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Connecting the dots...

According to Oliver Sacks (Neurologist)- Much more of the brain is devoted to movement than to language. Language is only a little thing sitting on top of this huge ocean of movement.

My first experience of any child with Autism Spectrum Disorder (ASD) was with Rubina (name changed). Those days, I was working in a special school and I was asked to choose a child to work with. I saw Rubina, 5 year old girl, nonverbal child with ASD, holding a doll of her size, sitting in a corner of the class. I approached her and made an effort to say hello with a broad smile on my face and touched her doll. A slap on my face was the reply from Rubina in the very next moment. I did not know how to react and I chose her to work with.

 Every day, I sat next to Rubina and observed her actions without any interaction with her. After 3 days I picked up a similar doll as her’s and copied Rubina’s actions. She did not show any interest in me and my doll. I was bored, amused and little frustrated but I continued the same for next few more days. After 7 days, she touched my doll thrice, third time for longer duration. I jumped with joy and hugged her and I received a tighter slap this time. People around us laughed and I sat little far from Rubina that day.

I was reading about Autism, whatever I could find on internet/books, talking to people working in the school and parents about their children but no one could tell me how should I work with Rubina except repeating the definition of Autism and issues associated with Autism. I continued my work with Rubina, following her behaviours. I witnessed small changes in her behavior, movements, and level of engagement with me that went unnoticed by other staff till the day our school director saw me playing with Rubina with our dolls, though there was no verbal communications or facial expressions. I was summoned to the director’s room immediately. I was nervous but to my surprise I received an USB drive with a movie to watch.

Son-Rise: A Miracle of Love is a televised docudrama film that aired on NBC in 1979 and is adapted from the nonfiction book Son-Rise (currently Son-Rise: The Miracle Continues) by Barry Neil Kaufman. It is the real-life story of how, according to his parents, Raun Kaufman completely recovered from severe autism.

I was moved by the movie and since then, this movie has been an integral part of all IEPs I make for children with special needs.

What is Autism?

Autism Spectrum Disorder is a Neurodevelopmental Disorder that takes place early in a child’s development. Autism Spectrum Disorder affects social interactions, communication, behavior and interests of children with autism. This means there is difficulty engaging and maintaining reciprocal social interactions, and trouble with receptive and expressive language. People with ASD have been described as feeling isolated and trapped in their own world of bodily sensations.

After doing my Practitioner Program of NLP (Neuro Linguistic Programming), I found that my primary intervention with Rubina was mirroring/matching.


The Mirror Neuron System

 So how do things like intersubjectivity and implicit processing actually happen? How is the person looking at the other able to imitate and feel in order to understand what the other is doing? The process of seeing, understanding and recreating a mirrored image of what we are seeing lies in the mirror neuron system. This is science, because we can actually trace the process within our brains that we can feel when done with attention.

“Neurons that fire together, wire together.” Neuropsychologist Donald Hebb first used this phrase in 1949 to describe how pathways in the brain are formed and reinforced through repetition. The more the brain does a certain task, the stronger that neural network becomes, making the process more efficient each successive time. Birds have been shown to have imitative resonance behaviors and neurological evidence suggests the presence of some form of mirroring system. In humans, brain activity consistent with that of mirror neurons has been found in the premotor cortex, the supplementary motor area, the primary somatosensory cortex and the inferior parietal cortex.

Some researchers in cognitive neuroscience and cognitive psychology consider that this system provides the physiological mechanism for the perception/action coupling. Neuroscientist Marco Iacoboni has argued that mirror neuron systems in the human brain help us understand the actions and intentions of other people. In a study published in March 2005 Iacoboni and his colleagues reported that mirror neurons could discern whether another person who was picking up a cup of tea planned to drink from it or clear it from the table.

Upon further investigation I found, not only a definition for mirroring, but also a complete description of the process of my therapy was based on NLP. I worked in a very non-directive way, using improvisation and providing the opportunity for Rubina to explore movement while passing in and out of relationship. Over time I began to involve props including a stretch band, balloons, bubbles, balls and scarves throughout our sessions.

