2012年6月30日 星期六

Understanding the Links Between ADD/ADHD and Sensory Integration Disorder

Many frustrated parents are unaware of the similarities and the links between ADD/ADHD and Sensory Integration Disorder. In fact, many people have not yet heard of it. Sensory Integration Disorder is basically a condition whereby the brain is unable to fully utilize the information gathered through the senses in an effective, organized way.

Children with sensory integration disorder (SI) may have difficulty finding the right balance to react to information received. Sufferers tend to react in extremes to things such as touch, smells, sounds and tastes that other people take in their stride as part of their daily life.

A child with this condition will display extreme and anti-social behavior as the senses are experienced. The behavior could involve extreme emotional outbursts, crying, tantrums and more. Parents' first instinct is to assume that the child is trying to get attention through this behavior when in fact it is sensory integration disorder.

Kids with ADD/ADHD and SI disorder will display a number of other symptoms. Kids with hearing sensitivities will hear noises that other people do not hear, such as people chewing or breathing or other background noises.

Children with touch sensitivities will be indifferent to temperatures or pain. They will refuse to wear clothes made of certain fabrics or wear long sleeves even in summer to avoid skin showing. They may also avoid physical contact with other people. They are also likely to avoid grooming and any activities that involve touching their faces, hair or teeth. Kids with ADD/ADHD and SI may have very low or very high activity levels, spin things around and taking things apart.

The brain is unable to process and interpret information that is entering properly, which causes them to be unable to form a proper impression from the combined information of all the senses. Parents are likely to view the child's reaction as misbehavior, but the child suffering from ADD/ADHD and sensory integration disorder is probably very fearful and confused.

Lizette has extensive experience in creating home education tools and resources that are available freely from [http://www.twinstaracademy.com/]

She also has a lot of experience in dealing with an ADHD child, thanks to her 9-year old daughter. However, she has found benefit from Minerals for ADHD

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The Daily Sock Battle

Every morning, five-year-old Emily would begin her day by arguing with her mom about putting on socks. Emily hated socks or anything on her feet, toes, or ankles for that matter. She complained to her mother that this sock felt too "big", this seam "poked her", and the elastic on another pair made her ankle "itchy." Even after a happy medium was finally found an hour later with the "right" pair of socks, Emily would next resist putting on shoes, wearing a long-sleeved shirt, and finally to having her teeth and hair brushed.

Her mother Dena tried patiently to find the right clothing combinations that agreed with Emily, but many times this seemingly benign routine of getting dressed caused a loud commotion, which sometimes ended in tears of frustration. Finding sympathy but no answers from her friends and family, Dena began searching the Internet for a reason why Emily made mornings such an intense ordeal. This could not be how every child acts about dressing and grooming! Dena felt there must be something else going on that made these mornings such a battle. She found parenting forums that outlined some of the same clothing dramas her family had been experiencing. More importantly, Dena's reading introduced her to a condition known as Sensory Integration Disorder (SID).

A simple definition of Sensory Integration Disorder is the inability to process the information a person receives through their senses. Also called Sensory Integration Dysfunction, SID is a glitch in the central nervous system, which hinders the brain's ability to analyze, organize, and connect sensory messages. As a result, children with the condition might have trouble associating many basic sensations including touch, movement, body position, sight, sounds, smell, and taste. Since the brain is at times struggling to organize a multitude of stimuli from all the senses, many aspects of an affected child's behavior may seem disorganized or challenging.

In Emily's case, the feel of a cotton seam in a sock caused irritation that was almost unbearable on her toes and toenails. Emily was also hypersensitive to the tag on the inside of her shirts that continuously scratched her throughout the day, and long-sleeved shirts must have felt somewhat like wearing a straight jacket. The bristles on a toothbrush agonized her sensitive gums and nerves in her cheeks, while brushing her hair meant pain from her roots through to her scalp with every stroke. When the exaggerated sensations are brought to mind, Emily's aversion to dressing each morning seemed more appropriate.

Although there are many degrees of the disorder and the effects will vary by individual child, parents of SID children are many times the first to identify that something is a bit different with their son or daughter. Even a mild degree of SID can cause feelings of distress in a mother, when the lightest touch or even a gentle kiss is forever wiped off or never easily accepted by her toddler. There can also be endless inconsistencies in a child's behavior or reactions, for example complaining of discomfort when gently nudged on the shoulder but ignoring the pain of cuts and bruises received on the playground. There are also more pronounced degrees of the disorder that can greatly hinder a child's development, sometimes playing a secondary role to autism or fetal alcohol syndrome.

Many children with SID improve when parents and caregivers seek assistance early. By talking openly to a pediatrician, learning about SID, initiating Occupational Therapy, and developing a home life that is rich in sensory experiences tailored to the individual, children can build tools to respond to the daily challenges SID creates.

Anna Chavez is a former Editor Owner of a large weekly Newspaper. She is currently Editor and Author of several online resource sites that can be found at [http://www.thirdplanetsearch.com]

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2012年6月29日 星期五

ADHD Comorbid Disorder: Non-Verbal Learning Disorder

It's so easy to associate inattention or hyperactivity with ADHD comorbid disorders, especially when you consider how similar their symptoms are. Take nonverbal learning disorder (NLD), for instance. This fairly common disability goes easily undiagnosed because its most obvious symptoms resemble the non-stop talking often found in children with ADHD.

So what's the difference between a child with nonverbal learning disorder and a child with ADHD? The first thing you should know is that children with NLD are actually very verbal people - they have mature vocabulary, talk "like adults," have excellent reading ability, and demonstrate good rote memory skills. However, they are clearly deficit in the nonverbal arena. As a preschooler, your child might have trouble getting along with other kids, adapting to new situations, and troublesome but minor fine motor problems. For instance, your child might have incomprehensible handwriting.

During elementary school, your child might do fairly well in terms of academics, except for when a subtle symptom of NLD interferes with socialization or non-academic areas. As your child enters middle school or high school, things start to deteriorate as he is faced with more responsibilities. Teachers find him rude and he gets into fights with classmates because he cannot understand nonverbal cues like facial expressions or body language. Your child has difficulties completing homework, reading an assigned chapter, or writing an essay. Yet your child maintains his articulate speech and precocious language.

Children who have NLD are able to make up for the limitations of their disorder. It only starts to get worse once they hit puberty, when they start to suffer from anxiety or alienation. When they become adults, they experience problems setting priorities or picking up on social cues, or undergo mood disorders, which make it difficult for them to maintain relationships or jobs.

Diagnosing NLD involves a series of speech and language tests, neuropsychological tests, and other evaluation procedures. Since the most obvious symptom of NLD is advanced language skills, doctors usually administer the Brown ADD Scales and the Wechsler Intelligence Scale to distinguish NLD from ADHD. Children with NLD usually have 20 verbal IQ points more than their performance IQ scores.

Just like with ADHD, children with NLD will flourish if they receive holistic treatment. Some therapies that benefit NLD sufferers include:

Social skills groups, which teach children how to meet strangers, greet friends, recognize when they are being teased, etc.
Occupational therapy, an approach that improves fine motor skills and balance.
Sensory integration therapy. Some children with NLD tend to be hypersensitive to stimuli or have difficulties processing multi-sensory stimuli. This can make them feel agitated when confronted by distractions and other sensory stimuli. Sensory integration therapy can help them overcome these setbacks and reduce the anxiety caused by encountering strange sensory information.

Dr. Yannick Pauli is an expert on natural approaches to ADHD and the author of the popular self-help home-program The Unritalin Solution. He is Director of the Centre Neurofit in Lausanne, Switzerland and has a passion taking care of children with ADHD. Click on the link for more great information about ADHD Comorbid Disorder.

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Physical and Alternative Therapies for ADHD

Four and a half million American children aged between five and seventeen have been diagnosed with ADHD since 2006. The symptoms vary from one child to another and certain symptoms may be more pronounced in one child than it is in another child, depending on the type of ADHD that the child has. Generally, the symptoms could include overactivity, uncontrollable behavior, impulsivity, and the inability to remain focused.

Some medical doctors like to prescribe medications while naturopaths advocate natural remedies, such as mineral supplements that have proven helpful for the condition. In addition to any herbal or pharmaceutical medicines, research has shown that physical therapy can be very beneficial. It is suggested that parents exhaust all other options before settling for drugs.

Since there is a link between sensory integration disorder and ADHD, sensory integration is one of the therapies on offer to help improve hyperactivity, impulsiveness and restlessness. Strenuous exercise and deep pressure are some of the methods used. Research has shown that kids who receive sensory intervention therapy are better able to pay attention in noisy classrooms and generally more at ease.

The therapy will depend on the type of behavior which is most pronoounced. The exercise ball, swings and gentle or deep brushing of the skin are some of the most common therapies.

Occupational therapy is used to improve school performance by helping the child to learn self-management techniques. Sensory integration therapy stimulates the five senses in a regulated manner. The patient is assisted in effectively organizing the sensory information and interpreting it correctly.

The alertness is regulated with self-regulation techniques which helps the child to better concentrate on the task at hand. Programs exist for both adults and children alike.

