Movement breaks

Movement breaks. Oh my gosh, what more can I say about these?? I'm fairly certain that the teachers at the little superheroes schools see me coming and think "but I've been giving them movement breaks!"

But first a little background! As with most topics, I have briefly spoken about movement breaks in other posts but have referred to them as sensory breaks.

Movement breaks, or sensory breaks, are all about our proprioception and our vestibular senses - two of those hidden senses that people generally aren't aware of.

Children aren't meant to sit still all day at school, so they need to move, and not just children who are Autistic. All children are not built to sit still all day, every day.

O has always described the need to move or to fidget as "if I move my feet and legs, then my brain can stay still."

Movement breaks can assist children to focus - one of L's teachers a few years ago recognised the benefits of movement breaks for all children in her class, and started getting the students to do simple yoga poses every afternoon for the last ten minutes of school. When one of the students asked why, she responded "do you learn anything in the last ten minutes of the day?"

Movement breaks can assist children to self regulate their emotions - both little superheroes have various movement stims that reflect how they are feeling emotionally. By stimming, or moving, they are able to self regulate their emotions.

When we're out and about as a family, we will give both little superheroes the opportunity to run, jump, climb to burn off the excess energy, which in turn assists them to calm.

Allowing a child to run at school when they need to self regulate can be tricky, due to supervision of the child.

So movement breaks don't necessarily need to be big movements. They could be as simple as running an errand from their class to another - often L is sent on errands around the school to deliver an envelope to a specific teacher. The note inside the envelope simply says "I need to move, please now send me back to my class."

The movement break could be doing simple yoga poses as a class - there are many free yoga for children videos on YouTube.

The child could be asked to help to hand out books or other items in class - this simple movement is often enough to assist in calming a child. Even moving chairs from one part of the classroom to another can be enough to calm a child.

We'll often give L the opportunity to move before school - we head to a park near by his school that he can, run and climb in.

O used to have a sensory chair band on the front two legs of the school chair - think a lycra band looped around the front two chair legs. Just by bouncing O's feet on the band during the day was enough to provide the movement breaks that O needed.

The important point to remember about movement breaks, is that children may not know that they need to move until it is too late. By the time that L thinks he needs a movement break it is often too late and the movement break will have the opposite effect. Instead of assisting him to calm, L will become even more agitated and fidgety! 

Movement breaks, therefore, should be scheduled regularly throughout the school day. 

Why do Children need to engage in Sensory Seeking?

Something that O and L have always done on a very regular basis is actively seek out sensory input. 

From a very young age, and I'm talking as soon as L figured that he could start moving like a commando across the floor, he was constantly on the go. Even now L is constantly bouncing, spinning, wriggling, running, flapping, jumping and so on. He rarely stops.

O also seeks out sensory input but not as much as L does. O more seeks out sensory input when she needs to concentrate on a task or when she is anxious. 

So why do children need to engage in sensory seeking activities?

It all has to do with the proprioceptive system. Put very simply, our sense of proprioception tells us where our body parts are in relation to each other as well as giving us information on how much force to exert when we are hugging someone or when we are kicking a soccer ball. The proprioceptive system may be under responsive, over responsive or a combination of both.

If an individuals proprioceptive system is over responsive, they will actively avoid sensory input such as bright lights, loud noises, certain textures, busy places and so on.

If an individual has an under responsive proprioceptive system they will actively seek out sensory input so that they are able to function. Having an under responsive system in effect means that an individual is not able to process the normal sensations that we all receive throughout the day that would normally stimulate the sensory system. And as such they will seek out the sensory input more often than others.

Most individuals are a combination or both. Both O and L detest with a passion loud noises to the point that they both need to wear block out ear protectors when the noise becomes to loud. Both O and L will avoid certain textures and tastes of food - it isn't that they are being fussy, the texture or taste makes them feel physically ill or makes their skin crawl. And yet the both crave constant movement.

Sensory seeking can assist a child to focus in class or to concentrate on the task at hand.

O has a sensory chair band that goes around the front two legs of her school chair when she is seated in class. She will "play" with the band with her feet or bounce her feet on the band throughout the day - this assists her concentrate in class. When we are doing homework in the evenings, she will stand on a twist board and constantly move around. When she is doing this, she will always get all of her homework correct. As O has told us "being able to move my body means that my brain can stop moving and I can concentrate on my homework!" On a side note, I love how articulate O is when describing how her brain works!

Sensory seeking can assist a child to calm themselves when they are in an anxious state.

O has a small sensory tool kit that she keeps in her desk at school so that when she feels as though she is becoming anxious, she can fiddle with one of her sensory tools. The hands can be great tools for regulating one's emotional state. This is why fidget tools, not toys, when used correctly are incredibly useful. 

In some cases, the more sensory input that they receive, the more alert that they will become.

Both O and L require regular sensory breaks throughout the school day and also when we are at home or on family outings. The sensory breaks can be as simple as spinning around outside, going for a run, hopping into their sensory body sock, getting a tight cuddle. The sensory breaks assist them to escape from the sensory overload that they may be in and to get back on track!

