Gravitational Insecurity Activities

Children with gravitational insecurity typically respond to movement activities by overreacting emotionally.  Why?  Their vestibular system is not functioning properly. These kids are extremely afraid of heights, falling, and they resist having their feet leave the ground. For this reason, children with gravitational insecurity children prefer to stay low to the ground.  They are typically lying down or sitting and doing their best to avoid movement.

How can I help my gravitationally insecure child?

1. It may be helpful to physically guide your child during play activities such as climbing, sliding and swinging. You can swing with your child in your lap, and this might provide just enough security to prevent a fearful response.
2. Encourage your child to participate in climbing, crawling, and jumping activities that are within his comfort zone.
3.  Demonstrate movement activities such as this for your child, “watch me to this, or do it just it the way I do this.”
4. Introduce new movement activities gradually and a little bit at a time.
5. Encourage water play in the pool that includes movements such as twirling, jumping, and flipping.  The water might make your child feel more secure.
6. If your child has extreme responses to movement, I recommend pursuing occupational or physical therapy. 

 freedigitalphotos.net by dvrcan

Activities for Tactile Sensitivity

 

Photo by Sattva @ Freedigitalphotos.net 

 

      Try these activities with children who have tactile sensitivity. Any child's sensory system will benefit from these activities, defensive or not. Just be sure and remember to start slowly, and DO NOT force any input that your child resists. If your little one is extremely resistant, it’s probably time to consult your pediatrician and ask about the possibility of occupational therapy. There are more advanced treatments that can only be carried out under the supervision of a therapist. 

• Spend a few extra minutes after bath time to vigorously rub the child with a towel, or guide them in doing so.  
• Rub lotion or powder on the legs, hands and arms while singing (for distraction purposes). Let them also rub the lotion or powder on you, especially if they won’t tolerate it on their own extremities.
• Pretend face washing or shaving- with different textures of cloth or towels.
• Use a variety of textured materials such as corduroy, fur, terry cloth, etc. and rub on your child’s back, arms and legs.
• Put textured mittens or puppets on child’s hands and let him or her take them off.
• Encourage your child to play in binds of sand, rice, beans or popcorn. Hide items and have the child locate them, guessing what they are while still covered. If your child won’t touch the textures, provide cups and shovels for play.
• Have the child roll up in a blanket or sheet, then play hot dog – press on mustard, relish, etc., and then have them roll out.
• Put shaving cream, lotion, or pudding on a large piece of aluminum foil and have the child draw a picture or write spelling words. Be sure to get both hands messy!
• Finger painting or body painting with water-based paints. 
• Play in play dough or putty. Pulling, squeezing, rolling, etc.
• Draw numbers/letters on the child’s back, arms, lets, etc. and have him identify. You can make it a multiple choice or yes-no question - Is this a 2 or a 5?
• Provide activities that provide tactile input on the child’s entire body, such as a kid pool full of styrofoam, big soft pillows, or balls.
• Games with physical contact are good – bear hugs, piggyback rides, wrestling, back rubs, petting animals.
• Identifying objects with eyes closed – keys, comb, marble, block, coins, shapes, etc.

OCCUPATIONAL THERAPY: It's the Little Things that Make Life BIG!

Photo Credit: thanunkorm @Freedigitalphotos.net

Thanks to Cara Koscinski, MOT, OTR/L (The Pocket Occupational Therapist) for this informative "OT Month" guest post!

Is it Sensory or is it Behavior?

A child screams, yells, and hits other classmates at school.

Your daughter refuses to get her hair washed.

People stare at you because your son has thrown himself on the ground and has a tantrum-right in the middle of the mall!

The scenarios above occur daily in some of our lives. Our children have difficulty processing sensory input, making transitions, expressing their feelings, and controlling behavior. People often stare and offer suggestions about discipline, which we know won’t work for our kids. This situation is not only frustrating for the child, but leads many parents to believe that they are failing. So, the question remains….how much is behavior and how much is a sensory processing difficulty? Occupational therapists can help parents to determine the answers and provide strategies to help your child. Behavioral therapists may imply that the child is looking for attention. Each discipline has their theory as to what underlying issues are. Often, parents argue among themselves whether the child is ‘acting out’ or having a response to sensory stimuli. The entire situation becomes frustrating and overwhelming for everyone. As a result, cooperation from the entire team is a must!