As part of the intervention, the sensory input is managed along with the regulation of alertness levels. This helps the child to easily regain focus after a break and to help him or her maintain concentration during the day.

It is recommended that ADHD kids take part in physical activities such as organized sports. Sports provide an appropriate outlet for all that hyperactive energy.

Lizette has extensive experience in creating home education tools and resources that are available freely from [http://www.twinstaracademy.com/]

She also has a lot of experience in dealing with an ADHD child, thanks to her 9-year old daughter. However, she has found benefit from Minerals for ADHD

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2012年6月28日 星期四

Sensory Loss in Older Adults - Vision - Behavioral Approaches For Caregivers

As we age, our sensory systems gradually lose their sharpness. Because our brain requires a minimal amount of input to remain alert and functioning, sensory loss for older adults puts them at risk for sensory deprivation. Severe sensory impairments, such as in vision or hearing, may result in behavior similar to dementia and psychosis, such as increased disorientation and confusion. Added restrictions, such as confinement to bed or a Geri-chair, increases this risk. With nothing to show the passage of time, or changes in the environment, the sensory deprived person may resort to repetitive problem behaviors (calling out, chanting, rhythmic pounding/rocking) as an attempt to reduce the sense of deprivation and to create internal stimulation/sensations.

This article is the first in a series of three articles that discuss the prominent sensory changes that accompany aging, and considers the necessary behavioral adjustments or accommodations that should be made by professional, paraprofessional, and family caregivers who interact with older adults. Though the medical conditions are not reviewed in depth, the purpose of this article is to introduce many of the behavioral health insights, principles, and approaches that should influence our caregiving roles. This article addresses age-related visual changes.


A. The changes in vision that accompany aging include:

1. A loss of elasticity of the lens; this means the person is no longer able to focus or accommodate to changes in lighting conditions. (Starting in our 40's, glasses are needed to see fine print). It also means the older person cannot adjust to sudden changes in lighting, resulting in an uneasiness when leaving a bright room to enter a dark hallway, or finding seats in the dark in recreation rooms, or theater. Going in the reverse direction can be equally difficult: from a dark room to a bright area.

2. Decreased pupil size; the light reaching the retina is reduced, requiring more light to see. This results in the need for lighting 3x to 4x what younger people need to see clearly

3. A loss of transparency; with age, there is a yellowing of the lens in the eyes, making color discrimination more difficult, especially blue and green. Warmer colors, such as reds and yellows are perceived best, explaining why bright colors are preferred.

4. More susceptibility to glare, and longer time is needed to recover from the effects of glare;

5. Eye diseases and disorders, such as cataracts causing a clouding of the lens; glaucoma, resulting from increased pressure of fluids in the eye, damaging the optic nerve and impairing vision. Glaucoma, the number one cause of blindness in U.S., in advanced stages results in yellow halos around images. Macular degeneration may occur, where vision is distorted, and images appear different sizes or different shapes, and are missing a central element. Visual disorders may be secondary to stroke, in which the eye can see the image but the brain cannot interpret the images. Diabetes may result in disrupted blood flow to the retina, causing diabetic retinopathy and a loss of vision, and blindness, in extreme cases.

B. What are the effects of visual loss on the older adult?

1. An increased dependency on others;

2. A sharply reduced quality of life (changes in activities in daily living and instrumental activities of daily living, reduced connection with outside world);

3. And, a fearfulness and reduced tendency to venture outside.

C. What are the effects of vision changes on demented elderly?

1. With the losses in visual acuity, other problems in cognitive functioning are heightened, such as difficulty processing unfamiliar faces and settings;

2. Because the person with dementia already has difficulty learning new behaviors, he or she is less able to learn new habits to compensate for the visual losses (e.g., learning to use visual aids to identify articles of clothing or other possessions;

3. There is likely to be an increased disorientation and confusion, as the search for structure and external cues is strained.


The following principles apply to caregiving approaches with older adults who have diminished sensory function. Increased sensitivity and insight to the needs of these individuals improves their quality of life and improves our effectiveness:

1. Observe the behavior of the person, and look for cues and signs of pain or discomfort;

2. Help the person work through the emotional impact of the sensory changes, allowing expression, acceptance, and support of the grief and sadness accompanying these losses;

3. Do not try to fix the unpleasantness; acceptance and support goes a longer way toward healing than a quick fix or a patronizing attitude;

4. Reduce excess disability by maximizing whatever functioning is still left, such as proper eyeglass prescriptions, or functioning hearing aids;

5. Consider assistive devices (phone amplifiers, large text books, headphones, and the Braille Institute for a variety of useful visual aids).

Approaches for impairments in vision:

1. Address the person before you touch him or her, identify yourself, let him or her know when you are leaving, speak normally, and do not shout;

2. Describe his or her surroundings to help orient and familiarize the person to the environment, tell him or her location of belongings, and if things have been moved;

3. Use as much contrast as possible, e.g., red objects on white background is better than black on a gray background, or blue on green background, (consider switch plates on walls, toothbrushes, combs);

4. Avoid moving quickly from a bright room to a darkened room, or v.v. Make sure the visually-impaired person takes the time for the pupils to adapt to the changes in lighting;

5. Introduce yourself every time you come into contact with the person, and explain what you are going to do because there are no visual cues;

6. Help to identify others in their environment with colored clothing, name tags with large print, etc.

7. Clean eyeglasses regularly, provide adequate lighting, and avoid glare;

8. Provide night lights, and arrange furnishings in the environment for safety and ease of mobility.

Even with normal aging, functioning of our five senses is not like it was when we were younger adults. This article offers caregivers who work with visually-impaired older adults some insights into the special needs and adjustments that will turn unpleasant, frustrating situations into more caring, helpful, and sensitive interactions. By integrating these behavioral approaches in the delivery of the health care with older adults, we can favorably impact the management of these conditions.

Copyright 2008 Concept Healthcare, LLC

Joseph M. Casciani, PhD, is a geropsychologist who has devoted his professional career to working with older adults and their caregivers. His company, Concept Healthcare, http://www.cohealth.org, offers online resources to integrate behavioral health approaches in the health care of older adults.

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Children with Sensory Needs - The Misunderstood Five Percent of the General Population

Many children, perhaps your own, exhibit difficulty processing sensory information including: touch, taste, smell, vision, and hearing. As many as 5% of the school age population exhibit characteristics of sensory processing disorder (SPD), sometimes known as sensory integration disorder.

Further, many children with autism, ADHD (attention-deficit/hyperactivity disorder), learning disabilities have SPD coexisting or underlying these conditions. Research has shown that as many as 40% of children with ADHD display symptoms of SPD.

If you are a parent of a child with special needs, perhaps you are struggling with the added stresses this can have on the family.

Your family relationships may be affected.
Siblings may be envious of the extra attention provided to the child with special needs.
Mothers may feel that fathers are not involved.
Fathers may feel unfairly blamed, when in their opinion, they are struggling to support the family.
Extended relatives, while intending to provide support, may instead offer conflicting advice, or just not understand the needs of the child and the family.
An already tight family budget may be stretched even greater to cover the added expenses associated with providing the best possible care for the child with special needs, and the family as a whole.

Only by sharing information and working together can we have adequate recognition and support for those impacted by SPD. Search the internet. Resources exist on the internet through non-proft foundations, and parent connections groups. It is my hope that all children grow up with the courage and wisdom to share their natural talents for the betterment of the world,

...express understanding and respect for humanity

...appreciate and extend the work done by previous generations of people.

Christopher R. Auer, MA is the author of Parenting a Child with Sensory Processing Disorder: A Family Guide to Understanding and Supporting Your Sensory Sensitive Child (New Harbinger, 2006) Additional information at http://www.spdresources.com or email spdresources@comcast.net

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2012年6月27日 星期三

Parenting a Child with Sensory Integration Disorder

After suffering another incredibly stressful morning trying to get my 5 ½ year old son dressed, I've come to the conclusion that there must be other families who go through the same frustration every morning. Most just wouldn't believe that we have it different than anyone else who has young kids. When I'm talking to someone about Jeremy, my stress shows but the explanation is too long so I don't usually elaborate. Their usual answer is "sounds like a typical 5 year old". I guess I've grown used to that. What is harder is to hear from other people who are trying to be helpful that we have a "discipline problem." They offer their typical advice of how to reign a child in and get them to behave.

The fact of the matter is, is that he is NOT a typical 5 year old! Oh, Jeremy loves to play instead of work, throw rocks and finds an empty box utterly fascinating, but the day to day events of our lives, the usually mundane things, are stressful and incredibly different.

This morning was supposed to be a lot of fun. We all woke up early to take a trip to Miami to see my husband's family. It's a 3 day weekend so we wanted to get an early start on Saturday morning so we could enjoy the afternoon in Miami. My husband got up and made coffee, I wrapped about 6 gifts that we're bringing and Jeremy started pulling out clothes and toys he wanted to bring.

I encouraged him to bring the clothes and toys into his room but instead more and more toys got dragged into our living room. When it was time to sit down and eat his breakfast, his favorite of 'waffles and cream', the battle started. Normally, a good tactic is to put a clock in front of him so he can see how much time he has. Today we didn't do that because we were not thinking about the exact moment we had to leave like we do every day for school. That was a BAD CHOICE on my part. I should have showed him the exact time he needed to have eaten and gotten dressed by. Then we should have marched out the door. Unfortunately, we had to pack our suitcases and pack the car.

