autism temperature regulation

Autism Tips for Emergency Responders: Temperature Regulation

autism temperature regulationGetting my son to wear a coat in the winter takes an act of Congress, regardless of the frigid outside temperatures. I used to think he was lazy, or perhaps that the material of the coat bothered him (he has a multitude of sensory processing issues and I often have to make sure his shirts are tagless and socks are seamless). Yet, here we are in the midst of an Atlanta summer and for some reason he prefers turtlenecks and heavy sweatpants, despite the array of shorts and t-shirts he owns. What’s going on?

In addition to sensory overwhelm and sensitivity to sounds, lights, smells, and textures, many people on the autism spectrum also have difficulty with temperature regulation.

How does temperature regulation work?

Aspie writer Jeannie Davide-Rivera describes it perfectly as:

…an automated body system that regulates the body’s core temperature in response to outside stimuli. The temperature of the body is regulated by neural feedback mechanisms in the brain, which operate primarily through the hypothalamus. It has the remarkable capacity for regulating the body’s core temperature that keeps your body temperature somewhere between 98F and 100F. When your body is exposed to heat or cold conditions this system balances your internal temperature with the temperature outside.

Why is this an issue for emergency responders?

When you interact with an autistic person that may be hyper- or hypo-sensitive to heat or cold, it creates several issues. First off, recognizing temperature regulation issues in a patient can be tricky. Picture someone peeling off their clothing in the dead of winter, in the face of freezing weather (yes, it DOES get cold in the south!).

What about someone on the playground wearing several layers of clothing when it’s 96 degrees outside? It looks rather suspicious. What’s the first thing you would think as an emergency responder? Drugs? Mental illness?

Not necessarily.

Children AND adults with autism may not feel or experience temperatures the same way we do. They’re acting out what feels natural to them because of temperature regulation issues. Additionally, medical conditions and medications can interfere with the body’s ability to cool itself or to maintain a fluid/electrolyte balance. Couple this with impaired communication and decreased body awareness, and you may witness someone going downhill quickly with no obvious cause.

As we are dealing with these ‘Hotlanta’ wet blanket days right now, hyperthermia is a huge risk. It’s important to recognize the signs of heat exhaustion and heat stroke as rapidly as possible and start treatment right away, regardless of how a patient is dressed or how “disconnected” from our logical, neurotypical world they may seem.

Symptoms to look out for:

  • NOT SWEATING
  • Red, hot, dry skin
  • An extremely high body temperature (above 103°F)
  • Loss of consciousness
  • Rapid and unusually strong pulse
  • Shallow, noisy breathing
  • Dizziness or confusion
  • Nausea, with or without vomiting

Be aware of comorbid medical conditions when treating an autistic patient. There are many conditions that present with autism spectrum disorders such as epilepsy/seizure disorders, anxiety, bipolar disorder, bowel disease, immune disorders, OCD, Tourette syndrome, sleep disorders and more.

Round Two of Sound Training – My Son’s New Gains

We’ve successfully completed our second round (“intensive”) of Sound Training and I am once again blown away by my son’s progress. It wasn’t until I sat down to create his update that I realized just how many new gains I’ve observed in the past few weeks.

During the “off time”, his brain is integrating all the changes that were created during his Listening Time. Remember, children may have different rates of integration when it comes to seeing noticeable gains. It is a process – not an overnight miracle!

You can check out the list of gains (and what I thought might be regression!) I saw after his first intensive here.

What’s new since then?

  • Traveled for 7.5 hours in someone else’s car (with his immediate family and family friend) with no meltdowns or major issues (whoa! No seat kicking, bathroom catastrophes or tantrums!)
  • Interacted with a family friend – engaged her in games and conversation (he acted calm and polite, using manners and asking lots of questions – bravo!)
  • Took direction from family friend (responded favorably when asked to quiet loud voices or stop a behavior)
  • Rode his first “big person” roller coaster without fear (and what a ride to choose as a first! Dangling from the car, suspended horizontally… loops and craziness ensued!)
  • Looks to me for facial expressions/reaction/approval when he’s about to exhibit a behavior or perform an action (this is HUGE! The entire thought process of ‘will Mom get mad if I do this?’ was never present. He was simply incapable of processing a connection like that. I can’t be more thrilled.)
  • Brought two Cs up to As and Bs on fourth quarter report card (yeah!)
  • Started asking me questions about his Autism – wants to learn more, recognizes that he is not his diagnosis (his brain is really hungry to learn, not just soak up extraneous video game facts)
  • Willingness to help – will bring objects to or do favors for others (again – whoa! He even gets something from another room for his older sister if she asks!)
  • Desires more independence – makes own breakfast at times, somewhat dresses himself more often (this is extremely exciting for me. I sometimes forget how much I have to do for him until I take a step back and realize that it is atypical for a child his age)
  • Continues to create flipnote videos with more expressions and emotions in the scenarios (not just aping his favorite characters)
  • Was able to participate in the birth process and early rearing of six puppies until five were adopted out (this would have been a very unsafe and unsettling situation if he hadn’t made this incredible progress)
  • Is gentle and caring with the puppy we kept (I still have to keep a close watch, but he is interacting with animals much more appropriately than he had with previous pets)
  • Is a lot more expressive, which of course is not always an ideal situation for ME even though it is good for him to be in touch with his feelings (I’m BORED! Will this EVER END? I don’t WANT TO!)

All in all, I can’t WAIT to see what’s next, as the struggles are falling away from him like layers of skin shed and his true personality starts to really shine.

Don’t forget! If you want to hear more about Sound Training IN PERSON and you’re in the Atlanta area, come to An Evening Seminar with Angie Marshallclick here for the deets!

In other news…

I had my first mission as a volunteer Bike Medic with the Fire Department at the PDK Good Neighbor Day Air Show Saturday. I trained hard for this during the month of May and was absolutely honored to be able to serve my community as a First Responder in this capacity. I’m in a world of hurt currently, but it is the pain of accomplishment, so I’ll survive :)