Tag Archives: sensory sensitivity

Parents of Formerly Picky Eaters Can Feel Like The (Food) War is Still Going On

What do parents of children who have had successful treatment for oral sensory sensitivity have in common with Vietnam veterans? Parts of them do not know that the war is over.

Raising a child that can become unglued over the texture or taste of a new food is like walking through a minefield. As a pediatric OT, I have seen many children make amazing progress. The toddler who once grimaced while watching his mom eat a piece of chicken now grabs it from her hand and stuffs it into his mouth. The baby who screamed when cereal fell onto her hands is now happily swishing it around the high chair tray.

It’s the parent that is still frozen in fear. PTSD is something that people assume only happens to victims of crimes or war. Wrong. The daily emotional rollercoaster of dealing with sensory issues in young children (and older ones too, to be honest) can leave parents with all the signs of PTSD. Anticipating problems, recalling the worst mealtime blowups even when things are going well now, feeling anxious even as your child munches down a snack happily. And reacting to any minor and non-sensory complains with an internal “Oh, here we go again, I knew it would come back!”

It makes sense to me. The stress seemed to never end because the meals kept on coming. You never know if it will be a horror or an easy meal. The level of reaction your child exhibits is not always the same, so you wonder what will happen. All the time. And you feel as if no one could possibly understand how this feels. You feel alone and on edge. The next meal could be the worst, so you have to be prepared for it.

If this description fits you, please don’t think that you are alone. You are not. Good therapy can help your child learn to manage their reactions to food and mealtime. It really can. But you may need some support too. Seek it out, and reject any professional that tells you to just relax. You would have relaxed if you could have. You have been through a lot, and sometimes getting some support helps.

Infants With Sensory Sensitivity: When Your Fussy Baby Takes Over Your Life

Parents are often the first to suspect that their infant’s constant and intense complaints are more than just fussiness.  Sometimes pediatricians pick up on a pattern of edginess that cannot be explained by all the usual suspects:  teething, food sensitivity, temperament.  Having a baby who complains bitterly about the most common events, such as diaper changes and nursing, can take over a parent’s life and make them question their sanity.

Judging by the research literature, you would think that sensory sensitivity only happens to toddlers or preschoolers!  Those 4 year-olds who refuse to wear shirts with long sleeves and cannot handle a car ride without vomiting often started out as super-fussy babies.  Their parents may have tried the lactation consultant, the pediatrician, maybe even the neurologist, in a frantic search for help.  They could have used an OT.

I have treated babies as young as 6 months-old that displayed clear signs of sensory sensitivity after prolonged periods of peri-natal NICU stays or procedures.  Why would a few months in the NICU make a baby sensory-averse to diaper changes and being held?  Well, look at it from the perspective of an immature nervous system.  They got more stimulation than they could handle, and their brains responded by interpreting everything as a potentially invasive experience.  Turns out, a good percentage of children who require intensive and ongoing medical procedures to save their lives don’t recall the experience, but their body does. Ask psychiatrists doing fMRIs, or functional MRI’s, what they see in adult trauma victims.  Parts of the brain that encode emotion and memory will light up like Christmas trees when faced with innocuous stimuli.  Oops.

Progressive NICU’s are making changes, but those nurses have no choice to perform multiple and invasive procedures and do them in a very stimulating environment.  They are working hard at a very difficult task; saving the lives of really tiny, really sick babies.

Is a NICU stay the only way to become a sensory-averse infant?  Not at all.  It seems some infants are just wired to be more sensitive, and some babies need only a little bit of extra excitement to become sensitive.  I treated an infant under 6 months of age that struggled to nurse.  She had the oral motor skills to suck, the swallowing skills to avoid choking, but she disliked the feel of her mother’s skin touching her face.  She nursed until she wasn’t starving, then refused any more.  Her mother felt rejected and not in love with her little girl any more.  The baby wasn’t growing and was constantly agitated.  We worked hard in therapy to help this baby, but until we realized what the problem was, every time her mom tried to get her to nurse more, she was repeating the cycle of aversion and agitation.

My approach for my youngest sensory-averse clients combines everything I know from Happiest Baby on the Block and all my training in sensory processing theory and practice as a pediatric occupational therapist.  The first step is convincing parents that they didn’t cause this behavior, and then convincing them that there is treatment that works.  Combining calming sensory input, environmental adaptations, and skill building in these little babies can make a huge difference in their lives and their family’s experience.  If your baby is incredible fussy and no one can find a good reason, pursue pediatric occupational therapy with an experienced therapist.  It could calm things down more quickly than you think!