When Jeremy got to the table ate a few strawberries and milk and got up. My insistence of him sitting and eating finally got ugly after about 15 minutes. While I was running around trying to get everyone ready to go out of town; I continued to put him back in his seat and demand that he eat. I sat with him for about 5 minutes and he didn't eat. I told him he could get a star for his chart if he ate, and got dressed. He started whining and crying so I took a star away from his chart that we've created. On one trip to the bedroom he started playing with a tractor. When I found him again ( I was now taking a shower) he wanted to bring the tractor to the table. I told him NO and to get back to eat. He was screaming and crying because now he wanted the tractor and then he said that "you are the only mommy in the world who is mean to me every day". That is when I told him that if he said that one more time he would get his mouth washed out with soap. (This works wonders for those awful things that kids tend to say sometimes but If I could live without ever doing anything drastic like this, I would!!!)

That stopped the complaining about how "mean" I am but the whining continued. I had to finish feeding him myself in between his tears. He finally finished eating after about 45 minutes. I had turned off the TV by this time of course. I've learned that having the TV on or light music can easily overwhelm Jeremy.

Next, getting him dressed was no easy feat. The first shirt I put on didn't feel comfortable. This was a brand new pre washed long sleeve t-shirt from Osh Kosh. It's darling, but unfortunately, new clothes rarely stay on my son. He prefers old and soft. Many of his very favorite clothes and shoes have spots and tears, but they are the only ones that I can get him to stay in. This morning was no different. I put on Gap underwear, Osh Kosh Jeans and the Osh Kosh t-shirt. After he was completely dressed, he started screaming and wailing about the shirt being too small and the pants being too big. So, off the clothes came! And it wasn't just a calm, "mommy I'm taking off these clothes", it was a screaming crying whining fit accompanied by throwing his clothes across the room which landed on my husband's face as he was walking across the room. At least today he didn't RUN when it was time to get him dressed. That is the typical scenario. He races across the room when it's time to take off his pajamas or time to get changed any time. I can't figure out why! I don't know if that is his body having an automatic reaction to change, or if it's a behavior issue. But it's something that we want to work on in occupational therapy.

Because I already know the drill, that nothing I can say or do will make him keep clothes on when he doesn't want to wear something, I went to the drawer and brought out the old favorites. The yellow long sleeve t-shirt with the #63 and the army looking pants that are soft and comfy. If you see Jeremy out of his school uniform, this is more than likely the outfit he'll be in.

I think of all of the hundreds of dollars that I've wasted by buying clothes that don't quite feel right. I think of the dozens of pairs of shoes that he has kicked and screamed about. I have thrown out piles of socks that just didn't have the seam in the right place. Getting Jeremy dressed to go anywhere, is a struggle nearly every single day.

Recently, the school had a second hand sale on uniforms. I felt like I struck gold by finding the oldest shirts in the school. To me, that means, the SOFTEST and that is perfect for my kid! He is 5 years old, and he wants to wear size 12 shirts. They are big and don't cling to him. Also, discovering the GAP undershirts has been a miracle in our lives. My friend Diane has a red head boy (I believe red heads are more sensitive) and they recommended the GAP undershirts.

I remember trying to get Jeremy dressed at age 2 was no different than now. He went to the Montessori school and because it was pre-school, they weren't particular on the time we arrived. Many, many mornings Jeremy would fight and scream when I had to get him dressed. He would have been perfectly happy staying at home watching TV all day. He would be completely happy just doing that every day of his life. But, fortunately for him, he has two incredibly active parents who rarely ever sit around and watch TV. We have our traditional "Friday night movie night" but we don't watch TV much during the week.

Jeremy does get to go to After Care at school if he's had good behavior the day before. There, they run around the fields, play ball, climb on the jungle gym, have snacks and play with their friends. He loves it! I find that it's the best place for him since he races the kids and exerts more energy there than anywhere else. The hardest part is when it's time to go. What else? He runs away! My mom has found it completely embarrassing because he doesn't pay attention when it's time to come. He just continues playing and then runs to the other side of the field where he can't even hear us yell for him.

By reading books like "The Out of Sync Child" and talking with other mom's I've found a few things that work in this situation. First of all, when you get there, allow the child 5 minutes or 10 minutes to play. Tell him/her that he has 5 minutes and then it's time to go. For Jeremy, he then gets time to transition to the next activity. And the expectation is set. Our new rule is that he is able to achieve a star for his chart at this point. If he comes immediately after the 5 minutes is up, he can get a star for that which when added up every day can determine whether or not he gets to go to after care the next day. He needs to get 5 stars a day - for getting out of bed quickly, for eating and taking his plate to the sink, for making his bed, for getting dressed (almost) by himself, brushing his teeth and hair, etc. He has the chance to earn 3 stars in the morning. Several of the above list is combined into one section for instance: putting dishes in sink and making bed = one star.

The chart system is working for us pretty well. He gets stars taken away for negative attitudes or whining. One day he ripped all of the bad and the good extra stars down. He didn't realize he also ripped the good ones down. Jeremy can earn EXTRA stars for having excellent behavior like the day he had such a great attitude one morning. I was so pleased and so proud of him that he got to go to After Care that day even though he didn't have enough stars the day before. The extra stars can accumulate to 20 and then he gets to go to Toys R Us to buy a toy. So far, he has only a couple of extra stars for good behavior.. and believe me.. I'm looking!

It's hard for Jeremy's self esteem to have these problems. He's gotten in trouble nearly every single day at school. He's come home many times saying, "I'm a bad kid, I'm a bad kid", which really rips out my heart! The system of putting their "apple or acorn" in the yellow, or red basket brings a reputation of "bad behavior". Jeremy has also had his apple on the teachers' desk many times. If he gets bad behavior like this, they take him out of recess. They'll take him out for 5-10 minutes or even the whole time! When I learned this, I freaked out! Jeremy NEEDS activity in order for his brain to FUNCTION correctly. By taking him out of free time outside, they're just hurting the situation. I caused a stink about that at the school and I think they've made some adjustments. The school counselor is now involved and helping to guide the teachers in working with Jeremy. It's truly been a collaborative effort.

Jeremy has also been slow to finish his work. We had him professionally evaluated and it was also discovered that he has auditory processing disorder. This doesn't allow him to process more than one thing at a time. He can hear well, but he can't focus on more than one thing at a time. It doesn't allow him to hear people calling his name if he is immersed in another activity. Next summer, he'll be doing a 10 day intensive program for auditory processing which includes 2 hours in the morning and 3 hours in the afternoon. He'll be listening to headphones which somehow reprogram his brain to hear more than one thing at a time. I am really looking forward to this time to see if we can correct some of the behavior that he has.

We've found a few things that can work for Jeremy in regards to his behavior at school. First of all, Jeremy is OFF of all sugar. He used to have waffles with syrup every morning and all of the sugar gave him too much energy and he was bouncing off the walls! We finally realized that sugar has adverse effects so he now gets little if any sugar in the morning. We even prefer milk over orange juice since fruit has sugar in it.

Next, Jeremy has to take time to exercise in the morning. We put a mini trampoline in our living room and he bounces a few hundred times in the morning before school. If we have time, my husband will take him out to ride his bike before school or run around the field and play Frisbee. On mornings that he doesn't get to exercise, he seems to be more talkative and figity at school.

I've had to explained to Jeremy that sugar is "poison" to his brain. It makes him react in such a negative way where he throws fits and disobeys. I seem to automatically know when he's had sugar! When he acts like this and I know he's not overtired, I automatically ask if he's had sugar!? Usually, the answer is yes and so then I require him to start bouncing on the trampoline to get the energy out.

Jeremy might also have ADHD, which is a possibility since he was a preemie and upwards of 40% of preemies have ADHD. I went to one doctor and within about 1 minute he was telling me that Jeremy had ADHD and would require medicine! That appalled my husband and I was quite put off myself. Even if Jeremy does have ADHD, we're not going to put him on medication without trying to find every other way to manage it first. Besides occupational therapy, we've heard of other therapies that families have used and have had great success. Besides monitoring diet, they've used biofeedback and also some sort of testing of the electrodes in the body to eliminate toxins. I may have those details wrong, but we haven't gone down that road yet. Right now, Jeremy is in Tae Kwan Do 2 times a week. There, they teach self discipline, self esteem, leadership and focus. These are all qualities that I want for Jeremy.

If anyone could have told us where we'd end up even 6 months after we started down this path, I wouldn't have been able to handle it all at once. When we first discovered it, people came out of the woodwork to tell us their discoveries and what they went through. A friend from high school confided in me about her family situation and how they dealt with it. It was hard on her husband to imagine that their kid, coming from two "over achiever " parents, would have developmental problems. I could relate to that of course, but when she started telling me that her child couldn't stand loud noises and would cover his ears and cry and scream, I couldn't relate to THAT. She also told me that it'd be best for Jeremy to repeat kindergarten and at the time, it was a thought that I couldn't bear. We've since determined that Jeremy will repeat kindergarten next year. Coming to that conclusion took a lot of time and was a result of visiting numerous pre schools, talking with our own principal, vice principal, other parents, his teacher and the counselor. It was our principal who encouraged us not to do anything rash. I trusted her and I kept him in school and made the decision early on to repeat next year.

