis, Ben started speech therapy and a daily home ABA program and went to an ABA center twice each week. We also entered a season of intense biomedical interventions and supplements. We consulted with DAN doctors, did blood tests and sent blood overseas, changed his diet and used supplements. With all of that, Ben began improving a little, but something was still missing. The various professionals working with our son didn’t really understand some of our unique requests and even with all this help, we felt there was more possible. Intuitively, we knew that an integrated method would help our child best, but had no idea where to find it. Luckily, while researching homeschooling online, we came across a message from an Australian mom who spoke about an integrated approach to treating Autism. This is how we learned about the NACD.

At first, in addition to implementing the NACD program, we continued with ABA and speech therapy (ST). Later, when we saw that the NACD speech activities were effective, even more so than what we had been doing until then, we discontinued ST. Meanwhile, Ben continued to participate in an ABA social skills group for the extra local support since we were the only NACD family in South Africa at that time.

Before NACD, Ben insisted on watching the same movie over and over again, obsessed over trains and cars and stimmed incessantly on their wheels. He also laid on the floor and looked at things sideways. We learned from NACD that he was using his peripheral vision, which is not unusual for children on the spectrum to do, but which NACD identifies as a harmful DSA or Debilitating Sensory Addiction. He was not interested in other people and if he didn’t want to do something he just wouldn’t comply and wouldn’t focus on the person addressing him. Within six months of being on the NACD program however, Ben’s ability to function improved so dramatically that we could tell he was beginning to connect with our world.

Now, after five years of working with the NACD, when people meet Ben for the first time they can’t tell he has special needs. He enjoys judo, gymnastics, Sunday school, woodworking, drama, art, and music classes—all in an environment that is not controlled by mom and dad. He integrates well with other children and gets along just fine. He still has some mannerisms that make him unique, but they are virtually unnoticeable by outsiders and I can honestly say that nothing in him is bad enough that needs explanation.

We are also quite pleased with his academic development. Though it took him a while to learn to read, currently at 10 years old and in the 4^th grade, he is reading at a 6^th grade level. He is doing 6^th grade math, has beautiful handwriting, great general knowledge and his ability to generalize information and to think conceptually is expanding at a steady rate. In fact, seeing how Ben is flourishing while following the NACD homeschool program, we had our other two children evaluated as well. Sara has been great at helping us organize our day efficiently, explaining to us why we do certain program pieces and teaching us how to implement them correctly. NACD has given us structure and support for daily life.

Four-and-one-half years after we began working with the NACD, we took Ben to the same pediatric neurologist to certify a form making us eligible for a tax deduction. Before meeting with Ben, the doctor inquired about him and what therapies we were implementing. When we told her about the NACD she couldn’t understand why or how a mom would do all the work at home and began telling us about a school for children with autism which would be the perfect place for our son. She went on and on for a while trying to convince us how good this school would be for Ben. Then she invited Ben in, had a lengthy conversation with him and asked him several conceptual questions, which he easily answered. The doctor was simply speechless! At the end of the session, she turned to us and said, “Forget everything I’ve said about the school. Keep doing what you are doing, because it obviously works.” We knew Ben was no longer locked up in his little world, but oh, how satisfying it was to receive the validation of the expert!

We are blessed by the work of NACD. It is an integral part of our lives, from helping us understand our children to giving us hope for a brighter, more normal future for our special son.

—Tammy, mother of Ben (as told to Iliana Clift)

Update 2017

Let’s jump ahead to today—Spring 2017! Ben has been on our program for several years since this article was originally written. He, along with his brother Levi and two sisters, Shiloh and Eden are all seasoned NACD kids. I have loved working with this family, whom I have never met in person, but thankfully technology allows us to meet using Facetime and Skype, where I have gotten to know this wonderful South African family even more. I have wanted to write an update on Ben and his family, because they are just doing so fantastic!

Ben, who is 13 1/2, is quite the scientist. This past month he was selected to spend five days on a cruise to the continental shelf to learn about birds. (He is an expert.) He is in the Junior Rangers program and is applying to take a Junior Biology course at the local aquarium (they live near Capetown, South Africa), where only a few children from the state are selected. This is for college credit. He reads biology textbooks for fun and is so present and driven to learn more and help animals. We are already looking into opportunities for him to help pursue his dreams. I am so proud of him. He is so fun to talk to and I learn so much from our conversations!

