Friday, April 25, 2008

Be Aware: Sensory Integration

The baby was so active in the womb that her mom dreamed it was sticking it's arms down it's mom's legs, and then when she felt her stomach stretch and looked down, she could see the shape of a small arm and hand sticking out. After the baby was born, she was cleaned, poked, and prodded, wrapped up and picked at to draw blood. Barely a peep escaped her lips. But then, they went and put a diaper on her. Her wails brought the house down. This baby jumped a foot when a door shut, wanted to suck incessantly, and went for 6-7 hours stretches at a time without sleeping. She was never floppy, never needed to have someone support her head. That was just the first 3 days of life. Lucky for her mom, it was her first and she had no idea what she was in for. The nurses knew, they sent her home with extra diapers and things because they were pretty sure Mom wasn't going to get out much...

Sensory integration refers to how we receive and process the information that comes in to us through our senses. New babies have to learn how to process things and over time we get better at it. For some of us, things don't go all that smoothly.

To some extent, sensory issues are pretty clear to all of us, as we all have our little quirks. Some of us think okra is yummy and others can't stand it's slimy texture. Some people fall apart when a chalkboard is scratched, others couldn't care less. I'm sure you've noticed that sometimes it's fun to listen to loud music, but other times, it is just annoying racket. Think of things like this on a much bigger scale. Some kids seem to only deal with these issues and for others, it comes along with Autism, Downs Syndrome, ADHD and many other conditions. The next Diagnostic Scale Manual will list this as it's own condition, Sensory Processing Disorder. Right now, it is known by many names, but Sensory is usually in there.

Ho-Hum!, you are probably thinking. Well, not if you had been searching for nigh unto 16 years for the root cause of a set of confusing symptoms that were making life difficult for your children and yourself, and they keep getting labels that fit in some ways but don't really quite match up completely. Then it's about as exciting as winning a lottery, or discovering a new galaxy or falling in love or something along the lines of "EUREKA!". This is the Espinoza Syndrome: the hub around which all our difficulties lie. That's why I'm going to write this sort of boring thing so that someone else who had no idea and needs to know, will find out and it will change their life. This discovery has been cathartic for me, because it is the first thing that totally fits. Everything ties back into this. It is THE MISSING LINK; finally found!

So here's the deal. We all come with our own little wiring system. In utero, millions of little nerve cells form and attach together into a neat little system that looks like a tree, ever branching out. The deal is, we usually form a whole lot more of these little branches than we really need. Partly because some of these connections are kinda messed up; imagine someone who got on the wrong flight and ended up in Jersey instead of Jamaica. So, usually the ones that end up in the right place form better connections, just like puzzle pieces in the right place work better. Sometime late in pregnancy, the body kinda prunes this tree, getting rid of weak or dysfunctional branches. Too bad you can't do that to your family tree you're thinking, right? But guess what? Sometimes too many or too few branches get pruned. Or simply, the wrong branches get cut off. This makes for little ones (and grown-ups) who have a much harder time using their senses. The information coming in through their senses can be incorrect or inconsistent. They can be over or under sensitive with any and all of the different senses and this can vary from day to day. Because of this, some people seek out more sensory stimuli or actively avoid some stimuli that they find overwhelming. This also affects their arousal level- which involves alertness, focus and filtering information as well as self regulation and relaxation. The different senses being processed are: Touch, Proprioception - (gotcha! This means your awareness of where your own body and it's parts are at without looking at them.) Hearing, Vestibular (how you handle movement), Sight, Taste, and Smell.

That's the boring part. Well, actually, here's another pretty boring list of symptoms you might see in a child with these issues, but I promise you that living with them is anything but boring:
-Oversensitivity or undersensitivity to different sensory experiences.
-High distractibility, problems paying attention and staying focused on tasks.
-Unusually high or low activity levels.
-Frequent tuning out or withdrawing.
-Intense, out of proportion reactions to challenging situations and unfamiliar environments.
-Impulsiveness, little or no self control
-Difficulty transitioning from one activity or situation to another
-Rigidity and inflexibility at times
-Clumsiness and carelessness
-Discomfort in group situations
-Social or emotional difficulties
-Developmental and learning delays and acting silly or immature
-Awkwardness, insecurity, or feeling stupid or weird
-Low frustration threshold; tendency to tantrum longer and more intensely that other children and more difficulty returning to a calm state
-Difficulty transitioning from an alert, active state to a calm, rested state like from waking to sleeping or active to calm activity.
*this list basically comes from this book here.

