Anxiety, autism and sensory processing challenges are intricately linked, which can make it difficult for autistic children to see progress in learning and critical thinking skills

 In this second in a three-part series on autism and anxiety, several ideas for understanding sensory experiences and how parents can develop a toolbox for coping with emotional situations are presented, and how Invirtua’s interactive avatars can help. Also included is a live demo of an Avatar Adventure, featuring Marley and Leslie Baldwin.

Here is our recording of the recent webinar by Gary Jesch and Leslie Baldwin – Autism  and Anxiety Part 2. 

For more information, contact us using the CHAT function on this page. 

LINKS TO HANDY RESOURCES FOR PARENTS –

PDF files you can download and share

Sensory Diet Activities

Sensory Check List

Sensory Processing Materials

Profectum Parent Toolbox

Sensory Smarts Working with Schools

SENSORY PROCESSING ACTIVITY PRODUCTS

Sensory Kids Store

Southpaw Website

Therapy Shoppe 

Autism and Anxiety Part 2

Webinar Transcript – Introductions and Overview [0:00:00]

Gary Jesch:

Hello there, yes, it’s me—your good friend, Gary Jesch of Invirtua. I’m so happy to be here with you today, to do this second part of our webinar series on Autism and Anxiety.

So, we gathered here today with my colleague, Leslie Baldwin. And, you know, it’s great to have you guys on board, we’re going to have a nice little talk here today. And Leslie is taking us through a really interesting topic, to me, the idea of how sensory perception can impact not only anxiety, but impact the daily lives of autistic children. So, let’s start out right off the bat here with a little introduction to Leslie, if you don’t mind. And I do want to say a couple of things before I actually get started.

First of all, I’m producing as well as hosting this webinar. So, from time to time, I might glance over there. Don’t worry about it. I’ll come back to you. And lastly, and we’ll be doing it that way for this presentation.

And we’ve kind of divided this up into two sections today. The first section is where Leslie is going to take us through this information about sensory processing. And then we’re going to go into a little bit of information about our Avatar Adventures here at Invirtua, relating to sensory processing. Then also we’ll give you a demonstration of just how that works live, in real time.

So, we are not going to be giving you anything that’s prerecorded here. In this webinar, we’re actually going to let me go and show you a live brief look at our avatar experience—our Avatar Adventure, right here in our webinar today.

So, we plan to pretty much use up that hour. And we’re going to be also offering a shot for you folks to ask us questions during this presentation as well. So that’s how it’s going, we are going to record it. And we’ll have a video replay up on our website so that you can go back and look at it. And also, we’ll have a transcription there.

For this particular session, Leslie has gone to a lot of trouble to prepare some special resources for parents, in the form of other documents and tips. She’ll be discussing that a bit as we go through our program today.
So, let’s go ahead and start out here by introducing Leslie Baldwin. Leslie, here we are back again. It’s great to have you. Thank you very much.

Leslie Baldwin:

Thank you for having me, Gary, I’m really excited to be here. And I’ll tell you a little bit about myself.

I am a teacher by trade. I’ve worked with children on the autism spectrum, for quite a few years. I hate to say how many, but one of the privileges I had as a teacher was to work with Texas Children’s Hospital, in a program for children on the autistic spectrum, which was multi-disciplinary, where they received not only educational instruction, but physical, occupational, and speech therapy.

I’m hoping I can share some of the things I learned during my time working with kids and with my fellow colleagues.

Gary Jesch:

Thank you, Leslie. Yeah, I think what you have for us today is really fascinating, actually. And the perspective of being a teacher and working with kids really makes this information valuable.

I’m Gary Jesch. I am what’s called, these days, the digital puppeteer or an avatar pilot. I came up with a technology a few years ago about using interactive avatars, first of all in entertainment and marketing. And then about six years ago, I decided that I think I’ve got a way of bringing this to help folks that are dealing with problems that are presented because of autism. And so, we’ve been working with therapists that work with autistic kids and directly with autistic kids, autism clinics at the University of Nevada, Reno and also supporting actual research from Brigham Young University, where they studied our software and the way to use it. They wrote that up and published that about a year ago when that was published, and you can read that publication actually on our website.

So, you know, things are moving along quite nicely. We nowadays, offer this to parents helping focus on parents seeing dramatic improvement in the lives of their autistic children. So that’s what it’s all about for Leslie and me here at Invirtua.

Leslie Baldwin:

Absolutely.

Gary Jesch:

And there’s a way that we’re doing it, as we set up a virtual clinic. When I say virtual, I mean that it’s based on access through a web browser online, so that nobody has to leave their home and they can get involved with us through telecalls, telehealth sessions and video calls, and navigate around our secure portal, which we’ll be telling you about a little bit more.

So, Leslie, I’m going to let you jump in here and tell us more about this. I’ll be right along with you. And we’re going to work on this together. And let’s see what we have going on here. So, what is the issue today?