Sensory processing and integration is our ability to take in information and make sense of it. Our brain compares the information with our previous experiences in order to determine what is dangerous to us and what/how we should respond. Children who have mature sensory processing systems are able to effectively take in and process the information and form an appropriate response. For example, a child is at school and the fire alarm sounds. He quickly raises from his desk, gets into line, and exits the building. However, a child who has sensory processing difficulty hears the fire alarm and screams in absolute panic, next he runs for the hallway in attempt to escape. He is unable to organize himself to finish his day and is sent to the counselor’s office. He is labeled a ‘difficult child’ because he often exhibits aggressive behavior in response to something that others consider harmless.

Determining sensory verses behavior requires some detective work. In my book, The Pocket Occupational Therapist for Families of Children with Special Needs, I encourage families to take a step back and analyze a child’s behavior by asking some key questions. What is the environment in which the behavior occurs? What happened before the child began the behavior? What was the child’s response? How did the adult respond to the child’s behavior? How did the child recover from the episode? If the behavior was prompted by a sensory experience then talk with your child to determine how he/she felt during the experience.

The old saying is true, “An ounce of prevention is worth a pound of cure.” Talk with the teacher to make a plan for the next fire drill (of course, there may be unplanned alarms). Involve your child in the process. Create a social story book and review it on a regular basis. Use actual pictures whenever possible. So, take a picture of the actual fire alarm at school. Consider purchase of noise-cancelling headphones or earplugs that your child has quick access to.

Working as a team to help a child is always best. Keep a journal of your child’s outbursts and tantrums. You might see a pattern. As a parent, make sure to get support from a friend or loved one. Always remember that you’re not alone and millions of others (parents and professionals) are trying to determine the question: Is it sensory or is it behavior.

Cara Koscinski is a long-time pediatric occupational therapist, speaker, and author of the Pocket Occupational Therapist book series. She is the mother to two sons with autism. Her books include, The Pocket Occupational Therapist for Caregivers of Children with Special Needs and the Special Needs SCHOOL Survival Guide for Autism, ADHD, learning disabilities, and More! For more information, visit her website at www.PocketOT.com.

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Interoception: The “Other” Sense

Of course, occupational therapists are familiar with the traditional senses: vision, hearing, smell, touch, taste. We are also knowledgeable about the vestibular and proprioceptive senses, but there’s an “eighth” sense that may not be as familiar to us…the interoceptive sense. This sense takes the sensory input from certain internal organs and shares the information from those organs with the central nervous system. The interoceptive system regulates body temperature, thirst, hunger, heart rate, digestion, and bowel and bladder functioning.

For a child with sensory processing problems, it’s possible that the interoceptive system is impaired. Consider the following issues that are often present in individuals with sensory processing challenges:

-       Difficulty regulating body temperature

-       Stomach issues (constipation or diarrhea)

-       Challenges with potty training (may not be able to feel when bladder is full)

-       Feeding issues (decreased awareness of fullness or hunger/thirst)

-       Respiration and/or heart rate sensitivities (too fast, too slow, or problems transitioning from being sedentary to exertion)

If your child has a sensory processing disorder and struggles with several of these issues, consult with your occupational therapist. There are therapy techniques and adaptive strategies that may be effective in addressing these challenges.

Sensory Diet Activities

When a proper sensory diet is put in place, it helps a child with sensory processing issues function better on a daily basis. Typically, I recommend that a child carry out two to three of the sensory activities below approximately every two hours throughout the day. Please consult with your child's occupational therapist for recommendations that are appropriate for your child's sensory needs.