Of course, everyone does some of this sometimes but if it is not age appropriate, is just much more intense or frequent and interrupts daily function, welcome to the SI crowd. What causes it? You guessed it, we're not sure, but if you take a father who sniffs everything he touches and can't pay attention to a sentence that is longer than 7 words, and add a highly distracted mother who can't look at American cheese without getting a headache and then you add this kind of pregnancy and delivery, you have a good recipe for it.

What does it look like day to day? Read my blog :) I must clarify that my kids are primarily sensory seekers, mixed with a healthy sprinkling of sensations they avoid. Kids who are mostly over sensitive may look really different. (They probably don't ever comb their hair either though-it bugs them too much.) Everyone is unique. The list above is the unpleasant side of it, but it can also be as exciting as an action flick: kids who jump out the second story window, eat drywall, or bounce on their hoppy ball at the tip top of a pile of blankets and towels. It can be pretty racy too. You see a lot of skin: skin that doesn't want to feel clothes on it. Not everyone is lucky enough to have a free naked butler racing to open the door the minute the doorbell rings. On the other side of the coin, you will have someone piling on the tight layers of clothes or wearing their coat all day long to feel comfortable. Your furniture may be in constant movement, to the point that you feel like you are living with a bunch of stage managers and the play is never over. The trampoline becomes an outdoor room, more indispensable than kleenex, because the natives are literally bouncing off the walls. It can also lead to emotional traditions like the Annual Basement Flooding, and the Furniture Hacking Fests. It's an action-packed lifestyle, but if it gets too exciting- like your daughter doesn't sleep till she's 5 years old, your son is slashing your mattress and box springs because you sent him to his room, and another can't stay seated long enough to eat a meal or learn at school, you can help. Check out the book reference above, click on the sensory smart link at the bottom of my sidebar, or take a look through some web sites like this. Even if you don't have these issues, you'd be surprised how much better you will understand any kid or how your senses affect you.

How do you help? In a nutshell, you can do some occupational therapy that helps them meet their craving for sensory stimulation in safe and productive ways and helps them calm, or you can gradually help their bodies learn to tolerate things that are way too overstimulating for them. Hope this is helpful to someone somewhere who's just getting started down this road-pass it on!


The Sports Mama said...

Oh hon.. you are preaching to the choir on this one. My Bug is ADHD, Bipolar, AND has Sensory issues. We aren't sure if its Integration or Perception, but it absolutely makes life interesting.

It also explains why the child wouldn't wear shorts until he was almost 9; wears socks ALL THE TIME except in the shower or the pool (although I am so proud of him these last few months... he lets me take his socks off at bedtime, and leaves them off! That's a HUGE step!); and refuses to brush his hair despite it being long and shaggy.

And you're right. Since these issues so very frequently go hand in hand with something else, they often get overlooked or misdiagnosed. Thanks for posting this!

If nothing else, I know I'm not alone out there. And that? Is invaluable.

Kellan said...

Very helpful information - thank you!

Have a good day - Kellan

AutoSysGene said...

How I wish I had this post to read after Hope was born. There is so much information here that I could have used.

We have never been officially dx'd but most of the "symptoms" we deal with fall under SI.

Thanks for this post.

Anonymous said...

I'm well familiar with SPD since my grandson has experienced many of these symptoms. He is 3-1/3 y/o and early intervention is making a huge difference in a positive way. His little sister seems to be fine, but we watch her like a hawk and my daughter rejoices as she experiences milestones that her brother never exhibited in his early months.

It is a joy to see him grow and change and learn.

Blessings to you and your little ones. This grandmother enjoys reading your blog.


Carrie and Troy Keiser said...

I am really loving all the info you've been sharing with the blogging world!

Anonymous said...

This is SO interesting! My oldest son has puzzled me all his life (almost 8 years) - and just a couple months ago I bumped into the proprioceptive sensory integration bit, and that fits my son almost to a 't'. He has been working with an occupational therapist for about 2 months. He's very bright and has lots of 'high points', but she's discovering ... why he never really picked up a crayon or pencil until he started school and had to; why he writes so slowly (tho' well); why he sticks his belly out and his bottom out when he's standing still without leaning on anything; ....... I could go on and on. I think you know the feeling. Someone else truly understands!!! I really feel that lots of people think (especially because he's a very bright boy) that we just don't know how to control his behavior (because his energy level is SO high.) I could go on all night, but better quit! Thanks for taking the time to post on these issues. My heart goes out to your family - I also know what you mean when you say that you also 'finally' know what some of your own quirks are. Me too!!!

caramama said...

This was fascinating and not at all boring! Thank you for once again sharing such important information with the blogging and googling world.

You are educating us not only on things to watch for our own children but also you are helping us understand other children around us.

Good luck with your children! The book looks very interesting, and I've heard it recommended in other places too.