Does Hand Flapping Mean Autism?

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With today’s easy access to the Internet, it is common for many of us to try and diagnose our own symptoms and ailments; however,girl stimming even if your symptoms come to a match, it does not necessarily mean that you have that particular diagnosis that shows up on your computer. The same can be said with children. If you notice what might be a ‘red flag’ in your child, it does not automatically imply that your child has something ‘wrong’ with him/her. One such ‘red flag’ that many parents get overly worried by is the action of hand flapping. It should be noted that hand flapping can occur for many different reasons, and not only in children with Autism.

Hand flapping can occur due to:

  • Excitement
  • Nervousness/Anxiety
  • Fidgeting
  • High engine level/Arousal level
  • Habitual behavior
  • Decreased body awareness (child does not even know he is doing it)

Overall, it is important to keep in mind that every child is unique and reacts to various situations in a different manner as well as with different mannerisms.  Be sure to reach out to your child’s teachers and therapists if you notice that your child using hand flapping behaviors, so that you may all be on the same page in relation to treating this behavior. It is important to monitor when the hand flapping occurs in order to look for trends. If hand flapping does occur with other “red-flag” behaviors, talk to your pediatrician or a Pediatric Therapist.  

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Stay tuned for my next blog on strategies to replace hand flapping behaviors.

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Winter Holiday Activities for Children With or Without Sensory Processing Disorder

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Play is the occupation of children. Through the action of playing, children are able to develop themselves as well as explore the worldChildren building a snowman around them. Sensory integration is a process that automatically occurs in most individuals, such as when everything we see, hear and feel makes sense to us. Some individuals have a difficult time in processing sensory information. Sensory integration provides the groundwork for developing better physical, academic and social skills. Four aspects of sensory integration as well as activities to enhance them are listed below:

The touch sense involves the tactile system. It is defined as a sensation that is derived from stimulation to the skin. Through this system, we learn about various textures, shapes and sizes. We are able to differentiate between soft and rough, sharp and dull and small and big sensations. The sense of touch offers feedback, allowing us to utilize a pencil, button a shirt or even zip a jacket.

Holiday activities that are able to aid the tactile system:

  • Finger paint with Christmas/holiday colors
  • Create gingerbread men ornaments or cookies
  • Snow play
  • Snow angels on the carpet
  • Decorate the Christmas tree
  • Play with Christmas/holiday-colored play dough

The gravity and movement sense involves the vestibular system. It is defined as a sensation that is derived from stimulation to the vestibular mechanism found in the inner ear that occurs through both movement and position of the head. This system contributes to posture and the maintenance of a stable visual field. When we close our eyes while riding on a roller coaster, we are aware that we are moving as well as the position of our body.

Holiday activities that help better develop the vestibular system:

  • Ice skating
  • Sleigh rides
  • Sledding
  • Passing snow balls overhead or through legs
  • Lying on the couch with head upside down
  • Watching a holiday-themed movie
  • Toy soldier marching.

The body position sense involves the proprioceptive system. It is defined as a sensation that is derived from movement, muscle and joint perception. We are aware of what items we are holding in our hands with our vision obstructed. Children must be aware of how far to flex and extend their upper and lower limbs so that they are able to climb the playground or to hold a utensil.

Holiday activities that are able to enhance the proprioceptive system:

  • Making a snowman
  • Making snow angels in the snow
  • Digging snow tunnels
  • Rolling out cookie dough
  • Shaking a heavy snow globe.

Many of the activities that help establish the tactile, vestibular and proprioceptive systems will also aid in the development of motor skills. This process is called praxis. It is the ability of the brain to conceive of, organize and carry out a sequence of unfamiliar actions. When we were initially taugt how to climb a ladder or ride a bike, we had to think about how to determine our movements.

Holiday activities that help improve praxis:

  • Constructional toys, such as holiday-themed Legos or making a gingerbread house
  • Making winter holiday cooking recipes
  • Coloring and cutting shapes for a winter holiday picture
  • Creating an obstacle course in the snow to crawl under, over, through, etc.

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Toe Walkers Part 1: What are Reasons Children Toe Walk | Pediatric Therapy Tv

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In today’s Webisode, a pediatric physical therapist explains why children may walk on their toes.

Learn more from this blog called “Is Toe Walking Normal?”

In this video you will learn:

  • How sensory input is related to toe walking
  • What is muscular dystrophy
  • What is idiopathic toe walking

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide audience, this is Pediatric Therapy TV, where we provide experience and innovation to maximize your child’s potential. Now, your host, here’s Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn Ackerman, and I’m standing here today with Colleen Kearns, a Pediatric Physical Therapist. Colleen, can you give our viewers an explanation of why some children toe walk?

Colleen: Of course, Robyn. There are three main reasons why children may toe walk. The first one is related to sensory issues. Some children may actually be hypersensitive to certain textures on the floors that they are walking on, and the surfaces that they are walking on. So if that occurs, they may be more prone to walk on their toes to avoid those uncomfortable textures.

On the other hand, they may also be seeking extrasensory input. Maybe, some kids need a little bit more of the sensory input, and by walking on their toes they are locking their ankles and knees, and by doing that, they are actually getting more input from their joints. So that’s also why children with autism will walk on their toes, to get that extrasensory input.

The second main reason that children toe walk is due to an underlying diagnosis. Muscular dystrophy is a big one. That’s a genetic disorder where the muscle tissue is destroyed and it’s actually replaced by fat, and the calf muscles are often the first ones to be involved with that. So children with muscular dystrophy will toe walk in an effort to stabilize, due to the decreased strength. Any condition that results in an abnormal increase in muscle tone will also result in toe walking. A common one with that would be cerebral palsy.