Other parents of kids of SID children had other stories. One parent's child had low motor skills and didn't want to swing or play with other kids. That was completely OPPOSITE of Jeremy. I did meet one mom at a workshop for parents with kids of SID who is very similar to Jeremy. He's a "crasher" and needs just as much physical stimulation as Jeremy. We laugh over the fact that we TELL our kids to jump on the couch... instead of getting off of them. So, little by little, with more reading and more talking, I found we all had one thing in common: MAJOR FRUSTRATION!

My friend from high school also had some of the same issues I was facing at home. My husband, who is a complete overachiever, couldn't deal with the fact that it was recommended that Jeremy go on medication. He absolutely REFUSED to even consider the possibility and so this would create lots of tension. My resolve was to find a solution, whatever that was. I was dealing with the teachers and with Jeremy every day, not just in the morning or at bed time. When I took Jeremy to school, the stress stopped for my husband, but not for me or his teachers. After speaking with numerous wives, I've discovered that the husbands don't believe it, or WANT to believe it. It appears that because men feel that they must be strong in every situation and must handle many obstacles in life, and that having a son that is facing problems is just too much to bear. Most of the dads of the boys with SID are in denial at first. The wives tend to have to deal with finding out what the issues are all by themselves by researching, talking and finding solutions. Many of the husbands fight the wives to the end until the wife finally convinces her mate to "just speak with an expert". In one case I know, the father uses the excuse, "he's just like I was" so he assumes it is okay. Meanwhile, everyone including his wife is going crazy having to deal with his child. My friend is of the mindset that if there IS help available, then she's going to get it! In reality, many of these men are right, because the kid IS just like them... and if there would have been help for their own mothers way back when, then the moms more than likely would have taken it instead of suffering through it and of course it would have made everything easier on the child. They could have learned tactics that would have helped them manage their actions, their bodies and their behavior.

My husband finally came around when he was able to speak with the Occupational Therapist where we got Jeremy evaluated. They promised to do whatever possible to work with Jeremy to correct many of these issues. The whole topic of using medication to help Jeremy hasn't come around for a while, but I know that my husband will be open to it if we have to do it. He's had to deal with Jeremy while I've been out of town and it nearly put him over the edge.

We're really just starting on this journey to getting the help we need. I've discovered many successes through trial and error. I've found that having a chart that rewards Jeremy for his chores and responsibilities for the day motivates him better than punishment. Tae Kwan Do has been fantastic to improve his self esteem. Talking with the teacher on an almost daily basis alerting her with new research I've found or discoveries that have happened has really helped. Daily massages on his feet, legs, back and hands are helping the stimulation of his skin so he doesn't freak out quite as bad when putting on socks and shoes. Teaching him to breathe himself through frustrations is an ongoing process and educating him about what to feed his body to it works correctly has helped me just as much!

Had I known what it would take to parent a child with Sensory Integration Disorder, then I would have said that I didn't have what it took. And I probably would have been right. My stress level has been through the roof ever since I had Jeremy but in reality finding out that he had something that was actually diagnosed gave me the power back! I knew that if I educated myself, our situation would improve and indeed it has.

I'm now able to understand that I need to implement complete structure in order for him to function at his best. That structure does include plenty of free or down time, but when it's time to do something or go some where, I put on my "drill sergeant" hat to get him to perform. It goes against my nature to be that firm, but I've learned that in order for our family to function, then I have to do what I have to do.

Please feel free to share your stories with me or to reach out for support. Perhaps if several of us can reach out to others to help, then others will be able to educate their spouses, their teachers and their friends.

Mary Gardner is an executive communications consultant and lifestyle coach. She is the mommy of Jeremy, a precious and active 5 year old boy who has Sensory Integration issues. Mary can be reached at mary@marygardner.com

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Heavy Work Activities for Proprioceptive Input in the Classroom - For Kids With Sensory Issues

All children, but particularly those with sensory processing disorder, can benefit from movement activities in the classroom that provide input to the proprioceptive receptors in the joints and ligaments. In addition to providing exercise, these types of "heavy work" movements make it easier for the child to focus and attend. For the child with SPD, it's vital to get proprioceptive and deep pressure input throughout the course of the day as part of what's called a "sensory diet" of activities. It is not enough to get plenty of exercise and calming input before or after school, or during one session of OT. Most children with SPD need to be encouraged and guided to get the input they need throughout the course of the day.

There are many ways to help kids get this input within an ordinary classroom and school building. The child who is a sensory seeker will likely eagerly participate and even find her own ways to get the input she senses her body needs (be sure to guide her in finding appropriate activities, though). In contrast, the child with sensory issues who is underaroused or a sensory avoider may have to be reminded to follow the sensory diet the OT has set up. In either case, while it is great to provide opportunities for input, a child who isn't disciplined or self-motivated enough to carry out a sensory diet on her own will definitely need guidance to ensure that it happens. Given that the alternative is a child who is unfocused, becoming more anxious and agitated, and moving toward sensory overload and a fight-or-flight panic reaction such as aggression or total withdrawal, implementing a sensory diet during the school day during the school day is crucial.

When you integrate these activities into the classroom routine, and other children may participate as well, it helps the child with SPD to not feel quite so different or singled out. If the child is the only one doing the activity, give it a positive spin. Let her be the "playground equipment monitor," carrying the balls and equipment to and from the playground, or the "whiteboard monitor" who erases the whiteboard at the end of each day. You might even have a team of kids, including the children with sensory issues, in charge of washing desks or helping the janitor, and give them an honorary name such as the "clean crew." All of these strategies will reduce the stigma for the sensory child who must have an in-school sensory diet in order to stay focused.

Remember, the child who is focused on the discomfort in her body and her urge to move may be polite and obedient, appearing to pay attention when, in reality, her mind is not on what the teacher is saying. By incorporating a sensory diet tailored to the sensory child's specific, unique needs by a sensory smart school or private OT, you make it far easier for her to focus on what we would all like her to focus on: learning! If the child is verbal, be sure to include her in the setting up of a sensory diet. What works for one child may not work for another.

And check in regularly to be sure that she's really getting the benefit of the activities set up for her, and make it a goal to have her advocate for herself and meet her sensory needs in a socially acceptable way.

Here are some easy ways to get proprioceptive and deep pressure input within a classroom and school environment (of course, the playground and gym offer plenty more activities during recess and gym time, too):

* Move stacks of books

* Deliver items from one classroom to another place in the building (especially if it requires carrying something and climbing stairs)

* Stack items, such as reams of paper, books, or storage bins

* Erase blackboards and whiteboards

* Move chairs or tables, put chairs on top of tables at the end of the day and take them down at the beginning of the day

* Wash desks or cafeteria tables

* Set up and put away folding chairs and tables

* Carry bins of lunchboxes into and out of cafeteria

* Empty wastebaskets, sweep, mop

* Sharpen pencils with an old-fashioned, crank pencil sharpener

* Assist gym teacher or playground supervisor with taking out and putting away equipment such as bags full of balls, mats, scooters, etc.

* Do laps around the gym or playground

* Climb stairs

* Cut cardboard and heavy paper card stock

* Do pushups against the wall

* Do chair push ups (holding the chair on either side as you sit, then pushing up to lift the body)

* Bounce while sitting on an exercise ball (loose or in a holder)

* Press legs against a lycra band stretched around chair or desk legs

* Sit on an inflatable cushion such as the Disc O' Sit

* Walk up a ramp or incline such as a wheelchair ramp or hill on the playground

* Hold open heavy doors, or open them for individuals entering or exiting the building

* Push or drag boxes, carts, or furniture across carpeted floor.

Nancy Peske is a professional writer and editor and the mother of a child diagnosed with sensory processing disorder and multiple developmental delays. She is the coauthor of the award-winning book Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues and has been active in the special needs community since 2002. She sends out a weekly newsletter of practical tips for parents and provides helpful information on SPD on her website at http://www.sensorysmartparent.com

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2012年6月26日 星期二

Teenagers and Sensory Processing Disorder: The Special Challenges

Teens with sensory processing disorder have special challenges because of the stage of development they're in and the fact that until now, their sensory issues may have gone unaddressed.

1. Finding the right OT can be difficult. Few occupational therapists are trained or experienced in working with teenagers who have sensory processing disorder. Play-based SI therapy may seem silly and embarrassing to teens.

2. Poor self-esteem. Teenagers who have had sensory issues for years will have learned at least some accommodations to get around them and are less likely to experience the extreme behaviors and responses they did when they were younger. However, years of feeling different and not knowing why, and noticing that they have never been quite as mature and self-controlled as their peers, take their toll. Teens with sensory processing issues usually struggle with self-esteem. They need a lot of encouragement to admit they have sensory issues and need some help.

3. Need for independence. Teenagers need to have their independence respected, so being told, "You need to do X, Y, and Z to manage your sensory issues" usually doesn't go over very well!