Your Gifted Child: More Than An Amazing Intellect

 

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The characteristic that convinces a parent that their child is gifted is often an impressive vocabulary or mathematical ability.  This is the criteria that will get them into the “G and T” program in school, and is often a source of pride for both parents and children.  Wait!  There are other characteristics of giftedness that aren’t always so well received.  Making the most of a powerful brain will sometimes mean addressing all the effects of giftedness on behavior, emotional reactions, social interaction and even physiology.

My primary point in writing this post is to mention that giftedness brings with it a host of abilities, and managing all them effectively will be your child’s lifelong challenge.  Poorly managed, a child can struggle internally or fail to use their gifts with joy.  Success starts with parental awareness and support.

Your gifted child, from toddlerhood onward, may demonstrate common patterns of behavior or thinking that can be challenging for parents:

  • intense feelings and reactions
  • high sensitivity to other’s feelings
  • idealism and a sense of justice, intolerance of rigid rules at school or home
  • daydreaming or preoccupation with own thoughts
  • intense focus on specific tasks or topics, ignores other’s interests
  • unusual sense of humor and playing with objects in atypical ways
  • vivid imaginations, including imaginary playmates
  • difficulty tolerating classroom routines and simple games
  • less interest in playing with peers; seeks out older children or adults
  • worries or becomes fearful of anticipated events or things they don’t understand

When children are assessed by a psychologist and found to have asynchrony in their development (a fancy term that describes a chart of testing scores that look like the Alps:  high in some areas, average or below average in others), this can add to the frustration of living as a gifted child.  Preschoolers with advanced cognition but poor articulation of speech cannot express themselves but are thinking amazing thoughts.  This is so frustrating for them!  Super-sensitive children may pick up on a teacher’s stress over her home life just by her posture and her energy level.  They know that something bad is going on, and wonder if they should be concerned.  Children with sensory sensitivity complain about scratchy shirts, irritating lights and can have difficulty with typical levels of noise, scents or movement.

Gifted kids can be incredible negotiators, remember every promise you make and hold to to them,  develop sarcasm to control people, or try to influence every game so that it reflects their strong interests.  They can be overwhelmed by commercials requesting donations for animals or children, and become upset when they listen to adults discuss political issues.  All at 6 years of age or less!

What can parents do to help their gifted children, right from the start?  Notice which characteristics seem to be most difficult for your child to handle.  Some kids are irritated by stimulation from the physical world, some are under stimulated or simply lonely for sure peers at school, and some are overwhelmed by emotions.  They are like snowflakes; each one is different.

Support your gifted child where she needs it most.  Energetic kids need lots to do, and ways to calm down.  Sensitive kids need to learn ways to manage the world without being overstimulated.  Children who wear their hearts on their sleeves can take action to help others and understand how many adults are working for the same purpose as we speak.

Gifted children who learn to manage all the characteristics of giftedness are the leaders of the future, the innovators, and the people that will bring us forward.  With the right support and understanding, they can use their abilities freely and joyously!

Is Your Sensitive Child Gifted As Well?

Happy New Year!  The topic of sensitivity (in all it’s expressions) in young children isn’t new to this blog, but the correlation with giftedness hasn’t been a part of my other posts.  It is today.

Sensitivity is common in gifted toddlers and preschoolers, and sensitivity is ubiquitous in young children with diagnoses such as ASD and SPD.  Could you have both?  Sure.  Could you have neither, and just have a very sensitive little soul who avoids socks with seams and still can’t spell their name at 5?  Sure.  Seeing the pattern of sensitivity that gifted children can express isn’t that easy, but it can make dealing with a young child so much easier when you understand the source and know how to support them.

Gifted children make mental and emotional connections that other children their age do not.  They see and feel the world differently.  They are still young children, without fully developed emotional regulation, and they bear the weight of all that they perceive.  It can  accumulate throughout the day and over time, and overtake them.  You can see more outbursts, more episodes of being overwhelmed, and more crushing waves of emotion.  Strong emotions are common with the gifted populations, and they can be more challenging during the toddler years.  Remember: not every aspect of brain development is advanced at the same level in gifted children.  In many ways, your 3 year-old who reads chapter books is still just 3!

