(2016) The ‘Sensational’ Tot: Recognizing and Dealing with Sensory Processing Disorder

Published May 24, on Mother.ly

Envision two unique babies.  Benjy has been on the go since Day 1. Constantly active, frequently fretful, easily startled, and a fitful sleeper, he sure keeps his parents on their toes. Speaking of toes, he skipped crawling and walked on tiptoes at nine months! Mom and Dad are exhausted—but that’s just how it is with an infant, they guess.

Valerie’s parents appreciate her peaceful nature.  She goes to anyone, naps often, sleeps all night, and is content being moved from car to grocery cart to stroller to house, strapped in her baby seat.  Her parents notice that she’s uninterested in watching it snow or grasping a rattle, but she does seem entranced with the laptop’s screensaver beside her on the kitchen counter.

Two very different tots—one underlying disorder.

Read more

(2012) Moving Experiences that Will Last a Lifetime

Co-authored with Joye Newman in “Exchange: The Early Childhood Leaders’ Magazine Since 1978,”  Vol. 34, Issue 1, No. 203, January/February

Summary of Article’s First 150 Words

It’s 50 degrees and raining outside. The playground is all mud and puddles. The morning has just begun, and the preschoolers are full of energy. You, like most early childhood educators, want to give your young students a leg up and a head start in reading and other academic endeavors. So, how do you use this time? Do you:

  1. Set up your four-year-olds at the computers to play the latest ‘educational’ video games?
  2. Conduct a longer-than-usual Circle Time?
  3. Bring out the flashcards and try to entice the kids to call out quick answers?
  4. Take your children outside to splash in the puddles?

Would it surprise you to learn that the last option will have the most profound impact on your children’s physical, emotional, academic, and overall success? How can that be?

In options 1, 2, and 3, the children are involved in sedentary activities. Only in the final option are they using their whole bodies …

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(2000) Music and Movement Bring Together Children of Differing Abilities

Published in Child Care Information Exchange magazine (May 2000), and in Curriculum: Art, Music, Movement, Drama – A Beginnings Workshop Book (Exchange Press, 2006)

Typically-developing children are usually adaptable. They sing and dance, play rhythm instruments, and willingly try traditional preschool experiences. Children with special needs, however, may prefer sticking to the same-old-same-old activities that make them feel successful.

Whatever the skill level of your preschoolers, a variety of sensory-motor activities in your curriculum can satisfy most children’s needs. Music and movement activities, with their flexible structure, can foster every child’s creativity and competence.

These stories illustrate how children of differing abilities play together at St. Columba’s Nursery School in Washington, DC.

1) Music and movement allow children to use their imaginations.

Quint has spinal muscular atrophy. He has little use of his lower body. As a result of extensive and intensive therapy, however, Quint’s upper body is strong. Using a wheelchair, he maneuvers expertly outdoors and inside.

He excels at singing and rhyming, at parachute games and rhythm band activities. He welcomes enacting playlets, such as “The Gingerbread Man.” When the farmers and animals run, run, as fast as they can in pursuit of the Gingerbread Man, Quint joins the chase in his wheelchair. “Watch!” he says. “I can do it myself!”

Quint is decidedly less enthusiastic about up-and-down activity songs, such as “The Noble Duke of York.” He mutters, “I hate that song,” and who could blame him?

Still, the musical activities he shuns are often the ones other children love. While inclusion is the name of the game, and sensitivity to Quint’s feelings is crucial, the other children have needs, too. Balancing the needs of all the children is all-important.

Quint’s classmates are a varied bunch. Several children have marvelous motor skills, while others are at various points along the developmental bell curve.

One day the program includes a game designed to strengthen the sensory-motor skills of body awareness, motor coordination, flexion and extension, listening, and beat awareness. We sit in a circle, legs in front.

The singer on the phonograph record instructs us to raise and lower our feet and wave them in big arcs. Most of us do our best, while Quint slumps and scowls.

Next, the singer tells us to move our arms, shoulders, and head – up, down, and all around. Quint can do this. He sits up tall and easily complies with each of these demands.

Then he says, “I have a good idea. Let’s lie on our tummies.”

Hey! Cool! We have played this game before, but never on our stomachs. Quint’s compensatory strategy sounds like fun.

We roll onto our stomachs and repeat the activity. Quint cannot raise his toes but can lift his arms, shoulders and head. His agility impresses the other children. “How do you get your arms so high?” one asks.

Pleased, Quint says, “Oh, I’m just really good at that.”

Then Giorgio asks, “Can we do it on our backs?”

Following Giorgio’s suggestion, we flip over and repeat the game, lifting our body parts into the air. We discover that when our bodies rest on the floor, resisting gravity is easier.

Then Emma wants to try the game lying on our sides. Ooh, that is hard! Charlotte suggests trying it face-to-face with a partner. That’s funny!

Instead of a five-minute warm-up activity, this game absorbs the entire half hour. The children’s creative collaboration, regardless of their differing needs, is too purposeful and fun to stop.

2) Music and movement awaken children’s brains.

