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Welcome to the podcast Beyond Expectations, Parenting Autism.
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Follow Michelle Shabola's journey of raising a child with autism, the challenges, victories, and rewards.
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If you're a parent, caregiver, or simply someone seeking to understand autism on a personal level, you're in the right place.
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This is Michelle with Beyond Expectations.
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We are back for an amazing informational episode with a guest, and we have Rondolyn Whitney here and of course John Dobson.
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Hi, Rondolyn.
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Welcome.
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Hello, thank you.
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Thanks for having me.
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We're excited to have you here.
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Yeah.
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So shall I introduce myself for a minute?
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Can you take a minute?
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Okay.
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Sure.
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So uh I'm an occupational therapist.
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My area of specialty was working with children with uh neurobehavioral disorders, uh, autism, nonverbal learning disability, bipolar, ADHD, just a whole cluster.
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You know, they they it all falls kind of in a soup anyway, so it all's in that little that bucket.
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So there's very these labels are frustrating because they can be frustrating.
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Um, and we we can talk about that today if you'd like, because I I think that's an interesting um uh idea of of why it's like that.
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Anyhow, uh those are the kids I worked with, and of course, when I'm working with children, that means I'm working with families and I'm working with the systems, the schools, and the community.
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So that was my work.
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Um I have advanced practice specialties in sensory integration, uh, which uh be really great to talk about.
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I did a rotation at Ayers um clinic out in California, so I got to learn right there with her stuff, which was nice.
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Uh, and then I had the great um uh privilege of working alongside of some of the people that actually worked with and they were trained by Jean Ayers, who is the founder of sensory integration as a theoretical intervention.
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Um, and so they really understood the cis the sensory system in ways that a lot of other people downstream over the years either don't understand or have um uh deviated from.
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So working with them allowed me to understand the um evidence behind sensory integration as an intervention.
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So that I know that's something that Michelle, you and I talked about, and that I'd like to talk a little bit more about it today.
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That's great.
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I already have like 19 questions.
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So legit here.
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I don't know anything about this whole topic.
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Excellent.
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I try to imagine the questions that people might ask.
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So I'm I think there's nothing better than to have an open mind and know very little because then you get to ask the questions that other people don't think to ask because they think they already know.
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So I'm playing the idiot very well.
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So I'm not familiar with the Ayers work or the Ayers clinic, so maybe start there.
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Okay.
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So Jean Ayers, uh, back in the 50s, was a uh a neurologist, and she worked primarily with individuals with the ADHD, and she started noticing that there were um I'm gonna hijack her story a little bit, but she started noticing that there seemed to be something else going on neurophysiologically that was in the way of them being able to regulate.
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So a lot of people talk about um sensory integration and regulation, but she really thought that there was something going on that was uh inhibiting the uh child's ability to integrate information through the eyes, ears, nose, mouth, etc., the all of those systems.
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And just a sidebar to kind of put it in context, if we were to look at the uh nervous system, all nerves to the brain are sensory nerves, and all nerves from the brain are motor nerves.
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It's just the way everything's wired.
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Now, once it gets in the brain, they like you know mess around a little bit, but all nerves to the brain, so the way we understand our world information in, action out, basically.
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Exactly.
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So the way we understand our world is through the senses.
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And you know, when we're in kindergarten, we teach the five senses, but there's actually more like eight senses.
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Um, neurologist neurologists think there's probably more like 200 senses, but we're gonna talk about eight because that just um helps us understand it.
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So Gene Ayres was really the first person to sort of think about this and put it together and say if a child can't organize and integrate information coming into their body, it's gonna be really hard for them to use it in behalf of the things they want to do.
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So her theory specifically says sensory integration for use.
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So oftentimes I see people that provide sensory input and call it sensory integration, but it's not because you have to do sensory integration for use.
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So you use the the um principles of the intervention, and then you give the child something to do that they really couldn't do before, so that you put that pathway together.
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So sensory integration for use is AIR's sensory integration uh approach.
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Wow.
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That's that sounds incredible.
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So so in your so so tell us about going in your in your practice, um, I guess what is that to put more context on it.
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So when you're when you're sort of you using these interventions, how do you how do you break it down to like a most simple this most simple?
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So let me let me tell you a little bit about let me define um the senses that uh we pay the most attention to, and then talk about how to sort of do an intervention um uh during a treatment, I think we put it in context for you.
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So the senses that we talk about, the ones we all know are eyes, ears, nose, mouth, right?
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Um sense of touch, that's a big one.
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Um, but the sense of touch has two different pathways.
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There's one that brings information like tickly touch, itch, temperature fast, and then we have the deep pressure system, which is um a um a bigger nerve, and it's it's organizing.
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So that's why, you know, it's sort of silly if you ever hit your um thumb with a hammer.
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It doesn't make sense, but the first thing you do is grab it and squeeze it.
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That doesn't make sense.
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It seems like you'd want to like not touch it, but you grab it and squeeze it because you're taking pain, which is the tickly touch and pain and itch system, and you're putting in deep pressure, which regulates, calms, and organizes that input.
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So the touch system has two.
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We also talk about the vestibular system, that's that system in your inner ear that tells you where your head is in space when you're going round and round or you're going forward, and you've probably had that experience sitting in your car where you're minding your own business, you're sitting at the red light, and the car beside you goes backwards and you freak out and you push the brake.
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That's because your vestibular system got information through the eyes and said, Hey, I'm moving.
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And then you push out with to the brake, and then you're your the rest of you says, No, I'm not silly, right?
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But that's that the visual and vestibular system works together.
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Uh, and then the um the proprioceptus system uh is is that system in the joints and muscles, so it tells us where our arms are and where our body is in space and time, tells us how heavy something is.
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You can play a lot of fun tricks on people with a proprioceptus system.
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There's this great um trick where uh like a comedian walks in with a box and they act like it's super, super, super heavy and they struggle and they hand it to a person, and that person is watching this and calibrating how heavy the load is without really thinking about it, but they do that.
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And then you put the empty box in their hands and their arms will go up, right?
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So that's the proprioceptive system.
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Um, when the proprioceptive system is not working uh in a um typical fashion, those are kids that break their pencil lead, or they push too hard, or they push too softly, or they can't figure out how to make their fingers work together to make buttons or zippers go together because that system and the joints and muscles is just not quite working.
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So let's see, did I get each of the systems?
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Oh is that the reason I can't handwrite very well?
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Um the reason you can't handwrite uh very well is a little more complicated, but if you want, I can help you handwrite in a pretty good way.
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You can't read it.
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That's interesting, we're Ronald, as we go through all the symptoms that Gregory has, we realize that we all have some version of it.
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We all have some version of it, yes, yes.
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Um the uh final system, uh sensory system that I think is really important to talk about, and we really just started talking about it about 10 years ago, uh, is called the introsceptive system.
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And the introsceptive system, each of these systems only works because it has a receptor, and some kind of input makes that receptor fire.
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So if I get visual input in my eyes, my receptors fire.
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If I get auditory input through my eyes, nothing happens.
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That makes sense, right?
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So in the introstors are in the organs in your body inside, and they really only pay attention to um distinction and pressure, and that's really pretty important.
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So your stomach says, I'm empty, I'm full.
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Your heart says, I'm empty, I'm full.
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Your colon says, I'm empty, I'm full.
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This gets back to what we're gonna talk about with the brushing in a minute.
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I'm empty, I'm full.
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And the way I like to explain it is it kind of makes a lot of sense.
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Like you don't want your colon to say anything other than I'm empty or full.
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You don't want it talking to you about anything else, like TMI, right?
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It's like, okay, you're full.
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That's that's your interoceptive system.
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And we're learning a lot more about that system uh over the most recent uh years.
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Uh, and it comes into play a lot with people who have anxiety, like I don't know why I feel this way, I can't locate why I feel this way.
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Um it is um um prone to uh trauma, it gets uh faulty messaging during trauma for children.
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So, anyway, so those are the systems that we'll talk about today.
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So at the end of the whole story about the sensory system, sensory integration for use, we want the system to be in balance, we want it to be regulated, and we know that we can put information into the nervous system that alerts you or calms you down, right?
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That makes sense.
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So I could scream really loud.
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I'm an alto, so it's hard for me to scream loud enough that would really annoy you, but um there are things that we can do that really activate somebody's, you know, fight, flutter, fright, and things that we can do to calm it down.
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A baby crying.
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Right, a baby crying.
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So um an alto singing, right, is really calming, that kind of thing.
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So um what gene errors helped us understand is when the certain sensory system is um not regulated, it's either too high or too low, we can put information into the proprioceptive system or the deep pressure touch system, and that helps regulate it, and it has to do with the way the nerves are like a freeway.
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And that takes us back to brushing.
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Now we can talk about brushing.
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So, brushing bear with me for the whole story.
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Brushing does not work.
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I live that stay with me, stay with me for just a second.
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For those that don't know what we're talking about, this isn't this is my only job here on the the will barger brushing protocol brushing method, and we did talk about it somewhere.
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We talked about this, but it but it is it is literally brushing.
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It's it's using a it's using a surgical scrub brush, and you and you brush the skin of a child.
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One direction, like you're not scrubbing, you're you're doing correct, one direction.
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Very good.
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And Gregory, and Gregory, is this something that you used to try with Gregory?
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I did, I did with Gregory.
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This is this is what changed my life with Gregory big time.
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Okay, now Rondolin says it's Rondolyn.
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I interrupted you.
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You said stay with you and we interrupted you.
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Stay with me on this.
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All right.
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All right, Patty Wobarger uh and uh created the brushing protocol, and the brushing protocol does not work, but don't quote me there.
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You have to let me finish the whole sentence.
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The brushing protocol is a systematic way to deliver deep pressure and proprioception in a very systematic way so that it goes on all the skin, the deep pressure on all the skin.
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So when you use the brush to deliver the deep pressure input, you're pushing down on the breast so that the bristles are bent, right?
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You don't do light tickly touch, you push down really hard.
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A lot of times, if you do it correctly, you're sweaty at the end of delivering the input.
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So it's it's it it's you know, it's got and then the second part of the quote brushing is you do joint compressions, right?
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You push the pull on the joints and muscles, that's proprioception.
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So deep pressure and proprioception, and the brushing protocol was designed to help parents and other people deliver deep pressure and proprioception in a systematic, regulated way.
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Interesting.
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So so I'm I'm catching up here.
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The deep pressure, I understand what is the other the proprioception proprioception.
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So I'm gonna I'm gonna have you do some proprioception to yourself.
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All right.
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Okay.
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So if you take your fingers and you push really hard on your fingers, all right, and then you pull on all your fingers.
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Yep.
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If you were nine years old and in my clinic, and we were gonna work on handwriting, we would get your hands ready for good work by pushing and pulling on your joints and muscles that use a pencil.
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Interesting.
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And the concept there is that it does what to the joints?
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By by opening them up, you increase the neural pathways or you're yeah, we're we're actually not working on the joints so much as we're giving input into the brain carried through the joints and muscles of your hands, that wakes up your brain, has it be regulated, so that when we put a pencil in it, it says, Okay, I can be calm now, I can be organized now.
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I have more input through the touch system.
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A lot of children have difficulty with writing because they hate the way it sounds on the paper, the pencil, they hate the way it feels where it's been um, you know, the wood.
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They hate the way it smells.
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They got all kinds of reasons for hating it.
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So if we put deep pressure and proprioception into the system, that gives us a little bit of a regulation for the child so that we can then give them some work to do.
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And in your case, if you were nine years old, that might be working with your pencil for handwriting.
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Interesting.
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So really it's it's I'm catching up now.
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So it's basically priming your nervous system by very intentionally producing those signals that go into your brain that regulate your system.
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Those things are they're effectively your is this your subconscious, or we call this your autonomic system?
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What do we call this?
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This is your sensory nerve, this is your nervous system, your sensory nervous system.
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Your sensory nervous system that's processing information that you're really not aware, it's processing.
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You may or may not be aware, but you are always aware of your sensory processing one way or another.
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Some people are over-registering information, like a slightest breeze, and they're like, right?
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Um, that's over-registering, and some are under-registering, they're like, What?
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Yeah, you're like, you got food all over your face.
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Like, what?
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Like under-registering, right?
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So over-registering or under-registering, and you can over and under-register in any of the sensory systems.
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Interesting.
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And so your therapy, and the the the therapy you're talking about, is this therapy that that with very intentional inputs basically allows you to, I don't want to say reset, but you're saying regulate.
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Regulate.
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Right, regulate your nervous system.
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I've heard these terms before.
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I didn't really know.
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Yeah, we want we want to integrate those systems.
