Breaks and Breakthroughs

Like many students with autism, Alex has a laminated card that reads, “I need a break” his therapist gave him a few years ago. These visual aids communicate an important need for those who have limited verbal skills or for those who simply may be too upset to speak. In addition, knowing that break time is available may also relieve stress. Considering how difficult communication, social interaction, and motor tasks can be for people with autism, certainly they need to know that taking a break is always an option. Over time, as Alex has mastered skills and learned how to cope with stress better, he has relied upon his break card less and less, needing fewer breaks and more easily verbalizing his needs.

In June, after writing this blog for nine years, I decided to take a break from writing at least for the summer. Frustrated with the lack of useful studies being done to help people with autism, I couldn’t find interesting research to share. In addition, I knew that my summer would be devoted to weaning Alex off an anxiety medication that drug companies had stopped manufacturing. Even though he has done well when we have taken him off other medications, we know that he deals with sensory issues as his nervous system adjusts to the changes. Specifically, everything sounds louder to him, and his sense of touch is more sensitive. I imagine that his nerves respond similarly to when numbing subsides after dental work or a foot “wakes up” after being “asleep.” At first, this sensory overload can even be painful until the nerves adjust.

Consequently, we have helped Alex adjust to the changes, keeping him from places where noises could bother him, and understanding that he may be irritable at times, dealing with the physical changes. While he has been adjusting to the medication reduction, I have been continuing to research, hoping to find ways to help him cope in a world that overwhelms him at times. After watching a webinar last month, I found a simple solution that has helped Alex tremendously.

In an online Facebook talk sponsored by TACA, The Autism Community in Action, Dr. Jerry Kartzinel explained the link between autism, anxiety, and adrenaline. He likened some with autism as being like rabbits, who flee when sensing danger, and others as being like lions, ready to fight when adrenaline rises. He recommended monitoring the pulses through fitness devices to observe rushes of adrenaline that cause heart rates to spike. Since all of his explanations made perfect sense to me, especially with my observations of how Alex reacts to anxiety, I began researching fitness trackers.

After comparing various features, I wound up getting a Fitbit Inspire HR (heart rate) for Alex at Target for less than one hundred dollars. Since he always wears a wristwatch, he was unfazed about also wearing a Fitbit on his wrist, especially since it offers data he finds interesting: time, date, steps and distance walked each day, and heart rate. While this Fitbit also records data related to sleep, we don’t have him wear it during the night, for fear it may impede his healthy sleeping habits. At the end of the day, we sync the Fitbit to an app on our iPads and can see graphs showing Alex’s heart rate throughout the day.

In the past month, whenever Alex seems agitated, we ask him to check his pulse on the Fitbit. He then calls out the number displayed, and typically his pulse is over 100 if he’s upset. Because he’s so attuned to his body and numbers, he understands the link between his emotions and his physical response measured by his heart rate. We remind him to get his heart rate down, and he will sit calmly, sometimes rocking, until his heart rate returns to a normal level. As we check his heart rate graph at the end of the day, we are rarely surprised because his numbers correspond to specific events at specific times during the day. Not only can we track any times he was upset marked by increases in his pulse, but we can also see increases in heart rate due to activity, such as coming downstairs for meals or excitement when his therapists come to see him. Moreover, we’ve discovered that he’s remarkably mellow, as evidenced by low pulses, most of the time.

A bonus feature of the Fitbit Inspire HR is the Relax mode, which has also proven quite helpful. The Relax feature flashes instructions on the Fitbit screen, telling the user to focus on breathing and the stars that move on the screen. Intermittently, the Fitbit will send gentle vibrations that softly buzz. According to the website Enabling Devices, “Vibration Therapy Tools are fundamental when working with sensory integration. Vibrating products are beneficial to special needs children especially for those with autism, ADHD, or sensory processing disorder. They can calm kids who need more sensory feedback or help train hypersensitive kids to tolerate more sensations.” Although one might think this buzzing would be annoying to someone with sensitive hearing and touch, Alex finds this gentle stimulation calming. After the two-minute Relax session is complete, Alex’s pulse will usually drop at least twenty beats.

While eliminating an anxiety medication has caused Alex to deal with sensory issues in the past few months, he has adapted remarkably well for the most part. Because he is aware of his physical needs, he usually knows when he needs to take a break. Recognizing the connection between his heart rate and stress has enabled him to be even more in tune with his body and to gain greater control when his adrenaline levels make him feel out of control. Once again, I’m convinced that God guides our path, as research led us to a simple device that has proven extremely helpful to our everyday lives. By keeping track of his heart rate, Alex is learning to cope with stress and better reflect the pure heart God has given him.

“Then Jesus said, ‘Come to me, all of you who are weary and carry heavy burdens, and I will give you rest.’” Matthew: 11:28