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Neurodiversity and A Changing World

Previously, I wrote about the intricacies I learned about neurodiversity from my granddaughter, Alexandra. When she was very young, we noticed how certain fabrics bothered her. She had difficulty smiling, responding to her name when called and was otherwise distracted. She appeared distant, lost in a far- away land.

After learning of her diagnosis as autistic spectrum disorder (ASD), early intervention, extensive therapy and working with professionals has given Alexandra the communication and social skills to run, laugh, talk and play like any other 5-year-old. Though this journey has its challenges, it spurred me to dig deeper, learn more, and further develop my skills and understanding of neurodiversity in all its forms.

Researchers and scientists have come a long way in uncovering the different forms of learning that autistic individuals use to experience the world.

Still, there is much to learn about neurodiversity. Specifically, we need to focus on autism in an increasingly technologically advanced world and a growing population. In fact, the Centers for Disease Control and Prevention (CDC), in a new report published April 26, 2018, found new data on the prevalence of autism in the United States. This surveillance study identified 1 in 59 children (1 in 37 boys and 1 in 151 girls) as experiencing autism spectrum disorder (ASD).

Autism Linked to Addiction

In addition to new-found statistics, I also discovered research that linked autism to addiction – a finding that is commonly dismissed amongst behavioral health professionals as irrelevant or untrue, as cited in The Atlantic’s article about autism and addiction. Despite this common misconception, my research uncovered information on the topic that I believe is imperative to talk about and spur conversation that will lead to new therapies and modalities in working with and understanding neurodiversity.

If you don’t believe that people who experience autism may also be at risk for a substance abuse disorder, just ask Shane Stoner, a 44-year-old man who discovered his autism after a bout with heroin addiction.

“I felt like heroin gave me confidence,” explains Stoner, in The Hidden Link Between Autism & Addiction (Atlantic Magazine , March 2017). “I could get out of bed in the morning and do the day. No matter what happened, it made me feel like it was going to be alright.”

After a run-in with the law, Stoner entered a detox program to kick his addiction to heroin, but it wasn’t till years later that he received his autism diagnosis. The diagnosis opened his eyes – it helped him understand his strange behaviors, his heightened experience of severe anxiety, and the way he relates to the world around him.

“It explained Stoner’s sensitivity to things such as tags on his t-shirts, and his succession of obsessive interests. It clarified why he had such a difficult time fitting in as a child, his problems with roommates in college—and why he continued to struggle with social connections as an adult.”

Likelihood for Substance Use Disorders

Stories like Shane Stoner’s are becoming more prevalent. In fact, a new study in Sweden – the first to explore the link between people with autism and addiction – found that individuals with autism who have average or above average intelligence quotients (IQs) are twice as likely to become addicted to alcohol or other drugs than their peers.

This study looked at 26,896 Swedes diagnosed with autism born between 1973 and 2009. Researchers found, in addition to the general population of autistic people having double the risk of addiction, there is an elevated risk amongst those with autism with an IQ of 100 or above.

Furthermore, researchers looked at co-occurring disorders and found that those with autism and a dual-diagnosis of attention deficit hyper-active disorder (ADHD) “increases the risk of addiction fourfold; among those with an IQ in the typical range or above, ADHD increases the risk eightfold.”

These findings help us understand how someone with autism may develop a substance abuse disorder.

A Clearer Picture Emerges

Decades ago, when patients exhibited severe signs of autism, their need for caretakers (and not living independently) made it difficult to obtain alcohol or illegal drugs. The assumption also prevailed that an autistic person’s penchant for obsessive compulsive behaviors such as strictly following rules made it unlikely to experiment with drugs or alcohol. It has been noted that children with autistism display little fear and enjoy twirling, spinning, roller coaster rides, climbing walls, and other high risk behaviors

However, now that researchers and clinicians have learned more about autism spectrum disorder, the Swedish study and stories like Shane Stoner’s help us see a clearer picture of autism and addiction.

Stoner did not understand the source of his anxiety, nor his strange behaviors, but when heroin was introduced to him as a way to cope and give him confidence, we can understand how the door was opened to an addiction.

Though his addiction led him to eventually uncover his autism diagnosis, stories like these help us see that more research must be done to uncover more about neurodiversity.

Sensory Integration as Treatment

Now that we see the bigger picture of autism and addiction, an emerging modality to help with addiction may be in sensory integration. What is sensory reintegration?

According to the Novak Djokovic Foundation (NDF), a global organization committed to giving children equal access to quality preschool education, sensory integration has been defined as,

“the ability to take in information through senses, to put it together with prior information, memories, and knowledge stored in the brain, and to make a meaningful response.”

I had the privilege of speaking at the Post Traumatic Growth Symposium in Utah this year, where I toured two facilities, Recovery Ways and The Heritage School that employ sensory integration rooms used as a form of therapy. What is a sensory integration room? Again, according to the NDF, this is:

“a special room designed and equipped to stimulate the senses of hearing, sight, touch and smell. It is a place where people with sensory integration disorder can explore and develop their sensory skills, and also where they can relax, relieve stress and anxiety.”

Stormy Hill, an occupational therapist at Recovery Ways, the Utah-based treatment center where I visited a sensory reintegration room put it this way, saying its goal is:

“to teach the patient to stay grounded, to stay organized, to stay calm within an emotional range, no matter what life is throwing at them.”

In the rooms I visited, there were climbing walls and swings, and everything was soft to the touch. There were even fiber optic sets, interactive fiber optic light cables that you could pull, bend, stretch and coil.

Sensory Integration Rooms as Clinical Tools

During my time in the room, I learned that sensory integration, an emerging type of therapy for dual-diagnosis clients, can be used for a wide range of clients and patients. In fact, sensory integration is suitable for children or adults with autism, concentration disorder, sensory impairments, mental development or insufficient development problems, speech difficulties, learning disabilities and behavioral problems.

I dug deeper and was fascinated to discover these rooms could be beneficial in de-escalating an upset client. They might serve as a place to hit pause, to rethink what is upsetting them and pushing them to want to leave treatment AMA. I watched how my usual hypervigilant self -calmed down by playing with the manipulatives and realized how easy it would be to open up about past traumas hiding behind fiber optic cables while swinging in a hammock.

I was further jarred into my senses when the OT offered me a hot chew. WOW! Whatever I was focused on, ruminating about was suddenly jarred out of my sensibility or existence. The sweet bitter taste startled me and altered my senses and my thought processes. I was immediately pulled into refocusing my thoughts, my sensibilities. I marveled over this experience thinking how wonderful it was to stop my obsessions by simply giving me a candy and putting me inside this magical room.

I thought this might be a perfect way to facilitate a clinical intervention with a patient. In this room, the combination of manipulatives juxtaposed with a hot chew will allow one to settle down and process the pros and cons of rash decision making.

In that moment, I wondered, “Why don’t all treatment centers have sensory rooms?”

As we peel back more layers of understanding behavioral health, addiction, neurodiversity and autism, I’m encouraged to see researchers and behavioral healthcare professionals employ these types of strategies with their patients. Likewise, it’s imperative that we keep our eyes open to the way addiction affects neuro-diverse learners and develop protocols and strategies that meet the needs of this ever emerging population.

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