Please visit our new web site www.autism.com
Please visit our new web site www.autism.com
Please visit our new web site www.autism.com
Please visit our new web site www.autism.com
These suggestions are based on use of equipment by 75 students with autism and a data base maintained by undergraduate students (Program: Michael Reese Hospital & Medical Center Summer Research Fellowships, teachers, and clinical staff. In a school setting, access and scheduling issues resulted in some practical limits. Nonetheless, the "Squeeze" Machine is a significant option for some students' use.
WHO? Students offered opportunities to use the equipment were students who demonstrated tactile defensiveness, who sought out deep pressure experiences in the environment, and/or students who could not readily self-calm or regulate their arousal state. Recommendations for the program were based on occupational therapists' evaluations as well as teachers' observations.
Some students needed time and modeling to desensitize themselves to entering the space and letting the sides contain them. Some students experimented with positions over time or during each session. Some students needed to learn what to do "with themselves" or their attention while in a contained space for increasing periods of time. Students had repeated/daily opportunities to rehearse going to the equipment's location, adjusting positions, etc. over six week periods. When some students entered adolescence, they become more consistent and interested in the using the equipment.
WHERE? The equipment was initially kept in a classroom corner with a low divider system so that a student could have some privacy but still be observed for safety and other reasons. Some provision to accommodate a noisy air compressor (e.g., closet plus foam) or the movement of the sides against the device should be considered. A small observation or other room was later used to allow more students access without classroom disruption.
WHEN? Initially students were encouraged to use the equipment when they "wanted" to go in it. While a student may have occasionally opted to not "work," such excursions were limited and usually very short duration. Most classes have such planned days, and the problem of only one student at a time using the equipment resulted in very limited use. When a student came in having a "very bad day" and went directly to the device or was very upset by someone else's behavior, they were given priority access. A decision based on pattern of use was made to offer the students regular supervised times to use the equipment; they did not have to use it at the planned time but were reminded or encouraged to use it. Specific times related to the activities of their day and behavioral patterns were planned by the clinical team to take advantage of calming before and/or after a particular activity. Students were offered sessions four days a week given staffing constraints and the academic schedule. Students developed a weekly average time using the equipment; perhaps staying a minimal amount of time one day, then doubling their time the next( minimum of 5 minutes to 20 minutes). The schedule was based on noncontingent use. The option for use was never withheld because of behavior problems or insisted on because of behavior problems.
HOW? Students were encouraged to maintain the preferred quadruped position, on all "fours." However, even with the use of foam rolls, etc., students often went to a prone position, on their stomachs; occasionally they chose to be on their backs or sides. The side position was often an attempt to pull the sides in or increase pressure. Rarely and briefly students would attempt novel positions such as kneeling which were discouraged. When a student indicated or wanted the teacher to do the "pulling" for the pressure effect, they were informed they could rest but had to do their own "work." Students developed their own style of applying pressure. Records were kept of these styles, the time spent holding the lever in the "on" position as rapid, intermittent or sustained. The longer a pull was held, the more time was spent and more relaxed behaviors were observed. Some students started every session with bursts of rapid pulls almost providing a series of light touches, rebuilding their tolerance to the pressure.
SAFETY NOTE:
Following these guidelines, over a 10-year period no students were ever injured or unable to stop and leave the equipment.
INFORMATION PRESENTED:
(1991) Autistic students' use of lateral pressure equipment ("Hug Machine"). Annual
Conference of the Association For the Advancement of Behavior Therapy, New York.
(1994) Project SMART: Sensory modulation, assessment, research and treatment. Annual Conference of Autism Society of America, Las Vegas.
The opportunity for extended studies at the Day School (Developmental Institute, Michael Reese Hospital & Medical Center now administered by Easter Seals, 3424 S. State Street, Chicago, IL 60616) was made possible through the generous consideration of Temple Grandin, Ph.D., equipment developer and the Therafin Corporation (800.843.7234).
© Copyright, 1995, Margaret P. Creedon.