What Are Sensory Processing Issues [0:06:04]

Leslie Baldwin:

Well, we’re going to be talking about sensory processing issues that we often see in autistic children and adults. It can be that the world and environment around them seems a little too fast, a little too noisy, a little too bright. There’s a lot going on, which affects the sensory processing system. If it’s not working well, what we often see is a really high anxiety level.

And what we want to do is look at how the sensory processing system is working or not working for them, and make some changes in their daily activities that might help. And that, in turn, we often see will lower their anxiety level.

Gary Jesch:

Excellent, because it’s all kind of linked, right?

Leslie Baldwin:

It really is, I think. You know, I look at the sensory system, the mind-body connection, you really can’t separate it. And when you see the work, the kids I’ve worked with over the years, when that anxiety level really gets to a heightened level, it’s very difficult to pay attention in class, it’s difficult to focus, it’s difficult to problem-solve, you know, even outside of the classroom, when you’re in a store and the community, or if you’re at home. I think all the parents I know have experienced what can happen when a child becomes overwhelmed.

Gary Jesch:

Right, exactly. And when we’re speaking of anxiety, we’re talking about an emotion, basically, right, that could also be referred to as overwhelm, or fear, helplessness, worry. And so, to some extent, I’ve seen it kind of show up as similar to stage fright. Autistic kids just have this big rush of performance anxiety, if you will. And they get stuck in it so much. I’ve seen some adults end up with that performance anxiety also, right?

But it’s really an intense emotion that they can get stuck in and it can block them from doing everything from simple things, you know, in their day, to actually learning and improving and communicating.

Leslie Baldwin:

Yes, absolutely.

Gary Jesch:

So, what’s the groundwork to be laid here in terms of our senses?

Leslie Baldwin:

Well, you know, what I really like to look at is the emotional regulation and physical regulation and how the sensory system can affect that. And we’re talking about touch, movement, taste, smell, vision, and hearing. It’s how you as a human being, all children and adults, take in the world around them. When your sensory system is working well, no problem, you don’t really experience roadblocks that prevent you from being able to function in your daily life.

However, when you’re having sensory challenges, or sensory processing disorder, that’s when we look at something that is preventing you from really being able to fully function and adapt to your environment. It makes it very difficult.

Gary Jesch:

And that can show up in people of any age as well, right?

Leslie Baldwin:

Yes, we’re all born with a sensory system, but there can be different experiences in life or different physical things that you go through, that can change how your sensory system is working.

So, it’s always good to be aware of how it’s working. And most of us don’t even think about it, you know, you just don’t even think “I’m cold,’”right? You think “this is too hot,” or “I don’t like that fan going, it’s bothering me,” but you don’t really think about it in terms of your sensory system.

How Sensory Challenges Affect Us [0:10:25]

Gary Jesch:

So, this is a little list of some of the challenges that we might face. Are all of these equally important? Or does it more depend on the situation that a person is in?

Leslie Baldwin:

I think, to me, everything is equally important. If you look at the list of what we have here, you know, if you are having some sensory challenges that heighten your anxiety, it’s going to make it more difficult to communicate, whether it’s verbal or non-verbal, to stay connected, and have a back-and-forth flow of communication, to stay connected with others, to problem-solve, to share your ideas.

One of the major things that I’ve seen over and over is, it really affects physical, and emotional regulation. What we want for all of our kids to be able to do is to start to do some independent problem solving as they move forward.

And, you know, many times the sensory system when it’s overwhelmed, it makes it almost impossible to be an independent problem solver. And so, we really want to help support kids to move through that and past it, so they can feel successful.

Gary Jesch:

So, when you worked at Texas Children’s Hospital, with autistic kids, what did you see, in your experience? What was one of the most dominant challenges? Is there one that really jumps out at you out of these?

Leslie Baldwin:

Frequently, I would see kids that were dysregulated. And by that, I mean, that it might have been that their sensory system isn’t working as effectively. So, they could be overwhelmed with being in a different environment. So, you’re seeing emotional and physical dysregulation, because the anxiety then comes in, and it just kind of escalates.

And so, what we were working on were strategies to help them first to co-regulate with us, and then eventually be able to regulate on their own. But, you know, depending on what you know, what I can tell you is that I never saw two children that were alike. They’re all completely different.

So, you really have to take into account, when you’re seeing a behavior that looks dysregulated, you want to look beyond that: What is going on underneath that? Is it a problem with the sensory system?

You know what, what is going on, because frequently we found, if you, really observe and take the time to understand, you can help the child learn some strategies that can be really helpful and comforting to them.

Gary Jesch:

Let’s take a look at some of that. You had said earlier the importance of being emotionally and physically regulated—what does that mean to us?

Leslie Baldwin:

What I want to talk about is even as adults, we all do things to help ourselves stay regulated, and we are stimulating our sensory system. We’re either bringing it down by taking a deep breath, talking, or maybe we just need to get up and move around after a meeting. Or if you’re tired, you’d rather go and take a nap, but you’ve got to stay awake: There are all sorts of things we do—grab a cup of coffee, or a cup of tea, things that help make us feel a little more emotional and physically regulated.

