Category Archives: Autism

Attachable FootFidget® Footrest

Flexible Seating Options in The Classroom & Home Learning Environments

Autism, Sensory, , , , , ,

Allyson Locke M.S., OTR/L

In this post we take a dive into flexible seating options that are available for classroom and home  learning environments.

First, What Does Flexible Seating Mean?

Sometimes called alternative seating, flexible seating is simply a seating option that is different from ‘traditional’ seating arrangements and is often used to address a sensory need. Traditional seating arrangements may be things like the desk chair students use in a classroom, the dining room chair at the eating table or the office chair at a work desk. Flexible  seating arrangements  may be a therapy ball in place of an office chair or it may be a beanbag in place of the traditional student desk setup. Read on to learn more!

classtoom showing traditional desks attached to chairs
Traditional Classroom Seating
Flexible seating arrangement showing a boy sitting on a Kore Wobble Stool and working at a Kore Sit to Stand Mobile desk.
Example of a Flexible Seating Arrangement with the Kore Sit to Stand Mobile Desk

Next, Understand the Importance of Flexible Seating Options in Learning Environments.

Having a variety of seating options helps to ensure all learners have a setup that is most effective for their learning style. Some options may help to address underlying sensory needs while other options  provide the movement that has been shown to be preferred by students when learning (Cole et al., 2021, 72).   Having just the right seating arrangement can make the difference between a successful learning experience and one that is full of distractions, position changes, and learning sessions that don’t  last as long as they should.

Finally, Pick the Right Seating Options. 

Understanding the need (or needs) you are trying to address will help you determine the best seating option(s).

For the wigglers, movers, and bouncers who just need a little extra sensory input to focus and sustain attention, try a seating option that provides movement (vestibular) or light touch (tactile) input. A seating option that provides tactile or vestibular input will help the sensory system that is seeking movement, get it in a way that is more conducive to learning and working. 

chair with wobble feet attached

Wobble Feet: These are simply four, rubber domed shape ‘feet’ that slip onto a standard chair leg.  The Wobble Feet provides a subtle rocking and a soft bounce feel.  These are especially popular for users who are looking for a “low profile” option; they can be slipped onto a regular classroom chair and are small enough that they are not very noticeable in the sea of classroom chairs. 

red and blue senso spot seats, round disks to sit on with a textured side

Sensory Spots: Spot Sensory Seats and Senso Seat Pads are flat pads that have a textured side.  This textured side provides subtle sensory input without much challenge to postural stability. They can be used in just about any seating situation and can easily roll up when moving seats.

wiggle seat sensory cushion, butterfly shape, basketball shape, flower shape, and monster shape

Cushions: Air filled or foam cushions can be added to just about any chair, bench or even used on the floor.  They are usually round or wedge shaped but newer versions now offer fun shapes like monsters or flowers.  The amount of air, that can be added, to the air filled cushions is typically adjustable allowing for users to increase or decrease the amount of movement offered.  Cushions are generally portable making them a great option for those who change work areas throughout the day.  For even more convenience options with handles are now available!

Wobble Stools: The Kore Wobble Chair offers a seating option much like sitting on a stool with the exception of the innovative rounded bottom that allows the user to rock in all directions.  In addition to the rocking movement the stool shape allows more freedom to move the legs in different positions.  

the alert seat a large round ball inside a metal base with wheels for sitting

Ball Chairs: Ball chairs come in all shapes and sizes. At the most basic level a large therapy ball is used in place of a chair. This is a great option for users who need a lot of input but therapy balls are unstable and can be difficult for users with poor postural control.  A base can be added under the ball to help prevent the ball from moving out of position.  Another option is to use a peanut or egg shaped ball; these balls have an elongated shape that increases stability for the user.  The  Alert Seat puts the traditional therapy ball on a wheeled base allowing for more mobility.  The Ball Chair Deluxe  takes the shape of a traditional office chair but replaces the seat with a large inflated ball.

For the fidgeters, hair twirlers and those with a little extra nervous energy try a seating option that provides deep pressure input or gives the big muscles a chance to work. This type of input can help calm an anxious or overstimulated sensory system. Try:

foot swing, a small plastic stand that goes on the floor under a work space. it has two pedals to place the feet. the peals move back and forth

Body fidgets. Unlike smaller, handheld fidgets, body fidgets allow other parts of the body to interact with the fidget leaving the hands free for work.  Foot fidgets can be attached to chair or desk legs, allowing users to kick, push and pull the heavy elastic bands with their feet.  For users who frequently change work spaces portable foot fidgets are available; these can be placed under the workspace and interacted with in the same manner. The footroller is a unique body fidget; fidgeters place their foot on the roller, spinning it forward, backward or both ways. Another unique option is the Foot Swing; the foot swing allows for a silent swinging motion of both feet, independent of each other. 

boy sitting at a desk with ta weighted neck wrap around his neck and resting on his shoulders

Weight. Adding weight to the lap or shoulders is a great way to center, orient and calm an over responsive or anxious system. An added bonus, many offer textured covers for additional tactile input.

