Learn Your Special Education Laws, Special Education Rights, and Share IEP Goal Ideas

Feb 28
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by Jess

Imagine for a moment that you meet a five-year-old boy at a birthday party. This boy is withdrawn, he continuously flaps his hands in the air, and he paces around the room. He makes minimal eye contact, shifts between wanting no attention and appearing like he can’t get enough, and speaks in short repetitive phrases.
In later discussing this child with friends, they conclude that this child is autistic. They could be wrong. There could be vastly different explanations for his behavior. Could they be the result of an off day, exhaustion or a need for solitude?  This paper will demonstrate that such behaviors can be influenced by physical, biomedical, developmental, or emotional forces.

When asked at a conference on children and Autism Spectrum Disorder to imagine a child with this diagnosis, professionals, parents, and educators offered nearly identical responses: a child who can’t sit still, a child who does not speak, a child who plays on his own, and a child who acts aggressively. In fact, these symptoms describe not only Autism but other types of disorders and the causes that underlie them.

That the child described may in fact have a completely different etiology than another child. That like the talkative party goer – this behavior may be environmentally driven or may be physiological – I will continue to explore this notion by describing the 5 ways I have broken down the autism symptoms to better understand why a child presents as he/she does and further how we can distinguish the difference so that we can treat and support these children.

Perhaps the confusion is caused by the broad definition of Autism and the fact that criteria do not take into consideration the etiology of the symptoms.  Autism (sometimes called “classical autism”) is the most common condition in a group of developmental disorders known as the Autism Spectrum Disorders (ASDs).   Autism is characterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests.  Other ASDs include Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS).

Notice that the definition does not talk about the causes underlying these behaviors. Research reveals a range of potential causes. Genetics and environment are believed to play a role. Genes, chemicals in the brain, white matter differences, environmental factors and brain development issues at birth have all been linked to Autism. And parenting styles and vaccinations also have been suggested as possible causes although there has been no conclusive evidence.

To deepen the understanding of symptomology, I propose a breakdown of 5 criteria that distinguish the differences in etiology between children with these symptoms. These are based on clinical experiences within a treatment program in which children entered therapy given the diagnosis of Autism Spectrum Disorder. Their etiologies allowed this author to view them as individualized cases. The five criteria are Physical, IQ/Personality, Developmental, Sensory/Biological, and Trauma/Emotional. Case studies of each help to illustrate how these behaviors have different causes.

1.  Physical/Immunity/biomedical  (This category may include ear, throat, eye concerns, and seizures)

Seth a 2- year- old, Mexican boy, diagnosed with Autism Spectrum Disorder.  Seth’s language is at a 1.5 –to-2-year-old level. He makes minimal eye contact with new strangers; he will often turn his face in a different direction when experiencing an unfamiliar place/person. Seth gets upset when he has to leave a preferred task- he will stomp his feet and say, “No.” Seth plays cooperatively with his 5-year-old brother. In class, he is able to participate in activities and join peers; however, he continues to seem behind in social situations as compared to his 3- year- old peers. When presented in a new situation (testing scenario) he refrains from talking, he often “fixates” on a preferred item (cars). He is seen to be affectionate to his family with hugs and kisses.

Physical: Seth has experienced ear infections since birth. He is frequently sick with a fever and flu-like symptoms. Ear infections are common in family as his older brother experienced infections from birth to 4 years old. Medical concerns have hindered his involvement in school and social situations on a weekly basis.

The Change: Although given the diagnosis of Autism Spectrum Disorder, Seth had tubes placed in his ears at 2 ½ -3 years of age. He immediately reduced sickness. He engaged more with gross motor play. He increased his language skills and initiated interactions with peers. Seth had a supportive atmosphere involving family, speech/language therapy, academic support as well as Dance/Movement Therapy. Through the treatment of Dance/Movement Therapy he was able to learn social activities and self-regulation techniques to help him have an expansive range of movement, balance, and self-awareness. 

2.  IQ/Personality (This category may include anxiety disorders, learning disabilities, OCD, ADHD, ADD and comorbid disorders) 

Oscar is an 8-year-old, Israeli boy. Who has a diagnosis of Autism Spectrum Disorder. He is often viewed as fidgeting with his hands, holding onto his mother or a familiar item, and repeating questions. He tenses his body up with hands over his head and grimaces when he receives attention. His eyes move with quick darting motions, and he has a slumped posture and gate. Oscar screams when he is uncomfortable and makes somewhat odd statements and thoughts about death and sexuality. He often mimics a woman’s type of walk and enjoys playing dress-up. He experiences a high level of pressure for school, academics, and social interactions which do not match his personality.

IQ/Personality: Oscar has experienced stress upon entering a new school. He has changed houses twice in the past two months. Oscar’s family has traditional customs in which his mother is the primary care-giver and matriarch of the family. Oscar often interacts with woman in the household. Oscar’s mother presents with narcissistic personality.  Oscar has minimal choices on a daily basis and suffers from nightmares. He is exposed to violent and aggressive themes on television and within family discussions at home.

The Change: Oscar’s family worked to replace aversive themes in Oscar’s daily life. Oscar was provided with schedules and choices throughout his day. Oscar’s mother started individual and group therapy. Oscar was provided with a place to explore feelings, and learn new coping strategies through Dance/Movement Therapy.

