Myofascial Tension Reduction in PDD/ASD

[EChess]

Greetings all,

My name is Eric Chessen and I am a Fitness Therapist and Wellness Consultant working exclusively with the ASD/PDD (Autism Spectrum Disorder/Pervasive Developmental Disorder) population in the NY area. Lately I have been focusing my attention on physical/emotional stress reduction in children/teens on the spectrum.
While many of my athletes would clearly benefit from therapeutic adjustment and/or energy work (ART, BEST, ect.) many children on the spectrum have particular sensory issues and do not enjoy being touched.
As much as I focus on ROM and gross motor patterning, I feel that there is a key element missing in loosening joints and muscles. Thusfar, the one successful integration with vibration training that I have implimented is trampoline work. Most other methods I have explored thusfar are too invasive for ASD athletes.

I'll open this one up to discussion and welcome any and all questions/input.

Thanks,

-EC

[Scott Sonnon]

Eric,

I am not sure that I understand your question. Please rephrase.

[EChess]

Coach,

Allow me to elaborate,

With a mojority of the young athletes I come into contact with, there are signs of postural imbalance (anterior rotation of the shoulders and hips, gait issues such as inverted heels, difficulty ascending and descending stairs, ect.) I know that for some of the athletes this places extra tension on certain muscle groups. My question concerns alleviating these areas of tightness with less-invasive measures than massage or active release. Does this help?

Thanks,

-EC

[Scott Sonnon]

Yes, I believe I understand your question.

My experience with those children I have worked with of this condition is no different than those of the everyday person. The only difference between teaching children with autism is the creativity in getting them excited and interested in the movement.

For instance, one 350lbs child (a LOT of muscle) I worked with for about a year suffered Aspergers disorder. His 'eccentricity' was professional wrestling, and it was only when talking about it did he leverage out of his social isolationism. Over the course of a year, we performed Softwork together and to learn his favorite skills, I taught him through range of motion exercises. After the end of his therapy, he looked me in the eye, shook my hand firmly for a second and said "thank you. That was fun." You know what kind of break through it was for him to engage me like that.

[Robert V]

That's incredible. I'd love to hear more about it.

[Randell Waddell]

Evening Eric,

Folks - when I posted this


In the coming weeks, we may be bouncing some ideas around in here pertaining to people that have some specific learning difficulties / special needs.

on the following thread a few days ago [ http://www.circularstrengthmag.com/forum/viewtopic.php?t=8700 ], it was an introduction to the interaction with Eric that I was pre-empting.

So Eric - welcome, welcome, welcome.


Could I clarify something for my own terms of reference first please ?

When you discuss your work and refer to ASD/PDD, are you defining your work to be with clients of any of the five disorders as identified under the category of Pervasive Developmental Disorders:

(1) Autistic Disorder,
(2) Rett's Disorder,
(3) Childhood Disintegrative Disorder,
(4) Asperger's Disorder, and
(5) Pervasive Developmental Disorder Not Otherwise Specified, or PDDNOS

or are you specializing in just the PDDNOS group ??????

Based on your observations:


there are signs of postural imbalance (anterior rotation of the shoulders and hips, gait issues such as inverted heels, difficulty ascending and descending stairs, ect.)
and


.....focusing my attention on physical/emotional stress reduction in children/teens on the spectrum.
I would assume this to be the former. ( My approach with just PDDNOS cliental is somewhat different at times.)

In my limited experience, these kids/young adults often have very little confidence, consciously and sub-consciously, in their ability to function well physically.

I believe a particularly useful approach when working with some these clients ( client does sound cold, but saves me having to say “children, young adults, and adults” each time) is to view them as having a scrambled Vestibular System - few enjoy the degree of integration you and I may enjoy between

* eyes and semi-circular canals,
* eyes and proprioceptors from around the body, and
* semi-circular canals and proprioceptors from around the body.

To me, there is little wonder that these clients display little outward communication, poor social interaction skills, and presence of repetitive behavior etc, when internally, a disordered / scrambled mess of disjoint information is barraging them.

When people see the stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements), often some of them feel very uncomfortable. I personally feel very pleased, as to me it displays great perseverance on these clients' behalves, to strive to bring order to the chaos within.

