Autism Theraphy

Play Therapy for Autism

Play therapy was originally conceived as a tool for providing psychotherapy to young people coping with trauma, anxiety and mental illness. In that context, play becomes a way for children to act out their feelings and find coping mechanisms.

This type of play therapy is still popular; however, it is NOT the same thing as play therapy as used for children with autism.

Most specialists offering something called "play therapy" to children with autism are actually providing something akin to Floortime Therapy. Floortime is a play-based technique which builds on autistic children's own interests or obsessions to develop relationships and social/communication skills. The Play Project is another therapeutic approach which uses play as a tool for building skills in autistic children. Like Floortime, it builds on children's own interests.

It is possible to be officially credentialed in Floortime therapy through a certification program that includes a wide range of content. This certification is offered through the Interdisciplinary Council on Developmental and Learning Disorders (ICDL), but is not recognized by any of the national therapeutic associations. Thus, most "play therapists" are not so much credentialed as they are experienced and/or trained. Of course, as with all autism treatments, the onus is on the parent to investigate the therapist's background, training and references, and to closely monitor progress.


Why Would a Person With Autism Need to See a Play Therapist?
Autism is largely a social-communication disorder. Children with autism find it extremely difficult to relate to others -- particularly to peers -- in ordinary ways. Instead of playing with toys in imaginative or symbolic ways (pretending a doll is really "my baby," for example) they may perseverate on objects, use them for self-stimulation, and become entirely self-absorbed.

Play is a wonderful tool for helping children (and sometimes even adults) to move beyond autism's self-absorption into real, shared interaction. Properly used, play can also allow youngsters to explore their feelings, their environment, and their relationships with parents, siblings and peers.

Very often, too, play therapy can allow parents to take an active role in their autistic child's growth and development. Play therapy can be taught to parents, and, over time, parents can become their child's therapist while also building a stronger, more meaningful relationship.



What Does a Play Therapist Do for People with Autism?
A good play therapist will get down on the floor with your child and truly engage him through the medium of play. For example, the therapist might set out a number of toys that a child finds interesting, and allow her to decide what, if anything, interests her. If she picks up a toy train and runs it back and forth, apparently aimlessly, the therapist might pick up another train and place it in front of the child's train, blocking its path. If the child responds -- verbally or non-verbally -- then a relationship has begun.

If the child doesn't respond, the therapist might look for high-interest, high-energy options to engage the child. Bubble blowing is often successful, as are toys that move, squeak, vibrate, and otherwise DO something.

Over time, the therapists will work with the child to build reciprocal skills (sharing, turn-taking), imaginative skills (pretending to feed a toy animal, cook pretend skills) and even abstract thinking skills (putting together puzzles, solving problems). As a child becomes better able to relate to others, additional children may be brought into the group, and more complex social skills are developed.

Many parents find they can do play therapy on their own, using videotapes and books as a guide. Others rely on the experience of trained play therapists. And still others choose to simply bring their children to a play therapist or have the therapist come to their home. In any case, play therapists can provide parents with tools to connect with and have fun with their children on the autism spectrum.
How Can I Find a Qualified Play Therapist?
Play therapy may be offered through a local early intervention program as a free service, or it may be incorporated into a special needs preschool program. It's unlikely to be incorporated into a schoolage public school program, though it may be possible to make the case that such a program is appropriate for your child. Outside of these programs, it is unlikely that play therapy will be covered by any kind of insurance, so it is up to the parent to find and pay for the therapist.

If you are looking for a certified Floortime specialist, go to the Floortime website (www.floortime.org) and look for a local therapist. If you don't live near a major city, it's unlikely you'll find such a person nearby, which means you may need to travel and/or work with the therapist at long distance. This is accomplished through a combination of shared videos and telephone conferences; while not ideal, this can be helpful.

If you're looking for someone local with experience and skills in play therapy in a more general way, you might find just what you're looking for in an occupational therapist or child psychologist with a specialty in autism. You might even find a play therapy program (usually a group program) offered through autism clinics, hospitals, or private service providers.

Oxygen therapy benefit in autism

A decompression chamber may help children with autism, say researchers.

