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Questioning autistic people
Published in Nichola Tyler, Anne Sheeran, Working with Autistic People in the Criminal Justice and Forensic Mental Health Systems, 2022
Michelle Mattison, Clare Allely
As highlighted by Crane and colleagues (2009), individuals with autism can experience general sensory overload. General sensory overload is not specific to a particular sensitivity (e.g., lighting or sounds), and can involve sensitivity to multiple modalities (i.e., lighting and sound). Particular sensory sensitivities can lead to significant distress, which is referred to as a ‘sensory overload’ (e.g., Jones et al., 2003; Pellicano & Burr, 2012; Bogdashina, 2016). Sensory overload can result in the presentation of challenging or self-injurious behaviour as well as adverse effects on communication (Pellicano, 2013). Being present in unfamiliar settings such as police stations and courts can trigger sensory overload which can lead to a negative experience or a poor level of engagement. In some forensic situations, it is possible that these reactions are misinterpreted as indications of guilt or deliberate acts of anti-social behaviour (e.g., Debbaudt, 2002; Murphy, 2018).
Autism in Doctors
Published in Clare Gerada, Zaid Al-Najjar, Beneath the White Coat, 2020
Challenges are situational and often transient. Sensory overload is real. Beware of assuming that a trainee who is struggling in a stressful sensory nightmare of a theatre with a colleague who communicates in a non-autistic friendly style, is simply a trainee struggling with the job itself. Understanding, acceptance of difference and minimal adjustments to the environment can have disproportionate effects in such circumstances. Be aware of the additional effort it takes to socialise and appear part of the team and be understanding when someone needs solitude. It can be confusing when a colleague happily chats one day but sits in silence appearing to ignore people other days. Be understanding, be tolerant. A high degree of social masking often means the condition remains hidden. It may be that a doctor’s professional life is unremarkable but personal life is chaotic. Life events and unexpected changes may mean that demands exceed an individual’s capacity to cope, which can result in a sudden and catastrophic decompensation. This may require a period away from practice, but with awareness of the specific challenges arising from autism, in my view many of those doctors can be supported to return to practice. It is my opinion that an autistic spectrum condition should be specifically considered whenever a doctor presents in difficulty, particularly when the difficulties arise after any sudden change to professional or personal life.
Sensory integration
Published in Jill Christmas, Rosaline Van de Weyer, Hands on Dyspraxia: Developmental Coordination Disorder, 2019
Jill Christmas, Rosaline Van de Weyer
Chronic ear infections may affect the child’s ability to hear distinctly, and this in turn will affect speech output. Despite a successful hearing test, very high and low sounds may be missed. The child with dyspraxia may hear but be unable to process the sounds and lose focus. A busy, noisy environment may cause ‘sensory’ overload, which in turn causes reduced attention and concentration. They may also take longer to process auditory information and require extra time to take information in and respond accordingly.
Two Halves of the Same Whole: A Framework to Integrate Autism and Mental Health Services
Published in Issues in Mental Health Nursing, 2023
Michelle Cleary, Sancia West, Loyola McLean, Rachel Kornhaber, Catherine Hungerford
Mechanisms to address sensory overload include therapy sessions in a quiet place with minimal movement and soft lighting (Maddox et al., 2020). Allowing the additional time to adapt to the surroundings and people when unfamiliar, ensuring continuity, predictability and consistency in people, place and structure of sessions to build trust (Jackson et al., 2020) and accepting that progress may be slow (Brookman-Frazee et al., 2012). It is important to understand that sometimes an aid, can help the person with ASD regulate and stay on track in the interview. Approaches to a sensory-informed setting could include a written agenda for sessions, consistent appointment times, ongoing explanations of session expectations (Maddox et al., 2020) and an agreement that sometimes fidget toys or other aids, such as doodles or notebooks, may be needed. There may also be a need to continue sessions for a more extended period (Brookman-Frazee et al., 2012), but perhaps some with allowances for recouping breaks for rest and regulation.
Virtual reality gaming in rehabilitation after stroke – user experiences and perceptions
Published in Disability and Rehabilitation, 2022
Martha Gustavsson, Emma K. Kjörk, Mattias Erhardsson, Margit Alt Murphy
Several factors must be considered when incorporating VR gaming into rehabilitation, including the choice of game and available adjustments. It is important to choose wisely and to ensure that adequate adjustments can be made. Some games may contain violence or other features that may be unacceptable or less suitable for some participants. Our present participants found the game Beat Saber to be engaging, and the rhythm-based music provided reinforcement to movements and made the training engaging. However, the participants would not recommend using games with substantial visual or audio input early on after suffering a stroke. In another study of participants with more recent stroke, sensory overload was described due to features in the VR game, resulting in fatigue, dizziness, and sickness [4]. The side effects of cybersickness is considered to be higher in fully immersive head-mounted displays VR games [8]. This suggests that immersive VR gaming may be better suited for long-term stroke rehabilitation rather than rehabilitation in the acute stage.
Perspectives on tactile intervention for children with cerebral palsy: a framework to guide clinical reasoning and future research
Published in Disability and Rehabilitation, 2018
Megan L. Auld, Leanne M. Johnston
Irrespective of the strategy chosen, it is important to plan appropriate monitoring of sensory engagement, tolerance and functional outcomes. When delivering any tactile intervention, it is important to monitor for sensory overload since repeated stimulation may inadvertently create or exacerbate tactile hypersensitivity problems. Secondly, it is critical to always consider safety. Since a significant proportion of children with CP have an impairment in tactile registration [2], it is important to educate families and teachers about the potential safety risks of certain tactile stimuli (e.g., rough sandpaper) and to consider this when providing tactile stimuli as part of therapeutic interventions. Finally, it is important to reflect on the tactile assessment framework to identify the measure of tactile function that is most likely to be responsive to the chosen intervention. Likewise, if there are parallel gains to be made in motor function or visual perception, then these outcomes should also be measured before and after intervention. Each of these areas would benefit from further research in order to inform clinical decision making.