quinta-feira, 30 de agosto de 2012

Aplicación Baluh, interesante para mejorar la comunicación


Hoy os traemos una nueva aplicación informática que pretende ayudar a las personas con Autismo y su entorno (familiar, escolar, etc.) gracias a técnicas de Comunicación Alternativa y Aumentativa (AAC)  basadas en imágenes.  Funciona utilizando los pictogramas de ARASAAC,  y está estructurada en cuatro apartados: mi libro, yo quiero, saludos y quién soy.
Se trata de una app que ofrece una solución de comunicación para las personas que tienen dificultad para la comunicación oral. Se ofrece con una selección inicial de 400 pictogramas que incluyen audio, y permite al usuario descargar más pictogramas o bien hacer fotografías con la cámara del iPad e integrarlas en el libro de imágenes.
La finalidad de Baluh es que resulte muy funcional y útil para sus usuarios, y conseguir una comunicación ágil y duradera con su entorno. Está enfocado a niños y adultos con TGD (Trastorno Generalizado del Desarrollo) pero no es exclusivo para estos usuarios, siendo de gran utilidad a personas con otras dificultades tales como parálisis cerebral, Síndrome de Down, discapacidades del desarrollo, accidente cerebrovascular o una lesión cerebral traumática.
Su página web ofrece más información sobre la app. Sus creadores (Josep Martínez, padre de un niño con autismo, Melchor de Palau, experto en temas de Internet, y Sergi Vélez, programador de lenguaje Ios de Apple, asesorados por profesionales del colegio Paideia) complementan la información con un video explicativo de su funcionamiento y las aplicaciones es posibles.
Del Blog Ipad y Autismo

quarta-feira, 29 de agosto de 2012

Terror en el hipermercado, horror en el ultramarinos



Muchos padres de niños con autismo temen, por encima de muchas otras cosas, las rabietas en público del muchacho, algo que muchas veces se asocia a salir de compras juntos. En nuestra casa estamos en territorio conocido, rodeados de gente que nos quiere y entiende la situación. En un viaje al hiper, estamos en un lugar con estímulos sensoriales elevados, rodeados de extraños, algunos de los cuáles pueden tener la insensibilidad y la falta de educación de hacer un comentario jocoso o crítico ante un niño que ha perdido el control. También habrá muchas otras personas que sin saber lo que está pasando, qué es lo que ha desencadenado esa “tormenta”, quieran ayudar pero no saben cómo.

Tessa Jordan, una madre de cuatro hijos, tres de los cuáles tienen distintos grados de trastornos del desarrollo, escribió en su blog, después de una de esas terribles tardes de compras, una lista de cosas que alguien podría hacer para ayudar en uno de esos momentos. Estas son sus palabras:

1.- Entiende porqué estamos aquí. Algunas personas pueden poner en cuestión porqué se hace pasar a un niño por una situación donde se pueda sentir abrumado, sobrepasado, y reaccione con una rabieta terrible. Primero, no todos los días son iguales. Hay veces que ir de compras funciona perfectamente. En otras ocasiones, un elemento desencadenante hace que una situación que hasta el momento se había tolerado sin problema, de repente sea insufrible. No siempre sabemos la causa que ha originado la respuesta anómala.

La principal razón de que continúe llevándole de compras conmigo es que tengo una visión del futuro de mi hijo.  Durante el resto de su vida, cada vez que esté en un recinto público, estará en riesgo de tener una sobrecarga sensorial. No sé si alguna vez se llegará a casar, pero confío en que tendrá un trabajo y se irá a de nuestra casa en algún momento de su vida. Debe aprender a reconocer cuándo se está viendo superado por la situación y tiene que buscar un ambiente más tranquilo. Como madre suya, mi obligación es prepararle para la vida.

2.- Por favor, no pretendas iniciar una conversación. Agradecemos tu ayuda pero no podemos ponernos a hablar sobre ello o nuestro hijo en este preciso momento. Nuestras manos, nuestros sentidos, nuestros cerebros están ocupados con un niño que grita, llora, que está fuera de control y nuestra atención está puesta al 100% en él o ella en este momento. El primer objetivo de nuestro hijo es, a menudo, escapar y si estamos en un lugar donde pasan coches, un momento de distracción puede ser fatal.

En vez de preguntar o decir “Disculpe, señora, ¿necesita ayuda?” algo que implica retirar la vista de nuestro hijo para contestarle, es mucho mejor que simplemente nos digas “Señora, vigilo su carrito el tiempo que necesite, esté tranquila” o lo que sea. Nos hace saber que hay una mano amiga cerca, nos quita un preocupación de la cabeza por unos momentos y no requiere una respuesta.

3.- Ábrenos paso. Si nos va rodeando un círculo de pesados o curiosos, la cosa empeora. Si estoy deseando sacar a mi hijo de esa situación, ruega a la gente que se aparte y nos deje irnos al coche.

4.- Recoge mis cosas. Es posible que haya tenido que soltar bolsas, paraguas, cualquier cosa para hacerme cargo de mi hijo. Si ya he pagado las cosas del carro, puedes asegurarte de que no aproveche la ocasión un desaprensivo.

5.- Vigila el tráfico. En un aparcamiento, ayudarme a controlar los coches que se están moviendo puede ser una gran ayuda. Esto tiene una enorme importancia.

6.- Defiéndeme. Si ves que alguien está siendo agresivo o insensible, sal en mi defensa, párale los pies. En ese momento no puedo defender ni a mi hijo ni a mí. Pero agradeceré que alguien lo haga.

En el próximo post intentaré añadir nuevas cosas dirigidas no al espectador bienintencionada, sino al padre o madre.