Since then, his younger brother Levi has also been on program for the last 4-5 years. He is homeschooled like his brother, but hasn’t had any developmental issues. Reading has been a struggle but he is getting much, much better. Through dedicated work on processing, on establishing neurological organization and providing him with the right input, he is in a much better place academically, reading and is quite the math expert. He can be emotional, but only because he wants to do things well. Speaking of doing things well, this kid started doing competitive stand-up paddleboarding and surfing a few years ago. He has done exceptionally well—so well that Under Armour has sponsored him as the company moves their product into South Africa. In addition, he has won many competitions, is the top stand-up paddleboarder for his age in the COUNTRY and is possibly Olympics bound. He is 11! How cool is that? As homeschoolers, they generally get to start their days surfing or “SUPing” before they read. I wish I could do that!

Then you have the two little girls. Shiloh, who is very bright, is just starting her homeschool journey, while Eden is already in the mix of processing, reading, flashcards, exercise, fun unit studies, chores and learning from her siblings. These two will bring their own unique gifts to the table as we learn more about their passions.

I feel so honored to know the Mayes family. I have much respect for all their hard work and dedication. They are a true example of how different our children are and how each one has their own unique gifts to bring to our world. We need scientists. We need athletes. We need thinkers. We need doers. We need talent. We need comedians. We need businessmen. We need entrepreneurs. We need doctors. We need engineers. We need cooks. We need landscape artists. Our children truly can be anything with the gifts they have. Much praise to parents out there like the Mayes family, who help their children reach those dreams and follow their passions.

—Sara Erling, NACD Developmentalist

The post Ben – PDD-NOS (Autism Spectrum Disorder) appeared first on NACD International | The National Association for Child Development.

Printed in the Autism
Health and Wellness Magazine
Volume 1 Issue 3 – Autumn 2009

Bob Doman has been working with autism since the late 1960’s and was part of the team that first discovered the connection between sensory dysfunction and autism. Bob has been instrumental in establishing the foundation for today’s understanding of neurodevelopment and those within the autism spectrum.

Understanding and remediating neurodevelopmental issues of those within the autism spectrum is critical if we are going to provide these individuals with an opportunity to overcome their debilitating developmental issues and to function within “typical” or “normal” limits. The underlying neurodevelopmental issues associated with autism are often not addressed. And when they are addressed, it is often only in part or with inadequate or inappropriate interventions. A thorough understanding of all of the related pieces is necessary if a comprehensive and effective strategy is to be created and implemented.

Most neurodevelopmental issues will not simply go away. Teaching new skills or utilizing aggressive medical or nutritional intervention without addressing the underlying issues may change some function; but if the neurodevelopmental foundation is not established, results are going to be limited at best. And sadly, some of the more aggressive treatments may actually be harmful and cause regression. The predominant view that most children within the spectrum have only limited potential and cannot overcome their issues reflects the overall misunderstanding of the problem. There is a lack of attention to the uniqueness of each individual and a general misperception that we are dealing with a specific disease that will ultimately be cured or eradicated through pharmaceutical or medical intervention. Autism is not polio or chickenpox; you can’t catch it. It is neurologically based, regardless of the initial cause. I am sure we will ultimately see that there are many causes, and like other developmental problems, that there is neither a single cause nor a single solution. The disease model is leading many parents, researchers, and practitioners in the wrong direction. Those within the spectrum are unique individuals, each with their own set of issues and underlying problems, who should not be perceived as having a disease. Those who are and were within the spectrum cover a broad range of ability and disability. Included within the autism spectrum are those who have been “cured,” who are no longer identifiable as having a problem, to savants such as “The Rainman,” Kim Peek, or Daniel Tammet, to those individuals who are so involved and dysfunctional that they cannot be safely maintained in anything other than a very protected, restrictive, and controlled environment.

Discovering, understanding, and learning how to address the unique underlying neurodevelopmental issues has been an effort of a lifetime and a dynamic process. Each insight opens more doors, assists in the understanding of these unique minds, and leads to better results.