And so, that is the same type of thing that we’re talking about doing with kids who may not have learned those coping skills yet. Whereas adults, most of us can regulate on our own. We don’t need someone to help us regulate.

Although at times, you know, something happens—say you’re in a car accident. Sometimes, having someone help you gather yourself can really make a difference.

And so, I liken that to having a child that is upset to the point like we would be, if we were in a car accident. Like “Oh my gosh!” You get your adrenaline going and everything. You know kind of helping them learn those strategies to bring that anxiety down, to be calm and attentive, rather than either under- or over-reactive.

Gary Jesch:

And so, I guess a lot of this has to do with our senses, as you say. So, you said that all these kids were different. So, does that mean that they have a sensory profile, that’s all their own. Right?

How You Can Use a Sensory Profile Checklist [0:15:31]

Leslie Baldwin:

Right. And one of the things that I think we’ll be sharing with the families today that we’ll be putting on the website, is a sensory profile checklist.

That’s extremely helpful. You can use it for yourself, your child, your friends, and really look at what is your sensory profile in your life. Your hearing, your vision, you know, all of the modalities that we talked about. Then you’re looking at each one. You can be over-reactive in one area, like hearing. I have worked with many children. The loud noises, or sometimes even noise we’re not paying attention to, can drive them up the wall. So, this is where you get those noise-cancelling headphones out, and things like that can be helpful.

Sometimes, you might have a profile where someone is very over-reactive to everything, or they might be very under-reactive. And by under-reactive I mean, it’s kind of like the “couch potato syndrome,” where, they’re there, but they don’t even look like they’re paying attention. They probably are, to some degree, but they kind of look like they’d rather be sleeping than paying attention. What you’re going to do is help them rev up their sensory system, so that they are more alert.

Then, we look at sensory-seeker versus sensory-avoidance. And you can be a little mix of everything, but sensory-seekers are the ones that don’t mind if they get food on their hands or their face, or they love to finger-paint, or roll around in the grass. We all know the sensory seekers. Then you have the avoiders, who will not get on the grass with bare feet, will not finger-paint. They might hold on to a long paintbrush and kind of dab it, but they don’t want to have anything to do with having that paint on them.

And so you start looking at are they avoiding things or are they seeking things out? That’s going to tell you a little bit about how their sensory system is working and what type of input they need.

The activity tells us about the kids—that sometimes they’re the seekers, and sometimes they’re avoidant, or sometimes they’re over-reactive. Sometimes they’re under-reactive. I always help parents and work with them, saying, “You know your child better than anyone.” And I really think that by using a sensory profile checklist, if you haven’t already gotten a sense of what your child’s sensory profile is, it will give you a starting point.

Gary Jesch:

So, something like, say a child is hyper-sensitive to sound or hearing. That would go on to that profile to alert the child’s caregivers and to remind the parents that, his sensitivity to sound might indicate that a set of noise-cancelling headphones or sound protection might be a valuable thing for him, if anxiety started to show up?

Leslie Baldwin:

Right. Right. And, when you’re seeing behaviors that are concerning, or not really what you’re hoping for, say a meltdown or total dysregulation, you start looking at what else is going on in the environment that could be contributing to it. As a teacher, this was a valuable, valuable lesson for me. If I don’t assume a child is acting out just to be naughty, typically, what I found is there’s an underlying reason that we’re seeing that behavior come out.

Gary Jesch:

Oh, okay. And it could relate back to this profile, right?

Leslie Baldwin:

Yeah.

Gary Jesch:

Interesting. Okay, so tell us a little bit about how routines fit into this profile that we developed. How about habits and routines in autistic kids? What do we learn when we examine daily routines?

Leslie Baldwin:

Well, I think what we want to look at, a lot of the kids really like a predictable routine. And if you are seeing dysregulated behavior, in certain routines, whether it’s morning—I frequently see transitions can be really difficult. Say, he’s fine at home, but in the classroom, it’s very difficult.

Certain stores? Are there certain times of the day where you are noticing a pattern of behavior that’s fairly predictable, that isn’t very helpful or is preventing your child from accomplishing what they need to do. That’s when you want to start looking at that environment and what is going on. Sometimes, it may even be, a lot of our kids deal with constipation, and may not be able to verbalize it.

And that’s a sensory issue for a lot of the kids that are having stomach issues. It doesn’t feel good, it’s painful, or they’re not feeling well. So really tuning into what’s going on with them can help you in figuring out how you want to strategize to help them.

What Is a Sensory Diet [0:21:33]

Gary Jesch:

Alright. So, the other thing that kind of came up when we were talking about this earlier, you mentioned, I guess it’s a technique or a method called a sensory diet. And I don’t think we’re really talking about nutrition, specifically here, although nutrition might fit in.

But overall, do you mean that with a sensory diet, we “eat” certain senses every day? Do we have a better pathway of things that are helpful to us? Is that what we’re talking about here?

