Monday, April 15, 2013

     Sensory Issues:  Emotional & Social Milestones…..

     Children with Sensory and Auditory processing issues often will be delayed in maturity milestones.  Emotional regulation, Impulse control, Frustration tolerance…..these are just some of the areas you may see your child a bit delayed.  When a sensory child is delayed in these areas, it can also cause delays in other areas: attention span,  learning, social skills, etc….

     Here is what I have understood about the world of Sensory Issues, how I would explain it, in general, and simple terms.  I have learned that Sensory kids, when encountering the outside world, (we will refer to it as “stimuli) will “short circuit”.  Their central nervous systems are 1) Failing to take in stimuli accurately: by either perceiving too much or too little 2) Failing to organize stimuli effectively 3) Therefor they will be unable to process thru and effectively respond to stimuli, negative or positive. It is these glitches in the central nervous system that I believe, lend themselves to the above listed emotional and social milestone delays. 

     Emotional Regulation:   For example, a child who has not yet mastered or begun to master Emotional regulation, can be short tempered, prone to meltdowns that are not age appropriate, likely to give up easily when learning new tasks,  appear very “needy”, appear very “angry”, have a difficult time with “stops & starts”.    In order to control their temper for example, exhibit emotional regulation,  a child must be able to:  A) quickly assess a given situation, B) Identify how they are feeling, C) problem solve, D) choose & demonstrate socially & age appropriate reactions. Until a child is able to do the above listed, they will not acquire “emotional control”.   Hence we see our children have meltdowns, whether they are being asked to sit quietly at the library, put a puzzle together, or even when at a best friend’s birthday party.  Stimuli are stimuli:  Positive or negative, a sensory child can have difficulty and be challenged by both.   We can easily understand the child becoming frustrated with a puzzle, but completely mystified when Disney World renders our sensory child irritable, hyper, moody, or even detached.
      Children with emotional regulation also have problems with stops and starts.  Whether it involves starting a new task or moving on to a new one.  We have all seen this happen in all children really.  It is time to leave the park, Johnny has a meltdown…The key difference I think is that in sensory kids, the meltdowns  happen frequently, and they tend to happen on grand scales and last much longer.   Eventually, most kids, after repetitive tantrums, realize that their “gig is up”, the tantrums “don’t work”, and move on to a more self-adjusted approach.  Starts are a key difference as well.  They have trouble settling in, acclimating to new beginnings.   Sensory kids, don’t make these shifts with just time and typically expected maturity leaps.  They must be sensory organized first.  It is then and only then, that these shifts happen. 

  Problems with emotional regulation unfortunately have a ripple effect, and contribute to exacerbating other milestone delays exhibited in sensory challenged children. 

     Frustration intolerance, Attention span & Learning:  Sensory challenged children can also appear to have a diminished ability to deal with frustration, which can lead to  shorter attention spans.  Again, I believe it all ties into the same quirky central nervous system issue.  In order to sustain focus & learn, take learning to read as an example: a child must be able to  A) Understand that focus is needed (assess a situation) B) Recognize on some level that they are anxious. (Identify how they are feeling: anxious) C) accept that focus is necessary, & remember that they can & have managed it before (problem solve) D) manage their frustration level in order to sustain required  focus (choose too and execute an age appropriate response). In the above scenario, the sensory or auditory challenged child often reacts this way instead: Feel bombarded by anxiety at the thought of learning a new task and become over stimulated:  (stuck in the emotion and is rendered unable to mentally assess the situation accurately).  They will then begin to  over react, “over feel” frustration and either act out or shut down:  (fail to organize stimuli effectively and fail to Identify). They will then proceed to get lost in that level of frustration and fail to try to gain control of their frustration (unable to process through stimuli and problem solve ). They will give up (fail to find a solution).   Thus the sensory kid, who is not taking in given stimuli accurately, organizing  effectively, will be unable to move thru these necessary processing and can have great difficulty with attention span, thus, affect the ability to learn a new task, such as learning to read.

