Raising Kids With Sensory Processing Disorders

A Week-by-Week Guide to Helping Your Out-of-Sync Child With Sensory and Self-Regulation Issues

Rondalyn V Whitney, Varleisha Gibbs, Rondalyn L. Whitney, Varleisha Gibbs, OTD, OTR/L

• Publisher: Routledge
• Year: 2021
• eBook ISBN: 9781000495591
• Topic: Psychology
• Subtopic: Education General
• Index: Psychology

Taking a look at the most common sensory issues kids face, Raising Kids With Sensory Processing Disorders offers a compilation of unique, proven strategies that parents can implement to help their children move beyond their sensory needs. This updated second edition: Shows parents how to characterize their child's sensory issues into one of several profiles. Helps parents find the best adaptations and changes to their child's everyday routines. Provides a week-by-week series of activities and checklists. Helps improve children's performance on tasks like homework, transitions between activities, and interactions with friends. Is written by parents and occupational therapists. Whether it's having to remove tags from clothing or using special dimmed lighting when they study, kids with sensory disorders or special sensory needs often need adaptations in their everyday lives in order to find success in school and beyond.

Part I
About Sensory Processing Disorders

Chapter 1
Demystifying Sensory Processing Problems

DOI: 10.4324/9781003237501-2

Every family has its own unique habits, routines, and rituals that allow for organization and support engagement in daily life activities. But if you are reading this book, it’s likely that your child is having some difficulty being a kid—something is in the way of allowing him to engage in the day-to-day tasks and activities in which you would expect him to engage. Maybe he can’t stand hearing his brother chew spaghetti. Maybe she screams and thrashes when it’s time to change out of her pajamas. Maybe he can’t go to sleep at night or is overly lethargic in the mornings. Or maybe the smell of her teacher’s perfume causes her to become upset. These issues are baffling, perhaps leaving you to seek the assistance of a professional. Despite the implementation of therapeutic services, or lack thereof, your relationship with your child may be compiled of a lack of understanding and disconnect. You may ask yourself, “Do I really know my child?”

Parents sometimes wonder what occupational therapists know about their child that parents do not. How do we have the “magic key”? Although that may not be completely true, occupational therapists are trained experts in viewing your child as a unique individual, incorporating the entire family unit, and providing caregiver training for a successful intervention process. However, you are the expert for your child! Yes, you are the most important expert. If you are debating that idea, we hope to change your perception. Our aim is to enhance the vision you already possess by allowing you to look through our “glasses.” Better yet, you are probably on the right path. Perhaps you have approached what feels like the edge of a cliff. Well, let’s bridge the gap to complete your family’s path to success.

Despite wonderful advances within the field, many still question the occupational therapist’s role. More specifically, who are occupational therapists and how do we use Ayres’s (1972) sensory integrative approach? And how are the components of such an approach helpful in everyday life? Sensory-related problems affect the routine of the entire family (Schaaf et al., 2011). As occupational therapists who specialize in working with children, our work is guided by the question of “How do the problems the child is having impact their quality of life and the quality of life of their family?” We are interested in the child and their family’s ability to fully engage in the day-to-day activities, or occupations, important to the life of that child (e.g., getting adequate rest and sleep, being able to play with friends, and having an uninterrupted dinner with the family). During evaluations, an occupational therapist’s questions may sound intrusive. However, our goal is to gain the clearest picture of your child and family. We are constantly observing how children behave even during the most basic of activities. Although this appears to be a simple process, we use theoretical and scientific evidence to broker a fit between the way your child makes sense of their body and environment and their participation in play, school, home, with friends, self-care, and learning activities.

Our philosophy is constructed on the foundation that your child is not only your child, but also a friend, a sibling, and a learner. Children are constantly growing and, therefore, constantly in a state of transition. In addition, a large role they play is that of being a student. As scientists, we study the activities that promote positive habits and routines related to the occupational role of student, and therefore homework strategies and morning routines. We are frequently invited to use the body of knowledge related to sensory processing as we observe sensory barriers interfering with an individual’s ability to interact with others, adapt to the environment, and perform expected tasks, such as getting dressed or eating with the family.

