autism

Book Review: The Out of Sync Child

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Book Review- Out-of-Sync Child Grows Up: Coping With Sensory Processing Disorder in the Adolescent and Young Adult Years

               Kranowitz, C.S. (2016). Out-of-Sync Child Grows Up: Coping With Sensory Processing Disorder in the Adolescent and Young Adult Years. New York, NY. The Penguin Group.

 

 

 

In Carol Kranowitz first book The Out-of-Sync Child, many challenges and strategies of living with sensory processing disorder (SPD) are brought to light. It was an enlightening read that I would recommend to professionals, parents, and friends that interact with individuals of all ages, stages, and diagnosis involving SPD. Based on the overall knowledge I gained from that book, I was excited to read Kranowitz’s sequel The Out-of-Sync Child Grows Up. The material is very applicable to the age groups and backgrounds that I have been privileged to work with at The George Center thus far. After learning more about sensory processing, I was left with several specific questions. This book answered many of them!

 

Before jumping into details of the book, think with me first to back when you were or teenager or young adult. The hormone changes, the emotions, the desires or disappointments, the perspective you had on life, how you compare yourself to others, maybe even how you judged others around you, and so on. Teenage years can be an awkward time of maturing and an exciting time of development, but they can also be a painful stage if support systems are not present. We can all remember mentors, parents, siblings, teachers, and coaches that influenced and encouraged us. But, what if you were different physically? What if you couldn’t wear clothes that were in style because they irritated your skin or you couldn’t participate in extracurricular activities due physical challenges? What if people didn’t understand and support you? Not having certain opportunities in this stage of life can feel confusing, unfair, and often hurtful, as peers are not always accepting of anything or anyone deemed “different”.  This is something that individuals with SPD face, especially considering that SPD is often diagnosed alongside other diagnosis such as autism, obsessive-compulsive disorder, and attention deficit disorder.

 

Sensory obstacles come in all forms. There are sensory modulation disorders, sensory discrimination disorders, and sensory-based motor disorders (Kranowitz, 2016). No matter the form, everyday tasks like getting dressed, eating meals, and travel have unique challenges. Many normal daily activities may be painful, over stimulating, or physically challenging to individuals with SPD. Considering this, Kranowitz emphasizes the importance of family relationships amongst this population.

 

For the purposes of this review I would like to focus mainly on what Kranowitz shares about coping with relationships and gaining self-acceptance. Often individuals with diagnoses that cause them to perform differently than others also are perceived differently, which can have a large emotional effect. Through working with multiple populations that face SPD, especially motor movement differences and speech challenges, I know from experience not to assume anything based off of what is perceived  on the outside. There is always more going on with the body and mind of a person than what we perceive from the outside. This book exemplifies this reality through research review and testimonial compilation.  

 

Let’s talk about negativity. Many different emotions, for example shame and guilt, stem from negativity. For individuals with sensory differences, these feelings are a huge issue (Kranowitz, 2016, p. 44). This is important for teachers, peers, caregivers, and especially family of individuals with SPD to be aware of. Although SPD has no found cure, individuals and families can learn to make adaptations and live in a way that works for them. Instead of frustration when it takes longer for an individual with SPD to complete classwork, there should be encouragement. Kranowitz shares one adult male’s testimony with SPD, saying, “Stop listening to those that don’t understand you” (Kranowitz, 2016, p. 51). The individual went on to encourage people to research their symptoms, reframe their situation, and seek out effective therapeutic resources to help them overcome big challenges. This individual had friends and family that supported him throughout an occupational therapy journey. Over time he was able to report feeling hopeful instead of hopeless in a world of sensory obstacles.

 

As teenagers with SPD struggle emotionally, so can their close family members. It is not easy when a parent lacks understanding for the way their child reacts to certain situations or stimuli (Kranowitz, 2016, p. 155). The family dynamic can be negatively affected if therapeutic approaches and lifestyle adaptations are not utilized. An example shared was a teenager who grew up feeling distant from her parents and siblings because she was misunderstood. Her reactions to scratchy clothes and loud noises were treated as misbehaviors. When she had a meltdown and received additional attention from her parents, her siblings teased her and exhibited jealousy towards her. It wasn’t until later in life that she was diagnosed with mild autism and SPD. She was thankful to finally have an answer to why she felt so out of place (Kranowitz, 2016, p. 157).