     It is important to know that it is difficult to understand in the beginning if this is just a “sensory issue” or a separate issue all together.  Time will tell.  As you work with your child, and help their world’s to become more “sensory integrated”, if it is just sensory related, their attention spans will grow to an age appropriate range. It is important to understand that you must sensory integrate your child before you heap upon him big learning challenges that are not yet within his/her emotional range.  To do so before they are sensory ready will only serve to frustrate you and your child, and lead to failure.  Do not misunderstand, all children no matter where they are can and will learn.  It is just very important to understand where “your” child falls on that curve…Very important.

     Social cues, Filtering, Boundaries setting proper limits & respecting them:  Sensory kids can exhibit problems in these areas as well.  First, their proprioceptive “time & space” is often off, again a mismanaged central nervous system.  These kids have a difficult time assessing themselves “in the moment”, mentally & physically.  Which can lend itself to social problems.  For example, the local playground:  By as young as age three, kids are starting to take in, understand, and manage some social protocol.  Waiting their turn at the slide, respecting others space such as not bumping and leaning into others, learning not to dart into others to avoid collisions, standing at an appropriate physical space next to another.  Voice regulation: not speaking to loud or too soft.  The ability to filter starts to develop: When kid’s start to learn the ability to appropriately respond to others in a way that is conducive to relationship building. They learn that they can control what they “voice”, choose their words more carefully as not to alienate others.   Able to accurately “read” other’s body language:  a smile means “I like you”, a frown conveys “back off”.  Kids are learning to intuitively “feel” the emotional, physical and social temperature in the given social setting, and adjust their actions age appropriately.  They understand and are able to adjust their mind and bodies so that they “fit in”.  All of these milestones are the early building blocks in becoming social integrated.  In order to read social cues, properly filter, set & respect boundaries both physical and mental, these things must happen:  A) Perceive & read the social protocol of the playground (assess) B)   Be self-aware of how they are acting and how their actions are affecting others (Identify)  C) Recognize proper ways in which how they can navigate assessed “social protocol”. (problem solve)  D) A desire to adjust/ successfully Change their behavior to socially acclimate. (Choose age appropriate reactions).  Sensory kids often are not physically integrated into their worlds.  There also can be a misfire when it comes to spatial relations, “time & space”.  Again, their central nervous systems are failing to take in stimuli accurately, and organize it effectively, but now in a physical sense.  Watch some sensory kids.  They often bump, over lean, and even completely miss when it comes to relating to the physical world.  They trip over their own feet, bump into walls, fall off chairs, and miss their mouth when eating….so it is so with their peers.  You see them bump into others, crowd social space, talk too loud or too soft.  Socially, this can get in their way, and if at the same time they are unable to take in social cues accurately, problem solve and make appropriate adjustments…..well….do you see how it all ties in?
      The good news is, as they become sensory integrated, emotionally, mentally, and physically, the rest will fall into place.  Chances are high, because you have worked so hard as a parent, gone above and beyond with communication, setting examples, patience, and behavior management programs, because you have instilled in them many ethics and values that many non-sensory challenged kids have yet to learn, when all of you turn this corner….much of your future work could be easier…you may indeed find your children ahead of the game.  I have witnessed this phenomenon in my own children. So as I have always said…there is usually a  pay off at the end of  every the tunnel.
     Impulse Control & learning from past mistakes:  The sensory child can have a tough time here as well. Again, let’s look at the cycle.  Impulse control: assess- identify- problem solve- make appropriate choices….In order for a child to master Impulse control many things have to happen correctly.  Consider this:  Johnny is playing ball outside with several of his friends.  Kids are laughing, running, yelling.  Balls are flying and it is hot outside.  The ball inevitably ends up flying in the street….and of course, it is  your child who runs into the street to retrieve the ball without even looking up to check for cars….an accident waiting to happen.  Impulsive.  Let’s examine what went wrong from a sensory standpoint:  First it is likely that your Johhny’s central nervous system failed to take in the external stimuli accurately (in this case too much-over stimulated), and then failed to properly organize it.  Chances are high that the laughing and yelling was perceived by his brain to be much louder than that of his peer’s brains.  The running and ball flying, probably way too much stimuli and was perceived by his brain as frenzied and chaotic.  The hot day, if the other children were feeling the effects of the heat, Johnny was probably boiling hot and it was starting to affect him mentally and emotionally.  His brain/central nervous system most likely started to “short circuit” before Johnny even had the chance to Assess: The ball went in to the street. Identify: Move from an excited state to one that allows one to stop and think.  Problem solve: recognize that streets can be dangerous.  Choose appropriate response: Look both ways before carefully entering the street to retrieve the ball. Instead, Johnny ran into the street without breaking speed.   Do you see the connection?  Johnnie's impulsive nature is directly tied to his sensory issues.  And can you imagine how difficult it would be to demonstrate the ability to learn from past mistakes when your body is unable to A) accurately take in and B) organize the “moment” smoothly, and in a time efficient manner that is required in order to make good choices?  When prompted, either before playing or after, Johnnie may be able to explain the dangers of running blindly into the street, but that does not mean that while in “the moment”, he can effectively process himself to a state that facilitates non-impulsive actions and good choices.  So you can see how sensory issues can lend themselves to impulsivity and appear that the child is unable to learn from past mistakes.  I believe that these children do indeed learn, they have the ability to understand, but the problem lies more in their ability to react appropriately while in the moment. Have you ever gotten lost in an unfamiliar area while driving?  Remember how that felt?  Most likely you became disorientated and frazzled which caused you to be unable to think clearly, so you kept going in circles, making wrong turns over and over, when if you had just pulled over and made a call or consulted a map you could have avoided the whole situation.  Your central nervous system temporarily “short circuited”.  I believe that this is how sensory kids feel on most days. 
     Sensory challenged kids are often delayed when it comes to some or many Emotional Milestones.  In my opinion they are often misunderstood and can get a bad rap, as well as us parents.    Sensory Integration disorders are still relatively new to the medical arena, and much is still needed to be understood.  It is difficult to understand how sensory issues can lend themselves to poor behavior.  Kids can be viewed as spoiled, out of control; “bad”….Parents can be seen as irresponsible, ineffective, and oblivious.  I believe that this is not the case.  When you look at behavior from a sensory standpoint, see how it directly effects things like emotional regulation, impulse control, attention span and mood, you can begin to understand your child.  Begin to help them. 
     The great news is that research shows that with early intervention, great strides can be made to help your child’s brain/body to integrate and organize with the outside world.  Buy the books, find the professionals, do the work, if it fails try harder.   Don’t give up. 