Los padres norteamericanos de niños con autismo, que luchan por concienciar y educar sobre los trastornos del espectro autista no tienen ningún reparo, todo lo contrario, en repartir fotocopias de estas cosas en el supermercado donde hacen la compra para que las dependientas, los clientes habituales, el responsable del comercio sepan que no es un niño “maleducado” sino un niño con un trastorno del desarrollo. Un padre o una madre no tiene que sentir vergüenza y ocultar que su hijo tiene autismo. Todo lo contrario, deben sentir un legítimo orgullo por la tarea que afrontan cada día y el amor y esfuerzo que dedican a su hijo. El día que alguien me dé en el Mercadona o el Carrefour una fotocopia de estas cosas sabré que las cosas están mejorando.

Artículo publicado en el Blog personal de Jose R. Alonso

Surfing Day

16 de Setembro - 10h30

Aula de Surf na escola Surfing Life Club na Praia de Matosinhos (entrada pelo Vagas Bar). 

Preço por aluno 10€, é obrigatório um acompanhante por cada criança/jovem e o valor 

inclui uma prancha, fato para cada uma das pessoas e balneário com agua quente.

Inscrições através do email: apeeautismo@gmail.com

sábado, 18 de agosto de 2012

Estrategias para mejorar el sueño en niños con trastornos del espectro autista (TEA)


Muchos niños con Trastornos del Espectro de Autismo tienen problemas a la hora de dormir. Este folleto informativo está diseñado para mejorar el sueño de los niños.  La  Federación Andaluza de Padres con hijos con Trastornos del Espectro Autista nos ofrece esta interesante Guía.
Lass sugerencias de este folleto se basan en la investigación y la experiencia clínica de expertos en sueño.
propone estrategias para:
  • Proporcionar al niño un ambiente cómodo para dormir
  • Establecer una rutina regular del sueño
  • Consejos para mantener un horario regular
  • Enseñar a su hijo a dormir solo
  • Promover comportamientos diarios

sexta-feira, 17 de agosto de 2012

Reunião de Partilha

Com o inicio de mais um ano lectivo reveste se de enorme importância a partilha entre as familias dos seus anseios, das mudanças, dos medos e a troca experiências positivas para que possam ser usadas por outros.
Por isso a APEE Autismo organiza no próximo dia 01 Setembro pelas 15h00 mais uma reunião de partilha com o tema " Debate de ideias sobre o que pode mudar neste ano lectivo e perspectivas de futuro",  o local da partilha será na sede da Associação.

Pedimos que nos confirmem a presença através do email: apeeautismo@gmail.com






segunda-feira, 13 de agosto de 2012

Intervenção Intensiva Contextualizada


É com muito prazer que anunciamos a equipa do projecto de Intervenção Intensiva Contextualizada:

Coordenador Tecnica:
Dra. Vania Peixoto 

Equipe Técnica
Psicóloga:
Dra. Daniela Santos 

Terapeutas da Fala:
Dra. Rita Mendes 
Dra. Ana Dias 

Terapeuta Ocupacional:
Dra. Ana Barreira

Pos Escola:
Dra. Catarina Marques 
Dra. Joana Silva 
Inês Sevilha

sábado, 11 de agosto de 2012

Manual de Teoría de la Mente para niños con Autismo


Saber ponerse en el lugar de otra persona y comprender que cada uno de nosotros percibimos, pensamos, sentimos, deseamos o creemos cosas distintas. Así resumiría la autora del libro lo que se denomina Teoría de la Mente.
Gracias a Erik fueron naciendo todos y cada uno de los ejercicios. Gracias a Erik y sus progresos iba engordando un Manual práctico que es el fruto de nuestro trabajo constante. Sí, una dedicación de la que nos sentimos muy orgullosos porque ¿quién puede poner límites al esfuerzo de un niño? Teníais que haber oído su vocecita cuando se acercaba y me decía: “mamá, ¿te hago otro dibujo para el libro?”
La personas que convivimos con el autismo somos conscientes de la importancia de esas frases de Erik y de los grandes logros que implican en general, y en Teoria de la Mente en particular.
EL libro trata de temas clasificados por:
- Lenguaje comunicativo y en contexto.
- Atención compartida al comunicarnos algo que acababa de ver por la ventanilla y que le había llamado la atención.
- Emoción e interés al compartirlo con otros.
- Interpretación de la intención de dos personas desconocidas que corría bajando las escaleras hacia el tren, así como comprensión de la situación al ver que se les cerraba la puerta sin oder montarse en el tren.
- Asociación de emoción a una situación.
- Empatía, al definirlos como “los pobres”.
- Atribución de un estado mental al decirnos “los pobres deben de pensar que ahora tienen que esperar 30 minutos”

quinta-feira, 9 de agosto de 2012

Protocolo APEE Autismo/Cães Amigos

A APEE Autismo informa todos os Associados e Amigos que no passado dia 01 de Agosto assinou um protocolo de colaboração com a Associação Cães Amigos com o objectivo de poder disponibilizar Terapia Assistida com Animais a todos os Associados
Esta parceria também é extensível no projecto Intervenção Intensiva Contextualizada e no desenvolvimento de outros projectos em conjunto.

quinta-feira, 2 de agosto de 2012

Centro de Recursos para o apoio às pessoas com Perturbações do Desenvolvimento e Especto do Autismo

O Conselho Executivo vem por este meio informar que a partir de Outubro a APEE Autismo irá abrir o seu Centro de Recursos com o projecto Intervenção Intensiva Contextualizada que em seguida passamos o seu objectivo geral:

Este projeto tem como objectivo principal potenciar e/ou melhorar a intervenção junto das crianças com Perturbação do Espectro do Autismo (PEA), Perturbação de Desenvolvimento (PD) e Perturbação da Comunicação e da Relação (PCR) e as suas famílias, através de características como intensidadem precocidade e naturalidade. Estes critérios estão comprovados pelo National Resourch Institute (2000) como efectivos na intervenção com esta população, no que diz respeito às competências comunicativas sociais e comportamentais da criança/jovem, de modo a promover a máxima autonomia e integração social ao longo da vida em diferentes contextos.
Resumindo:
A revisão realizada pelo National Resourch Institute (2000) no sentido de determinar quais as características que conferem efetividade a um programa de intervenção dirigido a crianças/jovens com autismo determinaram que a intensidade, precocidade, intervenção parental, intervenção em contextos naturais, intervenção dirigida a diferentes interlocutores (adultos próximos e mais afastados, pares) e intervenção dirigida à funcionalidade da comunicação são cruciais neste tipo de trabalho.
Daí resulta este projeto, no sentido de criar uma resposta para estas crianças e suas famílias, integrando todas estas características, assim como respondendo a uma necessidade familiar das nossas famílias, nomeadamente a ocupação produtiva dos tempos não letivos da criança.
De acordo com o supramencionado, a equipa de intervenção atuará nos seguintes contextos:
     - Jardim-de-infância/Escola onde a criança está integrado e casa: onde os terapeutas (TO, TF, PSI e TAA) atuariam partilhando/praticando estratégias específicas adequadas a cada caso com os diferentes envolvidos no dia a dia da criança;
     - Centro da “Intervenção Intensiva e Contextualizada” (situado no CRSP) onde os terapeutas realizariam o acompanhamento individualizado e com a equipa de apoio pós escola e estagiários da UFP realizariam atividades em pequenos grupos, planeadas previamente pelos terapeutas.

Os custos para os associados para usufruirem do IIC sera o seguinte:


Escalão A
Escalão B
Valor unitario por sessão de TF
15,00 €
20,00 €
Valor unitario por sessão de TO
15,00 €
20,00 €
Valor unitario por sessão de Psicologia
15,00 €
20,00 €
Valor unitario por sessão TAA
11,00 €
12,50 €
Serviço Pós Escola
8,00 €
10,00 €
Serviço Pós Escola - Desporto Adaptado
12,00 €
15,00 €
Transporte
0,25 €/klm
0,25 €/klm
Pacote ICC - TF/TO/PSI/TAA/POS I E II
304,00 €
304,00 €
Pacote Terapeutico - TF/TO/PSI/TAA
224,00 €
224,00 €

Informa mos tambem a quem estiver interessado de que se encontram abertas as pré inscrições para o projecto

Olga Bogdashina

DIFFERENT SENSORY EXPERIENCES - DIFFERENT SENSORY WORLDS
By Olga Bogdashina
Bio: Olga Bogdashina received her Ph.D. in Linguistics from Moscow Linguistics University and her MA Ed. Autism from Sheffield Hallam University. Olga’s son, aged 13, is autistic. She has worked extensively in the field of autism as teacher, lecturer and researcher, with a particular interest in sensory-perceptual and communication problems in autism.

For 10 years Olga Bogdashina lived in Gorlovka in Ukraine. Autism has limited recognition in the countries of the former USSR. In 1994 Olga established and became President of the first Autism Society in Ukraine - “From Despair to Hope”. She is Director of a voluntary day school in Gorlovka for children on the autistic spectrum.

Olga has had several articles and leaflets published in Ukraine, Belgium, Poland and the USA. She is the author of two books - “Autism: Definitions and Diagnoses”, Ukraine and “A Reconstruction of the Sensory World of Autism”, SHU Press, UK.
She is an active conference presenter and is presently conducting research on sensory and communication issues in autism in the UK.

‘Learning how each individual autistic person’s senses function is one crucial key to understanding that person.’ (O’Neill, 1999, 31)
Everything we know about the world and ourselves has come through our senses. All our knowledge therefore is the product of what we have seen, heard, smelt, etc.
Though autistic people live in the same physical world and deal with the same ‘raw material’, their perceptual world turns out to be strikingly different from that of non-autistic people.

It is widely reported that autistic people have unusual (from non-autistic point of view) sensory-perceptual experiences. These experiences may involve hyper- or hyposensitivity, fluctuation between different ‘volumes’ of perception, difficulty interpreting a sense, etc. All these experiences are based on real experiences, like those of non-autistic people, but these experiences may look/sound/feel, etc. different, or they may be interpreted differently. We think about the world in a way we experience it and perceive it to be. Differences in perception lead to a different perceptual world that inevitably is interpreted differently. So can we be sure that we are moving in the same perceptual/social, etc. world if our reconstructions of it are so different? Can we be sure that we see, hear, feel etc. the exactly same things? How can we know that only our ‘perceptual version’ of the world is correct and theirs is wrong? Whatever the answers to these questions are, it is worth remembering that autistic people can’t help seeing and hearing the ‘wrong thing’, and they do not even know that they see or hear the wrong thing (Brad Rand).“Normal” connections between things and events do not make sense for them, but may be overwhelming, confusing and scary.

Since the first identification of autism in 1943 (Kanner) a lot of research has been carried out to study this condition from different perspectives. What has not been taken into account by the experts in the field, however, is the opinion of the ‘native experts’ - autistic individuals themselves. Despite the fact that many people with autism have tried to communicate their views and insights, these attempts have mostly passed without much professional notice, one of the reasons being, their views and insights are unconventional to the majority of people (so-called ‘normal’ people).

Here we try to show that ‘different’ does not mean ‘abnormal’ or ‘defective’, and ‘normalcy’ is a very relative term, as the ‘norm’ is often applied to the performance of majority, and it is more justifiable to term it ‘typical’. To avoid having to use the term ‘normal’, autistic people at Autism Network International have introduce a new term - ‘Neurologically Typical’ (NT) to describe non-autistic people.

