I spoke in my previous blog post about the many disorders which have similar symptoms. I firmly believe that you don’t need an official diagnosis in order to treat a child. The diagnosis is important if it helps with obtaining appropriate services, but for the parent or caregiver it is unnecessary.
You know if your child over-reacts to touch, or has meltdowns over the smallest problems, or can’t focus, or can’t sit still. All these issues interfere in your relationship with your child, and create problems for your child in school and with friends.
Take an honest assessment of your child and make a list of those things that you recognize as a problem. Write down everything you can think of, such as: eating issues, behavior issues (when they occur and what precipitates them), sleeping issues, learning issues (reading, writing, focusing, remembering), tactile issues (doesn’t like to be touched, craves a lot of physical contact) and movement issues (too active, underactive, uncoordinated, etc). Ask teachers what are the specifics of the classroom problems. Is it that your child is combative, or that he doesn’t pay attention, or that he can’t sit still? By ascertaining all this information, you will have a better idea of what you need to do in order to help your child.
Before I give you details of the various therapy techniques and how they can help, I want to caution that there are no blanket solutions. Each child is unique, and that even though a protocol may be recommended for a specific symptom, there is no guarantee that it will work for your child. You may need to try a combination of strategies, or another approach before you find the one that works.
I also want to emphasize that these strategies are meant to decrease symptoms. As of today, there is no known cure for Asperger’s or ADHD or ODD or SPD. Maybe there will be someday, but for now all we can do is treat the symptoms.
I am a strong believer in using a multi-treatment approach. When dealing with any of these children, there are overarching similarities. Most have difficulty with organization, most have behavior problems and most have problems with focus and attention. Even though some children with any of these disorders can be low energy, my experience is that most have too much energy and need to get calm. There are also the issues of poor impulse control and low frustration tolerance.
For all these reasons, I encourage caregivers to use both behavioral and sensory treatment when working with their child. It is also a good idea to help them improve their motor skills and coordination through exercise and therapy.
Today I am going to discuss some sensory tools and activities which can make a great deal of difference to your child – and to you. I will explain why they can help and how to implement them.
Children who have difficulty calming themselves, sitting still and who get frustrated and lose control easily seem to have internal pressure which pushes them to react. Their ability to process and respond to stimulation appropriately is impaired.
The central nervous system is our regulatory system which basically integrates all information coming in and going out from our bodies. It includes the brain and spinal cord. The peripheral nervous system is responsible for body movement and for stimuli coming in or going out. It is also involved in regulating heart rate, emotional responses, digestive responses, recognizing impending danger, and so on. The premise of some sensory integration theory is that if you can affect the system by altering the incoming stimuli, the information can influence all these regulatory systems and help them improve their responses.
There is a brushing protocol which is recommended for children who have trouble organizing themselves and in calming themselves. It is appropriate for children with Autism spectrum and for ADHD children who present with hyperactivity and tantrums (meltdowns). The rationale behind it is that the skin is the largest sensory organ and that if you can influence the central nervous system via the skins receptors, then you can effect change. Brushing can be very effective in calming children, which will help them to listen and focus better, and will help them to avoid the internal pressure associated with aggression and meltdowns. When it is first started, it is important to do it every 90 minutes to 2 hours, every day for a week or two. The calming effect is not long lasting, so it needs to be repeated often. As your child gets calmed, the experience should be a positive reinforcer. They don’t feel the pressure, and the problems associated with a meltdown are absent. They will be able to take in information in school and at home, which should help their performance. This reinforcement will help them learn to self-regulate as time goes on. But initially, until a new pattern has emerged, it needs to be done at a minimum of every 2 hours. The brush that is used is designed for this protocol, and can be purchased at most sites which specialize in sensory integration tools, or it can be found in therapy catalogs. You can also use a surgical brush. Whenever you brush, you need to use firm strokes. Light touch is an irritant (noxious stimuli). Never brush the stomach, neck or head. It is recommended that the brushing be followed by joint compressions, which I described in a previous post.
1. Hold brush horizontally if clothes are off, and vertically if clothes are on.
2. Hold right hand and brush right arm in up and down motion. Turn the arm so that you are sure to brush the whole arm. (5-8 times)
3. Brush right hand 5 times on each side
4. Hold left hand and brush left arm same as you did with right.
5. Brush left hand 5 times on each side
6. Brush child’s back
7. Brush right leg in up and down motion, and then brush foot 5 times on each side
8. Brush left leg (5-8 times) in up and down motion and then brush foot 5 times on each side.
As I mentioned above, you can follow this up with the joint compressions.
If you decide to start this program, it is a good idea to get the help of a trained therapist just to ensure that you are doing it correctly. Please be aware that some children can be very resistive at first, but most find it enjoyable once it becomes routine. Also, some children can get nauseous from too much sensory input. Remember, it does affect the nervous system. Keep an eye on your child and be sure to note any adverse reactions. If this works for your child, you can do it less and less often as time goes on, or only on an “as needed” basis. Older children can do it for themselves, if they prefer.
Another option for a child with oversensitive or over-reactive sensory system is a weighted vest. The weighted vest was designed to help give external pressure and proprioceptive input. Proprioception is the sense of your body in space which comes from the receptors in joints, muscles, tendons and ligaments. Again, the theory is to alter nervous system processing so that responses are delayed or calmed. In addition to vests, there are weighted blankets and lap pads that children can use at school.
If your child has severe problems in self-calming or with hyper-stimulation, you can try making a sensory friendly environment.
This can be costly, however, because many of the sensory lights and tools are expensive. But you can start with a small space with dimmed lighting and a bean bag chair and a few fiber optic lights or simply a lava lamp. Most people are mesmerized by a lava lamp. By the way, Mesmer was a physician whose work was the basis for the development of hypnosis (an altered state). So certain lights and environments have the capacity to alter our state and create relaxation. These things also work the same way for your child.
Overactive children who never seem to slow down can benefit from swinging, spinning and jumping activities, which I also mentioned in an earlier post. Jumping helps with proprioception, and swinging and spinning help with vestibular organization (movement and coordination and spatial organization).
There are many other sensory products and activities which can help. The list is too long to describe each one. It helps to keep in mind that organization is an integral part in treating a child with any of the problems I have discussed. Not only does it help to work on improving their internal regulation, it helps to work on external organization. Setting up routines and schedules is helpful. Breaking up tasks into manageable increments can make a big difference. Helping your child to get enough sleep and maintaining a regular bedtime is crucial.
Treatment can make a huge difference. If you are uncertain where or how to begin, ask your physician to refer you to an occupational therapist. Or you can check in the resource section of this site to get state information. Don’t give up or let your frustration impact your goals for your child. I guarantee that if you maintain a good treatment program and include sensory and behavior management strategies, you will be amazed by the results.