Leslie Baldwin:

Yeah, I think you’ve got the idea. You know, I look at a sensory diet, as you know, really having some activities built into your child’s day on a regular basis, that meets their sensory system needs. If you help them meet their sensory system needs, then you should typically see their anxiety come down. They’re better able to function throughout their day without dysregulating.

You want to look at the types of things that your child did, that you can identify, that are already helpful for your child, and then build from that.

Gary Jesch:

Sounds like an interesting process, because if nothing else, it is something you could write down, right?

Leslie Baldwin:

Yes, absolutely, absolutely.

Gary Jesch:

Does a sensory diet impact anxiety, though?

Leslie Baldwin:

What we find is that if you are providing some sensory-related activities that are addressing their needs, that it will help a child stay regulated. It helps them pay attention and typically improves their classroom behavior. If their behavior issues are at home, they’re able to be more calm and attentive, which is what they need to be, to learn.

It can also help them shift from one activity to another, when you have a sensory activity kind of interspersed or available to them. So, it’s just easier to transition.

Building a Sensory Toolbox [0:23:57]

Gary Jesch:

So, Leslie, I think I have one of our favorite slides back up again. Can you see our little girl here?

Leslie Baldwin:

I can see her.

Gary Jesch:

With colors all over her face? So, this makes it special, when kids over-compensate or over-engage in a way, right? Makes for bigger messes, and cleanups that call for a sensory toolbox, right?

So that’s what we’re going to talk about doing next—building a sensory toolbox, if you don’t mind, jumping back.

Leslie Baldwin:

Sure, I know the slide—no problem.

Gary Jesch:

Thank you.

Leslie Baldwin:

When we talk about building our sensory toolbox, we’re going to be looking at strategies that are going to address your child’s sensory challenges.

So, whether it’s touch, smell, taste, smell, vision, hearing—what you really want to do is help them so that they can function within their sensory system, and when they’re overwhelmed, it brings their anxiety down.

And so, we’re going to talk about some of the activities and things that you can do with that.

Gary Jesch:

Okay, sounds good. And these six, then, are pretty much what we would try to cover all six bases with these kids, right?

Leslie Baldwin:

I think it’s sometimes impossible to do it all at the same time, depending on the activity, and yes, you do want to address the sensory system, especially what you think might be a trigger for dysregulation.

Gary Jesch:

Right, so the toolbox that you’re going to be telling us about is going back to this idea of the sensory diet.

So, we’re going to run a set of slides here. And if you would just kind of take us through the details here a little bit, that would be great.

Leslie Baldwin:

Okay so what we already talked about, just going through that quickly, is you know, making a sensory processing profile. Because you’re really going to want to have a basic understanding of your child’s sensory processing profile, before you start choosing activities and strategies for how you can help them.

Then I want to do a visual chart of your child’s schedule. I have really found, whether your child is verbal or nonverbal, having the visual chart can really be helpful with for them with sequencing, but also with transitions, helping remind them. “Okay, first test and then we’re going to be doing this next. And yes, you get to do that after.” So they can see even now, that one activity or another, especially during the school day may not be their favorite. But, hopefully, there’s some fun things built in.

Okay as part of a schedule, but what you want to do is build in sensory breaks, thinking about the times where your child has real difficulty in participating, or following through on an activity or transition. Those are the times where you really want to build in the sensory break. Or, if you have a predictable pattern that you have built in, and if something happens and they become dysregulated, you want to have something available for them.

And if you have a visual of what options they can choose from, then it’s very simple, not overwhelming. Frequently, they will choose an activity that is going to address the sensory need that they have.

Gary Jesch:

And some of the resource documents show this too, right?

Leslie Baldwin:

Right. The resource documents which we’re posting online, have some great ideas for activities. Really simple. You don’t have to go out and buy a bunch of things, because a lot of things you’ll have at home.

These are ideas that can be used by a therapist or a parent. In the classroom, if your child’s classroom doesn’t have these breaks built in, it can always be a discussion you can have with the teacher or in their IEP.

Gary Jesch:

Okay, the activity menu, then.

Leslie Baldwin:

Right. So, similar to their schedule, what I like to do is have an activity menu that has choices for them that they can choose, or you can help them to choose, that you are okay with them doing.

What you don’t want to do is put finger painting on it, if you’re not prepared to let them finger paint. Then it’s pretty disappointing and you might see some more dysregulation.

Think about the activities that are easy, whether it’s a squeezy toy, for a child that needs that input, whether they need some tight squeezes or to be wrapped up in a blanket like a burrito to help them regain their regulation. There are tons of activities and I think many families will see the list, and will see some of the things that your child is probably already seeking out. You can make some really fun games out of it, too.

Gary Jesch:

All right, and then finally, that break box or basket with go-to items. Pretty much every therapist has something like that going on, and parents should too.

Leslie Baldwin:

Absolutely, absolutely. I think it’s one of those things that you want to really encourage your child to do when they are feeling overwhelmed and anxious, when their sensory system says that’s a little too much, or when you see that they need to be revved up a little bit, because that works both ways. You want to have something at the ready.