4. Desire to fit in. Even teenagers who don't feel the need to have a lot of friends or be conformist want to have some friends they feel they fit in with. Sensory challenges can embarrass them and may make them feel isolated, and different in a negative way.

5. Changing hormones. Teenagers have ever-changing hormones that can exacerbate sensory issues by making them more sensitive to input than they were in the past. The normal changes of adolescence can also make them more moody and emotionally sensitive.

6. New expectations. People are less likely to see your teen as a young, immature person with a hidden disability and more likely to see him or her as a young adult whose behavior is willful.

What's a parent, teacher, or therapist to do?

1. Modify traditional SI therapy techniques to be more teen friendly. As a substitute for playing with a tray of shaving cream or finger-paints, encourage the teen to cook, garden, do art or arts and crafts, and engage in other activities that challenge his tactile issues. Work with a sensory-smart occupational therapist who is willing to alter her approach to helping your teenage son or daughter to reduce any embarrassment or defensiveness.

2. Talk about sensory issues positively. Reassure your teenager that sensory issues are simply a difference in brain wiring that can have advantages but that can also be controlled and addressed to make life a little easier. Explain what SPD is and why in some cases, it's good to be extra sensitive or to crave certain sensations, and that people with sensory issues often have other gifts as well, such as the ability to "think in pictures." Then explain that there are "tricks" you and/or an OT can teach them to "make their lives easier." Everyone wants his life to be a little easier! Acknowledge how hard your teen has to work to be organized or tolerate certain sensations and praise her for her efforts.

3. Offer accommodations and sensory diet ideas for him or her to choose from. Present accommodations and activities to teenagers and let them decide which they would like to use. Honor and respect their choices and encourage them to engage in collaborative problem solving with you. If they don't want to be seen doing a brushing protocol for tactile issues, can they do it discreetly in the bathroom at school? If all the kids are wearing loose clothes and they prefer them tight, can the teen wear tight clothing, such as bicycle shorts, underneath looser clothes that seem more stylish?

4.Help your teen with sensory issues to feel okay as he is and find a group of peers he's comfortable with. Practical solutions for grooming, picky eating, and dressing, and encouraging talks about the upside of being different, can help your teen with sensory issues feel more comfortable among his peers. However, he may also feel better about himself if he expands his group of friends. Encourage your teen to develop hobbies and engage in new activities from individualized sports that don't require high levels of skill and competitiveness to enjoy them to groups that engage in the arts, community service, spiritual growth, etc. Extracurricular activities can help kids find their "tribe" and feel the power to make a difference in the world as well.

5. Accept that your child may be more emotionally sensitive at this stage. Be alert to signs of increased anxiety and depression and consult a medical health professional with any concerns you have. Remember, addressing sensory issues will reduce overall anxiety that can lead to mild or moderate depression (when you feel you can't manage your discomfort, over time, you can develop depression). Don't forget some of the most effective treatments for mild or moderate anxiety and depression include physical exercise, time spent outdoors, meditation, and breathing exercises. Mindfulness practices from yoga and tai chi to tai kwan do and karate can help, too.

6. Focus on self-awareness and accountability for self-regulating. It's very difficult to get others to accept poor self-regulation in a teen, even if you educate them on hidden disabilities. Therefore, the sooner you collaborate with your teen in creating a workable sensory diet that prevents negative behaviors, the better. It will be easier for your teen to develop better self-regulation if she is trained in using specific self-calming and self-alerting techniques that she knows work for her. Hold her accountable for using her alerting music and gum, taking time out to sit in a quiet space and do breathing exercises or use a brushing protocol, etc. Have her participate in creating a sensory diet tailored to her needs to keep her sensory needs met and to prevent fight-or-flight behaviors. Let her experience the natural consequences if she refuses to use her calming, focusing, alerting techniques.

Above all, never forget that kids with sensory issues need a "just right" challenge, a balance of accommodations to make them more comfortable and challenges that take them out of their comfort zone. Sensory diet activities for teenagers help them to develop a higher tolerance for situations and activities they'll encounter in life, and over time, retrain their brains to process sensory information more typically. Be creative and encouraging in setting up a sensory diet for a teenager, and always be collaborative to respect the teen's need for independence.

Finally, if you're a parent frustrated by trying to get your teenager's sensory issues under control, consider joining an in-person or online support group or creating one. Knowing that you aren't alone, and having practical and emotional support from other parents going through the same experiences with their teen, can help you enormously at this stage of your child's development.

Nancy Peske is the coauthor of the book Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues. Learn more about sensory issues at http://www.sensorysmartparent.com and visit Raising a Sensory Smart Child on Facebook.

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Treating the Sensory Problems of Autism

So what is autism? First of all, we must make some distinctions. There are various types of difficulty within the spectrum of disability of which we are speaking. The major distinctions are as follows:

Autism Asperger's syndrome, Rett Syndrom, Childhood Disintegrative Disorder. The most prevalent and commonly known two of these are autism and Asperger's Syndrome.

What do we mean when we say autism is a 'spectrum disorder?'

When the term, 'spectrum disorder' is used it means that there are a range of symptoms, which can be attributed to autism. Any one individual may display any combination of these symptoms, in differing degrees of severity. Therefore an individual at one end of the autistic spectrum may seem very different to an individual at the other end of the spectrum.

Who first discovered autism?

Autism was first recognized in the mid 1940's by a psychiatrist called Leo Kanner. He described a group of children, whom he was treating, who presented with some very unusual symptoms such as; - atypical social development, irregular development of communication and language, and recurring / repetitive and obsessional behaviour with aversion to novelty and refusal to accept change. His first thoughts were that they were suffering some sort of childhood psychiatric disorder.

At around the same time that Kanner was grappling with the problems of these children, a German scientist, Hans Asperger was caring for a group of children whose behaviour also seemed irregular. Asperger suggested that these children were suffering from what he termed 'autistic psychopathy. ' These children experienced remarkably similar symptoms to the children described by Kanner, with a single exception. - Their language development was normal! There is still an ongoing debate as to whether autism and Asperger's syndrome are separable conditions, or whether Asperger's syndrome is merely a mild form of autism.

What is the cause of autism?In the 1960s and 1970s there arose a theory that autism was caused by abnormal family relationships. This led on to the 'refrigerator mother' theory, which claimed that autism in the child was caused by cold, emotionless mothers! (Bettleheim, 1967). However the weight of evidence quickly put this theory to bed as evidence was found to support the idea that the real cause was to be found in abnormalities in the brain. This evidence was quickly followed by findings, which clearly demonstrated that the EEG's of children with autism were, in many cases, atypical and the fact that a large proportion of children also suffered from epilepsy.

From this time, autism has been looked upon as a disorder, which develops as a consequence of abnormal brain development. Recently, evidence has shown that in some cases, the abnormal brain development may be caused by specific genes.

However, we should not forget that genes can only express themselves if the appropriate environmental conditions exist for them to do so and so, we should not rule out additional, environmental causes for autism. We should not forget that autism can also be caused by brain-injury, that an insult to the brain can produce the same effects as can abnormal development of the brain, which may have been caused by genetic and other environmental factors. I have seen too many children who have suffered oxygen starvation at birth, who have gone on to display symptoms of autism. So, it is my view that autism can also be caused by brain-injury.

There are also other possibilities, which can ultimately produce the type of brain dysfunction, which we recognize as autism. There is a great deal of research being carried out at the moment in the area of 'oxidative stress' and methylation and it's effects upon the integrity of neural networks. There is also the debate surrounding mercury levels in vaccines, which is as of yet, unresolved.

The fact is that 'many roads lead to Rome. ' - There are likely to be several factors both genetic and environmental, which can ultimately lead to the type of brain dysfunction, which we call autism.

So, how do we recognize autism?

On a descriptive level, autism involves a dysfunction of the brain's systems, which control communication, socialization, imagination and sensory perception. My theory is that it is the distortions of sensory perception, which are so characteristic of autism, which exacerbates many (but not all) of the other difficulties. Imagine a child suffering from autism who suffers distortions of sensory perception. For instance, the child who suffers distortions of visual perception, might find situations which require eye -contact to be exceptionally threatening, or on the other end of the scale might become obsessive about specific visual stimuli. The child who suffers distortions of tactile perception, might at one end of the spectrum find any situation which requires physical contact to be terrifying, whilst at the other end of the spectrum, they might be a 'sensation seeker' to the point of becoming self -injurious. The child who suffers distortions of auditory perception might at one end of the spectrum, be terrified of sounds of a certain pitch or intensity, whereas at the other end of the spectrum, they might actively seek out, or become obsessive about certain sounds.


The question is, what can we do to help redress these distortions of sensory perception. Well, we can learn from the newborn baby. When baby is born, he sleeps for most of the time, only spending short periods of time interacting with this new environment in which he finds himself; - a new environment which bombards his senses with new sights, noises and smells. So he retreats into the safe, calm environment of sleep, which provides the sensory safe haven which up until recently was the sanctuary of the womb. Very gradually, as baby adjusts his sensory system to his new environment, he spends more and more time in the waking world, interacting and learning to communicate, - but he adjusts very gradually!