That Fear Reactivity should set in from past falls and the like, in my mind, is to be fully expected. (In fact when one considers how often and badly these folk “hit the deck” at times, it is huge respect from me that they continue to pick their butts up and persevere.) The limp wrist, flexed elbow type configuration often seen, (it is somewhat similar to what some of you might have seen or even utilized in an Animal Form like “Praying Mantis” or use in a “sticking hands” / “chi sau ” type martial activity) is actually very useful for if you topple forward or to either side before your body can activate an appropriate response to the falling and hitting the ground. Utilizing the Tensegrity body model we actively endorse and advocate here at RMAX, this arm configuration makes more than great sense, because the localized forces that impact upon the body as it hits the ground, can be dissipated quite effectively throughout the body. You may observe some amazing subconscious ground-engagement spirals from some of these clients, as they fall and strive to protect their heads from dashing onto the ground.



My understanding is that you have started working with Bao.

Would either of you mind elaborating, please, on the “level” of the following you have explored:

WW or Intu Flow type work
Grappler’s Tool Box / BodyFlow / Prasara / FlowFit type work.

Could you also highlight any of the other resources from RMAX such as “Be Breathed “you have purchased and are using, so we can cross reference specific activities (such as particular Spinal Rocks etc) ???


teaching children with autism is the creativity in getting them excited and interested in the movement.


Scott has "hit the nail squarely on the head" - keeping this cliental focused and motivated can "tax the patience of the gods", and the ability to find and utilize strategies to effectively do so, I imagine you must find exceedingly important in your work.

Cheers
Randell. :D

PS The following may not sound real welcoming, but please be aware that the information that I am willing to share with all openly here on the forum as you ask questions, is a part of research I have been exploring as part of my Post-Graduate studies, and the production of resources for our RMAX people.
As such, it is expected that you and everybody respects the "credit where credit is due" concept, and that credit be given to any material that you sourced from myself or anybody here.
(Sorry if this sounds heavy, but this must be clearly understood from the outset.)

[EChess]

Thank you both for your comprehensive and meaningful input. I am glad to know that there are others in the wellness/athletic community involved with the ASD community. Now on to the list...

Coach Sonnon,

Motivation is, as you pointed out, an absolute neccessity for working with, well, anybody, but particularly the ASD population where self-initiated interaction with neurotypical individuals is not a regular occurence. Much of naturalistic behavioral intervention and teaching follows a child-centered approach and guides the individual through play with the child at the "helm" of the activity.
It is fantastic that you were able to connect with the individual you mentioned. With individuals who have a diagnosis of ASD/PDD (Autism Spectrum Disorder/Pervasive Developmental Disorder) rather than Asperger's (whose obsevable components are primarily social interactive/social cognition) the functional communication deficit may prove more comprehensive. The initial focus, then, becomes identifying a reinforcing factor, or something that will motivate the individual to accomplish a task.
In your instance, Coach, the activity itself had intrinsic reinforcing properties as it directly related to skill acquisition that was desired by the athlete (and I'm sure feeling more energetic and free did not help either). Many of my athletes have difficulty attending (being able to focus on a task, directions, or the person giving them) for what would be understood as a normal/functional amount of time. As I come from a Behavioral Modification background, I am trained to study the reinforcing aspects of the environment and/or opportunities (a "reward") that will motivate individuals. Ongoing debate surround what makes an appropriote "reinforcer" (I despise food and non-food food, see also: candy being used as it is both physically detrimental and undermines the individual's intelligence).

And...time. Okay, Randell,

First and foremost I must echo your sentiments concerning information sharing. A healthy respect for ongoing research both professional and scholatic will aid in a far more open and trusting dialogue. Furthermore, I think that both you and I can attest to the fact that this is a rather new and unexplored field of study, ripe for exploitation by whomever is disgraceful enough to do so.
Secondly, thank you for the welcome (x3). I appreciate the warming. Now onto the world of practitionary science!

My individual athlete work is with individuals located on the Autism Spectrum (Diagnosis of Autism with some Axis II diagnosises) and I have consulted with some parents of PDD/NOS children.
You are completely right on with your discussion of the Vestibular system in relation to ASD. Sensory integration is becoming a larger area of practice here in the US. Many OTs (Occulational Therapists) are now incorporating "Sensory Diet" programs for their clients with autism. Music has become a primary component in many of these programs and shows much promise as a therapeutic modality for aiding children, teens, and adults in achieving a sense of balance and positioning (talk about feedback loops...)
Because public awareness about Autism is so poor here, many people do not understand that the stereotypies (flapping, rocking, humming, perseverative behaviors) are also functional behaviors that may be increasing a child's sense mastery, aiding kinesthetic awareness/aptittude and/or serving a communicative role. I think this is certainly an area we can discuss further.