I recommend having, a box or basket that they know is theirs, that they can go get something out of it, a squeezy toy, or something for movement or music that might help them regulate, and then maybe something like a bag, to keep in the car.

Most classrooms, many teachers, encourage the fidget objects and other things, maybe a little pad for their chair, so that if they’re wiggly, they get the appropriate stuff to support movement. And it really does help them pay attention and stay alert and focused in class, and can also be very helpful at home.

Gary Jesch:

Let’s take a look at a couple of examples of that, Leslie.

Leslie Baldwin:

All right, so here we have a visual schedule. And, you know, kind of a typical day for many kids.

What you want to think about are any times in between that you can build in a sensory break, if you see that pattern of behavior where your child needs to get some movement in, or they need some quiet time to bring things down, because the environment is a little overwhelming.

And, you know, that can really help make their day go more smoothly again. Our goal is to have these children learn to regulate on their own without needing a partner to really coach and get them through that.

How to Encourage Activities [0:31:58]

Gary Jesch:

This chart then might be something that you would put up. And you would refer to it during the day as a kind of a break. We’ve mentioned that break box, but there are other activities that can go up on this chart to break things up, whether it’s maybe playing video games, for a child who really loves those video games, but instead going on a walk. It’ll be good for everybody, that type of thing. Right?

Leslie Baldwin:

Right, right. I think many times children will tell you or express what their favorite activity is. But if it’s something like playing video games, or being on the computer, to the exclusion of everything else, you want to look at doing it within a limit because you want them to be moving their body.

Kids are going to choose the activities that are maybe easier for them. And some of the other things are a little harder, and that’s okay. But we want to encourage them to be well-rounded.

Gary Jesch:

Right, and that their own profile may indicate that they are not that excited about motion and moving or walking or doing physical exercises. And so, that’s where we take that information from the profile, and build a visual schedule up.

The other one is another chart here, for that sensory diet. That’s how that fits in. Right?

Leslie Baldwin:

I just put together a quick visual chart as an example. But, certainly families can do this at home, you know, teachers, therapists, and having those options.

You choose, as a parent, what you think are the acceptable activities. I put on there typically, a chew toy since many kids need that oral input. Playing with playdough for a few minutes, and taking a 10 or 15 minute break, going in the quiet corner, to read or do a puzzle, some time on the computer, then jump and move, or a squeezy toy, something that they can fidget with their hands, because, we know a lot of them are seeking that input.

And if you think about a child who you would talk to about their stimming and what they’re doing, different things that they’re moving or feeling like others. The way I like to view it is that they are organizing their sensory system. They found a way to either calm themselves down or to ramp it up.

And it may look unusual, but what you have to remember is that as these children get older, they are going to find more socially acceptable ways—people would say, socially acceptable ways, to regulate themselves.

Sometimes they don’t, or they’re not recognizing at an early age that that’s what they need or what they’re doing. And so, part of our job is to help them understand how they’re feeling, let them express that and see how we can mitigate any sensory processing difficulties they’re having, so that they can fully function rather than being constricted, in different environments.

Why Play Is More Than Fun [0:35:48]

Gary Jesch:

Sounds like play is a big factor, is that your experience as well?

Leslie Baldwin:

I’m a huge proponent of play. I feel like you can make almost anything into a game and make it fun. And that’s how children learn about their world, when they’re young.

Their first teachers or their parents, you play peekaboo, you start out with little, fun things. And, that’s how parents really teach their kids, their first teachers, then, they learn by playing house, by playing they go to the doctor, or they pretend they’re the OT. I think that’s how they view the world and experience it and learn how to problem-solve. So, I think it’s never going to be underestimated—the power of play.

Gary Jesch:

And parents are so important there, especially when we’re talking about the kids, right?

Leslie Baldwin:

Absolutely, you’re doing a real disservice, if you are working with a child alone in your home, you’re not interacting, and really bringing the family into what you’re doing.

Because I’ve seen over the years is the kids who are carrying over some of the things that they’re doing in a classroom or in therapy, those are the ones who overall, will do better with that, similarly in practice.

Gary Jesch:

There are any number of things that can help kids learn in their lives. As you said earlier, critical thinking skills, self-confidence, creativity, that’s where it starts, and, even empathy, learning how to share and take turns, things like that, that these are social skills that are developed through play, actually. Maybe the game that they play, or how long they play isn’t necessarily the point. It’s the richness of being involved in a play environment or play scenario, right?

Leslie Baldwin:

It’s the experience. I’ve seen it in our the children—that if you can help them, if you think about being regulated and not being over-anxious—when you’re anxious, it’s pretty hard to enjoy an experience and to be into it—where if you can let that anxiety go. If you are paying attention to those sensory processing issues, it opens up a whole new world for these kids that otherwise, they’re stuck on. The parent that asked about, the textures and the food—what you really want to do is help them address that in a way that can be playful, and not forceful.

