Brian is a 4 year, 2 month old boy who had received a diagnosis of moderate to severe Autism when he was 2 years, 6 months of age. He showed significant problems with self-regulation, was showing no joint attention, significant delays in his verbal and non-verbal skills, aggressiveness with peers, as well as delays in his play skills and attention skills. He was also observed to show a significantly high activity level as he was observed to constantly seek out movement input and was rarely observed to “sit still.”
When I first met Brian, he was 3 years old and was invited to participate in our school readiness group for children with Autism. There were 6 children in the group, and Brian was by far the most challenging to deal with. Brian would come into the group with a huge smile on his face, clearly excited about being there to have fun, but this smile would quickly fade and turn to tears or screams. He very much had his “own agenda” of things he wanted to do and things he wanted to play with, and if anyone interrupted him or did not fit in with his agenda, this resulted in extreme behavioural fits or meltdowns. Brian was able to say only a handful of intelligible words and the rest was garbled gibberish, to which, no one, including his primary caregivers understood. If Brian wasn’t understood the first time he made an attempt at communicating, he would instantly become very frustrated, often screaming and crying uncontrollably. Brian did not seem to use gestures such as pointing or bringing someone over to something he wanted. His grandparents, who were his primary caregivers noted that his meltdowns would often last for hours, and the only way they found to “console him” was to put him in his high chair to cry his head off until he was too tired to cry anymore. Brian would not share with others and often hoarded toys, to the point that he would be seen carrying at least two toys around the group room at all times. Brian was observed to be quite aggressive with other children to get toys and to push them out of his way where he was playing and he would often come running from across the room to hit or push another child. Transitions were also very challenging for Brian. To put it lightly, everyone in the group was very aware of what Brian was doing or where he was at any given time due to the potential threat he could pose to safety of others as well as the general activity level of the room.
Brian was known as “the screamer” as, even when no specific demands were placed on him, he would scream in discontent for no apparent reason. At the time, he was the single most concerning child I had seen thus far, and I desperately wanted to help him with his self-regulation. After the end of the school readiness group, his name came up on my list of children to see for an occupational therapy assessment. I experienced some mixed emotions about this as I knew he would be challenging to work with, but I desperately wanted to help him with his self-regulation and sensory processing. The first time I met with Brian and his grandmother in mid November of 2010 (who was one of his primary caregivers), was very chaotic. I had setup one of the large rooms with a platform swing, trampoline and other fun activities with the goal of having fun and building some rapport with Brian. I had not expected to place really any demands on him, and was taken aback as he became highly emotional during our visit, including crying, and screaming and jumping up and down. It highlighted to me just how significant his problems with self-regulation were at the time. I had tried to have him lie down on a mat so I could show his grandmother how to complete some of the passive rhythmic movement training movements with him. He refused to lie down, seeming unsure of what I was going to do to him. After explaining what I wanted to do, I went out to get another staff member so I could demonstrate to his grandmother and have her practice engaging in the passive rhythmic movements. Once I began engaging my co-worker in the passive rhythmic movements, Brian came over and lied down beside her and started kicking his feet, seemingly in an attempt to demand it was his turn! He stayed lying on his back for a period of a few minutes, in which I was able to show his grandma the passive rhythmic stimulation from the feet, passive stimulation from the rib cage and passive rolling of the bottom from side to side. He was so dis-regulated that when I engaged him in the passive rhythmic stimulation from the feet he kept crying and engaged in drawing on a magnadoodle board which was held up in front of him, shielding me from his view and he rocked back and forth. Before we had this magnadoodle board in place, it was if seeing me at his feet was too much stimulation for him. His grandma agreed to engage Brian in the movements for a few minutes total daily. I emphasized the importance of starting off slow with the movement input due to the potential to cause some increases in moodiness and I also expressed my concerns that he was an already very moody child with lots of regulation problems. I explained that I had hoped that this input from these passive movements could significantly help Brian with his self-regulation by stimulating his Reticular Activating System to help with sending calming input to his brain. I also explained that some increased moodiness that we would likely see as a result of implementing this movement input, was a sign that his emotional brain was building new connections and maturing.