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And in a typical, typically developing nervous system with babies, those systems are getting integrated when they crawl, when they walk, when they play, when they rock, and so on.
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But for some nervous systems, I like to talk about nervous systems and not people, but for some nervous systems, they need more input in order to integrate.
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Some need less in order to integrate, and so they avoid it, right?
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And so, because of those two things, they're not getting the kind of input that a typical developing nervous system would be getting.
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And so then when we give them work to do, holding a pencil, being a good friend, whatever it is, they're uh they're not ready to do it.
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Developmentally, they're not ready to do it.
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So air sensory integration uh as an approach, as a science, uh, systematically provides that input.
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It's a developmental theory, so it systematically provides that information into the nervous system to help it develop in a more typical fashion, to catch up, so to speak.
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You explained that so well.
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It makes sense.
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So, what are the what are other kinds of sort of inputs that you can sort that you can intentionally provide?
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There are a whole range of them.
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Yeah, so if if you've ever seen a sensory integration clinic, it's it's like a playroom, right?
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It's got all kinds of stuff going on.
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So there's uh suspended equipment, uh uh maybe with a um like a um what do they call it, like a board, swing, uh, and it's suspended, right?
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And so the child might sit on that and we twirl them or we rock them back and forth.
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And while they're doing that, that's the vestibular system.
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They're getting input into the vestibular system.
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When you get input into the vestibular system, I can't talk about it without moving.
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You get input into the vestibular system, your proprioceptive system, your muscle system wants to correct.
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So, Sean, you don't remember me having one in my basement in Colorado?
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Yeah, I remember, but I but you know, so many people have Gregory would not get dizzy, Rondolin.
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He could not get it.
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I'm gonna I'm gonna name that for you.
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He was under registering.
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So Gregory was under-registering vestibular input into his spun him and spun him and spun him and spun him, and he would get off and walk a straight line.
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And I will never forget the day that he fell down when he got off, because we that's what he did every day.
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We just Sean just in a circle as fast as you could spin him, and he would just laugh and get off and walk right off.
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Like you put Michael on it, and he never get dizzy, never got dizzy, you'd have to assume that you believe it.
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Yeah, and so we we we say of children they never they never get dizzy, and then if we were to say that in uh scientific neurological neurological terms, or if we were to write that in the chart, under-registering of vestibular input.
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Wow.
00:20:14.640 --> 00:20:16.400
And then now I have a question for you.
00:20:16.559 --> 00:20:27.200
So if a person is under-registering or over-registering for sensory input, I have two tools in my toolkit to help them become more integrated and regulate.
00:20:27.279 --> 00:20:28.720
Do you remember what they are?
00:20:31.839 --> 00:20:34.319
I brushed Gregory, I did the swing.
00:20:34.640 --> 00:20:43.359
Okay, so well, let's let's again, one of the things that I thought was really fascinating, Michelle, when you and I talked before the podcast, that I'm really committed to.
00:20:43.519 --> 00:20:56.079
I'm really committed to helping parents and families understand what is going on so that they are able to choose 10 more things without me being there to help them.
00:20:56.319 --> 00:20:56.720
Right.
00:20:56.960 --> 00:21:01.839
That they can say, okay, it's kind of like, you know, I'm a I I grew up in the South, I'm a scratch cook.
00:21:02.000 --> 00:21:05.279
So I can open an empty refrigerator and make a meal for 20 people.
00:21:05.359 --> 00:21:07.200
Like I that's how I was taught, right?
00:21:07.440 --> 00:21:12.720
And it's because I know what things go well together and I know what to choose and what not to choose, right?
00:21:13.039 --> 00:21:19.599
So sensory integration as a uh air sensory integration uh approach is like that.
00:21:19.839 --> 00:21:23.519
We need to help people understand why did this work?
00:21:23.680 --> 00:21:24.160
Okay, good.
00:21:24.240 --> 00:21:27.920
Now that I understand that, what's 10 more things like that I can do?
00:21:28.480 --> 00:21:38.799
Because then the child gets enough doses throughout their day, they're gonna get better faster because they're getting it 20 times a week instead of once a week.
00:21:38.960 --> 00:21:42.160
So I'm really passionate about this.
00:21:42.559 --> 00:21:44.880
So go back to your story.
00:21:45.680 --> 00:21:59.519
I know without having been there, when um Jeffrey Gregory was on the swing, um, I know that after you did the swinging, you had to do some kind of deep pressure and proprioception after maybe.
00:22:00.160 --> 00:22:03.759
While he was on the swing, he was pulling on a rope, which would be proprioception.
00:22:04.240 --> 00:22:07.599
Maybe he was catching a heavy ball, which would be proprioception.
00:22:08.160 --> 00:22:14.400
Maybe he was listening to music with deep tones, which would be proprioception, into the eardrums.
00:22:14.960 --> 00:22:18.960
Maybe he was squeezing putty, which would be proprioception.
00:22:19.119 --> 00:22:24.559
Or maybe you did the brushing either before or after, which would be deep pressure and proprioception.
00:22:24.640 --> 00:22:29.519
And I know that because you said after a while he was able to walk a straight line.
00:22:29.839 --> 00:22:30.160
Yeah.
00:22:30.319 --> 00:22:35.839
Well, he walked a straight line and then he once finally got dizzy and he couldn't even get off of it.
00:22:36.000 --> 00:22:36.640
It was amazing.
00:22:36.720 --> 00:22:38.160
It was just like in one day.
00:22:38.400 --> 00:22:42.400
We did a lot of brushing, a lot of brushing, a lot of deep pressure.
00:22:43.039 --> 00:22:46.480
Um, and he just he loved all of it.
00:22:46.559 --> 00:22:50.160
He was really, he was very receptive to all of it.
00:22:50.480 --> 00:22:50.960
Right.
00:22:51.279 --> 00:23:05.200
Which I I often think about if children could talk, if their brains could talk, they would say, I don't mean verbally, but if their brains could talk, they would say, Oh, thank God that deep pressure improprioception is really helping me out.
00:23:05.279 --> 00:23:06.960
I did not know how to organize this stuff.
00:23:07.039 --> 00:23:12.960
I got papers everywhere in this brain of mine, and you gave me this deep pressure and proprioception, and now I can put it into categories.
00:23:13.039 --> 00:23:21.839
And now, it's like anything, if I have an organized uh desk, I can reach in and get what I need and put it to use.
00:23:23.279 --> 00:23:24.240
That's a great way.
00:23:24.319 --> 00:23:25.519
That's a great way to explain it.
00:23:26.000 --> 00:23:32.559
And there's just so many little tools, like I told you, we found the mini backpack and put books in it when we go to the mall.
00:23:32.720 --> 00:23:36.240
And so let's let's do a quiz again to center him.
00:23:36.559 --> 00:23:38.640
He wants to do a quiz again like crazy.
00:23:39.039 --> 00:23:40.559
Yeah, ready for your quiz?
00:23:40.880 --> 00:23:41.680
Ready for your quiz?
00:23:42.079 --> 00:23:43.119
It's been a while.
00:23:43.440 --> 00:23:43.680
Sure.
00:23:44.160 --> 00:23:44.720
I have a question.
00:23:44.799 --> 00:23:48.640
Was the book thing not something to mess with the books?
00:23:48.720 --> 00:23:51.039
You're saying the physic the weight and the pressure on him?
00:23:51.279 --> 00:24:00.480
Weight was feeding information to his nervous system that was allowing him to organize all of the inputs in a way.
00:24:01.519 --> 00:24:05.680
That was that was infra if you think about a backpack that's heavy, a weighted backpack.
00:24:05.920 --> 00:24:10.880
You could have a weighted belt, a weighted backpack, a weighted vest, a weighted hat.
00:24:11.200 --> 00:24:16.880
Uh we've we've sewn uh fish weights into people's uh pockets, weighted.
00:24:18.079 --> 00:24:25.039
So if if you have something weighted that is putting extra gravity on your joints and muscles, that's proprioception.
00:24:25.599 --> 00:24:30.559
And if the backpack is nice and tied up against you, that can be deep pressure.
00:24:30.720 --> 00:24:32.400
So deep pressure and proprioception.
00:24:32.480 --> 00:24:34.319
So you figure that out on your own.
00:24:34.640 --> 00:24:40.240
Had you known, oh my god, I need uh 20 more deep pressure and proprioceptive ideas here.
00:24:40.400 --> 00:24:42.079
What else have I got around the house?
00:24:42.319 --> 00:24:44.880
You would have come up with a lot of other things around your house.
00:24:45.200 --> 00:24:49.839
Yeah, he liked the weighted blanket, but he did not like the weighted hat at all.
00:24:50.079 --> 00:24:51.200
It was awful, though.
00:24:51.279 --> 00:24:52.240
It was pretty awful though.
00:24:52.319 --> 00:24:54.079
If you put it on yourself, you'd like it.
00:24:54.160 --> 00:24:54.319
Yeah.
00:24:55.359 --> 00:24:58.640
Some people love it, and now they make weighted blankets for you and I.
00:24:58.799 --> 00:25:00.720
Sean just gave me one for my birthday.
00:25:00.799 --> 00:25:02.400
That's a weighted blanket, right?
00:25:04.400 --> 00:25:11.200
Is it's the pressure on your muscles is helping you organize all of the inputs going through your almost.
00:25:11.279 --> 00:25:17.200
So the a weighted blanket is um deep pressure into the tactile system.
00:25:19.200 --> 00:25:19.519
Right?
00:25:19.599 --> 00:25:22.480
So that's that's deep pressure in the top tactile system.
00:25:22.720 --> 00:25:29.359
If you push on the weighted blanket and lift it, that's information into your joints and muscles, the proprioceptive system.
00:25:30.559 --> 00:25:31.599
That's fascinating.
00:25:31.839 --> 00:25:32.720
Isn't it fascinating?
00:25:33.119 --> 00:25:38.319
It's fascinating, but it's kind of giving me a whole series of questions that maybe you guys don't want to spend time on.
00:25:38.559 --> 00:25:42.319
But uh when we talk about someone that's diagnosed with autism, right?
00:25:42.720 --> 00:25:44.079
I've never really understood.
00:25:44.240 --> 00:25:47.200
Are we talking about uh a brain issue?
00:25:47.759 --> 00:25:50.720
Are we talking about uh an intelligence issue?
00:25:50.799 --> 00:25:50.960
Uh uh.
00:25:51.279 --> 00:26:05.119
Or are we really just saying that it's that not just saying, but are we saying that it's uh it's really uh this uh it's the the exact it's this it's the fact that you're receiving all these inputs, they're very difficult to organize.
00:26:05.279 --> 00:26:10.240
I think Michelle at some point someone told us that Gregory has a hard time prioritizing inputs.
00:26:10.319 --> 00:26:14.640
He kind of sees he sees it all, hears it all, and that becomes overwhelming.
00:26:15.039 --> 00:26:17.200
With autism, is that really what we're talking about?
00:26:17.279 --> 00:26:24.559
Is that is it this this or this nervous system that is becoming overwhelmed because the information streams are not integrated?
00:26:25.200 --> 00:26:29.440
Or is that that one fat or is that one factor of someone that has autism?
00:26:29.759 --> 00:26:32.559
Yeah, that's a that's a very important question.
00:26:32.880 --> 00:26:38.960
So there's a a book called the Diagnostic Statistical Manual, the DSM.
00:26:39.519 --> 00:26:49.039
We have written it multiple times, not me, but the profession, uh psychology, um, and we're on uh version five.
00:26:49.359 --> 00:26:50.720
So version five.
00:26:50.960 --> 00:27:12.240
So over time, the writers of the diagnostic statistical manual have tried to identify and specifically um uh describe what is and what is not autism, what is and what is not bipolar, what is and what is not any of the mental health clusters, ADHD, etc.
00:27:12.400 --> 00:27:13.599
They're all in there.
00:27:13.920 --> 00:27:25.440
So it's like the Bible of um diagnoses for mental mental health, and each one has a code, and you need that code in order to get reimbursed.
00:27:25.519 --> 00:27:26.720
Like that's that's the Bible.
00:27:26.880 --> 00:27:27.200
Okay.
00:27:27.519 --> 00:27:30.000
So I'm gonna ask a little clarifying question.
00:27:30.160 --> 00:27:35.440
Once this, I guess someone does, I I guess uh it's almost I guess a questionnaire, right?
00:27:35.519 --> 00:27:42.720
Of like trying to fit into one of these these designations of ADHD or autism or things, does that also prescribe their treatment?
00:27:43.039 --> 00:27:46.880
Or does someone in your role have the ability to kind of drift across the phone?
00:27:47.039 --> 00:28:00.079
Yeah, uh well, uh some of the many of the treatments are the same for all of the diagnoses, um, but uh some interventions might be more appropriate for one versus the other.