I think I don’t want to be forceful. And I think it would be traumatizing for the person if they try to force things out. I’m not into that at all. You want to be playful and fun. Because otherwise, who wants to do it?

How the Avatar Adventure Technology Works [0:39:29]

Gary Jesch:

We can all tell the difference between fun and drama. Thank you, Leslie. You know, you really covered that well, and I have a feeling we’re going do a little bit more with this topic going down the road together, because it’s such a rich area. Your experience and knowledge about it is really vast, too. So, we’ll get into some specifics one of these days and there so.

When it comes to play, this is a lot of the way that our Avatar Adventures are set up. Where we bring in these interactive avatars, into a family’s home, on their laptop, or even in some cases on the TV in the living room, if it’s possible to do that, and to give the autistic child the opportunity to play with a cartoon character that can see them and hear them and talk back and forth with them, to have a conversation.

That’s what we’re going to demonstrate next, here: how that goes. You’ve seen the images of the avatars here, and our slideshows and these particular images of a character that I created based on an autistic boy that we worked with about five years ago. So, you can see, we can get into that as well.

These avatars appear in real time, fully interactive, where we can use sound effects that engage those senses. We see kids reaching up and touching the screens often. That’s not unusual at all. You know that we can make the character react to that touch, simulate it with jumping around when they get tickled or something. And we also use technology that we call infotainment, right? The educational, or edutainment, education that’s entertaining as well.

So, this isn’t a software that you can buy. It’s actually signing up for sessions where the avatar comes into the home via video calls. So, it’s what we call telehealth, and the avatars are friendly. They’re supportive. They’re encouraging. They really want to make friends and to be there in a totally different way, a new and unique way of providing social interaction for autistic children.

As the avatar pilot—and that’s what I’m describing, the work that I do as an avatar pilot, of puppeteering and controlling the avatar—I come prepared with additional content, as well as game plans that I’ve discussed with the parents, so that we have a good idea of how to approach the session. we’ve learned about the child, and their preferences and what they like and don’t like, and we come up with ideas for the content. All that stuff’s pretty, pretty exciting, isn’t it, Leslie? You get the compassionate sidekick, right?

Leslie Baldwin:

It’s been very exciting for me as a parent and an educator to observe the children and their reactions to the animated characters.

I will always remember Stanley Greenspan, who was a child psychologist, talking about going for the gleam in the eye, and I’ll tell you now, there is a gleam in the eye of every child I’ve seen interacting with the avatars. It’s really kind of magical. And while it’s hard to describe, it’s so compelling. That somehow, these kids get to know these characters and know that they’re their friends. And it’s supportive and it really keeps them engaged, much longer than many parents think they’re capable of.

Gary Jesch:

Especially, when it comes to these, we’ll talk about anxiety, right? So, the playfulness, and this idea of a sidekick who cares, reduces the anxiety. When the anxiety goes down, then the learning can go up.

Leslie Baldwin:

Absolutely.

Gary Jesch:

These are some of the avatars that we’ve created and that we use in these sessions. So, each parent has their pick of the avatar that they want to work with their child.

And if it’s a female character, sometimes I’ll actually do a voice-altering software that makes me sound high pitched. Each of these characters has a different backstory and attitude. So, that’s a lot of fun. And even SyberSanta’s down there. It’s fun that way with talking babies too. I mean, yeah, we’ve got it all.

And the way it shows up, as I said, is through our virtual clinic, each of our clients and their parents are given their special place in our portal. And so, when it comes time to have a session, they just simply click on the appointment that’s marked there on the calendar and our interactive video session opens up. And there’s the avatar. In this case, the fish Marley is engaged here with Braeden.

This is a young man that was involved in sessions about a year ago. And we had a lot of fun with Braeden and got a lot of great comments back from his mom. We’ll have to go through some of those comments from Braeden’s mom and others, one of these days, and share.

Leslie Baldwin:

Yeah, yeah.

Gary Jesch:

Say we’ve just done the telecalls. And then this picture here shows a situation where we’re actually at the autism clinic at the University of Nevada Reno, which is a two-room setup, where I’m in one room, running the avatar, and then the therapist and the child are in the other room, looking at the avatar on the screen. And is that an interesting setup?

Right now, we’re set up to do all telehealth, all video calls. One of the things that we learned here, Leslie, was that in some cases, we can actually turn the software over to the child.

Leslie Baldwin:

Yeah.

Gary Jesch:

Let them be the voice of the Avatar. And that also gets really interesting. That’s a good topic for another call!

Leslie Baldwin:

Yeah, absolutely.

Demonstrating a Live Avatar Adventure [0:46:40]

Gary Jesch:

It’s another way to use the technology. So, what do you think? Shall we go ahead and see if we can jump into a live session here?

Leslie Baldwin:

Yeah, that’s…

Gary Jesch:

…recording. And I’ll turn the screen sharing off. So, if we haven’t recorded this, I’m actually going to switch my camera over if the power doesn’t go off again.

Leslie Baldwin:

I hope not.

