Thursday, May 26, 2011

How Does Your Engine Run?

I have been attending the Autism One Conference over the past few days. There are a ton of really great sessions, and the interesting thing to me is that the information doesn't just apply to autistic kids - or in some cases just to kids at all. I have come away with so many things to think about and tactics to use with myself and with both the wee ones.

This is the first of my posts on many sessions. This was the presentation by Mary Sue Williams, OTR/L and Sherry Shellengerger, OTR/L on their "How Does Your Engine Run?" and The Alert Program. More information can be found on their website The Alert Program by Therapy Works, Inc.

We all need to be regulated to effectively navigate our world. That holds true whether we have special needs, like Mister Man, or whether we are completely neurotypical (or “normal” to the rest of the world). Every day we do things that helps us regulate ourselves so that we’re in the right frame of mind to function. And when we don’t… we aren’t functioning well.

Have a habit of chewing on straws? Do you tap your feet when you’re bored? When you talk on the phone, do you doodle on paper? Or maybe you twirl your hair? Or are you someone who takes a bath or a long walk when you need to calm down? All of those are things that we do to self-regulate. The difference between what we “normal” people do and what those on the spectrum do is that they do it “longer and stronger,” according to Mary Sue Williams and Sherry Shellenberger who presented on “How Does Your Engine Run?” The Alert Program and Autism earlier today.

The two therapists presented on their “How Your Engine Runs” program and self-regulation strategies. I found it very interesting and – once again – applicable to so many people beyond just those on the autism spectrum. We do all need to be self-regulated, and that level of awareness or arousal varies based on what we’re doing at the time. If we think about it, our energy levels are very different at bedtime than they are if we just finished eating a big lunch versus being a kid coming in from recess versus sitting down to work. And our energy levels aren’t always where they need to be to successfully do what we need to do. Have you ever been to a football game after having been up way too late the night before? Our engines aren’t running nearly high enough for what’s appropriate in that situation. Or what about when we’ve drunk a few too many cups of coffee and need to sit down in a yoga class and meditate – our engines aren’t running low enough there.

The idea is that we all have engines, and they can run at different speeds. And we need different speeds for different situations, but they don’t always match up with what we need them to, nor do they always match with others in our environment. Picture that teacher who just finished a huge lunch having to corral the children who are coming in from playing at recess. The teacher’s engine is likely going to be running too low for where it needs to be, and the children’s engines are going to be revving far too high after their fun running around and playing. And the mismatch there is likely to lead to a not exactly optimal classroom situation until they get closer to where they need to be.

The ability to understand where all our engines are running – us as parents and those of our children, whether they are neurotypical or not – is sort of important in having successful interactions with others and functioning within our environment. Fortunately, the two therapists also presented several ways to help get us all self-regulating better.
So what is self-regulation? Essentially, it’s the ability to sustain or maintain and change a level of alertness appropriately for a task or situation. When you think of a high state of alertness, you think of someone who is high or wild or out of control. Someone who has a low state of alertness isn’t necessarily someone who needs more sleep but someone who still looks lethargic, droopy, or like a couch potato. The optimal state of alertness is where we are alert, focused, and attentive. And yes, that optimal state is different for different situations – again, picture yoga and that football game.

The Alert Program from Mary Sue Williams and Sherry Shellenberger uses an engine analogy to help kids attain an optimal state for learning attention and behavior. When they’re in a high state, it’s hard to remember to follow the rules. We all have engines; some of us are just need more help changing gears.

To help children tell us where their motors are and to help them understand what it means to them, there are different ways to explain it rather than just high, low and just right. Some children are good with sounds (Whoo! for running high, for example). You can also use colors as defined by children where red might be running high and green being just right. You can use Winnie the Pooh as a just right and Tigger as a high and Eeyore as the low engine. Or you can find something that is a special interest to them like dinosaurs or Star Wars – anything that will help them understand the concept. For some children, even this is too abstract, however. For them, you can try something more concrete like feeling how quickly your heart is beating. There are, also, some children who can’t understand even that in which case you can simply use the analogy with the adults in the situation – parents communicating with each other or between the parents and teachers sharing in a spiral notebook to help everyone understand how the child’s engine has been and help them understand how the child is doing and why.

A child who tends to have a high or a low engine will both have issues, though it obviously manifests itself differently. They aren’t in just one place on the engine spectrum, however. It will fluctuate throughout the day. Though it may always be low, sometimes it is a little higher or a little lower. Either way, it is hard to learn when our engines are running too high or too low.

For families, it’s really important to figure out the times of day when there are mismatches in engines – the times when Mom’s engine is running low and the kids’ engines are running high and the like. That’s when it’s even more important to get everyone to the just right point. That means Mom, too.

Being alert isn’t just “paying attention” the way our teachers told us in school. By second or third grade, we figured out that we could put our eyes on our teacher and not really be paying attention – instead we can look at them and think about something else entirely with our mind wandering. Or we could be focused on the teacher and absorbing the information while looking at our desks and doodling – because the doodling helps us to self-regulate and get our engine into the just right place to be able to learn. It isn’t about what how we get to learning always but the fact that we’ve found a way to allow us to focus enough to learn. We really want to watch our level of alertness at the beginning and the end of each activity and at transition times to make sure that we’re in the just right place – and that our children are.