00:28:00.799 --> 00:28:15.119
Um so in the diagnostic statistical manual five, um, that was written by a group of people from uh Kennedy Krieger Institute, Center for Autism and Related Disorders in Baltimore.
00:28:15.359 --> 00:28:17.839
And I know that because I worked there when that happened.
00:28:18.240 --> 00:28:32.720
I didn't I wasn't part of the people writing it, but I got to be in the room and talk to them and give information and answer questions and and you know basically um enjoy being there, right, and listening to them talk.
00:28:33.039 --> 00:28:44.640
So what they what they did in the DSM 5 that that was really helpful is they said, okay, autism has three things that happen.
00:28:45.039 --> 00:28:52.880
And um one of those things is that they have difficulty, they have differences with sensory, with the sensory system.
00:28:53.039 --> 00:28:55.599
So that became part of the diagnosis.
00:28:55.759 --> 00:29:01.359
All right, so they had difficulty with social, uh, they had difficulty with um uh sensory.
00:29:01.920 --> 00:29:17.279
All right, those are the two biggies, and then they also in the DSM 5 did something super helpful, and they said, and one can have autism with or without an intellectual disability.
00:29:17.519 --> 00:29:21.119
We have another category called intellectual disability.
00:29:21.920 --> 00:29:24.720
Autism can either have or not have.
00:29:25.039 --> 00:29:26.240
Oh, I didn't know that.
00:29:26.480 --> 00:29:30.079
I always associate it with some sort of intellectual disability.
00:29:30.400 --> 00:29:30.799
Correct.
00:29:30.880 --> 00:29:35.279
That would that that got when someone has Asperger's versus autism.
00:29:35.440 --> 00:29:47.279
I the layman's perspective, I think, is Asperger's is someone that's extraordinarily high functioning intellectually, but then has sort of a different, you know, a difficulty or a different approach to social interaction.
00:29:47.440 --> 00:29:52.160
Is that sort of so I think that's a lay person's understanding?
00:29:52.640 --> 00:29:59.519
Fun fact the DSM 5 chose to not include Asperger's or nonverbal learning disorder.
00:29:59.599 --> 00:30:00.400
It's not in there.
00:30:00.799 --> 00:30:01.680
Oh, interesting.
00:30:01.920 --> 00:30:05.440
Yeah, they're like, oh, you know, somebody made this up a long time ago, uh Dr.
00:30:05.599 --> 00:30:07.920
Asperger's, and we really don't know what it is.
00:30:08.079 --> 00:30:12.160
We can't distinguish it from anything else, it's not distinctive.
00:30:12.400 --> 00:30:14.319
So we're gonna just leave it out.
00:30:14.559 --> 00:30:21.759
And so now we have um autism with or without um intellectual disability.
00:30:22.000 --> 00:30:33.359
Anyone with autism has uh some uh unusual atypical ways of processing sensation by by definition in the DSM.
00:30:33.839 --> 00:30:36.880
Um okay, so that's really helpful.
00:30:37.039 --> 00:30:46.640
And so now we have these people who have some type of autistic tendencies, like maybe just the social or so on.
00:30:46.880 --> 00:31:01.839
So they have the categories and they have uh autism level one, two, three, four, and five, and those levels are related to how much assistance the individual needs in order to live their life.
00:31:02.079 --> 00:31:22.160
So autism, level one, two, three, four, five, with or without intellectual disability, and that became specifically important for the research because before that it was very difficult to say we have a group of individuals, we're doing some research, they have autism, we think.
00:31:22.319 --> 00:31:23.279
We're not sure.
00:31:23.519 --> 00:31:30.079
Some of the we've excluded anyone with an intellectual disability because that's hard to include in our intervention.
00:31:30.319 --> 00:31:39.839
So every time we re would read about interventions for people with autism, it had excluded anyone with an intellectual disability.
00:31:39.920 --> 00:31:42.880
So then you read, okay, here's the best practice for people with autism.
00:31:43.039 --> 00:31:45.039
It's like, but it doesn't work for my kid.
00:31:45.200 --> 00:31:47.839
It's like, well, okay, now we can understand that.
00:31:48.000 --> 00:31:52.079
So they did us, I think, a great service of teasing that out.
00:31:52.160 --> 00:32:02.960
They it was a it was hard work, um, had some political conversations around that because some people, you know, had ideas about it, but that's what we have to date for the DSM.
00:32:03.119 --> 00:32:06.559
And I think that's been very helpful for parents.
00:32:07.200 --> 00:32:21.519
Um, we have a lot of young adults who now understand that they have autism and had autism, that either went undiagnosed or they were given the wrong information about the way they process the world.
00:32:21.599 --> 00:32:33.359
Um, and they're really helping us understand, like feeding back and feeding forward even more data now that we have this better system of understanding what autism is and isn't.
00:32:34.480 --> 00:32:37.359
And how old is that how long has that system been in place?
00:32:37.920 --> 00:32:43.599
So the DSM 5 diagnos again, it's a diagnostics, right?
00:32:43.680 --> 00:32:45.359
It's the category of diagnosing.
00:32:45.519 --> 00:32:51.759
Um, that came out, it must have been around I'm gonna say 2015-ish.
00:32:52.160 --> 00:32:53.759
I can I can find that out exactly.
00:32:53.920 --> 00:32:59.599
But but we're but we're 10 year plus years into having essentially 10 categories, right?
00:32:59.680 --> 00:33:05.440
So it's five five levels with or without um a mental disability or an intellectual disability.
00:33:05.759 --> 00:33:07.279
Yes, intellectual disability, yeah.
00:33:07.359 --> 00:33:15.200
And and they tweak it, you know, they have DSM 5R, and you know, they're they're like always looking at it and updating it.
00:33:15.279 --> 00:33:17.519
And at some point we're gonna have the DSM six.
00:33:17.599 --> 00:33:20.480
I don't I don't know when that's coming, but we will have it.
00:33:20.720 --> 00:33:26.559
Um because as we learn more, uh we we can do better.
00:33:26.720 --> 00:33:28.640
And so I I think that's a good thing.
00:33:29.839 --> 00:33:32.160
People are using the levels now, I've noticed.
00:33:32.319 --> 00:33:32.880
Level one.
00:33:32.960 --> 00:33:34.319
There's a you know, what level?
00:33:34.559 --> 00:33:36.559
I I couldn't even answer that question.
00:33:36.640 --> 00:33:43.119
I don't know how they I don't know, one, two, three, four, five must be very high.
00:33:43.279 --> 00:33:45.440
Is level one is very low functioning, right?
00:33:45.519 --> 00:33:47.200
And level five is higher.
00:33:47.839 --> 00:33:55.279
Yeah, we we tr we try hard to say to not say high and low functioning because that indicates some things that we don't mean.
00:33:55.519 --> 00:34:03.359
So really the level the levels are about how much assistance does the individual need, and that's important in schools.
00:34:03.519 --> 00:34:19.679
So if you have a child in a you have children in a classroom um who are say level um two, they're going to need different levels of assistance in that classroom in a different classroom setting than a child with a level five.
00:34:20.159 --> 00:34:20.800
I see.
00:34:21.280 --> 00:34:22.719
So that's that's super all.
00:34:23.119 --> 00:34:24.880
Are we getting politically correct though?
00:34:24.960 --> 00:34:28.559
I in a way to me it seems well.
00:34:28.639 --> 00:34:48.400
I think um what I would say is um from the feedback that we've gotten from adults with autism, they have asked us to be more inclusive and to talk about them in a way that they feel like they're not broken, but that they're who they are.
00:34:48.639 --> 00:34:59.760
And and I am super grateful for uh all that the children I've worked with have taught me.
00:35:00.000 --> 00:35:01.760
I am such a better person.
00:35:02.079 --> 00:35:07.119
We talk about this a lot, that that Gregory is a pleasure, it's a pleasure to be around.
00:35:07.760 --> 00:35:15.519
Yes, they're lovely, and he seems to not seem to have, he has an incredible level of empathy, almost to the to the to a point that it hurts him because he is.
00:35:16.960 --> 00:35:24.960
So how is that connected to this nervous system that's that's that's you know has this structure that's confusing and and not surrogated?
00:35:25.039 --> 00:35:28.159
How is that empathy that we see that's so common?
00:35:28.559 --> 00:35:30.079
Uh how is that connected to this?
00:35:30.400 --> 00:35:37.039
Well, I I I haven't seen a lot written about this or researched about it, but I can speak to it from my personal experience.
00:35:37.199 --> 00:35:50.320
Yeah it's it seems to me that these children, uh and I know we're talking about all ages, but I'm gonna use children because they're um innocent and you can see them better, right?
00:35:50.480 --> 00:35:54.320
We haven't like put all of our blankets on them, you know, like then you know whatever.
00:35:54.559 --> 00:36:09.840
Um but the the way back in time the way that autism was distinguished is is the diagnostician said they look angelic, right?
00:36:10.480 --> 00:36:17.039
They're beautiful, they're beautiful, and if they aren't beautiful, it's probably not autism.
00:36:18.960 --> 00:36:20.880
And that's the peace they have in their face.
00:36:21.039 --> 00:36:23.920
That's those innocent eyes, those big puppy dog eyes.
00:36:24.320 --> 00:36:24.719
Uh-huh.
00:36:25.360 --> 00:36:25.840
Yeah.
00:36:26.079 --> 00:36:35.360
And they have a little bit more fat in their tissue because they have lower proprioceptive systems, so their muscles aren't taunt, right?
00:36:35.760 --> 00:36:36.719
Oh, interesting.
00:36:36.960 --> 00:36:37.280
Yeah.
00:36:37.519 --> 00:36:40.880
So we they used to say angelic.
00:36:41.519 --> 00:36:45.599
And I I I'm on for that.
00:36:45.679 --> 00:36:48.400
Like I way better.
00:36:48.719 --> 00:36:50.719
So level one through five.
00:36:51.039 --> 00:36:59.760
And they are, I think, in my experience, they have good radars, but they don't necessarily know what's going on.
00:37:00.000 --> 00:37:08.480
So they don't necessarily take their understanding of social information and put it into what to do with it.
00:37:08.719 --> 00:37:14.320
So like they may understand that you're sad, but they may not understand what to do about that.
00:37:14.480 --> 00:37:19.360
Or they, you know, and then their filters, they don't have the social language, so their filters are off.
00:37:19.519 --> 00:37:25.519
And again, I love these kids because they say things like, I'm one of my favorite kids.
00:37:25.599 --> 00:37:30.239
I I got called in to work with a kid one time and they were gonna kick him out of the school.
00:37:30.320 --> 00:37:31.599
Like the teacher had had it.
00:37:31.760 --> 00:37:37.519
She was like, you know, lobbying to get this kid kicked out and sent to another school, and she was all about it, man.
00:37:37.920 --> 00:37:38.960
Everybody's all ahead up.
00:37:39.119 --> 00:37:42.239
So I go in, I'm like, okay, well, I'll do a classroom observation.
00:37:42.400 --> 00:37:50.320
I go in, and the problem was this this this boy, fourth grader, kept saying the teacher is ugly and she stinks.
00:37:50.480 --> 00:37:52.320
She's ugly and she stinks.
00:37:52.559 --> 00:37:53.280
I hate her.
00:37:53.440 --> 00:37:54.800
She's ugly and she stinks.
00:37:54.880 --> 00:37:56.079
I'm like, hmm.
00:37:57.519 --> 00:38:00.880
So I go in, I'm sitting in the back of the classroom.
00:38:02.639 --> 00:38:05.760
The you know Mary Kay, the the makeup.
00:38:07.760 --> 00:38:12.000
This teacher looked like she had put the entire Mary Kay kit on every day.
00:38:12.079 --> 00:38:12.719
You know what I'm saying?
00:38:12.800 --> 00:38:18.159
Like she was she was ugly in the sense that she was way too loud.
00:38:18.800 --> 00:38:23.519
Yeah right now, this boy didn't know how to say she's wearing too much makeup, she's too loud.
00:38:23.760 --> 00:38:27.440
And I'm sitting in the back of the room, I'm a redhead, I'm sensory sensitive.
00:38:27.599 --> 00:38:34.400
I'm sitting in the back of the room, and the woman has perfume on this like 40-foot perfume, you know what I'm saying?
00:38:34.719 --> 00:38:36.079
Wow, so that's what it was.
00:38:36.800 --> 00:38:39.280
She was stinky and she was ugly.
00:38:41.119 --> 00:38:46.079
You know, like I think if you washed her up a little bit, maybe, but the kid was dying.
00:38:46.239 --> 00:38:52.079
He was dying, his sensory system was completely freaking out, and it was using the only words he knew.