I attended Bao's seminar several weeks ago and have every intent to keep him quite busy with both myself and some friends from my Capoeira group. I have used clubbells on and off for the last year+ and have been practicing Intu-Flow for about three weeks now. I am doing well on the beginner level and can do most of the Intermediate level without contraindication (neck is progressing slower, Egyptian is tough for me).
My personal goals surround hip flexibility, shoulder ROM (two prior injuries from Brazilian Jiu-Jitsu), and continuing progress in my martial art.

Thank you both again and for everyone taking the time to read this.

-EC

[Scott Sonnon]

Exactly what I found as well working at the neurobehavioral clinic.

Good luck on your Intu-Flow practice. Mastering your own practice is the best way to be able to help others.

[Randell Waddell]

Morning Eric,


First and foremost I must echo your sentiments concerning information sharing. A healthy respect for ongoing research both professional and scholatic will aid in a far more open and trusting dialogue. Furthermore, I think that both you and I can attest to the fact that this is a rather new and unexplored field of study, ripe for exploitation by whomever is disgraceful enough to do so.

Thank you - I am very happy to assist anywhere I can, though I close the door on those who do not respect or appreciate the concepts / material that I have been willing to share.


Hopefully you are keen and able to get some exploration happening over at your end. Perhaps we might start here:


...the stereotypies (flapping, rocking, humming, perseverative behaviors) are also functional behaviors that may be increasing a child's sense mastery, aiding kinesthetic awareness/aptittude and/or serving a communicative role.

Please consider the concept presented in:

http://www.circularstrengthmag.com/28/waddell.html

Hopefully you have a client at present for whom I could design a short (clubbell/body weight/exercise) sequence similar to, (though easier if need be) to the one presented in "5lbs. Clubbell® Combination Routine" ?

If that client also enjoys music, then all the better - this program could be trialled to their favourite music (preferably an 8 count beat if possible). If you have access to sound editing software, this is benefitial - splice the same song together well so that it runs for say 15 minutes.

If you can identify several basic (clubbell/body weight/exercise) movements that this client can both do well, and enjoys doing, then please get back to me, and I'll strive to put together an optimal sequence that may allow your client to get a taste of this Grat Flow sensation.

I also invite you to do similar - give me details of some of your favourite clubbell exercises, prep/splice a favourite music track together of some 30 minutes duration, send it over to me at [ randellw@iprimus.com.au ], and I will design a specific sequence for you, based on my understanding of your present stage of training.

Please also keep updated journals of how these dual projects are evolving, in here on the forum.

If your client and parents/carers, etc, are ameniable, then supporting photos etc, may be useful in sharing this process with our forum members. Adapted, it may also yield a useful article for CST magazine as well - this should help you to build your professional profile both within and without our immediate RMAX community.

Cheers
Randell. :D

[EChess]

Randell,

Great to hear from you and it looks as though we may have an interesting project to work on. I am considering a few of the athletes I work with and I may be able to integrate a motion series similar to your demonstration in the article (which, I will add, is quite excellent in its fluidity and concise structure) with the 5. lb clubbell.
I would immediately make a couple of adaptive changes so that the movement generation, enjoyment factor, and safety issues are addressed:

1) Among the athletes I would consider for this particular protocol, none are currently ready to progress to weighted equipment for optimal movement. I would employ a ball and progress to a 2 lb. weighted ball that my athletes absoultely love (it has a gel-like substance inside and yeilds to pressure) and/or a very light dowel of about 1' in length.
2) Using a descreet trial methodology (based on application of ABA principles) I would teach the movement in smaller incrimental steps culminating in the entire movement complex. I think arm circles, both frontal and lateral are a great starting point with particular interest in the area of vestibular awakening.
3) Successful completion of each targeted step in the movement would also rely on, obviously, differential factors occuring during the exercise (appropriote head positioning, ect.)

I will see what I can do about pictures and possibly some video footage which could really track progress. Can you please elaborate on the benefits of an 8-count beat within this and other programs?

