I love working with gifted children. OTs get referrals to work with gifted kids whether or not they have been tested by a psychologist. Some have motor delays amplified by the asynchronous development, but many are sloppy at handwriting because their motor skill cannot keep up with their language skill. Some are sensory avoiders or sensory seekers. Or both. They aren’t always in distress. They are almost always out of synch with their families, peers, and teachers. Without understanding how to manage sensory processing issues, these kids are driven by the need to handle motor demands and sensory input, often driving their teachers and parents a little bit nuts.
Some gifted kids really do need motor skill training and sensory processing treatment. They are struggling with tolerating their world, and can’t achieve their potential in school, with peers, and at home. While many kids are “twice exceptional” and have a learning disability or other disorder in addition to being gifted, simply being gifted creates permanent processing challenges. The gifted brain will always be driven, and it will always prefer intensity and complexity to an extent that exceeds people with typical skills. Almost all younger gifted kids need help to understand that their brains will always respond this way, and they will constantly bump up against the typical world in ways that can create problems. Knowing how to manage this conflict in daily life is our wheelhouse. Occupational therapy is focused on function. Always. We don’t stop with a neurological explanation of giftedness. We have solutions.
One of the most useful strategies to address a child’s aversions or sensory seeking behaviors is to create a “sensory diet”. This can be very simple or very complex. A sensory diet provides activities and equipment that help people tolerate sensory experiences that overwhelm them, but it also “feeds” the desire for sensory experiences that can derail them from interaction and participation.
Avoidant kids learn that more proprioception will help them tolerate noise without wearing headphones and blocking out all interaction. Sensory seekers learn that they don’t have to kick another kid’s chair to get input; they can do wall push-ups or wall sitting quickly in the hall between classes. Therapy that includes a sensory diet helps the child who has such pressure to speak that they interrupt everyone, and it helps the child that learned to escape bright lights and scratchy clothes through daydreaming.
Developing a sensory diet that a child can use independently is the goal of Mary Sue Williams and Sherry Shellenberger’s book “How Does Your Engine Run? Children learn about sensory modulation by thinking about their ability to perform sensory processing as an engine. Running too fast or too slow doesn’t allow for great performance. Running “just right” feels good internally and allows a child to learn, respond appropriately and achieve mastery. Finding the right activities and environments that allow for “just right” processing is based on what therapists know about neuropsychology, but this program asks the client to assess what works for them, and asks them to use these strategies effectively.
This book isn’t new, and it isn’t perfect. But it is a good place to start. It explains behaviors using neurological strategies that work, and provides a framework for inexperienced therapists to move from prescribing to guiding. A gifted child can begin the process of using a self-directed sensory diet far earlier than their typical peers. I have seen 4 year-olds start to master their own drives once it is explained to them. They feel terrific when their abilities are recognized, and adults are seen as supporters instead of controllers.
The biggest problem I encounter is unlearning the behaviors that children have developed before their parents and teachers understood that giftedness is more than a big vocabulary. Children may have learned to push a parent to exhaustion to get what they wanted. They may have bullied adults or intentionally alienated adults to be allowed to do what they want. They may have become extremely bossy and gotten away with it. They may have decided that any skill that takes time to develop isn’t worth it. They will lead with the things that they find effortless. This will trip them up over time, but without understanding the life of the gifted child, these behaviors sprout like weeds.
Gifted children are still children, and they need guidance and support to grow into their gifts! Occupational therapists can help them and their families do just that.