How Isaac’s autism plays out physically never used to weigh too heavily on me. Mainly because it was as a mental condition that I’d feel its full force.
With diagnosis and subsequent treatments clustering around social interaction, speech delay, obsession and routine that’s no surprise. It’s not that there haven’t been noticeable physical manifestations. There absolutely have – from simple coordination issues, to how he holds objects for everyday tasks, to sport and more. It’s just that the more domineering psychological and social effects have tended to force physicality onto the periphery. The toil demanded to study the workings of Isaac’s wildly complicated mind took precedence.
Sensory processing difficulties similarly perched on the sidelines; grouped in one amorphous, mysterious whole. The challenges have shouted much louder and clearer than explicitly physical ones. But there’s been little in the way of genuine understanding and treatment.
Our unreconstructed knowledge of Isaac means always front of mind is: obtaining order in a chaotic world, heightened senses, stimulation seeking, and discomfort distinguishing noise and sound, food phobias and maddeningly narrow diet. However, true tangibility has been difficult to track somehow.
But that changed when he entered his specialist school some 3-4 years later. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life, so it encompasses the whole gamut of physical skills. Balance, touch, vision, coordination, strength. Programming in people with disabilities what is so instinctive in people without.
Which is that Isaac has a diagnosis of dyspraxia. A developmental disorder of the brain (in childhood) that causes difficulty in activities requiring coordination and movement. Profoundly physical symptoms then.
Saying his autism, in my mind at least, has parlayed into a more complex mental and physical condition is purposefully dramatic. The physical and sensory struggles Isaac has have a tangibility now. I can’t help but feel the unlevel playing field he’s on anyway has got that bit more wonky.
Fortunately this new discovery of dyspraxia, this new label to process and live with, comes with a confidence that it’s awash with the sea of knowledge we need to get by and get on. It all slots in to his autism too.
During the last school year, it became clear that structured motor movements in PE such as balancing, running from cone to cone, passing and catching a ball, throwing with one hand were arduous for him. Progress has been made but problems like these together with fine motor skills difficulties will perhaps always be part of him. Part of his autism. Handwriting, holding implements, a cup, a plate. Running, sport, any type of physical interaction with the world around him. Leaps of improvement happen, but it’s not always linear. A fluid approach is best.
Highlighting all these physical and sensory problems is instructive. However, viewing them in isolation is a misleading and miserable process. What has actually happened with the detailed, expert reporting of dyspraxia is a crystallisation of my confusion with sensory processing difficulties and nagging physical concerns into a more complete, coherent understanding of his autism. Into an interlinked mental, physical and sensory condition.
Because at the heart of what’s been discovered is that Isaac’s difficulties are due to sensory processing and integration difficulties which are impacting on his ability to conceive, plan and actually execute movements. A direct link between sensory processing and physicality in other words. With myriad psychological and social implications – that we’ve always known, but now have added context.
He’s also learnt that hugging has a social element, but its intricacies are still maybe alien. So his desire to touch and squeeze is to align his physical sense of gravity. But the social reward he’s had from parents and grandparents cannot be transferred to teachers, which he has had trouble learning. One step forward, one back. How complicated, how cruel.
Visual perception and visual motor skills are equally major challenges for him. Copying simple physical actions (in PE for example) – something so instinctive to typical people – is fraught for him.
Then there’s the implications for food we need to digest. Why he needs it uniform and ideally beige for visual soothing. Touch, taste and smell of course. That’s without venturing into battles we have always known about; the phobias, anxiety, routine and more.Finding one item in a bag when he can’t see all the items laid out in front of him is next to impossible. I can’t assuage the guilt I feel when pondering the times I’ve casually and impatiently asked him to pick something up, told him to ‘look, it’s straight in front of you’.
The school year ahead will have a heavy focus on the physical and sensory. It will be exercising my mind like never before, knowing we need to adapt a lot to support him properly. Sensory integration and action skills that are so critical to life and come so laboriously unnaturally to him. Life skills – dressing, eating, basic participation in activities. These will be painstakingly practiced by him. There will be frustration and anger. Impatience will trump patience most of the time.
Isaac’s sensory and physical realities – their toughness, their realities – have knocked me a little. Life was far from easy for Isaac. Now the burden has got that bit bigger.
(I always try to reply)