I took the week to let the HANDLE appointment sink in and now it’s sunk so far, I don’t know where it’s gone.
Let me start by saying that Christine referred to Judith Bluestone as the Autism Whisperer and now I know why. Judith, the founder of the HANDLE Institute and the author of The Fabric of Autism in which she talks of her Holistic Approach to NeuroDevelopment Learning Efficiency (and her own sensory issues including what she now believes was her own struggle with autism growing up), is the most present and calm practitioner I’ve ever met. She gives the impression of having nothing else in the world to do other than be right there, with you, in that moment for as long as it takes. There was no rushing, no checking the clock, no referring to checklists or questionnaires. There was observation and conversation and long pauses during which she sat on the rug, bare-footed, and alternately watched, and interacted with, my son.
I love that.
The bare-footedness is not a groovy thing, it’s an information gathering thing. We all ended up barefoot that day, Dave and I because it was finally warm and we wore flip flops, Fluffy, Judith and the intern who worked with her, because the sock eating frog puppet couldn’t help himself. Judith needs to see the feet, to study the feet, to look for clues, and she hit on one immediately.
Plantar’s warts. Fluffy’s got a nasty cluster of them on his left big toe. We’ve been trying to get rid of them for a while now, trying Compound W, caster oil, and these days, duct tape, to no avail. Hmm, she said, How long has he had these and did I notice if he started asking for the mouth massages around the same time these appeared?
You know, it could be, I said.
It turns out, the spot on his big toe is directly connected to his upper jaw. She wondered if the pressure in his toe caused by the warts could in some way be disturbing his mouth.
The assessment was Friday morning. Fluffy did puzzles, double-doodled with his eyes closed, experimented with red/blue glasses, and set up an elaborate pattern with little wooden blocks. We were in a small room and had to keep moving here and there in order to reposition the video camera to capture all the activity. He did great but understandably got antsy after close to two hours and spent the last 10 minutes trying to hurdle the camera and escape to the outer room where a big yoga ball beckoned him. He was ready to leave, tired of the new toys, having explored them all, tired of all the talking, simply tired of the whole scene.
We took a delightful and long lunch break and returned in the afternoon for feedback and to learn the recommended daily exercises to try for the next 6-8 weeks, exercises that would hopefully help Fluffy take in and integrate sensory information more completely and effectively. Judith and the intern took turns going over the notes they accumulated after reviewing our paperwork, the taped morning session, and their own observations. They got Fluffy, spot on. They also got some things I’ve never noticed, for example, that he protects his fingertips when he plays on the floor; he either rests the heel of his hand on the rug, lifting his fingers in the air, or curls them under and rests on his knuckles therefore missing all that information. I never knew that. But he uses those same fingertips like mad when he’s on the computer or manipulating his playmobile, I said. He’s most likely blocking during those times, Judith replied, shutting down input in order to do those tasks.
Her approach is all about looking at how the child takes in sensory information, where they may be blocking, where they are strong, where they are weak, and then design simple ways to wake up and strengthen these core systems in order to support the whole body. She also looks at how the many systems are communicating and works on increasing the internal exchange of information. So, she wants the child (or adult) to be able to use available means of taking in the world, and maximize the ability to use that information in an integrated way in order to allow for the most success back in the world where they can continue to take in more information. In other words–in order for them to be in the world without bracing for survival some or most of the time.
She says, Fluffy attentional priorities are at odds: his intellectual interests and natural curiosity is thwarted when survival needs overtake him. This makes perfect sense to me when I watch how he changes when kids are around. There is no physical ease. How can he be free to observe and experiment?
I don’t have a handle on HANDLE yet. The best I can do is say it’s similar in style to RDI in that it seeks to strengthen core systems in order to increase connections so that, at some point, the body/brain can get back on track, on a more ‘natural’ developmental pathway.
One of the things she wrote on Fluffy’s sheet was that he expresses concepts more than feelings. I hesitated, thinking of all the amazing things he’s said about his feelings, metaphors and connections he’s made. But then I realized that Fluffy really doesn’t express his feelings, his harder feelings in the moment. Fluffy may be a master talker but he’s not a master communicator. He can explain things, some very complicated things, in marvelously creative ways but when it comes to something basic, like, Stop that, or I don’t like that, he’s stumped. He becomes immediately dysregulated and overwhelmed; he lashes out.
How could her exercises, things like tapping his skull in a particular patterns, wiggling his fingers, rolling a ball on his back, stomping his feet, affect the way he’d respond if I started singing silly words to a familiar song and he didn’t like it? How would he say something simple like the not quite three-year old I watched in the park the week before say to his mom when she started playing a game of “I’m gonna get you!” that he wasn’t up for: “Stop it!” He said, his hand up, “That scaring me!”
I used to think his difficulty in this area was related to not mastering Variations (old stage 4) in RDI, that is was about impulse control, that it had more to do with not yet being comfortable with flexibility, making necessary repairs in order to stay in a pattern with another person. After listening to her, I began to wonder if it was due to miscommunications within his own sensory system.
Judith described things like interactions among the fluid in the inner ear in the vestibular system with the fluid system of the lymph system with spinal fluid that runs up and down the back, the neck, and all around the brain. She talked about the sensitivity of the tiny but significant trigeminal nerve that connects ears, eyes, nose, mouth, teeth, and jaw. She talked about how if one was blocking the information coming from the fingertips than one will have poor self-help skills; we need to use the tips of our fingers for dressing, brushing teeth, washing hands and face, putting on socks, zipping and buttoning.
We spent a whirl-wind weekend in New Jersey and New York City, interspersing our activities with our best stab at the assigned exercises. We returned Monday morning to make sure we had them down, got some pointers, and then set off for home.
It’s been a week and I tell you, I think it’s making a difference:
∞ There’s been no request for mouth massages the last two nights at bedtime.
∞ There’s been no aggression with other kids. In fact, he asked two kids he’s never met before if they’d like to play a game with him? He had his transformers, noticed they each had toys on their laps. Did they all want to play a game together?
∞ Yesterday, he requested a notebook for writing his thoughts. Today, he opened it and wrote, entirely on his own, “I Lov Mom.” with the period and everything.
∞ The plantars warts are fading.
∞ A few days ago, Dave said something that annoyed him and instead of hitting or growling or shaking his fist in the air, he marched out to the kitchen, saw me and said, “I’M IN A BAD MOOD! DON’T BOTHER ME!” I nearly fell down.
He’s been saying that sort of thing more and more. “I FEEL LIKE HITTING YOU!” but no actually hitting. “I DON’T FEEL HAPPY!” “I DON’T WANT TO DO THAT!” “I DIDN’T LIKE THAT!”
∞ Aggression, overall, is WAY down.
It’s huge. And it’s only been a week.
How does it work? Where are the balance boards and trampolines and hippity hops? All the various tasks to incorporate throughout the day, the push/pull/lift/carry? I don’t know. I guess what they say is true: there really is more than one way up the mountain.
We may look into a more traditional sensory integration program down the line, but for now, we’re sticking with HANDLE. It’s simple, it’s portable and if it’s really behind the changes I’m seeing, behind what looks like my son’s increased sense of clarity and safety and self-expression, I say Hooray! and, I wish we’d tried this sooner.