Martin has been a little off this week. Not in the same way as last week—his attention span is back up (thank goodness). Instead, he lacks coordination and balance, he’s restless at bedtime, and he’s had a couple difficult nights. (We used to have terrible troubles with Martin’s sleeping, which were misdiagnosed by the experts at the Big Imposing Hospital as Restless Leg Syndrome, or RLS; Martin’s sleeping was more or less the first thing that improved when we started treating his autism biomedically.) I attribute this week’s symptoms to the fact that, on Monday, we visited his HANDLE therapist, Katie Penque.
Of the various therapies in which Martin participates—RDI, PT, OT, speech therapy—HANDLE therapy has proved to be surprisingly powerful. Counter-intuitively so, even, as it relies on simple and gentle “organized movement activities,” like tilting Martin slowly backward and forward, or tapping my fingers across his skull in a particular pattern. The therapy is designed to help Martin gain better control over his physical self, his movements, his actions.
We noticed immediately after we began HANDLE therapy, three months ago, that Martin had a series of restless nights and seemed a little discombobulated during the day. Katie advised us to reduce the HANDLE exercises, then work back to full capacity. We did so. Even so, I sometimes have to skip a particular exercise because Martin seems to resist it. (In HANDLE language, this is called a “state change.”) But more or less, we got the hang of it and proceeded accordingly.
Now we see restless nights after a visit like Monday, when Katie evaluates his progress and recommends new, more advanced exercises. This week we added “hoop elevator,” in which Martin stands still whilst I slowly lower a hoop around him, from his head to the floor and back up again. We also added “joint tapping,” which is about what it sounds like, i.e., me tapping Martin in a bouncy motion at various joints. Doesn’t seem like much, right? But even Katie doing the exercises with him on Monday, to show me how, set Martin on a course of nighttime restlessness and diminished coordination. It was Thursday before I could complete any HANDLE exercises at home without him resisting.
As Adrian and I see it, the HANDLE therapy is as successful with Martin as it is occasionally overwhelming. Martin truly is more in control of himself. He remains still for longer, and many of his movements have lost the clumsy jerkiness sometimes associated with ASD. The improvements are evident even when he sleeps. Martin used to circulate the bed during the night. Head at the top of the bed. Head at the foot of the bed. Head hanging off the side of the bed. Feet up the wall. Blankets on the floor. He continues to toss and turn, like any toddler, but for the most part he has become able to keep his head on the pillow, and a light blanket approximately over his body, from sleepy-time till morning.
It’s Friday night, and he has evened out since Monday. This weekend I will introduce the more advanced HANDLE exercises and see where they take us. I enjoy that Martin no longer attracts curious glimpses from passers-by, who look as if they can’t put their finger on why he appears different from other kids. Day by day, he looks more and more like the others at the playground.