     I want to add that this post, as with all my posts, is an eclectic collection of ideas that I have learned from health professionals, teachers, family members, close friends, as well as some of my own thoughts.  I make no declaration that I have it all figured out, because I don’t.  I suppose I could easily find some who agree and others that  don’t.  My point in sharing these thoughts is just that.  Sharing.  If you take something away from it that helps, then that is what I think counts.  
  Hope this helps,

Sunday, April 7, 2013

Sensory Processing Disorder & and learning to read.

     Sensory Processing Disorders & Reading.....This was a tough one.  My Michael struggled with learning to read.  In short, he hated it.  Here is why.  As I have mentioned before, kids with Sensory Issues are often behind in some maturity milestones.  Particularly frustration tolerance.  Learning to read requires a lot of patience and having to deal with frustration.

     Michael's ability to deal effectively with feeling frustrated at the beginning of 1st grade was probably about that of a 4 yr. old.  His reading level at that time was barely meeting kindergarten requirements.

     I choose not to worry about it.  I choose to work on his emotional needs first.  I felt that he needed to acquire skills such as frustration tolerance, patience, anger management, impulse control....pretty much anything that came under the umbrella of "emotional regulation".  I let his teacher know that this was my chief area of concern, so reading, writing, etc...would not be a daily part of our regime.  If Michael got through the day sitting still, keeping his hands to himself, and was able to follow rules I would be thrilled.