 

This is where music therapy becomes a wonderful option, because it creates a therapeutic atmosphere that is client centered, effective, and generalizable in the home. Music also becomes a means of sensory integration and coping through the support of music interventions. In chapter 13 individuals share examples of their successes and thriving careers. After years of therapy, supportive families, informed teachers, and applied coping strategies, they were able to overcome challenges to accomplish their goals. Several of them mention music in their excerpts. There is a drummer and a singer, both advocates in the SPD community. They share about how music was their lifeline, as it restored order in their bodies when other activities were too much (Kranowitz, 2016).

 

One of many skills I have been able to work on during my time at The George Center has been counseling. Counseling techniques are important because many of the patients we serve not only want to improve and meet their therapeutic goals, but there is also an element of coping with a diagnosis that is a constant battle in many of their lives. Kranowitz elaborates on the emotional impact living with SPD can have on individuals sharing pieces of personal testimonies, as well as sharing therapeutic success stories from professionals. Applicable coping strategies for life skills and emotional trials are also shared in each chapter.  Some of these topics include daily activities, relationships, and transitioning into adulthood. The last section of the book focuses on specific treatment and shares multiple examples of therapies as well as lifestyle changes that have benefited individuals with SPD in the long run. Although music therapy is not explicitly referenced, the importance of music is mention multiple times.

 

I think it is important to note that this book has a strong occupational therapy focus, but encourages all options. After reading the many testimonies and complimentary terminology to music therapy, I was ready to research more. I would LOVE to find the music therapy based equivalent of this book. Music therapy fits in so well with this population, and I have seen first hand sensory success made in music therapy sessions. One beneficial technique mentioned throughout this book is deep pressure. In music therapy we utilize a similar technique, called rhythmic body mapping. Other techniques used are lyric analysis, sensory integration using music and instruments, movement to music, music performance, and therapeutic singing.


Overall I was pleased with the information this book had to offer and I enjoyed the way the author connected the medical research to real life examples. It was a truly eye opening read as some of the testimonials were sad, but very real. For anyone wanting to read more into how it feels to live with SPD or a diagnosis with similar challenges, this is definitely the book for you.

 

 

 

 

 

 

 

 

 

 

 

 

 

Songs, Sensory, and Social Skills: Group Music Therapy for Children with Autism

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The possibilities that music brings to the therapeutic process are endless. Communication, motor movement, processing, stimulation, sensory elements, and so much more are easily accessed through the use of music alone. As a new intern, my first weeks at the George Center have been full of observing all of this in action.  My mind seems to be more full than ever of examples of how music therapy is used to benefit the lives of individuals everyday. Considering all of this, as I chose my first journal article, I decided to pick something that addresses one of many populations that I am passionate about: children with autism.

In my experience, Autism Spectrum Disorder (ASD) presents itself differently in every child. There is beauty in this, but it definitely does NOT make an easy job for science. This diagnosis can still be a highly controversial in many settings and even homes. The history of therapy for this population can be both inspiring and heartbreaking to those who know how far the world of healthcare has come in regards to individuals with ASD. All of this is exciting as we see research lead to successes being documented, especially with music therapy.

According to the  article Effects of a Music Therapy Group Intervention on Enhancing Social Skills in Children with Autism, statistics show that 1 in 88 children in the United States are diagnosed with ASD (LaGasse, 2014). Since this study statistics have changed. According to the Center of Disease Control and Prevention 1 in 68 children now meet the criteria for ASD. Autism is defined in short, as a neurodevelopmental disorder. Current research suggests that neurological aspects influence specific features of ASD. Some of these directly relate to motor deficits and difficulties with sensory processing. However, research also confirms that individuals with ASD demonstrate different musical processing skills, in that the activation of their brain surpasses that of neurotypical or normally developing individuals (LaGasse, 2014). So, good news: music is a multisensory medium!  

You may ask, “What is one of the biggest challenges for children with ASD?” I would venture to say that one of the largest areas of focus in general is socialization and communication. Although this is a large focus, to achieve goals in this area the regulation of the sensory system is what current research has shown to be most important. Therefore, it may be language development we are trying to foster; other times it is socialization skills and interactions that are required on a daily basis that we are trying to build on or make more tolerable through music therapy. The areas of expressive, receptive, verbal, and nonverbal language all fall under social and communicative areas of development. One way music therapy can help children that battle issues like this is through group interventions. This article by LaGasse exemplifies recent successes in this area, so let’s jump into the details!

Studies show that music therapy can improve social behaviors and joint attention in children with ASD. LaGasse delves into what impact music therapy has in a group setting along with areas of focus within the groups relating to social skills, which included eye gaze, joint attention, and communication. To examine this in the study children ages 6-9 with ASD were assigned a music therapy group or a non-music therapy group. The children participated in two 50-minute sessions per week for 5 weeks, for a total of ten sessions during the study. Each group was designed to target social skills.