All of the strategies that we have in place that assist O and L to gain the appropriate amount of sensory input that they both need, is part of their sensory diet. 

Another way in which individuals on the spectrum are able to gain sensory input is through stimming. The word stim is short of self-stimulation and it is classed as repetitive behaviour in the diagnostic criteria under the DSM-5. Everyone has at some stage in their life done a little stimming - it could have been tapping your foot while seated a desk, chewing on a pencil during examinations, fiddling with a pencil or ruler, tapping your fingers over and over on your work desk. In most cases, a stim will come and go when you need it. In individuals with autism, the stim is there for good. Just as babies may suck their thumbs to relax themselves, some stims serve the purpose of soothing or comforting an individual on the spectrum, hence short for self-stimulation.

Both O and L have various stims based on their emotional state. They don't stim for the sake of it, they stim because they need to.

O and L stim to help themselves calm down when they are anxious. They stim to express different emotions. Stimming assists O to focus on one thing and gets her mind away from the sensory overload going on around her.

So how can YOU help your child to gain sensory input?

• The very first thing that you need to do is work out exactly what your child likes to experience and why. Ask them why they like to do particular body movements. Ask them what does it feel like when they're bouncing or spinning and so on, you'd be surprised at what they might be able to tell you.

• Try to figure out the impact that the sensory seeking activity has on your child. What can you observe about your child when they are engaging in a sensory seeking activity? I know just from watching L, that spinning on the spot or spinning while seated on an office chair helps him to calm. When you think too hard about it, it doesn't make a lot of sense but in some cases being overly active is actually calming for a child.

• Make a note of what works and why it works. This is useful so that you can pass the information onto teachers, carers, family members so that they too are able to assist your child when they need to gain some sensory input.

• Make sure that your child knows if there are any limits in place when they need to sensory seek. L loves playing rough and tumble, the down side is that he simply isn't aware of when he becomes too rough. Again this has to do with the fact that he is not yet aware of how much he can and can't use when engaging in rough and tumble play. One of the limits that we have set is that he is only able to play rough and tumble with Daddy Superhero!

• Put together a sensory kit for your child to take to school each day. This way they will have items that they are familiar with which will help them when they are needing to gain sensory input.

• Give your child plenty of opportunities to engage in sensory seeking activities - you will notice the benefits for your child!

Now before I finish this post off, there is one final vital piece of information that you NEED to know.

Sensory seeking and stimming is NOT a bad thing. However if the individual is physically hurting themselves, otherwise known as self harming, or is in danger of hurting others or if the stim is an inappropriate behaviour, then of course the individual should be redirected. But if you do find that you need to remove an inappropriate or dangerous behaviour, you do need to replace it with a preferable behaviour.

Preventing an individual from gaining sensory input when they need it will only make the situation worse. They are sensory seeking for a reason and they may very quickly enter in meltdown mode.

Stopping an individual from sensory seeking or stimming simply because you don't like it or you don't think that they need to engage in the activity, can be detrimental to their emotional and mental well being. By telling them to stop stimming you are in effect telling them that that aspect of their autism is a bad thing. All you will succeed in doing is help them to withdraw into themselves and no one wants this to occur.

So the next time you find yourself becoming frustrated at the constant movement of your child or someone close to you, take a closer look as to why they might be engaging in that behaviour. What can you do instead to assist your child?

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.

What is Sensory Proprioception?

If you’re like me and new to this Autism journey, you probably read the title of this blog and thought “what the hell is that?”

Let me explain, but you’ll have to bear with me as I will have to go back to the beginning.

From a very early age L used to love engaging in rough play. When I say rough play, I don’t just mean rolling around on the floor bumping into the occasional object. He would go up to O and other children and start hitting them for no reason. L would seek out rough and tumble play but take it one step too far and would often hurt himself or others. He would engage in rough play with myself and Daddy superhero and start head butting us or squeezing our arms and legs to the point that it would really hurt.

L is and always has been a sensory seeker. He is constantly moving, jumping, bouncing, spinning, pushing things, pulling things and running. He’s an insatiable bundle of energy. He often uses way too much force when doing simple day to day tasks, opening and closing doors, moving toys around and hugging us. He’s always been loud, he loves crashing into objects and people.

L has always chewed on and mouthed objects, he still does occasionally. He is constantly bumping into or pushing people, including when he is asleep. He constantly seeks out physical touch in the form of hugs and standing or sitting super close to people. L loves tight hugs and heavy blankets.

He would never hurt us and other children on purpose, but he could never understand why O, his peers and us would be upset with him. He never understood why he had to say sorry. And when he did say sorry, it was just a word, there really wasn't any empathy behind it.

We always thought that L just didn’t know his own strength. We immediately started teaching L the “right” way to play. We started teaching him who he could play really rough with (Daddy superhero) and who he couldn’t (everyone else!)