Zack, lost in his own world, exhibits symptoms of autism. His play comprises lining up cars and banging together two plastic blocks. His language skills are severely delayed. When he is spoken to, his limited responses are more gestural than verbal.

He seems to enjoy coming to music with his class, but we aren’t sure. Sometimes he joins in the movement activities; other times he tunes out.

His classroom teacher remarks, “If only we could learn how to give Zack a jump start!”

One day, I’m rounding up Zack’s classmates to come to the music room. The other children are congregating in the corridor. Zack is still in his coat, gazing dreamily at his coat hook, stuck.

I ask, “Are you ready for music, Zack?”

He nods. Otherwise, he doesn’t move.

I try a different tactic. I pick him up, give him a bear hug and rock him side to side. To the tune of “Twinkle, Twinkle, Little Star,” I repeat: “Are you – ready for – music – Zack?”

Suddenly, Zack comes alive. His eyes light up. He laughs. He returns my hug and leans into the rocking motion. After I set him down, he whips off his coat, hangs it neatly on his hook, and leaps into line. “I’m ready!”

What’s happening? Is the combination of singing, deep pressure, and rocking the technique to arouse Zack?

Walking behind him and pressing firmly on his shoulders, I start the song again, making up rhymes that are inexpert, but good enough:

Are you – ready for – music – today?

Let’s get – moving – here’s the – way.

Now we’re – walking – down the – hall,

Here we – go – one and – all,

Are you – ready for – music – now?

Let’s go – in and – take a – bow.

Zack loves it and participates in the music class as never before.

Now, to get Zack’s attention, we sing while hugging and rocking him. The words needn’t make sense, rhyme, or even be there. Humming does the trick, too. The tools that rev him up are melody, deep pressure, and rhythmic motion. This approach helps him get in sync.

3) Music and movement allow children to be in control.

“No, I won’t. You can’t make me. I’m the boss of my body,” is Fiona’s mantra.

Her diagnosis of oppositional defiant disorder (ODD) is not surprising. We know that she struggles to be in control because she feels powerless. To help her learn to be the legitimate boss of her own body, we require more than a label. What can we offer this contrary, needy child?

Resistive experiences! Resistive experiences benefit everyone. Pressing different body parts against the wall, carrying heavy buckets of sand, kneading mudpies, digging, shoveling, sweeping, and raking are examples of resistive activities. Hard work is fun! And for children who resist everything, resistive experiences can be a potent prescription.

In the music room, a game planned with Fiona in mind employs resistive, stretchy latex bands, often used for exercise or physical rehabilitation. The children sit on the rug surrounding three piles of bands. Red bands are for kids who feel a little sleepy. Green bands are for kids who feel strong. Blue ones are for kids who feel r-e-a-l-l-y strong. The children consider this information, choose a band, test it, change their mind, select another, and prepare to play.

Fiona, of course, refuses. Children like her cannot be jollied along. The reason is not that they won t participate, but that they can t. That s all right; we are not in a rush here. “I’ll leave the extra bands on the rug,” I say. “When you re ready, you can choose one.”

The game is a follow-the-leader activity. While a lively instrumental rendition of “Yankee Doodle” plays, the first leader steps onto her band, holding the ends in her hands, bending and straightening her knees. The other children follow her example for 16 strong beats.

The second leader centers the band behind her back and pumps her hands forward and back. The others follow. One by one, we go around the circle, and everyone has a turn.

Meanwhile, Fiona sits against the wall, watching attentively. She sees the fun everyone is having even the teachers. She hears the participants clamor, “Let’s do it again!”

Suddenly, Fiona jumps up. “I’ll do it,” she growls, “but I won’t follow any leader!” She snatches a blue band (the most resistive) from the pile.

The music starts again.

Fiona ignores the leaders and invents her own movements. Who could object? At the moment, she is not interfering with anyone, is having a good time, and is gaining physical and motor control of her own body.

4) Music and movement strengthen children’s problem-solving and motor-planning skills.

Shep has dyspraxia, which means he has difficulty planning his motions and organizing his body to go through a sequence of unfamiliar movements. Some symptoms of his disorder are poor motor coordination, social immaturity, and emotional insecurity.

The musical game today is tapping rhythm sticks. I splay the sticks out on the rug. “Take one smooth stick and one bumpy stick,” I say.

As the other children reach for sticks, Shep hangs back. He wants to participate but doesn’t know how to begin.

I hand him a pair, saying, “Here are your sticks. Feel how this one is bumpy; this one is smooth. Now, come be my helper.” I open my arms and indicate that he can sit on the floor in front of me.

Shep whispers, “I don’t know what to do.” I whisper back, “We’ll help each other.” I adjust the sticks in his hands and place my hands over them. Working as one, we tap his sticks together, on the floor, on his knees, in the air. I guide his motions as the game continues, actually putting the sensation of motion into his muscles. Gradually, I let go. By the end of the game, Shep has scooted back to the circle. He is doing a fairly good job of watching his friends to figure out what to do.

When music time is over, and we have sung the “Good-bye Song,” and the children are lining up to return to their classroom, Shep turns back and grins. “That was fun,” he says. “That was easy!”