-      Lying under a weighted blanket

-      Wearing a weighted vest (as recommended by an occupational therapist)

-      Jumping on a trampoline

-      Jumping on overstuffed pillows
-   Climbing through homemade obstacle courses

-      Carrying heavy objects- i.e. Helping put away heavy groceries

-      Wheelbarrow walking

-      Tug-of-war games

-      Popping bubble wrap

-      Rolling self up in a blanket like a burrito, then rolling back out

-      Sit-ups

-      Push-ups on the floor, or against a wall while standing

-      Spinning on a sit-n-spin

-      Stomping feet/clapping hands (have the child follow your pattern)

-      Tossing/rolling a weighted ball back and forth

-   Sitting on a therapy ball and bouncing

-   Tummy down on a therapy ball rocking forward and backward 
     
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Does Your Child Have a Sensory Processing Disorder?

Pathways.org "strives to empower health professionals and parents with knowledge of the benefits of early detection and early intervention for children’s sensory, motor, and communication development." Their website has some wonderful informational videos that I'm excited to share with you. Please check them out!

Sensory Processing Videos by Pathways.org

Tummy Time Video by Pathways.org

Typical/Atypical Development by Pathways.org

The Importance of Early Therapy by Pathways.org

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Weighted Blankets

 

This article was originally written for Pediastaff.com

Have you ever felt a sense of relaxation when someone gives you a big hug? Sleeping under a weighted blanket is like getting a big, warm hug all night long. Weighted blankets provide deep pressure/proprioceptive input to an individual’s joints, muscles, and bones. In many cases, the input is calming and leads to improved sleep. Weighted blankets have been used successfully with individuals who have sensory processing disorders.

When selecting a weighted blanket for a client with sensory processing issues, the treating therapist should carefully consider the client’s specific sensory needs. There are no “official” research-based guidelines for selecting the weight and size of a blanket, but based on feedback from occupational therapy practitioners, 10% of the individual’s body weight is often effective when using weighted vests or lap pads. The treating therapist may want to start with 5 to 8% and make adjustments based on the reactions and/or feedback from the individual. If the client is nonverbal, it may be necessary to get feedback from the parents. For safety reasons, it is critical that the user be physically capable of independently removing the blanket. Most importantly, a weighted blanket should never be used for restraint purposes. If the user does not like the sensation of the blanket, use of the blanket should not be forced.

The blanket should fit evenly on top of the mattress so that no weights are hanging over the edge of the bed. This could cause the pressure provided by the blanket to be uneven. The blanket should NEVER cover the individual’s head, and parents should always provide supervision when using a weighted blanket with their child.

The effects of weighted blankets vary. Many parents have reported that the first night of use resulted in a good nights sleep for their child. However, it may take two to three nights to observe improvements in sleep. If no changes are noted at that point, the treating therapist may want to consider increasing the blanket’s weight. As stated previously, there is no evidence-based research on weighted blankets, but anecdotal reports from therapists and clients are generally positive. For someone with a disorganized nervous system, a weighted blanket may be the perfect solution for a good night’s sleep.


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Sensory Processing Disorder Support Group

I've recently become the group leader for a wonderful sensory processing disorder support group at MDJunction.com. If you have SPD or have a child who struggles with this disorder, you may want to join the support group. First you'll have to join MDJunction then join the Sensory Processing Disorder Support Group. It's all free. There are lots of conversations already going on, or you can start your own. I hope that you'll check it out...it's a wonderful resource! While you are visiting MDJunction, check out the many other amazing support groups available. It's an awesome website!

Guest Post: What is Sensory Processing Disorder?

This past year I wrote a guest post for Our Journey Thru Autism, titled What Exactly is Sensory Processing Disorder? I just found out that it was ranked in the top 10 articles for 2011...it was #3! Here is a link to the article if you want to check it out!
                                   What Exactly is Sensory Processing Disorder?

The Oprah Show Controversy

Many of you may be aware of the controversy regarding the portrayal of Sensory Processing Disorders on a recent Oprah show. The show featured a very disturbed young man who attempted to kill his mother, and during the interview the boy’s mother shared that his first diagnosis was SPD. Obviously, the boy was later given another diagnosis (I would assume some sort of mental illness), but that was never made clear in the remainder of the show. I recently wrote an article for a website called Our Journey Through Autism, that summarizing the facts about SPD, and there is now a letter writing campaign encouraging people to write to the Oprah show asking her to clarify what SPD is on a future show (http://spdfoundation.net/oprah/oprah-letter.html). I would encourage you to click on this link and join the letter writing campaign, so that we can get accurate information out to the public about SPD!