There is possibly a neurological explanation for this. There are structures within the brain, which act to 'tune' sensory attention. These three structures, which allow us to tune our attention are structures, which enables us to 'tune out' background interference when we wish to selectively attend to something in particular. They also enables us to 'tune in' to another stimulus when we are attending to something completely different. They are the same mechanisms of the brain, which allows us to listen to what our friend is saying to us, even when we are standing in the midst of heavy traffic on a busy road. It is these mechanisms that allow us, even though we are in conversation in a crowded room, to hear our name being spoken by someone else across that room. It is these mechanisms, which allow a mother to sleep though various loud, night-time noises such as her husband snoring, or an airplane passing overhead and yet the instant her new baby stirs, she is woken. It is a remarkable feature of the human brain and it is the responsibility of three structures operating cooperatively - these are the ascending reticular activating formation, the thalamus and the limbic system.

Having made such a bold claim, allow me to furnish you with the evidence to support it. The three structures just mentioned receive sensory information from the sense organs and relay the information to specific areas of the cortex. The thalamus in particular is responsible for controlling the general excitability of the cortex (whether that excitability tunes the cortex up to be overexcited, tunes it down to be under excited, or tunes it inwardly to selectively attend to it's own internal sensory world. ) (Carlson, 2007). The performance of these neurological structures, or in the case of our children, their distorted performance seems to be at the root of the sensory problems faced not only by newborn babies, but the sensory difficulties our children face and yes, as the newborn shows, their performance CAN be influenced, - they can be re-tuned.

I believe the sensory system of some children with autism is experiencing similar difficulties to that of a newborn, - at one end of the autistic spectrum, the cortex is being over-excited by these structures and the person is overwhelmed and has difficulty accommodating the mass of sensory stimulation within the environment. At the other end of the autistic spectrum, the cortex is being under-excited and the person has trouble in perceiving sensory stimulation from the environment. The question is; - How do we facilitate the re-tuning of this neurological system in individuals who have autism. The newborn retreats into sleep, a self imposed dampening of incoming sensory information. Whilst the child with autism does not do this, many children with autism attempt to withdraw from their environment because they find it so threatening.

We believe at Snowdrop that for the child at the end of the autistic spectrum who is suffering an amplification of sensory stimulation, we should create a setting where he can retreat from a world, which is overwhelming his immature sensory system. This 'adapted environment,' which should be as free as possible from all visual, auditory, tactile and olfactory stimulation will serve as a milieu where his sensory system can re-tune itself. Of course it may just be a single sense like vision, or hearing, or tactility, or any combination of senses, which are causing the difficulties and the environment may be adapted appropriately. The child suffering these difficulties will usually welcome this adapted environment, which is in effect a 'safe haven' for his immature sensory system. He should be given free access to, or placed within the adapted environment as needed and you will notice hopefully that he will relax and begin to enjoy being within its safe confines, where there are no sensory surprises.

This procedure should be continued for as long as necessary, - for several weeks or months. Indeed, some children might always need periods of time within the 'safe haven. ' As the child begins to accept and be at ease in his safe haven, stimulation in whatever sensory modality is causing the difficulties, should begin to be introduced at a very low level, so low in fact that it is hardly noticeable. If the child tolerates this, then it can be used more frequently until it becomes an accepted part of the sensory environment. If the child reacts negatively in any way, then the stimulus is withdrawn and reintroduced at a later date. In this way, we can very gradually begin to build the level of tolerance, which the child has towards the stimulus.

For the child at the other end of the autistic spectrum, the child whose sensory attentional system is not exciting the cortex enough, with the consequence that he is not noticing enough of the stimulation in his sensory environment, the approach needs to be the exact opposite. These are the children who we see producing self-stimulatory behaviour. I believe that this behaviour is an attempt by the nervous system to provide itself with what it needs from the environment, - a sensory message of greater intensity! We see many children with autism 'flapping' their hands in front of their eyes, or becoming visually obsessed by certain toys, movements, colours etc. I propose that this is a reaction by the nervous system to attempt to increase the intensity, frequency and duration of the sensory stimulus due to a problem with perceiving visual stimuli from the environment.

Of course, children with autism display a far greater range of difficulties than a theory, focused upon a malfunctioning sensory - attentional system could explain. I am not attempting to claim that sensory problems on their own are an adequate explanation for every facet of autism, - that would be ridiculous! This is merely a possible explanation of a range of issues experienced by some children who have autism, which could be produced or exacerbated by the child suffering distortions of sensory perception. For instance, the following symptoms within the autistic spectrum could possibly be explained at the sensory level.

Failure to make eye contact. Difficulty in sharing attention with anyone. Avoiding interaction with others. Avoiding physical contact. Seeming disconnected from the environment. Appearing not to notice anything visually. Visual distraction, as though the child is looking at something which you cannot see. Visual obsession with particular features of the environment. Inability to 'switch' visual attention from one feature of the environment to another. General discomfort with the visual environment. Appearing not to hear anything. Auditory distraction, as though listening to something which you cannot hear. Auditory obsession with particular sounds within the environment. Inability to 'switch' auditory attention from one sound within the environment to another. Inability to 'tune out' extraneous sounds in the environment. General discomfort with the auditory environment. Appearing not to feel much sensation. Appearing to bee distracted by tactile stimuli of which you are not aware. Obsession with particular tactile sensations within the environment. Appears unable to 'switch' tactile attention from one sensation to another. General discomfort with the tactile environment. Difficulty in communicating with others.

We believe at Snowdrop, that our sensory re-tuning environments offer the best chance for children to overcome such distortions of sensory perception.

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2012年6月25日 星期一

8 Important Items to Help You Advocate For Your Child With Aspergers Syndrome

Has your child recently been diagnosed with Aspergers Syndrome, and you are struggling to get your school district to recognize the diagnosis? Would you like to learn some important information to help you in your special education advocacy efforts, for your child? This article will specifically address things that you need to know to help you fight for special education services for your child.

Things that you need to know.

1. Aspergers Syndrome has its own category in the Diagnostic Statistical Manual (DSM IV) that is used for diagnosis. It is under the umbrella of Pervasive Developmental Disorders (PDD).

2. The American Psychiatric Association is proposing changing Aspergers Syndrome from its own category to within the autism category for the DSM V. The intent is to try and make the diagnosis of autism clearer. The decision will be made within several months (middle to end of 2010).

3. From an educational standpoint this is a wonderful decision, in my opinion, that will benefit thousands of children throughout the United States. Why? Many school districts have denied children with this disorder special education services because they state that the child does not have autism, and so therefore is not eligible. But in reality the Individuals with Disabilities Education Act state that a child must have one of 13 covered disabilities and have educational need. Aspergers is a part of the autism spectrum and should be a covered disability; though you may need to advocate for this.

4. Many children with this disorder will require help learning appropriate social interactions and social skills. This should be provided as a special education services for your child if they need it. It could be working directly with a school social worker or participating in a small group social skills class.

5. Small groups may help your child with their education and also to develop appropriate social skills.

6. Modifications and adaptations in the regular classroom may help your child keep up with their peers.

7. Sensory integration disorder is common in many children with this disorder, and shows itself in difficulty with lights, sounds, different foods and different fabrics. If your child shows this difficulty, ask your school district for testing by an Occupational Therapist who is SIPT qualified (has received specialized training in the area of sensory integration/processing disorder).

8. Many children with Aspergers may need Occupational Therapy also for motor clumsiness. Ask for specific testing in this area if your child shows need.

Keep these 8 items in mind when you attend Individual Educational Plan Meetings (IEP) for your child. They will assist you in trying to help your child receive a Free Appropriate Public Education!

JoAnn Collins is the mother of two adults with disabilities, and has helped families navigate the special education system, as an advocate, for over 15 years. She is a presenter and author of the book "Disability Deception; Lies Disability Educators Tell and How Parents Can Beat Them at Their Own Game." The book has a lot of resources and information to help parents fight for an appropriate education for their child. For a free E newsletter entitled "The Special Education Spotlight" send an E mail to: JoAnn@disabilitydeception.com. For more information on the book, testimonials about the book, and a link to more articles go to: http://www.disabilitydeception.com.

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Alternative For ADHD - Discover the Truth About Sensory Integration Therapy and ADHD

Probably the most famous treatment for persons with ADHD is pharmacotherapy. Why is that, you may ask. Well, that is because when children, let us say your child is diagnosed with a condition, the first professional that you may think can help you are doctors. Yes, that is correct; they can help you. However, you should know that the help they can provide you is limited. They may know a lot about ADHD but the treatment approach that they are trained to perform is limited into prescription of medicines. However, they know the right persons who can attend more to your child's problem that is why there are things like referrals.

