Sensitive to Everything (2): Storminess, Medications, Change
Autistic children are slower to integrate multiple stimuli than same-age children whose development is more typical, according to a recently published study in Autism Research. Electrical activity in the brain was measured in 17 autistic children ages six to 16 and in 17 'typically developing' children while they watched a silent movie and were presented with unrelated auditory and tactile sensations. The researchers then
…..summed the responses to the single sensations, as measured by high-density electrophysiology, and compared them with responses to the combined stimuli. The combined responses of all the children exceeded the sum of the single responses — an indication of multi-sensory integration. But the autistic children had less pronounced differences, the researchers said, suggesting their integration was less effective.
As well, the multi-sensory integration took place within about 100 to 200 milliseconds of the stimuli in the typical children, the researchers found, but only occurred after about 300 milliseconds in the autistic children.
It's not that autistic children can't integrate different types of stimuli, but that they have difficulties doing so.
While the study doesn't address whether this difficulty in 'sensory integration' can be correlated to behavior issues, I don't think Jim and I are alone among parents of kids on the autism spectrum who think, there is a connection, and we're not necessarily in need of a research study to prove it.
I wrote a while back that Charlie is 'sensitive to everything.' 'Everything' meaning sensory stimuli including sounds, textures, smells, tastes, how his favorite little items are set on the floor, the barometric pressure, what Jim and I wear and whether or not a shirt is tucked in or someone's hair (mine, that is) is pulled up in a ponytail, when Jim and I return to work after much of the summer off. Being the creature of intensely guarded habit that he is, Charlie would prefer, or is inclined to think he would prefer, that things be always the same.
But oh what an overly, entirely OCD world we'd inhabit then!
And too, there are small changes that Charlie is not so aware of, but that nonetheless affect him, in a physical sense. One of these would be, or might be—because it's not really possible totally to know what causes Charlie to have two bouts of neurological storming as he did for the past 24 hours (of me writing this post)—a very small change in one of the four medications that he takes.
Charlie's neurologist has wanted to see if he does not need to take all those meds. It's never entirely clear how any one medication is affecting, helping, hindering: Giving psychiatric, antipsychotic, and anti-epileptic medications to a minimally verbal autistic teenager who isn't yet able to type or express too much verbally is a fairly daunting challenge. One is as frequently likely to be wrong as right, and sometimes one is both at once.
After our June neurologist visit, we attempted to lessen the amount of Zoloft Charlie takes. He's taken Zoloft for over five years and, now that he takes a number of other meds, it's not so easy to figure out what is doing what. Frankly, it's often seemed that Charlie was taking Zoloft more out of habit and because of our worry about what might happen if he didn't. So back in June we halved his dose.
After two days, charting a notable increase in anxiety and OCD fixativeness in Charlie, I called the neurologist's nurse and Charlie went back to the (relatively low) dose of Zoloft he's been taking for years.
Monday, following Charlie's appointment, we gave Charlie a half-pill less of Trileptal.
Tuesday morning, 'contained' SIB in the white car.
Wednesday afternoon, 'contained' SIB in the white car following a new and challenging bike road on the D & R Canal.
Past 24 hours as I type this post, two instances of heavy duty neurological storminess.
Mid-Thursday morning, I stood in the hallway of my office building and left a message with the neurologist's nurse. She called back after a few hours. After stating that—with the Zoloft experience in mind—Charlie seems very sensitive to even small changes in his medications, she said to increase his Tripleptal dosage to what it was prior to Monday.
Granted, there are other reasons for those storms, the chief one being, Charlie is not in school and, Wednesday night, rather gloomily counted off the 20 days till school resumes on the calendar I made for him. Another possible reason is big-time stomach trouble due to something that Jim and I can't fathom, there being no change in Charlie's diet. Charlie could, should, drink more fluids but getting him to drink more water is easier said than done. (Yeh, like everything.) Charlie does like diet Coke and, after I came home from work (Thursday was the last day of Orientation for the incoming first-year students and I had gone in to help schedule their classes), Jim went to the convenience store and returned with a couple of 'brown drinks.'
It wasn't a peaceful-easy afternoon. We were lucky that a friend—a young woman who's a college student and disability activist—stopped by for a nice visit and a nice break from the routines the three of us can't help falling into. Charlie had been groggy and sleepy and just uncomfortable all day and at last went out for a bike ride with Jim.
It was a far, far from perfect day. It did end a lot more peacefully, as in less stormily, than it had begun.
It is good (not sure that's quite the right word) to know how the meds Charlie takes may be—are—helping him.
We do hope—and I think we're not alone—that there can be some less stormy way to figure that out, and to help Charlie allay the riot in his head when things don't come together the way he so thought they must.