Gravitational Insecurity

On February 8^th, I shared how children with sensory issues can be classified as having sensory defensiveness, registration problems, modulation issues, and sensory integration problems. In that blog entry, I reviewed tactile defensiveness (sensitivity to touch), which falls under the category of sensory defensiveness. Today, I’m going to talk about another type of sensory defensiveness, specifically gravitational insecurity. A child with gravitational insecurity typically responds to movement activities with exaggerated emotional responses. This is because their vestibular system is not functioning properly. (For more information about the vestibular system, see the entry on Feb. 11^th)

Gravitationally insecure children prefer to stay low to the ground. You will typically find them lying down or seated, trying to prevent any possibility of movement. Children with this type of defensiveness avoid most active physical tasks and may get upset when movement is required of them. To get a gravitationally insecure child moving, it may be helpful to physically guide them during play activities such as climbing, sliding and swinging. I’ve gone down a slide with a child in my lap, and sometimes, this provides that extra security needed to tolerate the vestibular input. Also, role-playing can also be beneficial, tell your child, “watch me to this, or do it just it the way I do,” then provide demonstration. If you attempt any of the activities suggested in the Feb. 11^th post, be sure to stop if your child fervently resists an activity. Always introduce new movement activities gradually and in small doses, and ALWAYS stop if your child appears to be frightened or over stimulated. If your child has extreme responses to movement activities, I would recommend that you pursue occupational or physical therapy.

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Tactile Tips

 

Photo by David Castillo Dominici- freedigitalphotos.net

        Children with sensory issues can be classified as having sensory defensiveness, registration problems, modulation issues, and sensory integration problems. In this entry, I’m going to share a little about sensory defensiveness, specifically tactile defensiveness. A child with general sensory defensiveness is overly sensitive to certain types of input from the environment, such as touch, textures (including food textures), sounds, lights (usually fluorescent), smells, and movement. When someone reacts negatively to touch in particular, that is called tactile defensiveness. Remember in the last post how I briefly explained the tactile system? Well, just imagine if this system was not functioning efficiently. All sorts of problems can present themselves!

        There are five sensory nerve receptors in the skin that let the central nervous system know what’s going on in the environment. These receptors are light touch (top of the skin), deep pressure, temperature (hot & cold) and pain. It is likely for one type of receptor to be overly sensitive and the other to not have a problem, which explains why some children may tolerate firm hugs, and then freak out when touched lightly. Here are some signs and symptoms that you might see with a child who is dealing with tactile defensiveness.

• Frequently resists being held or cuddled by unfamiliar people
• Dislikes water splashing or bath-time
• Difficulty falling into a regular sleep/wake schedule
• Dislikes being moved quickly such as being tipped in the air, swung around, bounced, or rocked suddenly
• Difficulty with sucking, chewing, or swallowing new textures
• Does not tolerate new foods or food textures – diet is limited
• Exaggerated separation anxiety
• Sensitivity to bright lights, loud noises, crowds
• Dislikes hands or face to be dirty
• Uncomfortable around strangers or unfamiliar people
• Late with milestones such as talking, walking, sleeping through the night, etc.
• Problems with reflux or allergies to foods
• Must be in a familiar environment to fall asleep
• Prefers to be swaddled tightly, likes weight and deep pressure
• Toe walks
• Dislikes shoes and socks
• Does not crawl before walking
• Craves movement such as swinging, rocking or bouncing

       If a child has tactile sensitivity, here are some activities to try. Any child's sensory system will benefit from these activities, defensive or not. Just be sure and remember to start slowly, and DO NOT force any input that your child resists. If your little one is extremely resistant, it’s probably time to consult your pediatrician and ask about the possibility of occupational therapy. There are more advanced treatments that can only be carried out under the supervision of a therapist. 