Zack, Quint, Fiona and Shep could very well be placed in classes for children with special needs. However, both they and their typical peers benefit from their inclusion in a mainstream preschool. Here, the emphasis is not on speaking in complete sentences, doing only what the teacher says, or doing things the “right” way. Instead, children are given opportunities to heighten their arousal level, use their imaginations, and develop motor-planning and problem-solving skills.

Thank you, music and movement!

(2004) In Praise of Mud

Published in S.I. Focus magazine (Winter issue), and adapted from a 1990 article originally in Carol’s column, “Gentle Reminders,” in Parent and Child magazine

A child comes to school on a soggy day. Tentatively approaching a puddle, she sticks in one spotless boot, watching with interest as her foot sinks into the mud. She puts in the other boot. She is entranced. Looking up, she says to her teacher, “Is this mud? It’s fun! Is it okay?”

A child comes to school in his caregiver’s immaculate car. Tearfully, he announces, “My babysitter said not to get dirty.” He cannot be persuaded to paint at the easel, jump in the mulch, or wriggle on the floor like a caterpillar, although he itches to get into the play.

A child comes to school on a wintry Monday. He says, “Daddy and I watched football all weekend. We’re couch potatoes!” Good news: Big Potato and Potato Chip spent time together. Bad news: they limited their sensory stimulation to watching television. They missed the chance at half time to engage in active, physical contact with each other, a leathery football, scrubby turf, and frosty air.

What’s wrong here? Have our children lost the freedom to get down and get dirty? Growing up to be tidy is commendable, but many children seem to be maturing without a strong sensitivity to touch.

The touch (or tactile) sense is essential to children’s development. Like vision and hearing, touch opens the main avenues of learning. Much of our knowledge about the importance of touch comes from the field of sensory integration (or sensory processing), pioneered by A. Jean Ayres, PhD, OTR. Her research revealed that the ability to interpret tactile information not only promotes optimum development of the young child’s nervous system, but also helps the child learn about his world.

Learning about the environment is a child’s primary occupation. His brain needs to process and organize all kinds of sensory information, just as his body needs all kinds of food to function best. His tactile sense provides information about texture, shape, density, pressure, temperature, and other attributes of the world.

Nature’s plan is simple: let the senses, working in sync, do the teaching. For children whose sensory processing develops typically, learning through messy play is pleasant and interesting. They know how to get the just-right amount to satisfy their neurological system. Some children with Sensory Processing Disorder (SPD), however, may seem never to get enough tactile experiences; they crave more, more, more. Others may have tactile overresponsivity (or defensiveness), causing them to avoid touching and being touched. Whether seekers or avoiders, kids with SPD need tactile activities just as much as typical kids do.

When we encourage tactile experiences, we do more than provide vital nourishment for children’s maturing brains. We do more than offer the unadulterated fun of molding mud pies. We also open the way that may become their preferred route to learning. Just as the photographer Ansel Adams took the visual route, the composer Mozart the aural, and the sculptor Rodin the tactile, so each of us chooses one favorite mode.

What if Rodin’s babysitter didn’t let him get his hands dirty because he’d soil the upholstery? What if Julia Child’s mother kept her out of the kitchen because she’d spill flour? Or Jacques Cousteau’s father told him to read instead of lingering in the bathtub? Or the pope advised Gregor Mendel to pray more and spend less time messing with sweet peas? How deprived we all would be!

Rather than deprive our children, let’s broaden their sensory input with activities that are S.A.F.E. (Sensory-motor, Appropriate, Fun and Easy). Let’s provide tactile sensations of dough, water, clay, glue, rock, mud, sap, earth, paint, feathers and fur. Children thrive when their bodies ingest and digest all kinds of sensory stimuli. They may develop to their greatest potential if they have opportunities to feel rain on their faces, leaves in their hair, goo on their fingers, and mud between their toes.

SOME S.A.F.E. TACTILE EXPERIENCES FOR PRESCHOOLERS

• Finger-painting on a tray with chocolate pudding. This open-ended, hands-on activity feels as good as it tastes. Next time, offer shaving cream and enjoy the smell and easy clean-up.

• Digging for worms. Handling worms is about as tactile as you can get.

• Going barefoot, lakeside. The differences between firm and squishy, warm and cold, dry and wet are worth investigating.

• Forming rice balls or meatballs.

• Kneading playdough or real dough. Make shapes, people, pretzels, or blobs.

• Ripping paper. Strips of newspaper are useful to line the hamster cage. Strips of construction paper or tissue paper make beautiful collages. Remember that the process, not the product, is the goal.

• Discovering treasures in a Feely Box. (Cut a hand-sized hole in a shoebox lid. Fill the box with lentils, cotton balls, packing peanuts, or sand. Add buttons, shells, uncooked macaroni, or small toys.) The idea is to thrust a hand through the hole and let the fingers do the seeing. No peeking!

• Collecting seeds, pebbles, or shells in an egg carton. Loading up the receptacles and dumping them out is great fun for a very young child. The ability to sort and classify the items comes later.