When I called his grandmother a week later to ask about how things were going with the rhythmic movement training movements, she reported that things were going very well. When asked how long she was completing each of the 3 movements for, she replied that she was completing about 15 minutes for EACH movement just before bedtime! I advised her that this may be too long to start with and that she should think about engaging him in up to 5 minutes per day total to start. When I saw Brian later that same week, he had a wonderful visit with me. He was observed to engage in lots of pretend play, showed good eye contact and referencing and even shared toys appropriately with me! He still showed some difficulty with transitioning out of the room when it was time to leave, but it seemed less of an issue than previously. I had attempted to see Brian in December that year before the Christmas holidays to follow up with the rhythmic movement training movements, but Brian was noted to be sick on and off and I wasn’t able to coordinate with the family. *Please note that the RMT program always recommends that "Less is More" because there can be a lot of emotionality stimulated by these movements because of the connections being stimulated with the emotional part of the brain - the limbic system.
I followed up in early January of 2011 in regards to how Brian was doing and how the Christmas holidays were going. His grandma reported that he was a different child, as she reported that he was not screaming nearly as much as he had been before, Christmas went really well for him and he was using many more words to communicate than he had ever had before! When I visited with him for the first time in the New Year, I was blown away by his ability to engage and interact with me for a period of about 40 minutes. He showed the ability to engage in a game with me with good turn taking, engaged in cooperative play, and I was able to understand his commenting on things he was playing with. He was observed to get upset at the transition time when he had to leave, but was noted to recover quickly. His grandfather reported that he can “last” (cooperate with others and play well) for about 40 minutes before having a meltdown and beginning to scream and cry like he used to. His grandfather also reported that Brian’s ability to communicate had drastically improved, that he was now persisting on finding a way to communicate his point with his grandparents instead of having a meltdown if they didn’t understand him the first time. Brian was noted to point at things, bring his grandparents to things or find other ways of getting his point across without become frustrated as before. He was also noted to be able to interact with other children successfully without engaging in hitting or pushing behaviours. Brian was noted to become very excited, in a good way this time, as he was reported to be more interested in the “norm” (for example, he wanted to help his grandparents in daily activities and was interested in playing like other kids did). His grandfather reported that Brian was now trying a much larger variety of foods (he was previously noted to be a very picky eater). One of the biggest changes in Brian was noted to be around his ability to self-regulate for certain periods of time (before he was never noted to be able to control his regulation level to be calm, happy and attentive). His grandfather happily reported that Brian was one of the best behaved children at a Christmas party they attended and that everyone was astounded at his behaviour; commenting that something had changed drastically with Brian and they wondered what it was. He noted that many people asked if they had drugged Brian or were curious as to what “miracle” they had worked with him!
As it turned out, Brian became an unusual and astounding case study of sorts due to the long amount of time that his grandmother had engaged him in the passive rhythmic movements and the drastic changes which were noted in him! I never would have suggested completing this amount of time on the movements this soon with an individual like this, but it was truly amazing to see the effects that this amount of stimulation had evoked within a very short period of time. It seems as though this input really helped to “reorganize” Brian’s brain and really significantly helped him with his self-regulation, but also helped with putting into place the building blocks to enable him to develop his language abilities. Not only this, the strong stimulation to his neural chassis seemed to significantly help him to be able to attend to things and decrease his impulsivity. His limbic system was significantly impacted by the passive rhythmic movement stimulation and his emotions seemed to mature somewhat over this period of a month and a half.
I showed Brian’s grandmother how to complete some more rhythmic movements with Brian such as encouraging him to actively roll his bottom from side to side as well as windscreen wipers to help further stimulate his cerebellum to make new connections thereby helping with his speech development, coordination skills, etc. I also showed her how to engage him in rocking on hands and knees to help him with his motor skill development and possibly retained STNR, as well as facial tapping to help him with his facial reflex integration. I also showed her home to complete the sensory hand program with Brian, to hopefully help him further with facial reflex integration as well as improve his fine motor skills. I also showed her how to complete the rotation of the head from side to side to further stimulate and mature Brian’s neural chassis.
