Q&A HELP! I Don’t Know How To Handle Inertia With Autism
Do you have any information on inertia and the best ways to help a young girl diagnosed with autism handle it? –Anne
Hi Anne. As an occupational therapist, we specialize in helping people with the motor planning part of inertia (also known as the clinical term “praxis”). Motor planning is a higher level skill than motor coordination and refers to the ability to spontaneously adjust your actions and responses in context according to what is going on around you.
The analogy I like to use with parents to explain motor planning is to consider a basketball player. Someone can do all the things it takes to be a good basketball player. They may be able to dribble the ball, pass the ball, shoot and score, run, or jump. However, if someone can’t do these things in the context of the game using a play and do it based on who is where and based on what is happening in the game at that moment, they won’t be able to be a very good basketball player. Just because someone has the component skills does not mean they will be able to execute them when they are needed or every time. This is motor planning.
Motor planning has three parts: ideation, sequencing, and execution. Ideation means having the “idea” of what to do or what needs to be done. Sequencing is being able to put together the steps needed to accomplish the idea. Execution is being able to carry out those steps effectively, so the idea is carried out successfully. All three parts of motor planning need to happen fluidly and with ease in order for a person to be able to function.
The motor planning part of inertia is what many people with autism might struggle with because they struggle to physically adjust their actions and/or to adapt their actions according to the context of what is going on around them. Now, the second part of your question has to do with how to help with inertia.
Here are some suggestions for helping young children to improve their motor planning which will thus likely help with inertia:
1. Slow down
Going slowly helps children notice the steps of the activity.
2. Demonstrate vs. explain
Showing young children how to do something vs. explaining with words is often more helpful. Many children with autism have auditory and/or language processing issues, so words are sometimes harder to follow than watching.
3. Use hand over hand assistance when teaching new skills
By guiding young children with your hands, they are “feeling” with their body the action that is needed. You can fade off the amount of assistance you are providing as you repeat the practicing of the activity. Many children with autism can’t “feel” their body accurately which is one reason that motor planning is tricky for them. By offering touch input while doing something, not only are you helping them feel the correct action and sequence, you are offering a potentially helpful input, so they feel connected to you while they are doing it.
4. Practice – practice – practice
The more practice children have at doing something, the more likely they are going to be able to do it themselves and just because children can do something one day, does not mean they will be able to do it the next. Therefore, to help children keep going, keep practicing. It will be easier for them to give up some days and those days that something is tricky to do, you can offer more amounts of hands-on assistance, but practicing will help to build motor patterns and build their confidence, so they are more likely to keep doing something and to break the inertia.
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5. Connect with the child
Even though children with autism struggle with social skills, they notice the responses of other people, especially those with whom they are closest. Often they notice but can’t show that they notice. Therefore, if you are able to connect to the feeling that you think the child might be having, whether it’s excitement, frustration, anxiety, or fatigue, that connection will show you understand and you are “with” him/her, which will help you lead the child to the next steps or guide him/her to do something you need or want the child to do. This connection is important if you are trying to get him/her to stop doing something or if you are trying to get the child to transition from a preferred activity to a non-preferred activity.
Both situations require the child to break from his/her motivation to follow yours, and if the child doesn’t feel connected or feels like you don’t understand, he/she is less likely to follow. Emotional connection during activity literally connects different parts of the brain together. You can connect by using facial expressions to show the feeling you think the child might be having. You can connect by using sounds (a sigh or groan if you suspect frustration; a cheer if you think he/she is excited). You can also connect by standing close by and extending your hand and/or by getting down to his/her level. These strategies won’t work all the time, but they might help.
Finally, it should be noted that inertia means being able to break the flow of what’s already happening to make personal adjustments. Many children with autism struggle to adjust to their word because they feel out of control in their world or their world is overwhelming them. Please consider the sensory elements of what might be overwhelming them and consider using sensory strategies to help young children shift their level of arousal. Remember there is a neurological difference between on-purpose and automatic and autism means neurological differences in both.
People with autism often do many things on purpose to help themselves feel physically better, and they also have many automatic patterns of behavior that are a result of a dysregulated and overwhelmed nervous system. Sometimes they do things on purpose to avoid being overwhelmed. Here is a resource that shares many strategies for helping children with sensory differences (including autism) regulate their nervous system: www.asensorylife.com Children who are regulated are more likely to engage and thus more likely to interact. Breaking inertia means being able to engage and interact, so I suggest reading through the information on the aforementioned website.
Inertia is a challenging thing for people living with autism and difficult for parents and caregivers because it can be so limiting. Inertia is about the brain’s patterns and often becomes or seems like habit of avoidance. Movement can help with many aspects of inertia, and I hope the above suggestions give you a place to start when trying to implement movement with your child and as you both go about the activities of your days.
Kelly Beins, OT, is a seasoned therapist with more than 23 years of experience in occupational therapy. Kelly received her BA in psychology and her bachelor of health sciences in OT from McMaster University in Ontario, Canada. She received her specialty certification in sensory integration in 2005 and has an extensive clinical background combining OT and sensory integration with behavioral health interventions. Kelly is a newly published children’s author of a book series about a young sheep with sensory processing disorder (https://www.otc-frederick.com/ovis-the-sheep/), and she approaches her work with an intuitive, empathic, and playful style while implementing the most current evidence-based interventions available. Kelly also owns and operates her own group private practice in Frederick, MD, where she lives with her husband and two daughters. You may learn more about her practice, books, and unique approach to therapy by visiting her website.
This article was featured in Issue 77 – Achieving Better Health with ASD