The remainder of the session focused on how to get to the just right point. The theory? “When in doubt, do heavy work – pushing, pulling, tugging, or towing.” It works when our engines are high or when they’re low. We did an exercise to get us there, especially since this session happened right after lunch and our engines were starting to run low. We put our hands together in a prayer position and pushed hard, then relaxed twice. Then we cupped our hands together and pulled apart before relaxing twice. We put our hands behind our heads and leaned our heads back to stretch before putting our elbows together and looking down to stretch that way. We placed our hands over our heads and shook them, then shook each leg. The difference in our alertness was impressive. It didn’t last the whole rest of the presentation, but it was amazing to see how much of an impact it caused. And this is a simple thing that we can do – or that our kids can do.

My other favorite exercise was the shake exercise. I can see Mister Man really enjoying this one, as it’s a bit silly, but it worked even better than the previous one for getting us to the just right place – again this works whether our engines are running high or running low. They called it the shakes jar. Pretend like you’re holding a jar in your hands. Take a deep breath and blow it into your jar, which turns on the shaking. Shake it over your head. Then put the shakes into your head and shake your head. Pull the shakes out and back into your hands. Proceed to put the shakes in your shoulders, arms, hands, face, knees, feet, and the like before taking another deep breath at the last with the jar in your hands and blowing the shakes out of the jar. The deep breaths at the beginning and the end make a difference, so don’t forget to do those. Our posture changed, we were more alert, and it was far easier to listen.

Another example of heavy work that can be done while sitting is one I may have Mister Man work on, as he can do it himself at school – or out. You simply place your hand on your knee, then push up with your knee and down with your hand. Then do the same with your other knee and hand. After that, place one foot atop the other, pushing up with the bottom foot and down with the top foot. Reverse this, and you’re done. It’s nearly invisible to others and something that can be done without disrupting the class. I love it!

Studies have been done on this, and heavy work has been found effective to assist in self-regulation, changing tasks smoothly, organizing themselves, and more. So why does it work to use heavy work? The number one job of the brain is to keep us alive and safe. If it sees danger, there is almost an unconscious reaction in the middle part of our brain which decides if it needs to pay attention to the alert or ignore it. If it decides this is a valid threat, it will send messages to other parts of the brain and then to the autonomic nervous system – making our hearts beat faster, sweat, dilate our eyes, create shallow, upper chest breathing, change our skin color, etc. Our bodies go not just into fight or flight mode – the most common two responses we think of – but also potentially into fright mode, which is where we freeze like a deer in headlights. What we think is happening is that there are people who simply have an overactive sensitivity to this system. When they are bumped lightly, as in line at school when someone doesn’t stop in time behind them, they punch the person behind them. They can’t tell the teacher why they did it because it was an almost unconscious fight response, not a thought process. That isn’t to say that children don’t punch others or act out for other reasons, but for many, this is the fight, flight or fright response kicking into gear – or overgear, as the case may be.

All team members need to recognize that if we can stimulate the back part of the brain, it will send a message to the rest of the brain that everything is ok. And we do this with bottom up self-regulation, which is where the heavy work comes in. When we carry a heavy box of books or push a wheelchair or a cart with extra weight on it, then we’ve sent messages that everything is ok to our brain through this heavy work – and we’re in that just right place with our engine – and we are less likely to hit someone if we get unexpected sensory information.

The fight or flight response is typically not too subtle and easy for us to see. The fright response is easier to miss, as are the more subtle flight or fight responses. When a child is told that he needs to finger paint but has sensory issues, he may ask to go to the bathroom or point out a crack that needs to be fixed, so he has to go get a custodian to do that. Or he may react with anger (fight) saying, “No! This is stupid!” or he may do the activity but be in a fright reaction where he just starts crying during the activity. We can also sometimes see the reactions in the changes in their tones of voice. When a child uses a lower tone of voice or a growl, that may be a signal that they’re having a fight reaction. Or they may use a might higher or thinner voice that is leading to a flight response. If we can capture these before they go into the higher response and get them to re-regulate, that’s the ideal. Our aim is to be a detective to figure out what may have brought on this initial response so that we can assuage it for the next time or help them work through it this time – or both.

Top down self-regulation is what we typically ask kids to do. We tell them to think through it: if you don’t finish your work in time, we can’t go on the field trip. We make them remember constantly that they have to calm down to be able to do X, which is mentally exhausting to do all day long. Ideally, we want to use both top down and bottom up regulation at the same time so that they understand the consequences of their actions (the top down) while being able to effectively regulate themselves (bottom up) to be able to accomplish the necessary tasks. How do we do this? Ask the child to do some heavy work and explain that this will help them get their work done because they need to get it done in time to be able to go on the field trip.

