The Core Issue

We all know and use the word “core” very easily in different contexts and the oxford dictionary gives us many definitions for this word; nevertheless, I want to put two of them out here as is.    1.The muscles of the torso, especially the lower back and abdominal area, which assist in the maintenance of good posture, balance, etc.  2.The part of something that is central to its existence or character.   While both these definitions are different usages of the word core; I want to say that by building our son’s core muscles we helped elevate his quality of existence! The core strength literally proved to be beneficial in building his character. Following post is how it all began….

OT Assessment. In the first assessment done by the Occupational Therapist, we saw that our son was developmentally affected in many areas. The language in the report was so new to us. Apart from low postural muscle tone and poor shoulder stability he had sensory processing disorder (SPD), which meant that he got overwhelmed if there was too much information for the various senses to process. He had an impaired proprioceptive sense as in, he isn’t aware of his body relatively speaking; example- he couldn’t with closed eyes use his left hand to touch his right knee. He had bilateral integration issues and he couldn’t cross the midline which meant that the left and right hemispheres of the brain were not coordinating effectively and he had poor motor planning or dyspraxia.

What this assessment meant. In our son’s case, we received concerns on fine motor skills being very poor; way below peer-level. Picture this, a child of 4 years trying to use a pencil or crayon to trace a dotted curvy line. His shoulder and wrist are not stable so his attempt looks like a hair that’s fallen on the paper! However, he notices that his peer next to him is having thick lines on his work and is quicker than him. The next time the task comes to him what do you think will be his response? A young child isn’t going to talk about his problems, instead he or she is just going to try every trick in his little kitty to escape- crying, tantrum, running away, and in some cases may have a meltdown. There is a good chance he will not pick up the pencil, or he will wait to be supported. The teacher or parent may consider this as being stubborn, because if they just put their hand on his he writes the letters! Until we saw the OT’s report, we didn’t know that his shoulder muscles were affected. By placing our hand on our child’s hand, we actually give support to muscles that are lacking strength and stability. We also received feedback that he was very distracted and the teacher noticed he was very fidgety. Sometimes he would attract attention by making funny voices or shouting and would end up getting the naughty chair (timeout). All this because he can’t sit upright due to poor postural tone. Bilateral integration and Midline crossing issues come into play when the child has to use both left and right sides of the body like in scissor work, bead work, tying shoe laces. Often if a child isn’t working hard enough or doesn’t seem inclined to do these activities before judging their behaviour, it’s best to check on these underlying factors.

Information is everything– During the 2018 Autism summit, there was an interview with David S. Geslak, the founder of Exercise Buddy http://www.exercisebuddy.com/.He explained that exercise does wonderful things for children on the spectrum. It has been made into an Evidence-Based-Practice that helps autistic children and he had a free 10-day access to the videos on how to execute the exercises. We felt there was so much to be done and from our understanding of the OT activities we decided that we will get our son into an exercise regimen incorporating animal crawls and build muscle strength. We hoped that it will address some of the concerns like fine motor skills by building stability around his shoulder joints and attentiveness by building core stability as it would able him to sit upright in class for longer durations or get through ABA(Applied Behaviour Analysis) therapy sessions with more ease.We understood that physical inhibitions that are not so evident can have behavioural implications.I feel a sense of guilt that I didn’t catch these pointers early on. It’s not just early diagnosis that’s the key it’s also how we understand the diagnosis and what we can do about it, that matters the most.

Exercising our way through. When we started out, we didn’t have gyms that catered to kids. There were group yoga classes and group karate sessions but we needed more one-on-one type intensive sessions. I consider our son’s exercise regimen as not just a practise but as an intervention.  As first steps, we got monkey bars and a trampoline installed in our lawn. We requested my husband’s gym trainer to help us with our child and despite being a trainer for adults he obliged us. My son did 40 min sessions for about two times a week and we saw gradual gains in his core stability. Another important point is that, we had already begun on ABA, GFCF diet and homeopathy before starting on making exercises as part of our son’s routine. It wasn’t a conscious decision but in retrospect it couldn’t have been a better sequence of events. He wasn’t as sick as he used to be before the GFCF diet so we could get him to exert. We got our son’s compliance through the use of ABA techniques. We used visuals to explain exercises so that he transitioned well and was not irritated by too many instructions. In the beginning, most exercises were tough for him and we had to use many fun elements and games to get through them. We then indulged him with tennis, swimming and horse riding. When the kids’ gym opened, he was instantly a member there. Since he had Mon-Fri packed with school and ABA sessions, we had to pack all the exercise regimen into the weekend. This clearly meant more commitment from our side as parents. Then recently we restarted his one-on-one exercise routines again with the help of  the exercise specialist at ‘My World Ahead’ https://www.myworldahead.co.za/services/. What I like about this program is, it is very specific to skills development, and mostly intended for children on the spectrum. The program looks at strengthening his core muscles, increasing stability, endurance, balance, coordination and response times. Even with the Covid situation this is one aspect we haven’t given up on. We do zoom sessions and we participate with our son!

Did we achieve what we set out to do? Yes, indeed and more! Exercising is in general good for the moods. It releases endorphins which help relieve stress and pain. Brain chemicals like dopamine and serotonin are also released which help in the sleep cycles. Our son was sleeping better and sleeping through. We noticed he could focus better after the exercise routines. He does 3-hour ABA sessions without any behavioural issues. We could never have imagined he will sit on the same seat and work for so long in a Zoom session. I have absolutely no involvement and he takes minimal breaks. His confidence in ball skills has increased. His balance, fine and gross motor skills are all in place. His love for hiking is what motivates us to try the difficult hikes. He never complains of being tired and feels a sense of accomplishment when he finishes the hike. He is a confident swimmer when compared to when he started. In the 800m end of year running event at school, he showed his stamina and confidence by being amongst the first three in the entire Grade 1 to complete the run. He knows he can write and is quick at it too so he persists despite his inability to imagine and articulate. His handwriting needs improvement but he can write 2- 3 pages without getting tired. Since the motor skills are better, he can go about his work independently. Before he would need help to fill water from the heavy jug into his narrow water bottle, now he did rather do it himself. Sometimes we find him trying out some stunts on the bicycle and we see stability, control and coordination in play. We know we have come a long way. These may be little achievements but he is proud of them.

Self-esteem goes a long way for anyone and more so for a child on the spectrum. Getting through a normal day is a lot of work. Social interactions are too heavy to handle. We have with exercise managed to raise our son’s self-esteem- the wind below his wings. Rather than be anxious and insecure, this inherent strength helps him stay motivated and happy.

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