Innovative Interventions to Treat Children on the Autism Spectrum

Thursday, December 8, 2016

Deep Pressure Sensory Rings

Make "sensory rings" by filling socks or sleeves of an old fleece shirt with plastic bags and sew ends. Size to be tight when child puts them over the head and pulls down to the waist. It creates nice deep pressure and motor activity when they put it on and off. The client in the photo has a big smile on her face after putting three of these on and wearing a weighted bag on her lap.   

The sensory ring I demonstrate in the video is fairly large and loose so that it can be used in motor activities such as pull down the body and stepping out of it.  

Saturday, November 12, 2016

Functional Vision, Visual Perception, and Hand Skills

In my book From Flapping to Function: A Parent's Guide to Hand Skills I describe some of the factors that impact functional vision. Functional vision is not the same as acuity but rather the ability to use visual information to perform functional tasks such as reading, writing and catching a ball. Of course, acuity or focusing power are important for functional vision but there are several other skills that are important in order to scan the environment, follow moving objects and persist at longer visual tasks.

Children with autism may have difficulties with one or more of what is called " the 7 Fs. "These are:
1) Following a moving target using smooth, coordinated eye movements
2) Fixation to gaze at a stationary object
3)Focus to see clearly
4) fusion to use the eyes together to see in 3 dimensions
5) Flexibility to look back and forth between different things
6) Field or the breadth of what the eyes can see while staring straight ahead. For example, people with glaucoma may have extremely diminished visual fields to the point of using "tunnel vision". Children with autism may not seem to be aware of what is in their visual field.
8) Fatigue- is eye strain from the effort put into using the eyes. Also some people with autism tend to use side or peripheral vision and using peripheral is more tiring than using the direct central gaze.

My son discovered that he was a very slow reader and was exhausted after reading for 15 minutes due to his eyes not working together. A developmental optometrist gave him helpful exercises to do .

Parents and others may notice that their child with autism does not look directly at objects or may look briefly directly and then look away while picking them up. Other atypical behaviors include stimulating the visual system by flicking fingers or an object near the eyes (often from the side of the eyes) or staring at lights.
  •  They may be particularly bothered by fluorescent lights
  •  seek out darkened areas, perhaps play in a tent or large cardboard box to avoid lights 
  •  have difficulty using the eyes together or
  •  moving the gaze back and forth between distances or from vertical to horizontal planes.

My son avoids sunlight when possible, and can only sleep in a very darkened room while wearing eye covers. He can do a Rubiks cube in under 2 minutes !

Here are a couple of adaptations that I describe in my book in greater detail.


  • Use Velcro to attach puzzle pieces to the top of the box lid. (see photo above) 
  • Attach puzzle board to the bottom of the box with tape or Velcro

Children will need to use one hand to stabilize the box lid while removing the puzzle piece. The child will need to repeatedly switch gaze back and forth between the vertical and horizontal planes. This is a type of visual flexibility, number 5 in the above list.

The skill of being able to look back and forth between distances and planes is also called  Accommodation . It is used when students look back and forth between the board and desk to copy from board to paper.  It may be difficult to fixate on the word on the board, find the last word on the paper to continue writing and then go back to the board to again find where one left off reading.
There are some compensatory strategies that teachers can implement to help students such as allowing them to sit closer to the board or have a copy at the desk to copy from instead of copying from the board.

Here is a visual activity that parents can do at home......


Tape cards, words or pictures on the wall  and provide identical cards at the table or desk.  Start out with 2-3 cards that are fairly close together on the wall and gradually increase the number used and spread them further apart. As you can see in the photo I then looked back and forth in order to arrange the cards to be in the same sequence.


Try this activity using simple pictures or photos. Try using number or letter cards to teach some numerical or alphabetical  sequencing at the same time.

I hope that these tips, adaptations and activities are helpful. If you have any questions about your child's functional vision please check with a developmental optometrist who specializes in working with children with these types of challenges.   Check out this website to find one...

Thursday, November 3, 2016

Helping Your Child learn about letter Size and Spacing

Here is one of the strategies I share in From Flapping to Function: A Parent's Guide to Autism and Hand Skills.

 Attach 3 Velcro Strips to a plastic backing. I used a see through envelope so that I could store the plastic pieces. I cut these out of a white orange juice bottle.