Gary Jesch:

I’m going to put on this extra headset. It’s got a microphone on it that picks up my voice. And then here, I’ve got what’s called a digital tablet. And this is how I control the avatars. I’m actually sitting right here at my desk, and I’m animating or puppeteering our avatars in real time, using this, and this is how it comes out.

And Leslie, in this case, would you mind taking the role of a child who’s our client? And maybe, this girl, we’ll call her “Little Leslie,” she is showing some distress, some anxiety, something’s going on. And we’ll demonstrate just what ways that Marley here can use his skills to change the dynamic of the situation.

Avatar Demonstration

Little Leslie:

Hi.

Marley:

My name is Marley. It’s so good to see you. What’s your name?

Little Leslie:

Hi, I’m Leslie. Hi, Marley. How are you today?

Marley:

Oh, I’ll tell you it’s all going pretty good. Lastly, you know, I’m down here in the ocean and a lot of buddies around here—we’ve got whale sharks and little fish and big fish. And, you know, I just kind of noticed, Leslie, while you’re sitting there, you looking a little bit anxious. And, you know, I hope that everything’s okay.

Little Leslie:

I don’t know, Marley. I hang on now. I just don’t know. I’m a little anxious today.

Marley:

Oh, it makes me a little bit sad to hear that. But you know what? I have something that I think might cheer you up a little bit. Let’s go take a look at my friend the turtle.

Little Leslie:

Wow!

Marley:

Yeah, look at this. This is a beautiful place under the ocean. This is called a turtle cleaning station. And you know what? What I’d like to see is you noticing how Fred is just swimming along. And he doesn’t look like he’s got a care in the world. That’s how you would like to be—what do you think?

Little Leslie:

I think I was like that. He looks, He looks pretty calm.

Marley:

He does. Maybe you could do what Fred does, to calm down a little bit. You know? Can I show you?

Little Leslie:

Okay?

Marley:

All right. So, what Fred does—see how his big flippers move, right? He just barely moves them, just enough to stay with these little fish that are eating the algae off of his shell now, slowly…

Little Leslie:

Like this?

Marley:

… as he moves. Well, no, that’s a little bit too fast. I would say, try just moving really nice and slow with your hands. See how Fred’s flippers are just kind of hanging there? That’s more like it, yeah, that’s the idea. He rests and gives it a little flip, stopping. Another little flip. You kind of get the idea there?

Little Leslie:

I wonder if he is ticklish.

Marley:

Oh, I don’t know, with all those fish trying to eat algae off of the back of his shell. Well, you were doing really well, let’s see, that’s the exactly the idea. Move nice and gentle and maybe take some breaths. You know? Yeah, you did a great job with that. Thank you.

Little Leslie:

Oh, thank you, Marley. Yeah, he’s fun.

Gary Jesch:

So, there we go. That was a demonstration of interacting with the avatar in real time. And, Leslie, you noticed a couple of things.

One of them was is that there’s a physical aspect to this engagement with Marley, along with the visual one. Right?

Leslie Baldwin:

Right. And I think, that’s one of the things that I really like about this—it’s not a passive, “just watch and no participation” act. You can really make sense with Marley, the characters can see you and interact with you in real time, when you can tell that you’re losing someone’s attention, or they’re looking anxious, or they’re up and down or all around, you can really kind of bring them back in by asking them to play a little game of imitation, or Simon says. You know, “Oh, I’m gonna, I’m gonna hide, can you find me now?” And, it brings them back in.

I think what Marley can do, or any of the characters, you really key in to where that child is, if they’re a little over-reactive, or are they under-reactive? And then you kind of adjust your approach, in terms of what they need.

Gary Jesch:

Exactly. And as our good friend, Dr. Tom Buggey would point out that, that’s squeezing in a little bit of video modeling, right? Here is the Fred the turtle, and he’s modeling that calming physical behavior.

And then Marley is trying to explain how it helps. So, you get a fairly complex interaction that the child could have a conversation about.

Leslie Baldwin:

Right, right.

How You Can Start Your Avatar Adventure [0:52:55]

Gary Jesch:

This is what it looks like in our interactive avatar setup. So, let’s just explain real quickly how that works and then we’ll take a couple of questions.

Leslie Baldwin:

Okay.

Gary Jesch:

Somebody who wants to get into the internet for the Avatar Adventure, all they need to do is to simply be in touch with us. And we’ll make an appointment and sometimes a couple, to tell them about it, how to get acquainted with us. And we’ll also get acquainted with them to learn about your children and conditions and the special cases we’d be looking at in this Avatar Adventure, to try to guide them into the most helpful and resourceful way to bring about dramatic improvement.

So, we discuss the goals and we begin the development of this action plan. And then we’ll also as part of this, give the parents a behind-the-scenes demo, where they’ll see me like you folks did today, actually puppeteering and controlling the characters so that they know what to expect there.

Then we schedule the first Avatar Adventure. And that session is completely free for the child to come in with mom or dad or a family member at their side. And all of our sessions, we’d like to include the parents, because we feel that the parents there are great teachers and supporters also.

