more about stims
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| Fri, 10-07-2005 - 11:31am |
As I've mentioned before we have been concerned with the social impact Kyle's Stims on the playground at school are having. We asked the school to have the recess aide re-direct him or bring him inside to stim. As far as I know he's never been brought in to stim. Ok, Kyle started with a private counsler last week. She's really great. She does sand tray therapy. She said Kyle told her about his need to stim at recess. His sand tray was a war theme, good guy/bad guy thing, that Kyle named something conflict. Ugh, I can't remember the exact name he gave it. The counsler said it was representing Kyle's inner conflict with needing to stim and wanting to fit in and make the adults happy by doing what they/we want him to do. She suggested if we stop his stimming on the playground without replacing it he may start having more trouble in the classroom. She asked if we HAD to make him stop. She said if we do then we should wean him off of the stim and find an approriate replacement. So I'm looking for any input here. What would you do? If we decide on an replacement for the stim what would that be? His stim is pacing/skipping with his head down while muttering to himself. He also holds his fingers/hands a certain way while doing this and flaps a little with the skip. I really am so conficted about this issue. I want him to fit in socially because he cries to me sometimes about the other kids thinking he's weird. But I don't want to stress him out and cause bigger problems by taking away his coping skill. The counseler thinks maybe we should just teach him how to deal with people thinking he's different/weird. Is that even possible to teach kids? We all know kids just want to fit in.
Thanks for any feedback.
Samantha

Samantha,
I deal with this issue too. Nathan stims at recess and also in class (when they are switching from one activity to another). Nathan also paces and he talks to himself on occasion too. He tries to stay connected, but I know it's difficult. He will also just stand there, not answering anyone who speaks to him.....and he has a quirky kinda smile on his face too. At home, I only interrupt stimming if his disconnection is too long. But not being at school, makes it difficult for me to do this. And I don't know if it's possible to have someone there all the time to stop the stimming. I also know that this is a stress releaser for him too, so I don't want to take that away either.
I would like him to be redirected as well. So I'm interested on what everyone has to say about this topic too.
Michelle
I would be curious about what others' thoughts on this topic are too. In general at home, we don't stop Eric stimming unless it is something that will hurt him, because it is obviously his stress-reliever. But I do some redirection that lets him get his stim in another way, instead of twirling his hair, I put a koosh ball in his hand, instead of spinning himeself in circles, I give him a top to spin. Instead of jumping up and down flapping, I suggest he jump on the trampoline. That kind of thing.
However, Eric also does the pacing and muttering thing and I have no idea what one should or should not do about that. I don't do anything, he usually stops on his own. But I admit of all his little quirks, this one bothers me the most and I think in the future stands to cause the most problems for him socially. Right now he is too little, all the kids sort of accept each other at age 3. He used to just pace and talk, now he also has added a little visual stim thing he does with his peripheral vision.
Our OT has suggested doing more relaxation techniques, I wonder if doing something like that at school would help? I wonder if increasing some kind of OT activity at school, although I don't know what it would be, would decrease the pacing? It wouldn't be replacing it, but maybe if they felt more relaxed and had another relaxation outlet, they wouldn't pace etc. so much at school?
Just thinking out loud. Hopefully others will have more concrete suggestions.
Katherine
"I wonder if increasing some kind of OT activity at school, although I don't know what it would be, would decrease the pacing?"
Kyle gets brushing and joint compressions 2xday at school now. He also is supposed to have a move-n-sit cushion on his chair. He hasn't had it this yr yet but he did have it all last yr and still did the pacing. I do agree that more OT stuff might help at school but I'm not sure what more could be done with him being mainstreamed. His OT at school is supposed to be working with him on self regulation. As of yet she hasn't come up with anything helpful.
Samantha
Samantha,
I haven't responded to this sooner, because I have been thinking about it. It's a very difficult question, and one most of us will face, sooner or later.
Kyle is a little older, right? I think he's 11? I think you can get him involved in designing his own therapies. Do you still have access to an OT? IF so, work with the OT to design a plan.
I think you should work with Kyle at home: two pronged approach:
Try various therapies and see if they reduce his need to stim
Have him tell you when he has a need to stim, and try to find a replacement on the fly (just for a few minutes -don't stress him too much).
OK. Stimming is sensory input and self-calming/self regulatory behaviour, so you need to find a self-calming or self regulatory sensory replacement (IMHO). From a sensory perspective, there are three key inputs which usually help:
* Pressure
* Weight / heavy work (which is about the same thing, if you think about it)
* Containment
Pressure things to try: (mostly passive proprioceptive input)
* lay him on the floor, and roll a big therapy ball over his body, applying some of your body weight in increasing amounts. -see if this helps.