Now, let us first have an overview of ADHD. It is a neurobiologic disorder that has three hallmark features; that is inattention, impulsivity and hyperactivity. Now, here comes the tricky part. Most of you may think that these symptoms are purely behavioral, but you are wrong. There is actually what professionals call the sensory integration dysfunction. Now, what exactly is sensory integration? It is the ability to process, organize and synthesize sensory information that a person may receive from the body and/or the environment. Most of the time, it is the children with Autism that usually have sensory integration dysfunctions. However, there have been cases of children with ADHD who also have Sensory integration (SI) problems. These SI problems may manifest either the child will withdraw or seek a particular sensation. In your child with ADHD, his or her hyperactivity may actually be a sign that your child is seeking a particular sensation. Therefore, treatment approaches like behavior therapy would not work in your child, thus the Sensory Integration Therapy. This is an alternative for ADHD treatment which makes use of sensations and will manage your child's behavior through giving your child the amount of sensation that your child is seeking. After this has been achieved, there will be an immediate and significant change in the behavior of the child. Your child may be more attentive in the tasks assigned to him or her. Although there are studies proving its effectiveness, for some, these studies are still insufficient. Therefore, there still are debates regarding this intervention approach. However, these are still used in clinics but those who perform it do it carefully.

This information only means that there are still a lot to learn about ADHD and that the problems that your child may have may not be what you expect. So if your child is not responding to a treatment approach, this may mean that this is not your child needs, and so you may study more about the condition and ask question to expand your knowledge.

Puneet writes a blog about ADHD and helps ADHD sufferers to find new treatments in naturopathy and alternative medicine. If you are looking for a well-researched herbal remedy for ADHD, you may read more

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Halloween Fun For Children With Sensory Processing Issues

Halloween parties, costumes, masks, and treats--you can't count on any of these being fun for the child with sensory issues! No wonder October 25-31 was chosen to be National Sensory Awareness Week, drawing attention to the 1 in 20 children who have the hidden disability of sensory processing disorder, also known as SPD, or sensory integration dysfunction. Fortunately, you can make Halloween more enjoyable for the child who struggles with sensory issues.

Costumes and masks often involve new sensations against the skin and body that a child may find repulsive. Experiment beforehand with any make-up, masks, wigs, or hats and see if the child can truly tolerate them for a few hours. For a costume, consider working from the basic pieces of a soft, cotton top and bottom, such as a sweatsuit or pieces of clothing purchased at a used clothing store or pulled from his play clothes pile. Add elements and props that he can hold or wear comfortably. Start looking for a costume early, when the selection is best. Purchase a used costume or costume elements through eBay, second hand shops, and Craigs List to keep your costs down because after trying a costume for a few minutes, your child may realize it is too tight, scratchy, or uncomfortable in some other way.

Treats with plenty of sugar and artificial colors and flavors should be limited for all children, but kids with sensory issues are often more sensitive to these substances. Let her gather all her loot post trick or treating and choose the favorites, then have the rest mysteriously disappear overnight (maybe after using them as math counters!). Or hoard it to use a piece at a time as rewards for overcoming challenges, doing extra chores, or use in therapy. If your child has an occupational therapist or speech therapist, speak to this professional about the possibilities. For example, sour candies in particular can be good for helping a child with poor self-regulation who is stuck in the "loose and floppy" mode to become more alert so she can focus and attend to homework or school work.

If your child has food allergies and intolerances, skip the highly processed, sugary treats altogether. Have a party instead of going Trick or Treating, and provide healthy, fun snacks and nonfood items such as stickers, pencils, and small toys.

Offer opportunities to escape from the noise and bustle of a party or trick or treating. A quieter street to walk down or an empty bathroom or bedroom where she can regroup will help her avoid sensory overload. Let her know what to expect from the occasion, from kids jostling her in doorways and running past her on the street to scary sounds and lighting changes like strobe lights at a Halloween party. And consider celebrating Halloween at a nature center, zoo, or cultural center with a quieter, more structured program, or having a small party at home.

You may want to use this opportunity to talk about fears and how to manage them. Books such as Go Away Big Green Monster by Ed Emberley, featuring a monster the younger child constructs then deconstructs as he turns the pages, can help ease anxiety about monsters and other scary creatures.

And if you do not celebrate Halloween, or your child finds it too scary, consider creating an occasion to give her the "just right" challenge of dressing in unfamiliar clothing and using her imagination to pretend she is someone else for a short time. Costumes and dress-up play encourage young children to break out of cause-and-effect, parallel play and graduate to cooperative, imaginative play, which are important developmental skills. Whatever you do on October 31, please be sensory smart and understanding of your child with sensory issues.

Copyright © 2009 Nancy Peske

Nancy Peske is an author and editor and the parent of a child who at age 2 was diagnosed with sensory processing disorder and multiple developmental delays. Coauthor of the award-winning Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, available from Penguin Books, Nancy offers information and support on her blog and website at http://www.sensorysmartparent.com She has been active in the SPD community since 2002.

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2012年6月24日 星期日

Dealing With Attention Deficit Disorders

Attention deficit disorders are associated with neurotic hyperactivity, the acronym for the disorder name is "ADHD." As the name suggests, the person with this kind of affection has episodes characterized by mental haziness, fidgeting and impulsiveness. Because these behavioral patterns are normal but infrequent manifestations in human beings, it becomes difficult to diagnose a patient as an attention deficit patient. There are no clear-cut percentages or counts to determine the boundary line between normal and pathological attention deficiency. The symptoms may appear in three ways, prevalently inattentive, prevalently hyperactive, or, inattentive and hyperactive in equal intensity.

Inattentive symptoms include:

1. Distraction, forgetfulness, overlooking details and fidgety-ness

2. Great difficulty in focusing attention

3. Getting bored easily with emotionally monotonous tasks

4. Unable to organize one's self or the activity on hand

5. Tendency to lose items

6. Tendency to ignore what others are saying

7. Daydreaming

8. Slow movements

9. Unable to process information fast

10. Inability to follow instructions

Hyperactive symptoms include:

1. Restlessness

2. Continuous chattering

3. Jumping about and touching and playing with things

4. Unable to remain still

5. Impatience and impulsiveness

6. Irresponsible actions or speech

7. Difficulty waiting for one's turn in a game or in a queue

Attention deficit and hyperactive disease has been attributed to many causes. The first is evolutionary. This hypothesis claims that this disorder is really a hand-me-down from the pre-agricultural, hunters of past ages. It suggests that during those times, the symptoms of attention deficit disorder, may have been essential for survival. It further claims that this pattern of behavior may actually be beneficial to a society.

Another possible cause is the exposure of the fetus to alcohol, nicotine and lead. Also implicated in this respect are complications and abnormalities during child birth. Nicotine produces hypoxia in fetuses and has been tagged as one of the factors increasing the chances of acquiring attention deficit disorder.

Substances used for coloring food are also suspected to encourage attention deficit disorders. Some artificial food colors; sunset yellow FCF (E110), quinoline yellow (E104), carmoisine (E122), allura red (E129), tartrazine (E102) and ponceau 4R (E124), and the preservative sodium benzoate have been linked to attention deficit disease. While many countries have not banned the use of food colors, some countries may require manufacturers to inform the public of the presence of suspected culprit colors in their products. In the USA food labels may contain text like: "Contains FD&C Red #40." This suggests that the effects of food dyes may influence the person's capacity for sensory integration, resulting in the various manifestations that simulate the symptoms of this disease

Child violence and child abuse are also known to produce behavioral patterns in children similar to attention deficit affliction.

The beneficial effects of stimulant drugs on ADHD patients has produced the theory that these people have a high arousal threshold. This directly causes the lack of attention and dreaminess states. In turn, to cope with this under-stimulation from the surroundings, the patients resort to intense movement, talkativeness, emotional behavior and fidgety-ness.

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Non-Medication Options For Addressing (ADD) Attention Deficit Disorder And (ADHD)

Though the degree and severity of symptoms vary from person to person, physicians typically look for indicators of inattentiveness, impulsively, and hyperactivity in children. Parents and teachers may notice off task behavior, inattentiveness, disorganization, fidgetiness, impulsiveness, poor penmanship, failure to complete assignments, difficulty following multiple step directions in their children. Also the child may exhibit frustration or short temperedness. These challenges may impact individuals in all areas of life.

Children desire to please both their families and teachers but they are often unable to control the behaviors that may appear as noncompliance and require continuous redirection. Persons with ADD/ ADHD have been described as having brain activity that moves quickly with multiple thoughts in more varied direction than they can focus upon. Often, children unconsciously move their bodies in an attempt to match the pace of their thoughts.

Sensory integration dysfunction (over sensitivity with 1 or more of the 5 senses), food and environmental allergies, and vision problems are often associated with ADD/ADHD. The lack of structure and consistency may also increase symptoms. Excessive rigidity of movement in the class without movement breaks or supports can increase behavior challenges.

Foods that are highly processed with artificial ingredients, colors, and dyes, burden the body and fog the brain, and can amply increase the symptoms. Food sensitivities to wheat, gluten, dairy, and vitamin deficiency can also impact focus and attention.

Supportive Aids to reduce the impact of symptoms in school:

Children can be provided with checklists for routine activities to support independence and task completion, organizational binders for school, color code information by categories, highlight key information, use graphic organizers for note taking, alternate note taking options or response options that could include audio or video recording information.

Strategies to Improve Focus:

Deep breathing, meditation, "location of focus", and allergy elimination techniques are holistic non-medication ways to support children with ADD/ADHD:

Deep breathing can slow down and quiet the body and mind. This is great for children who may have difficulty sleeping. Meditation can also be incorporated before lengthy tasks. Though the child's mind may wander, practicing this daily technique will assist the child with the awareness of drifting attention.