Social skills are important to be addressed in children with autism because the lack of development in these skills will have lifelong implications (LaGasse, 2014). It is stressed that social skills are needed in every relationship and activity. Noting this, another important piece of research is referenced in this article, stating that, “ The notion that persons with ASD do not want to be involved in their environment is being challenged as self-advocates with autism indicate that it is not a matter of wanting to interact; rather, they have an inability to follow through or tolerate the desired interaction” (Goddard & Goddard, 2012). Key words there are inability and desired.  As research like this advances, it is becoming more apparent that by helping develop these skills in children with ASD, we are also giving them tools to enhance their overall quality of life.

The outcome of this study was very interesting. Through the use of uniform scales to measure the changes in social behaviors, the results found over this brief period of time that the music therapy group showed more improvements. Positive differences primarily showed up in attention with peers and eye gaze towards individuals (LaGasse, 2014). After 10 sessions the mean for eye gaze variable in the final calculations increased by 3.73 for the music therapy group. The mean decreased 14.75 for the non music social skills group. The explanation of these results pointed toward musical structure being able to maintain children’s attention to their peers more than the prompts and visuals used in the nonmusical group.

These results are important because they validate techniques being used in music therapy and highlight an issue that has a lasting impact on the ASD population. In the music therapy group of this study, some intervention tools used were rhythmic cueing, rhythmic deep pressure exercises with songs, instrument playing, as well as music and movement. For both groups the goals were the same, however, outcomes for the music therapy group were different. Both groups had interventions revolving around group interactions, cooperative play, and sensory experiences. The rhythmic and structural components of music can provide a cue or foundation externally that assists individuals with ASD in organizing their responses to their surroundings (LaGasse, 2014). This fact only supports why the music therapy group had higher positive outcomes.

This article is one of many that scientifically support the use of music therapy for children with ASD. This type of research impacts my work as a future music therapist and as an advocate for individuals I serve because it supports the use of music as a therapeutic tool to reach nonusical goals. Going forward, I will continue to observe and participate in ASD groups with the mindset that this type of research gives of hope and a solid foundation to what possible benefits music therapy services can bring. There are opportunities everyday to observe success happening at the George Center. I appreciate the proactiveness, integrity, and assumed competence I have observed each therapist treat ASD clients with at this facility.

The importance of early intervention and consistent complimentary treatments like music therapy cannot be advised enough by professionals.  It is my hope that through being able to share small pieces of this, that parents, teachers, and current therapists will continue to take initiative and stay updated on ASD research. For this relates to our professions, our caregivers, our community, and most importantly our loved ones impacted by this diagnosis everyday. It is our job to advocate and support these children that cannot always access the ability to do so for themselves.   

 

 

A. Blythe LaGasse (2014). Effects of a Music Therapy Group Intervention on             Enhancing  Social Skills in Children with Autism, Journal of Music Therapy,         51,(3). 250–275.     


Goddard, P., & Goddard, D. (2012). I am intelligent: From heartbreak to healing- A         mother and daughter’s journey through autism. Guilford, CT: Skirt!

Round Up, January 6th

Welcome to the first Round Up of 2014! Have you settled into the work groove yet after a nice break? Perhaps you're still snowed in if you're up North (winter break 2.0!). If that's the case, you might be getting a case of cabin fever right about now and could use some reading material. Don't worry, I got you.

Why Does Music Aid in Memorization? (The Wall Street Journal)

Prepare to get nerdy. This is an excellent write up about just how music helps us memorize things (think about how you learned the alphabet, or even the state capitals), down to which areas of the brain are activated. Pretty interesting stuff!

 

Your Aging Brain Will Be in Better Shape If You've Taken Music Lessons (National Geographic)

Two recent studies found that children involved in a music class showed no difference in intelligence level following the class than a group of students not involved in the music class. That might sound disappointing, but we should also remember that this study was limited to one type of music curriculum, and did not investigate and long term changes involved in music participation.

In fact, this story from National Geographic highlights some possible gains in the VERY long term as you age!

 How Close is a Treatment for Alzheimer's Disease? (CBS This Morning)

CBS's chief medical corespondent discusses some new studies regarding our knowledge of Alzheimer's disease and how close we might be to finding effective treatments. It's a race against the clock, unfortunately, as our aging population points to a possible explosion of Alzheimer's diagnoses in the coming years.

Boynton Beach man on the autism spectrum turns music ability into a profession (WPTV) 

Good story about a phenomenally talented musicians who happens to have autism who turned his talent into a career! And kudos for the person-first language in the headline, WPTV.

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