The third reason why kids may toe walk is actually unknown. Some children, who don’t have an underlying diagnosis and don’t have sensory issues, just prefer to walk on their toes, and that’s what we call idiopathic toe walking, which means we just don’t know. Unfortunately, they can get into a very strong habit of doing it, and when they do that it results in a shortening of the muscles in their calf, and that actually makes it harder for the child to be able to get their foot flat on the ground. And when that happens, it’s kind of like a vicious cycle. They are more likely to be walking on their toes because they have a strong habit, then their muscles get shorter, then it’s harder for them to walk on their flat feet, so then they are even more prone to walking on their toes.

Robyn: All right. Well, thank you so much, and thank you to our viewers. And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind to your family with the best in educational programming. To subscribe to our broadcast, read our blogs, or learn more, visit our website at learnmore.me. That’s Learnmore.me.

Differential Diagnosis: Autism versus Aspergers

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Autism and Asperger’s Disorder are diagnoses which both present with a hallmark feature of social impairment. There are several differences between Asperger's Childthe two diagnoses which help classify the two disorders.

Autism Diagnosis:

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IV-TR), which is the diagnostic guidebook published by the American Psychiatric Association, indicates that there are three domains of diagnostic criteria for a diagnosis of Autism. Impairment with social relationships is the first domain which includes impaired nonverbal communication (poor eye contact and lack of gestures), poor peer relationships (lack of social interest when young to one-sided social interactions when older), poor joint attention (lack of pointing to show interest, not bringing items to show parents), and a lack of emotional reciprocity (failure of the child to notice parents and peers emotions). The second area is impairment in language which includes: language delay (not speaking at a year, or not speaking in sentences at two years), inability to carry on a give-and-take conversation, perseverative and repetitive language (repeating lines from television shows or the same thing over and over), and absent or delayed pretend play. The final area of Autism is repetitive behaviors which include: preoccupations or over-interest with favorite objects or topics that are unusual for the child’s age, routines and rituals that cause distress if interrupted, stereotypical movements (rocking, hand flapping, spinning), and interest in parts of objects (playing with only the wheels on a car). According to the DSM-IV, the main differential between the diagnoses of Autism (as described above) versus Asperger’s Disorder is that children with a diagnosis of Aspergers do not evidence impairment in language.

Asperger’s Diagnosis:

Neuropsychological studies have documented that children with Asperger’s Disorder often exhibit relative strength with regard to their verbal skills with deficits in their visual spatial and visual motor ability. Whereas children with Autism will often exhibit the opposite profile; strength with visual spatial and visual motor ability and weakness with verbal skills (Wolf, Fein, Akshoomoff, 2007).

Overall, the diagnoses of Autism and Asperger’s Disorder are quite similar in that they both feature impairment with social relationships and repetitive behaviors. The main exception between the two diagnoses is that children with Asperger’s do not exhibit the concern with language functioning.

If you believe your child would benefit from an evaluation from an expert, please click here.

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What Are Functional Assessments and the Four Main Functions of Behavior?

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What are functional assessments?

Functional assessments are used to develop interventions for helping people change their behavior. A functional assessment is a procedure that is used to help identify what is reinforcing or

maintaining the behavior of concern. In order to generate a hypothesis about why an individual does something, a behavior analyst gathers information about the problem behavior (anything an individual does that is harmful or undesirable in some way). By observing the antecedents (what happened immediately before the behavior) and the consequences (what happened immediately after the behavior) of the problem behavior, behavior analysts can develop a probable cause for the behavior.

What is the function of behavior?

The function of behavior is the reason people behave in a certain way. People engage in millions of different behaviors each day, but the reasons for doing these different behaviors fall into four main categories.

The four main functions that maintain behaviors are:

  • Escape/Avoidance: The individual behaves in order to get out of doing something he/she does not want to do.
  • Attention Seeking: The individual behaves to get focused attention from parents, teachers, siblings, peers, or other people that are around them.
  • Seeking Access to Materials: The individual behaves in order to get a preferred item or participate in an enjoyable activity.
  • Sensory Stimulation: The individual behaves in a specific way because it feels good to them.

Once you have identified what function or functions are maintaining the behavior, you can start to implement an intervention that will help decrease the problem behavior and increase more appropriate behaviors.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Basic Principles and Practices for Teaching Children With Autism New Skills

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Teaching new skills to children with autism can be very difficult. It is important to first understand the fundamentals of behavior.

Behavior is an important part of teaching because in order to learn a new skill, a child must understand what response is desired and when. A child learns when a response is desired by experiencing a stimulus (i.e. item/request/instruction) and discrimination (Sd- discriminative stimulus).  A child simultaneously learns there is a desired response and discriminates that the response is only desired in the presence of the Sd. For example, if you are teaching a child to say “book” in the presence of a book, the Sd would be the book itself and the desired response would be saying “book.” That child will learn to say “book” only when that book is present. Later on, that child may begin saying “book” in the presence of new books, a pattern called generalization.

So, why is behavior important in teaching a new skill? It is important because a child’s response IS a behavior!

 Descriptions Of Behaviors:

• Reflexive Behavior is our bodies’ natural reaction to environmental stimuli (e.g. blinking when someone blows in your eyes, or jerking your leg when someone hits your knee cap). These behaviors are called reflexes and occur without being learned. Read more