Although each child is unique, we have discovered some neurodevelopmental issues that are expressed in varying degrees in virtually every individual on the spectrum. Successful intervention necessitates an understanding of and attention to these fairly universal neurodevelopmental components, including:

Neurology and physiology are interrelated. That which is impacting the child’s physical function impacts their neurological function. Most children on the spectrum are extremely physiologically sensitive. Diets, medications, supplements, and interventions need to be applied with a gentle scientific hand, measuring and evaluating the effects of each specific component with an understanding that generally many interrelated aspects of physiological function are involved. Aggressive intervention often creates another problem. Also, as the neurological function and efficiency improves, so does the physiology–the child becomes healthier and less physiologically sensitive. Intervention needs to by applied gently, with the goal of producing overall health and wellness.

The brain develops if it receives specific, appropriate input through the sensory channels. Specific auditory, visual, and tactile input stimulates the brain and triggers neuro-growth that physically changes the brain and its function. This process is called neuroplasticity. In autism the primary issue is sensory dysfunction. The brain does not correctly process sensory input, thus interfering with the typical neurodevelopment and triggering what is now being referred to as negative plasticity. Function determines structure; how you use your brain determines how it develops. Normalization of all these sensory channels establishes the foundation upon which typical neurodevelopment can occur.

Abnormal sensory function coupled with low sequential processing generally leads to what I have coined as DSAs—Debilitating Sensory Addictions. Generally DSAs are referred to as “stims,” or self-stimulatory behaviors. The reality of DSAs is that the child is playing with what is improperly developed or “broken” in a sensory channel. For example, under-developed central vision and enhanced peripheral vision trigger DSAs that involve the child fixating on the movement or edges of objects. This behavior becomes additive, with the brain responding exactly as it does to a drug or any other addiction. It thus results in the creation of a more addictive brain, which further delays the development of the central vision, the component of our vision primarily responsible for learning, and focuses the brain on fulfilling the addiction. These DSAs often involve many, if not all, sensory channels; and they often dramatically disrupt and corrupt typical development.

Complexity of thought, conceptual thought, language, and global neurological and developmental maturity are critically linked. For those within the spectrum, the developmental delay produced from the sensory dysfunction creates both neurodevelopmental delay and an imbalance affecting these critical functions. The delay is in the development of sequential processing. Sequential processing is the ability to take in a series or sequence of auditory or visual information and to then hold those pieces together and manipulate them. This ability is that which permits us to learn and think. The primary global neurodevelopmental difference between a typical child of one, two, three, four, or five years of age is the difference between their abilities to process information sequentially. Delaying the development of sequential processing delays critical aspects of the child’s total development. Delays in auditory and language development create an imbalance between the ability to think in pictures (i.e. visualization–typically very strong in those with autism) and the ability to think in words (i.e. conceptualization–generally significantly delayed in this population). This imbalance, if not addressed, can and often does have a devastating effect on the ability to process, understand, and utilize language, as well as the ability to think conceptually, thus impacting global function.

A comprehensive treatment regime for children with autism and those on the spectrum involves creating specific neurodevelopmental programs for each child. These programs and treatment protocols must address health and wellness, sensory issues (visual, tactile, auditory, olfactory and taste), processing problems (auditory and visual), lack of development of and imbalance in visualization and conceptualization, fine and gross motor function, cognitive and academic function, and speech and language, as well as behavioral and social issues. We tackle these issues by designing a very child-specific, holistic, coordinated Targeted Developmental Intervention (TDI)® program. A TDI program is created after we thoroughly review the child’s history and conduct an in-depth developmental and educational assessment.

The work we do at NACD with children with autism has changed the previous notions that they are unable to progress and learn, or that the only effective treatments are behavior modification programs and skill-based training programs. NACD does not see children on the autism spectrum as being unreachable. We respect them for who they are and believe that they, like any child, are capable of attaining their innate potential and that they deserve the opportunity to do so.

Reprinted by permission of The NACD Foundation, Volume 22 No. 10, 2009 ©NACD

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Children labeled as “autistic” have been enigmas since they were first identified. Fortunately, some questions surrounding these children are being answered. Many “autistic” children (children with sensory dysfunction) are now being helped, and some are achieving “normal” function. As a result of NACD’s work with “autistic” children, we have also gained a better understanding of sensory function. This understanding has had implications and applications to our work with all children.

