I have been working with children with learning differences and challenging behavior in preschools and school age settings for over 15 years. Sensory processing differences are increasingly common in today's kids, yet often mistaken for ADHD. When a child's brain isn't quite firing correctly to process input from lights, sounds, tastes and touches, kids can either be easily overwhelmed and distracted. These struggles- exacerbated or caused by nutritional deficiencies and food reactions- underpin a lot of impulsive behavior at school and home. A child with sensory processing challenges does not need drugs, they need sensitivity, accommodations, and an Occupational Therapist who can help design a routine to re-wire the brain and help children (and families) learn coping skills. Of course we'd all prefer no diagnosis at all, but if your child is truly struggling in school system that requires conformity, a formal diagnosis done by an Occupational Therapist can provide some protections for your child and an opportunity to open a conversation about more individualized instruction. For example, my child's diagnosis allowed me to create a plan with his school that provided accommodations for his need to wiggle, and restricted the teacher from ever taking away his recess as punishment. Diet changes and movement programs don't just help at school. By integrating the nervous system more completely, children can feel more grounded and more able to navigate busy scenes, frustration and change.
What is Sensory Processing Disorder?
From the Sensory Processing Disorder Foundation's website:
Sensory processing (sometimes called "sensory integration" or SI) is a term that refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses. Whether you are biting into a hamburger, riding a bicycle, or reading a book, your successful completion of the activity requires processing sensation or "sensory integration."Sensory Processing Disorder (SPD, formerly known as "sensory integration dysfunction") is a condition that exists when sensory signals don't get organized into appropriate responses. Pioneering occupational therapist and neuroscientist A. Jean Ayres, PhD, likened SPD to a neurological "traffic jam" that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. A person with SPD finds it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks. Motor clumsiness, behavioral problems, anxiety, depression, school failure, and other impacts may result if the disorder is not treated effectively.Some children are hypersensitive to certain senses, temperatures and pain. Imagine trying to focus in a room with 5 radios, tuned to different stations. Now add a strobe light and an itchy wool sweater. This is the experience of a child who experiences heightened sensations. For these children, the hum of a fan and the teacher's voice are all mixed up. They are painfully aware of the seam in their socks, the tag on their shirt, and the maddening flicker of florescent lighting. These are the kiddos who get completely hyped up at the big box grocery store and will melt down over a twisted sock.
Other children are hypo-sensitive (often called under-responders). These kids view life as a full contact sport and don't feel grounded unless they are moving, crashing, bumping or hugging. Imagine living inside of a fog, where nothing quite feels concrete, until you smash into the wall and get a satisfying reminder of where your body is. Children who are under responders are often seek out movement and contact, even to the point of pain. They love to run, jump, spin, crash and wrestle. My son learned to climb to the highest point in any room and jump with a thud to the ground, rolling across the floor with joy. The trampoline rebounder in the living room made it possible for him to stay off of my furniture, but sitting quietly in kindergarten was a different story. It can be very difficult to live with a child who has sensory processing delays, but it can also be a huge relief to finally understand what's going in for them and be able to help.
If any of this sounds familiar, use the checklist here. You'll also want to have someone else complete it (a teacher, babysitter or another family member). If your child has several red flags, observed by more than one person in more than one setting, bring the checklist to your pediatrician. Request a referral for a sensory evaluation with an Occupational Therapist. There, you will be interviewed and the therapist will do a series of games and exercises with your child to get a sense of how well they are able to deal with sensory experiences.
Nervous systems that are not functioning properly are made up of malnourished wires. Bathing them in good nutrition provides the vitamins, minerals, and fatty acids that are critical for strong development. Since children with sensory processing challenges are often picky about food textures, it is common for them to gravitate towards unhealthy processed foods. Chicken or the egg? Under responders will sometimes only eat foods that are crunch, sugary or salty, while children who are hyper sensitive will want foods that are creamy and bland. These texture and flavor challenges can make it harder to keep a balanced diet of whole healthy foods. Remove processed foods from the house entirely and gradually introduce more fresh fruits and vegetables, grass fed beef, fish, nuts, and pastured eggs. Deficiencies in magnesium B vitamins, and Omega 3 fatty acids are common in children (and adults) with SPD, and supplementation can make a world of difference. Find a naturopath who can make recommendations for supplement dosages to strengthen cognitive function.
SPD is often linked to inflammation from gluten sensitivity or other food allergies. Although it may seem like a nightmare to take away a picky eater's favorite cracker, removing gluten may reduce the tactile sensitivity so that the child may be more willing to try new foods. Try an elimination diet for one month. Remove gluten completely for one month, and see if your child's symptoms improve. You may also want to eliminate dairy. Two weeks seems to be enough to notice if dairy causes increased symptoms or not. In our case, we did elimination diets and learned that gluten makes my mancub absolutely foggy and unable to concentrate, while dairy makes him incredibly irritable.
Holistic Treatment
In our case, we opted for some occupational therapy paired with a clean diet and supplements. Most children naturally get a steady "diet" of sensory experiences from a very young age that help them to make sense of the world. Crawling, running, digging in the mud, eating, and listening to the sounds of the world help to integrate their nervous system. But for children who haven't integrated the senses properly, a more intentional sensory diet is needed. By planning consistent opportunities and activities, children's senses become more strongly aligned.