In February of 2011, Brian was noted to show a lot of emotionality and assertiveness in visits with myself and his speech and language pathologist, which we took as a good sign of his developing sense of self. He was also noted to continue to struggle with self-regulation at times as well, but this was fleeting instead of being a continuous and ongoing problem involving long meltdowns! Brian was noted to show a good awareness of real versus pretend in March and was also reported to have become a much better sleeper, as he was noted to sleep through the night and also sleep in his own bed. Brian entered daycare around this time and he was observed to generally interact well with the other children and was noted to have adapted fairly well to routines and structure of the daycare environment. I was particularly impressed one day when observing him really want to play at the playdoh table but it was “full” so he had to wait until there was a place for him to join the table. He stood there for about 20 seconds, watching the children play with the playdoh, then proceeded on to another play area on his own without a fuss! This is something he would have totally blown up about in the past! A few minutes later, from across the room he noticed that there was a spot available at the playdoh table, and he proceeded to throw his toys he was playing with and made a run for the empty spot!
I haven’t had that much involvement with Brian in recent months, as he was noted to be away at his cottage for most of the Summer and had recently started an intensive behavioral intervention (IBI) program for children with Autism this Fall. He was noted by his grandparents to be doing very well in many areas. They noted that he is now completely toilet trained and is starting to eat more of a variety of foods. She also noted that Brian is talking in full sentences and is now enjoying activities such as sitting down to colour and playing games. He was noted to be engaging in pretend play and more cooperative play with other children and was noted to be currently learning to print and starting to read. Brian was noted to be on a gluten/casein free diet some of the time by his grandparents and they noted that gluten and various food dies, etc. seem to have an effect on Brian’s behaviour. Concerns were noted by the IBI program staff related to Brian’s behaviour at the program such as hitting and biting as well as general non-compliance and dysregulation.
When I recently visited Brian at the IBI program to re-assess his skills, I was deeply impressed by the boy I saw and engaged with. He was much more articulate with words than when I had seen him last and was able to talk with me in a back and forth communication, asking appropriate questions and interjecting with comments. He was able to wait his turn and transitioned fairly easily between most activities. He showed a drastic improvement in his visual motor integration skills and scored in the above average range for visual motor skill development! Before this, Brian was engaging in exploratory colouring and very basic imitation of lines. He showed a good awareness of counting and colour concepts and fairly good fine motor ability to engage in activities using mini tongs to pick up items and use in hand manipulation to move a button from his palm to his fingertips. Despite the fact that Brian is still showing some problems with regulation and behaviours, I am deeply impressed by his progress and attribute much of this progress to the stimulation he received from the rhythmic movement training program. I do believe that there are likely many factors that have helped Brian, and a big one also seems to relate to his sensitivity to gluten, casein and red dye and his grandparents have cut out these things in the past 6 months.
When I first met Brian, he was 3 years old and was invited to participate in our school readiness group for children with Autism. There were 6 children in the group, and Brian was by far the most challenging to deal with. Brian would come into the group with a huge smile on his face, clearly excited about being there to have fun, but this smile would quickly fade and turn to tears or screams. He very much had his “own agenda” of things he wanted to do and things he wanted to play with, and if anyone interrupted him or did not fit in with his agenda, this resulted in extreme behavioural fits or meltdowns. Brian was able to say only a handful of intelligible words and the rest was garbled gibberish, to which, no one, including his primary caregivers understood. If Brian wasn’t understood the first time he made an attempt at communicating, he would instantly become very frustrated, often screaming and crying uncontrollably. Brian did not seem to use gestures such as pointing or bringing someone over to something he wanted. His grandparents, who were his primary caregivers noted that his meltdowns would often last for hours, and the only way they found to “console him” was to put him in his high chair to cry his head off until he was too tired to cry anymore. Brian would not share with others and often hoarded toys, to the point that he would be seen carrying at least two toys around the group room at all times. Brian was observed to be quite aggressive with other children to get toys and to push them out of his way where he was playing and he would often come running from across the room to hit or push another child. Transitions were also very challenging for Brian. To put it lightly, everyone in the group was very aware of what Brian was doing or where he was at any given time due to the potential threat he could pose to safety of others as well as the general activity level of the room.
