Integrated Therapy as a Treatment for Asperger’s Disorder:

Sandy Bothmer, M.Ed., Reiki Masterby Sandy Bothmer, M.Ed., Reiki Master
Children’s Creative Yoga and Movement Teacher

Life for Joey was one meltdown after another both at home and at school. After an incident at school, it would take an entire day for Joey to calm down, his mother said. Ã’You could forget about his learning.Ó One day in early June 2004 at the end of third grade, Joey had become so angry at school that he had to be restrained twice that day. His aide was concerned that as he got older it would become increasingly difficult to restrain him. This prompted Joey’s mother to look for help that would teach him self-calming techniques. She did not want his teachers to have to be given restraint training to handle him, feeling that that approach would be like, Ã’ . . . putting a band aid on top of an infection.Ó She wanted Joey to get control of his emotions and his body. My work, Integrated Therapy, was the answer to her search.

JoeyÕs History

Joey was diagnosed with AspergerÕs Disorder when he was 5 years and 11 months old. The results of his neurodevelopmental evaluation showed that he had significant impairment in his social interactions as well as diminished friendships. He had limited ability to play with other children without adult facilitation. Joey did make eye contact but would forget as he became involved in his own conversation. This self-involvement resulted in difficulty with reciprocity of conversation. It was also difficult for him to recognize that other people had different ways of doing things than he did. Often, this caused him to become upset if others didnÕt follow the rules that he had developed or incorporated. Joey showed a restricted and repetitive range of interests and behaviors revolving around dinosaurs. Atypical for his age was the degree of his upset if his rituals and routines were not followed. In addition, Joey exhibited difficulties in social interactions, play, and communication. Finally, it was felt that he would probably be a child with an uneven learning profile. This view was based upon impressions observed by the evaluator that found Joey to have extraordinary memory for performance with favorite tasks that differed from previous testing results that indicated global developmental delays. (Neurodevelopmental Evaluation 2000)

Treatment Plan

Much of the effort and time spent with children with AspergerÕs centers on improving their social skills. From what I knew, not as much was done about their emotional state, bringing that to a state of equilibrium so that they can be more receptive to learning, think more clearly, focus their attention, and interact more appropriately (Geller, 2005). These are the issues I believed Integrated Therapy would address. It would help to change JoeyÕs inner and outer worlds.

My treatment plan for Joey involved six aspects:

* energy diagnosis Ð A scanning technique to determine the vitality of the seven major energy centers was used. This involved locating the seven major energy centers (charkas, Hindu system) over the body and then feeling inside each of them, one at a time, with a finger, for their vitality. Vitality is determined by how open the circling energy center is (size of the energy center). To be balanced, they should be of the same size/circling and connected.

* relaxation and rejuvenation techniques Ð Various relaxation (calming) and rejuvenation (energizing) techniques were explored to find out which techniques worked best for Joey. Deep abdominal breathing was taught as the foundation for other calming techniques.

* yoga Ð The practice of yoga, the oldest form of exercise (Gessner 2004), includes several different aspects. We worked with asanas (postures), pranayama (breath), and relaxation. Together, these practices help to quiet the nervous system, improve concentration, strengthen the muscles, and increase flexibility. The result of this mindful movement practice is Ò. . . increased mental clarity, emotional stability, and a greater sense of overall well-being.Ó (Sumar 1998) The mind/body would be more receptive to learning.

* breathing Ð Breathing (pranayama) has been mentioned as part of yoga but is such an important relaxation technique it deserves to be a separate category. Learning deep abdominal breathing helps to calm and focus creating an opportunity for increased learning in school, improved interactions, and better decision-making.

* movement Ð Movement experiences through concept exploration help to develop body awareness in space and in relationship to others. Movement Based Learning techniques (Cecilia Koester) help the childÕs body learn or relearn movement patterns that may be missing or not yet integrated into the childÕs mind/body. Movement is the underlying foundation to learning.

¥ Energy balancing Ð Energy balancing releases stuck or stagnant energy and reestablishes the flow of energy in the body bringing balance, homeostasis, on all levels: physical, mental, emotional, and spiritual. Reiki, a Japanese hands on healing practice, and other energy balancing techniques were used.

I believed that there would be noticeable change in some or all of the energy centers after each segment of the session.

Treatment Session Format

Each treatment session was divided into two, half hour segments providing a structured routine. Segment One included an energy diagnosis at the beginning of the first half hour followed by relaxation and rejuvenation techniques, yoga, and movement. Another energy diagnosis occurred at the end of this segment.

Segment Two was half an hour of energy balancing followed by a final energy diagnosis.

The frequency of sessions for Joey was set up for every other week with the exception of weeks one and two that were back to back and barring any unforeseen conflicts or vacations. A period of two and half months during the winter, January, February, and half of March 2005, we were unable to meet. During this time, I worked remotely, using distance Reiki to balance his energy centers.

