Tuesday, 5 December 2017

The Hidden Sense of Interoception

One of the things that I have learnt on our Autism journey thus far is that you never stop learning. Never!

Since O started her therapy sessions we have begun yet another learning journey.

But before I get onto the topic of this post, there is some background information that you need to know about first, otherwise you may become slightly confused.

Ever since O started Kindy, we have always struggled to get her to drink water regularly, eat her recess and lunch at school and go to the bathroom on a more regular basis.

I am sure that she has a hidden camel hump somewhere, as on some days she will rarely drink water during the day but then she loads up in the afternoon and evening. I also wonder if she has a bladder of steel as this little superhero can hold on for a very, very long time!

We've always put these struggles that we have down to O just simply being too busy at school or simply forgetting. Now the issue with not drinking enough water or eating enough food throughout the day leads to other more serious complications. On more occasions than I would like, we have ended up in the emergency department of our local hospital with a very dehydrated child.

It was only in talking to O's key therapist and the school age services coordinator that we realised that perhaps, just perhaps, O's sense of interoception hasn't fully developed.

I can now hear you asking, what on earth is interoception?

I have talked briefly about interoception in a previous post, but let's go into a little more detail.

First we need to go back to basics. We all know about the five senses - hearing, sight, smell, touch and taste. But there are three others that are considered our hidden senses. Senses that we don't consciously think about or are aware of on a daily basis.

The sixth sense is our vestibular sense - this sense provides our bodies with information as to where our head and body are in space. It helps us to keep our balance as we move about.

Then we have the seventh sense which is proprioception. This is our body sense that tells us where our body is in relation to the rest of us. It also tells us how much force to exert when performing different activities like hugging someone, shaking hands, cracking an egg open and so on.

Then we have an eighth sense - our interoception sense. This is a relatively unheard of internal part of the sensory system and consists of all of the internal sensations that we may feel on a daily basis when we're hungry, thirsty, anxious, nervous or when we need to go to the bathroom. Any sensations that originate from within our bodies all stem from the sense of interoception. Receptors in our body organs and skin, are constantly sending information about the inside of our bodies to our brain.

Our sense of interoception is always there in the background and it isn't something that we are generally consciously aware of.

In some individuals, particularly those who have sensory processing difficulties, this hidden sense may still be developing. And as with sensory processing difficulties, individuals may be under-responsive, over-responsive or a combination of both.

Some specialists consider that individuals with sensory processing difficulties may not know how to verbally label the data that their brains receive from the interoceptive sense. If they are not receiving enough data, the sensations that they receive may be confusing. And likewise if their brains are receiving too much data from the interoceptive sense, the sensations may become very overwhelming.

In O not feeling the need to drink water regularly in essence means that this part of her interoception sense is under-responsive - she simply isn't receiving enough data to register that she is thirsty.

In O being in a constant state of anxiety at times in essence means that this part of her interoception sense is over-responsive. Her brain is receiving too much information and the data becomes a distraction so she is unable to focus on anything else and enters into an anxious state.

The tricky thing about our sense of interoception is that the data that it sends to our brain, is required for a range of basic and advanced functions. These functions range from breathing, being hungry or bring full, needing to go to the bathroom, being aware of our own emotions, being able to manage our own emotions and everything else in between.

So it makes sense then that if a child's sense of interoception is still developing, then they may struggle with recognising and responding appropriately to their own emotions and to those of others.

If an individuals brain has difficulties in making sense of the information that it receives, then the individual may not be tuned into their internal body cues that assist others to interpret emotions. They may have difficulty "feeling" the different emotions that they experience. If an individual is not able to interpret their own different body sensations, then they may have difficulty in identifying their own and others emotions.

So how can we help children whose sense of interoception may still be developing?

One of the activities that O's key therapist has been working on with O is labelling different emotions and talking about what some of the external AND internal feelings that she may feel that are associated with these emotions. We have quite a number of body outlines with different sensations written around them - anger, nervous, happy, sad, you get the picture. This has been incredibly beneficial and very effective as O is now starting to recognise the early warning signs of her different emotions and can now verbally tell us how she is starting to feel.

Earlier this year, I developed a social story called "My Book About My Feelings" to assist O in labelling her own emotions. The story started to assist O to identify how she felt inside when she was sad or anxious.

We regularly read books and talk about how the characters might be feeling in particular situations.

When we see the little superheroes experiencing different emotions, we will verbally assist them to label their emotions - "Oh you look very excited....." or "I can see that you are becoming angry/frustrated by ..............." This not only assists them to label their own emotions but it also provides them with the appropriate language so that the next time, they may be able to verbally express themselves.