Our brains do not have barriers, so emotional and cognitive floods will create sensory floods as well.  This is something that every adult can understand:  if you have had a fight with your partner, it is more likely that the bright sunshine will bother you a bit more, the TV will seem too loud, and the people in line at a store are crowding you a bit more than you’d like.  You are an adult, so you can take action to reduce your sensitivity (sunglasses, remote control, choosing a shorter line or leaving) but children cannot.  They do not even know what is making them uncomfortable.  And they often cannot put feelings into words, even if they can tell you all about every dinosaur or how tornadoes affect the planet.  Emotional maturity and expression is not always developing at the same amazing pace as cognitive skills in gifted toddlers and preschoolers.

What can you do to help a gifted and sensitive child?  The general methods to address  sensory sensitivity will be helpful for these children.  OT’s use a wide range of physical and behavioral strategies effectively, about which I will write about in more detail later this week.  Verbally gifted children may be able to comprehend an explanation of why they explode the way that they do, and they may even be able to help you create a plan to help themselves.  Loving your child isn’t enough, but accepting the entirety of who they are can go a long way to making life easier with your sensitive gifted young child.

I will be writing more about this topic in 2017, and hoping to expand my posts to an e- book and a few local lectures.  Please comment here, and let me know if there are specific issues with sensitivity and the gifted child that you would like to see posted!

 

 

Dressing Without Tears: Sensory-Sensitive Strategies That Work

If your child has tactile (touch) sensitivity, getting them dressed can mean more than a chore.  It can mean tears.  Tags in shirts, “scratchy” jeans, and all that pulling of clothing over their face!  I know families that scheme for months to find clothes that their child will wear to a wedding or buy clothes online because trying on clothing in a store is a nightmare.

The low-hanging fruit:  soft tees and sweatpants/shorts are the most tolerated clothing for kids with sensitivity.  Even these have some caveats.  Clothing that is too loose creates movement while worn, and long cotton sleeves are a good example of irritants for sensitive kids.  Get a good fit and forget about buying things large for growth.  Comfort and compliance now is absolutely key.

Pressure garments and compression underwear:  I have never been a fan of Theratogs.  They are expensive and awkward for most kids.  When they work, they are amazing, but there are lower-tech and lower-priced possibilities.  UnderArmor underwear fits smoothly  and creates a bit of comforting pressure.  Even the lycra sunsuits that kids wear to the beach can be worn under clothing in cooler conditions.  Children who are not toilet-trained are the hardest, since you need to pop off pressure garments to change them.  This could be a great reason to begin pre-training and make your potty training plan.  Take a look at Waiting for Toilet Training Readiness? Create It Instead! for some ideas.

Don’t forget that all sensory responses have a behavioral component.  I am not saying that there isn’t a neurological reason for a child’s discomfort.  Sensory sensitivity is real.  The behavioral piece is that responses can be diminished or increased by experience.  All experiences.  Children with mild to moderate sensitivity can react less when the fear and the novelty of wearing clothes is diminished.  How is that done?  Depends on the child, but short periods of wear that happen frequently and are not forced but are rewarded can transform a child.  Having control over which button-down shirt he wears for 3 minutes, or which video he gets to watch that is only available while wearing “the shirt”, can really make a difference.  So much of tactile sensitivity is anticipatory fear and feeling trapped, that when he doesn’t feel trapped and doesn’t fear it, tolerance can develop.  Parents have to be firm and loving, and kids can expand their tolerance.

Try the Brushing/Joint Compression program.  The one I use is the Wilbarger Protocol, developed by an amazing occupational therapist, Pat Wilbarger.  It works, but it has to be done correctly and it has to be understood.  After about 10 years, I almost stopped teaching this technique because it had turned into a game of “telephone”, in which parents would show me what a previous OT had taught them.  It looked only slightly like the protocol that Pat taught me directly.  A poorly executed protocol can actually make a child more sensitive.  It was awkward to tell parents that they had been taught incorrectly.

Get it right, and make sure that your therapist can explain the neuroscience behind it.  Have your therapist explain the gating theory of sensory modulation and the reasons that you don’t brush the abdomen or do neck compressions.  That way you know you are getting the real deal.