00:38:52.239 --> 00:38:58.079
So I went to the principal and I said, because my job was to report back on what to do with this problem child.
00:38:58.400 --> 00:39:02.079
I went to the principal and I said, Okay, I'd like to meet with you privately.
00:39:02.159 --> 00:39:07.039
I think I have some uh information um to to provide to the team.
00:39:07.280 --> 00:39:13.920
So I meet with the principal and I said, I don't want to go to the team and say he's right, she's ugly and stinks.
00:39:14.079 --> 00:39:15.119
I don't want to say that.
00:39:17.360 --> 00:39:18.960
But here's what's happening.
00:39:19.199 --> 00:39:36.159
And I explained what was happening to the principal, and I said, I think it would just be better for everyone if we moved him to another room, and the other fourth grade teacher is a guy who wears nothing, you know, like he's got flannel on every day, he got boots on.
00:39:36.320 --> 00:39:41.280
Like, if we just move him, I think it'll all be over.
00:39:41.440 --> 00:39:43.039
Yeah, that's and that's what they did.
00:39:45.039 --> 00:39:46.320
That's my story with Gregory.
00:39:46.480 --> 00:39:54.159
Remember, Sean, with the their the psychologist or psychiatrist that wanted to give him every med known to mankind because he got the giggles, Rondolyn.
00:39:54.239 --> 00:39:55.840
He got the giggles really bad.
00:39:56.079 --> 00:39:58.719
And I what he walked, I walked out with all these prescriptions.
00:39:58.880 --> 00:40:00.239
I'm like, Gregory, what happened?
00:40:00.320 --> 00:40:02.159
This guy thinks you're you're luther.
00:40:02.480 --> 00:40:04.880
He goes, he's so funny looking.
00:40:05.039 --> 00:40:08.880
He just laughed and the guy was funny looking.
00:40:09.039 --> 00:40:11.280
He had big suspenders, big strapid shirt.
00:40:11.440 --> 00:40:14.880
He had he had a lot going on, and Gregory just couldn't process it.
00:40:15.119 --> 00:40:17.679
So I think that gets back to Sean's question.
00:40:18.000 --> 00:40:19.840
It's a perfect example.
00:40:20.639 --> 00:40:26.880
Perfect example because Gregory was picking up his radar, was working.
00:40:27.039 --> 00:40:44.719
Yeah, he was taking in information from a social situation, but he couldn't really organize and articulate it in the way that we could understand, and then unfortunately, people jumped to the conclusions from their own way of thinking.
00:40:45.119 --> 00:40:47.039
Yeah, what they think that means.
00:40:47.360 --> 00:40:48.239
That's crazy.
00:40:48.320 --> 00:40:51.679
It's it's very interesting for hours.
00:40:51.920 --> 00:40:56.239
Um, how does a find a rondolin?
00:40:56.400 --> 00:41:00.400
Well, first of all, are you publishing somewhere that that people can follow you?
00:41:01.039 --> 00:41:09.360
Yeah, so I have uh I always tell Michelle that years ago I really wanted to figure out how to put OT in a box, right?
00:41:09.519 --> 00:41:11.280
Like, okay, here's a box.
00:41:11.360 --> 00:41:18.400
Because I had people at the time I had a clinic in California, people come from Canada and all over the country, and that really broke my heart.
00:41:18.559 --> 00:41:24.719
I I I didn't feel my ego was was not impressed by that.
00:41:24.880 --> 00:41:28.000
I my mother was my motherhood was sad about that.
00:41:28.159 --> 00:41:32.320
People should be able to find what they need in their local community.
00:41:32.559 --> 00:41:42.000
So I have written uh several books on this that are very family friendly, and they're available on Amazon, and I I recommend them.
00:41:42.159 --> 00:41:45.440
I mean, you know, I I can give them away free sometimes.
00:41:45.519 --> 00:41:46.800
You know, I've got a big stack of them.
00:41:46.960 --> 00:41:50.239
I do talks at libraries all the time, and I'm like, here, take them, take them, take them.
00:41:50.559 --> 00:41:53.679
Um, because I I just want people to have the information.
00:41:53.760 --> 00:42:06.079
I'm getting ready to do a uh an updated revised vision version of one of the books, but the books on Amazon about sensory are meant to be OT in a box.
00:42:06.159 --> 00:42:09.679
One of them talks about just what we've just talked about, goes through it all.
00:42:09.840 --> 00:42:18.320
I co-wrote it with Wendy Pickering, who's a genius out in California, genius, uh, and we break it down very simply so parents can understand it.
00:42:18.480 --> 00:42:23.280
And then the other book is definitely um OT in a box.
00:42:23.440 --> 00:42:25.360
It has 52 activities.
00:42:25.519 --> 00:42:28.559
So an activity for one a week.
00:42:28.800 --> 00:42:30.960
Every activity has what I call a power-up.
00:42:31.199 --> 00:42:33.039
Here's how to make it harder, right?
00:42:33.280 --> 00:42:36.239
And they're meant to be integrated into your day-to-day life.
00:42:36.320 --> 00:42:45.360
So here's some activities for meal time, uh, here's activities for um uh evening routines, here's activities for morning routines, etc.
00:42:45.599 --> 00:42:46.719
And they're organized like that.
00:42:46.800 --> 00:42:49.440
So parents open it up, they do one, send the kids to school.
00:42:49.760 --> 00:42:50.880
Open it up, do one, send it.
00:42:51.199 --> 00:42:56.880
So, like, for example, time for bed, often a problem for children.
00:42:57.119 --> 00:43:10.559
So instead of saying, go brush your teeth, uh, then you the child might do bear walks into the bathroom because they're getting that deep pressure and proprioception into the joints and muscles, which will help them feel more regulated and organized.
00:43:10.719 --> 00:43:12.719
They can brush their teeth and go to bed.
00:43:13.039 --> 00:43:13.440
Nice.
00:43:13.519 --> 00:43:16.000
Okay, what are the names of both books, real quick, before we have to.
00:43:16.320 --> 00:43:17.199
Yeah, that's a really good.
00:43:17.280 --> 00:43:20.000
Let me let me grab them off my shelf here because I never remember.
00:43:20.239 --> 00:43:27.599
One one of us raising raising kids with sensory processing disorders, and the other one is which I did.
00:43:33.360 --> 00:43:35.519
How do you how do you find an OP?
00:43:38.239 --> 00:43:46.079
This is such great information, and this the what I really want to tell none of this is gonna hurt your child, it's only gonna make it better.
00:43:46.320 --> 00:43:52.159
And it's very inexpensive, or right here it's in a book.
00:43:52.239 --> 00:43:55.840
I went to you know, clinics and learned it different ways, cost me a lot of money.
00:43:56.320 --> 00:44:03.679
Insurance cover, if I if if if if my child would benefit from this, can I can I get a prescription for an occupation?
00:44:03.920 --> 00:44:04.480
Like, how does this work?
00:44:04.559 --> 00:44:09.840
How do I get how do I so here's here's the other one self-regulation, a family system approach is the other book.
00:44:10.079 --> 00:44:11.519
I probably can't myself.
00:44:11.679 --> 00:44:12.239
I read it.
00:44:12.960 --> 00:44:16.800
Yes, they get they get a diagnosis and they need OT, they get OT.
00:44:17.519 --> 00:44:17.760
Yeah.
00:44:18.239 --> 00:44:26.559
Well, and and importantly, um because in the DSM they added sensory, it's now covered.
00:44:26.800 --> 00:44:27.519
It's got a code.
00:44:27.840 --> 00:44:38.639
And and because uh sensory processing disorder is not a diagnosis in and of itself, it's not been put into the DSM, right?
00:44:40.559 --> 00:44:55.199
When we're talking about uh third-party reimbursement, your insurance, when you work with an occupational therapist, they can often help you work with your doctor to identify a diagnosis that does qualify for the intervention.
00:44:55.519 --> 00:44:55.840
Yes.
00:44:56.079 --> 00:44:56.400
Excellent.
00:44:56.639 --> 00:44:59.760
It's it's an elaborate shell shell game, but we're happy to help you play it.
00:45:00.400 --> 00:45:01.679
Wow, that's so complex.
00:45:01.840 --> 00:45:03.199
The whole process is so complex.
00:45:03.519 --> 00:45:04.480
I'm glad you found us.
00:45:04.639 --> 00:45:05.840
This was really, really nice.
00:45:05.920 --> 00:45:07.679
This was so fun.
00:45:07.840 --> 00:45:09.199
Thank you for letting me talk about this.
00:45:09.360 --> 00:45:12.239
I can obviously I can go on and on and on and on because I just think it's so good.
00:45:13.360 --> 00:45:17.039
There was no way we could we there's so much value here, so we definitely want to have you back.
00:45:17.199 --> 00:45:17.840
Thank you so much.
00:45:18.239 --> 00:45:18.800
You're welcome.
00:45:18.880 --> 00:45:24.639
Thank you for the opportunity, and I'm sure it's gonna help more kids, and that's that's the point of life, right?
00:45:24.800 --> 00:45:26.480
Is to help families and children.
00:45:26.719 --> 00:45:27.280
That's right.
00:45:27.519 --> 00:45:27.760
Absolutely.
00:45:28.480 --> 00:45:29.039
Well done.
00:45:29.840 --> 00:45:33.440
All right, and Sean, you can take me up on helping you with your handwriting, really.
00:45:33.599 --> 00:45:34.400
I'm hoping with that.
00:45:34.880 --> 00:45:36.719
57 years into not knowing how to write.
00:45:36.800 --> 00:45:38.239
So there you go.
00:45:38.800 --> 00:45:44.320
Well, it's it's it's really okay unless it's in your way of doing the things you want need to do.
00:45:44.480 --> 00:45:48.719
If it is in the way not knowing how to type, so I've got I'm I'm I'm progressing.
00:45:48.960 --> 00:45:49.920
You're all set then.
00:45:50.000 --> 00:45:50.320
Okay.
00:45:53.199 --> 00:45:56.320
We thank lots of therapists for the broadcast.
00:45:56.559 --> 00:45:57.920
Lots of therapy for song.
00:45:58.159 --> 00:45:59.360
All right, have a good one.
00:45:59.920 --> 00:46:00.320
Bye.
00:46:01.119 --> 00:46:01.440
Bye.
00:00:00.479 --> 00:00:05.679
Welcome to the podcast Beyond Expectations, Parenting Autism.
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Follow Michelle Shabola's journey of raising a child with autism, the challenges, victories, and rewards.
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If you're a parent, caregiver, or simply someone seeking to understand autism on a personal level, you're in the right place.
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This is Michelle with Beyond Expectations.
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We are back for an amazing informational episode with a guest, and we have Rondolyn Whitney here and of course John Dobson.
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Hi, Rondolyn.
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Welcome.
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Hello, thank you.
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Thanks for having me.
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We're excited to have you here.
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Yeah.
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So shall I introduce myself for a minute?
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Can you take a minute?
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Okay.
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Sure.
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So uh I'm an occupational therapist.
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My area of specialty was working with children with uh neurobehavioral disorders, uh, autism, nonverbal learning disability, bipolar, ADHD, just a whole cluster.
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You know, they they it all falls kind of in a soup anyway, so it all's in that little that bucket.
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So there's very these labels are frustrating because they can be frustrating.
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Um, and we we can talk about that today if you'd like, because I I think that's an interesting um uh idea of of why it's like that.
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Anyhow, uh those are the kids I worked with, and of course, when I'm working with children, that means I'm working with families and I'm working with the systems, the schools, and the community.
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So that was my work.
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Um I have advanced practice specialties in sensory integration, uh, which uh be really great to talk about.
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I did a rotation at Ayers um clinic out in California, so I got to learn right there with her stuff, which was nice.
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Uh, and then I had the great um uh privilege of working alongside of some of the people that actually worked with and they were trained by Jean Ayers, who is the founder of sensory integration as a theoretical intervention.
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Um, and so they really understood the cis the sensory system in ways that a lot of other people downstream over the years either don't understand or have um uh deviated from.
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So working with them allowed me to understand the um evidence behind sensory integration as an intervention.
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So that I know that's something that Michelle, you and I talked about, and that I'd like to talk a little bit more about it today.
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That's great.
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I already have like 19 questions.
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So legit here.
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I don't know anything about this whole topic.
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Excellent.
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I try to imagine the questions that people might ask.
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So I'm I think there's nothing better than to have an open mind and know very little because then you get to ask the questions that other people don't think to ask because they think they already know.
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So I'm playing the idiot very well.
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So I'm not familiar with the Ayers work or the Ayers clinic, so maybe start there.
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Okay.