We also verbally label our own emotions and our internal sensations to the little superheroes. If they recognise that they too experience these internal sensations then they will begin to connect the dots!

Interoception issues are not as well known as other sensory processing difficulties and as such, medical professionals are still developing strategies to further develop this sense in those who need it.

The great thing about being on a learning journey with the little superheroes is that as we have an awareness of and basic understanding of the possible causes behind the little superheroes behaviour and/or functional limitations, means that we are helping the little superheroes. Just having an awareness of the sense of interoception and implications of this sense still developing means that we are able to trial different strategies to see what works best for them. It means that we are more understanding when we see them struggle with skills that everyone seems to take for granted.

So the next time you see a child who can't seem to get the hang of toilet training, or they never seem hungry or thirsty, or they fly off the handle at the drop of a hat, keep in mind that perhaps their sense of interoception is still developing.

Friday, 1 December 2017

Peek-a-Boo Treasure Bag Tutorial

Another of the sensory tools that we use on a regular basis at home and when we are travelling are Peek-a-Boo Treasure bags.

Essentially a Peek-a-Boo Treasure bag is a fabric bag with a clear vinyl window and the bag is filled with an assortment of small treasures to find. Playing with the bag is great distraction when O or L are in overload or when they just need to be distracted from what is happening around them.

Playing with a Peek-a-Boo Treasure bag is also great for fine motor control and hand eye co-ordination as the child has to use their fingers to manipulate the bag to find all the treasures in the bag.

Peek-a-Boo Treasure bags are also great activities for children to do when it is quiet time. I have made a few for my charges at work for rest time and the children love to play with them.

Quite a number of people have asked me how to make these magical bags so I thought that it was about time that I published another tutorial. So here goes ....

You will need:

- A small rectangle or square of strong clear plastic vinyl. I generally use a rectangle that is approximately 20cm by 18cm in size. You are able to purchase the clear vinyl from Spotlight by the metre.
- Fabric for the front and back of the Peek-a-Boo Bag. I generally use two different patterned fabrics - one for the front and one for the back, just as a contrast.
- An assortment of small toys, large over sized buttons, poly beads and other objects to put into the bag. I use small plastic animals, small toy cars, buttons, small dinosaurs and anything else that I think children would like to look for in the bag. The poly beads are great to fill up the bag so that the child has to push the toys through the beads to find them.

What to do:

Step 1: Cut four rectangles of the fabric that you are using for the front of your treasure bag. My rectangles overhang at each end of the clear vinyl rectangle by approximately 5cm.

Step 2: Pin two of the fabric rectangles to the two long edges of the clear vinyl. Once pinned, first straight stitch and then zig zag stitch the two long edges approximately 1cm in. As the vinyl/fabric seam is going to be getting a lot of manipulating, these seams need to be strong.

Step 3: Pin back the two edges that you have just attached. This keeps them out of the way when you do the two side edges but also keeps them in place to make the window of the bag.

Step 4: Pin the other two fabric rectangles on the two remaining sides of the clear vinyl. Then as per Step 2, straight stitch and then zig zag these two edges to ensure that the seams are strong.

Step 5: Pin the two short edges back as per Step 3. In effect you will now have a window of vinyl surrounded by four fabric panels.

Step 6: This step is optional. I do this step to add extra strength to the vinyl/fabric seam. I simply straight stitch all around the edge of the vinyl window.

Step 7: Cut a rectangle of your backing fabric that is larger than your vinyl window. Ideally you want the backing fabric to be at least two or three centimetres wider than your vinyl window. Pin the fabrics right side to right side together.

Step 8: Straight stitch and then zig zag stitch all edges, leaving an opening of approximately 10cm on one edge so that you are able to turn the pocket through. Once sewn, trim the edges and corners and then turn through.

Step 9: Before adding the assortment of small toys and other bits and pieces, I pin around the edge of the vinyl window. This serves two purposes - the pins keep all the treasures away from the edge of the bag, which in turn makes it easier to sew around the edge of the bag. Once pinned, add the treasure to the bag and then pin the bag closed along the opening.

Step 10: Use a straight stitch to sew around the entire edge of the Peek-a-Boo bag, ensuring that you close the opening securely. Once I have sewn the edge of the bag, I sew an extra row approximately 1cm in from the edge to add extra strength to the seams of the bag. Depending on what you chose to put in the bag, there may be small parts. The extra seam just adds a little extra strength to the bag.

And voila, you have your very own Peek-a-Boo Treasure Bag.

