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Asperger's Syndrome and Unequal Reaction to Pain
Asperger's Syndrome we are all familiar with the enigma of their
unequal reaction to pain and injury. A stubbed toe or paper cut
may set off a pain response (crying, screaming, and sobbing)
such as is equalled by the loss of a limb; yet a burst ear drum
or broken limb may go seemingly unnoticed. As carers of children
with Asperger's Syndrome we are often bewildered by this
'unequal' response to pain stimuli. Anecdotal evidence from
clients worldwide is full of reports on this topic. So, what's
the answer to this confusing puzzle? The questions surrounding
Asperger's children's unequal response to pain can be explained
scientifically.
The assumption that, physiologically, humans are equipped to
limit the amount of stimuli entering our brains thereby
preventing the brain from becoming overloaded, has led to the
establishment of a 'normal' range of feeling. However, those
with Autistic Spectrum Disorder are recognised as having a
hyper/hypo sensitivity to stimuli i.e. above average range of
feeling or super-sensitivity, first written about in 1949 by
Bergman and Escolona.
Accounts written by people with Asperger's Syndrome state that
their disability is directly linked to their senses and their
sensory processing. So let's look at the biochemical processes
that occur when our senses are stimulated.
Stimulation from the environment enters our brain through our
eyes, ears, skin, nose and mouths. Our nervous system passes
this information around our brain and body by the use of
biochemical neurotransmitters. The amount of stimulation felt is
determined by the amount of neurotransmitter processed in each
neuron. The enzyme dopamine beta hydroxylase is released from
nerve endings during stimulation. Dopamine beta hydroxylase
(DBH) is essential for cell communication and regulating neurons
in the central and peripheral nervous systems. An increase in
stimulation results in an increase in the level of this enzyme.
Scientific studies have shown that individuals with Asperger's
Syndrome have much higher levels of dopamine beta hydroxylase in
their systems than in ordinary individuals. The presence of this
enzyme is also linked to behaviours such as repetition,
agitation and aggression.
Repetitious activity, such as rocking, flapping or pacing,
results in the release of Endorphins through the system.
Endorphins reduce the sensation of pain and have the ability to
block pain. In other words, when endorphins are present, the
amount of sensory reaction is reduced or stopped completely.
Children with Asperger's Syndrome have the ability to purposely,
but unknowingly, overload their sensory system in order to shut
it down completely i.e. by rocking, flapping or pacing etc.
Blocking out all sensation by the production of endorphins might
seem like a simple and easy way of coping with sensory
overstimulation; however, in caring for Asperger children we
must realize that reaction to ALL sensation becomes limited.
They won't recognize hunger, tiredness, body temperature (risk
of overheating), full bladder/bowel or pain. Children with
Asperger's Syndrome display agitation through use of repetitious
behaviors such as rocking, flapping, pacing, head-banging,
staring, screaming, spinning, chanting or humming. Our job as
Carers, Teachers and Professionals of children with Asperger's
Syndrome is to recognize these signals of agitation. These
behaviors are used to block out · direct over stimulation from
their environment; · their emotions (happy, fearful, or excited)
and · their response to pain. These repetitive behaviors also
serve to calm an Asperger child, if their use is monitored
rather than unlimited.
For Asperger children, the build-up or cumulative affect of
these endorphins throughout the day also needs to be taken into
consideration. This is why Asperger children who suffer
accidents in the afternoon or evening may not show pain or seem
to feel it.
All physical exercise causes the release of natural endorphins
into the system that can help to 'protect' the child with
Asperger's Syndrome without switching off the sensory response.
So exercise such as walking, running, and swimming is extremely
beneficial in your child's daily routine as a preventative
measure. It may be used during periods of agitation to help calm
the child with Asperger's Syndrome. In this way exercise is used
to develop appropriate social responses e.g. it is more
acceptable to jump on a trampoline rather than on the furniture.
With this information revealed it becomes obvious that we must
monitor our Asperger child's production of endorphins, because
the presence of excess endorphins causes them to lose the
ability to respond to any stimulation. This means that children
with Asperger's Syndrome miss much of what they are meant to be
learning.
Also, we must realize that these stereotyped/repetitive
behaviours have social consequences for children with Asperger's
Syndrome - they are a visual reminder that these children are
different from their peers. We must take into account the
Asperger child's socializing skills and ability when monitoring
and setting limits on the use of repetitive behaviors. That is,
we should tell them times and places when
flapping/rocking/head-banging are acceptable, for controlled
periods of time.
We should not attempt to eliminate sensory stimulation in order
to protect children with Asperger's Syndrome. Without
stimulation, our world becomes meaningless to them. Rather we
should attempt to provide them with a safe sensory environment -
dim lights, softer noises/voices, reduced odors - giving them
the opportunity to learn and respond appropriately.
www.nellefrances.com/tips1.html
About the author:
Nelle Frances is the mother of a 15 year old with Asperger's
Syndrome, a Special Needs Educator and Author of the Ben and His
Helmet series of books for Asperger children. She is also an
active member of 5 Asperger's Syndrome Support and Advocacy
Groups. For more information and Support Strategies visit
www.nellefrances.com/tips1.html
Published by: Nelle Frances
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