• Petting the pet. Drying a wet dog, stroking a kitten, providing a finger perch for a parakeet, or hugging a baby are tactile experiences that make a child feel good, inside and out.

(2005) Indoor Obstacle Courses for Parents and Teachers

Published in Sensations, Volume 3, Issue 2 (September 2005), newsletter for The KID Foundation (now STAR Institute for Sensory Processing Disorder)
Fish gotta swim, birds gotta fly, and kids gotta climb, jump, and balance. While dangling from banisters, scooting under turnstiles, teetering on curbs, and jumping into puddles may dismay grown-ups, children persist with good reason.

How do kids learn to think and relate to the world around them? By scanning their surroundings; touching wooden, metal, rubber, or concrete surfaces; grasping and releasing handholds; changing body positions; maintaining equilibrium; and experimenting with different movement patterns. Furthermore, they are having fun, and “fun,” Dr. Ayres wrote, “is the child’s word for sensory integration.”

An obstacle course is sensational, both to provide fun and to promote praxis. Praxis, a sensory-based process, involves: Ideation (having an idea of something you want to do); Motor planning (figuring how to do it); and Execution (carrying out the plan). Just as the person who chops his own wood is warmed twice, the person who builds and moves through his own obstacle course strengthens praxis many times over.

You and your child can build an obstacle course outdoors, where everything is better, or indoors in bad weather. You don’t need special equipment – just a fresh way of looking at ordinary objects, with an eye on how they can promote sensory processing.
WHAT TO DO
1) Brainstorm, or ideate, with your kids to make three lists with these headings: Ways to Move, Prepositions, and Objects. Encourage children to tell or show you what they have in mind. For example:
Ways to Move:
Step, walk, creep (on all fours), crawl (on belly), scoot (on bottom), roll, somersault, jump (two feet), hop (one foot), leap, run
Prepositions:
Up, upon, down, into, onto, between, beneath, beside, under, over, through, across, around
Objects:
Consumables: Construction paper shapes, shoeboxes, paper plates, bubble wrap, masking tape, Bottle Babies (2-liter soda bottles, half-filled with colored water)
Kitchen: Stools, chairs, mixing bowls
Garage: Sawhorses, boards, inner tubes, tires, thick rope, flower pots, tarpaulins
Household: Wastebaskets, couch cushions, mattress, bridge table, exercise bench, telephone books, wash tubs, rugs, carpet squares, and sheet to drape over chairs for a tent
Kids’ equipment: Plastic hoops, big blocks, gym mats, Crash Pad (duvet cover, stuffed with pillows and foam blocks)

2) Together, plan the course by mixing and matching list ingredients, e.g.:
Step / Into / Shoe boxes
Scoot / Around / Wastebaskets
Creep / Under / Table
Crawl / Through / Tunnel
Walk / Between / Lines of tape
Somersault / Across / Mattress
Roll / Over / Bearskin rug
Jump / On / Bubble wrap
Vary movements, prepositions and objects to reinforce children’s ability to handle and discriminate different materials (tactile sense), stretch muscles and develop body awareness (tactile/proprioceptive senses), balance and move through space (vestibular sense), perceive spatial relationships and negotiate around obstacles (visual-motor skills), and improve motor planning, coordination and postural responses (sensory-based motor skills).

3) Execute the plan by laying out the course. In tight spaces, such as a hallway, a linear course is okay for one or two kids. In the yard or cleared room a circular course is best for a crowd. Let youngsters help! Kids with SPD often sense what their systems need; honor their ideas and be flexible about altering the plan. Also, remember that the heavy work of lifting, carrying, pushing and pulling materials into place is like over-the-counter OT.
TIPS

  • Have everyone travel in the same direction to avoid traffic jams.
  • Prior to a happy birthday party, practice building and going through a course with your child so she feels in-the-know, adept, and ready to help her friends if they get stuck.
  • For holidays, spice up the course with seasonal accents, e.g.:

Valentine’s Day:

  • Use red Bottle Babies (soda bottles half-filled with tinted water) to circumnavigate
  • Make a curvy or soft, heart-shaped path with red masking tape
  • Stick down red paper hearts to jump on and red arrows to manage the flow

President’s Day:

  • Play patriotic music
  • Emphasize red, white and blue objects (sheets, cushions, tape, hoops)

St. Patrick’s Day:

  • Tape tiny paper feet along the course so kids can follow the leprechaun’s path
  • At the start, hand each child a large gold piece to toss into a pot at the end
  • Have the kids go barefoot, or backwards, or with music.
  • Incorporate your child’s favorite theme. Does he love trains? Pretend that obstacles are the locomotive, freight car, caboose. Are planets her thing? Obstacles can be Mercury, Venus, Earth. State capitals? Hartford, Annapolis, Denver. This thematic technique may jump-start the child who is not a self-starter.
  • Be vigilant about safety. Allow sufficient space between obstacles for the child to readjust his posture before moving to the next. Always be there.

To give children the chance to master new physical challenges, learn problem-solving skills and develop praxis, make an obstacle course every day! Build it, and they will come.