We learned to create a consistent routines that provided frequent opportunities throughout the day to move in appropriate ways that helped him to feel organized and grounded, and get energy out before being expected to be still and focused. New vocabulary to express his needs and very basic exercises like jumping and massage both strengthened the nervous system and built coping skills. He can now recognize the need to move and say "My engine is running way to high, is it OK if I do 10 jumping jacks before homework?". Working with an occupational therapist for about 6 months gave us the opportunity to play with different equipment and experiences (swinging, trampolines, weighted equipment, big yoga balls, scarves, and different kinds of fidgets") to learn about how they impacted the brain, and to figure out what sensory activities were calming, and which ones wound him up even more. Once we designed a home program and started to see progress, we phased out the therapy pretty quickly. Your mileage may vary, and some children need therapy for longer.
We eat mostly whole, unprocessed foods, with absolutely no dairy and minimal gluten (hypocrite disclosure: although I eat no gluten, it's crept back into his diet due to peer pressure and summer camp snacks. We'll be back on track starting in August, to prepare for school!) We supplement with fermented cod liver oil and a calcium/magnesium tablet.
I'm happy to report that the Mancub won an award at the end of first grade or having made the highest academic progress in his class. He still gets bored and wants to be the center of attention at all times, but his teacher was adamant that she had never felt the need for any accommodations this year and did not see any symptoms that would indicate sensory processing or ADHD.
School Advocacy: Know Your Rights and Don't be Afraid to Speak Up
Just because it's not ADHD and doesn't require medicine, doesn't mean that Sensory Processing Disorder isn't a real experience. Some will argue that it's simply another learning system, that may be true, but not all schools and teachers are able to individualize lessons and schedules to meet your child's unique learning style. Don't be afraid to use a diagnosis to force the issue of accommodations and individualized classroom environments. A diagnosis of Sensory Processing Disorder allows a child to have a 504 plan at school for accommodations, but will not hold the child back in any permanent way, or cause a change in placement.
With a 504 plan in place, Mancub was protected from losing his recess. Really, it was his teacher who was protected from the chaos that would have ensued had she tried to keep my kid inside all day. His 504 plan also allowed him to sit on a stool instead of the rug for group lessons, and hold a fidget if he chose to during large group activities. In some schools these may be common practices that don't require any formal mandate, but if your child's school isn't one of those, contact the principal and ask to schedule a meeting with the 504 team. This will usually include the principal, teacher and a nurse. Bring your sensory evaluation, which will contain recommendations for a school setting. A 504 plan is different than an IEP or Individualized Education Plan because your child will not receive special education services, unless there are other delays and you wish to request eligible services.
If your child's behavior continues to be a problem in school, either despite accommodations, or because the accommodations are not happening as planned, you also have the right to request that a school behavior specialist conduct a Functional Behavior Analysis. This is a questionnaire that should be filled out by a trained observer who will look for clues as to why your child is acting out. When does the behavior occur most? When does it never occur? What happens right before and after the behavior. What other patterns are noticed? After the FBA is completed, you will meet with a team to plan for how to prevent the behavior and better support your child. Is too much sitting triggering frustration and melt downs? A plan should be created to provide more frequent breaks and teach the skill of waiting over time.
While the FBA and behavior plan is being created, your child is legally protected from suspension or expulsion and may be protected from certain punishments such as seclusion or loss of recess. You also have the right to refuse to medicate your child or discuss other diagnosis such as ADHD. If your child's teacher still believes your child has ADHD, you have a few options. You can politely remind the teacher that diagnosing ADHD is outside the scope of teacher training, and request that you continue working together on individualized classroom strategies, which should be well within the teacher's scope of training. You can also request that the school district pay for an independent full developmental diagnosis with your preferred provider. Again, from the time you contact the school and request formal evaluations and planning, until all results are in and planning is completed, your child cannot face any severe or permanent punishments. I've seen children kicked out of school for something a small as balling their fists and crying out in kindergarten, so having this protection can be useful for an easily frustrated child.
For more on school advocacy and legal rights, go here
For more information on Sensory Processing , check out these sites:
Sensory Processing Disorder
http://www.sensory-processing-disorder.com/
Sensory Processing Foundation
http://www.spdfoundation.net/about-sensory-processing-disorder.html
And for more on nutrition and Sensory Processing, here:
Is SPD The New Black?
http://www.huffingtonpost.com/heidi-brod/sensory-processing-disorder_b_1326858.html
How SPD and Nutrition Interact:
http://devdelay.org/newsletter/articles/html/99-sensory-integration-and-nutrition.html
Dr Weil: Sensational Problems in Kids
http://www.drweil.com/drw/u/QAA400633/Sensational-Problems-in-Kids.html
Tips for Picky Eaters:
http://www.spdfoundation.net/newsletter/2011/10/starlights-parents.html
As always, leave your questions in the comments or my Natural Evolution Facebook Page!!
In Partnership,
Kellie :)
