Tag Archives: sensory aversion

How Parents Can Teach Healthy Body Boundaries To Young Children

 

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One of the greatest horrors of the Larry Nasser story is that parents were often mere feet away from these girls while they were being molested.  The people most invested in a child’s safety had no idea that anything violent was occurring, and these girls did not reveal their discomfort at the time.  These parents are beyond distraught now, and often filled with guilt.  I do not blame them for what happened.  They were deceived by Nasser and their children weren’t able to communicate their distress or confusion.

Parents who read these news reports are wondering how they would react; would they recognize abuse?  And they are wondering what to say and do to prevent this from ever happening to their own children.

My strong belief is that there will always be people like Larry Nasser in the world, and that children who have experience with being touched with respect could be more likely to recognize and report abusive touch, even when it comes from an authority or a family member.

I would like to share my best suggestions to teach children the difference between healthy touch and invasive touch, drawn from my practice as a pediatric occupational therapist who treats children with ASD and sensory processing disorders.  I would also like to say very clearly that there is never any reason for any occupational therapist to make contact with a child’s genital area.  Ever.  But since parents and caregivers perform diaper changes, dress children, and provide bathroom assistance, it is important to me to teach the following strategies for respectful contact in therapy so that children have a sense of what type of touch is unacceptable:

With non-verbal children of any age, I use a combination of observation, use of my own body language before I begin physical contact in therapy.  If children can make eye contact, I use visual regard to establish a connection, and I do not initiate physical contact quickly.  If they cannot meet my gaze, I read their cues, and often wait for them to come closer to me and reach out.  I use intermittent touch that avoids hands, face and feet initially.   Deep pressure is less alerting to the nervous system than light touch, so my contact is stable, slow and steady.  I will describe what I am doing therapeutically, in simple statements with calm tones, even if I am not sure that they will understand me.   I remove my contact when I see any indication of agitation, and before a child protests strongly.  What I am communicating is “I get you.  I see you and I respect you.  I will not force you, but I will invite you to engage with me”.

With children that can communicate verbally, I do all of the above strategies, and I ask permission.  Not always in complete sentences, and not always using the word “touch”.  I constantly tell them what I am going to do or what movement I am going to help them to accomplish.  It doesn’t matter if they fully comprehend my words; they can read the tone in my voice.  If they protest, I will voice their protest without criticism “You want no more _______; no more __________.  OK.”  I reconsider my approach, adjust, and either begin contact again or shift activities to build more tolerance and trust.

With slightly older children that can understand my question and can respond clearly, I will teach them that they have a choice about greetings.  I teach “Handshake, Hug or High-Five?“.  Children get to choose what kind of physical contact they wish to have when greeting me or other adults.  I must agree to their choice.  I encourage parents to teach their family members to offer this choice and to never force a child to kiss/hug or accept a kiss or a hug from anyone.  Children need to feel that they have agency over their bodies without criticism.

Anyone who remembers enduring a sloppy smooch or a crushing hug from a relative can relate.  You may or may not have actively protested.  It doesn’t matter.  Allowing an adult to have this form of contact with a child is not just an irritating experience for them.  It is a serious message that children of all genders are given:  The people that are in power have the right to do things to your body that you don’t like, and you have no right to complain.

Is this the message that parents intend?  Of course not, but that doesn’t make it any less a clear communication.  Larry Nasser and his kind depend on a combination of authority, status and compliance to perpetrate abuse, even if the child’s parents are in the room.  I believe that children who know that any uncomfortable touch from any adult, even those closest to them, can be refused, they are more likely to recognize and report abuse. They will be believed and they will not be shamed.

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Sensory Sensitivity In Toddlers: Why Responding Differently to “Yucky!” Will Help Your Child

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!