For more on obstacle courses and heavy work activities, see The Out-of-Sync Child Has Fun, revised (Perigee, 2006), The Goodenoughs Get in Sync (Sensory Resources, 2004), and Growing an In-Sync Child (Sensory World, 2010).

(2010) Revelation from a Paper Plate

Published in S.I. Focus, Summer issue

Imagine coming to one of my “Getting Kids in Sync” presentations. You are here to learn new strategies for supporting children with SPD. At the door, you receive a warm welcome, a hefty handout, and two paper plates.

Get a cup of coffee and snack, but please, do not put food on the plates. We’ll use them in many different ways — just not for bagels and berries!

During our synergetic day, one activity is drawing on a paper plate. This activity requires some thought, so it comes immediately after a break. From years of teaching, I know you will think better if given opportunities to stretch and move every 10 minutes or so.

Tip: Human beings are born to move. Movement gets the body and brain in sync and makes learning easier. Want your child to be ready to learn? A few minutes devoted to a physical action, such as jumping or swinging, prepares him for the cognitive action of reasoning and problem-solving.

Once you all are refreshed and reseated, I say, “Please get one of your paper plates. Then I’ll give you an assignment.”

What? An assignment? Now you are alert and possibly on guard, because you don’t know what is expected. You may fumble as you search for the plate. Take your time. We’ll wait until everyone is ready.

Tip: Rushing a person to do a novel task is counterproductive. “Doing,” or “praxis,” takes practice. Want your child to taste success when trying a new task? Give her plenty of time to ideate (conceive of) what she needs to do, to do the necessary motor planning, and to carry out her motor plan. Practice leads to praxis!

Got your plate? Paying attention? Great!

I say, “On your plate, sketch an experience you had as a child that you like to think about, now that you are an adult. This memorable experience may have happened once, or many times.” As Robert Schumann’s Traumerai (Scenes from Childhood) plays in the background, you pick up your pen and begin to draw.

Tip: Instrumental music (especially by Mozart, Bach, Schumann or other classical composers) is conducive to reading and writing. Music with lyrics (i.e., songs or opera), however, competes with these verbal tasks. Want your child to improve her study skills? Encourage her to listen to quiet music without words.

After a minute, I stop the music and get your attention by blowing into a slide whistle. You alert to the sound as the whistle rapidly glides up and down a musical scale.

♬ Whooosh! Whooosh.

Tip: People with SPD or autism often have an affinity for music, drum beats, poetry, and chants. Rhythmic patterns help their brains get organized so they can pay attention. Want your child to listen to you? Sing it, strum it, clap it, or tap it!

When you are all ears, I say, “Briefly share your story with the person next to you — or with two other people, so everyone is included. This story-sharing can be a ‘twosie’ or a ‘threesie’ activity.”

Tip: People with SPD often feel isolated. Want your child to feel part of the family or group? In conversation or activity, be mindful about ways to include everyone.

The room is abuzz as you and your neighbor(s) describe wonderful childhood memories. You gesture, laugh, nod in understanding, and lean toward your new friends. After a few minutes of “speed stories,” you again hear the slide whistle’s glissando whooshing up and down to get your attention.

Now I say, “Let’s hear some of your stories. Someone, please volunteer to tell your story in a few sentences.”

You may think, “Is this a trick question? What might my story reveal about myself? It was just about climbing a tree…. Would others consider it silly?” You — and many others in the room — may freeze.

Tip: When your senses take in a sudden, unexpected message, you are instantly aroused and self-protective. Your brain integrates and organizes sensory messages to help you assess whether you are in danger — and whether to fight, to take flight or fright, or to freeze. Only when your senses tell you that you do not need to be defensive, can you relax and use your senses to discriminate what is going on around you. Want your child to be an active and discriminating learner? First make sure your child feels safe!

If no one in the hotel ballroom ventures to share a story, I’ll offer one of mine, such as raking with my family and then jumping and rolling in a pile of fragrant, crunchy, colorful autumn leaves.

Tip: Throughout the day, everyone needs the sensation of deep pressure to the skin, muscles and joints. Want to calm your over-responsive child … or to arouse your under-responsive child? Let her run and jump into a pile of leaves, hay or snow or onto a mound of cushions, or give her a “Squeezit” (bear hug) until her sensory system gets in sync.

My leaf-pile anecdote alleviates your worry. It’s okay, this story sharing is a safe activity, and soon hands go up. We hear stories about building dams in the creek, jumping from swings, rolling down hills, and bike riding with buddies. We hear about what you did with trampolines and tree stumps … roller skates and rowboats … brownies and mudpies … horses, hikes, and hopscotch.

After several memorable stories, I say, “Even without hearing every story, I know a few things about what you drew, because your experiences share many common qualities. Times may change, but children’s needs stay the same.”