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So Jean Ayers, uh, back in the 50s, was a uh a neurologist, and she worked primarily with individuals with the ADHD, and she started noticing that there were um I'm gonna hijack her story a little bit, but she started noticing that there seemed to be something else going on neurophysiologically that was in the way of them being able to regulate.
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So a lot of people talk about um sensory integration and regulation, but she really thought that there was something going on that was uh inhibiting the uh child's ability to integrate information through the eyes, ears, nose, mouth, etc., the all of those systems.
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And just a sidebar to kind of put it in context, if we were to look at the uh nervous system, all nerves to the brain are sensory nerves, and all nerves from the brain are motor nerves.
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It's just the way everything's wired.
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Now, once it gets in the brain, they like you know mess around a little bit, but all nerves to the brain, so the way we understand our world information in, action out, basically.
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Exactly.
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So the way we understand our world is through the senses.
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And you know, when we're in kindergarten, we teach the five senses, but there's actually more like eight senses.
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Um, neurologist neurologists think there's probably more like 200 senses, but we're gonna talk about eight because that just um helps us understand it.
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So Gene Ayres was really the first person to sort of think about this and put it together and say if a child can't organize and integrate information coming into their body, it's gonna be really hard for them to use it in behalf of the things they want to do.
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So her theory specifically says sensory integration for use.
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So oftentimes I see people that provide sensory input and call it sensory integration, but it's not because you have to do sensory integration for use.
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So you use the the um principles of the intervention, and then you give the child something to do that they really couldn't do before, so that you put that pathway together.
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So sensory integration for use is AIR's sensory integration uh approach.
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Wow.
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That's that sounds incredible.
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So so in your so so tell us about going in your in your practice, um, I guess what is that to put more context on it.
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So when you're when you're sort of you using these interventions, how do you how do you break it down to like a most simple this most simple?
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So let me let me tell you a little bit about let me define um the senses that uh we pay the most attention to, and then talk about how to sort of do an intervention um uh during a treatment, I think we put it in context for you.
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So the senses that we talk about, the ones we all know are eyes, ears, nose, mouth, right?
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Um sense of touch, that's a big one.
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Um, but the sense of touch has two different pathways.
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There's one that brings information like tickly touch, itch, temperature fast, and then we have the deep pressure system, which is um a um a bigger nerve, and it's it's organizing.
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So that's why, you know, it's sort of silly if you ever hit your um thumb with a hammer.
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It doesn't make sense, but the first thing you do is grab it and squeeze it.
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That doesn't make sense.
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It seems like you'd want to like not touch it, but you grab it and squeeze it because you're taking pain, which is the tickly touch and pain and itch system, and you're putting in deep pressure, which regulates, calms, and organizes that input.
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So the touch system has two.
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We also talk about the vestibular system, that's that system in your inner ear that tells you where your head is in space when you're going round and round or you're going forward, and you've probably had that experience sitting in your car where you're minding your own business, you're sitting at the red light, and the car beside you goes backwards and you freak out and you push the brake.
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That's because your vestibular system got information through the eyes and said, Hey, I'm moving.
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And then you push out with to the brake, and then you're your the rest of you says, No, I'm not silly, right?
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But that's that the visual and vestibular system works together.
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Uh, and then the um the proprioceptus system uh is is that system in the joints and muscles, so it tells us where our arms are and where our body is in space and time, tells us how heavy something is.
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You can play a lot of fun tricks on people with a proprioceptus system.
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There's this great um trick where uh like a comedian walks in with a box and they act like it's super, super, super heavy and they struggle and they hand it to a person, and that person is watching this and calibrating how heavy the load is without really thinking about it, but they do that.
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And then you put the empty box in their hands and their arms will go up, right?
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So that's the proprioceptive system.
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Um, when the proprioceptive system is not working uh in a um typical fashion, those are kids that break their pencil lead, or they push too hard, or they push too softly, or they can't figure out how to make their fingers work together to make buttons or zippers go together because that system and the joints and muscles is just not quite working.
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So let's see, did I get each of the systems?
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Oh is that the reason I can't handwrite very well?
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Um the reason you can't handwrite uh very well is a little more complicated, but if you want, I can help you handwrite in a pretty good way.
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You can't read it.
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That's interesting, we're Ronald, as we go through all the symptoms that Gregory has, we realize that we all have some version of it.
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We all have some version of it, yes, yes.
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Um the uh final system, uh sensory system that I think is really important to talk about, and we really just started talking about it about 10 years ago, uh, is called the introsceptive system.
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And the introsceptive system, each of these systems only works because it has a receptor, and some kind of input makes that receptor fire.
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So if I get visual input in my eyes, my receptors fire.
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If I get auditory input through my eyes, nothing happens.
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That makes sense, right?
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So in the introstors are in the organs in your body inside, and they really only pay attention to um distinction and pressure, and that's really pretty important.
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So your stomach says, I'm empty, I'm full.
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Your heart says, I'm empty, I'm full.
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Your colon says, I'm empty, I'm full.
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This gets back to what we're gonna talk about with the brushing in a minute.
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I'm empty, I'm full.
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And the way I like to explain it is it kind of makes a lot of sense.
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Like you don't want your colon to say anything other than I'm empty or full.
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You don't want it talking to you about anything else, like TMI, right?
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It's like, okay, you're full.
00:10:00.000 --> 00:10:02.559
That's that's your interoceptive system.
00:10:03.120 --> 00:10:09.440
And we're learning a lot more about that system uh over the most recent uh years.
00:10:09.759 --> 00:10:18.480
Uh, and it comes into play a lot with people who have anxiety, like I don't know why I feel this way, I can't locate why I feel this way.
00:10:18.720 --> 00:10:29.519
Um it is um um prone to uh trauma, it gets uh faulty messaging during trauma for children.
00:10:29.679 --> 00:10:32.960
So, anyway, so those are the systems that we'll talk about today.
00:10:33.279 --> 00:10:54.799
So at the end of the whole story about the sensory system, sensory integration for use, we want the system to be in balance, we want it to be regulated, and we know that we can put information into the nervous system that alerts you or calms you down, right?
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That makes sense.
00:10:55.919 --> 00:10:57.200
So I could scream really loud.
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I'm an alto, so it's hard for me to scream loud enough that would really annoy you, but um there are things that we can do that really activate somebody's, you know, fight, flutter, fright, and things that we can do to calm it down.
00:11:10.080 --> 00:11:11.360
A baby crying.
00:11:12.799 --> 00:11:14.159
Right, a baby crying.
00:11:15.200 --> 00:11:20.159
So um an alto singing, right, is really calming, that kind of thing.
00:11:20.320 --> 00:11:45.519
So um what gene errors helped us understand is when the certain sensory system is um not regulated, it's either too high or too low, we can put information into the proprioceptive system or the deep pressure touch system, and that helps regulate it, and it has to do with the way the nerves are like a freeway.
00:11:46.480 --> 00:11:48.720
And that takes us back to brushing.
00:11:49.919 --> 00:11:51.600
Now we can talk about brushing.
00:11:51.919 --> 00:11:57.039
So, brushing bear with me for the whole story.
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Brushing does not work.
00:12:00.320 --> 00:12:04.399
I live that stay with me, stay with me for just a second.
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For those that don't know what we're talking about, this isn't this is my only job here on the the will barger brushing protocol brushing method, and we did talk about it somewhere.
00:12:13.600 --> 00:12:17.600
We talked about this, but it but it is it is literally brushing.
00:12:18.080 --> 00:12:24.960
It's it's using a it's using a surgical scrub brush, and you and you brush the skin of a child.
00:12:25.360 --> 00:12:28.879
One direction, like you're not scrubbing, you're you're doing correct, one direction.
00:12:29.120 --> 00:12:29.440
Very good.
00:12:29.759 --> 00:12:33.279
And Gregory, and Gregory, is this something that you used to try with Gregory?
00:12:34.159 --> 00:12:35.840
I did, I did with Gregory.
00:12:35.919 --> 00:12:39.360
This is this is what changed my life with Gregory big time.
00:12:40.000 --> 00:12:43.200
Okay, now Rondolin says it's Rondolyn.
00:12:43.919 --> 00:12:44.960
I interrupted you.
00:12:45.039 --> 00:12:46.960
You said stay with you and we interrupted you.
00:12:47.200 --> 00:12:48.000
Stay with me on this.
00:12:48.480 --> 00:12:49.039
All right.
00:12:50.000 --> 00:12:59.759
All right, Patty Wobarger uh and uh created the brushing protocol, and the brushing protocol does not work, but don't quote me there.
00:12:59.919 --> 00:13:02.080
You have to let me finish the whole sentence.
00:13:03.200 --> 00:13:18.480
The brushing protocol is a systematic way to deliver deep pressure and proprioception in a very systematic way so that it goes on all the skin, the deep pressure on all the skin.
00:13:18.639 --> 00:13:26.159
So when you use the brush to deliver the deep pressure input, you're pushing down on the breast so that the bristles are bent, right?
00:13:26.399 --> 00:13:29.200
You don't do light tickly touch, you push down really hard.
00:13:29.600 --> 00:13:34.000
A lot of times, if you do it correctly, you're sweaty at the end of delivering the input.
00:13:34.240 --> 00:13:43.120
So it's it's it it's you know, it's got and then the second part of the quote brushing is you do joint compressions, right?
00:13:43.519 --> 00:13:47.279
You push the pull on the joints and muscles, that's proprioception.
00:13:47.440 --> 00:13:59.200
So deep pressure and proprioception, and the brushing protocol was designed to help parents and other people deliver deep pressure and proprioception in a systematic, regulated way.
00:14:00.559 --> 00:14:01.519
Interesting.
00:14:01.919 --> 00:14:03.679
So so I'm I'm catching up here.
00:14:03.840 --> 00:14:07.759
The deep pressure, I understand what is the other the proprioception proprioception.
00:14:07.919 --> 00:14:11.039
So I'm gonna I'm gonna have you do some proprioception to yourself.
00:14:11.200 --> 00:14:11.519
All right.
00:14:11.600 --> 00:14:11.919
Okay.
00:14:12.159 --> 00:14:18.639
So if you take your fingers and you push really hard on your fingers, all right, and then you pull on all your fingers.
00:14:18.879 --> 00:14:19.360
Yep.
00:14:20.000 --> 00:14:35.279
If you were nine years old and in my clinic, and we were gonna work on handwriting, we would get your hands ready for good work by pushing and pulling on your joints and muscles that use a pencil.
00:14:36.240 --> 00:14:37.120
Interesting.
00:14:37.440 --> 00:14:40.799
And the concept there is that it does what to the joints?
00:14:41.279 --> 00:15:07.919
By by opening them up, you increase the neural pathways or you're yeah, we're we're actually not working on the joints so much as we're giving input into the brain carried through the joints and muscles of your hands, that wakes up your brain, has it be regulated, so that when we put a pencil in it, it says, Okay, I can be calm now, I can be organized now.
00:15:08.159 --> 00:15:10.879
I have more input through the touch system.
00:15:11.279 --> 00:15:21.919
A lot of children have difficulty with writing because they hate the way it sounds on the paper, the pencil, they hate the way it feels where it's been um, you know, the wood.
00:15:22.240 --> 00:15:24.399
They hate the way it smells.
00:15:24.879 --> 00:15:27.200
They got all kinds of reasons for hating it.
00:15:27.440 --> 00:15:36.639
So if we put deep pressure and proprioception into the system, that gives us a little bit of a regulation for the child so that we can then give them some work to do.
00:15:36.799 --> 00:15:41.679
And in your case, if you were nine years old, that might be working with your pencil for handwriting.
00:15:42.000 --> 00:15:42.720
Interesting.
00:15:43.759 --> 00:15:46.879
So really it's it's I'm catching up now.
00:15:46.960 --> 00:15:57.759
So it's basically priming your nervous system by very intentionally producing those signals that go into your brain that regulate your system.
00:15:58.000 --> 00:16:02.399
Those things are they're effectively your is this your subconscious, or we call this your autonomic system?
00:16:02.480 --> 00:16:03.600
What do we call this?
00:16:03.919 --> 00:16:07.600
This is your sensory nerve, this is your nervous system, your sensory nervous system.
00:16:07.840 --> 00:16:12.320
Your sensory nervous system that's processing information that you're really not aware, it's processing.
00:16:14.159 --> 00:16:20.960
You may or may not be aware, but you are always aware of your sensory processing one way or another.
00:16:21.200 --> 00:16:27.679
Some people are over-registering information, like a slightest breeze, and they're like, right?
00:16:28.080 --> 00:16:33.440
Um, that's over-registering, and some are under-registering, they're like, What?