Here I deliberately use the term ‘autistic people’ rather than ‘people with autism’ because autism is not something that is just attached to them and cannot be easily removed. I am aware of the ‘people first, then disability’ approach. However, without autism they would be different people as being autistic means being different. If people with autism themselves prefer to name themselves autistic why should we be so shy to call them that? Just to show them our respect? But there are other ways to do it. Why should we be ashamed to call them autistic? Autism is not something to be ashamed of.

For autistic people, autism is a way of being. It is pervasive, it colours every experience, every sensation, perception, thought, emotion, in sort, every aspect of existence (Sinclair, 1993). They do not respond in a way we expect them to, because they have different systems of perception and communication. Bob Morris (1999) calls it a different set of SPATS - Senses, Perceptions, Abilities and Thinking Systems, that are not in the same spectral range as NT individuals. Of course, it is very difficult to communicate with someone who uses a different ‘language’ (and autistic people are ‘foreigners’ in any culture). But it is equally wrong to use non-autistic methods to teach and treat autistic children. It is sure to fail and sometimes even to damage their life.
We have to give up our conventional non-autistic assumptions and let them teach us how their SPATS work in order to build bridges between the two worlds. Our approach should be to listen to autistic individuals who are willing to communicate and explain how they experience the world and not to assume that only our views are right because we are specialists/parents. It is the same as if I said to you: “Sorry, but you speak English (French) with an accent. Let me teach you English (French) pronunciation. It doesn’t matter that I am Russian. I am a linguist so I know better than you how to speak your language properly.”

Although in the 1960s-70s the idea of possible sensory-perceptual abnormalities as one of the core features of the disorder was put forward (Rimland, 1964) and theory of sensory dysfunction was formulated (Delacato, 1974) till recently it has been ignored by the researchers. What makes one wonder, is that, though unusual sensory experiences have been observed in autistic people for many years and are confirmed by autistic individuals themselves, they are still listed as an associated (and not essential) feature of autism in the main diagnostic classifications - DSM-IV (APA, 1994) and ICD-10 (WHO, 1992).

It is worth learning how autistic individuals themselves consider the role of sensory-perceptual difficulties they experience.
The personal accounts of autistic individuals reveal that one of the main problems they experience is their abnormal perception and many autistic authors consider autism as largely a condition relating to sensory processing.

Temple Grandin suggests that there is a continuum of sensory processing problems for most autistic people, which goes from fractured disjointed images at one end to a slight abnormality at the other. Nonverbal individuals usually have more severe distortions and sensitivities. As the systems work differently their responses to sensory stimuli are ‘normal’ (from autistic point of view), though different and unconventional, and not abnormal or defective.

What makes the matter even more complicated is that no two autistic people appear to have the exactly same patterns of sensory-perceptual experiences.
It is vital to understand the way autistic people experience the world, as often very well-meaning specialists are “failing people with autism… (and) most (autistic people) have not been helped at all, many have felt degraded and some have been harmed” (Gerland, 1998) because of the misunderstanding and misinterpretation of the condition.

Understanding of the way autistic people experience the world will bring respect to people with autism in their attempts to survive and live a productive life in our world instead of unacceptance often exhibited by the general public.

When a child is diagnosed autistic, educational priorities focus on behavioural interventions aimed at development of social and communicative skills, while the child’s ‘sensory needs’ are often ignored. Paradoxical as it may seem, sometimes autistic children benefit from being misdiagnosed as having visual and/or auditory impairments. It especially applies to the so-called low-functioning (or ‘severely autistic’) children whose sensory perceptual problems are usually very severe. Being placed into the environment where their sensory difficulties are addressed these children might respond to social and communication interventions better than if they were placed into autistic units/schools where the main emphasis is only on training in social/communicative behaviours.

In the case of such disabilities as blindness/deafness the main emphasis is on providing sensory substitution in order to replace one sensory input the person lacks (vision/hearing) by another (e.g., tactile aids: Braille alphabet, etc.) and adjusting the environment to facilitate functioning of people with visual/auditory impairments. The problem with autism specific sensory perceptual difficulties is that they are often ‘invisible’ and undetected. The matter is complicated by the fact that autistic individuals are very different in their sensory perceptual profile. Treatment programmes that are appropriate and beneficial for one child may be painful and harmful for the other. Thus, if the ‘right problem’ is addressed, the child gets more chances to benefit from the treatment.

Likewise, we never blame a blind child when he cannot name the colours of the pictures we show him, or never expect a deaf child to come when we call him from 2 rooms away, we should not demand from a child whose disability is not straightforwardly visible to ‘behave himself’, but we’d better try to find out the reason for his ‘misbehaviour’. We accept that we cannot cure blindness and we do not waste time and effort to teach a visually impaired child to recognize the colours while using a bar of chocolate as a reward. We see our task to help a blind child function using different ways and compensatory strategies, and adjusting the environment to make it easier for him to orient in space. We accept and respect his disability that, if appropriately addressed, does not interfere with the quality of life.

While people with ‘visible’ disabilities, such as, e.g., visual/hearing impairments or cerebral palsy, are provided with special tools to lessen their problems (glasses, hearing aids, wheelchairs, etc.) autistic children with ‘invisible’ sensory processing problems are often denied any support to accommodate their difficulties.
Whatever educational approach is implemented (TEACCH, Applied Behaviour Analysis, etc.) sensory interventions are vital in order for the child to benefit from it. To effectively teach and treat autistic children it is necessary to understand how the qualitative differences of sensory perception associated with autism affect each particular child. Often it is not the treatment and the number of hours you work with your child, but in ‘what perceptual world’ you both are, i.e., whether you are in one and the same perceptual world or in two different ones.