Most of your drawn experiences were:

  • Outdoors. If your story was outside, I ask you to raise your hand and look around the room. You turn and see a forest of hands.
  • Sensory-rich. Most of your reminiscences involve active touch, movement, vision and hearing, and perhaps smelling and tasting, too. The more meaningful and memorable an experience, the more senses are integrated. (Because they are essential for survival, the two human activities that use all senses simultaneously are eating and lovemaking. Watching TV uses only vision and hearing.)
  • Safe. Even if the activity was very challenging, you felt secure enough to keep going. You had “inner drive” to satisfy your curiosity, reach beyond your grasp, try new moves, or vary the game to make it more complex. You climbed out further on the branch, bowled with your left hand, planted peach and cherry pits together to produce a mystery fruit, and so forth.
  • Social. You were probably with family or friends, all relatively dependable and predictable. No bullies, no spoilers —just cohorts. You were part of a team. You felt needed. (Even if reading was an extremely pleasurable pastime when you were a child, you probably have not drawn it on your plate. Being alone may have been pleasant, but participating in activities with others is more memorable.)
  • Untimed. The experiences were over when they were over — when you were satisfied, or went home for supper. No clock imposed an artificial ending to the activity.
  • Meaningful. You had some or much control of the situation, and you were learning or developing a new skill that you could generalize to other scenarios.
  • Desirable. You liked the experience so much that you wanted to repeat it.
  • Active. You were the doer — not the “do-ee” who passively allowed the experience to happen without your participation.
  • Not in the classroom. Let’s hope that as educators bring more sensory-motor experiences into the classroom, this will change!
  • Independent of electronic equipment. You were using kid power, not electric or battery power. You — not purchased, plugged-in games — were the source of your own entertainment.

What do you think your children will draw on their plates, 20 years hence? If we provide many sensory-rich opportunities to move and play (especially outdoors), we can ensure that their memories will be as meaningful as ours.

Thank you for coming to the presentation and for engaging in this paper plate activity. In a future article, we’ll consider more sensory-motor and perceptual-motor experiences with paper plates, designed to get you and your children actively moving, learning, and growing “in-sync.”

 

(2010) Two “Look-Alikes”: Sensory Processing Disorder and Attention Deficit Disorder

Published Summer 2010.

Picture Brian. While the other children are settling down to a workbook task, Brian rocks in his seat, whining, “Owwuu,” and rubbing his arm where a classmate grazed him en route to her chair. Abruptly, he stands and shoves his desk away from passing children.

The teacher frowns. “Sit down, stay put, and start working, Brian!”

He wriggles in his seat. “Um, what are we supposed to do?”

“Pay attention! Page 36, even-numbered questions.”

He gropes inside his messy desk, finally locates the workbook, and drops it. Retrieving it, he sags to the floor. He plops into the chair again, grips a pencil like a dagger, and starts writing — but presses so hard that the point breaks. He hurls the pencil across the room and screams, “I hate this!”

Brian is inattentive, impulsive, and fidgety. Does he have Attention Deficit Hyperactivity Disorder – or Sensory Processing Disorder? Recognizing the differences between these two disorders and providing appropriate treatment can greatly benefit children and adults like Brian.

Like ADHD, SPD is a neurological problem affecting behavior and learning. Unlike ADHD, SPD is not treated with medicine. Instead, occupational therapy using a sensory integration framework (“OT-SI”) helps most. This therapy addresses underlying difficulties in processing sensations that cause inattention and hyperactivity.

In The Out-of-Sync Child, I define SPD as the “difficulty in how the brain takes in, organizes, and uses sensory information, causing a person to have problems interacting effectively in the everyday environment.” Sensory stimulation – too much, too little, or the wrong kind – may cause poor motor coordination, incessant movement, attentional problems, and impulsive behavior as the person strives to get less, or more, sensory input.

Brian’s central nervous system inefficiently processes tactile sensations. The slightest touch overwhelms him. A “sensory avoider,” he is over-responsive and cannot regulate, or “modulate,” sensory input. Also, touch stimulation confuses him. A “sensory jumbler,” Brian cannot discriminate differences among sensations.

How does his SPD play out? Brian cannot interpret how objects feel when they contact his skin. His chair, desk contents, workbook, pencil, and classmates bother or befuddle him. Fidgeting and squirming, he pays a lot of attention to averting ordinary tactile sensations. Meanwhile, he pays scant attention to the teacher’s words or classroom rules.

Imagine Dana, a child who processes movement and balance sensations very slowly. This under-responsive child, or “sensory disregarder,” has difficulty starting or stopping an activity. With encouragement, she eventually settles into a swing, enjoying the movement that helps her nervous system get organized. However, Dana does not know when to stop. She swings and swings, inattentive to her own body-centered sensations screaming, “Enough!” 

Envision Jayson, a “sensory craver” who needs much more action than his peers. An impulsive “bumper and crasher,” he seeks intense, vigorous movement. Constantly, he rocks, climbs, gets upside-down, and gyrates, darting from one experience to another. He pays much attention to satisfying his craving for movement and little attention to his mother’s instructions or where he left his shoes.

Inattention . . . impulsivity . . . fidgetiness … constant movement … these are definitely symptoms of SPD.

Now consider this definition for Attention Deficit Disorder: a “neurological syndrome characterized by serious and persistent inattention and impulsivity. When constant, fidgety movement (hyperactivity) is an additional characteristic, the syndrome is called Attention Deficit Hyperactivity Disorder.”