Is your child hypermobile?  Children with ligament laxity can have difficulty dressing too.  They just don’t have the stability even if they have the strength, to pull up their clothes and fasten garments.  Read about how your therapists can help you:  Hypermobility in Young Children: When Flexibility Isn’t Functional

Comment about any great techniques you have used successfully, so that other families learn from you!

Why Do Some Kids With ASD and SPD Refuse Toilet Training?

Toilet training is one of the few self-care skills that fall primarily on special needs parents.  Speech therapists, feeding therapists, occupational therapists and ABA instructors all do assessments and create plans.  Hints on toilet training from your therapy team are often very helpful, but “the boots on the ground” are yours as a parent.  You are the one that deals with it when *&%$ happens, as it most certainly will!

Many parents find themselves with children that do not cooperate or become defiant to the entire process of training, regardless of their level of cognitive, sensory or motor involvement.  A child with profound issues can cooperate well, and a child that is in a integrated class can be steadfast in not participating.  What gives?

  1. Sensitivity to multi-sensory input:  The noises, smells, even the lights in a bathroom can be mildly to very irritating to sensitive children.  They may not verbalize it, even if they have lots of language; they just want out.  Try to minimize what you can, and use the sensory calming techniques your OT has shared.  Ask for all her good ideas!
  2. Sensory seekers that aren’t motivated to remove wet or smelly diapers, don’t register the experience, or actually want to explore what is in that diaper.  Some children are at the other end of the sensory spectrum, and may not find the odor and feeling of a soiled diaper offensive or even that noticeable.   See Pull-ups do a wonderful job of reducing the sensory input, so try training pants with a leak-resistant cover. Just like a younger typically-developing toddler, some ASD and SPD kids “smear”, which is exactly what it sounds like: decorating the room and/or themselves with their feces.  This is a behavioral issue with older children, but it also suggests that the motivation to get trained isn’t going to include wanting to be rid of the diaper and it’s contents.
  3. They dislike being exposed to room-temperature air, and wiping/being wiped.  These kids probably have always dislike diapering.  They might avoid you after they have had a bowel movement to avoid being changed.  You may have had to become an expert in the “fast change” so that they are not totally hysterical.  Well, sitting on the pot with their pants off for a while and learning to wipe might be even harder than being diapered.  Try warming the room, get a warmer for the wipes (these exist) and make sure that you communicate that this doesn’t mean they have to sit there for a long, long time.
  4. They hate the feeling of the clothing sliding over their legs.  Time to work on reducing their tactile sensitivity.  It can be done; ask your OT.  And find some super-soft clothes for the toilet-training period.  Fleece shorts, anyone?
  5. Sitting on the toilet seat feels like they are perched over a big scary hole.  Children with poor spatial awareness or poor proprioception aren’t good at judging how large the opening is or how deep.  Add some instability with low tone, and you have a recipe for fear.  Then flush the toilet while they are still sitting, or standing nearby, and that potty seems like it could suck them down!  Try a potty seat and gradually move them over to a toilet once they are confident and independent there. Do more homework exercises on core stability and postural control, and don’t forget vestibular activities from OT.
  6. Without a clear sense of time, sitting there seems like it takes forever.  Kids can have no sense of how long something they don’t enjoy will take.  Use a visual timer, the microwave timer, or your smartphone timer.  My iPad has a visual countdown clock to see when time is up.

These are the most common that I have encountered.  Some of my posts on toilet training children with low muscle tone will also apply to kids with ASD and SPD, so check out  Low Tone and Toilet Training: How Your Child’s Therapists Can Help You  and Low Tone and Toilet Training: The 4 Types of Training Readiness.

The Practical Guide to Toilet Training Your Child With Low Muscle Tone is finally available! My 50-page e-book is for sale on my website  tranquil babies  (or buy a clothbound hard copy if you live in the U.S.) to help you with training.  Check out  The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Help Has Arrived!  to learn more about my book and how I can help you navigate potty training without tears!

 

 

Happy Fourth Of July! Make Things Easier For ASD and Sensory Kids Today

I wanted to place a link to last year’s post on handling the excitement and multi-sensory chaos that is July 4th in America.  Holidays can be the hardest of all events for kids that have sensory challenges. Coping With Sensory Sensitivity and July 4th Celebrations

Although the politics and violence in my country alarm me, I am proud of the principles of freedom of expression and inclusiveness that we hold as a nation.  My wish is that everyone will be fully able to embrace those principles in the coming year.

Happy Fourth of July, America!!