These tools can be used just a few minutes multiple times a day. For children who are unable to sit and meditate, it can be done standing, lying down or walking. If this is done walking, place the focus on the lower half of the body and the placement of the feet. No special position or stance is necessary. Just a comfortable posture that works for the child can be used. The pacing can be set to the needs of the child but they should be thoughtful, deliberate, and conscious.

Doing a quick location activity can be done in the class or home within minutes to increase attention prior to lengthy assignments or tasks that require sustained engagement.

"A location" is done with by pointing and verbally identifying objects in the physical setting using the statement " I see a ... book, picture, phone, clock, ...) Continue with 10 items or until there is an apparent calmness or increased focus. This helps bring the child to a conscious presence.

Allergy elimination techniques assist the body of removing and reducing food and environmental burdens that create dis-ease in the body that may cause attention and focus dysfunction.

Addressing the Pressure to Medicate:

The school staff is well aware that they should not offer medical advice when they are not qualified to do so. It may be presented as recommendations to seek medical advice and that medications may assist the child to be more compliant in school.

As a family, succumbing to pressure by school staff to medicate your child can be minimized by redirecting the attention to the current interventions that are being used and letting school personnel know what you as a family are also doing as well. Reassure school personnel that your child's academic and social success is a family priority but be firm if medication is not an option for your family.

As medications are not a cure all and require ongoing monitoring for continued success and side effects, a family may choose to include medication in their intervention protocol. It is highly recommended that medication be considered only after other approaches with less long term detriment have been found ineffective.

Connecting with Other Families:

(CHADD) Children and Adults with Attention Deficit/ Hyperactivity Disorder is the national ADD organization with local chapters around the nation. There are local support groups in many major areas to assist families to connect with community resources. Getting your child involved in athlete activities or other community structured activities can support a positive self image.

Families may connect with supportive, attentive, and respectful medical and holistic professionals that welcome feedback and support your family's desires for your child. Continue to search and ask others for referrals until you find someone who you feel has your interest and concerns as a priority.

Children want to please, so creating or supporting opportunities for success will go a long way to reinforce intervention efforts. Set expectations within reach of your child's functioning level even when they may not be comparable to that of his or her age or someone else's abilities.

Patricia F. Glenn, Ed, S., is the President and Founder of Practice in Motion Training Institute, Inc. in Atlanta, GA. Practice in Motion's primary goal is to empower and equip families to better care for children with special needs. However its staff is trained in many therapeutic disciplines to serve all children from preschool through young adulthood. For more information about Practice in Motion Training Institute, its programs and services, visit http://www.practiceinmotion.com or email practiceinmotion@gmail.com.

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2012年6月23日 星期六

Gifted Children - Do They Have Sensory Sensitivities?

Gifted children are a joy and wonder to watch as they effortlessly progress through many different facets of growth and development. Their intellectual capabilities are far beyond those of their peer age group. They possess outstanding abilities and are capable of performing at astonishingly higher levels of performance when compared to other children. Although there are many standardized tests of intelligence that help educators and professionals accurately identify gifted students, parents usually recognize their advanced development first.

It is very likely that most parents recognize that there is something unique and special about their gifted child during the first three years of life. Gifted children demonstrate extraordinary growth and development skills during this time. They accomplish and surpass expected milestones months or even years before other children their same age. Parents observe their children rapidly progressing through various stages of development and they are often described as "ahead of their age". Some of the signs of a gifted child include:

Many gifted children learn to read earlier than expected and can more easily understand what they read.
They learn basic skills more quickly and apply reasoning at an early age.
They are curious and ask more questions about "how" and "why".
Gifted children usually communicate well verbally with their parents, siblings, peers, and even strangers -- and they usually have an expanded vocabulary.
They appear to be very organized and efficient.
Gifted children enjoy a challenge and seek opportunities to grow developmentally and solve new problems.
They are able to understand abstract ideas, non-verbal communication, and other types of communication.
These are just some of the potential characteristics of gifted children. There are many more signs that indicate a child has a special talent and ability to learn, communicate, grow, and develop. Parents and teachers who recognize these signs will often give gifted children many more opportunities to learn and excel.
But recent studies also indicate that gifted children may suffer from sensory sensitivities more often than their non-gifted peers. Based on his research, W. Roedell, in his article published in Roeper Review, theorizes that the gifted child often has intense sensitivity. This means that gifted children may undergo more stress due to their inability to effectively process some of the sensory signals travelling through their bodies and to their brains.

To understand what this means, it is important to understand how sensory integration works. Sensory integration is the ability for people to process sensory data and information collected from the five senses and from the environment surrounding them. It is a neurological process that carries the stimuli to the brain where it is processed, organized, and evaluated for usable information or actions. When sensory integration is interrupted or does not function properly, it is like a mis-fire or mis-cue to the brain. Pieces or parts of information are missing and it is difficult for the brain to process the data. This can result in problems with daily living skills, academic progress, or social interactions.

While parents may be swelled with pride and adoration as they watch their young gifted child grow and develop - and justifiably so - they may overlook this important aspect of their child's development and behaviour. They may believe that their child has difficulty socializing with peers because "he is just smarter than they are" or "he needs more mature interactions". Unfortunately, the real problem may be that he may be experiencing sensory integration dysfunction and it is too difficult for the child to engage in social interactions, develop friendships, or enjoy activities with other children.

If a gifted child is affected by sensory integration challenges, it is possible that he or she may have more functional problems than other children. They could become more aggressive, impulsive, withdrawn, and introverted than other children. They do not experience the gratification and developmental processes associated with healthy social interactions because they do not participate in social activities as often.

So where does all of this information and data lead us when it comes to helping gifted children overcome sensory integration dysfunction, or teaching them to manage through some of the challenges associated with this issue?

Educators, therapists, and counselors must be keenly aware of this issue and must evaluate gifted children carefully to assess whether or not it is a problem. Utilizing this information when developing and observing children in classroom settings, activities, and social activities becomes vital to understanding any special needs of gifted children.

For example, although gifted children may be well above their peers in intellectual capacity and application, they may experience more sensitivity and have difficulty processing certain noises, sights, or sounds. They may find that bright fluorescent lighting creates a feeling of confusion or anxiety for the gifted child. Turning down the lights to accommodate the child may help. If the child is more sensitive to loud noises, then playing music at a lower volume or speaking in a softer tone may be beneficial. Parents and teachers both need to understand the sensory stimulus that affects a child and help the child learn to deal with the challenge. But they must also teach the child how to cope with the sensory sensitivities in various ways.

In "Sensory Sensitivities of Gifted Children", there is an indepth view and analysis into this topic. The theories and hypotheses that are addressed through various researchers indicates that gifted children may have different sensory modulations (or different ways of processing sensory stimuli) than those who are not gifted. W. Roedell theorizes that "gifted children's unique challenges and skills are likely embedded in a neurological system that perceives and responds to the environment differently from children of typical intelligence."

As parents, teachers, and professionals, we must learn to understand the gifted child better and evaluate whether or not sensory integration challenges are present. This also means that we must find tools and resources to help gifted children manage their sensory challenges so they can focus, concentrate, and become more socially engaged. Until now, many educators and professionals believed that sensory integration dysfunction was a problem associated with children who had ADHD, hyperactivity, or other disorders. This new research opens up a whole new world of possibilities to provide the gifted child with better guidance and resources related to the sensory processing.

Rather than assume a gifted child is just acting inappropriately in a social environment, or that the child has behavior problems, or even that the child just doesn't want to play with children his own age due to his higher intelligence level, parents and professionals should explore the tools, resources, and information that can better assess and uncover the real problem. A higher intellectual capacity is just one aspect of a gifted child's life and world. They excel above their peers in this area, but they may also experience psychosocial issues that deter them from engaging in vital and rewarding developmental social interactions with others.

Accessing information and tools to support the growth and development in all aspects of the gifted child's life is an important part of the educational and nurturing process. For further information on research or resources related to gifted children and sensory sensitivities, or sensory processing difficulties, refer to the full studies noted in this article.


Roedell, W. (1984). Vulnerabilities of highly gifted children. Roeper Review, 6, 127-130.

Miller, L., Anzalone, M., Lane, S., Cermak, S., & Osten, E. (2007). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61, 135-140.

Gere, D. R., Capps, S. C., Mitchell, D.W. & Grubbs, E. (2009) Sensory sensitivities of gifted children. American Journal of Occupational Therapy, 64, 288-295.

Debbie Hopper, an accredited occupational therapist, has a Masters Degree in Occupational Therapy from the University of Sydney. Debbie is passionate about her mission of researching, evaluating, and making the most valuable resources and tools easily accessible to parents, teachers, and therapists.

With post-graduate training in sensory integration assessment and intervention, Debbie brings significant focus to this area of growth and development through LifeSkills4Kids.com.au. Debbie's passion gives her a relentless drive and motivation to continually research new and innovative resources to help children learn and benefit from all life skills.

To sign up to our newsletter, visit us at http://www.lifeskills4kids.com.au

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