Although we use social and behavioral theories, knowledge of medical science is also part of the toolbox. Our training in anatomy, physiology, and neurology helps us understand development from the basic systems of the body—the brain, the muscles, and the sensory system. Our background in psychosocial theory supports our interventions to be holistic and mindful of the spirit and the social-emotional aspects of development. We use evidence to guide our practices and the fields are science driven. Sensory processing disorder (SPD) is not an accepted diagnosis, but it has become increasingly used in clinical practice to explain behaviors that are sensory based and to describe processing through the sensory pathways that is disordered and impairs participation. Even while SPD is not an accepted diagnosis, the term can provide a framework with which parents and professionals can understand a child’s abilities.

In this book, our goal is to help you see what we, as experts, would see and to provide helpful suggestions that might make daily life easier. Although occupational therapists can use wonderful strategies in the clinic, carryover to the home and community environments is the ultimate goal for our interventions. We want to help you learn how to recognize the “soft signs” that suggest a child is struggling to take in information from their environment, organize that input, and use what they’re learning to grow and learn and play. As a parent, you are the expert on your child, but when there is a gap between their development and their potential, what do you do? How do you prioritize what you provide for intervention? When do you worry, and when do you watch and wait? We have worked with so many parents who say, “I wish I had started earlier,” or “I wish I knew this information when they were younger.” We have wished that too, and this book is our gift to your child and to you. We hope to partner with you through the following pages and together close the gap between parent and practitioner strategies.

Of course, our ultimate goal is to help you close the gaps between the performance and potential of your child as they grow and thrive within your family and within the larger community. Why is sensory processing so important, and why can it be so disruptive? All learning occurs through the senses and demonstration of learning through the motor system. All nerves to the brain are sensory nerves. You learn by what you see, hear, taste, smell, and feel, and how you move. Difficulties with participation related to sensory processing are characterized by the inability to take in sensory information and use that information received to function smoothly in daily life. When a child is unable to react adaptively to different sensory experiences, there can be a disruption in engaging and performing in certain contexts and environments, such as in the home or at school. Instead of concentrating on the required activities, they may be anxious about the unknown that may be coming. Children who experience sensory modulation difficulties may display signs of sensory seeking, sensory overresponsiveness, or sensory underresponsiveness during the course of a day. Children can seek sensation in a less than acceptable way or can retreat from sensation. Both strategies can impair family quality of life (FQoL) and interfere with a child’s primary occupations: playing, learning, and being a good friend.

This book will focus on helping the sensory system take in information from the world in a functional manner. Organization of sensory information will assist families in reducing impairment and improve quality of life through normalized patterns of participation.

BACKGROUND

Our sensory motor systems play a huge role in our ability to participate in our daily lives. All of us must be able to achieve sensory modulation, sensory discrimination, and sensory-based motor adeptness. When the sensory demands of your child’s environment are a misfit with their sensory preferences, it is our job to find ways to create a better fit between the child, the environment, and the activity.

Think about the times you were in the school cafeteria or lunch-room. In that setting, you can find a glut of other people’s food preferences and infinite ways that peers are interacting. You can smell peanut butter alongside pizza, hear high-pitched giggles from a gaggle of small girls, and see a quiet introvert sitting off to the edge of the more animated interactions. Where would you sit? How would you feel after the 45-minute lunch break? Would you be excited and energized or ready for an aspirin? What coping skills would you use to be successful in this setting? When there is a misfit with the environment and/or the population, children cannot fully participate in the activities of that environment. For example, a child who is very sensitive to smell, sound, and touch may absolutely fear the cafeteria! The mixture of food odors, multitude of simultaneous conversations, and the occasional peer brushing against their arm may lead to sensory overload. That overload may then result in self-isolation or simply negative behavior. Some children get overwhelmed and disregulated and act out, maybe yell at their classmates, smack them, or squirt them with juice. Others withdraw—many schools have a “peanut-free zone,” and this has become the default site of retreat for non-peanut allergic but sensory sensitive kids to retreat. This manifestation of behavior is frequently the result of poor interaction with a multitude of stimuli from the environment. A family dinner can feel like an overcrowded lunchroom to some children. The ultimate goal for any of us is to create balance between one’s inner and outer world.