So how do we set ourselves and our nervous systems up for success? And by “we” I do mean all of us, not just our kids or just our special needs kids. We need to encourage movement breaks for self-regulation – all of us. And when we’re asked to memorize and then access information, like in school where we have to pull all that together, it helps to use our mouths to self-regulate. We may drink tea or chew on straws or suck on hard candy or chew gum or something else. Finding the effective method for you – and your children – is key. And it may not always be the mouth that is the effective heavy work to re-regulate. It may be another method.

Some people need to move. It may be pacing, jiggling a foot, rocking in a chair or something else. Many children want to do well in school but find it hard to sit still for that long. They look for something that will help them attend but often gets misinterpreted. Touch is another self-regulator. We all have our favorite clothing that makes us feel comfortable or our favorite couches or blankies (mostly for little kids though, right?) that keep us centered. There are visuals that can work, too, from natural light to piles on a desk or a clear desk. It will vary by person, and that’s ok. Sound is another factor in our regulation – from fire alarms to classical music to complete quiet. They all put us in a different place. Perhaps when we’re doing something familiar and comfortable, we can have more sound. When we’re trying something new or more challenging, we may need complete silence to be in the just right place to allow us to focus.

There are certain things we do every morning to get us up and going and also to get us through the day. Think about all your different routines and tactics to get ourselves running higher or lower, as the moment requires. We don’t want to stop these behaviors if they are our (or our child’s) best attempt to attend to the task at hand. If they are walking around and fiddling, do they remember the story you’re telling them or not? Sometimes we have to do a little detective work to figure out what works for our children, as everyone is different.

Breath also supports our self-regulation. I really liked the phrase “When I feel upset, I can blow until I feel just right.” It’s a way of using deep breathing to self-regulate. I’ve tried in the past explaining the deep breathing philosophy to Mister Man, but it’s a challenge for him to understand how to do the deep breathing. The therapists showed us how to pretend to be smelling a flower (with a really deep breath, holding the “flower” in front of us) and then blowing out a candle (with a single finger held in front of our mouths to simulate the candle). I can see that being an easier concept for Mister Man and something that he could more easily get.

We all have engines, and we all self-regulate. Our kids just do it bigger, stronger, harder, etc. We all do it to some degree though, and communicating this helps everyone understand and takes away the shame and the stigma. We’re all doing it. We just don’t talk about it.

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NickiBabysits May 27, 2011 at 5:58 PM  

I'm a future special education teacher (I worked as an aide in a special ed school before) and I've worked a lot with kids with autism. This is great information to know! When I was an aide, kids were always being told to QUIT doing certain things because they were "inappropriate"... but some kids were just doing these things to self-regulate, to get to a level where they could calmly learn! I will remember this for when I become a teacher.

Tara R. May 27, 2011 at 7:09 PM  

I recognize when my son is doing things to help him regulate his emotions. I need to incorporate some of these techniques with him, I think they will work better.

Mrs4444 May 28, 2011 at 8:03 PM  

You are growing nicely into your autism education advocacy role, my friend :)You're a fantastic mother, too. Great post.

Mrs4444 May 28, 2011 at 8:09 PM  

I'm really thinking about this post, Michelle. I knew about self-regulation before, but the part about heavy work actually affecting the brain had never been explained to me. The reasoning makes great sense and makes me hopeful about a particular student who we make sure gets large motor exercise every day, but I'm wondering how a chin-up bar in my room might impact his day even more; a few chin-ups before certain classes could have an impact. I am definitely going to experiment! Thanks.

Heather E May 29, 2011 at 11:06 AM  

I have never learned so much in a blog post before-- I am going to give this to my SIL. My nephew would really benefit from this!

Pat May 30, 2011 at 1:42 PM  

Wow! This is great information for any teacher or parent of an autistic child, or even for a neurotypical adult like me. I tend to get anxious too easily. I'm gonna try that heavy work stuff.

You could probably publish this in a parents magazine or journal on autism. It's awesome.

tiarastantrums June 1, 2011 at 9:10 AM  

M- this is some great information! I always wanted to attend this conference - perhaps next year!

Michelle June 1, 2011 at 10:26 PM  

Nicki - I'm glad this is something that was helpful. I tell me son (even now!) ALL the time to stop doing things. Interesting perspective on this - and lots more yet to come!

Tara - I think as they get older, they figure out some of their own self-regulations. The key is finding ones that work that also don't make them stick out like a sore thumb... as much.

Mrs4444 - Why thank you :) I have so many interesting sessions that I attended yet to post. I'm not saying I agree 100% with all the speakers or what they had to say, but ... there's lots of info out there!

Heather - Really? You are so sweet! I hope your SIL does benefit form it. Keep an eye for additional posts, too!

Pat - I think it's great for everyone. Think about when we start to lag after lunch of when we're hyper after too much coffee or whatever - these techniques work on us, as well.

Teresa - You should so attend. The registration fee this year was only $25 for materials. Come in and go out as you can. I was there Wed 8am to Sun 3pm, but with the low cost, it's worth it just to come for a few sessions that really interest you. Let me know if you're up for it next year!

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