00:16:33.600 --> 00:16:35.519
Yeah, you're like, you got food all over your face.
00:16:35.840 --> 00:16:36.639
Like, what?
00:16:37.039 --> 00:16:39.120
Like under-registering, right?
00:16:39.200 --> 00:16:46.240
So over-registering or under-registering, and you can over and under-register in any of the sensory systems.
00:16:46.799 --> 00:16:47.360
Interesting.
00:16:47.519 --> 00:16:59.519
And so your therapy, and the the the therapy you're talking about, is this therapy that that with very intentional inputs basically allows you to, I don't want to say reset, but you're saying regulate.
00:17:00.320 --> 00:17:00.639
Regulate.
00:17:00.960 --> 00:17:02.480
Right, regulate your nervous system.
00:17:02.720 --> 00:17:03.679
I've heard these terms before.
00:17:03.759 --> 00:17:04.240
I didn't really know.
00:17:05.200 --> 00:17:07.279
Yeah, we want we want to integrate those systems.
00:17:07.440 --> 00:17:20.640
And in a typical, typically developing nervous system with babies, those systems are getting integrated when they crawl, when they walk, when they play, when they rock, and so on.
00:17:20.880 --> 00:17:32.640
But for some nervous systems, I like to talk about nervous systems and not people, but for some nervous systems, they need more input in order to integrate.
00:17:33.039 --> 00:17:37.680
Some need less in order to integrate, and so they avoid it, right?
00:17:38.000 --> 00:17:45.440
And so, because of those two things, they're not getting the kind of input that a typical developing nervous system would be getting.
00:17:45.599 --> 00:17:53.200
And so then when we give them work to do, holding a pencil, being a good friend, whatever it is, they're uh they're not ready to do it.
00:17:53.359 --> 00:17:55.440
Developmentally, they're not ready to do it.
00:17:55.599 --> 00:18:02.880
So air sensory integration uh as an approach, as a science, uh, systematically provides that input.
00:18:03.039 --> 00:18:14.640
It's a developmental theory, so it systematically provides that information into the nervous system to help it develop in a more typical fashion, to catch up, so to speak.
00:18:15.200 --> 00:18:16.720
You explained that so well.
00:18:17.440 --> 00:18:18.880
It makes sense.
00:18:18.960 --> 00:18:25.279
So, what are the what are other kinds of sort of inputs that you can sort that you can intentionally provide?
00:18:26.160 --> 00:18:27.839
There are a whole range of them.
00:18:28.640 --> 00:18:34.000
Yeah, so if if you've ever seen a sensory integration clinic, it's it's like a playroom, right?
00:18:34.079 --> 00:18:36.000
It's got all kinds of stuff going on.
00:18:36.319 --> 00:18:49.519
So there's uh suspended equipment, uh uh maybe with a um like a um what do they call it, like a board, swing, uh, and it's suspended, right?
00:18:49.680 --> 00:18:54.480
And so the child might sit on that and we twirl them or we rock them back and forth.
00:18:54.640 --> 00:18:57.359
And while they're doing that, that's the vestibular system.
00:18:57.440 --> 00:18:59.920
They're getting input into the vestibular system.
00:19:00.160 --> 00:19:04.480
When you get input into the vestibular system, I can't talk about it without moving.
00:19:04.640 --> 00:19:11.440
You get input into the vestibular system, your proprioceptive system, your muscle system wants to correct.
00:19:11.759 --> 00:19:15.279
So, Sean, you don't remember me having one in my basement in Colorado?
00:19:15.519 --> 00:19:22.880
Yeah, I remember, but I but you know, so many people have Gregory would not get dizzy, Rondolin.
00:19:22.960 --> 00:19:23.599
He could not get it.
00:19:24.559 --> 00:19:26.160
I'm gonna I'm gonna name that for you.
00:19:26.240 --> 00:19:27.759
He was under registering.
00:19:27.920 --> 00:19:37.920
So Gregory was under-registering vestibular input into his spun him and spun him and spun him and spun him, and he would get off and walk a straight line.
00:19:38.160 --> 00:19:44.240
And I will never forget the day that he fell down when he got off, because we that's what he did every day.
00:19:44.319 --> 00:19:50.400
We just Sean just in a circle as fast as you could spin him, and he would just laugh and get off and walk right off.
00:19:50.559 --> 00:19:57.279
Like you put Michael on it, and he never get dizzy, never got dizzy, you'd have to assume that you believe it.
00:19:57.680 --> 00:20:12.880
Yeah, and so we we we say of children they never they never get dizzy, and then if we were to say that in uh scientific neurological neurological terms, or if we were to write that in the chart, under-registering of vestibular input.
00:20:13.200 --> 00:20:13.839
Wow.
00:20:14.640 --> 00:20:16.400
And then now I have a question for you.
00:20:16.559 --> 00:20:27.200
So if a person is under-registering or over-registering for sensory input, I have two tools in my toolkit to help them become more integrated and regulate.
00:20:27.279 --> 00:20:28.720
Do you remember what they are?
00:20:31.839 --> 00:20:34.319
I brushed Gregory, I did the swing.
00:20:34.640 --> 00:20:43.359
Okay, so well, let's let's again, one of the things that I thought was really fascinating, Michelle, when you and I talked before the podcast, that I'm really committed to.
00:20:43.519 --> 00:20:56.079
I'm really committed to helping parents and families understand what is going on so that they are able to choose 10 more things without me being there to help them.
00:20:56.319 --> 00:20:56.720
Right.
00:20:56.960 --> 00:21:01.839
That they can say, okay, it's kind of like, you know, I'm a I I grew up in the South, I'm a scratch cook.
00:21:02.000 --> 00:21:05.279
So I can open an empty refrigerator and make a meal for 20 people.
00:21:05.359 --> 00:21:07.200
Like I that's how I was taught, right?
00:21:07.440 --> 00:21:12.720
And it's because I know what things go well together and I know what to choose and what not to choose, right?
00:21:13.039 --> 00:21:19.599
So sensory integration as a uh air sensory integration uh approach is like that.
00:21:19.839 --> 00:21:23.519
We need to help people understand why did this work?
00:21:23.680 --> 00:21:24.160
Okay, good.
00:21:24.240 --> 00:21:27.920
Now that I understand that, what's 10 more things like that I can do?
00:21:28.480 --> 00:21:38.799
Because then the child gets enough doses throughout their day, they're gonna get better faster because they're getting it 20 times a week instead of once a week.
00:21:38.960 --> 00:21:42.160
So I'm really passionate about this.
00:21:42.559 --> 00:21:44.880
So go back to your story.
00:21:45.680 --> 00:21:59.519
I know without having been there, when um Jeffrey Gregory was on the swing, um, I know that after you did the swinging, you had to do some kind of deep pressure and proprioception after maybe.
00:22:00.160 --> 00:22:03.759
While he was on the swing, he was pulling on a rope, which would be proprioception.
00:22:04.240 --> 00:22:07.599
Maybe he was catching a heavy ball, which would be proprioception.
00:22:08.160 --> 00:22:14.400
Maybe he was listening to music with deep tones, which would be proprioception, into the eardrums.
00:22:14.960 --> 00:22:18.960
Maybe he was squeezing putty, which would be proprioception.
00:22:19.119 --> 00:22:24.559
Or maybe you did the brushing either before or after, which would be deep pressure and proprioception.
00:22:24.640 --> 00:22:29.519
And I know that because you said after a while he was able to walk a straight line.
00:22:29.839 --> 00:22:30.160
Yeah.
00:22:30.319 --> 00:22:35.839
Well, he walked a straight line and then he once finally got dizzy and he couldn't even get off of it.
00:22:36.000 --> 00:22:36.640
It was amazing.
00:22:36.720 --> 00:22:38.160
It was just like in one day.
00:22:38.400 --> 00:22:42.400
We did a lot of brushing, a lot of brushing, a lot of deep pressure.
00:22:43.039 --> 00:22:46.480
Um, and he just he loved all of it.
00:22:46.559 --> 00:22:50.160
He was really, he was very receptive to all of it.
00:22:50.480 --> 00:22:50.960
Right.
00:22:51.279 --> 00:23:05.200
Which I I often think about if children could talk, if their brains could talk, they would say, I don't mean verbally, but if their brains could talk, they would say, Oh, thank God that deep pressure improprioception is really helping me out.
00:23:05.279 --> 00:23:06.960
I did not know how to organize this stuff.
00:23:07.039 --> 00:23:12.960
I got papers everywhere in this brain of mine, and you gave me this deep pressure and proprioception, and now I can put it into categories.
00:23:13.039 --> 00:23:21.839
And now, it's like anything, if I have an organized uh desk, I can reach in and get what I need and put it to use.
00:23:23.279 --> 00:23:24.240
That's a great way.
00:23:24.319 --> 00:23:25.519
That's a great way to explain it.
00:23:26.000 --> 00:23:32.559
And there's just so many little tools, like I told you, we found the mini backpack and put books in it when we go to the mall.
00:23:32.720 --> 00:23:36.240
And so let's let's do a quiz again to center him.
00:23:36.559 --> 00:23:38.640
He wants to do a quiz again like crazy.
00:23:39.039 --> 00:23:40.559
Yeah, ready for your quiz?
00:23:40.880 --> 00:23:41.680
Ready for your quiz?
00:23:42.079 --> 00:23:43.119
It's been a while.
00:23:43.440 --> 00:23:43.680
Sure.
00:23:44.160 --> 00:23:44.720
I have a question.
00:23:44.799 --> 00:23:48.640
Was the book thing not something to mess with the books?
00:23:48.720 --> 00:23:51.039
You're saying the physic the weight and the pressure on him?
00:23:51.279 --> 00:24:00.480
Weight was feeding information to his nervous system that was allowing him to organize all of the inputs in a way.
00:24:01.519 --> 00:24:05.680
That was that was infra if you think about a backpack that's heavy, a weighted backpack.
00:24:05.920 --> 00:24:10.880
You could have a weighted belt, a weighted backpack, a weighted vest, a weighted hat.
00:24:11.200 --> 00:24:16.880
Uh we've we've sewn uh fish weights into people's uh pockets, weighted.
00:24:18.079 --> 00:24:25.039
So if if you have something weighted that is putting extra gravity on your joints and muscles, that's proprioception.
00:24:25.599 --> 00:24:30.559
And if the backpack is nice and tied up against you, that can be deep pressure.
00:24:30.720 --> 00:24:32.400
So deep pressure and proprioception.
00:24:32.480 --> 00:24:34.319
So you figure that out on your own.
00:24:34.640 --> 00:24:40.240
Had you known, oh my god, I need uh 20 more deep pressure and proprioceptive ideas here.
00:24:40.400 --> 00:24:42.079
What else have I got around the house?
00:24:42.319 --> 00:24:44.880
You would have come up with a lot of other things around your house.
00:24:45.200 --> 00:24:49.839
Yeah, he liked the weighted blanket, but he did not like the weighted hat at all.
00:24:50.079 --> 00:24:51.200
It was awful, though.
00:24:51.279 --> 00:24:52.240
It was pretty awful though.
00:24:52.319 --> 00:24:54.079
If you put it on yourself, you'd like it.
00:24:54.160 --> 00:24:54.319
Yeah.
00:24:55.359 --> 00:24:58.640
Some people love it, and now they make weighted blankets for you and I.
00:24:58.799 --> 00:25:00.720
Sean just gave me one for my birthday.
00:25:00.799 --> 00:25:02.400
That's a weighted blanket, right?
00:25:04.400 --> 00:25:11.200
Is it's the pressure on your muscles is helping you organize all of the inputs going through your almost.
00:25:11.279 --> 00:25:17.200
So the a weighted blanket is um deep pressure into the tactile system.
00:25:19.200 --> 00:25:19.519
Right?
00:25:19.599 --> 00:25:22.480
So that's that's deep pressure in the top tactile system.
00:25:22.720 --> 00:25:29.359
If you push on the weighted blanket and lift it, that's information into your joints and muscles, the proprioceptive system.
00:25:30.559 --> 00:25:31.599
That's fascinating.
00:25:31.839 --> 00:25:32.720
Isn't it fascinating?
00:25:33.119 --> 00:25:38.319
It's fascinating, but it's kind of giving me a whole series of questions that maybe you guys don't want to spend time on.
00:25:38.559 --> 00:25:42.319
But uh when we talk about someone that's diagnosed with autism, right?
00:25:42.720 --> 00:25:44.079
I've never really understood.
00:25:44.240 --> 00:25:47.200
Are we talking about uh a brain issue?
00:25:47.759 --> 00:25:50.720
Are we talking about uh an intelligence issue?
00:25:50.799 --> 00:25:50.960
Uh uh.