The first step to make in the direction of addressing these problems is to recognize that they do exist. We must understand how the child experiences the world through each of the channels and how he interprets what he sees, hears, feels, etc. in order to design treatment programmes in accordance with his perceptual abilities and deficits. Understanding each particular person’s specific difficulties and how they may affect this person’s functioning is vital in order to adopt methods and strategies to help the person function in the community.
We can distinguish some features of ‘autistic perception’ of the world, based on the testimonies of high-functioning autistic individuals and close observation of autistic children. Below we will discuss just a few of many commonly reported perceptual phenomena experienced by autistic individuals.

These experiences are not unique. We all may ‘feel strange’ sometimes and have similar experiences now and then, especially when tired or drugged. What is unique about these experiences in autism is their intensity and continuity: these experiences are ‘normal’ for them.

'Literal perception': Autistic people seem to perceive everything as it is. It is sort of ‘literal perception’, e.g., they may see things without interpretation and understanding (literal vision).

Inability to distinguish between foreground and background (‘Gestalt perception’):
There is much evidence that one of the problems many autistic people experience is their inability to distinguish between foreground and background stimuli (inability to filter foreground and background information). They are often unable to discriminate relevant and irrelevant stimuli. What is background to others may be equally foreground to them; they perceive everything without filtration or selection.

As Donna Williams (1996) describes it, they seem to have no sieve in their brain to select the information that is worth being attended. It can be described as ‘gestalt perception’, i.e. perception of the whole scene as a single entity with all the details perceived (not processed!) simultaneously. They may be aware of the information others miss, but the processing of ‘holistic situations’ can be overwhelming.

Their difficulty to filter background and foreground information caused by gestalt perception leads to rigidity of thinking and lack of generalization. They can perform in the exactly same situation with the exactly same prompts but fail to apply the skill if anything in the environment, routine, prompt, etc. has been even slightly changed. For example, the child can perform the task if he is being touched on the shoulder and fails if he has not been given the prompt. Or a familiar room may seem different and threatening if the furniture has been slightly rearranged, etc. These children need sameness and predictability to feel safe in their environment. If something is not the same, it changes the whole gestalt of the situation and they do not know what they are expected to do. It brings confusion and frustration. The strategy is to always communicate to the child beforehand, in a way he can understand (i.e., visual, tactile, etc.) what and why will be changed. Changes should be gradual, with his active participation. Paradoxically, autistic people have much more trouble with slight changes than with big ones. For example, they can cope with going somewhere unfamiliar much better than with changes in the arrangement of the furniture in their room. The explanation of this phenomenon lies in the gestalt perception. Their encounter with new information is a new gestalt, which will be stored, while any changes in the ‘familiar gestalt’ bring confusion: on the one hand, it becomes a completely ‘new picture’, on the other hand, in the familiar situation they are confronted with an unfamiliar environment.

On perceptual level the inability to filter foreground and background information may bring sensory overload. Children are bombarded with the sensory stimuli. They are ‘drowned’ in them. For individuals with ‘auditory gestalt’ perception, e.g., a lot of effort should be made to understand what is being said if there is more than one conversation going on in the room or more than one person speaking at a time. They are bombarded with noises from all directions. If they try to screen out the background noise they also screen out the voice of the person they try to listen to.
The task should be to find out which modality does not filter the information and then to make the environment ‘visually/auditorily, etc. simple’. The next step would be to teach the person ‘to break the (visual/auditory/tactile/olfactory/gustatory) picture’ into meaningful units.

Here arises the question: Does the explanation of ‘gestalt perception’ contradict the ‘weak central coherence theory’ (Frith, 1989) in autism? No, it does not. The theory of weak central coherence ‘starts working’ at the next stage of the process of perception when gestalt perception inevitably leads to distortions and fragmentation, in order to limit the amount of information to be processed.
Gestalt perception is often overwhelming and may lead to all sorts of distortions during the processing of information, such as fragmented perception, hypersensitivity, delayed processing, etc.

Hypersensitivity and/or hyposensitivity:
In the case of hypersensitivities, even ‘visually/auditorily, etc.’ quiet environment may cause overstimulation and challenges for the child. Autistic people must be protected from painful stimuli. For example, in the case of visual/auditory hypersensitivity) visual and auditory distraction should be kept to a minimum. Tactile hypersensitivities should be addressed by choosing the clothes and fabrics the child can tolerate. Wearing tight clothes that apply pressure helps to reduce self-stimulatory behaviours. It is important to remember, that if you cannot hear/see/smell, etc. some stimuli, it does not mean that the child ‘is being stupid’ if distressed by ‘nothing at sight’. It is vital to consider the level of ‘sensory pollution’. If there are several conversations in the same room, plus fans working plus people moving around plus fan working two rooms away… the child with sensory hypersensitivities is sure to be overwhelmed. There are many challenging behaviours (self-injury, tantrums, aggression, etc.) that can be dealt with effectively by simply changing the environment.

However, if a child is hyposensitive, extra stimulation through the channels that do not get enough information from the environment should be provided.

As each child is unique, very often we can find children with different hyper- or hyposensitivities in one and the same classroom. It is often very difficult to adjust the environment to satisfy needs of several children as the same stimuli may cause pain in some children and bring pleasurable experiences in others. The knowledge about each child’s sensitivities can help the teacher to plan the activities and address each child’s particular needs.

We can get a lot of information from watching repetitive behaviours. These behaviours are the key to understanding the way the child experiences the world, the problems he faces and the strategies he has acquired to cope with his difficulties.
Consciously or unconsciously the child tries to regulate the environment and his responses to it and acquires defensive strategies and compensations for his deficits. The child shows us his way to cope with his problems. That’s why, no matter how irritating and meaningless these behaviours may seem to us, it is unwise to stop them without learning the function they serve and introducing experiences with the same function.