Inattention … impulsivity … fidgetiness … constant movement. These are definitely symptoms of ADHD.

SPD and ADHD are certainly “look-alikes.” However, they are distinct disorders, and optimum treatment for the two problems is very different. Before jumping to conclusions (and to drug therapy), professionals, parents, and teachers should consider the whole child to thoughtfully determine the best support.

If the child is frequently, but not always, inattentive, it is useful to observe her behavior and ask: Where, when, and how often does her inattention occur? What is happening, or not happening, when she concentrates well? What is her “self-therapy”?

When overloaded, an over-responsive child needs less stimulation. How can we help? We can undo something! Over-the-counter first aid for this child might be decreasing the offending sensations. We can make the environment softer, dimmer, quieter, calmer.

Then, we can do something! Comfort her with “deep pressure,” such as a massage or bear hug. Create a retreat under the dining room table or in a classroom corner, with pillows and a sleeping bag to burrow into. Apply deep pressure on skin and muscles to get her organized and ready to participate and learn. Provide heavy-work activities: pushing a grocery cart, pulling a wagon, lifting weights, or carrying a book carton. Ensure daily outdoor play. (Movement always helps, so the more recess, the better.) Jog together around the block or playground. Offer 3 opportunities for gentle roughhousing. Give her a rolling pin for pressing dough, a shovel for digging, a bar for chinning, a hammock for swaying, a wad of gum for chewing, a trampoline for jumping.

When “underloaded,” an under-responsive or sensory-seeking child needs extra sensory stimulation. Again, we can do something! Provide sensory-motor experiences like those mentioned above. The under-responsive or seeking child needs them, too, in varying degrees, for similar activities may calm one type of child and invigorate or satisfy another.

Providing just the right sensory-motor input will certainly help a child with SPD. No surprise, sensory-motor input will also help the child with ADHD. Indeed, it will help everyone, because we all require frequent, daily sensory-motor experiences.

Not psychostimulants, but a sensory diet may be the best “medicine” for the child with attention problems. (An occupational therapist can develop an individualized sensory diet with appropriate touch and movement experiences.) An approach that excludes drugs and includes movement, deep pressure, and heavy work never hurts and often helps the inattentive child whose problem is not ADHD but developmentally delayed sensory processing.

 

References:

Ayres, A.J., PhD (2005). Sensory Integration and the Child: Understanding Hidden Sensory Challenges. Los Angeles: Western Psychological Services.

Biel, L., & Peske, N. (2005). Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Integration Issues. New York: Penguin.

Kranowitz, C. (2005). The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder. New York: Perigee. Kranowitz, C. (2006). The Out-of-Sync Child Has Fun: Activities for Kids with Sensory Processing Disorder. New York: Perigee.

Kranowitz, C., & Newman, J. (2010). Growing an In-Sync Child. New York: Perigee.

Miller, L.J., PhD, with Fuller, D.A. (2006). Sensational Kids: Hope and Help for Children with Sensory Processing Disorder. New York: Putnam.

Smith, K.A., PhD, & Gouze, K.R., PhD (2004). The Sensory-Sensitive Child: Practical Solutions for Out-of-Bounds Behavior. New York: Harper Collins.

 

(2014) Focus on Survival Skills: When the Lights Go Out

Published in Sensory Focus, Summer issue

An advertisement from an electric power company dropped through my mail slot today, shouting, BLACKOUT: Could It Happen Again? It got me thinking about survival skills. When an outage occurs and we can’t switch on the electric power, we must switch to our own power to get from place to place, prepare meals, communicate with others, and entertain ourselves.

Will we be prepared? Especially those among us with SPD and other physical challenges?

Alas, so much is done for us these days that we all are becoming “do-ees” instead of “do-ers.” Learned helplessness is everybody’s problem.

Consider automatic doors, electric can openers, battery-operated pencil sharpeners, Velcro fasteners, electronic keyboards, TV remotes, pre-sliced vegetables, and public restrooms’ sensor faucets. (Who’s the sensor? Not us!) These “smart” things are designed to make life easier and cleaner today — but they deny children opportunities to develop skills they will need tomorrow. Kids need steady practice using their sensory systems and engaging their bodies to push, pull, squeeze, rotate, twist, tie, zip, write, slice, chop, and perform other everyday actions. How smart is a device that renders us senseless?

Let’s not allow devices to extinguish our senses! We need our senses!

We need them, first, for survival. We must be at-the-ready to satisfy physical demands like hunger and to protect ourselves from potential threats. When we feel safe and that we will survive, we can relax and use our senses for a second vital purpose — that of discriminating what is happening around us.

Sensory discrimination helps us do and master important skills. The more important an activity is for survival, the more senses are involved. Because eating and making love are essential for life, they are the two human activities that engage all eight senses simultaneously. (Can you think of a third? Let me know.) In contrast, watching TV while lying on the couch uses only two senses — visual and auditory — and passively, at that.