Cut smaller shapes to write the lower case letters and larger shapes to write the taller letters, upper case letters and the letters that dip below the writing line.

Show your child how to choose which size shape to write the letter and then place on the Velcro strips as shown in the photo. Be sure to use a dry erase marker so that children can wipe them clean- receiving great deep pressure stimulation to hand muscles and joints in the process ....

Sunday, October 9, 2016

Using Sensory Adaptations to Develop Hand Skills

Here are a couple of strategies from my book From flapping to function: A Parent's Guide to Hand Skills that involve making fine-motor activities such as stringing easier for children who have motor control challenges while at the same time adding sensory stimulation that motivates and meets their sensory needs.

This string has a squishy squeeze ball from the Dollar Store tied to the end. These don't last forever, but fun to squeeze in between inserting rings onto it.

I tied a bottle with beads and water inside that can be shaken after done with stringing the ring shapes.

A battery powered electric toothbrush can be taped onto the end of a stringing activity. The white toothbrush shown in the photo is taped to a long strip of plastic cut from a container. Its firmer and easier to manipulate than string.

The other toothbrush shown is covered with a decorative duct tape so that individuals do not consider putting it in their mouths. The "string" is made of a strip of stretchy cord.

Other options of sensory objects to attach to the stringing end are:
  • a Koosh ball
  • flashlight
  • flashing toothbrush
  • cat toys with bells
  • squeaky dog toys

These types of sensory materials may also be attached to the top of a ring stack.


As usual the rings are cut out of detergent and other types of plastic containers and they are not sharp. I can rub them across my face without creating a scratch.

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Saturday, August 13, 2016

Add sensory Stimulation with Pulling while Color Sorting on Button Board

This buttoning board was made out of a book stand with holes drilled into it. You can use any strong plastic or wooden surface to make something similar. I pushed elastic hair ties through two holes and then knotted each to attach plastic circles that function as buttons.

Some individuals are at a level where they can remove and insert them into an open container or a container with a slot to push into. Some of them have the motor planning skills to attach the fabric pieces and some of them are able to match colors. I love finding ways to combine working on dexterity and using a cognitive skill such as matching that they already they have already mastered and enjoy.

Some of  my clients really enjoyed the fact that the buttons could be pulled and snap back on the elastic. This gave them a fun sensory experience and because you can pull it away from the board, enabling them to  attach several of the fabric pieces.

Pulling, pushing and squeezing all provide  proprioceptive sensory stimulation to muscles, joints and tendons that can help with body awareness and motor planning.  This buttoning board adaptation provides this stimulation as they pull the buttons.  You can read about many other types of sensory adaptations in my new book: From Flapping to Function: A Parent's Guide to Autism and Hand Skills.   


Friday, July 8, 2016

Weighted Sock Activities

I have found some new ways to use my heavy weighted socks. These are made by filling plastic bags with sand and then placing inside a large old sock. You can make them as long or heavy as desired and I add a second layer of sock so that the outer sock can be removed and washed.

An individual was sitting in the lounge chair while I dropped several of the socks on his lap. He seemed to enjoy picking them up, walking across the room and dropping them into a box on the table. He was very focused and persisted for several minutes. He really likes moving and carrying heavy objects. It helped his body awareness and was something he could do successfully since he  has a lot of difficulty with motor planning any gross or fine motor activity.  At first I returned some of the socks back to the chair so that he could keep going. Eventually he caught on to what I was doing and he wanted to see the task reach a point of completion.

In the video you see a young man who is blind. He enjoys having the heavy socks thrown onto his lap as he tries to catch them. I taught a couple of other clients to throw them toward his lap and give a verbal cue that it is about to be thrown. This was great for promoting a social exchange and communication skills. The other client or I were able to keep this up for a good 10 to 15 minutes as we kept taking the socks back out of the box and throwing them into his lap again and again. Great fun for all.... 


Thursday, June 30, 2016

Tolerating Water with wet Objects

My client hates to get her hands wet and refuses to wash them after using the toilet. The staff had been working on a goal to wash her hands but she won't even place them under the water. Her new goal is to tolerate wet hands by removing the balls from a container that has a small amount of water in it and placing them in the 2nd container. She has always liked insertion tasks so she is willing to do this. We will gradually increase the amount of water so that she has to submerge her hands!! Sometimes you need to be a little tricky.....