After 40 hours of hyperbaric treatment autistic children showed significant improvements in social interaction and eye contact compared with controls.

The BMC Pediatrics study could not show if the results were long-lasting but should prompt further investigation of the treatment, the US team said.

One theory is that oxygen can help reduce inflammation and improve flow of oxygen to brain tissue.

Hyperbaric treatment - effectively giving high concentrations of oxygen at increased atmospheric pressure - has been shown to have some benefit in other neurological conditions such as foetal alcohol syndrome and cerebral palsy.

Some studies have looked at the treatment in children with autism but they have not compared with a dummy procedure raising questions around a "placebo effect".

In the latest study, carried out at six centres in the US, 62 children aged two to seven with autism were randomly assigned to receive 40 hours of treatment over a month with 24% oxygen at increased atmospheric pressure (1.3 atm) or normal air in a slightly pressurised room (1.03 atm).

Children who received the treatment showed significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory or cognitive awareness.

In all, 30% in the treatment group were rated by doctors as "very much improved" or "much improved" compared with 8% of those in the control group.

Overall, 80% in the treatment group improved compared with 38% of controls.

Behaviour

Study leader, Dr Dan Rossignol from the International Child Development Resource Centre, in Florida, said the use of hyperbaric therapy for autism has been gaining popularity in the US where parents can buy their own hyperbaric chamber if they have a spare $14-17,000.

He said the findings would be quite controversial and he too was initially very sceptical of the idea but was prompted to do more research after the treatment showed benefits for his two sons who have autism.

"We're certainly not talking about a cure, we're talking about improvements in behaviour, improving certain functions and quality of life.

"The next step is to try to find out which kids do respond, because it's an expensive treatment - it may be that kids with more inflammation respond better.

"It would also be nice to know how long the treatment lasts, and the finding needs to be confirmed."

Richard Mills, research director at Research Autism, said this was the first well-designed study looking at the therapy.

"We know this kind of therapy is useful in a number of neurological conditions and that's been well established.

"What we don't know is how useful it is in autism, what we could be seeing is an improvement in other neurological conditions that go alongside autism.

"We also don't know about long-term effects - it could be a transitory effect."

Professor Philip James, an expert in hyperbaric medicine at the University of Dundee, said the pressure used was no more than that used to pressurise an aircraft cabin on the ground.

He added that oxygen was the "controller of inflammation" but also had other effects on regulation of genes and tissue regeneration.

But even if proven, the treatment may not be for everybody.

"When you have any condition, there are people who have too much damage to get better."

"All the oxygen is doing is bringing things towards normal."

ECT Therapy

In recent years autism has been the focus of much attention. Parents worry about identifying the disorder in their children at a young age.

Scientists puzzle over the combination of biological and environmental factors that lead to autism, as well as how best to treat this enigmatic condition.

A new case report suggests an intriguing new approach for correcting some of the most severe behavioral problems associated with autism.

Autism is a developmental disorder that is characterized by deficits in language, social and behavioral skills. Autism represents a broad spectrum of disorders that range from mild to severe. A particularly severe symptom includes self-injury, or the act of hitting oneself so that it leads to tissue damage.

Many symptoms of autism are treated through medications or behavioral approaches. Both approaches often work well for individuals and have even proven effective in preventing self-injury.

Lee Wachtel of the Kennedy Krieger Institute presented a case report of an eight-year-old autistic boy with severe self-injury behaviors that were not responsive to treatment in a recent journal article.

Wachtel collaborated with colleagues at Hopkins Hospital and the University of Mississippi Medical Center, and they proposed the controversial treatment of electroconvulsive therapy (ECT) in this case.

They report that this boy, known as D., maintained self-injurious behaviors despite many different medical and behavioral interventions. This boy often was restrained with padded equipment to prevent serious injury from occurring. However, he still attempted to make hitting movements while restrained.

When observed without restraints over a 24-hour period, D. was reported to have hit himself in the head an average of 109 times per hour. Because of the high frequency of self-injury incidents, D. was unable to participate in structured school programs or family activities.

D.'s physicians felt that this damaging behavior might be ameliorated through ECT. ECT maintains a link with the shock therapy of early psychiatry, which was used on patients with a variety of mental illnesses.

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