Tuesday, June 10, 2014

Viewing the World Through Sensory Lenses

“For most of us, the delicate interaction between the brain and body known as sensory integration is nothing short of marvelous.  It allows us to move purposefully through the world without being driven to distraction by the cacophony of sensory experience that bombards us each moment we are awake.”
 -“The Sensory Sensitive Child”



             Today we were once again at the pool, Ben’s new favorite hangout spot.  The pool was getting quite crowded on this Saturday afternoon, but Ben didn’t seem to mind.  He was happily floating on his new shark noodle in the shallow end of the water, when I noticed a mother and her young son entering on the steps.  I had seen this particular boy at the pool before, always sitting off to the side near the chairs while his siblings swam, splashed and had fun.  He had attracted my curiosity then because he hadn’t seemed the slightest bit interested in the water.  He seemed more than content to play with his dinosaurs the entire hour.  But today, he was glued to his mother’s hip, clinging onto her for dear life, as she determinedly plunged them both into the water.  And then the screams began.  The boy was clearly doing everything in his power to make it quite clear that he wanted nothing to do with the water.  I turned my attention back to Ben as the wails continued.  I politely ignored this for the next several minutes, but when the plaintive cries did not subside, curiosity got the better of me.  As Ben swam close to the mother and son, I gave the mom my most understanding smile and told her confidingly, “My son used to cry in the water, too.  He still hates to get his face wet.”  Her expression visibly changed to relief and she let out a huge exhale.
            “I just don’t understand it,” she gushed.  “His brother and sister swim like fish.  He’s almost three years old, and I can’t let him sit by the side of the pool forever.” 
            I hesitated, knowing it would sound like an odd question, but I plunged ahead anyway. “Can I ask you something?  Does he like to swing when you take him to the park?” 
            “Why, no, he doesn’t” she said with a look of utter disbelief.  “He never has liked swings.  How could you have possibly known that?” 
            “Well,” I said carefully, “It may be a sensory issue.  He may not like the sensation of floating and flying through the air, when his feet leave the ground.  I noticed he was much more comfortable on the steps where he feet touched the bottom and wasn’t crying nearly as hard.” 
            The more we talked, the more this Mom opened up.  I was happy that I was able to pass on a few ideas to her, because I know the feeling all too well.  I know how it feels to be baffled by your child’s behavior.  Watching her little boy in the pool reminded me of my early days with Ben.    
            Ben’s behavior was always somewhat of a mystery to me, even from the beginning.   I remember the day after Ben was born, he cried loudly and inconsolably for what seemed like hours.  I remember rocking him back and forth while wondering if I was ready to be a mother.  The nurses would whisk in and out of the room, showing me how to swaddle him and jiggle him in just the right way, which helped for a while, but soon enough, the crying would start again.  The first few months of Ben’s life passed in a hazy blur of rocking, swaddling, and cuddling him close.  I frantically searched the baby books for advice, and I reassured myself in the fact that all babies cry.  Still, I sensed that there was something I was missing.  Sometimes Ben would screw his little eyes closed, as if the outside world was just too much for him. 
            Fast forward to his third birthday.  By then, Ben loved Thomas the Train, as many little boys do at that age.  We decided to throw him a big party with all of his buddies from school.  We rented out the community clubhouse and carted all of his train toys into their great room.  We hung Thomas balloons from the ceiling, strung brightly colored streamers from the walls, and filled the room with loud, upbeat train music. Finally, the big moment arrived.  All his friends where there, ready to celebrate.  It was time for Ben to make his grand entrance.   I walked Ben into the room while everyone eagerly leaned in to catch his reaction, video cameras glued to his face to capture the moment.  We all watched in disbelief as he studied the room, his normally boisterous personality suddenly very subdued.  Then, he quietly snuck over into a corner, slumping down on his Thomas chair, as silent tears began to pour down his face.  My dad joked he was crying tears of happiness, but the worried feeling inside me grew. 
            Everyday tasks were often very difficult for Ben.  On nights when we had to wash his hair (a task I always gave to my husband because I just could not bear it), I feared the neighbors would think we were torturing our child because of the heart-wrenching screams.  “No hair!” he would beg nightly at bath time, for fear that this would be the night when we would force this upon him.  Most nights I would let him off the hook, because I could not handle the emotional toll of the ordeal.  The same held true for clipping his nails and cutting his hair.  I would watch the other children at the "Little Tykes" hair salon sitting so still for the stylist, while my child twisted his body like a contortionist in a heroic attempt to escape the race car chair.  I felt like an accomplice as I held his head in a deadlock so the stylist could finish the job.  We would bribe him with several lollipops to get through.  I would wonder why it always had to be such a battle.
