Please note that in 2013, the DSM-5 (now the DSM-5-TR) shifted to centralize Autism Spectrum Disorder (ASD) as one diagnostic category, differentiated by level of severity rather than functioning, now referred to as Level 1, 2 or 3.
Although ‘Asperger’s Syndrome’ is no longer diagnosed, many individuals, particularly those diagnosed before 2013, still identify with the term ‘Asperger’s’. While Unyte Health makes every effort to use updated terms and inclusive language, this case study retains the author’s original title and descriptions to be most sensitive to the client’s identity and preferences.
About the Provider
Name: Susannah Cole-Hamilton
Discipline/Credentials: Health and wellness coach
Modalities: Safe and Sound Protocol (SSP), Tension, Stress and Trauma Release (TRE®), MindMoves, nutritional coach
Name: Kat (pseudonym)
Age and Gender: 15-year-old girl
Program Delivered: Safe and Sound Protocol (SSP) (SSP Core, Hours 1 through 5)
Kat has been diagnosed with high-functioning Asperger syndrome. She has severe anxiety and does not cope well with noisy environments. She finds certain tastes and smells overwhelming and irritating, and has severe tactile defensiveness. Kat does not engage easily unless it is about her passion, Minecraft. She needs routine and familiarity; in its absence, she has severe meltdowns.
Kat lives at home in a supportive family environment and sees a therapist weekly. She went through the Tomatis® Method three times in 2006 and it had a positive impact, but some of the benefits have since faded.
Her mother, a psychologist and TRE® practitioner, knew about the Polyvagal Theory and was very keen for Kat to experience the Safe and Sound Protocol (SSP). Kat has been feeling anxious recently, and this was the reason she was willing to do SSP.
Implementation of the SSP
The SSP was delivered to Kat in person over six weeks. For 30 minutes per session, she beaded while listening to the music. Kat also continued to see her therapist once a week during the delivery and to attend LEGO® sessions.
Kat’s mother completed the assessment for her as she is a minor, and kept detailed notes of observations and input from others who know Kat well. After Hour 3 of the SSP, Kat’s mother introduced the three nervous system states in a way to which Kat could relate. Kat chose her own language for the three nervous system states:
Kat is able to identify where she is and communicate this to her mother. This has also given them a language to discuss how Kat is feeling and how to move from blue or red to pink. At this point, Kat reported that her anxiety has decreased.
Kat’s mother noticed from Hour 1 that Kat was more engaged: she talks more, spends less time in her room, makes eye contact, and is regularly conversing about topics other than Minecraft. Before the SSP, she would mainly only talk about Minecraft with others and not engage in other topics of discussion. As she continued attending her LEGO® group sessions, Kat’s facilitator there noted that she is engaging more with the other students and with more varied conversations.
Kat would enter sessions with her provider Susannah Cole-Hamilton, sit down, and get stuck into making something with beads during a session. After Hour 3, Susannah noticed that Kat would start a conversation, including a long discussion about making pancakes and about the filling that she was going to make after one of the listening sessions. Kat is interested in trying new foods, which is unusual for her.
Improved Emotional Regulation
Kat’s mother finds that she is able to regulate her emotions much better than before and calms down faster after experiencing anger. Kat’s grandmother also noticed that she is more engaged and less disturbed by unexpected changes in her environment that would have triggered a meltdown. For example, during a 24-hour power outage, Kat played board games and had fun in a situation that previously would have “freaked her out.”
Kat’s youth leader noted that she shared a situation and explained how it triggered her sadness. Kat was able to cry in the group session and accept physical comfort, which is unusual for her.
“This was my first time working with a young teen with Asperger’s,” Susannah said. “I learned how important it was to maintain the routine of the appointments in terms of day, time and activities.”
Susannah had a selection of activities for her to choose from during the sessions. They communicated a bit, with Susanna sharing that she didn’t explain a lot to Kat. She explained the Polyvagal Theory to Kat’s mother and discussed developing a language for the three nervous system states, which worked well in this case as her mother initiated the discussions with Kat when the moment was right.
Discover the Safe and Sound Protocol
Developed by Dr. Stephen Porges, the SSP is a non-invasive acoustic vagus nerve stimulator that helps clients connect with themselves, others, and the world from a foundation of physiological safety.