Historically, the parents of “autistic” children have suffered more (if such suffering can in fact be measured) than the parents of any other group of children. The classic “autistic” child was viewed as a child with a severe emotional problem, or as a child with childhood schizophrenia. Often, this emotional or psychiatric condition was attributed to maternal rejection. In addition to society’s punishment of the parent (particularly of the mother for supposedly rejecting her child), was the child’s behavior, which often appeared to others as rejection of people in general, and to the mother as a rejection of her in particular. Add to this the child’s often rather bizarre, and in some cases, destructive behavior, and you have a description of a very untenable situation. Such is one’s introduction to the world of the “autistic” child. Fortunately, as with many of the mystiques built up around unanswered questions, the view of the “autistic” child as an emotionally disturbed child is based upon supposition, not fact. Suppositions that we strongly question.

The Isolated “Autistic” Child

Generally, descriptions of “autistic” children are rather similar. They are essentially descriptions of symptoms, leaving the questions of cause and cure open.

When Fenichel (1960) described children with “childhood schizophrenia” he described the “autistic” child as follows: “They have little or no speech, they rarely display any effective awareness of people, and they maintain a level of activity that has the barest relation to objects or events in the real world.” Fenichel then subdivides “autistic” children into two groups: “those who have been retarded in maturation from birth, and those children with a history of regression.”

Kanner, in 1958, established criteria for infantile autism as the following: “An extreme self-isolation, or an inability to relate themselves in the ordinary way to people or situations from early in life,” and “an obsessive insistence of the maintenance of sameness.”

Children who have been diagnosed as “autistic” function within a very broad range. On the mild end of the spectrum are children who in many ways look and even act rather “normal,” but who may have some perseverative or repetitious behaviors such as rocking, humming, or repeating verbatim what is said to them (echolalia). At the other extreme are children whose behavior appears to fit many people’s perception of a severely emotionally disturbed individual. Such children are characterized by behavior that can be very hyper (active) or hypo (inactive); they can be destructive, self-destructive, and at times aggressive. All such children can generally be described as exhibiting some degree of self-isolation.

A Problem of Perception

The “autistic” child can be perceived as an emotionally disturbed child without a great deal of difficulty. They are often in their own little world, and they essentially do reject others to varying degrees. They may strike out at others, at their environment, and even at themselves as though consumed by some inner emotional force. But if we view these behaviors through other eyes, they can begin to make even greater sense.

Why do many “autistic” children have perfectly “normal” siblings? Why do many “autistic” children have warm, loving mothers? Why do some children begin life “normally” and regress into an “autistic” condition a year, or two, or three after birth? These questions cannot be easily answered with the “emotional” model; however, they can be answered with the “neurological/sensory” model.

Autism – Sensory Dysfunction

Years ago, work with brain-injured children began with the “cerebral palsied” child and the traumatically brain-injured child (mechanical injury, i.e., auto accidents, etc.), and widened with ever expanding concentric circles as implications derived from the obviously brain-injured had application to other children. Such implications expanded to include the “autistic” child.

Many obviously brain-injured children exhibit some behaviors that are often used to characterize the “autistic” child. Severely brain-injured children, as their sensory awareness develops, engage in hand waving, fascination with light, rocking, repetitious noise making, “spacing out,” self-stimulation, and in some cases, self-destructive behaviors. Are these children “a little autistic,” and as they progress and improve their sensory function and these behaviors are eliminated, do they get over being a “little autistic?”

NACD’s perception of the “autistic” child follows the neurological/sensory model. A child who has been labeled as “autistic” is viewed not as an emotionally disturbed child, or as a child with a psychiatric problem, but as a child with sensory dysfunction whose abnormal behavior is a reflection of abnormal perception.

Typically, a child given an emotional/psychiatric label is not examined or evaluated beyond the parameters of the problem as it is perceived. However, NACD has had the opportunity to examine the results of full neurological workups of “autistic” children. The results of such workups indicate that “autistic” children are brain-injured.

Examining the “autistic” child as a brain-injured child clarifies many aspects of their development and function. Referring back to Fenichel, he subdivided “autistic” children into those who were retarded in maturation from birth and those with a history of regression. When viewed as brain-injured, those children with delayed development match the expected pattern of a child with injury that affected various levels of the brain, while the child who has regressed fits the pattern of a child with an injury to only higher levels of the brain; levels that the child might not attempt to utilize until months or years following birth. This picture is not dissimilar to that of the cerebral palsied child who develops normally for the first few months before exhibiting the cerebral palsy symptoms resulting from injury to the mid brain. The rather classic picture of the “autistic” child who is attractive in appearance with only minor motor problems, or with no motor problems at all, but who is very self-stimulating, self-isolated, and who lacks speech, is a picture of a child with what generally turns out to be mild-diffuse cortical brain injury that does not seriously affect motor function, but does seriously disorganize sensory integration and the cortical function of language.