Thank you,

-EC

[Scott Sonnon]

I am considering a few of the athletes I work with and I may be able to integrate a motion series similar to your demonstration in the article (which, I will add, is quite excellent in its fluidity and concise structure) with the 5. lb Clubbell.
I would immediately make a couple of adaptive changes so that the movement generation, enjoyment factor, and safety issues are addressed
Eric,

Only certified CST instructors may teach Clubbell training. You need to know how to use the tool and system which created it before making "changes". If you want to train your athletes safely and appropriately, register for a CST seminar and complete the battery of examinations.

[Randell Waddell]

Morning Eric,


I would employ a ball and progress to a 2 lb. weighted ball that my athletes absoultely love (it has a gel-like substance inside and yeilds to pressure) and/or a very light dowel of about 1' in length.

The ball in particular sounds great.


Using a descreet trial methodology (based on application of ABA principles) I would teach the movement in smaller incrimental steps culminating in the entire movement complex. I think arm circles, both frontal and lateral are a great starting point with particular interest in the area of vestibular awakening.

Successful completion of each targeted step in the movement would also rely on, obviously, differential factors occuring during the exercise (appropriote head positioning, ect.)

Great - hopefully you won't mind alluding to some of these principles, and sharing some of the dynamics of this ABA protocol/procedure here with our forum members also, so they can gain a finer appreciation of details one in your position needs to address, to work successfully with your cliental.


I will see what I can do about pictures and possibly some video footage which could really track progress.

Great.


Can you please elaborate on the benefits of an 8-count beat within this and other programs?

This is "visceral" at present - I know intuitively that most "Western" people exposed to "our" music relate most comfortably to this 8 beat, and will allow it to "carry them away". (I have not yet nailed down the research to support these ideas here yet - that is just another chore to do in a long line, if I need to specifically prove it one day - I have too many other projects "bubbling" up that I wish to explore / support like this one).

Perhaps Connie or one of our other "music" people might like to contribute here.

I utilize a variety of different music in my own explorations, but I think we will find the 8 beat will suit your cliental well.



Only certified CST® instructors may teach Clubbell® training. You need to know how to use the tool and system which created it before making "changes". If you want to train your athletes safely and appropriately, register for a CST® seminar and complete the battery of examinations.

Please do consider doing one of these - they are superb, explore a myriad of areas, and should open up multiple new dimensions in your cliental support.

My training partner awaits - must away.

Cheers
Randell. :D :D :D

[Connie Brown]

This all looks great. Thanks for sharing it.

Randell, here is a simple link on music and the brain:

http://www.cerebromente.org.br/n15/mente/musica.html

The "8 beat" that we Westerners resonate to, I haven't seen written up either. But I suspect it has to do with these, in random order...

60 beats per minute is kind of magical, as a tempo. Mozart and easy rock. It corresponds to an easy walking pace.

The "order" part of music : 8 beats is squarely in the number of items we can keep in short-term memory (the magic 7 plus or minus 2.) So we are keeping the beat, the melody, and now the movements, in a "stack" of 8. Then we recognize the beginning, clear the stack, it starts again and it's very cool.

I also wonder about the rhythm of breathing here. Average adult respiration is 16-20 breaths per minute. Multiple of three?

[Randell Waddell]

Magic site, Connie - thank you for joining us also.

(Eric - Connie is one amazing lady !!!!!!!!)

Another thought just sprang to mind also - one of my Uni lecturers (Ann Baker: www.naturalmaths.com.au - another absolutely amazing lady) highlighted that the musical area of Gardner's Multiple Intelligents is actually two parts in her mind - those who can create and play music, and (importantly though most people are not aware of this side) those who can greatly "feel" music. It may be interesting to diverge into this area to see the extent to which some of our cliental, are very capable of "feeling" emotions from music.

Cheers
Randell.:D

[Randell Waddell]

I will be offline for a while folks.

Please, please, please continue with great exploration here - I believe this will prove very valuable, and has the potential to make huge differences in a lot of people's lives.

Cheers
Randell.
:D :D :D :D :D :D

[EChess]

Connie,

Thank you very much for joining in on this conversation and lending your expertise as it is most helpful.

Randall, the rundown:


Great - hopefully you won't mind alluding to some of these principles, and sharing some of the dynamics of this ABA protocol/procedure here with our forum members also, so they can gain a finer appreciation of details one in your position needs to address, to work successfully with your cliental.

