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Fun learn Sensory Integration uses games on the swing, swing ladder and trampoline

This story is about a room with cushioned flooring filled with activity toys such as a swing, a hanging ladder, scooter board, trampoline, a foldable tunnel, therapy balls (these are just some of the ‘toys’), a room full of affirmation. For four-year-old Anil (name changed) playing there, it is a play room and more importantly a place where he learns important life skills which he, as an autistic child, lacks. He has been diagnosed with a mild form of autism.

The ‘playroom’ is the Sensory Integration Unit (SIU) of the Navajyothi Centre for Child Behavioural Sciences, a part of the Kusumagiri Mental Health Centre, Kochi. The SIU is part of Navajyothi Centre’s ‘Autism Training Centre’.

Autism manifests itself in a child by the time he or she is three, and therefore, ideally should be diagnosed as early as possible. “Somehow what happens is that paediatricians often miss out on the signs. That there is neither the inclination nor the time for detailed assessment or evaluation compounds the problem,” says Rajan Mathai, clinical psychologist, Kusumagiri Mental Health Centre.

Generally three senses – the sense of touch (tactile system), the sense of balance (vestibular) and the proprioceptive system – a lack of awareness of the body position in space (for instance to sit in a chair or a lack of awareness to manipulate small objects such as writing with a pencil or eating with a spoon) are affected or absent. There is no sensory integration or the requisite responses to sensory stimuli.

At the SIU every aspect of a child’s sensory integration is addressed. “Once a child is confirmed to be autistic after intense study by our team, which comprises a child psychiatrist, a social worker, an occupational therapist, special educators and a speech therapist then do we go ahead with the therapy,” says Sarah Daniel, occupational therapist at the Autism Centre. Even then the child is never pronounced autistic, and the diagnosis is left open, according to Rajan Mathai.

The Centre has around 40 children who come for the therapy. Any therapist working with autistic children, generally aims at providing the child with sensory information which will help organise the central nervous systemand assist the child in processing a more organised response to sensory stimuli. Seeing a session is an education. There is a lot of free-play, “the games will make no sense to the onlooker and that is the point of the whole exercise,” says Sarah.

Each ‘equipment’ the swing, the swing ladder, trampoline and the others areall important constituents of the ‘sensory diet’ for the autistic child.

Anil and Sarah jump on rubber tyre-like rings holding on to colourful pillars for support. Sarah swings with Anil on her lap, and then she gets off and makes him sit on the swing independently and hold the chain, balance himself and then swing. After a while he jumps off and heads to the trampoline and jumps around for a while till he is talked back on to the swing.

The swing is important for vestibular input, the sense of balance. Then it is on to the scooter board, where he has to propel himself to pick up the balls scattered on the way. Some of the other tools are finer such as beads, which require fine motor skills and dexterity.

Once the autism team identifies the kind of autism the sensory diet is worked out. The sensory input is controlled and the sessions do not last more than 45 minutes. The treatment schedule is combined with speech-language therapy, remedial education along with sensory integration.

The session at the SIU ends with (depending on the case) with traction and compression where the child is given a massage or neutral warmth (for instance the child is rolled in a mat, massaged with a therapy ball).

And it is not the physical play that constitutes the therapy, there is a lot of verbal interaction – the therapist talks, encourages and coaxes the child to do the various activities.

Hope The Sensory Integration Unit

l Absence of the smile as an infant.

l Lack of interest in children of the same age.

l A delay in talking or reaching milestones of growth.

l Repetitive actions such as flapping or clapping hands, rocking back and forth.

l Compulsively arranging things sequentially.

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