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New therapies are helping children with autism overcome sensory barriers

For some kids with autism spectrum disorder, the outside world can seem like a badly-acted, badly-dubbed film. Actors' lips don't quite sync up with their voices. The dialogue is drowned out by the deafening hum of a distant airplane. And the terrible acting confuses this rom-com for a thriller.

But now, several Toronto organizations have positioned themselves at a critical juncture to help children with sensory integration, emotional perception, and communication issues faced as a result of an ASD diagnosis. 

One in every 68 children will receive an ASD diagnosis, making it the most common neurological disorder affecting children in Canada. Its prevalence has grown 120 per cent since 2002. And although there is no cure for autism, there are a growing array of therapies that can help mitigate communication issues and create a better quality of life for kids and their families.

And more often than not, this help comes through music.

Ryerson's SMART lab is currently working on a game that helps kids exercise and develop their sensory integration and emotional perception – just like a workout, but for ears, eyes, and emotions. 

The game itself is straightforward. Kids watch actors on screen sing a sentence repeatedly, changing up the emotion using non-verbal cues. Kids then guess what emotion is being portrayed, as well as the degree of that emotion. Is she ecstatic? Mad? Happy? They are encouraged to mimic the expressions of the actor on the screen. After a few days, the music component is slowly scaled back and more speech-based sentences are introduced. 

This scaling back technique is often used with stroke patients who may have difficulty speaking, but not singing. “Song is accompanied by an external rhythm, so the presence of this external rhythm is going to help these kids put it all together in terms of time,” explains SMART lab researcher Lucy McGarry.

Music helps to tame sensory chaos. “I think that one reason might have to do with the sense of order that comes from music. Some aspects of music are more predictable, it happens to a regular rhythm,” says McGarry. 

McGarry went on to explain how many children with ASD are known to rock in an effort to engage these natural rhythms of the brain found in people without ASD. 

"When you're listening to music it helps bring out some of those regular rhythms in the brain, and it has been found that our brain will actually echo the rhythms of a song that we're listening to. It helps give a sense of order and relax to these rhythms that have been put back together in their brain.”

Music as a catalyst for communication

For years, Paul Madaule, Director of the Listening Centre in Toronto, has been using music to help kids with autism improve their communication skills. 

“Music, when it comes to brain development, has a lot of the qualities of language,” he says. “First of all, it's sound. Language has sound. Second, it has rhythm. Music has volume. Music has pitch. Kids within the autistic spectrum in particular, they don't have different heights of voice. They don't know how to regulate this. Many autistic children speak in a very scripted way, like robots. They do not have this melodic component in speech. But music has all those ingredients. Music has a melody. Music is training the brain to the flow of language. And language is a music.” 

Madaule believes that properly utilizing receptive music (what you listen to) and expressive music (what you can sing) can vastly improve language skills. “Some of these children can't speak, but they can sing beautifully. So we engage them and create an audio feedback of their voice, so they can start hearing and realizing, 'I am the one who produces this voice.'"

As children develop the understanding that they are the ones singing, they can begin to associate meaning and begin to establish a sense of self.  

“This sense of oneself is what very often is missing," Madaule says. "They do not know that they are an entity." Music helps children with ASD understand not only themselves, but also the people around them. The music becomes the perfect vehicle to language, leading to better self-awareness and communication skills.  

Sensory integration affects nearly every facet of speech. In order to truly understand those around us, we need to be able to combine information from sight, sound, and touch. 

Ryan Stevenson is a Banting Postdoctoral Fellow with the University of Toronto whose research focuses on how people bind visual and auditory information in a unified perception, particularly those with autism. He estimates that about 90 per cent of those on the autism spectrum have some sensory and/or temporal processing issue, making sounds and lip movements appear out of sync. Stevenson has found that improving sensory integration may simply be a matter of practice. 

Stevenson's research group presented kids with a number of out of sync visual and audio stimuli including flashes, beeps, and complex speech. They then used a variety of speech integration tasks to see if the kids could "bind" this sensory data and match it together. He found that kids who had issues with temporal processing were weaker binders. 

However, these children responded well to simple feedback. “Just by giving them these out of sync presentation and giving them feedback on whether or not they got it right, we've been able in a couple days to really increase the temporal precision across what they hear and what they see.” 

Making sense of movement and emotion

Taking these lessons from music, language, and stimuli and translating them into real-life communication skills that also take into account emotional factors is another challenge. An important aspect of these exercises is the reinforcement of what's called the mirror neuron system, which is what plays out when you see someone get hurt and you flinch in pain, or when a friend yawns and you follow suit. 

They are brain cells that fire not only when we make a movement, but when we observe someone else making a movement. Much of our understanding of other people comes not from thinking, but from feeling.

Ryerson's SMART lab combines audio and visual components in its game in an effort to challenge children with ASD's notion of mimicry. The game asks children not only to guess the emotions in the game, but to act them out as well, helping to create synchrony. 

"By echoing the movements of another, we physically enact an emotion, which influences our own understanding of the other," McGarry says. "By rewarding this mimicry and giving it positive reinforcement, it is developed and encouraged, and made easier to employ in day-to-day scenarios after the game is finished.”

Parents report seeing improvements in synchrony, emotional perception, and communication within two weeks of therapy, an early indication of the game's promise. 

But the major issue with autism treatment boils down to funding and access, and the majority of therapies (including many occupational therapies, listening therapy, etc.) are simply not covered by OHIP. Utilizing technology to treat issues with sensory integration and communication is a cost-effective tool that can help families that may not be able to afford other therapies, which can cost upwards of $12,000 per year. 

SMART lab recently received a grant to develop a more professional version of the game available for download. It will be available for iPad in October 2014.  For more information on how to join upcoming autism research studies for free, parents should contact Ryerson Smart lab.

And while there is no singular treatment that can 'cure' the negative sensory effects of autism, a comprehensive approach using both new and established therapies can help make order of the chaos.

Tiffy Thompson is a writer and illustrator who lives in Toronto. She is drawn to the quirky and eclectic stories of those that live and work here. 
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