* massaging his arms. feet, back,
* Joint Compressions (with or w/o brushing)
* Play "Pete's a pizza" (kid's book which describes a great therapeutic exercise -once saved my sanity in Cleveland airport)
* Sit on him. -OK not actually "on" him, but here we play the 'cushion game' where my kids get behind me on the sofa, and I lean on them -applying sustained deep pressure (and telling them to be quiet. "Cushions don't squeal"). they love it!
* Tight clothing: -Something with a little spandex or lycra worn under his shirt to make him feel more secure.
* a pressure vest -takes the above concept to a higher level
* push down with sustained pressure his head, then his shoulders - best get training from a professional for this one. You could try just pushing on his shoulders by yourself, if you feel comfortable with it.
Weight things to try: (mostly active proprioceptive input)
* "Hold up the wall" push against the wall as hard as possible for about 30 seconds -or longer if it helps.
* Sustained physical activity -particularly climbing, monkey bars, boxing, wrestling, swimming, gymnastics. But running, soccer, karate, dance, baseball are all good too.
* a weighted vest (or weighted belt, lap pad, backpack, toy, ball -something to wear, carry or hold that has heft to it). If he has very low tone, discuss with PT or PT so that posture is not impaired.
* a weighted hat (best to discuss this with a OT or PT -see above)
* playing catch with (or rolling) a weighted ball
* bouncing -pogo stick, those bouncy hopper things, trampolene or mini-trampoline etc.
Containment things: (least socially acceptable)
* make him into a burrito -roll him tightly in a blanket
* buy or make a body sak
* have a safe place -like under a desk or table
"The Out of sync child has fun" by Carol Stock Kranowitz has some great suggestions.
Unfortunately, the only way to find what may work is trial and error. I have found that some deep pressure techniques will work and others will totaly fail with the same kid. Also, (sadly) for me, what generally works for one kid will be a dismal failure for the other. Even more frusrating, sometimes it depends on the kid's mood and other unknown factors -so something which works one day, won't work the next.
The nice thing for you: At Kyle's age, he can give you direct feedback, and you (he) should very quickly see a pattern of what is and isn't working
My kids are now getting to the point where they can recognise a need for some sensory input and approach me for it. -OK Peter's approach is a body slam, which is getting increasingly difficult as he gets bigger (almost knocked me into a display at Pottery Barn last week!), but we are working on that!
I hope some of this helps.
-Paula
visit my blog at www.onesickmother.com
Paula, you are awesome in your sensory replies. We will have to put that to use, lol.
But you know, what hit me was vestibular. The pacing,jumping and such sound like vestibular to me with an auditory component.
For the vestibular, does he like swings? Vestibular is a little harder for them to treat with just diet in the classroom. This may be something he needs a sensory clinic for. 1 year in a sensory clinic for Mike on the swings and such made a huge difference with his vestibular stims and problems at school. He still does some at home but not as much as school. He didn't pace he was more spin things on his desk and tip upside down type. The school did pay for a sensory clinic after school for him because they didn't have one in district and it was interfering with his education.
Rather than the seat cushion at that time they ended up giving Mike an office chair that rolls and moves. Worked great. He is in a regular seat now. Needs some reminders not to tip it back or tip himself, etc, but he does well over all. Another thing that helped him was a weighted vest.
For auditory, see if they will let him have headphones during recess. Listening to music is more socially appropriate than talking to yourself. Also, look into TLP (the listening program).
These may help, but I think you should take a 2 prong approach. I think you should also teach him it is ok to be different. Even if you make the stims somewhat more socially appropriate he will still be different and I think it is important for him and his self-esteem to accept that he is different and that different is OK.
Have you ever read "Asperger Syndrome, the Universe and Everything"? It is by a 10 yo (then) named Kenneth Hall. It is a very positive look at his AS and what he struggles with. The only problem we had with it is that Ken is homeschooled so then Mike thought he should be. Otherwise, when Mike first heard about AS this book really helped him accept it as ok to have and be different.
In fact, Mike told me not that long ago that he was glad he was "gifted with aspergers". He doesn't understand it really well yet, and sometimes still struggles with it and knowing about it but it will be a long learning process to teach him about his differences and htey are ok.
Another AWESOME resource is "Aspergers Syndrome, What does it mean to me?". It is a workbook for this age kid and it helps them learn about them selves and what AS is. It has lots of good tips for adults in there too. Cait finished hers in 2 days. Mike refuses to look at his yet but it is there when he is ready.
Renee
>>We will have to put that to use<<
Well, I *offered*, but iVillage chose to shut down the SID board instead. It must be me... ;)
Good call on the vestibular stuff. I missed that one.
Clinical OT is a very tough one to push for. I am in awe of you that you managed to get it for Mike. I raised it with my SD once and got The Look Of Death. Trouble is, Peter manages to learn and function in the classroom with accomodations, and therefore my little angel functions in school and brings all the stress home. Managed to get verified independently that he is a different kid at home than at achool, but it didn't get me any real help... (Harumph)
-Paula
visit my blog at www.onesickmother.com