OT what is it??

OT what is it??
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Tuesday, March 1, 2011

Quirky Kids: Sensory Driven--what makes the TICK what makes them TICKED


The story of two children:
Johnny:
Five-year old Johnny is a mess. His teachers float between anger and frustration about him.  He has few friends and those he makes he cannot keep.  His parents walk on eggshells around him never knowing how he will react in a given situation.  And even worse, he talks about not liking himself and how he hates “everyone”.

In school he can be great, but then the fire alarm can go off and he is a “lost cause” for the rest of the day. Unable to “reset” himself, he stays “on guard” and anxious.  He does not like to stand in line to go to lunch because he says that the other kids “hit him”.  On the playground he is a “wild-man” running with abandon bumping into people and things and barely noticing. His gait is awkward and he cannot reasonably participate in team sports. He habituates wearing the same clothes so Mom has several of the same outfits ready for him each day.  He does not eat in school because the smells in the lunchroom “make him sick”.


Brent:
Brent is 6 years old.  He is smart, both his parents and his teachers agree on that.  At home he is interactive and plays well with his older brother Max aged 8.  Mostly he plays with Max’s friends and they generally include him.

At school the children are friendly to him, but he rarely gets invited for play dates, and during recess he seems to be a loner or randomly hangs with the same 1-2 classmates.

While he is not the athletic “star” he is not the worst either, but he is at the lower end of physical performances.  Academically bright, he nonetheless is very forgetful and turning in homework is a problem.

He insists on wearing long sleeves even in the summer and will not go into the water at the beach without a full body suit or at minimum a long sleeve t-shirt.

Although congenial and generally obedient, he does seem to be always in a “fog” needing guidance and redirection.

What is going on with these children? Are they lazy? Defiant? Uncaring?  The answer is most probably an unequivocal NO.

Both Brent and Johnny are having processing issues.  Obviously Johnny is much more overtly involved than Brent, but both are displaying developmental “red flags”.

Taking a sensory processing view of these behaviors, several issues come clear. Breaking observed behaviors into auditory, visual, tactile, movement, body awareness (muscle/bone/joint), olfactory/taste, and emotional categories it is easy to see the patterns of a skewed sensory processing impacting all of the above areas.

Johnny needs sensory “calming” while Brent needs sensory stimulation.  Both are having sensory processing issues but at opposite extremes.  Johnny needs to learn how to slow it down, and Brent needs to learn how to be more fluid. 

Brent needs to learn to be more assertive and to learn to try new things.  Johnny needs to learn how to be more discriminating and make better activity and behavioral choices.  Brent is probably harder to identify than the “squeaky wheel” Johnny. But clearly they both need help developing skill sets that are more in line with their life demands.

So how do we know when to seek outside help, and when to not? Although there are many developmental checklists online, I caution readers to use them sparingly and in conjunction with input from an occupational therapist or other related professional. One concern does not make an “issue”.  However, there are some questions you can ask yourself as a guide to whether or not you should look deeper.
You may want to ask:
Does your child_____________
§ Seem to need more “protection” than other children
§ Excessively fidgets or appears “on the go” most of the time
§ Seem to be unusually forgetful
§ School is a struggle
§ Refuse certain foods
§ Reject certain textures in clothing and/or habituates wearing the same clothes over and over
§ Motor skills are intimidating
§ Resist combing his hair/getting it cut
§ Seem to have “weak” muscles; tires easily
§ Has a difficult time calming down when upset
§ Has difficulty accepting criticisms
§ Social issues dominate school concerns
§ Doesn’t want to go to school
§ Depression* (*anger, “show off,” hypochondria, bossy behaviors, to name a few)

If your “quirky” kid has a reasonable number of friends, gets good grades, is generally an easy member of the family, has age-appropriate interests, is able to transition and go with flow, etc., then just love his quirks.

If however, any of the above-mentioned items are a concern to you, then I suggest you
consider consulting a developmental pediatrician.  They usually provide a lot of much needed answers. It is important to note that there is a huge difference between a developmental pediatrician and a general pediatrician.  The one most families go to is trained to look at developmental milestones, wellness and the absence of illness. The developmental pediatrician looks at neurological, emotional, physical and motor/cognitive development.  They look at the “nitty-gritty” of development and can discern if there are ambiguities that need to be addressed. They are one-stop shopping in the discovery process of how and why your child is performing the way he/she is.

To quote Mel Levine, MD author of “One Mind at a Time”; “Children do not outgrow anything but their clothes.”  So do not wait for your child to “grow out of it” or to “mature”.  Specific issues evolve but they do not go away, and research clearly supports the benefits of early intervention.

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