• Spend a few extra minutes after bath time to vigorously rub the child with a towel, or guide them in doing so.  
• Rub lotion or powder on the legs, hands and arms while singing (for distraction purposes). Let them also rub the lotion or powder on you, especially if they won’t tolerate it on their own extremities.
• Pretend face washing or shaving- with different textures of cloth or towels.
• Use a variety of textured materials such as corduroy, fur, terry cloth, etc. and rub on your child’s back, arms and legs.
• Put textured mittens or puppets on child’s hands and let him or her take them off.
• Encourage your child to play in binds of sand, rice, beans or popcorn. Hide items and have the child locate them, guessing what they are while still covered. If your child won’t touch the textures, provide cups and shovels for play.
• Have the child roll up in a blanket or sheet, then play hot dog – press on mustard, relish, etc., and then have them roll out.
• Put shaving cream, lotion, or pudding on a large piece of aluminum foil and have the child draw a picture or write spelling words. Be sure to get both hands messy!
• Finger painting or body painting with water-based paints. 
• Play in play dough or putty. Pulling, squeezing, rolling, etc.
• Draw numbers/letters on the child’s back, arms, lets, etc. and have him identify. You can make it a multiple choice or yes-no question - Is this a 2 or a 5?
• Provide activities that provide tactile input on the child’s entire body, such as a kid pool full of styrofoam, big soft pillows, or balls.
• Games with physical contact are good – bear hugs, piggyback rides, wrestling, back rubs, petting animals.
• Identifying objects with eyes closed – keys, comb, marble, block, coins, shapes, etc.

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The Tactile, Vestibular, and Proprioceptive Systems

Welcome to Pediatric Occupational Therapy Tips!
I’d like to talk a little more about sensory processing disorders. Yesterday, I answered the question "What is a sensory processing disorder?"  For this post, I plan to share more information about a few of the senses that most of us don’t know that much about. I’ll start with the sense of touch….

Tactile System: The tactile system is the sense of touch. This is the sensory system that helps us learn about our bodies and our environment. It is important in the development of a child’s body scheme (the internal map of our body and how we use our body to interact with the world around us). This system is composed of two subsystems: (1) discriminatory- allows us to know where we are being touched, (2) protective- lets us know if we are in contact with something dangerous. Tactile input is very important for the development of fine-motor skills, visual perception skills, and articulation of sounds.

The Vestibular System: The vestibular system is the sensory system that responds to accelerated and decelerated movement. It is through the vestibular system that we learn directions and are aware of our body position in space. This input helps us to form a basic reference for all sensory experiences. This system has interconnections with many parts of the body and influences many different functions, for example muscle tone, postural control, balance, eye and neck muscles.

The Proprioceptive System: Proprioceptive information is sensations from muscles and joints. Proprioceptive input tells the brain when and how muscles are contracting and stretching and how joints are being compressed or stretched. It helps us to know where our bodies are in space and how they are moving. Proprioceptive input provides a calming effect. It works along with the vestibular system.

            With sensory processing disorders, one, two, or all three of these sensory systems might be involved (as well as any of the other senses). An experienced therapist can evaluate and determine which systems are involved, allowing for more specific treatment planning, which leads to more effective treatment! In my next entry, I’ll share a variety of sensory activities that are alerting, calming, etc. Cheers!

Photo by David Castillo Dominici @ freedigitalphotos.net

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Sensory Processing Disorder

   

         Welcome to Pediatric Occupational Therapy Tips! Have you ever asked yourself, "What is a sensory processing disorder?"  If so, you're in luck, because that's the topic for today!
          Does your son freak out when it’s time for a hair cut? Do you absolutely dread clipping your daughter’s nails? Does you child complain about the tags in the back of his clothing? If you answered yes to any of these questions, you may have a child with a Sensory Processing Disorder (SPD). Sensory Processing Disorder, sometimes called Sensory Integration Dysfunction, occurs when someone has difficulty taking in the many sensations from the environment and integrating them in order to respond appropriately to their surroundings on a daily basis. Professionals have estimated that somewhere between 5 and 10% of children have sensory processing problems. However, the majority of these kids go undiagnosed because many pediatricians and other medical professionals aren’t aware of the condition. Fortunately the medical community is wising up on the topic, and there is even discussion about including SPD as a diagnosis in a future issue of the Diagnostic and Statistical Manual of Mental Disorders, which is the official manual put out by the American Psychiatric Association for diagnostic purposes. However, for now, the DSM-IV does not recognize SPD as an official diagnosis, which causes problems when it comes to insurance reimbursement for therapy!