            And then there was the time I had to take him to the eye doctor.  The doctor needed to dilate his eyes.  After pleading with him to open his eyes, just a little, I finally had to sit in the chair myself and restrain my little guy so the doctor could finish the job as he thrashed and screamed.  Weeks later, Ben would still talk about how Mommy held him tight at the doctor’s office, and the guilt inside me grew a little more.
            Mealtimes were especially challenging.  There were only certain foods that Ben would eat, and he wanted the same foods every single day.  Then, for no apparent reason, he would refuse to eat them anymore.  Like the day he stopped eating bananas, then mandarin oranges. My husband and I knew better than to make mealtime a battle, but I still felt like a horrible mother because there was little variety in his diet.  I had always sworn that my child would never know the taste of fast food, but McDonalds was slowly becoming the dinner of choice, especially on busy nights.  
            And then there was the way he would smell everything and everyone.  He was forever carrying around his favorite stuffed bear, holding its well-worn paw to his nose.  Anytime we would go somewhere new and different, he would loudly ask, “What’s that smell like?’  Sometimes he would walk up to strangers and sniff their clothes.  Odder still, at four years old, the teacher at school was reporting that he was putting everything in his mouth.   Things like Easter grass from the sensory bin.  Then, I watched one day during karate class as he bent down and licked the karate mat.  What was going on with my child?
            Luckily it was during this time when a colleague happened to be at a teacher training with me one afternoon, and as we were catching up, we were surprised to discover that we were both concerned about our sons, who are roughly the same age.  She shared with me that her son had started seeing an occupational therapist named Jen, and that this therapist was offering a free parent workshop if I wanted to come and learn more.  She said that Jen really “got” her kid.  Now, being in the school system, I’m familiar with OTs, but I had mostly thought of them as people who worked with kids who had physical disabilities or severe gross motor and fine motor issues.  With some trepidation, I decided to go check this place out.
            When I arrived at the sensory clinic, the woman behind the counter was barefoot and wore a tie-dyed shirt.  I quickly learned she was also the owner.  Jen immediately captivated me as she opened my mind to the sensory world.  I’ve always loved to learn new things, and for the next hour, I soaked up everything that I could.  This was the beginning of my journey into understanding sensory integration.
            I learned from Jen that we experience the world through our seven (yes seven) senses.  We all have sensory needs that are different for each person. Some people need their morning cup of coffee to get them going.  Some people need a shower in the morning to rejuvenate them at the beginning of their day.  Some need it completely quiet when they’re working, while others prefer background music.  Some, like me, don’t feel right if they don’t have “their” seat in the conference room or “their” exercise equipment at the gym.   However, most of us can manage our sensory needs without much issue.  Our brain blocks out the irrelevant sensory information before it ever reaches our awareness level, noises like the hum of the air conditioner or the cars driving by outside.  Without this “pruning” function of the brain, we would be incapable of getting through the day.  Our world would be too overwhelming, distracting, and we would cower and hide from it all. 
            For a child with sensory processing disorder, like my son, the pruning function isn’t working correctly, and things that we take for granted are extremely challenging for them.  Jen compares this sensory malfunction to a radio that either is playing to loudly or too softly.  Every sensation is amplified, from the buzzing of a light to the painfully scratchy sensation of a t-shirt tag to the noxious odor of someone’s fish sandwich at the next table over at the restaurant.  To complicate matters, everyone experiences sensory input in different ways.  The more Jen talked, the more the light bulbs flashed in my brain.  This is why Ben covers his ears every time the toilet flushes and why he hates to get his face wet in the shower.  I was hooked and eager to learn more. 
            Over time, I learned that my son is mainly a sensory seeker.  He craves sensory input.  This is why he runs his fingers alongside the walls in the hallway of school as his class walks.  This is why he loves the feeling of his whole body in the sand and the squishy feel of mud between his toes.  This is why he needs time every day, often multiple times a day, to swing, jump, and crash into mats.
           With Jen’s help, along with his OT at school, we created a sensory diet for Ben.  This is a daily plan that includes opportunities throughout the day to meet his sensory needs.   Here’s some examples of Ben's unique sensory makeup, as viewed through the lens of the seven senses:




