How To: Progressive Muscle Relaxation for Self-Regulation with Children & Adolescents

Progressive Muscle Relaxation (PMR) is a great technique to use with children struggling with self-regulation because it allows for personalization of the scripted passages we use to guide the exercise. Read more to download your FREE PMR Worksheet…

It can be challenging to find a self-regulation technique that works, especially if the child you’re working with has autism. Children with autism often struggle with self-regulation, making it challenging for them to express and manage emotions, anxious thoughts, or physical stress.

Progressive Muscle Relaxation (PMR) is a great technique to use with children struggling with self-regulation because it allows for personalization of the scripted passages we use to guide the exercise. You can use PMR as a calming technique at home, at the office, or in the classroom and tailor the session to meet the individual needs of the child.

PMR focuses on relaxing, then tensing, specific groups of muscles. It teaches the child to notice the differences between how muscles feel when they are relaxed, versus when they are tense. Besides the calming effect PMR has, it also teaches the child to recognize when their body feels stressed and will help them develop skills to reduce tension and self-regulate.

Tips:

  • It works best when the parent, educator, or therapist reads the script in a soothing voice, or plays a PMR script.
  • Try to practice once a day.
  • Practice in a quiet, comfortable place.

There are many different PMR scripts you can use. Feel free to individualize this sample sheet below to better meet the needs of the child you’re working with.

Download a FREE Progressive Muscle Relaxation Script Here


This free PMR worksheet is from The Key to Autism: An Evidence-based Workbook for Assessing and Treating Children and Adolescents by Dr. Cara Marker Daily.

Environmental Enrichment: A Multisensory Enrichment Protocol for Autism

Environmental Enrichment (EE) was designed as a low-cost program that has been shown to decrease autism symptoms and sensory issues and increase receptive language and cognitive skills at home. In this blog from Teresa Garland, MOT, OTR/L, you can download a free EE activity worksheet.

Environmental Enrichment (EE) is an awesome protocol that has been shown to decrease autism symptoms and sensory issues and to increase receptive language and cognitive skills in children with ASD of all ages. It was designed as a low-cost program for parents to do at home, but it can also be done in a school setting, or better yet, shared between home and school.

EE is a 6-month protocol with activities that change every two weeks. Parents/teachers select several multi-sensory activities from a list of 34 activities and do them for the two week period. They work with the child twice a day for about 15-20 minutes each. As the sessions progress, the child gains awareness of sensation and gains multi-sensory integration skills. The activities also build joint-attention skills, which are known to decrease autism severity.

The protocol is simply described in two published papers available for free online (see references below for more information).

In addition, my book, Hands-On Activities for Children with Autism & Sensory Disordersdevotes 80 pages to the protocol, providing approximately 200 activity variations and talking through program implementation details, including the Draw What You Feel activity.

Download the Draw What You Feel Activity (It’s FREE!)

Give it a try and let me know how it goes!


Teresa Garland, MOT, OTR/L, is an occupational therapist and author specializing in sensory and modulation issues. Garland works closely with other health professionals, teachers and doctors to understand and treat underlying sensory, timing, and coordination/motor planning issues as well as overlying socio/emotional behaviors in the symptoms of autism. She is the author of two books: Self-Regulation Interventions and Strategies: Keeping the Body, Mind and Emotions on Task in Children with Autism, ADHD or Sensory Disorders and Hands-On Activities for Children with Autism & Sensory Disorders.

She writes a blog at otselfregulation.blogspot.com/.


Woo, C. C., & Leon, M. (2013). Environmental enrichment as an effective treatment for autism: A randomized controlled trial. Behavioral Neuroscience, 487-97.

Woo, C., Donnelly, J. H., Steinberg-Epstein, R. R., & Leon, M. (2015). Environmental enrichment as a therapy for autism: a clinical trial replication and extension. Behavioral Neuroscience, 412-422.

How Does the Brain with Autism Work?

Understanding the brain with autism is quite complex, as it is with understanding the brain of any individual, whether that individual is neurotypical or not. The more we know about the brain, the more we will know what interventions are the most effective in working with ASD.

Have you ever wondered how the brain of an individual with autism works? I love studying the brain. It is the most complex organ in the body. Everyone’s brain is different, whether you have autism or not. When it comes to autism spectrum disorders (ASD), we have learned a lot about the brain in the last 10 years. Numerous studies document how individuals with ASD have more neurons in their brains compared to neurotypical individuals. These neurons may be disrupted or impaired, causing overconnectivity or underconnectivity in different parts of the brain.