In our experience, there are six areas that are particularly problematic for children who have delays in the development of their sensory-motor system that ultimately disrupt family routines. Both our clinical experiences and the emerging body of evidence have identified that many of these issues are the result of under- or overhypersensitivity to stimulation or are caused by poor modulation skills. Although that is an oversimplification of the nervous system, it’s probably worthwhile to pause and think about modulation.

Poor modulation occurs when an individual lacks strategies that provide support or balance for the sensations that feel overwhelming. For example, a child has difficulty with getting dressed in the morning because they find the touch of a shirt or underwear to be overwhelming. This in turn interrupts family routines and rituals and causes a stress-filled morning for the whole family. However, using what we know about the nervous system, we can provide sensory input that helps the child’s nervous system feel more organized, or in balance, and therefore able to participate in the morning routine of getting dressed. Imagine this scenario:

Joey wakes up and needs to get his clothes on, but he screams and refuses to take off his pajamas. Mom is in a hurry: She has an important meeting at 9 a.m. and cannot be late, but Joey is having a tantrum. The morning is off to a rough start.

Now imagine this:

Mom says, “Joey, time to rise and shine!” and turns on some music—the theme song from Star Wars blasts in the room, Joey sits up, and he smiles. Mom says, “We need to get dressed. Let’s get your body ready!” and she and Joey begin to dance to the music, pumping their arms. When Joey’s arms go up, the pajamas come off and a shirt replaces the top; the same routine happens with the bottoms and socks. Once he’s dressed, Mom says, “Now who’s ready for a power breakfast?” Mom serves crunchy cereal with apple chunks.

This heavy work to the nervous system involved in the breakfast Joey’s mom served (e.g., chewing, moving the muscles) is organizing and allows us to modulate sensation that is very alerting (e.g., changing temperatures, changing positions, changing textures on the skin). Music provides rhythm and the opportunity to match the internal sequence and timing to the external world; dancing provides strong proprioceptive input that helps to organize the nervous system and allow the individual to better meet life’s challenges—in Joey’s case, getting dressed. One other piece going on here that can’t be overlooked—moving to music floods the body with endorphins (Seligman, 2004). Think of these interventions as a “dose,” like when we take vitamin C to prepare our bodies to ward off an attacking virus; sensory strategies are used to prepare the body for good work (e.g., dressing, eating with others, sleeping). The research isn’t clear about how much and how long we need sensory input, but think of your own body—how much of a challenge can you persist against before you need to take a walk, have a coffee, or wiggle?

To help us develop strategies that will reduce impairments that families may experience, we took a careful look at the literature on sensory issues. The series of activities in this book were distilled from the real world and tested to help families develop positive habits, routines, and rituals in order to further sustain engagement in important and meaningful activities. Because none of us can make too many changes at once, we’ve provided a strategy a week for you to try, 58 total, or just more than a year’s worth if you complete each activity. We know it takes about 30 days to create a new habit—we hope using one strategy a week (maybe a few times a week) will build a repertoire of new habits that stoke your child’s nervous system, promote further positive habits, and support you to have greater FQoL.

Because the use of sensory strategies is a scientifically based set of interventions, we want to take a little time in the next chapter to identify some terminology that will be utilized throughout this book. The descriptions of common sensory problems shared in Chapter 2 will later be coupled to the activities in Chapters 5–9.

PROBLEM SOLVING

We all interpret what we see—some families watch a child’s reactions and think the child is behaving in a way to seek attention. Sometimes parents and teachers feel a child isn’t motivated. We believe children want to be good and live up to the expectations the adults have for them. When they aren’t, our experience has convinced us there is an underlying barrier to that aspiration. The same is true for parents—parents want to help their child learn prosocial behaviors and they want to provide discipline rather than punishment, but sometimes they don’t see what is hiding in the background that’s causing their child to behave in “crazy” ways. Because of our professional training, we view breakdowns in engagement, take a developmental approach, and ask questions about the sensorimotor and cognitive system. Can the child identify what they want to do? Can they make a plan and can their muscle system take the steps that will allow them to enact that plan? For example, are they motivated to climb on a tire swing to play with friends? And if so, can they plan how to move their muscles to make...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Activities
• Acknowledgements
• Foreword
• Part I: About Sensory Processing Disorders
• Part II: 58 Week-By-Week Activities to Restore Sanity to Your Family Life
• Conclusion Explaining Your Child
• Resources
• References
• Appendices:
• About the Authors