Effective learning takes attention, time and practice. We learn to write after learning to scribble, to obey traffic rules on the road after riding bikes at the playground, and to pitch a baseball after tossing a beach ball. Many hands-on moments with regular faucets lead the way to turning an unfamiliar faucet handle with appropriate force, in the correct direction, and to the right extent … and then to turning the handle to “off” before walking away. (Can a sensor faucet teach all that?)

To develop and enhance our kids’ survival skills, let’s provide real, three dimensional, fun and functional experiences to get their bodies and brains in sync. Think of heavy work activities that use kid power, not electric or battery power. Think of action verbs, like push, pull, lift, carry, slice, chop, jump, climb, throw, catch, and so forth. The more kids do, the more they can do, and the more likely they will be to survive, superbly, when the lights go out.

 

HEAVY DUTY ACTIVITIES TO DEVELOP KID POWER

  • HEAVE heavy, indestructible grocery items into the cart, such as bags of beans and potatoes, plastic bottles of water, cans of soup and iced tea, and so forth. The heavier, the better.
  • HOIST grocery bags into the car, into the kitchen, onto the counter.
  • LIFT the items out of the bags and stow them in the refrigerator and pantry.
  • SLICE vegetables for a Circle Salad (see Box).
  • CHOP vegetables for a Chopped Salad.
  • TWIST a mill to grind pepper.
  • GRATE a large, firm wedge of cheese using a box grater.
  • PEEL carrots, cucumbers, potatoes.
  • TUG the string, or ROTATE the handle, of a salad spinner to dry lettuce.
  • TEAR lettuce leaves into bite-sized pieces.
  • HUSK corn on the cob.
  • VACUUM, SWEEP, SHOVEL, and RAKE.
  • DRAG the hose to water the grass or wash the car.
  • TUG the puppy around the block.
  • CARRY the laundry basket upstairs.
  • STAND UP without using hands.
  • DO PUSH-UPS. • CLIMB STAIRS without leaning on the banister.

 

CIRCLE SALAD

For ages 7 and up (Note: Some children younger than 7 can handle a kitchen knife well, and some children — regardless of age — cannot. You know your child best, so please use your own judgment!)

What You Need
Sharp, round-tip kitchen knife Large cutting board Vegetables: • Yellow squash, zucchini, and peeled cucumbers (easy-to-slice for children with low tone, low stamina, or poor motor coordination) • Carrots, celery, unpeeled cucumbers, onions, scallions, radishes, grape tomatoes, and olives (requiring more motor-planning, strength or dexterity)

What You Do
1. Slice vegetables into circles.
2. Mingle all the pretty circles in a bowl and serve with your favorite dressing.

Helps Your Child Develop and Enhance …

  • Motor planning (for using kitchen tools)
  • Bilateral coordination (for using two hands in different ways to accomplish a task)
  • Social relationships (for being part of a team and helping to feed a group)
  • Can-do spirit (for trying new activities and perhaps new foods)
  • Nutrition (for nourishing the body as well as the central nervous system)
  • All eight sensory systems (even picky eaters who don’t engage their gustatory sense still use seven senses!)
    • Tactile — Hands manipulate the vegetables, developing touch discrimination and fine-motor skills
    • Proprioceptive — Hands, arms and upper body get into correct position to push the knife through the vegetables, developing appropriate force
    • Vestibular — Body is upright and stable, improving balance; muscles needed to handle the food and tool are engaged, improving muscle tone and stamina • Visual — Eyes see the vegetables, hands, and knife, improving visual discrimination and visual-motor coordination • Auditory — Ears hear the knife touching the board, improving auditory discrimination
    • Olfactory — Nose smells the vegetables, improving what the nose knows and stimulating the appetite
    • Gustatory — Mouth tastes the Circle Salad (let’s hope), increasing foods the child will eat
    • Interoceptive — Internal organs digest the food, improving general health

Ways to Make It More Challenging

  • Slant the knife to slice ovals for an Ellipse Salad
  • Cube the vegetables to make a Block Salad
  • Use a melon baller to scoop little orbs of watermelon, cantaloupe, and honeydew for a Sphere Salad
  • Celebrate holidays with color-coordinated vegetables (green peppers, parsnips and carrots for St. Patrick’s Day; broccoli, mushrooms and tomatoes for Columbus Day)

What to Look for

  • The child holds the vegetables firmly and has good control of the knife
  • The child slices the vegetables in somewhat regular circles
  • The work stays on the cutting board
  • The child is engaged and having fun

 

HARD WORK IS FUN

A preschool student of mine loved playing in the Housekeeping Corner. At home, this privileged boy had a nanny, housekeeper, and cook to serve him. At school, donning an apron, he served others. He swept, ironed, dressed the baby dolls, prepared imaginary meals like “Magic Soup,” and tidied up his own messes. One day, I said, “At our school, you are one of the hardest workers!” Laughing, this resourceful child said, “At my house, people who work hard have all the fun!”

Carol Kranowitz, author of The Out-of-Sync Child and co-author with Joye Newman of Growing an In-Sync Child and In-Sync Activity Cards, is working on a new book, The Out-of-Sync Child Grows Up.