So what does this all mean?

Several researchers, including Nancy Minshew from University of Pittsburg, have described certain intact and impaired abilities that individuals with ASD have based on brain research. In talking with adults with autism, many have reported similar abilities or impairments.

Those abilities that have been described as Intact include the following:

Basic attention. Basic attention means the ability to attend to one thing at a time. For example, if I had four items on my desk, such as a phone, a pencil, a piece of paper, and an eraser, an individual with ASD would only be able to attend to one item at a time. If attending to the pencil, that individual with ASD would not be able to attend to the phone, paper, or eraser.

Elementary motor. Most individuals with ASD have intact elementary motor skills. Elementary motor is defined as performing one motor skill at a time. If they have any other impairments in motor abilities, this would likely be related to a separate motor disorder.

Sensory perception. Individuals with ASD have intact or even enhanced abilities when it comes to sensory perception. Each individual with ASD is different. Some individuals of ASD may be more sensitive to sounds than lights. Other individuals may be more sensitive to touch then smells.

Simple memory. Individuals with ASD have an intact or even enhanced simple memory. It is important to not confuse simple memory with complex memory. Simple memory can be detailed. Many individuals with ASD can tell me every specific detail of a situation. This is called simple detailed memory, meaning they are attending to one piece of information at a time.

Formal language. We also know that the phonological and grammatical elements of communication, are intact and may be enhanced. This is why some individuals with ASD may talk more formally than neurotypical individuals. If an individual with ASD is demonstrating other communication impairments such as articulation delays or an expressive or receptive language delay, this would be considered a communication disorder that is not related to ASD.

Rule-learning. The rule-learning aspects of the brain are intact or enhanced. This is typically why individuals with ASD are extremely focused on schedules or rules. When a schedule or rule is changed or not being followed, the part of the brain that allows them to be flexible does not work the same as a neurotypical individual.

Visuospatial processing. Most individuals with ASD have intact or even enhanced abilities in visual spatial processing. They are not only visualizing what they hear, but they are processing information visually and spatially. For most individuals with ASD, visual information is their primary language.

Those abilities that have been described as Impaired include:

Executive functioning. Many individuals with ASD have an impairment in the temporal and prefrontal cortex, which is responsible for executive functioning. This higher-level cognitive functioning may include difficulties with inhibition, flexible thinking, problem-solving, planning, impulse control, concept formation, abstract thinking and creativity.

Integrative processing. Any type of integrative or complex processing may be impaired. For example, complex sensory, motor, memory, or language skills are going to be difficult for an individual with ASD. This is because they are only able to attend to one skill or piece of information at a time. Have you ever wondered why techniques that use Applied Behavioral Analysis (ABA) work with the ASD population? ABA breaks down complex tasks into single parts. ABA techniques teach one basic skill at a time, thus setting up the child up for success.

Visuospatial facial recognition. Individuals with ASD have difficulties with facial recognition. If individuals with ASD are only able to attend to one piece of information at a time, they may only be able to attend to the individual’s nose or mouth. In fact, if you ask adults with ASD how they recognize another person, they will typically tell you by another characteristic, such as their hairstyle or their skin tone.

Concept formation. Concept or prototype formation is the ability to organize information into different categories. For example, a neurotypical developing child at the age of two may see a poodle, cocker spaniel, and shih tzu, and call all of them “dog.” In comparison, an individual with ASD might say, “That is a poodle, a cocker spaniel, and a shih tzu.” The ability to create the concept of “dog” does not work the same way in their brain.

Auditory processing. Many individuals with ASD appear to process auditory information in the right hemisphere (occipital lobe) instead of the left hemisphere, which means they are processing auditory information visually. I have heard many individuals with ASD say, “I see in pictures.” This now makes sense. If an individual’s primary language is visual then it would be helpful for us to talk less and use more visuals. That is why using techniques like the picture exchange communication system (PECs) is helpful in teaching individuals with ASD.

Understanding the brain with autism is quite complex, as it is with understanding the brain of any individual, whether that individual is neurotypical or not. The more we know about the brain, the more we will know what interventions are the most effective in working with ASD.


This blog was brought to life by PESI speaker and author Cara Marker Daily, PhD.

