Occupational therapist Iriene Johns provides a review of combined physical and cognitive approaches effectively used in therapy for an integrated practice with autism.
As an occupational therapist who has spent years combining physical and cognitive training methods from the Occupational Therapy Practice Framework with the neuro-diverse population (children and young adults) in the UAE, I have seen first-hand how the miracle theory of neuroplasticity transcends and diversifies the meaning of rehabilitation.
Wikipedia explains it simply like this: Neuroplasticity, also known as neural plasticity, or brain plasticity, is the ability of neural networks in the brain to change through growth and reorganization. It is when the brain is rewired to function in some way that differs from how it previously functioned.
In this article I will look at some of the factors influencing wellness necessary for neuroplasticity to be effective in action related to physical activity and mental wellbeing; Also, how has this wellness factor affected the neuro-diverse population in the Gulf region?
The environmental factor: Making use of the sun
Owing to this part of the continent receiving ample sunshine, children and young adults and older individuals alike have demonstrated a greater level of energy and activity levels right from the starting of a day until night sets in.
Every weekend is celebrated in the UAE as a short holiday. Families and individuals along with their friends go out together to enjoy during all the seasons except during the hot summer. The rich outdoor sensory experiences provided by clean beaches can be availed free of cost here and this is an indispensable activity of every other family here.
Children who grow up experiencing a gradual exposure to the rich natural environment are less likely to form sensory aversions starting from a very young age. It has also been noted from several studies that neural connections that are formed early in the infant-child brain creates more meaningful and lasting neural connections creating learning pathways in the brain.
Play options
Parks with great outdoor camping options as well as riding bikes and playground, swimming and horse-riding amenities are also accessible across every community in the UAE.
Community parks with swings and trampolines and climbing ladder and rope bars as well as lush green grass carpet hills and long lanes to walk through as well as ride a bicycle has also boosted the physical activity level for these individuals. Indoor trampoline parks and indoor sports complexes teaching specific sport like basketball, roller skating ,badminton/tennis have also contributed to maintaining the physical wellness factor.
Programmes using animals to aid with intervention: riding horses and visiting farms
In my work, I saw that after receiving the therapeutic advantages of animal connection over the course of a 12-week (once-weekly) hippotherapy session, the sensory hyper responsiveness of some individuals with autism had virtually completely disappeared. To even become ready for the change, some individuals needed to gradually desensitise over the course of several weeks.
A trip to the farm or zoo was never complete without a little enthusiasm, and you could always hear people squealing with delight as they voiced the names and descriptions of the animals in firm tones.
Group classes involving specialists in physical therapy (PT) or speech language pathology (SLP) also showed promise in combining the cognitive physical training model for intervention.
An illustration of a typical session that lasted 30 minutes was as follows:
- OT/PT (session outside): Warm-up: five minutes of physical activity or a series of sensory-motor exercises like wall pushes or an obstacle course.
- OT and SLP: a job involving food preparation in which the SLP gives the kid a visual timetable, and the OT and SLP assist the child in carrying out the processes to completion, enabling the child to explore food using their senses of hearing, vision, touch, smell, and taste.
Following the first physical activity task given at the beginning of the session, it was observed that instructional compliance, intrinsic motivation, as well as the activity tolerance while sitting, all improved.
Task training methods:
This method was designed to teach specific tasks related to essential everyday activities like writing, eating, dressing, grooming, and taking part in community events.
Each of these abilities needed to be taught from the earliest stage all the way to completion for maximum independence to increase children’s participation in life skills and tasks. For this purpose, multi-sensory training strategies were combined with traditional task training approaches to produce desirable outcomes.
All these factors contributed to overall wellness that resulted in neuroplasticity changes in the brain and these were evidenced by the standardised outcome measures used at the beginning and end of the intervention.
Iriene johns is an occupational therapist who has been practicing in Dubai, UAE, for the past 13 years.
How the role of the mentor helps to shape best practice in case management
