Terms and Definitions of Cannon’s Various Diagnoses and Therapies……
1) Autism or Autism Spectrum Disorder (ASD)=
Autism is a complex neurobiological disorder that inhibits a person’s ability to communicate and develop social relationships, and is often accompanied by behavioral challenges. Autism spectrum disorders are diagnosed in one in 110 children in the United States, affecting four times as many boys as girls. The prevalence of autism increased 57 percent from 2002 to 2006. The Centers for Disease Control and Prevention have called autism a national public health crisis whose cause and cure remain unknown.
2) Hyperlexia= a syndrome observed in children who have the following characteristics:
– A precocious ability to read words, far above what would be expected at their chronological age or an intense fascination with letters or numbers. This is normally how hyperlexia is described. Precocious is quite a word defined as “early development or maturity”.
– Difficilty in understanding verbal language
– Difficulty in socializing and interacting with other people
Hyperlexics may exhibit the following behaviour/characteristics:
– Learn expressive language in a peculiar way, memorize the sentence structure without understanding the real meaning (echolalia) and reverse pronouns.
– Conversation is rarely initiated
– A need to keep routines, which at times proves to be difficult to break them
– Auditory, olfactory and / or tactile sensitivity
– Self-stimulatory behavior
– unusual fears
– Normal development until 18-24 months, then regression
– strong visual memory (auditory as well)
– Difficulty answering “W” questions, such as “what,” “where,” “who,” and “why”
– Think in concrete and literal terms, difficulty with abstract concepts
– Selective hearing
3)Focal Seizure Disorder= All seizures are caused by abnormal electrical disturbances in the brain. Partial (focal) seizures occur when this electrical activity remains in a limited area of the brain.
4) Severe Sensory Processing Disorder= (or SPD) is a neurological disorder causing difficulties with taking in, processing and responding to sensory information about the environment and from within the own body (visual, auditory, tactile, olfaction, gustatory, vestibular, and proprioception).
For those with SPD, sensory information may be sensed and perceived in a way that is different from most other people. Unlike blindness or deafness, sensory information can be received by people with SPD, the difference is that information is often registered, interpreted and processed differently by the brain. The result can be unusual ways of responding or behaving, finding things harder to do. Difficulties may typically present as difficulties planning and organizing, problems with doing the activities of everyday life (self care, work and leisure activities including work and play), and for some with extreme sensitivity to sensory input, sensory input may result in extreme avoidance of activities, agitation, distress, fear or confusion
Sensory Integration is the process through which the brain organizes and interprets external stimuli such as movement, touch, smell, sight and sound. Autistic children often exhibit symptoms of Sensory Integration Dysfunction (SID) making it difficult for them to process information brought in through the senses. Children can have mild, moderate or severe SID deficits manifesting in either increased (hypersensitivity)or decreased (hyposensitivity) to touch, sound, movement, etc. For example, a hypersensitive child may avoid being touched whereas a hyposensitive child will seek the stimulation of feeling objects and may enjoy being in tight places.
5) Severe Fine Motor Delay=
It is common to have fine motor delays among kids on the Autism spectrum. Hypotonia or low muscle tone is common, which contributes to the problem. The other problem is motor planning. They may have the strength, but not the motor planning. Motor skills are motions carried out when the brain, nervous system, and muscles work together. Fine motor skills are small movements — such as grabbing something with your thumb and forefinger — that use the small muscles of the fingers, toes, wrists, lips, and tongue.
6) Gastrointestinal impaction (this is a gross one…..read with caution) = the collection of hard, dry stool in the colon or rectum that can’t be excreted. Patients with an impaction usually experience constipation, cramping, pressure, nausea, and abdominal pain, as well as stool that leaks out when the patient coughs and explosive ………….. (I’m sure you can guess….eeeew!). If left untreated, an impaction can cause death.
7 & 8) Expressive and Receptive Language Delay=
Communicating is part of being a human being. There are many ways to communicate, body language, facial expression, gestures, oral language and written language. However we do it….communication is key to keeping us connected to the rest of the world. Children with Autism often have great difficulty communicating. But what are some of the necessary components of oral communication?
Receptive Language – This is what a child understands. Does he comprehend that a word represents a specific object or action? Can he follow directions? Often children with Autism understand significantly more than what they are able to formally show us.
Expressive Language – This is what a child says. Does he use consistent labels for objects and actions in his environment? Does he combine words to express new thoughts and ideas? Children with Autism often have trouble pulling out the “right” word. They may internally know what they want to say, but have difficulty doing so.
Speech – This is how a child says what they say. Does the child use the speech sounds that are expected of his age? Many higher functioning children with Autism have articulation skills within the typical range.