Brian was known as “the screamer” as, even when no specific demands were placed on him, he would scream in discontent for no apparent reason. At the time, he was the single most concerning child I had seen thus far, and I desperately wanted to help him with his self-regulation. After the end of the school readiness group, his name came up on my list of children to see for an occupational therapy assessment. I experienced some mixed emotions about this as I knew he would be challenging to work with, but I desperately wanted to help him with his self-regulation and sensory processing. The first time I met with Brian and his grandmother in mid November of 2010 (who was one of his primary caregivers), was very chaotic. I had setup one of the large rooms with a platform swing, trampoline and other fun activities with the goal of having fun and building some rapport with Brian. I had not expected to place really any demands on him, and was taken aback as he became highly emotional during our visit, including crying, and screaming and jumping up and down. It highlighted to me just how significant his problems with self-regulation were at the time. I had tried to have him lie down on a mat so I could show his grandmother how to complete some of the passive rhythmic movement training movements with him. He refused to lie down, seeming unsure of what I was going to do to him. After explaining what I wanted to do, I went out to get another staff member so I could demonstrate to his grandmother and have her practice engaging in the passive rhythmic movements. Once I began engaging my co-worker in the passive rhythmic movements, Brian came over and lied down beside her and started kicking his feet, seemingly in an attempt to demand it was his turn! He stayed lying on his back for a period of a few minutes, in which I was able to show his grandma the passive rhythmic stimulation from the feet, passive stimulation from the rib cage and passive rolling of the bottom from side to side. He was so dis-regulated that when I engaged him in the passive rhythmic stimulation from the feet he kept crying and engaged in drawing on a magnadoodle board which was held up in front of him, shielding me from his view and he rocked back and forth. Before we had this magnadoodle board in place, it was if seeing me at his feet was too much stimulation for him. His grandma agreed to engage Brian in the movements for a few minutes total daily. I emphasized the importance of starting off slow with the movement input due to the potential to cause some increases in moodiness and I also expressed my concerns that he was an already very moody child with lots of regulation problems. I explained that I had hoped that this input from these passive movements could significantly help Brian with his self-regulation by stimulating his Reticular Activating System to help with sending calming input to his brain. I also explained that some increased moodiness that we would likely see as a result of implementing this movement input, was a sign that his emotional brain was building new connections and maturing.
When I called his grandmother a week later to ask about how things were going with the rhythmic movement training movements, she reported that things were going very well. When asked how long she was completing each of the 3 movements for, she replied that she was completing about 15 minutes for EACH movement just before bedtime! I advised her that this may be too long to start with and that she should think about engaging him in up to 5 minutes per day total to start. When I saw Brian later that same week, he had a wonderful visit with me. He was observed to engage in lots of pretend play, showed good eye contact and referencing and even shared toys appropriately with me! He still showed some difficulty with transitioning out of the room when it was time to leave, but it seemed less of an issue than previously. I had attempted to see Brian in December that year before the Christmas holidays to follow up with the rhythmic movement training movements, but Brian was noted to be sick on and off and I wasn’t able to coordinate with the family. *Please note that the RMT program always recommends that "Less is More" because there can be a lot of emotionality stimulated by these movements because of the connections being stimulated with the emotional part of the brain - the limbic system.
I followed up in early January of 2011 in regards to how Brian was doing and how the Christmas holidays were going. His grandma reported that he was a different child, as she reported that he was not screaming nearly as much as he had been before, Christmas went really well for him and he was using many more words to communicate than he had ever had before! When I visited with him for the first time in the New Year, I was blown away by his ability to engage and interact with me for a period of about 40 minutes. He showed the ability to engage in a game with me with good turn taking, engaged in cooperative play, and I was able to understand his commenting on things he was playing with. He was observed to get upset at the transition time when he had to leave, but was noted to recover quickly. His grandfather reported that he can “last” (cooperate with others and play well) for about 40 minutes before having a meltdown and beginning to scream and cry like he used to. His grandfather also reported that Brian’s ability to communicate had drastically improved, that he was now persisting on finding a way to communicate his point with his grandparents instead of having a meltdown if they didn’t understand him the first time. Brian was noted to point at things, bring his grandparents to things or find other ways of getting his point across without become frustrated as before. He was also noted to be able to interact with other children successfully without engaging in hitting or pushing behaviours. Brian was noted to become very excited, in a good way this time, as he was reported to be more interested in the “norm” (for example, he wanted to help his grandparents in daily activities and was interested in playing like other kids did). His grandfather reported that Brian was now trying a much larger variety of foods (he was previously noted to be a very picky eater). One of the biggest changes in Brian was noted to be around his ability to self-regulate for certain periods of time (before he was never noted to be able to control his regulation level to be calm, happy and attentive). His grandfather happily reported that Brian was one of the best behaved children at a Christmas party they attended and that everyone was astounded at his behaviour; commenting that something had changed drastically with Brian and they wondered what it was. He noted that many people asked if they had drugged Brian or were curious as to what “miracle” they had worked with him!