00:25:51.279 --> 00:26:05.119
Or are we really just saying that it's that not just saying, but are we saying that it's uh it's really uh this uh it's the the exact it's this it's the fact that you're receiving all these inputs, they're very difficult to organize.
00:26:05.279 --> 00:26:10.240
I think Michelle at some point someone told us that Gregory has a hard time prioritizing inputs.
00:26:10.319 --> 00:26:14.640
He kind of sees he sees it all, hears it all, and that becomes overwhelming.
00:26:15.039 --> 00:26:17.200
With autism, is that really what we're talking about?
00:26:17.279 --> 00:26:24.559
Is that is it this this or this nervous system that is becoming overwhelmed because the information streams are not integrated?
00:26:25.200 --> 00:26:29.440
Or is that that one fat or is that one factor of someone that has autism?
00:26:29.759 --> 00:26:32.559
Yeah, that's a that's a very important question.
00:26:32.880 --> 00:26:38.960
So there's a a book called the Diagnostic Statistical Manual, the DSM.
00:26:39.519 --> 00:26:49.039
We have written it multiple times, not me, but the profession, uh psychology, um, and we're on uh version five.
00:26:49.359 --> 00:26:50.720
So version five.
00:26:50.960 --> 00:27:12.240
So over time, the writers of the diagnostic statistical manual have tried to identify and specifically um uh describe what is and what is not autism, what is and what is not bipolar, what is and what is not any of the mental health clusters, ADHD, etc.
00:27:12.400 --> 00:27:13.599
They're all in there.
00:27:13.920 --> 00:27:25.440
So it's like the Bible of um diagnoses for mental mental health, and each one has a code, and you need that code in order to get reimbursed.
00:27:25.519 --> 00:27:26.720
Like that's that's the Bible.
00:27:26.880 --> 00:27:27.200
Okay.
00:27:27.519 --> 00:27:30.000
So I'm gonna ask a little clarifying question.
00:27:30.160 --> 00:27:35.440
Once this, I guess someone does, I I guess uh it's almost I guess a questionnaire, right?
00:27:35.519 --> 00:27:42.720
Of like trying to fit into one of these these designations of ADHD or autism or things, does that also prescribe their treatment?
00:27:43.039 --> 00:27:46.880
Or does someone in your role have the ability to kind of drift across the phone?
00:27:47.039 --> 00:28:00.079
Yeah, uh well, uh some of the many of the treatments are the same for all of the diagnoses, um, but uh some interventions might be more appropriate for one versus the other.
00:28:00.799 --> 00:28:15.119
Um so in the diagnostic statistical manual five, um, that was written by a group of people from uh Kennedy Krieger Institute, Center for Autism and Related Disorders in Baltimore.
00:28:15.359 --> 00:28:17.839
And I know that because I worked there when that happened.
00:28:18.240 --> 00:28:32.720
I didn't I wasn't part of the people writing it, but I got to be in the room and talk to them and give information and answer questions and and you know basically um enjoy being there, right, and listening to them talk.
00:28:33.039 --> 00:28:44.640
So what they what they did in the DSM 5 that that was really helpful is they said, okay, autism has three things that happen.
00:28:45.039 --> 00:28:52.880
And um one of those things is that they have difficulty, they have differences with sensory, with the sensory system.
00:28:53.039 --> 00:28:55.599
So that became part of the diagnosis.
00:28:55.759 --> 00:29:01.359
All right, so they had difficulty with social, uh, they had difficulty with um uh sensory.
00:29:01.920 --> 00:29:17.279
All right, those are the two biggies, and then they also in the DSM 5 did something super helpful, and they said, and one can have autism with or without an intellectual disability.
00:29:17.519 --> 00:29:21.119
We have another category called intellectual disability.
00:29:21.920 --> 00:29:24.720
Autism can either have or not have.
00:29:25.039 --> 00:29:26.240
Oh, I didn't know that.
00:29:26.480 --> 00:29:30.079
I always associate it with some sort of intellectual disability.
00:29:30.400 --> 00:29:30.799
Correct.
00:29:30.880 --> 00:29:35.279
That would that that got when someone has Asperger's versus autism.
00:29:35.440 --> 00:29:47.279
I the layman's perspective, I think, is Asperger's is someone that's extraordinarily high functioning intellectually, but then has sort of a different, you know, a difficulty or a different approach to social interaction.
00:29:47.440 --> 00:29:52.160
Is that sort of so I think that's a lay person's understanding?
00:29:52.640 --> 00:29:59.519
Fun fact the DSM 5 chose to not include Asperger's or nonverbal learning disorder.
00:29:59.599 --> 00:30:00.400
It's not in there.
00:30:00.799 --> 00:30:01.680
Oh, interesting.
00:30:01.920 --> 00:30:05.440
Yeah, they're like, oh, you know, somebody made this up a long time ago, uh Dr.
00:30:05.599 --> 00:30:07.920
Asperger's, and we really don't know what it is.
00:30:08.079 --> 00:30:12.160
We can't distinguish it from anything else, it's not distinctive.
00:30:12.400 --> 00:30:14.319
So we're gonna just leave it out.
00:30:14.559 --> 00:30:21.759
And so now we have um autism with or without um intellectual disability.
00:30:22.000 --> 00:30:33.359
Anyone with autism has uh some uh unusual atypical ways of processing sensation by by definition in the DSM.
00:30:33.839 --> 00:30:36.880
Um okay, so that's really helpful.
00:30:37.039 --> 00:30:46.640
And so now we have these people who have some type of autistic tendencies, like maybe just the social or so on.
00:30:46.880 --> 00:31:01.839
So they have the categories and they have uh autism level one, two, three, four, and five, and those levels are related to how much assistance the individual needs in order to live their life.
00:31:02.079 --> 00:31:22.160
So autism, level one, two, three, four, five, with or without intellectual disability, and that became specifically important for the research because before that it was very difficult to say we have a group of individuals, we're doing some research, they have autism, we think.
00:31:22.319 --> 00:31:23.279
We're not sure.
00:31:23.519 --> 00:31:30.079
Some of the we've excluded anyone with an intellectual disability because that's hard to include in our intervention.
00:31:30.319 --> 00:31:39.839
So every time we re would read about interventions for people with autism, it had excluded anyone with an intellectual disability.
00:31:39.920 --> 00:31:42.880
So then you read, okay, here's the best practice for people with autism.
00:31:43.039 --> 00:31:45.039
It's like, but it doesn't work for my kid.
00:31:45.200 --> 00:31:47.839
It's like, well, okay, now we can understand that.
00:31:48.000 --> 00:31:52.079
So they did us, I think, a great service of teasing that out.
00:31:52.160 --> 00:32:02.960
They it was a it was hard work, um, had some political conversations around that because some people, you know, had ideas about it, but that's what we have to date for the DSM.
00:32:03.119 --> 00:32:06.559
And I think that's been very helpful for parents.
00:32:07.200 --> 00:32:21.519
Um, we have a lot of young adults who now understand that they have autism and had autism, that either went undiagnosed or they were given the wrong information about the way they process the world.
00:32:21.599 --> 00:32:33.359
Um, and they're really helping us understand, like feeding back and feeding forward even more data now that we have this better system of understanding what autism is and isn't.
00:32:34.480 --> 00:32:37.359
And how old is that how long has that system been in place?
00:32:37.920 --> 00:32:43.599
So the DSM 5 diagnos again, it's a diagnostics, right?
00:32:43.680 --> 00:32:45.359
It's the category of diagnosing.
00:32:45.519 --> 00:32:51.759
Um, that came out, it must have been around I'm gonna say 2015-ish.
00:32:52.160 --> 00:32:53.759
I can I can find that out exactly.
00:32:53.920 --> 00:32:59.599
But but we're but we're 10 year plus years into having essentially 10 categories, right?
00:32:59.680 --> 00:33:05.440
So it's five five levels with or without um a mental disability or an intellectual disability.
00:33:05.759 --> 00:33:07.279
Yes, intellectual disability, yeah.
00:33:07.359 --> 00:33:15.200
And and they tweak it, you know, they have DSM 5R, and you know, they're they're like always looking at it and updating it.
00:33:15.279 --> 00:33:17.519
And at some point we're gonna have the DSM six.
00:33:17.599 --> 00:33:20.480
I don't I don't know when that's coming, but we will have it.
00:33:20.720 --> 00:33:26.559
Um because as we learn more, uh we we can do better.
00:33:26.720 --> 00:33:28.640
And so I I think that's a good thing.
00:33:29.839 --> 00:33:32.160
People are using the levels now, I've noticed.
00:33:32.319 --> 00:33:32.880
Level one.
00:33:32.960 --> 00:33:34.319
There's a you know, what level?
00:33:34.559 --> 00:33:36.559
I I couldn't even answer that question.
00:33:36.640 --> 00:33:43.119
I don't know how they I don't know, one, two, three, four, five must be very high.
00:33:43.279 --> 00:33:45.440
Is level one is very low functioning, right?
00:33:45.519 --> 00:33:47.200
And level five is higher.
00:33:47.839 --> 00:33:55.279
Yeah, we we tr we try hard to say to not say high and low functioning because that indicates some things that we don't mean.
00:33:55.519 --> 00:34:03.359
So really the level the levels are about how much assistance does the individual need, and that's important in schools.
00:34:03.519 --> 00:34:19.679
So if you have a child in a you have children in a classroom um who are say level um two, they're going to need different levels of assistance in that classroom in a different classroom setting than a child with a level five.
00:34:20.159 --> 00:34:20.800
I see.
00:34:21.280 --> 00:34:22.719
So that's that's super all.
00:34:23.119 --> 00:34:24.880
Are we getting politically correct though?
00:34:24.960 --> 00:34:28.559
I in a way to me it seems well.
00:34:28.639 --> 00:34:48.400
I think um what I would say is um from the feedback that we've gotten from adults with autism, they have asked us to be more inclusive and to talk about them in a way that they feel like they're not broken, but that they're who they are.
00:34:48.639 --> 00:34:59.760
And and I am super grateful for uh all that the children I've worked with have taught me.
00:35:00.000 --> 00:35:01.760
I am such a better person.
00:35:02.079 --> 00:35:07.119
We talk about this a lot, that that Gregory is a pleasure, it's a pleasure to be around.
00:35:07.760 --> 00:35:15.519
Yes, they're lovely, and he seems to not seem to have, he has an incredible level of empathy, almost to the to the to a point that it hurts him because he is.
00:35:16.960 --> 00:35:24.960
So how is that connected to this nervous system that's that's that's you know has this structure that's confusing and and not surrogated?
00:35:25.039 --> 00:35:28.159
How is that empathy that we see that's so common?
00:35:28.559 --> 00:35:30.079
Uh how is that connected to this?
00:35:30.400 --> 00:35:37.039
Well, I I I haven't seen a lot written about this or researched about it, but I can speak to it from my personal experience.
00:35:37.199 --> 00:35:50.320
Yeah it's it seems to me that these children, uh and I know we're talking about all ages, but I'm gonna use children because they're um innocent and you can see them better, right?
00:35:50.480 --> 00:35:54.320
We haven't like put all of our blankets on them, you know, like then you know whatever.
00:35:54.559 --> 00:36:09.840
Um but the the way back in time the way that autism was distinguished is is the diagnostician said they look angelic, right?
00:36:10.480 --> 00:36:17.039
They're beautiful, they're beautiful, and if they aren't beautiful, it's probably not autism.
00:36:18.960 --> 00:36:20.880
And that's the peace they have in their face.
00:36:21.039 --> 00:36:23.920
That's those innocent eyes, those big puppy dog eyes.
00:36:24.320 --> 00:36:24.719
Uh-huh.
00:36:25.360 --> 00:36:25.840
Yeah.
00:36:26.079 --> 00:36:35.360
And they have a little bit more fat in their tissue because they have lower proprioceptive systems, so their muscles aren't taunt, right?
00:36:35.760 --> 00:36:36.719
Oh, interesting.
00:36:36.960 --> 00:36:37.280
Yeah.
00:36:37.519 --> 00:36:40.880
So we they used to say angelic.
00:36:41.519 --> 00:36:45.599
And I I I'm on for that.
00:36:45.679 --> 00:36:48.400
Like I way better.
00:36:48.719 --> 00:36:50.719
So level one through five.
00:36:51.039 --> 00:36:59.760
And they are, I think, in my experience, they have good radars, but they don't necessarily know what's going on.
00:37:00.000 --> 00:37:08.480
So they don't necessarily take their understanding of social information and put it into what to do with it.
00:37:08.719 --> 00:37:14.320
So like they may understand that you're sad, but they may not understand what to do about that.
