Sensory sensitivity and aversive behaviors are among the most common reasons families seek occupational therapy in Early Intervention. Their kids are crying and clinging through meals, dressing, bathing and more. What parents often don’t see is that they can help their child by being both empathic and educating them throughout the course of the day.
My clinical approach has matured over the years from the standard OT treatments to a whole-child and whole-family strategy. One important part of my approach is to alter how adults react to their children. It isn’t complex, but it is a shift away from thinking about the problem as being exclusively “my child’s issues with sensory processing”. Once adults understand the experience a child is having from the child’s point of view, they can learn to respond more effectively to a child, and get results right away.
I recently did a therapy session with a toddler and her mom. When the child became overwhelmed by her dog barking and rushed to her mom to be picked up, I warmly and clearly said “You want up?” twice while using explicit body language to convey calmness, while the mom looked at her child but didn’t scoop her up right away. The child turned to look at me, stopped whining and dropped her shoulders. She relaxed at least 50%, stuck her thumb in her mouth for about 30 seconds, then started to play quite happily. What I know is that this short interaction affected her body’s level of neuro-hormonal arousal, her thinking about how adults handle sensory events, and her memory of how she feels when she is overstimulated changed. I believe that those differences physically change the wiring of her brain in a small but meaningful way.
I cannot take full credit for this strategy; I used the Fast Food Rule from Dr. Harvey Karp Use The Fast Food Rule to Help ASD Toddlers Handle Change. I am using it for therapeutic means, but it the same tantrum-defusing method he developed. I responded with loving calmness to her over-the-top reaction, acknowledging her request while not granting it. She was “heard” and accepted. I gave her a moment to come up with an alternate response (quick thumb-suck and then search for fun a fun toy).
This little girl has a habitual reaction to sensory input that puts her into a fear-flight pattern on a regular basis. Cuddling her works for the short-term, but it leaves her seeking adult assistance for any fears, and it doesn’t give her any skills to handle things or suggest that she could handle situations differently. Shifting her habitual reactions to these benign events is essential to make progress, and telling her that it was “just the dog barking” doesn’t work.
Why? Because Dr. Karp will tell you himself that toddlers hear you saying”just” as if you were telling them “you are wrong”. They protest more to make you exactly see how upset they are. Explaining things rationally doesn’t help a little person in the throes of emotion. Modeling calmness while acknowledging their feelings is what helps them learn and grow.
Your child is wiring his brain every moment of every day. Your sensitive child is assessing all of your reactions to learn about what is a danger and what is not. His brain, not his hands, are interpreting the world as irritating or frightening. Your reactions to events and to his responses will help to hardwire his brain to believe something is scary, or challenge him to adapt and change that automatic pattern of response. It isn’t all psychological, it is neurobiological as well. Most researchers don’t differentiate between the two any longer. They know that biology drives thought and that thought can alter biology. The rubber meets the road right here, right now, in your own home!
OTs working with sensory processing disorders generally believe that an aversive response to a benign stimulus (hysteria when touching lotion or oatmeal) is not a skin issue or a mental health issue, but a brain interpretation gone wrong. There are many reasons why this would happen, but most of us believe that experience and exposure, done well, can change the brain. Some exposure is done with programs like the Wilbarger Protocol, the use of weighted or pressure garments, and many other great therapeutic techniques. Changing adults’ responses hasn’t been researched nearly as much, but my clinical experience tells me it probably should be. I know that teaching parents how to shift their behavior has made a difference for my clients almost immediately.
Good therapy can diminish a child’s aversions substantially, and even create exploration and excitement. It is wonderful to see a formerly anxious child move through her day exploring and enjoying the world around her!
Does your sensitive toddler struggle with toilet training?
The Practical Guide to Toilet Training Your Child With Low Muscle Tone is my new e-book (hard copies can be obtained by contacting me directly) that may help you tonight! Sensory-based strategies can really help children with sensitivity, and good instruction minimizes all the multi-sensory mess that training can become when you don’t know what to do. Your child doesn’t need to have severe issues with low tone. Many children have both sensory sensitivity and low muscle tone.
Visit my website tranquil babies, and click “e-book” on the top ribbon to learn more about this unique book!