Cara Marker Daily, PhD, is a licensed pediatric psychologist with over 20 years of experience providing assessment and treatment for children with autism in the home, school, hospital, and community settings. Dr. Daily is the president and training director of Daily Behavioral Health, a leading behavioral health provider in northeast Ohio specializing in assessment, consultation, and treatment of autism, anxiety and disruptive behavior disorders. She is also the founder and executive director of the Building Behaviors Autism Center, a nonprofit organization that provides free and reduced cost applied behavioral analysis services to families of children with autism spectrum disorders.


Read more from Dr. Daily in her newly released book “The Key to Autism: An Evidence-based Workbook for Assessing and Treating Children & Adolescents“.

 

 

 

How to Navigate a Sensory World with an Autism Diagnosis

When children with Autism learn to navigate their sensory world and understand that a simple touch on the shoulder is not a threat, they are better able to reach out socially.

“What? He doesn’t want friends?”

I hear this over and over from people who are talking about a child who has Autism. The human drive to connect to others is universal. We all want friends, all of us. However, as powerful as the drive to connect with other people is, protecting ourselves from perceived threat is greater.

Imagine if…

  • A simple touch ignited a fear response in you so great that you want to scream or hit.
  • The sound of a vacuum cleaner or toilet flushing caused you to cover your ears and run out of a room.
  • A room full of people caused your nervous system to become so overwhelmed that you started to flap your hands, talk to yourself or simply shut down.

Now think about how others would perceive you if you acted this way.

If people only judged your outward behavior, they may think that you don’t want to be social. When the truth is your fear responses to the sensory environment creates reactions that will often not look socially appropriate.

When children with Autism learn to navigate their sensory world and understand that a simple touch on the shoulder is not a threat, they are better able to reach out socially.

But to help children with Autism master this skill, we must first help them have a solid understanding of how each sensory system in our body works and impacts our ability to successfully navigate our social world. One way to teach this is to follow the Social Sense Program.

In the Social Sense Program, children are trained to view themselves as scientists trying to figure out their social world. As scientists, they strive to be keen observers of the world around them and ask questions about what they observe. This allows the children to draw conclusions about how the world works. The information gathered allows them to see opportunities to learn the how, what, and why of social interactions.

In this sample lesson from the Social Sense Program, we look at how the seven senses can be used as science tools to explore and interpret the social world.

Download the Social Sense Science Tools Lesson

The process of learning to navigate a sensory overloaded world can take years. Until then we need to understand that sensory defensiveness that results in a fear-response does not equate to a LACK of desire for friendship. Quite the contrary. Those with autism just need someone to understand them and be their friend. The best way for us to help children with autism is by helping the children and adults around them realize that they have the same drive we all do…to connect with those around them.


This blog was brought to life by PESI authors:
Tara Delaney, MS, OTR/L is a pediatric occupational therapist who has worked with children for more than 20 years. Tara regularly conducts seminars nationally and internationally on sensory integration, child development, Autism and behavioral issues. Tara is the author of the best-selling The Sensory Processing Answer Book (Sourcebooks) and 101 Games and Activities for Children with Autism, Asperger’s and Sensory Processing Disorders (McGraw-Hill).
Mary C. Hamrick, MA, CCC-SLP, is a nationally recognized speaker in the area of Speech and Language Development and Disorders, Specific Learning Disabilities, and Social Intelligence — specifically how sensory processing impacts social development.

Gain critical insights into the autistic brain with a FREE CE Seminar featuring Temple Grandin, Ph.D.

See the video here.

Temple

Sensory-Friendly Theatre: Making the big screen accessible to all

The experience of seeing a show, whether on the big screen or the big stage, can be particularly challenging for those who struggle with sensory processing. Thankfully, performers and venues across the nation are taking notice and offering sensory-friendly shows.

Broadway: a magical experience of dazzling lights, bright colors, and gut wrenching vocals. For many, it’s a dream come true to see a Broadway production, and on Sept. 23, 2015, an unnamed child and his mother excitedly attended the revival of The King and I. But for this family, the show was not magical. In fact, it was cruel.

In the quiet, intimate moments of the show, the child, who is autistic, made sounds that brought shushes from surrounding audience members.

Kelvin Moon Loh, a member of The King and I ensemble, was quick to notice and react on social media, drafting a powerful message that theatre is created for all people. He wrote:

For her to bring her child to the theater is brave. You don’t know what her life is like. Perhaps, they have great days where he can sit still and not make much noise because this is a rare occurrence. Perhaps she chooses to no longer live in fear, and refuses to compromise the experience of her child. Maybe she scouted the aisle seat for a very popular show in case such an episode would occur. She paid the same price to see the show as you did for her family. Her plan, as was yours, was to have an enjoyable afternoon at the theatre and slowly her worst fears came true.

