Kids with sensory processing disorder often experience anxiety. They are overwhelmed by all the transitions and unpredictable events taking place in their daily lives, but often cannot pinpoint the source of their discomfort. They might become irritable and appear to be irrational. Tantrums often become a modus operandi to attract human attention to their needs.
We all have emotional and physical needs, but as adults, we can (hopefully) identify our needs and address them. We can choose to take a coffee break, exercise, eat, take a bathroom break and speak with a friend or family member.
Children on the other hand, have very little control of their lives. Adults tell them what, where, when and how to do. The equation is simple: Emotional or Physical Needs +Decreased Control= Anxiety and Frustration.
Remember, children are little people with human needs. They benefit from choices and some control in their daily lives. Children deserve empathy and respect. Children deserve to be heard. Their feelings are real and their anxieties and frustrations have a root cause.
Whether it’s noise or new faces, travel and a new environment can be challenging for children with autism or sensory integration disorder. Here are some helpful travel tips:
-Prepare the child in advance either verbally or with pictures
-Have the child choose something familiar to take along as a transition tool
-Bring materials that help the child filter out overwhelming stimuli. Examples include noise reduction headphones, a weighted vest, fidgets, relaxing music
-Show your care and understanding and label feelings: You feel worried/sad/scared? I’m here to help.
-Present choices: Do you want to calm down with your headphones or stuffed animal?
When you are calm and prepared, it’s easier for the child because he/she can sense your anxiety.
Playing games can be a great opportunity to teach kids life skills in a fun and relaxed setting. General skills that can be targeted, taught and/or improved include:
cognitive/reasoning skills
receptive and expressive language
developing vocabulary and spelling
use of prepositions and ordinals- fist, then, after
following multi-step directions
delayed gratification
peer interaction
working in a group
turn taking skills
resolving conflict
maintaining attention to task
setting and achieving goals
decision making
Tips when playing with kids with special needs:
-Be prepared to simplify the game and break it down to fewer steps
-Clearly outline instructions one task at a time and demonstrate to the child. If needed, clearly illustrate the steps on paper in addition to demonstration.
-Some children get overwhelmed when interacting with others, so start with a smaller group of 2-3 people and allow the child to be successful before growing the group.
-Encourage child to look at opponents/peers and when appropriate say “my turn” or “your turn” or “good job”
-Pair children with different strengths and weaknesses and encourage them to coach each other as part of “teamwork”
-Praise healthy peer interaction, and positive behavior
-Recap positive lessons learned
Perseverative behavior is a well known tendency among individuals with autism and similar disorders along the austistic spectrum. Repetitive movements, echolalic speech patterns, rigidity of thought, obsessive interests, and ritualistic behaviors have in fact become hallmark features of autistic disorders and are often used for diagnostic purposes. As clinicians, educators, or parents, an important question to consider is what purpose these behaviors may serve and how they may be understood in the context of a child’s developing personality and general approach to life.
Cognitive science literature shows that in fact, the tendency to perseverate is observed not only in autistic individuals but in most normal adults along a continuum. In one very early study of behavioral rigidity (Morrow, 1946) older adults between ages 58-73 showed very extreme forms of perseveration during a card sorting task with changing rules. All of these subjects persisted in an unsuccessful rule despite repeated negative feedback over many trials. This work suggests that as people mature and experience more of life, they develop routines that often provide a certain sense of familiarity and comfort. These same habits, however, may also hardwire the brain to respond to situations in a predictable manner that does not leave room for new approaches or perspectives. A more recent study (Diamond & Kirkham, 2005) demonstrates that even younger adults show a tendency for “attentional inertia,” as revealed by longer reaction times for all responses that required a change in perspective compared to responses that followed an identical pattern. In other words, there is a normal cognitive bias toward our previous thoughts, behaviors, or responses -which explains the difficulty many normal adults have in seeing multiple perspectives to a question or problem - it is hard to adapt to a novel approach.
In a more general sense, most normal individuals experience discomfort with changes in routine. We all have different levels of tolerance for change and learn to appreciate our needs and work around them in order to adapt smoothly to the constant flux that is life. Perhaps we surround ourselves with friends during a difficult transition, bring familiar mementos when moving to a new place, or comfort ourselves with favorite books, foods, or music when encountering an unfamiliar situation that is threatening.
Appreciating the resistance to change that is in ourselves can help us relate to children who seem exceptionally rigid and who become agitated by transitions that are a part of everyday life. Be sympathetic to their reactions to unpredictability in their environments and anticipate that these situations will be challenging. Scripts that detail what the individual can expect are extremely helpful and can be used as a basis for problem solving and brainstorming (e.g., What time is our flight? How long will we be on the plane? What can we do if the flight is delayed?). Prepare comfort toys, books, or routines for a difficult situation or for other changes that may be overwhelming for the child or adult. Most importantly, remember that humans are creatures of habit and that the tendency toward perseveration is natural - use your own life experiences to develop an appreciation of the challenge of change and to identify means of coping that have been helpful for you and that can be used to help others.