 After following my natural kinesthetic response for mirroring to help increase the time in relationship, I began to see that mirroring is an actual preference of mine. As a preference, mirroring comes very naturally to me, so often the usage is less intentional and more automatic. While using mirroring as an intervention during my sessions I found that I was mirroring in different ways, although I was unable to verbally communicate what ways these were. I also noticed differences in how various children responded to these ways of mirroring, although this was unclear too; but, overall, I began to see differences in my intervention style and various changes in the students.

At this point in my work I understand and use mirroring to adopt the overall movements, and qualities of those movements, as a way to reflect back to the child's own physical expression for the purposes of gaining awareness and building rapport. I also use mirroring to help understand more about the child’s internal emotional experience that these movements might create for them. By doing this, I am able to form and feel a connection with the child because adopting their movement expressions is a way of getting to know them, especially if they are nonverbal. 

The literature also uses many other terms for Mirroring. Tortora’s (2006) definition of mirroring is “literally embodying the exact shape, form, movement qualities, and feeling tone of a person’s actions. Tortora describes mirroring as part of the first step of the therapeutic process outlined in the Ways of Seeing technique discussed in her book The Dancing Dialogue (2006) The technique begins with match, which consists of attunement and mirroring. In contrast to mirroring, attunement is defined as the “matching” of a particular quality of another person’s movement, by not completely depicting the entire shape, form, or rhythmic aspects simultaneously, as in mirroring”. Both attunement and mirroring are interventions that make up the first stage of the technique. It is important because “through spontaneous explorations children can discover their own developmental progressions; when children are given the chance to use their bodies to explore their environment, stages of development naturally unfold”.

From neuroscientist Daniel Wolpert: We have a brain for one reason and one reason only -- that’s to produce adaptable and complex movements. Movement is the only way we have affecting the world around us… I believe that to understand movement is to understand the whole brain. And therefore it’s important to remember when you are studying memory, cognition, sensory processing, they’re there for a reason, and that reason is action.

My therapy method contains three stages: Stimulate, Activate and Mobilize. An important aspect of my intervention is: how these stages are connected, so that when one has developed, it can be viewed as such. It is common knowledge that those diagnosed with autism spectrum disorder (ASD) have difficulty engaging in relationship. Yet those having experience with individuals with autism can describe moments of relationship as well as behaviours that signify the individual is aware of the other. This in a sense is a relationship. So in order to understand an atypical relationship and the development thereof, we need to look at the typical development of relationship. For that, as the literature suggests, the first experience of relationship we all have is considered the most important one, that between infant and mother.

In The Expression of Emotion in Man and Animals (1872), Darwin proposed that the movements of expression in the face and body serve the biological purpose of communication between the mother and infant. Hall (1976) introduced the concept of movement as the first “extension system” and thus a first form of communication. This idea parallels Darwin’s in that the movement of facial muscles that exhibit the facial expression of affect and thus emotion is a basic way to communicate, especially for one who has no verbal capacity. Darwin saw this way of communicating as a survival necessity. If the child, with no verbal capacity, must tell its mother it is hungry, the child must use its movements to get this point across, because that is all it has.

This is where the other side of the dyad comes in. The mother, who has the capacity for language, but is not receiving verbal information, must be able to read the language of movement the child is using to make sure the child survives and does not starve. In this way, it is evolutionarily imperative that the mother understands the language of movement of her child through her own capacity for movement as expression, which she already has developed. Darwin stated this, knowing that the ability to express in movement as well as understand movement is an evolutionary ability humans have developed.

From Moshe Feldenkrais:

I believe that the unity of mind and body is an objective reality. They are not just parts somehow related to each other, but an inseparable whole while functioning. A brain without a body could not think … the muscles themselves are part and parcel of our higher functions.

 Nothing is more revealing than movement. All that important in this one moment is movement. Make the moment important, vital, and worth living. Do not let it slip away unnoticed and unused.

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