Saturday, November 15, 2008

Sensory Processing

I never gave this subject much thought until my wife started pursuing what was different about our first son Rane. Soon after he could walk and talk, it became apparent in ECFE play groups that our son was a little different than the other children. During "Circle Time", when all the parents and kids sit in a circle to dance and sing, our son wanted to leave the circle to go sit off in a quiet corner to play with toys alone. In play groups, it was our son who would suddenly blow up emotionally and need to be separated to keep him from hitting (kicking, biting, etc.) the other children. We have some close friends who have a boy with Asberger's syndrome, which is a milder form of Autism. At first my wife was suspicious that our son had some other variant of Autism, but many of the indicators were just not apparent for Rane. Rane was very picky about everything including food, clothing, riding in the car, bath temperature, getting his head wet, bedding, toys, sounds and smells. At 2 years, it was also clear he was beginning to lag behind his peers in muscle coordination. Now, I attributed a part of that to the fact he has always been in the upper 90's percentiles for height, while being pretty normal for weight. This means he's been growing taller faster than his peers. At 3 years old, he was over 3 feet tall. Now, just turning age 8, he is 54 inches tall and weighs just over 52 lbs. which puts him in the 93rd percentile for height, and 26th percentile in weight. Due to the diligent research by my wife she determined that my son was exhibiting the symptoms of "Sensory Integration Dysfunction". It took me awhile and some extensive reading to come around to understanding that our son had some special challenges, but now that we understand it better we can do things to help his nervous system integrate normally.

Unfortunately, Sensory Processing Dysfunction, while discovered and written about for 30 years, is just now becoming recognized by the professional cognitive professions (neurology, psychology) and so it is not listed in the DSM-IV (the bible of psychological issues). This means that to the school, government, and to the insurance companies this disorder is not recognized and so help (and often even understanding) is absent. My wife attributes the problem to the gender of those making the discoveries and publishing the DSM (Diagnostic and Statistical Manual of Mental Disorders).

I mention this here in this blog since I have come to realize in reflecting back to my childhood that my sons struggles mirror my own issues. It is clear to me now that other people in my family also probably had challenges with SPD, but without understanding it can be mistaken for behavioral issues. Traditionally, I believe often people feel that these "willful children" just need more discipline. Rane has trouble in school, but not because he doesn't understand what is being taught. For example, on some tests in math he scores in the 98th percentile, but when the same material is given orally he will score very low ( even zero at times) because he shuts down aural processing at times. In order to test a child with SPD accurately, some special accommodations would need to be given to insure that sensory issues do not interfere.

You can imagine then that the traditional learning model of the teacher giving a lecture and the class listening would be a hindrance to a child with aural processing issues. For example, I can say something simple like "Do you want pudding or jello with your lunch?" and my son will reply "What?". Then I will ask nicely, "Ok, what did I just ask you?" and he will repeat it back verbatim. The issue is not one of hearing, but of processing. It took extra time for his brain to process the sounds and make sense of them.

Handwriting and printing is a nightmare for my son, first because of the lag in his fine motor control and also because of processing issues in the corpus callosum (any activity which causes the brain to cross the mid-line left to right, or bilateral coordination in doing one thing with side of the body and something else with the other). The development of the corpus callosum is delayed in males anyway, and for my son it is especially delayed. My scientific hypothesis is that SPD is related to a very slow development of glial cells and myelination in pre- and post-natal neural development which causes incomplete neural development until later in childhood. I've read some studies that indicate pre-natal stress can affect glial development. This is a childhood neural processing issue which can be overcome with appropriate neural focused occupational therapy.

"Our skin is our largest sensory organ, followed closely by our muscles and skeleton, connected by our nervous system and governed by our brain. The sensory systems feed information from our environment, through sense receptors, and neural impulses via our nervous system, directly to the brain. The brain then organizes it, sends it back through the nervous system for use as understanding, adaptation, learning, and skill development.

When this system functions well, it allows a person to interact with their environment efficiently, developing necessary motor and language skills, and appropriate social/emotional behavior. When this system is unable to organize the information appropriately, a variety of symptoms can present; motor delays, tactile defensiveness, learning disorders, social or emotional difficulties, speech, and language deficits or attention disorders."

Thankfully, Patricia Wilbarger and her daughter Julia have developed therapies for successfully treating these neurodevelopmental disorders. It took me awhile to understand the holistic nature of how physical therapies, like brushing or joint compressions will make vast improvements to my childs brain development in other areas and make him less prone to melt down due to sensory overload. On the opposite side, my son also seeks sensory input which can sometimes be inappropriate such as pushing or in other ways bothering other children. Some of this is behavioral, but there is a core underlaying issue with sensory processing we are working to correct. The appropriate behavior would be easier for a child with a better developed vestibular system, and he wouldn't need to seek so much additional proprioceptive input to stimulate his nervous system.

The recent revelation of my struggle is because of my sons issues, and I realize that there is some genetic factor in this. Here is a check list of potential symptoms that an adult might experience, and running through the list I can identify with quite a number of them. I have lived with this same problem long enough to overcome much of it on my own, or I've developed coping mechanisms to deal with my issues. My experience with elementary school was not good as I recall, and I know my mother did all she could to help me keep up with my peers. I also realize how I was pretty horrible to my younger sister, using her as my main source for keeping my nervous system at "high alert", just as my son fights with his younger brother for proprioceptive stimulation.


Gary Rith Pottery Blog said...

holy cats! well, glad you can help your son along!

Feener said...

wow, your story sounds very much like mine. my 4 year old has spd, she is very social and verbal and smart, but if she gets a drop of wetness on her she has a fit, she has problems with small motor skils, writing her name or using a spoon are very hard for her - she is clearly less skilled than her peers. as i have done the research i too have realized that i clearly had spd as a child. i was very picky and needy and that is what they thought, but in reality i know i had spd, i watch my daughter and i know what she is feeling.

Crafter of Khnum said...

In my reading somewhere I remember seeing a comment that it may be that up to 10 percent of children suffer some level of SPD. Like other developmental challenges, it would be a continuum from slight to severe.