Pragmatic Language – This is the ability to use your language appropriately for a variety of purposes, in a number of different situations, with a variety of communication partners. The most common pragmatic functions are 1) to request objects, 2) to request actions, 3) to respond, 4) to protest, 5) to label, 6) to greet, 7) to dismiss and 8)to negotiate. Children with Autism almost always have difficulty with this area of language.
1) Applied Behavior Analysis (ABA) = Applied behavior analysis is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behavior (Baer, Wolf & Risley, 1968; Sulzer-Azaroff & Mayer, 1991).
“Socially significant behaviors” include reading, academics, social skills, communication, and adaptive living skills. Adaptive living skills include gross and fine motor skills, eating and food preparation, toileting, dressing, personal self-care, domestic skills, time and punctuality, money and value, home and community orientation, and work skills.
ABA methods are used to support persons with autism in at least six ways:
- to increase behaviors (e.g. reinforcement procedures increase on-task behavior, or social interactions);
- to teach new skills (e.g., systematic instruction and reinforcement procedures teach functional life skills, communication skills, or social skills);
- to maintain behaviors (e.g., teaching self control and self-monitoring procedures to maintain and generalize job-related social skills);
- to generalize or to transfer behavior from one situation or response to another (e.g., from completing assignments in the resource room to performing as well in the mainstream classroom);
- to restrict or narrow conditions under which interfering behaviors occur (e.g., modifying the learning environment); and
- to reduce interfering behaviors (e.g., self injury or stereotypy).
2) Sensory Physical Therapy or Sensory Integration Therapy=
based on the assumption that the child is either overstimulated or understimulated by his environment. Therefore the aim of sensory integration therapy is to improve the ability of the brain to process sensory information so that the child will function better in his daily activities. A sensory integration room is designed to make the child want to run into it and play. During therapy, the child interacts one on one with the therapist and performs an activity that combines sensory input with motion. Examples of such activities include:
- swinging in a hammock (movement through space)
- dancing to music (sound)
- playing in boxes filled with beans (touch);
- crawling through tunnels (touch and movement through space)
- hitting swinging balls (eye/hand coordination)
- spinning on a chair (balance and vision)
- balancing on a beam (balance)
The child is guided through all of these activities in a way that is stimulating and challenging. The focus of sensory integration therapy is helping children with Autism combine appropriate movements with input they get from the different senses.
A physical therapist (PT) may also work on gross motor skills such as running, balance and climbing.
3) Occupational Therapy=
Occupational therapists (OTs) are trained in sensory techniques that will engage a child in playful activities designed to help him process the information he receives from his senses in a more typical manner.
The therapist may work with the child in a room with platform swings, large exercise balls and other equipment. The child may need to play with different textures (such as sand, play-dough or shaving cream), to swing, to chew on a special chewy tube, or to sit atop a large ball. The activities should be just challenging enough to help the child respond better to sensory information without feeling overwhelmed.
An occupational therapist also may work with the child to improve his fine motor skills (holding a pencil, using scissors, handwriting) and self-help skills (using buttons, zippers and silverware).
4) Speech Therapy=
is individually tailored therapy that involves parents along with professionals. The goal is to improve useful and realistic verbal communication. Though some autistic children have little or no problem with the pronunciation of words, most have difficulty effectively using language. Even those children who have no articulation problems exhibit difficulties in the pragmatic use of language such as knowing what to say, how to say it, and when to say it as well as how to interact socially with people. Many who speak often say things that have no content or information. Others repeat verbatim what they have heard (echolalia) or repeat irrelevant scripts they have memorized. Some autistic children speak in a high-pitched voice or use robotic sounding speech.
Two pre skills for language development are joint attention and social initiation. Joint attention involves an eye gaze and referential gestures such as pointing, showing and giving. Children with autism lack social initiation such as questioning, make fewer utterance and fail to use language as a means of social initiation.
Dr. Stanley Greenspan, a child psychiatrist, developed a form of play therapy that uses interactions and relationships to reach children with developmental delays and autism. This method is called the Developmental, Individual-Difference, Relationship-Based model, or “DIR®/Floortime” for short. Floortime is based on the theory that autism is caused by problems with brain processing that affect a child’s relationships and senses, among other things.
With Floor Time, the child’s actions are assumed to be purposeful. It is the parent’s or caregiver’s role to follow the child’s lead and help him develop social interaction and communication skills.
For example, a boy may frequently tap a toy car against the floor. During a Floortime session, his mother may imitate the tapping action, or put her car in the way of the child’s car. This will prompt the child to interact with her. From there, the mother encourages the child to develop more complex play schemes and incorporate words and language into play. Floortime is more child-directed than some teaching methods. Its goal is to increase back-and-forth interaction and communication between child and adult.
Osteopathy= or osteopathic medicine, is based on the belief that most diseases are related to problems in the musculoskeletal system and that structure and function of the body are related. The musculoskeletal system is made of the nerves, muscles, and bones — all of which are interconnected and form the body’s structure.