Another easy one: video games for sensory integration disorder

There’s two goals that can be served by video games, or any other SID therapy.  One is long term improvement by teaching the body new patterns.  For example, you could put a patient on something that produced constant motion (like a horizontal swing) and vary the angle of their head.  This teaches their body how an given motion and angle feels in their vestibular canals, which they will recognize in the future (like when they’re on the subway), thus lessening the stress on their system.  This is the equivalent of rehab exercises after a knee injury.  The other is short term calming of a sensory system that’s in overload.  Once a person hits overload, even stimulus they could usually handle becomes painful, often making the overload worse.  This is awesome not only for the immediately obvious reasons, but because it returns a sense of control when you need it most.

I haven’t read anything official on this, but from a patient’s perspective, the difference between these is a matter of degree.  The ideal stimulus for the first is something novel enough that I’m gaining a new skill, but familiar enough that I can relate it to something I already know, and learn by analogy.  The ideal stimulus for the second is very familiar, because a large part of the goal is to return a sense of control.  But both benefit from coordinating multiple types of input (aural, visual, kinesthetic)- one because it gives a new pattern more places to hook in, the other because it makes input more predictable.

With that said, here’s a list of video games I have found that do either of these things.

Dance Dance Revolution (available on all consoles, and a grey market PC knock off): the original rhythm game.  DDR has you tap a dance pad with your feet in time with signals on the screen.  Technically, the signals don’t have to match up with the beat of the music, and sometimes they don’t on advanced music.  I refuse to play those levels.  DDR is great because it uses the whole body, teaching you where you are in space.  It also involves jumping, which my OT says helps reset the vestibular system.

Enjoy this video of a four year old boy being better at DDR than you will ever be.

Patapon (PSP): control a tiny army by typing patterns rhythmically.  Patapon is awesome because the rhythm is in service to a greater goal, it is progressive but allows you to replay old levels (so you can push yourself for long term therapy or play an easy level to treat acute dysregulation), and because they did a great job coordinating the visual, auditory, and even spatial cues (if you play with headphones the sound of a beat corresponds to where the button is on the controller) .  There’s a very subtle visual indicator for the “beat”, which was invaluable when I was starting out.  The PSP is portable, so you can take it to stressful things like say your job and use it to keep one bad thing from ruining your day.

Synthesia/playing an instrument (PC/flexible).  Instruments coordinate physical motion and sound.  If you’re starting from scratch the piano is a good choice because playing individual notes is easy (as opposed to wind or most string instruments, where just getting a note out is a challenge), but I may be biased because that was my mom’s choice of instrument for me as a child.  I hated it then, but as an adult playing pop songs of her choosing, I’m really enjoying it.  There is something really calming about getting the right note, the one that matches the song in my head.  Additionally, music is heavily tied into the emotional systems, and can provide a way to express or access feelings people (especially children, especially ASDers) have trouble expressing.

Synthesia is DDR for the piano.  The song selection is a little limited, which is why I haven’t bought it yet, but just watching the videos calms me down.

Synthesia’s not the only learn-to-play-piano software, and if you’re really interested it’s worth researching.  The right software/piano combination will even light up the keys for you.

Speaking of which: if you’re buying an electronic piano, you have a lot of choices over a very wide price range. The ones don’t actually sound that much worse, but the keys are way less satisfying.  They don’t resist properly, and the cheapest ones don’t even modulate based on pressure.  I got used to playing on the $2000 keyboards at work, which have very satisfying keys.  I wasn’t willing to spend that much, but I discovered that the learning Yamahas (at least the PSR E433 and E343) are a pretty good compromise.  Their keys don’t have the same heft to them, but their speakers vibrate the keys ever so slightly, which gives a different kind of feedback.  They also have displays showing you exactly which key you’re hitting, which is really helpful when you’re still learning to read music.

WiiFit/other Wii Balance board games (Wii): these were pretty meh for me, there wasn’t enough kinesthetic feedback.  But they are a great way to provide visual feedback on balance, if that’s your particular issue.

Guitar Hero/Rock Band (XboX 360/PS3): these fill the same niche as DDR and piano, but have never worked for me.  Guitar is too hard, drums are too easy, and no one will ever let me sing.

Thomas was Alone (PC, PS3, iOS, PS Vitae): A game about rectangles making friends.  This has nothing to do with sensory integration but it’s my favorite game and I couldn’t not mention it.