00:37:14.480 --> 00:37:19.360
Or they, you know, and then their filters, they don't have the social language, so their filters are off.
00:37:19.519 --> 00:37:25.519
And again, I love these kids because they say things like, I'm one of my favorite kids.
00:37:25.599 --> 00:37:30.239
I I got called in to work with a kid one time and they were gonna kick him out of the school.
00:37:30.320 --> 00:37:31.599
Like the teacher had had it.
00:37:31.760 --> 00:37:37.519
She was like, you know, lobbying to get this kid kicked out and sent to another school, and she was all about it, man.
00:37:37.920 --> 00:37:38.960
Everybody's all ahead up.
00:37:39.119 --> 00:37:42.239
So I go in, I'm like, okay, well, I'll do a classroom observation.
00:37:42.400 --> 00:37:50.320
I go in, and the problem was this this this boy, fourth grader, kept saying the teacher is ugly and she stinks.
00:37:50.480 --> 00:37:52.320
She's ugly and she stinks.
00:37:52.559 --> 00:37:53.280
I hate her.
00:37:53.440 --> 00:37:54.800
She's ugly and she stinks.
00:37:54.880 --> 00:37:56.079
I'm like, hmm.
00:37:57.519 --> 00:38:00.880
So I go in, I'm sitting in the back of the classroom.
00:38:02.639 --> 00:38:05.760
The you know Mary Kay, the the makeup.
00:38:07.760 --> 00:38:12.000
This teacher looked like she had put the entire Mary Kay kit on every day.
00:38:12.079 --> 00:38:12.719
You know what I'm saying?
00:38:12.800 --> 00:38:18.159
Like she was she was ugly in the sense that she was way too loud.
00:38:18.800 --> 00:38:23.519
Yeah right now, this boy didn't know how to say she's wearing too much makeup, she's too loud.
00:38:23.760 --> 00:38:27.440
And I'm sitting in the back of the room, I'm a redhead, I'm sensory sensitive.
00:38:27.599 --> 00:38:34.400
I'm sitting in the back of the room, and the woman has perfume on this like 40-foot perfume, you know what I'm saying?
00:38:34.719 --> 00:38:36.079
Wow, so that's what it was.
00:38:36.800 --> 00:38:39.280
She was stinky and she was ugly.
00:38:41.119 --> 00:38:46.079
You know, like I think if you washed her up a little bit, maybe, but the kid was dying.
00:38:46.239 --> 00:38:52.079
He was dying, his sensory system was completely freaking out, and it was using the only words he knew.
00:38:52.239 --> 00:38:58.079
So I went to the principal and I said, because my job was to report back on what to do with this problem child.
00:38:58.400 --> 00:39:02.079
I went to the principal and I said, Okay, I'd like to meet with you privately.
00:39:02.159 --> 00:39:07.039
I think I have some uh information um to to provide to the team.
00:39:07.280 --> 00:39:13.920
So I meet with the principal and I said, I don't want to go to the team and say he's right, she's ugly and stinks.
00:39:14.079 --> 00:39:15.119
I don't want to say that.
00:39:17.360 --> 00:39:18.960
But here's what's happening.
00:39:19.199 --> 00:39:36.159
And I explained what was happening to the principal, and I said, I think it would just be better for everyone if we moved him to another room, and the other fourth grade teacher is a guy who wears nothing, you know, like he's got flannel on every day, he got boots on.
00:39:36.320 --> 00:39:41.280
Like, if we just move him, I think it'll all be over.
00:39:41.440 --> 00:39:43.039
Yeah, that's and that's what they did.
00:39:45.039 --> 00:39:46.320
That's my story with Gregory.
00:39:46.480 --> 00:39:54.159
Remember, Sean, with the their the psychologist or psychiatrist that wanted to give him every med known to mankind because he got the giggles, Rondolyn.
00:39:54.239 --> 00:39:55.840
He got the giggles really bad.
00:39:56.079 --> 00:39:58.719
And I what he walked, I walked out with all these prescriptions.
00:39:58.880 --> 00:40:00.239
I'm like, Gregory, what happened?
00:40:00.320 --> 00:40:02.159
This guy thinks you're you're luther.
00:40:02.480 --> 00:40:04.880
He goes, he's so funny looking.
00:40:05.039 --> 00:40:08.880
He just laughed and the guy was funny looking.
00:40:09.039 --> 00:40:11.280
He had big suspenders, big strapid shirt.
00:40:11.440 --> 00:40:14.880
He had he had a lot going on, and Gregory just couldn't process it.
00:40:15.119 --> 00:40:17.679
So I think that gets back to Sean's question.
00:40:18.000 --> 00:40:19.840
It's a perfect example.
00:40:20.639 --> 00:40:26.880
Perfect example because Gregory was picking up his radar, was working.
00:40:27.039 --> 00:40:44.719
Yeah, he was taking in information from a social situation, but he couldn't really organize and articulate it in the way that we could understand, and then unfortunately, people jumped to the conclusions from their own way of thinking.
00:40:45.119 --> 00:40:47.039
Yeah, what they think that means.
00:40:47.360 --> 00:40:48.239
That's crazy.
00:40:48.320 --> 00:40:51.679
It's it's very interesting for hours.
00:40:51.920 --> 00:40:56.239
Um, how does a find a rondolin?
00:40:56.400 --> 00:41:00.400
Well, first of all, are you publishing somewhere that that people can follow you?
00:41:01.039 --> 00:41:09.360
Yeah, so I have uh I always tell Michelle that years ago I really wanted to figure out how to put OT in a box, right?
00:41:09.519 --> 00:41:11.280
Like, okay, here's a box.
00:41:11.360 --> 00:41:18.400
Because I had people at the time I had a clinic in California, people come from Canada and all over the country, and that really broke my heart.
00:41:18.559 --> 00:41:24.719
I I I didn't feel my ego was was not impressed by that.
00:41:24.880 --> 00:41:28.000
I my mother was my motherhood was sad about that.
00:41:28.159 --> 00:41:32.320
People should be able to find what they need in their local community.
00:41:32.559 --> 00:41:42.000
So I have written uh several books on this that are very family friendly, and they're available on Amazon, and I I recommend them.
00:41:42.159 --> 00:41:45.440
I mean, you know, I I can give them away free sometimes.
00:41:45.519 --> 00:41:46.800
You know, I've got a big stack of them.
00:41:46.960 --> 00:41:50.239
I do talks at libraries all the time, and I'm like, here, take them, take them, take them.
00:41:50.559 --> 00:41:53.679
Um, because I I just want people to have the information.
00:41:53.760 --> 00:42:06.079
I'm getting ready to do a uh an updated revised vision version of one of the books, but the books on Amazon about sensory are meant to be OT in a box.
00:42:06.159 --> 00:42:09.679
One of them talks about just what we've just talked about, goes through it all.
00:42:09.840 --> 00:42:18.320
I co-wrote it with Wendy Pickering, who's a genius out in California, genius, uh, and we break it down very simply so parents can understand it.
00:42:18.480 --> 00:42:23.280
And then the other book is definitely um OT in a box.
00:42:23.440 --> 00:42:25.360
It has 52 activities.
00:42:25.519 --> 00:42:28.559
So an activity for one a week.
00:42:28.800 --> 00:42:30.960
Every activity has what I call a power-up.
00:42:31.199 --> 00:42:33.039
Here's how to make it harder, right?
00:42:33.280 --> 00:42:36.239
And they're meant to be integrated into your day-to-day life.
00:42:36.320 --> 00:42:45.360
So here's some activities for meal time, uh, here's activities for um uh evening routines, here's activities for morning routines, etc.
00:42:45.599 --> 00:42:46.719
And they're organized like that.
00:42:46.800 --> 00:42:49.440
So parents open it up, they do one, send the kids to school.
00:42:49.760 --> 00:42:50.880
Open it up, do one, send it.
00:42:51.199 --> 00:42:56.880
So, like, for example, time for bed, often a problem for children.
00:42:57.119 --> 00:43:10.559
So instead of saying, go brush your teeth, uh, then you the child might do bear walks into the bathroom because they're getting that deep pressure and proprioception into the joints and muscles, which will help them feel more regulated and organized.
00:43:10.719 --> 00:43:12.719
They can brush their teeth and go to bed.
00:43:13.039 --> 00:43:13.440
Nice.
00:43:13.519 --> 00:43:16.000
Okay, what are the names of both books, real quick, before we have to.
00:43:16.320 --> 00:43:17.199
Yeah, that's a really good.
00:43:17.280 --> 00:43:20.000
Let me let me grab them off my shelf here because I never remember.
00:43:20.239 --> 00:43:27.599
One one of us raising raising kids with sensory processing disorders, and the other one is which I did.
00:43:33.360 --> 00:43:35.519
How do you how do you find an OP?
00:43:38.239 --> 00:43:46.079
This is such great information, and this the what I really want to tell none of this is gonna hurt your child, it's only gonna make it better.
00:43:46.320 --> 00:43:52.159
And it's very inexpensive, or right here it's in a book.
00:43:52.239 --> 00:43:55.840
I went to you know, clinics and learned it different ways, cost me a lot of money.
00:43:56.320 --> 00:44:03.679
Insurance cover, if I if if if if my child would benefit from this, can I can I get a prescription for an occupation?
00:44:03.920 --> 00:44:04.480
Like, how does this work?
00:44:04.559 --> 00:44:09.840
How do I get how do I so here's here's the other one self-regulation, a family system approach is the other book.
00:44:10.079 --> 00:44:11.519
I probably can't myself.
00:44:11.679 --> 00:44:12.239
I read it.
00:44:12.960 --> 00:44:16.800
Yes, they get they get a diagnosis and they need OT, they get OT.
00:44:17.519 --> 00:44:17.760
Yeah.
00:44:18.239 --> 00:44:26.559
Well, and and importantly, um because in the DSM they added sensory, it's now covered.
00:44:26.800 --> 00:44:27.519
It's got a code.
00:44:27.840 --> 00:44:38.639
And and because uh sensory processing disorder is not a diagnosis in and of itself, it's not been put into the DSM, right?
00:44:40.559 --> 00:44:55.199
When we're talking about uh third-party reimbursement, your insurance, when you work with an occupational therapist, they can often help you work with your doctor to identify a diagnosis that does qualify for the intervention.
00:44:55.519 --> 00:44:55.840
Yes.
00:44:56.079 --> 00:44:56.400
Excellent.
00:44:56.639 --> 00:44:59.760
It's it's an elaborate shell shell game, but we're happy to help you play it.
00:45:00.400 --> 00:45:01.679
Wow, that's so complex.
00:45:01.840 --> 00:45:03.199
The whole process is so complex.
00:45:03.519 --> 00:45:04.480
I'm glad you found us.
00:45:04.639 --> 00:45:05.840
This was really, really nice.
00:45:05.920 --> 00:45:07.679
This was so fun.
00:45:07.840 --> 00:45:09.199
Thank you for letting me talk about this.
00:45:09.360 --> 00:45:12.239
I can obviously I can go on and on and on and on because I just think it's so good.
00:45:13.360 --> 00:45:17.039
There was no way we could we there's so much value here, so we definitely want to have you back.
00:45:17.199 --> 00:45:17.840
Thank you so much.
00:45:18.239 --> 00:45:18.800
You're welcome.
00:45:18.880 --> 00:45:24.639
Thank you for the opportunity, and I'm sure it's gonna help more kids, and that's that's the point of life, right?
00:45:24.800 --> 00:45:26.480
Is to help families and children.
00:45:26.719 --> 00:45:27.280
That's right.
00:45:27.519 --> 00:45:27.760
Absolutely.
00:45:28.480 --> 00:45:29.039
Well done.
00:45:29.840 --> 00:45:33.440
All right, and Sean, you can take me up on helping you with your handwriting, really.
00:45:33.599 --> 00:45:34.400
I'm hoping with that.
00:45:34.880 --> 00:45:36.719
57 years into not knowing how to write.
00:45:36.800 --> 00:45:38.239
So there you go.
00:45:38.800 --> 00:45:44.320
Well, it's it's it's really okay unless it's in your way of doing the things you want need to do.
00:45:44.480 --> 00:45:48.719
If it is in the way not knowing how to type, so I've got I'm I'm I'm progressing.
00:45:48.960 --> 00:45:49.920
You're all set then.
00:45:50.000 --> 00:45:50.320
Okay.
00:45:53.199 --> 00:45:56.320
We thank lots of therapists for the broadcast.
00:45:56.559 --> 00:45:57.920
Lots of therapy for song.
00:45:58.159 --> 00:45:59.360
All right, have a good one.
00:45:59.920 --> 00:46:00.320
Bye.
00:46:01.119 --> 00:46:01.440
Bye.