Repetitive behaviours in autism are multi-functional. They may be:
defensive: in order to reduce the pain caused by hypersensitivities;
self-stimulatory: to improve the input in the case of hypersensitivity;
compensatory: to interpret the environment in the case of ‘unreliable’ channels;
just pleasurable experiences that help to withdraw from confusing environment.
These behaviours will change with the child's changing abilities. As deficits in one area interact and affect other areas, improving functioning in one sensory modality may bring improvements in the others. For instance, reducing visual hypersensitivities (with the help of tinted glasses, e.g.) may make auditory and tactile stimuli less overwhelming.

By looking at how the child reacts, it is possible to reconstruct and assess the child’s problems in various sensory channels. The child’s ‘self-prescribed’ movements (rocking, flapping hands, jumping, etc.) give a very clear idea of what the child needs.
For example, if a child frequently covers his ears (even if you do not hear any disturbing sounds) it means his hearing is hypersensitive, and it is your job to find out which sounds/noises disturb him. If a child flicks his fingers in front of his eyes, he might have problems with hypersensitive or hyposensitive vision. Children who like crowds, noisy places have either mild sensory problems or are hyposensitive.
If we interpret these behaviours, we will be able to imagine (if not fully comprehend) how the child perceives the world and help the child develop strategies to cope with these (often painful) sensitivities.

However, one of the difficulties in interpreting the child’s behaviour caused by sensory processing differences is our own ‘non-autistic’ sensory function. We have to train ourselves to perceive and understand the world from the individual’s perspective. Only then will we join the person ‘on his territory’, in his perceptual world and will not have to live in two parallel ones.

Inconsistency of perception (Fluctuation between hyper- and hyposensitivity):
One of the baffling features of autistic people is their inconsistent perception of sensory stimuli. A child who appears to be deaf on one occasion may react to an everyday sound on another occasion as if it is causing acute pain; visual stimuli that may appear so bright on one occasion will on another occasion appear very dim. Similarly, reaction to pain may vary from complete insensitivity to apparent “over-reaction” to the slightest knock (Jordan & Powell, 1990). At times it may appear that everything goes well, at other times the child may exhibit challenging behaviours under similar environmental conditions.

Fragmented perception (Perception “in bits”, stimulus overselectivity):
Because of gestalt perception, when too much information needs to be processed simultaneously, very often people with autism are not able to ‘break’ the whole picture into meaningful units and to interpret objects, people, and surroundings as constituents of a whole situation. Instead they process ‘bits’ that happen to get their attention.
This fragmented perception can affect all the senses.

One of the theories attempting to explain this phenomenon is the Central coherence theory formulated by Uta Frith (1989) and developed by Francesca Happe (1994). According to this theory people with autism lack the ‘built-in form of coherence’ (Frith, 1989) and, as a result, they see the world as less integrated, i.e., analytically rather than holistically.

In contrast to weak central coherence hypothesis in autism, one may hypothesize that people with autism possess a very strong drive for coherence (i.e., holistic perception of the world) with the main difficulty being to break the gestalt into meaningful units in order to analyze them separately. Without perceiving separate units as integrated parts of a whole, it is impossible to interpret the situation. Fragmented perception caused by inability to ‘break gestalt’ into integrated and meaningful parts fits into the definition of weak central coherence. Thus, we may conclude, that weak central coherence theory may be applied at later stages of sensory perceptual processing.

In the state of fragmented perception, the person has a great difficulty to deal with people as not only they seem to consist of many unconnected pieces but also the movements of these ‘bits of people’ are unpredictable. The strategy to cope with the problem is to avoid people and never look at them. It does not mean that they cannot see an entire person (perceptual level). They seem to be unable to process the meaning of an entire person but process them bit by bit instead. As a result the mental image of a ‘collection of bits’ is often meaningless and often frightening. Fragmentation complicates the interpretation of facial expressions and body language and thus hinders or even blocks the development of non-verbal communication.

Fragmentation may be felt in all sensory modalities. For example, Alex, an autistic boy, is sure that he (like everybody else) has two foreheads and always asks his mother to kiss ‘both’ - ‘this one and that one’.

Perception ‘in bits’ results in that autistic individuals define people and places and things by these bits. They can suddenly find once familiar things to be strikingly unfamiliar if slight components are changed, such as when the furniture has been moved or someone does not wear the same coat as usual (Williams, 1996). As they process what they perceive piece by piece and not as a whole, they recognize things and people by the ‘sensory pieces’ they store as their definitions. E.g., they may ‘recognize’ their mother by the colour of her dress and may not ‘recognize’ her if she wears a dress of different colour, or they may know people and objects by smell, sound, intonation, the way they move, etc.

Routine and rituals help to facilitate understanding of what is going on and what is going to happen. Introduce any change very slowly and always explain beforehand what and why is going differently. Structure and routines make the environment predictable and easier to control.

Delayed perception (delayed processing):
It is not uncommon for autistic children to exhibit delayed responses to stimuli:
A person can be delayed on every sensory channel.
In the most extreme cases, it can take years to process what has been said. Sometimes it takes days, weeks or months. The words, phrases, sentences, sometimes the whole situations, are stored and they can be triggered at anytime. In less extreme cases, to process something takes seconds or minutes. They may be able to repeat back what has been said without comprehension that will come later.
Due to delayed processing autistic individuals may need some time to process the question and their response. (Immediate responses are often given on ‘autopilot’, triggered by memories). Before proper response autistic people must go through a number of separate stages in perception, and if this long decision-chain is interrupted by the outside world, the autistic person must start all over again because overselectivity has changed the scene completely (VanDalen, 1995). In other words, an interruption effectively wipes away any intermediate result, confronting the autistic person literally “for the first time” with the same object/event/situation”.