Once you have made one Peek-a-Boo bag, the possibilities of what you can put into the bags are endless. I have made an alphabet bag, complete with a card listing what can be found in the bag. I've made an insect bag and a dinosaur bag. Half the fun is finding treasure to go into the bags!

Wednesday, 29 November 2017

Perth - Our Home Town .... For now!

Perth .... this is our home .... for now. However in a little under two weeks we will be relocating back to Queensland.

We came to Perth in 2010 and after a few short weeks, it came to feel like home. It felt like we had been living in the glorious city for years.

One of the things that I really love about Perth is the amount of free and very low cost family activities that are available throughout the city, the Swan Valley and the surrounding suburbs. The little superheroes certainly have their favourite activities to do and places to visit so over the next two weeks, we've decided to try and visit as many of our favourite places as we're honestly not sure when we'll be back in Perth for a visit. O is a very sentimental child so she has been hinting about all the places that she would like to visit before we head back to Queensland.

Last week it was afternoon tea at our favourite chocolate factory. I have a feeling that one of the only reasons that the little superheroes like going to the chocolate factory is to find out the theme of the over sized chocolate display that is in their showroom. In fact the first thing that they both do when ever we go to the chocolate factory is race to the display and "ooo" and "ahh" over what they find. Last week it was an alien landscape!

On Saturday just gone, we decided on an impromptu outing into the city. O and L love wandering around, looking at all the sculptures and visiting one of their favourite city arcades, London Court.

There are numerous sculptures throughout the city, one of L's favourites are the kangaroos gathered around a watering hole on St George's Terrace so a visit there was a must! Visiting the sculptures throughout the city is also a small sensory break for both O and L. A chance to sit down and take some time out.

Out of the front of St Martins Centre there is a series of five sculptures commemorating the 175th Anniversary of Western Australia. L just had fun running around between the sculptures. O just had to shake hands, ask for directions and then tried to blend in with the sculptures!

We then ran into the big man in the red suit. O was suitably impressed, shook hands with him and then proceeded to tell him what she wanted for Christmas. This was a huge improvement from previous years when the only time we could get her even close to Santa to say hello was to go to a Sensory Santa session. Three smiling photos in three years, winning!

L on the other hand, he hid behind Daddy and then took off as fast as his legs could carry  him. L still isn't overly sure about saying hello to Santa. L would however sit on Santa's big red chair for a photo but only after telling us - "if you see him, you gotta tell me so I can run away!"

We then found an oversized Christmas bauble made entirely out of fairy lights. Apparently it was a light jail!

After that it was time to visit London Court and it just happens to be their 80th birthday this year. The court is wonderful at any time of the year - medieval style buildings, old English store fronts, castle style gates, you get the picture. 

Today there was also a convict doing free face painting, street performers, a town crier and a bobby, complete with bobby hat, doing some balloon tying.

And what is a city trip without a ride on the ferry across the Swan River to the South Perth shoreline for an ice cream! This is when the little superheroes just chilled out. The father of one of O's friends is a captain for the ferry company so they were quite disappointed to find that he wasn't the captain of our ferry! Never the less, they did enjoy the ride.

This outing was the first in a long time that L walked for the majority of the time - usually one of ends up carrying him so the fact that he wanted to walk was wonderful. By the end of the day I'm not sure who was more tired, us or the little superheroes.

But considering that both O and L were tearing around outside with our neighbours children at 10 o'clock at night while I was inside trying desperately to stay awake, I'm fairly certain that the little superheroes were NOT worn out! 

Sunday, 26 November 2017

Autism Association of Western Australia Publications

**** Please note that I do not receive commissions of any kind in regards to the publications mentioned in this post. They are simply publications that we have found useful and informative. ****

We have a lot, and I mean a lot, to do with the Autism Association of Western Australia.

L has been attending Little Stars Early Intervention Centre, aka Tara's School, since February 2016. While there he has made some wonderful friends and has also made the most amazing progress.

We chose to go through the Autism Association for L's, and now O's, therapy as in our eyes they are the experts in the autism field in Western Australia.

Since 2016 we have purchased a number of the publications that have been produced by the Autism Association for our own reference but also to pass onto L and O's teachers and carers.

So I thought that I would do a short post on the publications that we've found useful. Please bare in mind that the opinions in this post are mine and mine alone.

All of the publications can be purchased through the Autism Association of Western Australia website.

Autism and Sport - What every coach needs to know.

