ღ Sensory Processing ღ
'Sensory input pervades our everyday lives. It is how we make sense of the world and interact with the world around us. It is how we learn new skills and participate in play, school, work, and self-care. We have 7 different sensory systems that our brain must integrate in order to interact appropriately with our environment. These sensory systems include: proprioception (muscle-joint awareness), vestibular (orientation in space), tactile (touch), auditory (sound), visual (sight), gustatory (taste), and olfactory (smell). Our brain works hard to integrate all of those sensations without becoming too overwhelmed, distracted, or disengaged.
Even things that don’t seem “sensory” actually are. Take handwriting, for example. In order to write, your brain must integrate a huge amount of sensory information: to remain upright in the chair (proprioceptive sense), to hold the pencil with an appropriate grasp using the appropriate force (tactile and proprioceptive senses), to form the letters appropriately with adequate spacing (visual and vestibular senses), to sustain endurance throughout the activity (vestibular and proprioceptive senses), to filter out distracting input (auditory senses).
Everybody processes sensory input differently and requires different amounts of sensory input to respond to the demands of the environment, maintain an appropriate level of engagement, and perform activities efficiently. Many of the ways we do this are functional and integrated into our everyday lives without second thought. For example, someone who is bored in a meeting might swivel her chair back and forth to help her pay attention better; someone who is nervous might calm her sensory system by chewing on gum.
Children (and adults) with sensory processing disorders (SPD) manage sensory input in ways that are not functional, meaning they interfere with their daily activities. For example, a child who is sensitive to tactile input may avoid wearing certain clothes, or a child who seeks tactile input might constantly touch people or objects around him. Thanks to University of California San Francisco (UCSF) researchers, we now have tangible evidence of differences in how neurotypical children process sensory input versus children with SPD. This is not behavioral—the behaviors are simply an outpouring of an attempt to do whatever necessary to get back to a regulated state.
An adaptive response occurs when a child can successfully overcome challenges or demands in the environment. This is only possible when the brain effectively organizes incoming sensory input. Many children with SPD do not have the tools necessary to attain an appropriate arousal level in their current environments or with their current self-regulation strategies—so they are too overstimulated or too understimulated. Many children with SPD also do not organize sensory input into meaningful information, so they require extra time to perform tasks, perform them inefficiently, or get frustrated easily.
SPDs can manifest in different ways. The following table shows some of the possible different responses to sensory input. With Sensory Modulation Disorder, the brain processes either too much (overresponsive) or too little (underresponsive) sensory information. Children with Sensory Discrimination Disorder have difficulty telling the difference between sensory stimuli.
SPDs can also manifest in postural instability and dyspraxia—both of which are Sensory-Based Motor Disorders. Sensory-Based Motor Disorders occur when there is a disintegration of tactile, proprioceptive, and vestibular input. With postural instability, a child does not have the strength or endurance to sit upright without leaning on something (or someone), lying down, slouching, or changing positions. This inherently impacts the ability to focus at school or remain stable enough to write. Examples of dyspraxia are provided in the following table.
SPD Support has a comprehensive online survey that can help further identify if a child has SPD. If a child has few, scattered challenges then a consultation with an occupational therapist might be helpful to identify strategies to address those areas of functioning. If a child has multiple challenges in one or more categories, then an evaluation with an occupational therapist is highly recommended. It is important to note that sensory processing concerns do not spontaneously arise—there is a developmental history to them. For example: an infant who was difficult to soothe, an infant who learned to crawl late (or never crawled at all), or an infant who refused to touch food on the tray.
All are indicators of SPD. Research shows the following conditions have predisposition to SPD: prematurity, fetal alcohol syndrome, Autism, ADHD, fragile X syndrome, repeated ear infections, and sleep problems.
If, after you complete the SPD Support survey, you still believe the child has SPD, consider the following questions:
1) How are the sensory challenges impacting the child’s participation and function?
2) How will the sensory challenges impact the child if it’s not addressed?
3) How will the sensory challenges impact the child as demands in school increase?
4) Do other professionals see the same concerns?
Does the child perform differently at school than at home or in the community? Recognize that some children “keep it together” at school but fall apart when they get home. Factoring in how a child functions in different environments is highly recommended.
After identifying that a child has or potentially has a SPD that is impacting his/her function and participation, many parents are not sure what the next steps should be. I encourage parents to seek an evaluation with an occupational therapist by either obtaining a referral from a pediatrician through their insurance or contacting a private practice occupational therapist. I always let the parents know that advocating for their child, even with the pediatrician, will be important. Many professionals still deny that SPD is a “real diagnosis” and still there are no ICD-10 codes for SPD.
I also encourage parents to pursue an IEP from their school district to see if school services can be provided. Some schools might provide services through a contracted outpatient clinic if they do not have the necessary equipment. Most children with SPD will also require services outside of the school setting.
Sensory integration works to change the neurological system in the brain so that the child processes sensory input more effectively.
