Friday, February 12, 2010
Autism and Spinning
First, I typically have a few spinning tops with me if I go to visit a child with autism for the first time because I know that I can use those tops to entice most children into playing with me with these "Gizmoz" as my friend Sheila Merzer (Autism Guru Extraordinaire) likes to call all fail-proof little toys. She and I both keep Gizmoz in our pockets in order to make our jobs easier and make us look like we know what we are doing. The picture above, by-the-way, is from a website called Meet Mrs. Haugland's Class where they put together these cool homemade spinners. While acknowledging that spinners are useful as therapy tools, I have also experienced the frustration of having a child who wants to do nothing but spin things or watch spinning things all day long. Here is a blog post where a mother talks about her son, Zachary who went through an intense period of spinning. I loved hearing her thoughts and discoveries about the behavior. I also used her strategy of limiting the amount of time that a child spends spinning because I, too, have seen spinning start out as interest and become so intense as to be oppressive both to the family and to the child. I have known parents who removed ceiling fans, tops, and other obvious spinning possibilities from their child's environment. I found this mother's insight on how a behavior like this may feed the tendency toward obsessive compulsive disorder. I'd like to know more about that.
In the clinic, I might limit spinning this way: I say First we will (whatever activity we are doing together) then we will Spin! With a dedicated spinner, I might start with short activities that are followed by periods of spinning but soon I am saying things like Time for spinning. We will spin three tops. One (and I spin the top) Two (and I spin the top) Three (and I spin the top) All Done Spinning, Time for (whatever). Whatever gets to be longer and longer and spinning gets to be shorter and shorter and we might forget all about spinning on many days. We limit the spinning by deciding how many times we will spin and then move on calmly but firmly. The goal is to teach a child to leave a highly desirable activity calmly and to learn to enjoy many other activities so much that spinning does not seem like the most desirable activity all the time.
I do worry that the child who spends a lot of time spinning objects is learning to feed the brain's need for activity with an activity that does not help a child learn. Sheila Merzer talks about how children get stuck in these little mental loops and by doing them over and over again the child finds it harder and harder to do anything else. It becomes the only thing the child's brain wants to do. I think this can happen to any of us and we end up spending a lot of our life doing things that don't really make us happy. If this happens to me, I want people who love me to say "Enough already, Tahirih! Let's get out and take a walk--you are spending all day reading!"
Children with autism are not always appreciative when we want them to learn to do other things, though. Sheila's solution to this if a child is really stuck and gets really upset when we encourage new or different activities is to expand the loop gradually. We also expand the look in a variety of ways with the aim being to bring an activity like spinning more under the child's own ability to control.
Here are some ways that we might try to expand a little look like spinning into a more complex and mentally challenging behavior. First of all, we stay calm and relaxed as we proceed. I say this because if we get anxious about the fact that a child is spinning, it seems to feel the child's anxiety and the spinning becomes more compulsive. But, it is perfectly possible for adults to take the lead in play and calmly insist that we are going to spin but first we need to make some decisions. (I think of this step as helping the child access a different area of the brain from whatever area is involved in spinning.) We don't spin a top until we decide together Who will spin? On what surface we will spin? What we will spin? The way I offer these choices varies depending upon the language level of the child and I might use visual supports to help some children understand the new and more complicated game of spinning. With this last pre-meditated spinning decision, What are we going to spin? I would offer pictures of spinning options and after each choice, the one chosen is no longer an option. I am expecting the child to spin a variety of things and not just one favorite top. Over time, the game might become a Hide-and-Find game with clues and treasure maps that help us find each top and pretty soon there would be other interesting hidden objects for us to find together.
I don't favor trying to altogether stop a child from spinning or doing any other behavior that helps a child stay calm or escape overwhelming situations (except those that are really dangerous or terribly socially unacceptable). The reason I think this is inadvisable is that you end up chasing one behavior after another until the child eventually lands on one that you really can't do anything about. I do, however, often suggest that parents turn off and unplug or take out TV's, computers and video game players if children become too addicted to these because these are so clearly associated with very poor language and social development and brain studies are making it clear that we are providing a kind of opium-like stimulant. If carefully controlled, all of these technologies can be educational but many children with autism will become addicted so quickly that parents need to remove the option. You really don't have the option of removing everything that can be a spinning object nor all the things one can line up nor hands that flap. If you do insist the child stop one of these behaviors, the behavior that replaces the one you eliminated is often worse. Here is a good article on this subject.
When I put spinning and autism in the Google Search Engine, there were thousands of articles--many of these article explaining that spinning objects, lining up objects, and flapping one's hands are all symptom of autism. All of these behaviors along with echolalia (repeating things that others say without fully understanding the meaning of the words) are very distressing to parents because the behaviors are perceived as symptoms (a very medical term) of a disease (also a very controversial way of viewing autism). While this view is one way to view the story of a child's unusual developmental path, I think there are much more useful, and less distressing ways to understand all of these behaviors and hundreds of others that are associated with autism. I don't get too attached to any one theory regarding anything to do with autism because after so many years of learning about autism, I have had to change my theory too many times.
I do, however, have a steadily growing respect for children who have autism and for the complexity of the brain differences that these children have. There is always a reason why children do the things they do and the way we understand what they do shapes how we respond to these behaviors. I understand the most about echolalia (being that language is my field) and far from feeling upset when a child starts to repeat what others say in a way that would be described as echolalic, I am very happy to hear the child doing this because I know that the child is trying to find a way to communicate. See Can a Child Overcome Echolalia? I am able to show that child more than he or she can discover alone about communication and I can help that child learn to communicate in a way that is more effective but when a child moves from not talking to echolalia I know we are moving forward! Although I don't know all the answers regarding why children spin, I know I need to respect both the child and the behavior and work through with the child so that the child is able to spin things but not be stuck in such a rut with spinning that the child does not move forward developmentally.
Again, I will be happy to hear your comments and please offer links to interesting articles on the subject that you have found online.