Rebound Therapy is a very powerful therapeutic tool for working with individuals on the autistic spectrum. Rebound Therapy is fun. It can be an extremely effective motivator for individuals who seek movement, love energising their bodies and interacting with a surface that they are able to control and understand. Through Rebound Therapy we can continue to enhance strategies that have proven to be successful in the management of individuals with autism including ‘Intensive Interaction’, PECS and TEACCH methods.
We know that Rebound Therapy can support vestibular perception. The very fact that the moving surface can demand the body to adjust to changes in movement, head position, the effects of gravity, all reinforce coordination of the head, eyes, body, balance and improve muscle tone.
We know that Rebound Therapy gives enormous feedback to the individual and our central nervous system due to the compressional force of the bed and the effects of gravity. We become much more aware of our normally ‘unconscious’ proprioception. We feel the weight of our body through our joints, muscles, tendons and ligaments. We become much more aware of how and when our muscles stretch, contract, bend, extend and where our body is in space.
For individuals with autism this heightened awareness of balance (vestibular) and body (proprioception) can dramatically improve connections through the use of Rebound Therapy and give a ‘sense of being’, of connecting the previously unconnected.
Because Rebound Therapy is fun it provides an enormous amount of pleasure as is evident from the smiles and giggles of participating pupils. Used wisely it can be a very useful tool to aid communication with pupils who have autism/communication difficulties giving them the opportunity to take control and demand more fun!
We are challenged to work with ‘where the individual is at’ whilst there are many commonalities amongst individuals with autism, no two individuals are the same or share the same make up or require the same diet of Rebound Therapy. If we look at characteristics that make up some features of autistic disorders, there is a clear link to therapeutic benefits of using Rebound Therapy following a multi-professional assessment of need.
The following table attempts to highlight some of the key features of autism that Rebound Therapy can significantly shape, promote, enhance or decrease in relation to the following five key therapeutic areas: vestibular, proprioception, communication, coordination and perception.
The diagram shows us the differing powerful effects of rebound in relation to individuals with autism and why use this therapeutic tool. It also helps support our assessment and objective planning in relation to specific individuals. Rebound Therapy must be used wisely with a great deal of thought and evaluation. Assessment is key. You must take into account comprehension, behaviour, health, triggers, sensory profiles and previous experience. Many individuals have trampolines at home in their garden and are used to bouncing without restrictions. This is not Rebound Therapy and may well work against you for many individuals who have had no previous restrictions or limitations on their bouncing.
The following points may help in your planning and assessment:
Control the environment and environmental factors
Risk assess the activity and plan an exit strategy before commencing Rebound Therapy
Assess, plan a therapeutic programme and deliver it consistently
Use prior information on the individual, do your homework nand stick to the plan
Language and communication
Check for comprehension and compliance
Use a visual approach, visual cues, visual systems
Reduce verbal language to a minimum
Demonstrate movements, shapes, instructions
Don’t overload requests
Build in opportunities for social cause and effect, reciprocity, communication
Use information from their sensory profile where appropriate
Give a clear warning and countdown to the end of the session
Ensure you have an appropriate follow up task in hand
Be in control
Be aware of the use of touch
Give time for responses
Have fun but stay focused
Observe the individual carefully and act quickly on key signals of anxiety, stress and tension
Be aware of over confident, over bouncing, hyperactivity
Finish with calming activities, cool down
Quit whilst you are ahead, finish on a positive
WHICH PUPILS WILL ACCESS AND WHY?
All users, including staff, must be screened for contra-indications before beginning to access Rebound Therapy (contraindications checklist). Unless medical staff advise otherwise, pupils with the following medical conditions SHOULD NOT access Rebound Therapy: Brittle bones, Haemophilia, Spinal rodding, Detached retina. Special care needs to be exercised when working with pupils with Downs Syndrome because they may exhibit both hypotonic muscles and lax tendons. Pregnant staff members should not access the trampoline. Never allow any pupil to take part after an illness/ injury or absence due to illness/injury without first checking that the pupil is fit to meet the demands of performance.
Staff need to be aware of pupils who may experience epileptic activity, e.g. sudden drop seizures.
All users must be risk assessed before beginning to access Rebound Therapy. The risk assessment will specify levels of support and supervision for each individual user. All users must be supervised in accordance with their risk assessment.
All / most pupils would benefit in one way or another from accessing Rebound Therapy focusing on the five key therapeutic areas. It is up to the class teacher to complete the relevant check lists and risk assessments required and to organise staffing.
WHO CAN DELIVER REBOUND THERAPY?
All Rebound Therapy sessions must be supervised by at least one therapist who has received training and have gained practical experience by attending a Rebound Therapy course which will typically include the Winstrada Trampoline Development Programme (grades 1 to 3). Appropriate risk assessments must be carried out prior to any sessions commencing.
Running a successful Rebound Therapy course for individuals and/or groups will impact on pupils’ learning across the curriculum in different ways:-
Communication - pupils will be more motivated to communicate therefore communication will be more spontaneous.
Environment - the environment will be geared towards giving pupils the opportunity to work on activities which they find motivating and which also helps their regulation skills closely linking with SCERTS.
Independence and transitions - because pupils will be more regulated they are more likely to be able to cope with and be able to make successful transitions around school to other areas of learning.
Behaviour - pupils’ behaviour will reflect a more positive attitude as they should be demonstrating that they are able to cope with transitions, independence, communicating with more freedom, building positive relationships with staff and peers and more motivated to learn.
Well being - pupils being well regulated, more willing to communicate and more motivated to learn should reflect a happier child in general with better mental health as well as physical health.
Learning - pupils will be taking part in not just physical activities but also activities from right across the curriculum and at all levels according to the ability and interests of the individual/group. This will ensure that pupils motivated by fun activities which challenge them mentally and/or physically in a cross curricular way.
For more information - click the link below to take you to the UK Rebound therapy website