Autism; The Key to Self Regulation and Engagement

This week, I continued my thoughts from last week; to Support What is Given and Give Structure. Previously, I had trouble with my client “Frank”, staying engaged and wanting to leave the room. In my anxiety about this, I continually kept presenting new material to “Frank.” Last week’s blog ( presented a video clip of Frank staying and briefly engaging with the music. I know that “Frank” likes to rock or swing, but lately, he seemed to need to move on. The vestibular input had seemed to calm the existing anxiety, however, now seemed to move “Frank” to lethargy. Keeping in mind the comments “Frank’s” mother told me about recent needs of “Frank” to keep things in a certain place and in a certain order, and the recent stress in the home caused by the many people visiting the home. This prompted two thoughts. “Frank” either a) needed sameness to feel safe and needed predictability, and/or b) he needed some control over things.

Right before “Frank” came for his next session, I decided to put a rolling chair in the room. I wasn’t sure why the chair, but was firmly resolved that “Frank” needed to lead . I needed to not only observe more closely what Franks control looked like, but also how it was employed.

“Frank” spotted the chair and sat in it right away. He mostly rocked or shuffled back and forth in the chair at first. I sang and played subtly to the rocking, allowing the music to reflect the subtle rocking. He gently played my chimes now and then, and grabbed my cabasa and sounded it with his movement. Subtle vocalizing followed. Then combinations of the vestibular rocking and spinning, playing and vocalizing emerged.

As one response was reflected back in the subtle manner it was displayed, another response emerged. A look of peaceful happiness covered “Frank’s” face as he closed his eyes and listened also. Lastly, as he slowly spun, he opened his eyes and sustained eye contact with me for the remainder of the session. As he stopped moving, so did the music. His brief vocalizations began to match the tonality I played and sang in. Not only were there no attempts made to leave the room, but also yet at a sensory level response,   “Frank” stayed jointly engaged with the music and myself. As we peacefully ended our session, I had to lead Frank out of the session this time. I thought the session had ended well, staying jointly engaged and leaving the room peacefully regulated and content.

I thought the session had ended well as I closed the door to begin his brother’s session. A new, completely different session with not so subtle dissonant chords, high pitched, accented music. My assumptions were wrong however, “Franks” session had apparently not ended. “Frank” let himself in and began to engage to his brother’s vastly different music, this time seeking my eye contact. As I continued to play his brothers music, both the boys actions and sensory responses were integrated into the music simultaneously. Although the boys attended each to me, and to the music, at this point they seemed unaware of one another. However “Frank” not only engaged, but remained and stayed engaged with this foreign music for the entirety of his brother’s session. Follow to regulate, follow to support, and follow to engage.


debbi dunkley,PT

I resonate clearly and deeply with what you have written as you relate your experience and perception of that connection with Frank. The spark,growth,tenacity and courage that Frank expresses during this interchange is the substance of so much of what we are all so desiring to see in our kids.

I only practice a few hours currently in the pool but have explored and experienced some very treasured connections there dancing with the directions, rhythms,intensities and flavors of a certain child on a given day. Funny that the medical model “goal” happens best through this type of sensitive, intuitive, interactive engagement.

http://I have used some components of music therapy which you describe in your blog which can also characterize other mediums of therapy. I sing,rhyme,hum, bubble, bounce,swish,pause etc responsively as part of maximizing the environment in preparing for desired movement response. You have encouraged me to keep on….

Thank you for sharing…I treasure what you are doing and writing.

debbi dunkley


Thank you so much for your comment. It really sounds as if the medical model should look a little more closely into the arts. Our society today puts so much trust in only cognitive functioning. Wouldn’t things be different if we all paid a little more attention to the intuitiveness that we each poses? Keep up your very wonderful work Debbie, it is so needed.


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