Vulnerability to sensory overload:
Many autistic people are very vulnerable to sensory overload. They may become overloaded in situations that would not bother other people. A child vulnerable to sensory overload needs to be in control of his environment. Learning to recognize sensory overload is very important. It is better to prevent it. A child may need a quiet place (the ‘isle of safety’) where he can go to ‘recharge his batteries’ from time to time. ‘First Aid Kit’ (for sensory overload) should be always at hand. Possible contents are sunglasses, ear plugs, squeezy toys, favourite toys, ‘I need help’ card, etc.
Autistic children seem to develop (voluntarily or involuntarily) the ability to control their awareness of incoming sensory stimuli in order to survive in the world bombarding them with extraneous information. These compensatory or defensive strategies are reflected in acquired perceptual styles.

Mono-processing:
To avoid overload of sensory information, only one modality is processed consciously by the brain. The person might focus on one sense, for example, sight, and might see every minute detail of the object. However, while his vision is on, the person might lose the awareness of any information coming through other senses. Thus, while the person sees something, he does not hear anything, and does not feel touch, etc. When the visual stimulus fades out, the sound could be processed, but then the sound is the only information the person is dealing with (i.e., disconnected from sight). As the person focuses on only one modality at a time, the sound may be experienced louder because it is all the person focuses on (hypersensitivity).
The individuals with autism define this ‘mono’-processing (monotropism) as one of their involuntary adaptations to avoid sensory overload or hypersensitivity:
We should be aware of this style of perception in order to give the child information in a way he will be able to process it. The matter is complicated by the fact, that they could switch channels and our task is to find out which channel ‘is open’ to get the information.

Peripheral perception (Avoidance of direct perception):
One of the characteristics of autism is avoidance of eye contact. It is an example of peripheral perception, as it turns out that avoidance of direct perception is not restricted only to vision but also includes other sensory systems. Direct perception in autism is often hyper. It can cause sensory overload resulted in switching to ‘mono’. Autistic children often seem to look past things and are completely ‘absent’ from the scene. However, it could be their attempt to avoid experiencing a visual/auditory stimulus directly. This strategy gives them the ability to take in sensory information with meaning.
Perceiving sound, visual stimuli, etc. directly and consciously may often result in fragmentation: the person can interpret the part but lose the whole, and incoming information is interpreted piece by piece. Donna Williams (1996) explains that when taking things indirectly, peripherally, the fragmentation did not happen; things were more cohesive, they retained context, whereas the mind-jolting senses of direct vision and direct hearing could not be consistently relied upon as meaningful primary senses.
Some autistic people seem to be hypersensitive when they are approached directly by other people. For some, if they are looked at directly, they may feel it as ‘a touch’ - sort of ‘distance touching’ with actual tactile experience.
Avoidance of direct perception for them is another involuntary adaptation that helps them to survive in a sensory distorted world by avoiding (or decreasing) information overload.

Systems shutdowns:
When the person cannot cope with sensory information, he may shut down some or all sensory channels. Many autistic children are suspected to be deaf, as they sometimes do not react to sounds. Their hearing, however, is often even more acute than average, but they learn to ‘switch it off’ when they experience information overload.
A child with sensory overload learns to avoid overwhelming sensory bombardment early in life. When sensory input becomes too intense and often painful a child learns to shut off his sensory channels and withdraw into his own world.
Systems shutdowns may be considered as an involuntary adaptation (compensation) when the brain shuts certain systems off to improve the level of functioning in others (Williams, 1996).

Compensating for unreliable sense by other senses:
Because of hypersensitivity, fragmented, distorted perception, delayed processing, sensory agnosia, one sense is never enough for autistic people to make sense of their environment. Thus, in the case of visual distortions and meaning-blindness, they use their ears, nose, tongue or hand to ‘see’, i.e., they compensate their temporary ‘blindness’ through other senses. For example, a child can tap objects to produce the sound in order to recognize what it is, because visual recognition can be fragmented and meaningless. Some children smell people and objects to identify them. To many autistic people the senses of touch and smell are reported to be more reliable. Many autistic children touch and smell things, some constantly tap everything to figure out where the boundaries are in their environment, like a blind person tapping with a cane. Their eyes and ears function, but they are not able to process incoming visual and auditory information (Grandin, 1996). Those who experience visual and auditory distortions prefer using touch to learn about their environment - they ‘see’ the world mostly through their fingers.
The ability to perceive accurately stimuli in the environment is basic to many areas of academic, communicative and social functioning. As autistic people do have ‘differences’ in this area, it is important for those who work and/or live with autistic children to be able to identify these and to understand how these differences might relate to the problems autistic individuals experience in learning and in general functioning. This will enable the provision of more effective programmes of learning and treatment.

The sensory problems in autism are often overlooked. As children are unable to cope with the demands of the world they are not equipped to deal with, they are likely to display behavioural problems, such as self-stimulation, self-injury, aggression, avoidance, rigidity, high anxiety, panic attacks, etc. It is important to remember that these children have no control over their problems, as they are caused by some neurological differences.

The unique characteristics of each child will require unique individual strategies, techniques and environmental adjustments to be implemented. There is no single strategy for all autistic children as each of them exhibits a very individual sensory profile. Moreover, with age the strategy that was very useful for this particular child may not work any more and should be replaced by another one to reflect the changes in the child’s abilities to function.

As some sensory dysfunction is present in all individuals with autism it would benefit parents of autistic children and professionals working with them to become more knowledgeable about sensory perceptual problems they experience and possible ways to help them.