     About 1/2 way through the year, they did their quarterly standardized testing.....Michael came in at the 5%.  His report card reflected that he had not yet met the standards   I panicked.  I  second guessed myself.  What was I thinking?  OMG!!!, I was completely off!!! While we had made GREAT strides with emotional regulation, I had set my son up to be completely behind academically......I had failed as a parent. UGH.

     So I called one of my trusted advisers who had already been through all of this, who knew my children, and asked their opinion....Their advise seemed wise, so I took it.

     Twelve weeks later, Michael is not only reading, but has caught up to first grade reading standards.  As a matter of fact, today, 15 weeks later, he has met all the requirements outlined for the end of 1st grade.

     I was not wrong.  I had not failed.

     Coincidentally, when I discovered that Michael was so behind academically, it was at the same time that I was starting to see some real success in regards to emotional regulation.  It was time. Michael was ready to handle the pressures of learning to read.

     Here is what I did.

     I took all the 1st grade level books and tucked them away.  I pulled out all the books that he should have already mastered in Kindergarten.  "Little A & Little B" books.  Books that some three year old's were already mastering.  I did not care.  This is where we would start.  I would make it as simple/easy/stress free as on him feeling successful.  I never corrected him, never..when he stumbled on a word, I never let him struggle, I just read it for him.   Let him see that he could.....  He cried and cried through the entire first step process.  10 minutes a night.   I did this for about four weeks.  I did this until Michael was so adept at reading these books he could read them without looking at the pages.  No, Michael was not reading yet...he had memorized....but he was starting to feel successful.....

     Second stage.  I took him to books like "Green eggs & Ham".  Again, books that Kindergartner's were mastering.  Books that had lots of rhyming.  10 minutes....Lots of crying.   I just let him read.  Again, I never corrected him.  This is important.  The Sensory child is so concerned about failing, unable to move through mistakes,  that it can become a road block to learning.  So I made sure reading was an "error free" zone.

  At this point I started flash cards.  Twenty five a night..before reading.   I noticed  that flash cards were a breeze for him.  He could memorize, but did not have the patience yet for phonics.  That was okay, let him memorize....many words in early reading books are site words so I figured that  the more words he knew on a page, the more successful he would feel...can only lend itself to more success..  I also noticed that  he was extremely proficient at flash cards, when he read them one at a time.  However,  he struggled when it came to reading those same words in a sentence.....hmmmm....he was still too stressed to realize that he knew the words...that was okay, we kept going.  I eventually started putting his flash cards in five word linear groups, in sentence format.  This was a big shifted him from reading one word at a time in flash card style and got him comfortable with reading in sentence format.....and then we were off and running......

     Eventually, Michael felt successful enough to start trying to sound words out.  Phonics.

    Twelve weeks later, ten minutes a night & flash cards, report cards came....I believe the words verbatim were, "Michael has made "extraordinary" leaps in regards to reading and writing".  "I can see how hard you have been working at home, Michael is now meeting 1st grade standards".  TWELVE WEEKS....TWELVE!!!!!!  We had accomplished in twelve weeks the same skill sets that other moms have been working on since they were babies...

     Three weeks later, I checked Michael's reading levels just tonight, and found that he is meeting all reading standards that he needs to meet by the end of 1st grade...  Eight weeks left, he is ahead of the game...  Imagine what we can acomplish in eight weeks.  HA!

     Don't misunderstand, I am not bragging....My point, My big lesson learned as a mom.  While I will never undermine the importance of reading with a child, working on these very important skills that every child must master, remember that it is also very important that with Sensory children, you must meet them where they are.  Meet there own personal & unique needs first.  The rest will fall into place.

     Michael no longer cries when he reads.  He exclaims, "reading is easy!".  It makes me cry.  I am so proud of him.  So happy to see him feel proud.....

     So these are my tips....I hope they help...