For those who just need a change of scenery, setting up an alternative work spot is a great way to refocus.  Some options include: 

  • Standing at a counter height work space or taping work to a wall are options to allow for standing positions while working. To add a little dynamic movement try standing on a foam wedge or air cushion.
  • Laying Down.  Working while laying on the stomach is a great way to provide proprioceptive input through the shoulders joints (perfect for those needing calming and organizing input).  This position also gives students who are struggling with postural instability to get more support so they can focus on their work and not on staying stable!  Use yoga mats or cushions to provide comfort and a clipboard or slant board as a work surface. 
  • Get Cozy.  Another option for a position change is sitting in a bean bag, Howda Designz Chairs or the Comfy Cozy Peapod Chair.  While not the best option for all types of tasks these options are great  when the activity involves reading or listening. The deep pressure input provides calming and organizing input.

Having a  variety of seating options available in any learning space is a sure way to increase focus and attention.  Identifying options that are appropriate for the user and the environment are keys for successful implementation. 

Reference:

Cole, K., Schroeder, K., Bataineh, M., & Bataineh, A. (2021, April). Flexible Seating Impact on Classroom Environment. The Turkish Online Journal of Educational Technology, 20(2), 62-74.

Making April Autism ACCEPTANCE Month

Autism

Claire McCarthy

April brings the beginnings of warm weather. It brings more time spent outside and the return of the birds who went south for winter. It also brings Autism Awareness Month. Fundraisers are held for local and nationwide autism related organizations. Facebook and Instagram are full of memes, posts, stories, and quotes about autism. This is all great, but what happens on May 1st? What happens when the posts get buried under cute animal videos and the fundraising moves onto the next mission?

Now, don’t get me wrong. I think awareness is wonderful. However, most of the world is very aware of autism now. They know organizations exist for it. There are plenty of tv shows and movies that portray autistic characters. We see autism in the news. What we need to be striving for is Autism Acceptance. We need to be striving for a world where autistic individuals are valued as community members, coworkers, and friends. A world that values and honors autism 365 days a year instead of 30.

To begin the move towards Autism Acceptance, there are some key terms we should know.

  • Neuro diversity: a viewpoint that brain differences are normal, rather than deficits
  • Neurodivergent: people who have diagnoses such as ADHD, autism, OCD, dyslexia, etc.
  • Neurotypical: individuals of typical developmental, intellectual, and cognitive abilities
  • Ableism: discrimination in favor of able-bodied or neurotypical people

Most of us on this blog are familiar with autism. For those who may not be, it is defined as “a developmental disorder of variable severity that is characterized by difficulty in social interaction and communication and by restricted or repetitive patterns of thought and behavior”. It is deficit based. There is nothing wrong with acknowledging the challenges seen in an autistic individual. However, let’s flip that around with a quote from NeuroTribes and define neurotypical: “Neurotypical syndrome is a neurobiological disorder characterized by preoccupation with social concerns, delusions of superiority, and obsession with conformity. There is no known cure.” Makes one think a little, doesn’t it?

To continue on a path of autism acceptance, we also need to target the myths around autism. One I hear all the time is, “S/he can’t be autistic. S/he speaks so well.” The DSM-5 and DSM-5-TR say nothing about verbal communication deficits in regards to autism. “Accompanying language impairment” can be added to an autism diagnosis, but having typical spoken language skills does NOT mean an individual is not autistic.

Another common misconception is that every child who receives an autism diagnosis must receive Applied Behavior Analysis (ABA) services and must be eligible for an Individualized Education Plan (IEP) when they reach 3 years of age. Yes, ABA is one of the few evidence based autism specific teaching methods. This research dates back to the 1960s when autism rates were 1 in 2,500 people. This research was done on individuals that would be considered “low functioning” and often had accompanying Intellectual Disability. Autistic learners needs to be seen as individuals the same way that neurotypical learners are seen.

That last paragraph brings me to another issue that gets in the way of autism acceptance- functioning levels. Parents and therapists are so quick to get caught up in levels. Many people think that a functioning level can tell you all about the autistic individual. One of the problems with levels, though, is that it makes it harder to see past the diagnosis. When someone is diagnosed with “high functioning autism” people have a hard time understanding their challenges, honoring how hard that individual works day to day to appear high functioning, and sees less need for services. When someone is diagnosed with “low functioning autism” people don’t see their competence, assume lower intellectual capacity, and lower their expectations for the individual.