It’s been a while since my last post…I’ve been enjoying the summer with my children and have neglected some of my weekly rituals. Since the last post much has happened. The buzz is spreading- Fun and Function made it to the About Special Needs home page! I’ve been to the emergency room with two naughty girls who pilfered the Children’s Tylenol and had a tasting session. Last week the two year old intentionally stuck a pine cone up her nose. I was not prepared for that stunt, it’s not mentioned in What to Expect About Parenting or anything. Oh, and in between the drama I’ve been having fun at Fun and Function and just returned from the National Autism Conference at Penn State. Stay tuned for images. And hey- don’t stick anything foreign up your nose. It’s not pleasant, I promise.
Attention Deficit Disorder has a reputation as being a problematic condition that does not work in the classroom. In most schools, kids are required to sit, listen and write. They cannot pace, chew and listen. Or listen, multi-task, pace and sit.
If you are not familiar with ADD the second two options might sound dizzying. But for kids with ADD they are real methods of learning and being productive. So the challenge for kids with ADD is to survive school with intact self-esteem and to figure out how to squeeze into the neat little box of learning required for the standard classroom.
Why do children need to sit in school? What’s wrong with sitting and standing stations? Motor breaks? If ADD brains just work differently, why are they disordered?
Words and actions offered in poor taste can make tolerable situations unbearable.
Take my friend M. for example. She took her child to a neurologist due to her concerns with the baby’s poor development. Dr. Neurologist met with M. and announced all the grim possibilities and ordered an MRI. M. received no return call after the procedure for days. She called the office at the highly reputable hospital multiple times and was left on hold for 30-40 minutes at a time. Turns out, after a week of agonizing waiting and calling, Dr. Neurologist left a curt message. “The test is normal”. Slam.
Imagine this: M. meets Dr. Neurologist with concerns about her baby. Dr. Neurologist examines the baby and offers his expert opinion with words of hope. ” We will get to the bottom of this, and I am here to answer any questions. I will call you as soon as the results become available”. M. waits for two days for results. She receives a warm call from the Dr. “I’m am delighted to tell you that the results are normal.”
A year ago today, my 4-year-old daughter was scared to run. She cried at the playground and clung to my leg. She could not pump on a swing, climb the monkey bars or enjoy a see-saw. She shrieked in fright when a pack of 4-year-old boys and girls came too close. She feared the bathroom. Her confidence was down.
Today, a full year later, my daughter skipped happily into school to enjoy her last day. She can run with confidence. She can pump on a swing and attempts to climb the monkey bars. She enjoys the see-saw (on condition that there is a very gentle soul on the other side). I can calmly sit at the playground without her constant hovering, and whimpering and yanking. She is independent in the bathroom. She is happy and confident. She has friends.
Cindi Galvano her physical therapist, Pat Lobb her occupational therapist, and the wonderful caring teachers patiently taught her to climb stairs, run with ease, pump on a swing, jump, climb, and walk the halls at school without the fear of falling. They slowly taught her to engage with the other children without fear. They coached her to use her words. They encouraged and gave confidence. They wiped away her tears and were understanding throughout her downs. Week in and out, one skill at a time, they helped my daughter scale the highest mountains. I could not ask for more.
Backpacks and sweaters pepper the lawns while their young owners bike, run, skate, or just chat with each other. The sunshine feels warm and the air smells sweet and summer is clearly on its way. Though school buses will soon come down my street and break up this early morning scene, one can already taste those endless summer days. Those are the days in which the bike rides melt into ball games and ices and swimming and bike rides and ices and … until tired and happy children fall asleep.
My mind zooms ahead to the early days of September. I can’t wait to see the child who continues with his social skills group straight through July and August. Over the past few summers, he’s gone from learning to avoid being a target for teasing, to how to join a conversation, to how to make a real friend. I want to speak to the parents whose child attended a sports camp. Did he learn how to handle his anger in the heat of competition? I’m excited to hear about the summer experiences of the child who is transferring to our mainstream school from a self-contained program. I’m glad she had the opportunity to integrate with her new classmates in a non-academic setting. And I’m looking forward to seeing how that little three-year-old is doing after a summer of intensive sensory integration therapy.
What’s your summer plan for your child? The very notion of a summer plan seems outrageous - after all, isn’t summer meant to be days and weeks of unstructured enjoyment? Carefully consider your child’s summer, though. There are many experiences that can help your child soar, building his skills in the ways that the school setting cannot. A solid summer schedule can also ensure that your child continues to progress, and prepare your child for a smooth re-entry into school. Summer is a time to relax and play -and grow.