However, we need to stop trying to change them into ‘normals’. The aim of any intervention should be to help autistic individuals to cope with their problems and to learn to function in the community. Whatever treatment programme or therapy is used, it does not make them “less autistic”. However, increased self-knowledge can lead to better compensations for one’s difficulties, which in turn may decrease symptoms and make the autism less disabling (Gerland, 1996).

Whatever approach/treatment is chosen the person working with the child should make the environment ‘sensorily safe’ for the child and try to ‘move in the same sensory world’. Many behaviours that interfere with learning and social interaction are in fact protective or sensory defensive responses of the child to ‘sensory pollution’ in the environment.

Autistic people are vulnerable to being abused. They have to live in the world which is not designed for them, and they have to deal with people who, while being aware of the difficulties they experience, often overlook the effort they are making trying to survive in the world, which is not designed for them. If we look at their ‘bizarre’ behaviours and responses through their eyes, they make sense. Our behaviours may equally seem ‘bizarre’ to autistic persons. For example, how could one enjoy fireworks if your eyes are hit with ‘bunches of bright arrows’ and the sound in your ears ‘tears them raw’?

We often do not understand the ‘autistic perspective’, the problems they experience. And sometimes our ‘treatment’ does more harm than good. Let us take some examples.

The family was struggling to find the solution to a challenging behaviour of an 8-year-old autistic boy. The boy removed his clothes at any opportunity no matter where he was. The mother asked for advice from a ‘specialist’. And the advice was to encourage (?) the boy to keep his clothes on and reward him (with a chocolate biscuit) when he complies. If we look at this situation from the ‘autistic perspective’, tactile processing problems are obvious. The boy himself was aware of which fabric would ‘hurt’ him and tried to protect himself. His ‘clues’ were not recognized by the people involved. We could interpret the intervention as follows: A person with broken legs is encourage to run and promised to be rewarded with a chocolate biscuit. Would you run?

Another situation: At one of the autistic provisions a teaching support assistant is happily whistling and singing. Josh, an 11-year-old autistic boy with hyperhearing, is rocking back and forth. He covers his ears with his hands, but it does not seem to work and he pushes his index fingers inside his ears. No effect. Then he pleads with his ‘helper’: “Loraine, stop singing please. Stop it!” The reaction of the support worker? “Why should I? Don’t be stupid, Josh.”

If we look at the same situation from Josh’s perspective we could interpret it as a sensory assault of the child. For this boy ‘the singing’ (whether it was the pitch of the voice or the sounds of whistling he could not tolerate) physically hurt his ears, as if the helper threw stones or litter at him. So why should she stop?

The sensory environment is very important for autistic people. They lack the ability to adjust to sensory assaults other people accept as normal. If we accommodate the environment and try to ‘keep it clean’ in order to meet their very special needs, the world could become more comfortable for them. With sensory needs met, problem behaviour becomes less of an issue. If there were no danger to be attacked, you would not need defense. To make the world safer for autistic individuals the price would not be very high - ‘just stop singing’ when they ask you to. And if they cannot ask because of their communication problems, use your knowledge and imagination to find out what they need.
References
Delacato, C. (1974) The Ultimate Stranger: The autistic child. Noveto, CA: Academic Therapy Publications.
Frith, U. (1989) Autism: Explaining the Enigma. Oxford: Basil Blackwell.
Gerland, G. (1998) ‘Now is the time! Autism and psychoanalysis.’ Code of Good Practice on Prevention of Violence against Persons with Autism. (Pp. 31-33) Autism-Europe publication.
Grandin, T. (1996). Thinking in Pictures and Other Reports from My Life with Autism. New York: Vintage Books.
Happe, F. (1994) Autism: An Introduction to Psychological Theory. London: UCL Press.
Jordan, R. & Powell, S. (1990) The Special Curricular Needs of Autistic Children: Learning and Thinking Skills. London: The Association of Heads and Teachers of Adults and Children with autism.
Morris, B. (1999) ‘New light and insight, on an old matter.’ Autism99 Internet Conference papers www.autism99.org
O’Neill, J. L. (1999) Through the Eyes of Aliens: A book about autistic people. Jessica Kingsley Publishers.
Rimland, B. (1964) Infantile Autism: The Syndrome and Its Implications for a Neural Therapy of Behavior. New York: Appleton Century Crofts.
Sinclair, J. (1993) ‘Don’t mourn for us.’ Our Voice, Vol. 1, No. 3.
VanDalen, J. G. T. (1995) ‘Autism from within: Looking through the eyes of a mildly afflicted autistic person.’ Link, 17, 11-16.
Williams, D. (1996) Autism. An Inside-Out Approach. London: Jessica Kingsley Publishers.

PERCEPÇÃO SENSORIAL NO AUTISMO E SÍNDROME DE ASPERGER


A capacidade de perceber com precisão os estímulos do ambiente é fundamental para muitas áreas do funcionamento académico, social e comunicativo. Embora as pessoas com autismo vivam no mesmo mundo físico e lidem com a mesma “matéria prima” do mundo, a sua percepção é notavelmente diferente do de pessoas não-autistas. É amplamente reconhecido que as pessoas autistas têm experiências sensoriais e perceptivas 'incomuns' que podem envolver hiper ou hipo sensibilidade e uma flutuação entre os diferentes "volumes" da percepção e da dificuldade em interpretar o sentido muitas vezes, ignorado por muitos profissionais, este é um dos principais problemas destacados pelos indivíduos autistas.
A formação  é fundamental para pais, professores, educadores  e todos os profissionais que trabalham com indivíduos autistas e aspergers, de forma a compreenderem plenamente as diferenças de percepção sensorial no autismo. 

Oradora: Olga Bogdashina
Datas: 21 e 22 Setembro

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