From the age of 18 months until very recently he would constantly and randomly fall to his right, whether he was sitting or standing. This was of a major concern to both us and his pediatrician to the point that we had appointments lined up with a neurologist to try and determine the cause. And then he stopped falling to the right as quickly as it started.

It wasn’t until this year when we were talking with one of his therapists at the early intervention centre and we mentioned his apparent lack of knowing his own strength and what we thought was the relation to his extremely high pain threshold.

We had always assumed that because L’s pain threshold was so high, he therefore didn’t know when he was hurting others because he thought that everyone didn’t feel pain.

And wouldn’t you know it, we were completely wrong!

One of L’s therapists started talking about Sensory Proprioception and the term went straight over our heads. We must have looked like goldfish standing there with our mouths open and a stunned expression on our faces.

The therapist then explained in very simple language that when you or I hit something we can feel the force when we connect with whatever we have hit. We know when we’ve touched or hit something too hard or too soft or just right. L doesn’t. To receive the same sensation that we receive when we touch something lightly, L has to hit the same object a lot harder. It’s not that he doesn’t know his own strength, he doesn’t have the same level of receptors that you or I have.

Before speaking with L’s therapist I had never heard of sensory proprioception. So when I got home I did a little research, and this is what I found out.

You should be familiar with the five senses – sight, hearing, smell, taste and touch (tactile.) Well, our bodies have two additional senses that we receive input through. I knew about these, I just didn’t know that they had names. I mustn’t have been paying attention in Biology and Anatomy classes at University!

The first is the Vestibular Sense, or the movement and balance sense. This sense gives us information as to where our head and body are in space. It allows us to stay up right while we sit, stand and walk. It lets us know which way is the right way up. It helps us to keep our balance as we move.

The second little known sense is the Proprioception Sense, or body awareness and position. Put simply it tells us where our body parts are in relation to each other. It gives us information on how much force we need to exert in certain activities, for example how much force we need to exert when cracking open an egg so that we don’t crush it in our hands, or how much force we should be exerting when hugging someone.

We know that our eyes and ears are constantly sending information to our brain about what we see and hear. Our muscles, joints, ligaments, tendons and connective tissues are also constantly sending information to our brain, but on an unconscious level.

Humour me for a moment. If you close your eyes right now, well perhaps not right now but after you have finished reading, you’d be able to tell exactly how and where your body is positioned. Perhaps your legs are crossed or maybe your hand is supporting your chin as you try to stay awake while reading this! You didn’t have to think about this, you just knew. This is the proprioceptive system in action.

The proprioceptive system is primarily located in the cerebellum and it works closely with the vestibular and tactile systems.

We’d ordinarily gain proprioception input when we engage in resistance type activities like pushing or pulling activities or activities in which we’re actively engaging our muscles like when we're exercising.

When the proprioceptive system doesn’t function correctly it can be extremely difficult for an individual to sit still and stay focused. For a child it can be difficult for them to gauge how hard they can play with other children. It may even make it difficult for the individual to remain calm.

We knew that L was a sensory seeker and we now know that this is because he is under responsive to proprioceptive input. All the things that L loves doing are common indicators to an under responsive proprioceptive input!

All of the activities that L loves to do are assisting him to increase the input in his proprioceptive system. All the input is assisting him to understand just how hard he can play with others, how much force he needs to exert when doing certain activities and tasks.

I'm now starting to realise that some of the activities that O engages in are also because she is seeking proprioceptive input. O is constantly chewing on objects - toys, necklaces, clothes - and she says that she does to help her to concentrate. It's all starting to making a lot of sense!

And one of the many things that we as parents now need to do, is assist O and L to gain proprioceptive input through therapy based activities at home.

We do this by encouraging them to draw and play games while sitting and laying in different positions – sitting up with legs crossed, sitting at a table, sitting upside down on the couch or laying down on their tummies. They can gain input through using different fidget toys and playing with playdoh. We have different types of pillows and blankets that the little superheroes can stack, climb on and hide under.

We actively play rough and tumble games with L and we encourage them both to bounce on the trampoline in the backyard. But at the same time we're reiterating to L who he can and can't play rough with.

When L and O are particularly agitated, we do deep tissue massage by squeezing their legs and arms to try and calm them down.

We get L and O to help with heavy work activities around the house like carrying the shopping in from the car, helping to pack away around the house, lifting the washing into and out of the washing machine, watering the vegetable patch with a full 3L bottle of water, wiping the table after dinner.

It sounds bizarre but all of these activities not only provide proprioceptive input but they also help both O and L to become calm. The activities are giving them extra input to balance out their little systems.

We've always encouraged both O and L to engage in these activities, but now that we know just how much they are helping both the little superheroes, we encourage them even more!

It truly is amazing just how many common every day chores and activities around the house can be turned into therapy activities! I'd never really understood how occupational therapy worked, I do now!

**** If you believe that you or your child may benefit from activities that increase proprioceptive input, please speak to your GP or pediatrician for advice.****

For more information on the Proprioceptive Sense head over to these sites!

SPD Australia
Sensory Smarts