3.  Developmental ( This category may include DS, CP, Muscular dystrophy, additional Axis I disorders) 

James is a 12-year-old, American boy. He was placed in a hospital/institution setting for the first 2 years of life. His mother was a drug addict and his father relocated out of state. James was diagnosed with CP with impairment in gross and fine motor movement, and no language. James displayed the typical CP posture and orientation.

Developmental: At age 5 he was reunited with his father, in a new home, state, and school. He was given the diagnosis of Autism Spectrum Disorder due to his limited speech, repetitive tendencies and upsets, and his lack of social interactions with peers.

The Change: Acknowledging his new environment and limited exposure to social situations since birth, James and family worked on his ability to self-soothe, develop language and engage in social situations. James was given a more consistent structure within the home. James’ self-exploration was explored through Dance/Movement Therapy.

4.  Sensory/Biological ( This category pertains to the classic Autism) 

Although children with sensory deficits may not have autism, children with autism always have a sensory component. 

Patrick is a 5-year-old Russian boy with a diagnosis of Autism Spectrum Disorder. He has minimal language; he shows no interest in play activities, peers, and social situations. He is unable to perform self help skills. He has a slumped posture and his body is rigid in movement. He is carried mostly by his parents instead of walking. He is given chew toys so as to receive pressure and not bite others. He screams when he is touched and when he tries to escape a situation. He is seen darting down hallways and has no awareness of danger.

Sensory/Biological: Patrick responds to music.  He is a good eater. He seeks proprioceptive and vestibular movement. He has sensitivity to lights and textures. Father and mother display similar patterns of integration, and cultural differences within the home setting.

The Change: Patrick’s family worked with Dance/Movement Therapy to focus on self-soothing, body positioning and range of movement to effectively help Patrick navigate in his world. Patrick was given consistent interactions with movement and repetition to introduce self-discovery and independence. Patrick’s family has had yearly brain scans, specific diets, and alternative treatments to focus on reduction of symptoms. 

5.  Trauma/Emotional (This category pertains to emotional, physical and sexual abuse, birth trauma, and family violence) 

Lisa is a 6-year-old, Korean girl diagnosed with Autism at age 2 1/2. Born in Korea, she was abandoned by her mother at 6 months. She was physically abused by her father and then abandoned by him at age 3. She was then relocated to the USA, to be raised by her Korean-speaking elderly grandparents. She has minimal interaction with peers and presents with no language. At age 3 her grandfather passed away.   She then presented with screaming tendencies; she hit the ground with her body, and vacillated from climbing on others to hiding in corners.

Trauma/Emotional: Lisa had been given the diagnosis of Autism Spectrum Disorder with no reference/regard to her past trauma or current living arrangements (abandonment, physical abuse, neglect, acculturation). Originally her treatment was speech, occupational therapy and play therapy to focus on Autism symptoms and to diminish her rocking, banging and lack of eye contact.

The Change: By introducing Dance/Movement Therapy, Lisa was provided with a safe place to explore her emotional and traumatic history on a nonverbal level. The treatment was the most tangible and accessible way for her to communicate, assert her own ideas and eventually move from her lack of engagement to a place of sharing, mutual attunement and a relationship with her therapist and herself.

By examining each child’s symptoms in relation to their causes, factoring in all areas of the individual child’s life and development, the author (psychologist) facilitate therapy that worked. This process provided answers for parents and an alternative to the Autism Spectrum diagnosis. The children explored here are much like the vast number of other children given the diagnosis of ASD. These children are not harmed by receiving treatment for this diagnosis – having individualized attention, and services. However, the treatment can last years, parents can form misinformed groups and forums, and can tailor unnecessary approaches and ideas for the child’s future. By better understanding and accurately diagnosing the children based on their individual symptoms and backgrounds, treatment can be more effective. Parents can begin to understand why each child is different, and why treatment works for some but not for all. If etiology is more profoundly explored and recognized, families will be empowered to gain answers and appropriate support.

Dr. Lori Baudino has been a practicing clinician for the past eight years, providing services in Los Angeles, California; Washington, DC; Melbourne, Australia and Ghana, Africa. She received her doctorate in Clinical Psychology and her Masters in Dance/Movement Therapy. The Dance/Movement Therapy approach identifies symptoms and creates ways to work toward incorporating movement expression into everyday action. It also provides a place for self-exploration, which promotes well-being and self-awareness.Dr. Baudino has worked extensively in psychiatric hospitals with adolescent and adult populations, as well as at rehabilitation centers for pain management. She has specialized in supervising, facilitating and providing treatment for children with special needs and their families. She has worked as the coordinator for Behavior Intervention Programs within the home/school setting, and Dr. Baudino has also provided psychological services for families with special needs children through support groups with a focus on parenting from the inside out.

Through the Andrea Rizzo Foundation, Dr. Baudino brought the first Dance/Movement Therapy Programs to UCLA Mattel Children's Hospital and Los Angeles Children's Hospital, where she provides bedside therapy to children with cancer, special needs and terminal illness. Dr. Baudino's approach balances mind/body with child/parent and aims to provide answers to the endless questions of parenting and the developing child.

She can be reached at her website: http://www.cooperations.biz/index.html


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