Applied Behavioral Analysis is practice of therapeutic intervention that is often mentioned in the same breath as autism when discussing teaching methods, as it has proven quite successful in developing and maintaining skills ranging from speech and language acquisition to cognitive learning to behavioral/emotional mastery and, in my case, physical activity and movement patterning. ABA is based upon reward-cost systems of any behavior or action and becomes more intricate when discussing higher-order nuances of behavior, education and social exchange.
ABA has roots in the research of B.F. Skinner. Unfortunately, due to his noteriety in studying animals, the fact that many people immediately conjure up images of the "Skinner Box," and in conjunction with several other pieces of misinformation, ABA is often met with hostility and accusations of "training children/people like cattle." ABA protocols for the autism population were founded in the work of Dr. O. Ivar Lovaas, a reasearch and clinical psychologist who found that ABA methods proved meaningful in developing and maintaining skills in young persons with autism spectrum disorder. While ABA protocols work for all facets of development, the most common example of behavioral analysis in action is the Discrete Trial method of teaching.

Discrete Trials are often observed in "table work" when a student is completing a specific task. A reward is given by the instructor/teacher/parent for successful negotiation of the task. Should the student make an error, the instructor will "prompt" or guide the student through the task again, making sure that she/he completes the target task correctly. Discrete trial is not limited to "table work." I employ such strategies when teaching a new exercise or skill to one of my athletes. Because there are myriad factors in place during a physical and dynamic skill set (including but not limited to kinisthetic awareness, behavioral readiness, and muscular fatigue) I employ a "naturalistic" teaching method where the lesson/task is primarily guided by the child. For example, if one of my athletes is throwing a ball correctly however it is evident that she/he is not making eye contact or attending to the activity, the situation is repeated so that the child has the opportunity to negotiate the action correctly. It gets interesting with so many variables to account for, including that the athlete is having a good time which is of vital importance.


Quote:
Only certified CST®® instructors may teach Clubbell®® training. You need to know how to use the tool and system which created it before making "changes". If you want to train your athletes safely and appropriately, register for a CST®® seminar and complete the battery of examinations.


Please do consider doing one of these - they are superb, explore a myriad of areas, and should open up multiple new dimensions in your cliental support.

I intend to do so as soon as I can. Unfortunately I cannot make the March certification seminar but will see what I can do about joining the next time around. Until then I will continue to develop my skills and work alongside whomever would be willing to share their knowledge and experience.

Connie,

Again, awesome stuff and thank you for taking the time to get involved in this discussion. Interestingly enough there are geographical differences in breathing rates for adults. Apparently here on the East Coast of the US we take more breaths per minute than our West Coast citizens. I was alluded to this during a great seminar with a group called Vital Links, two OTs (Occupational Therapists) who do some fantastic work in the area of music/listening therapy and vestibular habituation (www.vitallinks.org). Their cds use Mozart and Vivaldi to elicit mastery of sensory awareness (vestibular, core habituation, and attention) in a very wide demographic of clients.

Lately I have been experimenting with using some of the music from Cirque Du Soleil. It has a slow, rhythmic and exotic quality that my athletes seem to enjoy. In addition, the music has been created specifically to accompany motion and athletic activity. I want to give the link you posted proper attention and have not yet visited the site.

Randall, will continue to bear the torch on this thread. Have an enjoyable whenever-until-we-hear-from-you-again.

-EC

[/quote]

[Connie Brown]

Wow, great ref to the Cirque de Soleil. I've had so many people say how much they like it and I never put those two together either.

The music made for chanting and meditative singing works too, at least at the slower speeds preferred by my elder swingers.

[gene]

way over my head here folks but,

60 beats per minute has been linked to a relaxed resting heart rate as regards the "Mozart effect" and the company MUZAK has tons of research on music and how it affects the brain, also there is a company called accelerated learning that uses music to teach because it accesses a different part of the mind...i believe alot of this is based on research by a man named Lazonov.

also,I worked with a blind and autistic child for awhile...he had a real aversion to touch except for he loved piggy back rides...that was his reward for staying engaged in our activity

peace
gene

[EChess]

Connie,

Thank you for the compliment. It is an interesting dichotomy working with my ASD athletes as I have to balance specific movement rehearsal and staying with a particular protocol with innovation and improvisation on a regular basis. If one of my athletes exhibits a unique and posture-enhancing/stabilizing motion, I certainly will not get in the way. Gene, thank you for your comment. I appreciate you taking the time to look over this thread.

Randall, when you get back around to a keyboard I'd like to discuss your experience with "stereotypic" or sensory-deficit-derived bahaviors such as flapping, clapping, oral stimulation via pica, ect.

-EC