You have left your first therapy appointment after months of waiting to receive some help with your child. Your therapist used a BUNCH of words that maybe sounded a bit like another language. You recognize the words...Sensory Processing Disorder. But, you have left that appointment MORE confused than when you entered! HELP!!
You are NOT alone!! I hope by the end of this blog, you will feel more confident about where to go from here and on a path looking up. Sensory Processing Disorder (SPD) is not new. It is, however, more common than in years past. I have a lot of theories as to why this is. I will not use this time to go over those. That is for another whole blog! Keep reading if you would like my watered-down version of what SPD is and is not!
I have been an Occupational Therapist for almost 30 years. It may have taken 25 of them to get a FIRM grip on SPD. I have read so many books. I've been to countless continuing education courses to learn more about this mysterious diagnosis that still does not get the recognition it needs from the DSM-5. I do not expect you to be able to "fix" your child after reading this, however, I do hope that you get a better understanding of where he/she may be coming from.
Sensory Processing as a whole is our brain receiving information about the senses in our world (you know the ones, sight, sound, taste, smell, touch) and using the information to react in a "typical" or socially "acceptable" manner. Some children/adults may have sensory irritants but they would not be considered a disorder. An example of this would be someone who is bothered by the "feel" of a tag on their shirt. This person may be irritated initially by that sensation, but his brain accommodates to that feeling and allows him to continue with his day without incident. He may occasionally be aware of it; but again reacts in no way that would be considered unusual to those around him and is able to get through his day with whatever he needs to get done.
A person with a disorder, on the other hand, will not be able to move forward until it absolutely is removed. Reactions may include shutdowns, meltdowns, tearing clothing off. His brain cannot shut the feeling out and has an extremely difficult time moving forward without the irritant being gone.
I'm going to throw in a few more senses just to make it a little more confusing! In addition to the ones mentioned, there are also the senses of proprioception and vestibular. I'm sorry...fancy words. Let me clear it up!
Proprioception is the sense of self-movement, force and body position. When you close your eyes you still know where your hand is. When you hold onto a styrofoam cup you "sense" what force is needed to keep it in your hand without crushing it or dropping it. You know that when you jump what it will feel like to land. What is important to know about proprioception is that it is a "fixer" of many behaviors related to SPD. If all else fails head for proprioceptive activities! Again, another topic for another blog!
Vestibular Input is the sense of "movement". The inner ear has a great deal to do with this. You know how your body responds if it spins round and round. You can imagine what it feels like to swing with your head upside down. Vestibular input is the King. It honestly is likely to be the most powerful sense. It can totally make or break how one feels. It can rev one up or calm one down, BUT if not used appropriately can quickly disintegrate someone's sense of feeling safe, calm and collected.
Interoception works constantly by giving us information on how we "feel" internally. Are we hungry, full, cold or hot? Do we need to use the restroom? Are we starting to feel like we are getting a cold or have a tummy ache? Children who have difficulty in this area are often have a difficult time with potty training. They complain frequently of tummy aches or seem relentless even when they have high temperatures. Their body simply is giving them mixed signals on how they should feel.
Now you know what Sensory Processing is. Let's discuss the "disorder" a little more in depth. With receiving and processing senses our brains release nuerochemicals. I'd throw out the names, but the less "fancy" this blog is the better in my opinion. I'd like to view the nuerochemicals like filling a cup (hence our brain). We can have too much, not enough, or just right! The result of any of those scenarios is a behavior.
Now we are talking. A Behavior?? Likely, that may be why you sought therapy in the first place. There is a behavior going on that has been making life of your child, family and those around difficult to manage.
I have yet to meet someone that does not have some sensory "quirks". Those that know me, know I do not, I repeat, DO NOT like to touch a cotton ball. Can I still do it? Yes...I'm an adult. I know that if I overreact when touching a cotton ball, I will draw unnecessary attention to myself. I can "make" myself do it and can "hold in" my disgust. I also as an adult get to choose when, how much and where I touch those disgusting white fluff balls!
Now, let's do this from a child's viewpoint. Our children have new and very attuned brains processing their senses. Their brains can be "ULTRA" sensitive or even at times "NEGLECTFUL" to sensations. That doesn't mean that their brains do not crave a "just right" filled cup. The result...BEHAVIOR! They lack the ability yet to communicate with us how or why they feel the way they do, so the best way they have to show it is through their behavior. As well, a child lacks the ability to be able to decide when, how much and where they receive these sensations as we the adults lead them through their lives without knowing or predicting which sensation are triggers for their brains and bodies.
When a child's behavior is such that it seems your child is unable to cope with the world they live in, it then may be labeled a "disorder". So should all "extra" behavior be labeled "Sensory Processing Disorder"? Goodness NO! That is when you and your therapist need to become detectives. You must work together to backtrack and dissect behavior. Your therapist may ask you to fill out forms. They may ask you to keep a journal of events surrounding the "extra" behavior that happened before during and after to help determine what if any, is in a child's environment that may be triggering the behavior or "overreaction". It may take months of therapy for your therapist to get a grip on triggers and actions you can take to prevent or get through one of these labeled "sensory meltdowns".
My general gut reaction to determine if this "overreaction" is typical child "behavior" versus a "sensory processing difficulty" is to ask...is the child getting something out of the behavior? Is he/she getting or getting out of doing something? Does the behavior magically stop when given in to? A sensory driven behavior takes a little more to "come out of". As noted in the pictures below, when a child's sensory system feels threatened with a cup that is too full...the body's flight or fight instinct takes over and "just getting over" the behavior is not quite that easy.
There are a few subtypes of SPD. Once again, they are given fancy names that I do not want to go into. Very seldom does a child fall in only 1 of those subtypes. And to make it even more confusing, some of them move from one subtype to another week to week or even within the same day. Just when you find a strategy that seems to help in either preventing or managing sensory meltdowns, it changes, and you may feel like you are starting from scratch! That same tag didn't seem to bother "Johnny" yesterday but today he can't move past it! Below, I have tried to come up with some visuals to help you sort out where your child may be when it comes to their cup being empty, full or just right.
This child's brain (cup) is Just Right! She is able to listen, learn and communicate clearly with those around her. Her body is filtering out unnecessary sensory information and she is engaged to be able to complete her schoolwork.
These Children are craving more sensations as their cups are empty. To get that their play seems disorganized. They create huge messes. They seem to wander aimlessly with no seemingly purpose behind it. They lack awareness of items and people around them, often appearing clumsy. It is difficult for them to learn while in this state.
This subtype is often the most noticeable. The child's brain is overflowing with sensory stimuli. Everything feels too loud, too bright, too scratchy. Their little bodies are in high alert mode. All it takes is one "extra" thing in their environment such as a flickering light and it will send them over the edge. Behaviors fall in the fight or flight realm. They can be aggressive, loud, quiet, run, hide, anything to help them avoid the sensation that is putting their bodies and brain into over drive. Expecting them to listen or learn when in this state is honestly impossible.
I have just given you a bunch to digest. There is sooo much more I can add. I touched on what SPD is and how to recognize it. In the coming weeks, I will begin to address what to do and where to seek help. Parenting children with SPD can be a challenging and lonely world. Your child's appearance is quite typical, but the behaviors elicited are not. Going out to places in public or attempting to visit friends and family can seem daunting and exhausting. There are many well meaning people who would like to tell you what you are doing wrong.
I see you! I support you in parenting your exceptional child who just happens to have a sensory system that is often unbalanced. Join my newsletter to get emails of updates when I continue to educate, answer questions and allow you to vent your frustrations.
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Again, I SEE YOU!