We only recently found this book and immediately knew that we needed to purchase a copy of it. Both O and L love playing team and individual sports but they struggle when it comes to participating in training and on game day. The book is aimed at coaches and includes some very brief information about Autism Spectrum Disorder. It also talks about why inclusion is important, the strengths of people with autism and it also lists the potential difficulties that people with autism may face when engaging in sport. The book also talks about how coaches may be able to assist people with autism while they are engaging in sport and twenty tips for coaching success. What really drew my attention to the book were the social stories at the rear of the book. L and O love social stories, so these will definitely come into handy. The other great thing about this book is that much of the general information about helping children in the book would be great for coaches to use for all children.

Let's Play! Facilitating interactive play skills in children with Autism.

I purchased this book for the sole purpose to use at work. The book talks about the development of play in children and lists strategies that can be used to promote the further development of children's play skills. Much of the book are resources on different play themes - beach, animals, camping, things that go and so on. For each theme there is a list of suggested toys and materials, suggested activities, suggested learning targets, a visual choice board for each theme and a photo social story. Again there are also various social stories that focus on sharing and recess time.

GOOD nights.

As the title suggest this publication is all about sleep. It is a manual aimed at parents and carers of children who have autism who experience difficulties with sleep. Both L and O have difficulties with falling to sleep and L has issues with staying asleep. We do use Melatonin on both the little superheroes as well as various essential oil blends. This publication was useful in assisting us to understand the difficulties that children with autism may have with going to sleep. The book goes through the process involved in developing a sleep intervention plan and again it has visual choice board pictures and social stories to use.

MAKING SENSE of the senses for children with Autism.

Both O and L have sensory difficulties and at times we have struggled to explain the difficulties that they both face to their teachers and carers. This book is aimed at those who work with children with autism. The book initially talks about the sensory issues that children with autism may face and how these may impact on their behaviour. The book then provides strategies that may be used in the classroom in regards to the impacts of various stimuli. The book also provides general teaching strategies that can be employed in the classroom to assist children with Autism. The great thing about this book is that all of the strategies can be used to assist students of all abilities.

AUTISM IN THE CLASSROOM - A Resource Kit for Teachers of students with an Autism Spectrum Disorder.

As the cover of the book states, there are three parts to this book. Part one contains information pertaining to what is an Autism Spectrum Disorder (ASD) - it goes into detailed information about ASD, communication difficulties in individuals who have ASD, social impairment difficulties, restricted and repetitive behaviours, obsessions, sensory issues, anxiety issues and so on. Part two is titled "Making it Work" and it is all about making the curriculum accessible for students with ASD. Part two goes through the various difficulties that students that may have and provides strategies on how teachers may assist their students in each of the areas of difficulties. Part three goes into detail on how teachers may prevent and manage difficult behaviour. This is a publication that I wish that I had discovered earlier into our Autism journey but I am sure that it will be very useful in the future.

Autism Spectrum Disorder in early Childhood Settings - Facilitating Participation and Inclusion.

I purchased this book about twelve months prior to us gaining L's ASD diagnosis when I began to suspect that L may have been on the spectrum. I purchased the book for the sole purpose that it has a section devoted to positive behaviour support strategies. At the time we were struggling with dealing with L's behaviour and we used some of the strategies mentioned in the book at home. The book also has a section devoted to supporting skill development in children with ASD. I have utilised this book many times both at home and at with my charges at work.

Is it Autism?

This is a smallish book that is more aimed to teachers, carers and parents wanting to know about the traits of autism prior to a diagnosis being gained. It is a very useful publication for early childhood centres to have in their resources.

Autism - Parents Handbook.

This publication is not listed on the Autism Association of Western Australia website but it is an incredibly useful book. We were given this book soon after we received L's diagnosis and it includes everything and anything that parents and care givers need to know about autism providers, support services and advocates in Western Australia. If you have already embarked on your own autism journey, you'll know first hand that it is a minefield when it comes to locating information and support services. Having all of this information handy in one book is wonderful.

There are many more publications listed on the Autism Association of Western Australia website and my aim was to purchase a copy of each publication but alas we are moving to Queensland in a few weeks time!

I would love to hear of any autism specific publications that you have found useful. And remember to leave a link so that I can check them out!

Thursday, 23 November 2017

The Girl Who Thought In Pictures: the story of Dr. Temple Grandin

**** Please note that I do not receive commissions of any sort for the book that is mentioned in this post. It is simply a book that I have found useful. ****

Several months ago I ordered a book titled "The Girl Who Thought In Pictures: the story of Dr. Temple Grandin." A good friend tagged me in a post on a social media site that was advertising the book and I was immediately drawn to it.

O knows that she is different from her peers at school but still struggles at times in understanding that different is good. So I thought that this book would be brilliant for O.