Sensory Dysfunction

NACD refers to the “autistic” child as a child with sensory dysfunction. Our work with these children begins by evaluating function in order to determine the degree and type of abnormal sensory function. That is to say, by looking at how the child reacts, it is possible to make a determination as to how the child perceives the world, which then makes it possible to assess the child’s problems in the various sensory channels. How we see the world is determined by how our brains interpret the information that comes through our five senses. How a “normal” individual perceives the world is not always as it is. For example, how loud do your children yell? If you are wide awake and relaxed, they do not yell too loudly. If you are tired and grumpy their yelling seems too loud; and if you have a migraine headache, the sound is intolerable. All the same volume but perceived differently. The way we see the world is determined by how our brains interpret it.

How does the brain of the child with sensory dysfunction perceive the world? Carl Delacato, in his book “The Ultimate Stranger,” classifies each sensory channel as being hyper, hypo, or being disrupted by “white noise” or interference within the system. Each sensory channel can be affected in a different way: For example, a child can be hypo-visual, “white noise” auditory, hypo to tastes and odors, and hyper-tactile. Each child needs to be considered on an individual basis. Evaluation of an individual is complicated by the interaction of the five sensory channels.

The Emergence of a Pattern

Through our work with children who have sensory dysfunction, a pattern has emerged into which more than half of the “autistic” children appear to fit. This pattern includes the following: hyper-auditory, hypo-central vision, hyper-peripheral vision, hyper-touch, hyper-pressure and temperature, and hypo-taste and odor. The abnormal perception produces what is termed sensory agnosia, or an inability to attach meaning to sensory impressions. Much of the input coming to these children appears to create antagonism between input, with the child’s ultimate interpretation being determined by the interplay between the various dysfunctional sensory channels. Let’s examine a typical/atypical child with severe sensory dysfunction.

Hyper-Auditory

Being hyper-auditory, sounds in the child’s environment seem much louder to him than they do to us. Because of the acuteness of his hearing and what appears to be a particular sensitivity to high sounds, the hyper-auditory child lives in a very confusing and often threatening auditory environment. He is bombarded with sound. As we attempt to talk to such a child, he is not only hearing our distorted voices, but a buzz from the fluorescent light overhead, the conversation in the next room and the traffic outside. The greater the quantity and volume of these sounds, the more difficult the interpretation. Depending upon the severity of the problem, such children will act confused, intensify their activity level and increase their degree of disorientation as the volume increases, or they may simply, turn off auditorily just to survive. As many of these children begin to improve auditorily, they understand much of what is said, but they do not hear clearly or cleanly enough to reproduce speech normally.

Hypo-Central Vision, Hyper-Peripheral Vision

The central, or macular vision of these children is hypo, or depressed, and the peripheral vision is hyper, or agitated. The result being that such children use their peripheral vision instead of their central vision to see. These children tend not to look directly at things; they do not make good eye contact, and they tend to reach for things without apparently looking at them first. These children often engage in self-stimulating visual play; they have a fascination for lights, reflections, and spinning objects; and they use, rather than play with, toys. The antagonism that exists between the agitated peripheral vision and the depressed central vision tends to perpetuate the problem until such time as direct remediative measures can be imposed.

Hyper-Touch, Hypo-Pressure and Temperature

Many things seem to create a pleasure/pain conflict with these children; their tactile systems often epitomizing this conflict. Often children with sensory dysfunction are hyper, or super-sensitive to touch. The touch receptors of the skin are so sensitive that the child may pull away from touch with fear and pain. The same child, however, if grasped firmly and deeply massaged, enjoys the sensations that this deep pressure produces. This sensitivity to touch complicates the teaching of manual skills. The self-destructiveness of some “autistic” children (biting, banging of their heads, etc.) provides them with pleasure/pain experience. Often, they appear to simply enjoy feeling.