Vestibular (Balance and movement)

The vestibular system is located in the inner ear and helps to control movement and balance.  Anyone who has had an inner ear infection has felt the ill effects of the vestibular system.  Most people have also felt the effects when returning to land after spending the day on a boat, or after riding a roller coaster.  Ben seeks vestibular input.  He is in constant motion.  He craves movement.  He is happiest when he is running, whether it is along the beach, through a field, or down the sidewalk.  He also loves equipment that lets him move or spin, such as swings and merry-go-rounds.   I learned that by giving him time to swing every day, Ben can stay much more calm, centered, and ready to learn.  We even purchased an Ikea swing for our play room so that he could have swing time during the day.

Proprioceptive (Positioning of the Body)

Proprioceptive input comes from the sensations of joints, muscles, and connective tissues, which leads to body awareness.  By pushing and pulling items, Ben can stimulate his proprioceptive sense.  Often, Miss V, our OT at school, will take Ben on the playground and encourage him to use the monkey bars.  She also encourages him to jump on the trampoline, and do heavy work activities.   As a sensory seeker, Ben benefits from deep pressure.  Weighted vests and blankets help him to stay focused in school.  He also loves tight bear hugs and squishing activities like rolling up into a burrito with a yoga mat.  In fact, as I'm writing this, he is begging me to "make him a burrito." This also explains why he loved to be swaddled as a baby.  Some children are sensory avoiders.  These children resist touch.  They may not like to be hugged and may pull away their hand if someone tries to hold it.  It is important to know and respect your child’s sensory needs. 

Touch:  Tactile

Ben also loves the feel of soft and squishy things, such slime, play-doh, and wet sand (see picture above).  He enjoys the feeling of soft and "cozy" things, such as piles of stuffed animals and warm blankets.  Lately, he has been interested in the texture of yarn.  For the past few nights, he has rummaged in the upstairs closet and pulled out every crocheted blanket to pile on his bed.  He even added his nap mat recently returned from school on top of his bed mattress, for an "extra cozy".  He experiments with running water, but he hates getting his face wet.  His swimming teacher discovered it is because he hates the feeling of water inside his nose (don't we all!)  Recently Ben has had a major breakthrough with water and now gives himself showers and washes his own hair.  My husband and I think that by being in control of the hair washing experience, it is less traumatizing to him.

Taste/Chew:  Oral

I learned from Jen that chewing, sucking, blowing are organizing to the brain and can improve attention, body awareness, and muscle tone.  Ben loves to blow balloons and eat crunchy things.  He also loves to eat anything sweet (as in the picture above, where he is being spoiled by Granny at the fair).  Every time he visits Ms. V, the OT at school, he gets a balloon, and he loves blowing them up at home.  My back room feels like a perpetual birthday party as I constantly kick balloons out of my way.  Thankfully, we have curbed his desire to put inappropriate things in his mouth, like the Easter grass. 
Look:  Visual


If the vestibular system is not working properly, eyes cannot work efficiently, which makes things like catching a ball, tying shoes, and reading difficult.  After the disastrous eye doctor visit, we did find out that Ben has perfect vision.  However, he has difficulty with something called motor planning, which is the ability of the brain to imagine an idea and then organize and carry out a sequence of unfamiliar actions.  This is why they set up obstacle courses in OT and encourage him to crawl through tunnels, climb an inclined hill, and weave through cones.  Ben still has difficulty with things such as fastening buttons, zippers, and clicking the seat belt in the car.  

