About the Provider
Name: Joseph Falkner, MST/CC-SLP
Discipline/Credentials: Speech Language Pathologist
Modalities: Rhythm of Regulation, Interpersonal Neurobiology, Integrative Manual Therapy, Play
Client Background
Name: AB (pseudonym)
Age and Gender: 12 years old, female
Diagnoses and Conditions: Autism, anxiety, sensory overwhelm, depression, irritability, allergies (including cats and milk that increase the intensity of mood difficulties), unspecified disruptive/impulse control/conduct disorder.
Program Delivered: Safe and Sound Protocol (SSP)
AB has lived with parents since her birth when she was adopted. AB did have some birth trauma that may have initially impacted attachment and connectedness, as well as contributing to her lifelong difficulties with these two. AB had been seen by other therapists, but prior therapy had not been successful.
AB was significantly reactive, spending a great deal of time in sympathetic arousal. She would withdraw at times, often appearing disconnected and hopeless. AB was prone to stealing from others, angry outbursts, resistance to connection, avoidant in attachment, oppositionality, and often sabotaged relationships by becoming too clingy. AB demonstrated significant food allergies, and would often seek out foods that contained these allergens, which would affect both her mood and physical health.
Implementation of the SSP
Parents sought treatment for AB due to her disconnectedness and reactivity, as well as the impacts of these on the family. Goals of treatment included increasing her felt sense of safety, increasing the flexibility of her nervous system, increasing connectedness and decreasing reactivity.
The SSP was delivered to AB (Hours 1 through 5). AB and Mom listened in-person on two different occasions to the Adult Playlist of the SSP. Each session lasted one hour with them co-listening.
Each session was structured so that both AB and Mom could do co-regulatory activities as well as solo activities with co-regulatory support, including:
- Movement to assist with any arousal that arose
- Interactive play to enhance co-regulation
- Hand placement over the lower mid-back to assist with acceptance and processing of any arousal
- Art activities to provide both movement and expression opportunities
Response
Following the second administration of the SSP, AB has been demonstrating less reactivity, fewer angry outbursts, more bids for connection with Mom, and better acceptance of co-regulation from parents.
Since the time of the submission of the case study, Mom has contacted me to cancel treatment because things have been going so well. The connection between the child and Mom and Dad has increased, and her reactivity has decreased to the point where Mom feels right now they don’t need the support.
AB has never been a child who would express missing her parents or seek affection (e.g., a hug) from her parents. Now, following the SSP, she has expressed missing Mom following a short vacation that the parents went on without their children, as well as seeking hugs from Mom at times. The intensity of seeking out the allergens that impact on mood and behavior has also significantly decreased at this time.
Parental Observations
We have done a great deal of work both with AB and with Mom to increase the felt sense of safety within their bodies up to the time the SSP was delivered. This is part of her integrated plan of care, and it worked because her body was ready to take in the stimuli, and the co-regulation with Mom helped to establish some connection that had been lacking.
Mom is pleased with the results of the SSP and has stated that this is better connection than she has experienced with AB throughout her life.
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