What can we do as therapists, parents, family members, and friends to change from Autism Awareness to Autism Acceptance? A simple place to start is to change our vocabulary. Try to ditch “red flags” or “symptoms” and replace them with “characteristics” or “learning profile.” Don’t be afraid to use “the A word” in your every day life. Talk about individuals being autistic the same way you would talk about someone wearing glasses or having black hair. Encourage children to ask questions about themselves or others. Using statements such as “don’t stare” or “mind your business” inadvertently tell children that what the autistic child or adult is doing is “wrong” or something to be ashamed of.

Along the lines of observing behaviors, remember that all behaviors serve a purpose. A tantrum or “noncompliance” is not the child being difficult or trying to upset an adult. They are letting us know they have had enough, do not understand what we are trying to do, or do not understand why we are trying to do something. Self-stimulating behaviors should not be a target in therapies. These are physical needs to self-regulate and make sense of a neurotypical world. The more an autistic individual suppresses the need to stim the more the individual will need to eventually “get it out” and it will likely be in a way that is not fun for them or others such as self-injurious behavior or a meltdown.

Some people may be reading this and thinking, “But what about all of the challenges? What about those who may never be able to live independently or have challenging behaviors day after day?” This blog is in no way saying that these challenges should be ignored. In fact, that would be just as ableist as saying the positive characteristics of autism should be ignored. What needs to be thought about is that we are not out there to “cure autism” or “teach a child to look typical.” We are out there to make an autistic person who has challenges become an autistic person with as little barriers in their life as possible.

One of the best things we can do is to listen to autistic voices. Autistic adults and children can teach us more about autism than any study or textbook can even begin to. Families who have loved ones with autism are also a wonderful resource. If it hasn’t been said clearly enough, the best thing to remember is that autistic individuals are just that- individual. They will all have different thoughts, feelings, and beliefs in regards to THEIR autism. Autism Acceptance begins with understanding that and valuing each individual for exactly who they are.

Saturday Seminar: Sensory Differences and Mealtime Behavior in Children with Autism

Autism, Events, Feeding Therapy, Filomena's Corner, Sensory

Jeanne-Zobel-LachiusaEvidence based practice (EBP) involves the integration of:

  1. Clinical expertise,
  2. Scientific research, and
  3. Patient/caregiver perspective.

The goal of EBP is the improvement of patient outcomes. It holds us accountable for our treatment plans, strategies and outcomes among our peers and other health care professions. According to the AOTA, generating research in the field of occupational therapy is “critically important for advancing the field and ensuring the viability of the profession.”

Jeanne Zobel-Lachiusa, EdD, OTR/L was the featured December Saturday Seminar Series speaker, who shared her research on Sensory Differences and Mealtime Behavior in Children with Autism (AJOT September/October 2015, Vol. 69, No.5).  In summary, the study results helped to identify problem eating behaviors in children with ASD that may be associated with sensory differences. Children with ASD were compared with typically developing age-matched peers. The study concluded that children with ASD who receive occupational therapy that offers sensory strategies might result in less stressful mealtimes.  The findings supported the need for further research in this area of self-care with children who have been diagnosed with ASD.

The seminar attendees were from varied backgrounds, including occupational therapy, speech therapy, special education, social work, psychology, child care, medicine, and parents. They engaged in a lively brainstorming session on sensory strategies in the different sensory domains that might provide mealtimes with less stress for both the child and family. They shared innovative as well as tried and true ideas with the group.

Just a few examples of the many suggestions include ideas for tactile and oral sensitivity:

Hush BuddyFor auditory sensitivity Jeanne suggested:

For children with sensitivity to fluorescent lights that flicker and glare in the cafeteria or classroom, Fluorescent Light Filters, which are magnetic were recommended. Another suggestion was for the student to wear a visor to reduce vision sensitivity.

Jeanne suggested a number of resources for the group including the book, Autism Interventions, and recommended the AOTA website for its user-friendly handouts on mealtime and feeding.

Producing research is essential for validating assessment and treatment strategies. Jeanne shared that her research was motivated by the question of whether interventions are actually effective.  Her current research demonstrated that there was a statistically significant difference in sensory differences and in mealtime behaviors between children with ASD and the typically developing group she tested.  This groundbreaking research paves the way for further studies to investigate specific treatment strategies discussed today for their effectiveness in helping make mealtimes a pleasurable experience for children diagnosed with ASD and their families.

To view Jeanne’s PowerPoint slides, click here.

Following the seminar, attendees provided feedback about the seminar.  Please see a few remarks below:

“It provided an opportunity to review recent literature and share strategies with other therapists.” Kristyn S., Occupational Therapist

“Loved the topic and the format. Jeanne was great!!   Diane H., Occupational Therapist

“Informative, interactive, insightful. It was interesting listening to other OTs experiences and suggestions.”  Sylvia K., OT student

“Helpful to organize sensory treatment with a food tolerance/mealtime behavior perspective.”  Anonymous Occupational Therapist

Thank you, Jeanne!

Filomena Connor, MS, OTR/L