Hear:   Auditory

Even though his hearing is fine, auditory processing can be difficult for Ben.  He has trouble focusing on what someone is saying, especially if there are other noises in the room.  For example, if a teacher is reading a story to the class, he is equally hearing her voice along with all the other “background noises” that most of our brains can automatically filter out.  He hears the class down the hall coming in from recess, the bubbling of the fish tank, the whoosh of the toilet flushing as a student returns from the bathroom.  It is not that Ben can’t hear, it’s just that he has trouble “dialing down” the external sounds and attending to the speaker.  He can handle loud noises that he can anticipate, like the whistle of a train that he sees coming (see above), but he is still sensitive to sudden noises, like fire drills.   He has become more accustomed to this over time and usually can handle it without melting down.  He is learning that these noises are startling but not threatening, and that he can put his hands over his ears and that eventually the noises will stop.  Social stories have also been very helpful with this.

Smell:  Gustatory

Scent is one of our most powerful senses.  It is a sense tied to long-term memory.  This is why when I smell my grandmother’s cooking, I am automatically taken back to childhood memories long forgotten.  One of my favorite pictures of Ben at Halloween is the one above, where he smelled every piece of candy in his bucket.  My son has a keen sense of smell and looks to it for comfort, which is why he smells his stuffed bear.  He is also bothered by unpleasant or strong odors, which is why he often asks, “What’s that smell like?”, and he is learning that it’s not polite to comment on people’s unique odors in public.
           


            Now that I view the world through sensory lenses, I won’t say that Ben’s problems have all been resolved, but I know that I am much more patient and understanding with him.  When Ben is having difficulty with something, I first investigate to see if there is an underlying sensory cause, and often, there is.  In the past, I was quick to dismiss his complaints about scratchy socks or shoes with sand inside them.  Now I take the time to address his sensory concerns, because I’ve learned that his sensory pain is very real.   Sometimes it’s as simple as giving the control over to him, such as letting him wash his own hair.   I have learned that all behavior is communication, and by using sensory strategies first, I have seen Ben’s meltdowns become less and less frequent.  When a meltdown does happen, Ben also much better at self-regulating, such as squeezing a squishy ball or taking deep breaths and going into a quiet place.  This has allowed him to control his own emotions and when he has a meltdown, they are generally much shorter in duration.  And now, just like my day at the pool, I try to view all people through a sensory lens first.   By addressing our sensory needs, we are all much more likely to feel comfortable in our own skin.







8 comments:

  1. Incredibly thoughtful and comprehensive. You reminded me of how sometimes when we reach out to people it can really help. (I've had people who know my son is on the spectrum get that horrified look when I say, "Oh, he does that!" - Ugh. Like your ben, my G is PERFECT.)

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    1. I know the horrified look of certain parents all to well, Full Spectrum Mama. I always fight this inner battle about what to say to other parents when I see certain...tendencies....in their children. Generally, if I see an opening in the conversation, I might slip something in and see how it goes. We Mommas have to watch out for each other!

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    2. MOMMA POWER.
      It genuinely helps to feel that sisterhood - it's just nauseating when this happens and, really, clueless too. Not that it's all a piece of normal cake...whoops better watch my metaphors... Anyway, exactly, we watch out for each other whether sharing information or pain or joys...

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  3. What a terrific post. I thought the sensory diet was so hard to understand when we were first learning. You have done a terrific job of breaking it down.

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  4. Thanks, Robyn-coolestmommy. In many ways I'm still wrapping my mind around the sensory diet and what my kiddo needs to feel calm and regulated in this world, but I have a suspicion I will be constantly re-evaluating his needs as he gets older, which is as it should be. I've also become more aware of myself and my sensory needs through this learning process, which has been possibly the most eye-opening part of all.

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  5. This was very perceptive. I loved how into understanding your child. I am on the autism scale...and my needs have fluctuated as I age. I would say I am more picky now but luckily also in more control so I seem less agitated. It is VERY painful to live in a world that is so loud, tight, bright and constantly assaulting. This was a beautiful way to describe your journey! Thanks:)

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  6. Lovely post! I really enjoyed reading it. You do a wonderful job explaining sensory processing issues.

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