And in some cases where you know, maybe a therapist is helpful, that’s good, we can do that. Or maybe we just want to have a session without a therapist and just see what happens. So, we do that.

And then once that’s all good, it’s off to the races here with the virtual clinic portal, and so, the appointments get scheduled and you come and do the appointments with me. And that’s how it goes. They can be once a week, twice a week, whatever type of schedule that you like to get on.

And I think one of the cool things now, you can see our prices are quite low for these sessions. And it looks like if we get the child tax credit passed, there might be a little bit of extra cash in your household to help pay for our sessions. So, you know, that’s a great thing too. Because we’re not, we don’t qualify for insurance coverage quite yet. Maybe someday, that’ll happen also, but in the meantime, maybe you have a chance to pay for it with a child tax credit. $30 per half hour. And if we go ahead and book a minimum of four sessions at a time, then we’ll knock that down to $99.

So, Leslie, I think that kind of wraps things up. We still have some folks with us.

Leslie Baldwin:

Okay.

A Conversation with Dr. Tom Buggey and Rebecca Gomez [0:56:03]

Gary Jesch:

I don’t know how you were able to hold this all together. But how about if we open the line again to Dr. Buggey if he’s there?

Leslie Baldwin:

Okay.

Yeah, it’s great. To get with him here. Well, Tom, are you there with us tonight? Today still?

Dr. Tom Buggey:

I think so. Am I?

Gary Jesch:

Yeah, you are fantastic. We can hear you.

Dr. Tom Buggey:

Very well done.

Gary Jesch:

Thank you.

Leslie Baldwin:

Thank you.

Gary Jesch:

Thank you so much. It was great to have you last time you were a real highlight to our talk. And don’t you think Leslie did a great job today of explaining about this?

Dr. Tom Buggey:

She did. Especially when you got offline…

Gary Jesch:

Sidelined? Yeah.

Dr. Tom Buggey:

In Nevada, I guess.

Gary Jesch:

A little thunderstorm, actually. Let’s open a line here to Rebecca Gomez, who’s also with us.

Leslie Baldwin:

Okay, great.

Gary Jesch:

See if we can do that. Come on, Rebecca, can you try to open your mic and join us? There you go.

Rebecca Gomez:

Hello.

Gary Jesch:

Nice to have you on board.

Leslie Baldwin:

Hi Rebecca.

Rebecca Gomez:

Thank you for the webinar and your time today.

Gary Jesch:

Oh, it’s our pleasure. Was Leslie able to handle the questions pretty well? Did you have anything else you’d like to ask?

Rebecca Gomez:

No, she did great. Thank you, Leslie, I appreciated your response. I just have a very stubborn child.

So, you suggested we continue to do and I think you touched upon it, is like keep going, don’t give up and just try to keep them involved with different things as they’re able to, right?

Leslie Baldwin:

Yeah, I really found with many of them—it’s a delicate balance, because with the sensory issues that you’re describing, it can be really difficult to overcome.

So, the only thing you can do is keep offering it. But I’ll tell you that one of the most striking examples I had with a child that I worked with, that I was talking about—it was super-restricted. To know what he would eat was when he started feeding his mom, like helping his mom with a little cooking. He was not going to touch it in terms of getting food for himself, but he would feed his mom or he would help her cook something for dinner. And then in that, he really enjoys anybody else eating it, but him.

But it did eventually get to the point where he started trying. He really liked all the cooking activities, and he did start trying and expanding his repertoire. But as I said, and as you know, as a parent, it doesn’t happen overnight. I wish it would, it would be so much easier.

But I commend you for trying and as I said, you know if it’s something they can’t even tolerate, smelling and how it feels, whether it’s in their mouth or on their hands. The other option is to put it in a baggie and let them kind of explore it that way. So that way it’s not quite as overwhelming. Have you tried that?

Rebecca Gomez:

No, that baggie idea was new. He did some finger painting and wearing of that when he was younger, in bags, but I didn’t think to try that with food. So…?

Leslie Baldwin:

Yeah. It’s another way you know, depending on what it is, you know if it’s messy, definitely in a baggie because I’ve had kids do finger painting with pudding, yogurt, whipped cream, those kinds of things where, depending on if you need to, put in a baggie. If they can tolerate touching it, and then sometimes, once in a while, it’s amazing how many things that kids will eat, besides a food item, like the playdough or something.

Just typical kids, they’re going to try it out and see what it tastes like. But it might help break that cycle. Sometimes they get into that cycle where they absolutely refuse to try anything different.

So, by not making it an eating issue, and more of “Let’s just explore the food,” it might bring their anxiety down a little bit.

Gary Jesch:

Okay, great. Well, thank you, Leslie. Thank you, Rebecca and Tom. It’s been a pleasure to have you and everybody else on our webinar today.

You can look forward to seeing this posted and in the meantime, keep an eye out for Part 3, coming up in about three weeks, in mid-July, of Autism and Anxiety, and we look forward to seeing you all then.

How do you sign up?

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