For those with Autism, being out and about in the community can pose significant sensory overload. The experience of seeing a show, whether on the big screen or the big stage, can be particularly challenging.

“For children with Autism, the experience can be overwhelming due to the intense sensory input. Combine loud sounds with a dark room where you cannot visually navigate your space and the experience may rise to the level of terrifying,” says Tara Delaney, MS, OTR/L.

The CDC estimates that about 1 in 68 children has been identified with autism spectrum disorder, and the rate continues to increase every year. But as more children and families in the United States are facing a diagnosis of Autism, something magical is happening; our communities are recognizing the increasing population of those with sensory disorders, and the conversation about the importance of sensory-friendly environments is growing from a gentle hum to a catchy power ballad belted out by the masses.

Take, for example, Micon Cinemas, a movie theatre in Eau Claire, Wisconsin. They’ve partnered with local radio station WAXX 104.5 to offer sensory-friendly movies for families.

During the show, the lights are turned up and the volume is turned down. Children are free to stand, sit, or roam about the theatre; whatever makes them feel comfortable.

“A kid went up to the screen and touched the screen because they were curious,” says WAXX 104.5 DJ and event organizer Cora Quinn. “We’ve also had children sit on the floor, because that’s what is comfortable for them.”

In addition to offering matinee prices and discount concessions to families that attend, sensory-processing disorder resources, such as local equine therapy group Trinity Equestrian Center, have also been invited to display information in the lobby to help connect families with valuable community resources.

Theatre owner Connie Olson said having a sensory-friendly showing was something Micon Cinemas had always wanted to do. “We’ve worked hard to make sure the experience of seeing a movie in the theater is available to everyone; this includes having audio-description and assistive listening devices available for our patrons. Having a sensory-friendly showing just made sense to us.”

Mim Ochsenbein, MSW, OTR/L, works with many clients struggling with Autism, and notes that our society is not set up for individuals with sensory sensitivities, especially children. “Children with autism are faced with many limitations in our culture. When you think of the typical childhood experiences – amusement parks, birthday parties, summer camp, and going to movies with family and friends – we don’t consider that these experiences are just not possible for our kids with ASD or SPD. The fact that this community recognized the needs of their ASD community and was able to create an event that is safe and normal for both the kids and caregivers is extraordinary. I hope that this is start of a wonderful movement to create sensory friendly events for children and their families where everyone can have fun and feel safe in the experience.”

Thankfully, sensory-friendly showings are becoming more prevalent. In 2011, the Theatre Development Fund launched the Autism Theatre Initiative making Broadway shows accessible to those on the autism spectrum, as well as their families.

And it’s not just Broadway taking notice. Blue Man Group recently announced that they will host a set of sensory-friendly shows in five major U.S. cities over the next year.

For those in small communities looking to make a difference, Micon Cinemas says it’s easy for theatres to offer a showing of a film that’s sensory friendly, and they hope that theaters across the nation will begin accommodating families that are struggling to find social activities that work for them. “The key is to find people like Cora Quinn and Alex Edwards from WAXX 104.5 who can help get the word out to the community,” said Connie.

If you’re ready for a community that includes every person, join PESI, Cross Country Education, Psychotherapy Networker, and the chorus of supportive voices for Light it Up Blue for Autism Awareness. Together, we can bring positive changes to our communities, both large and small.


Gain critical insights into the autistic brain with a FREE CE Seminar featuring Temple Grandin, Ph.D.

See the video here.

Temple


Do you live in the Eau Claire, Wisconsin area? Micon Cinemas and WAXX 104.5 will be announcing more sensory-friendly shows. Watch the Micon Cinemas Facebook page for details.

3 Meditative Techniques for Self-Regulation

With the help of children with and without autism, award-winning author and self-regulation expert Teresa Garland, MOT, OTR/L, has created a collection of interventions that can be used to help any child get calm and stay calm. Here are some fun methods to help achieve calm attention.

With the help of children with and without autism, award-winning author and self-regulation expert Teresa Garland, MOT, OTR/L, has created a collection of interventions that can be used to help any child get calm and stay calm. Here are some fun methods to help achieve calm attention.


Self_Regulation