As it turned out, Brian became an unusual and astounding case study of sorts due to the long amount of time that his grandmother had engaged him in the passive rhythmic movements and the drastic changes which were noted in him! I never would have suggested completing this amount of time on the movements this soon with an individual like this, but it was truly amazing to see the effects that this amount of stimulation had evoked within a very short period of time. It seems as though this input really helped to “reorganize” Brian’s brain and really significantly helped him with his self-regulation, but also helped with putting into place the building blocks to enable him to develop his language abilities. Not only this, the strong stimulation to his neural chassis seemed to significantly help him to be able to attend to things and decrease his impulsivity. His limbic system was significantly impacted by the passive rhythmic movement stimulation and his emotions seemed to mature somewhat over this period of a month and a half.
I showed Brian’s grandmother how to complete some more rhythmic movements with Brian such as encouraging him to actively roll his bottom from side to side as well as windscreen wipers to help further stimulate his cerebellum to make new connections thereby helping with his speech development, coordination skills, etc. I also showed her how to engage him in rocking on hands and knees to help him with his motor skill development and possibly retained STNR, as well as facial tapping to help him with his facial reflex integration. I also showed her home to complete the sensory hand program with Brian, to hopefully help him further with facial reflex integration as well as improve his fine motor skills. I also showed her how to complete the rotation of the head from side to side to further stimulate and mature Brian’s neural chassis.
In February of 2011, Brian was noted to show a lot of emotionality and assertiveness in visits with myself and his speech and language pathologist, which we took as a good sign of his developing sense of self. He was also noted to continue to struggle with self-regulation at times as well, but this was fleeting instead of being a continuous and ongoing problem involving long meltdowns! Brian was noted to show a good awareness of real versus pretend in March and was also reported to have become a much better sleeper, as he was noted to sleep through the night and also sleep in his own bed. Brian entered daycare around this time and he was observed to generally interact well with the other children and was noted to have adapted fairly well to routines and structure of the daycare environment. I was particularly impressed one day when observing him really want to play at the playdoh table but it was “full” so he had to wait until there was a place for him to join the table. He stood there for about 20 seconds, watching the children play with the playdoh, then proceeded on to another play area on his own without a fuss! This is something he would have totally blown up about in the past! A few minutes later, from across the room he noticed that there was a spot available at the playdoh table, and he proceeded to throw his toys he was playing with and made a run for the empty spot!
I haven’t had that much involvement with Brian in recent months, as he was noted to be away at his cottage for most of the Summer and had recently started an intensive behavioral intervention (IBI) program for children with Autism this Fall. He was noted by his grandparents to be doing very well in many areas. They noted that he is now completely toilet trained and is starting to eat more of a variety of foods. She also noted that Brian is talking in full sentences and is now enjoying activities such as sitting down to colour and playing games. He was noted to be engaging in pretend play and more cooperative play with other children and was noted to be currently learning to print and starting to read. Brian was noted to be on a gluten/casein free diet some of the time by his grandparents and they noted that gluten and various food dies, etc. seem to have an effect on Brian’s behaviour. Concerns were noted by the IBI program staff related to Brian’s behaviour at the program such as hitting and biting as well as general non-compliance and dysregulation.
When I recently visited Brian at the IBI program to re-assess his skills, I was deeply impressed by the boy I saw and engaged with. He was much more articulate with words than when I had seen him last and was able to talk with me in a back and forth communication, asking appropriate questions and interjecting with comments. He was able to wait his turn and transitioned fairly easily between most activities. He showed a drastic improvement in his visual motor integration skills and scored in the above average range for visual motor skill development! Before this, Brian was engaging in exploratory colouring and very basic imitation of lines. He showed a good awareness of counting and colour concepts and fairly good fine motor ability to engage in activities using mini tongs to pick up items and use in hand manipulation to move a button from his palm to his fingertips. Despite the fact that Brian is still showing some problems with regulation and behaviours, I am deeply impressed by his progress and attribute much of this progress to the stimulation he received from the rhythmic movement training program. I do believe that there are likely many factors that have helped Brian, and a big one also seems to relate to his sensitivity to gluten, casein and red dye and his grandparents have cut out these things in the past 6 months.
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