In order to understand Sensory Processing Disorders, let’s begin by thinking about the five basic senses: sight, smell, taste, touch, and hearing. In addition to those, there are three additional senses: the sensory system that processes movement, the system that tells where our body parts are located in space, and the system that lets us know how we "feel" internally. As our brains receive sensory input from each separate system, that input must be interpreted, integrated, organized, and processed efficiently, so that an individual can react appropriately to the input. For example, let’s think about the haircutting example. In the case of a child with SPD, the nervous system is “wired differently” than with typical kids, so that the sensory input is not processed efficiently. When a little boy with SPD sits in the barber’s chair, the first thing that typically happens is that a cape is place around his shoulders. If his sense of touch is involved, it’s possible that the texture of the cape will unnerve him. Then the “clippers” are turned on, and the noise that he hears is much louder and harsher to his ears than yours. In fact, to his little auditory system, the noise can actually be painful. On top of that, the barber frequently touches him and runs the comb through his hair, adding to the bombardment of negative sensory input that he’s having to endure. No wonder the little fellow hates getting a haircut!

The symptoms of SPD vary depending on which sensory systems are affected. Additional signs of dysfunction may include, but are not limited to poor sleep patterns, clumsiness, and over or under reaction to light, cold, or hot temperatures. Some children avoid certain food textures, and resist typical grooming activities such as hair washing, tooth brushing, or face washing. Many children also demonstrate an exaggerated fear of loud noises and crowds, while some little ones are extremely sensitive to touch and are fearful of playing on playground equipment. Avoiding messy materials such as play dough or finger paints and sensitivity to certain smells are also common. Children with SPD have also been described as having difficulty with transitions, and often complain about irritation from tags in the back of clothing or sensitivity to certain clothing textures. All of these issues can impact a child’s ability to interact with peers, and can ultimately lead to problems with social and play skills.

If you suspect that your child has SPD, carefully consider whether or not the issue is affecting his or her quality of life. If so, treatment should be considered. If you decide on therapy, seek out an occupational or physical therapist who has completed coursework on sensory integration theory and has experience using sensory integration techniques. Why is treatment is necessary? As children are developing, daily sensory experiences are crucial. Kids with SPD usually don’t explore their environments as typical children do, and this lack of exploration can lead to delays with gross-motor, fine-motor, and possibly speech and language skills. Through a thorough evaluation, the therapist will identify where the specific problems are, and determine the sensory input that is most appropriate for each child. During therapy, children will gain the skills needed in order to more appropriately explore and interact with the environment. An experienced therapist knows how to provide controlled input to each of the sensory systems and guide the child in making appropriate responses. It is common for the therapist to work with a little one individually in therapy on a weekly basis, as well as provide a home program to be carried out daily, or every other day. Therapy can last from several months, to several years, depending on the severity of the symptoms and how well the child responds. It is best to begin therapy at an early age, because younger children respond more readily to SPD therapy; however, this does not mean that older children will not benefit from treatment. It only means that therapy may need to be more frequent and of a longer duration.

How effective is SPD therapy? Most research on treatment of SPD has been conducted through case studies, and has been found to be effective. As an occupational therapist certified to administer the Sensory Integration and Praxis Test and 18 years experience providing therapy, I agree with the research, and I believe in SPD therapy. Admittedly, more research needs to be done on SPD treatment and its effectiveness, but personally, I have seen dramatic improvement in children who have received therapy on a consistent basis. Parents frequently share stories about how therapy helped their child better tolerate basic grooming activities, which made their day-to-day routines much more tolerable, and even pleasant. Personally, I love hearing how children that once resisted playing on the playground, swinging, or going to amusement parks are now in engaging in, and enjoying these activities. The sense of relief expressed by so many parents and the smiles on the kids’ faces are proof enough for me!

For More Information Contact: Sensory Processing Disorder Resource Center http://www.sensory-processing-disorder.com/

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