The book is written by Julia Finley Mosca and it is the first book in a new educational series about the inspirational lives of amazing scientists around the world. I couldn't think of a more inspirational person to write a children's book about.

The story of Dr. Temple Grandin is fascinating and her story has been retold in books and on the big screen but all of these media types are aimed at older teens and adults. There are many children who would benefit from reading about her life thus far and now there is beautifully illustrated book.

When the book arrived and I opened the front cover, I was met with the lines ....

"If you've ever felt different, if you've ever been low,
if you don't quite fit in, there's a name you should know..."

I immediately knew that O would enjoy reading the book and that she would want to do a book review on it! But due to school and other commitments, we've only just got around to doing the review this afternoon. So over to O!

Q. What is the book about?
It's about a lady named Temple Grandin who is a doctor of science and she thinks in pictures. She also has great ideas on how to make farms a better place for animals so that the animals are happier. It's also about if you try your hardest, you can achieve your dreams. And the book says that Temple has autism! That's really cool.

Q. What is your favourite part of the book?
It's when Temple has such a hard childhood but she goes to college and she gets her degree. She has such great ideas. I like the page with the staircase on it because it basically says that being different from other people is a good thing. And I like the note from Temple in the back of the book.

Q. Why do you like this book?
I like it because it shows what people can do if they have autism. The book also tells people that if you have autism, it isn't bad because you can have great ideas and change the world.

Q. Would you recommend this book to other children? Why?
Yes! Some people bully people that have autism because they think that having autism means that you can't do great things. Temple shows that having autism doesn't stop you from having great ideas. Nothing should stop you from having great ideas - anyone can change the world, we just need people with great ideas. The book also shows that being different is okay, it isn't bad. It would be good for kids to read so that they can understand that if other kids are different from them, then that is okay. If we all thought the same, then life would be very boring and there would be no new ideas.

Q. Out of 5 stars, what would you rate this book?
5 BIG stars! It's a really great book, I really liked it.

I couldn't have put it better. At times O really is an old soul!

The book may be about Dr. Temple Grandin, who just happens to have autism, but the book itself is not about autism, if that makes sense.

To me the book is more about believing in ourselves, regardless of what others may think of us, and that being different is a great thing, rather than a being a book about an autistic individual.

The tale in the book really does remind the reader to believe in themselves, follow their dreams and that no matter what obstacles they come up against, that they can overcome the obstacles to achieve great things!

It really is a great book for children and I cannot wait to read the next instalment in the series.

Tuesday, 21 November 2017

Our first Kidslfix event.

This weekend just gone, we had the privilege of being able to attend a Kidsflix event that was conducted by the Arthritis and Osteoporosis Foundation of Western Australia.

The Kidsflix event was a free morning of entertainment for children with disabilities and their families. The event was held at our local cinema prior to normal operating hours. 

I had heard of these events prior to the weekend but had no idea of what to expect other than some entertainment for the little superheroes and that we were going to watch an advance screening of Paddington 2.

What I did not know is that Kidsflix events are held Australia wide. The program is designed to enable children with Juvenile Idiopathic Arthritis, as well as children with other disabilities, to have an "out of the ordinary day" with their families. All of the Kidsflix events are supported by local businesses so that the families who attend do not have to pay a cent.

When we arrived at the cinema the band of volunteers were bustling about ensuring that everything was ready for the sea of children that were about to descend upon the cinema.

There were face painters, balloon artists, a colouring in station, a Bricks 4 Kidz Lego station as well as numerous Cosplayers wandering around dressed as characters from Star Wars, Alice in Wonderland and one of O's favourite movies, Guardians of the Galaxy!

Once the event started it was wonderful to see children of all ages and abilities enjoying themselves. They mingled and played together, swapped stories on why they there and just generally had fun.

For some of the children, I have no doubt that the event was a way of distracting them from the tough times that they were enduring.

O had a ball, L went into overload almost immediately and just wanted to stim. The great thing about the event and L stimming was that no one looked twice at him. He was accepted for who he was. There was no judgement what so ever from anyone at the event.

There were many parents who looked like us - tired, very tired, but happy to watch their children being able to have fun without a care in the world. The children were able to forget their worries and just be kids for a few hours.

I am grateful to the organisers for the opportunity to attend the event - it was great morning out for us as a family.

If you ask L, the highlight of the event was seeing his friend R from school and being able to sit next to R in the cinema - not that they did a lot of sitting still!

O, well she was in her element. New children to meet and play with, babies and toddlers to look after and she was able to make a pretty cool aeroplane out of Lego.

And the movie? Well it was fantastic. It is definitely one to go and see when it officially opens in December!