October 22, 2010

Up and Down, Salty and Sweet

There are times for thinking, contemplating, and planning. There are times for reflection and healing. And then there are times for action, when we have to pull up our big girl panties and get to work. This has been one of those times.

Moe has been having some trouble with regulation. This means that he'll go from being really mellow one minute to running, climbing, and screeching the next. This may sound like your average 3 year old, but it is more extreme than that, and, when he gets really keyed up, he can't easily calm down and needs external help. The great thing is that Moe is often able to recognize when he needs to calm down and will independently go to his room, close his door and climb into his crib, his comfort place. Or he might rock on his tummy on the rocking chair or exercise ball. But during the times when he's really up, he can be quite a handful, climbing walls, splashing in whatever water he can find (including the dog dish and the water that comes out of the refrigerator). It may look like he's having fun, but being so over-stimulated can be quite uncomfortable for Moe, and hard for me to deal with.

We've been working with an occupational therapist who is helping us create a good sesory diet for Moe, especially on the weekends when he lacks the structure of the school day. A sensory diet just means that Moe gets a good range of sensory input throughout the day, to make sure all his system's needs are met. It also means we have to find the right type of activities for different parts of the day. The first step is to figure out the right "up-regulating" and "down-regulating" activies for Moe. For example, a warm bath is usually a nice, calming activity for kids. Not here. Water is very stimulating for Moe. He seeks out this type of input, but we don't want such an exciting activity before bed. So I've started giving Moe his bath when he gets home from school. This is the crux of our new plan: make sure we do stimulating activities in early the afternoon, and calming activities after dinner. Sounds obvious, no? But it is actually quite challenging to make sure Moe is getting what he needs, especially since we aren't always sure what that is. And there is a 17 month old hanging around with her own agenda.

Some of the aspects of Moe's sensory diet include:
  • water and other sensory play, like shaving cream or sand
  • variety of snack textures, including chewy and crunchy, and strong flavors like salt or lemon
  • heavy work, including jumping, pushing heavy things, climbing
  • swinging, rocking, bouncing
  • brushing techniques, deep pressure, joint compresions, "active" sitting (sitting on an uneven surface, like a ball or wedge)
We know that some of Moe's sleep issues stem from this same inability to easily self-soothe. He wakes up in the middle of the night, is tired and wants to sleep, but is unable to calm himself enough to do so. This can be really frustrating for Moe, and lead to some pretty rough nights. I hope that being more regulated during the day will help at night. Our other goal is to help Moe learn some self-soothing techniques so that when he does wake up during the night he can get himself settled down and return to sleep. This may mean opening up the crib tent so he has access to things in his room, but we're not there yet.

Another way to think about this is that Moe may have trouble calming his mind at night. He has a lot of input to during the day that he needs to process. Older children with autism have said that they feel like their minds are very busy, and they can't shut them off. I know I've felt that way if I've had caffeine too late in the day or am worried about something. One suggestion I really like is to try using music as a calmer. We've started doing music time before bed, and are looking for a kid's mp3 player that Moe can control himself. The idea is to load some calming music on the player and if Moe needs to settle down in the night, he can turn it on. We're also experimenting with some guided meditation for children. These are calming audio stories that help kids relax. These can be really useful for older kids who have trouble shutting down at night. I don't expect Moe to understand the stories now, but I do think the relaxing cadence could be calming for him.

As you can tell, it is a time of putting in the work and trying lots of things. I wish someone could just give me a plan and say "do this." But it doesn't work that way, so we're experimenting. Some days will be better than others, but hopefully we'll hit on the right combination of up and down, high and low, salty and sweet.

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