RMTi and Autism

When I work with children or adults on the autistic spectrum, I always remind myself that it is a spectrum and that we can all ‘do’ autistic behaviour when stress overwhelms our brains. I find this awareness helps to build connections with people who others label as ‘odd’ or out of synch, remembering that maybe what we are seeing is a reflection of what we are projecting!

Over the years I have worked as a therapist with both adults and children labelled as having Autistic Spectrum Disorder (ASD), some of whom have been non-verbal and others who are ‘high functioning’ and well able to communicate. I have also trained therapists who work with clients who have ASD and will include feedback from them in this blog.

My starting point with clients with ASD is the RMTi passive movements, providing the client has no tactile defensiveness. If this is the case then I have to look at other options, which I will explore shortly.

If it is possible to use passive movements these work beautifully to calm the individual’s system and start to integrate the primitive reflexes that are often at the root of ASD. The Fear Paralysis and Moro reflexes are, in my experience, the cause of much anxiety and emotional outbursts associated with ASD. Once these start to integrate, the client is enabled to experience a sense of safety and belonging and modify their extreme behaviours.

One of the first children I worked with as a movement therapist was at the more severe end of the ASD spectrum. He was non-verbal, and, on his first visit to me, literally bounced off the walls of my clinic. He was so anxious it was very difficult to work with him, and I agreed with his mother that I would henceforth go to their home, where he would feel more comfortable.  Over the next year, I visited regularly but got increasingly frustrated because his mother would not do any exercises in-between visits. However, some sort of magic happened, because the child started to make progress, and, although non-verbal, we established a way of communicating.  When I was doing a movement with the child, he would move my hand to a position he found more comfortable. I found that I had to be the biggest, most interesting thing in the room to gain his attention, but once I had it, I could tangibly feel the changes happening.

One of the most profound experiences for me was when he started making the initial sounds of words. This was in a play situation, when I was massaging his toes under the guise of playing a game. He really liked this and we spent some time repeating the activity, all the time joining in with me and making the initial sounds of the words I was using. The lesson for me was that progress is often very slow and very small, but that we must recognise and celebrate it when we see it! This young person was enjoying the activity and happy to engage with me for a considerable time – it was also wonderful that he was making progress on his individual journey. Sadly, this young person was not able to progress to his potential because his mother refused to engage with the programme, although she was happy for me to continue my visits to the home!

I have also trained teachers and teaching assistants who work in schools for children with autism. Feedback from the practical ways they have used RMT has been truly inspiring. The following was sent to me by one of my students, a teaching assistant who started using RMT with a class of boisterous 11 – 14 year old boys:

“We are classroom based most of the day with limited access to the PE Hall and spaces where we can carry out physical activities. Also due to staffing issues at present I have been unable to deliver the RMT programme on a wholly 1:1 basis. However, with all these restraints in place I have had very positive results with the pupils and they have embraced lots of the movements.”

This teaching assistant used the movements as part of PE lessons as a warm up and cool down exercise and found very positive results in class, with the pupils transitioning between activities in a much calmer manner. They were also better able to focus on their school work afterwards. As the movements are enjoyed by the pupils they really like to use them and take ownership of them, using them to calm their emotional anxieties. So, when stress threatens to overwhelm the brains of these young people they choose a movement to do until they feel better. Having been shown the movements and having the choice to do them when needed really worked in this sometimes hectic classroom environment.

With another young person, also non-verbal, I found that I had to do the movements with her mother before she would co-operate. She would watch me and then eventually lie down beside her mother, as if energetically joining in. Then she let her mother engage her in the movements. Again, progress was slow, but I think the biggest benefit to using RMT is that it helps calm the system and children on the autistic spectrum sense this and benefit from it. Another huge learning for me is the importance of adults interacting with young people maintaining a calm approach: we are energetically connected and children and young people sense our stress and will react to it, often escalating already challenging situations.

Adults on the spectrum can also present challenges when engages in a  Rhythmic Movement Training programme. The biggest challenge I have found is that they like to stay very much in control of all that happens to them and can find it very challenging to ‘let go’. I find that passive movements are inappropriate to use in these circumstances, as the client has to surrender control to the therapist. As I mentioned earlier, the Fear Paralysis and Moro reflexes are often very active in people with autism. I have found some success with adults in using the active ‘pre-birth’ movements, as they feel in control of these. Progress has to be in tune with the client, and, sometimes, they may only able to make a small part of the required movement. Over time they can gradually build up to the full movement and it is possible to see the relaxation that follows as the client is able to release locked patterns of movement.

One adult client, a woman in her sixties, was so locked down by stress that she found all RMT movements challenging. She lived alone, so it was not possible to give her passive movements, so we worked together to adapt the active and pre-birth movements so that she could attempt them. Over a six month period she made amazing progress and regained a flexibility of movement she had not had for many years. She also reported that she felt much more grounded and emotionally stable after doing the movements.

I hope that you have enjoyed reading these examples of my work and feel inspired to learn more about RMT!

Janice Graham

January 2018