Autistic child gets help for selective mutism, meltdowns, sensory-seeking behaviors, social anxiety, and more
This 8-year-old girl struggled with many social situations. She was unable to speak outside her home or navigate interactions with other children and she often experienced extreme meltdowns after school. See the progression of results, starting one week into a program of rhythmic movements and primitive reflex integration, toward a dramatic transformation after 16 weeks.
Submitted by A.J.S., Occupational Therapist
| Before | After |
|---|---|
| Diagnosed with Selective Mutism; would speak at home but not at school or other social situations | Spoke at a scouting meeting; now able to play and draw with friends |
| Severe anxiety around social situations | More open to new situations; making new friends |
| Limited ability to participate in community activities or extracurricular activities | Better able to handle challenges; performed at a tap dance recital |
| Displayed very dysregulated behavior daily, frequent meltdowns after school | Now a much happier and calmer child |
| When her anxiety is high, she often showed maladaptive behaviors such as kicking, punching, and saying rude things | Using proprioceptive activities such as jumping, chasing, pulling, punching, etc. dramatically less frequently as a coping mechanism for her anxiety |
| Picky eater | More open to a wider range of food |
Sierra is an 8 year-old girl diagnosed with Autism (level 1-2), Selective Mutism, and social anxiety. She is unable to speak at school, but can speak freely with family and friends at home. She has differences in sensory processing, and often becomes dysregulated easily. She does not process proprioceptive or vestibular input well, and seems to always need more of it. When she engages in sensory-seeking behavior without structure, she will spiral into a meltdown. When her anxiety is high she displays sensory-seeking behavior but often shows maladaptive behaviors like kicking her sister, punching her dad, and saying rude things to all of the family. These behaviors quickly shift into meltdowns, which happen often. They are violent and destructive in nature, where she bites, kicks, scratches, and punches the closest person (usually a parent), and rips papers, throws toys, kicks holes in doors, and does what she can to destroy the closest items to her. Meltdowns tend to happen after school, when she’s been holding everything together all day. She has limited ability to participate in community activities or extracurricular activities due to severe anxiety around social situations. She is so far unable to attend Girl Scout meetings (although she is enrolled) due to meltdowns and anxiety around a new and unfamiliar social activity.
Goals for Sierra include being able to reduce the frequency and intensity of meltdowns, increase ability to adapt to everyday situations without crippling anxiety (attend school, attend doctors appointments, attend local festivals, attend Girl Scouts), and increase her ability to speak with different peers at school without anxiety paralyzing her vocal chords.
The tools from this [Brain and Sensory Foundations] course I chose to do with Sierra include the Brain Tune-Up, Rhythmic Movements, and Reflex Integration for many of the reflexes (starting with TLR, FPR, and Moro). I began doing all 5 RM’s [rhythmic movements] passively with Sierra on a nightly basis. I chose to do these first, in order to help set the foundation for all of the reflex integration that would be needed down the road. Also, the RM’s help integrate both Moro and FPR, so I thought those would be helpful because anxiety and Selective Mutism are such a challenge for her. After having success with the RM’s for a few weeks, I decided that I would start RI [reflex integration] by integrating her TLR, followed by Moro and FPR since those three tend to impact each other.
I used Brain Tune-Up because I thought it could help calm her anxiety, or help her to find her center again when she starts to become frustrated or anxious, before she goes into a full-blown meltdown.
Before the start of this program, Sierra displayed very dysregulated behavior daily, having big meltdowns for a few weeks straight. The first time I introduced Rhythmic Movements, I was able to do movements 1-3 with her passively, but then she became dysregulated after the 3rd movement…she was refusing all tasks except her preferred tasks.
One week into the program I introduced integrating movements for TLR, and two weeks after the start of the program, I introduced two new reflexes to integrate Moro and FPR. Each time there was something new presented to her, her immediate response was dysregulation and resistance. Yelling, ballistic movements, and argumentative behavior. To bring her back to a state of calm, she needs strong proprioceptive input. After enough sensory input, she tends to be able and willing to tolerate the rest of the RI movements and RM’s as well. Every time she completes the whole session successfully, she appears calm, happy, and really grounded. We do them before bedtime and she truly gets calm after sessions, in a very deep way. As if the happy child inside of her is finally able to be seen, with no other behaviors getting in the way.
At the end of the program, Sierra was much more adaptable to change, to challenges, and was a much happier and calmer child. Her nervous system was so much calmer and well-regulated, it was able to create space for flexibility, joy, courage, activity tolerance, and sensory integration. Her anxiety is closely linked with her sensory-seeking behavior, meaning the more anxious she is the more she tries to manage it by seeking out proprioceptive activities to calm herself (jumping, chasing, pulling, punching, etc). The frequency of these behaviors dropped dramatically a few weeks after this [Brain and Sensory Foundations, primitive reflex integration] program started. Her picky eating has improved as well, where she willingly ate chicken for the first time ever, and was generally able to better participate in meal times and try a broader variety of foods. She has made gains towards joining Girl Scouts, by playing with 2 troop members at Scout Hall without the structure of a formal meeting. She was able to speak in the room, play and draw, and participate in imaginative play with them. She was able to perform in her tap dance recital, without debilitating anxiety. And she even showed excitement to go to a birthday party at the bowling alley, which usually spikes her anxiety because of the social demands required.
I learned about the power of the rhythmic movements to transform someone. The total length of time I worked with Sierra using these tools was 16 weeks.
[Edited for length and clarity; emphasis added]