Hypo-Taste and Odor

Many of these children are hypo-responsive to tastes and odors. They do not appear to be aware of the tastes of most foods or the odors in their environment. Being hypo-taste can produce a variety of food preferences, or lack of such. Some of the children will eat anything and everything, including harmful substances. Some will only eat foods with very strong tastes B strong enough so they can taste something. Others will find a taste they can recognize and will not eat anything unless it is this one taste.

Assessment of the Individual

Although there are some patterns being identified in “autistic” children, general assumptions should not be made about individuals. Each child must be observed as the unique individual he or she is. Knowledge of children with similar problems, however, can provide insights that can greatly assist in the diagnostic and therapeutic processes.

Treatment

Treatment of the child with a sensory dysfunction is multifaceted, including components of neurological organization, specific sensory training, design of a protected sensory environment, behavior management, as well as general medical and nutritional care. The sensory environment is of utmost importance for these children.

Coupling these problems of hyper, hypo, and agitated responses with antagonism between incoming sensory input, produces the vital need for a controlled sensory environment. Many “autistic” children, when placed in a controlled environment, respond immediately to the new non-threatening environment. For example, the hyper-auditory and hypo-central, hyper-peripheral vision children spend as much of their day as possible in an environment void of all extraneous auditory and visual input Auditory input is provided via earphones so as to avoid interference from other sounds. The physical environment is as sparse as possible so as to avoid stimulation of the overactive peripheral vision. Blacklight rooms are utilized, which eliminate the entire peripheral world (only white and fluorescent objects can be seen in blacklight). Fluorescent toys are introduced to help stimulate the central vision and teach the children how to play appropriately. Such controlled sensory environments are an integral part of the NACD Centers, and they are major factors in assisting these children in achieving their full potential.

The “Autistic” Genius

The hyper sensory function found in most “autistic” children can be changed from a negative, inhibiting function to a positive, contributing function. There is numerous documentations of “autistic” children with unusual capabilities: children who, given a date, can immediately tell you upon which day of the week it had fallen, or will fall; children with incredible memories for trivia; children who can instantly calculate complex mathematical problems. Most of these children were never taught how to do these things, and for the most part could only do one such exceptional thing. We have learned however, that many “autistic” children can be taught to do many things exceptionally well.

Learning How We Learn

Most of our children with sensory dysfunction read before they speak. Some of them read better (faster and with better comprehension) than their “normal” peers. And a few read better than anyone would have thought anyone could read. Some compute mathematics exceptionally well and some learn foreign languages virtually overnight. We have learned to use teaching as a therapeutic tool to help these children “tune in.”

Thirteen-year-old Bruce did not talk nor respond to anyone talking to him. He just floated around, and he looked no harder at people than he did at pieces of furniture. Bruce was totally in his own world. Bruce was hyper-visual and auditory and had turned the world off. To help Bruce, we started flashing word cards at him very rapidly (l/2 second intervals). These rapidly flashing cards attracted Bruce visually as rays of sunlight or steam had previously. Bruce watched the cards. As they were flashed, they were named. Bruce began to listen to the names and to associate the names with the words. Soon Bruce noticed the hands holding the cards, and the person attached to the hands B his mother. Bruce began to learn faster than we could develop materials. Bruce was able now to learn something and remember it after having seen it only once, for l/2 a second. Within two years, Bruce could read, understand, and remember everything he read, and he could read an entire page in a glance! He also remembers everything he hears; he computes mathematics instantly and understands six different languages. Bruce is very affectionate and has a good sense of humor. But Bruce is not “fixed” yet. His verbal language is still delayed, and sensitivity in his hands makes him reluctant to manipulate many things as he should. But he is well on his way!

There are others. Some who began at levels above Bruce, and others below. But many of their abilities to learn have been shocking and eye opening. Rapid, clean (free of extraneous stimuli) presentation has been the key. The same key we have discovered that turns on the “normal” preschool child; the same key that enables many other children who supposedly couldn’t learn, to learn. We have ascertained things about perception and sensory function from our “autistic” children that are helping us understand more about the entire learning process.

It is unfortunate that we live in an age of specialization, rigidity, and segregation when there is so much we can learn from each other. As our insights become clearer, hopefully more doors will open, and we can help more of these children come closer to achieving their full potentials.

Reprinted by permission of The NACD Foundation, Volume 6 No. 11, 1986 ©NACD

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