Findings Summary

By the end of our work together in June 2005, Joey became more flexible in his homework environment. His academic work improved as evidenced by his achieving the honor roll each term. Physically, his muscle strength and balance improved and his body was no longer cold all of the time. JoeyÕs appetite and interest in food increased, and he started to drink water. He developed self-awareness of his body and emotions. He adopted a relaxation technique, deep abdominal breathing, that allowed him to manage his emotions on his own. A sense of Òother awarenessÓ was exhibited along with improved ability to initiate play with age mates. In addition, JoeyÕs eye contact improved along with his self-esteem and self-confidence as evidenced by his offering opinions about things and volunteering in school.

Interpretation of Findings

In drawing conclusions regarding the effectiveness of JoeyÕs Integrated Therapy treatment plan, one must look at the observable changes in how Joey presented himself when we first started to work together and how he presents himself now. Information for this comparison was gleaned from observations by JoeyÕs mom, the teacherÕs aide, his doctors, and me.

Findings Comparison

Before June 2004 After June 2005

*inflexible with homework environment *flexible with his homework environment

*no self-awareness of his body and *self-awareness of his body emotions and emotions
*needed others to help him manage his *emotional self-regulation emotions, frequent meltdowns using deep abdominal breathing, minor meltdowns
self-regulated

*no sense of the needs and feelings of *developed sense of Òother others awarenessÓ

*very little eye contact *improved eye contact

*low self-esteem and self-confidence *increased self-esteem and self-confidence

*only interested in playing with younger *interest in initiating children or needed adult facilitation play with age mates

*poor muscle strength and balance *improved muscle strength and balance

*extremities were always cold *extremities no longer cold all of the time

*little or no interest in eating and drinking *increased appetite, except for very few foods, did not drink eating a variety of
water foods, drinks water
*difficulty with academics due to his *improved grades, honor emotional state roll, more relaxed
emotional state

Conclusions

It appears that the combination of energy diagnosis, yoga postures, relaxation through deep, abdominal breathing, movement and Movement Based Learning techniques, and energy balancing made a difference in the positive changes seen in JoeyÕs functioning, because these techniques were not used with him before we began our work together. Connections in his brain may have been strengthened since he is functioning better. Also, discontinuing medication may have had a positive effect on his improved appetite and academic work as well, since the interfering side effects disappeared. JoeyÕs inner world is calmer these days and this has affected his outer world at home and at school in a positive way. HeÕs living a happier more productive life.

Resources

Bothmer, Sandy. (2003). Creating the Peaceable Classroom. Tucson, AZ. Zephyr Press.
Eden, Donna. (1998). Energy Medicine. New York. Jeremy P. Tarcher/Putnam.
Geller, Lynda. (2004, Summer). : Emotional Regulation and Autism Spectrum Disorders.Ó
Autism Spectrum Quarterly, 14-17.
Gessner, Geyer. (2003). ÒYoga, Breath, and the Brain.Ó Learning and the Brain: Using Brain
Research to leave No Child Behind.Ó
Judith, Anodea & Selene Vega. (1993). The Sevenfold Journey. Freedom, CA. The Crossing
Press.
Koester, Cecilia. (2004). Movement Based Learning for Children Who Have special Needs.
Hawaii.
Leschin-Hoar, Claire. (2003) ÒSeeking yogaÕs soothing touch: Many say children with medical
issues benefit from its use.Ó Boston Globe. November 20.
Mehl-Madrona, Lewis. (2000, July-August). Ã’Effective Therapies for Autism and Other
Developmental Disorders.Ó Arlington, Texas. Autism/AspergerÕs Digest Magazine.
Rowland, Amy Z. (1998). Traditional Reiki for Our Times. Rochester, VT. Healing Arts Press.
Sumar, Sonia. (1998). Yoga for the Special Child. Evanston, IL. Special Yoga Publications.

BIO for Sandy Bothmer

Sandy Bothmer has 20 years classroom teaching experience with an M.Ed. from Lesley University. She is a Reiki Master, energy diagnostician, ChildrenÕs Creative Yoga and Movement teacher, and the author of Creating the Peaceable Classroom. Her current work, Integrated Therapy, is an outgrowth and blending of her experience and trainings. Sandy brings a heart-centered approach to her work, creating a safe and accepting environment for her clients, tailoring each session to meet their individualÕs needs. Teaching continues to play a vital role in this work as she assists her young clients in learning yoga and techniques that will help them better manage their emotions so that they can live their lives from a place of greater calm. As a result, they can be more receptive to learning, think more clearly, focus their attention, and interact more appropriately. Sandy can be reached at sbothmer@aol.com.

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