Over time, the more sensory input the brain receives in a therapeutic way, the better equipped the brain becomes to integrate all the sensory input from a variety of environments. While sensory integration helps to find a balance in the brain, the child will continue to need a variety of sensory outlets to help stay regulated—just like any well-organized adult. For example, the child might need to continue participating in swimming throughout the year, just as an adult may need to continue participating in yoga on a weekly basis. Because children have brains that are more plastic than adults, meaning they are still developing and the connections can be changed, the sooner SPD is recognised, and services are pursued, the better the outcomes. It’s never too early but it’s never too late!'
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Dr. Jamie Chaves, OTD, OTR/L, SWC is a pediatric occupational therapist at The Center for Connection in Pasadena, CA. She also holds a California feeding and swallowing certification. The Center for Connection, founded by Dr. Tina Payne Bryson (author of The Whole Brain Child and No Drama Discipline is an interdisciplinary center that promotes health and happiness through a relationship-based perspective.
ღ Writing Readiness (Pre-Writing) Skills ღ
'What are writing readiness (pre-writing) skills?
Pre-writing skills are the fundamental skills children need to develop before they are able to write. These skills contribute to the child’s ability to hold and use a pencil, and the ability to draw, write, copy, and colour. A major component of pre-writing skills are the pre-writing shapes. These are the pencil strokes that most letters, numbers and early drawings are comprised of. They are typically mastered in sequential order, and to an age-specific level. These strokes include the following strokes: |, —, O, +, /, square, \, X, and Δ.
Why are writing readiness (pre-writing) skills important?
Pre-writing skills are essential for the child to be able to develop the ability to hold and move a pencil fluently and effectively and therefore produce legible writing. When these skills are underdeveloped it can lead to frustration and resistance due to the child not being able to produce legible writing or to ‘keep up’ in class due to fatigue. This can then result in poor self-esteem and academic performance.
What are the building blocks necessary to develop writing readiness (pre-writing)?
Hand and finger strength: An ability to exert force against resistance using the hands and fingers that allows the necessary muscle power for controlled movement of the pencil.
Crossing the mid-line: The ability to cross the imaginary line running from a person’s nose to the pelvis that divides the body into left and right sides.
Pencil grasp: The efficiency of how the pencil is held, allowing age appropriate pencil movement generation.
Hand-eye coordination: The ability to process information received from the eyes to control, guide and direct the hands in the performance of a task such as handwriting.
Bilateral integration: Using two hands together with one hand leading (e.g. holding and moving the pencil with the dominant hand while the other hand helps by holding the writing paper).
Upper body strength: The strength and stability provided by the shoulder to allow controlled hand movement for good pencil control.
Object manipulation: The ability to skillfully manipulate tools (including holding and moving pencils and scissors) and controlled use of everyday tools (such as a toothbrush, hairbrush, cutlery).
Visual perception: The brain’s ability to interpret and make sense of visual images seen by the eyes, such as letters and numbers.
Hand dominance: The consistent use of one (usually the same) hand for task performance, which allows refined skills to develop.
Hand division: Using just the thumb, index and middle finger for manipulation, leaving the fourth and little finger tucked into the palm stabilizing the other fingers but not participating.'
Source: https://childdevelopment.com.au/areas-of-concern/writing/writing-readiness-pre-writing-skills/
ღ Anger ღ
'Anger is an emotional response to a real, felt or imagined grievance. Anger can be an active or a passive emotion. In case of ‘active’ emotion, the angry person lashes out verbally or physically at an intended target. When anger is a passive emotion it characterised by silent sulking, passive-aggressive behaviour, and hostility.
The more anger the child expressed verbally, the less there would be to come out in destructive attitudes and behaviours. That will be true for your child too. Let him or her verbalise the anger. As you watch your child express anger, identify where he or she is on the Anger Ladder. Then you will know the next step and can help your child with that step. The goal is to progress from passive-aggressive behaviour (level 15) and verbal abuse to a calm response that seeks resolution (level 1)'
Sources: 'How to really love your angry child' by Ross Campbell & Rob Suggs psychologistanywhereanytime.com
ღ Math learning problems? ღ
Concrete - Representational - Abstract Sequence of Instruction
When students who have math learning problems are allowed to first develop a concrete understanding of the math concept/skill, then they are much more likely to perform that math skill and truly understand math concepts at the abstract level.
1. When initially teaching a math concept/skill, describe & model it using concrete objects, e.g. chips, unifix cubes, base ten blocks, beans and bean sticks, pattern blocks (concrete level of understanding).
*** Provide students many practice opportunities using concrete objects.
2. When students demonstrate mastery of a skill by using concrete objects, describe & model how to perform the skill by drawing or with pictures that represent concrete objects, e.g. tallies, dots, circles, stamps that imprint pictures for counting (semi-concrete or representational level of understanding).
*** Provide many practice opportunities where students draw their solutions or use pictures to problem-solve.
3. When students demonstrate mastery drawing solutions, describe and model how to perform the skill using only numbers and math symbols (abstract level of understanding).
***Provide many opportunities for students to practice performing the skill using only numbers and symbols.
After students master performing the skill at the abstract level of understanding, ensure students maintain their skill level by providing periodic practice opportunities for the math skills.
***As you move through a concrete-to-representational-to-abstract sequence of instruction, the abstract numbers and/or symbols should be used in conjunction with the concrete materials and representational drawings (promotes association of abstract symbols with concrete & representational understanding).
ღ Communication Disorders ღ
