Category Archives: OT

Teenagers and Sensory Issues: Special Challenges for a Special Time

As I look forward to my son entering his teens very soon, I’ve been thinking a lot about teenagers and sensory issues. Years ago, when I was first thinking about writing a practical guide for parents of kids with sensory processing disorder, I knew I wanted to cover teenagers and their sensory challenges. I knew of teens with SPD and I recognized that there was nothing out there in books or on the internet to help parents. I’m very proud to say that my coauthor, Lindsey Biel, OTR/L, and I were really at the forefront of talking about sensory issues in teens in our book.

I’m repeating here my most recent Sensory Smart News because I know how eager moms and dads, and professionals who work with teens with SPD, are to get info aimed at this particular group of kids. So here it goes:

 

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. In the award-winning book Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, you’ll find an entire chapter devoted to teens as well as many practical tips for older kids. If you are unfamiliar with the special challenges of teens with sensory issues, here they are—followed by practical strategies for addressing those challenges.

 

 

1. Finding the right OT can be challenging. 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. See Raising a Sensory Smart Child for specific advice on helping teenagers overcome their defensiveness about having sensory processing disorder and how to talk to them about the “little tricks” you and the OT can teach them to “make their lives easier.”
 

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 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?

 

Teens with sensory issues need teen-friendly activities as part of their sensory diet.

4. Help him 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, such as the ones on yahoogroups.com, 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.

Check it out!

 

Know the symptoms of depression in teens: See the information on the Mayo Clinic website. Information on Generalized Anxiety Disorder, which often begins in adolescence, can be found at WebMD.

Find more quick information on teens and sensory issues at www.SensorySmartParent.com and in the award-winning book Raising a Sensory Smart Child.

NEW WEBSITE AND BLOG! If you liked this article, PLEASE come join me at the new www.SensorySmartParent.com and sign up for my NEW newsletter and blog. Thanks!

12 Comments

Filed under exercise and movement for sensory kids, grooming, heavy work, helping your child with SPD at home, Lindsey Biel, Moms of kids with SPD, online support groups, OT, Practical tips for sensory issues, proprioceptive input, Raising a Sensory Smart Child, sensory diet, sensory diet at school, sensory processing disorder, sensory seeking, teenagers with sensory issues

Are You an Alphabet Soup Mom? Getting Beyond Labels

Just the other day, I was trying to explain to someone that we parents of special needs kids are, more often than not, dealing with an alphabet soup of diagnoses. It starts with one set of letters, disconnected from your actual child: EI (early intervention), OT (the occupational therapist who evaluates him as part of his EI evaluation)—or perhaps PT (physical therapist), or SLP (speech language pathologist). Then you get your IFSP which will later turn into an IEP and your alphabet diagnoses: SPD, ADHD, PDD-NOS, maybe FAS, RAD, ODD, OCD,  perhaps the CCC and the WPA and…oops, those are the New Deal programs of president FDR!

 

I think one of the hardest things in the beginning is to accept is that your child’s loveable quirks are now being pathologized: treated as problems, or symptoms of disorders, disabilities, and dysfunctions, and reduced to labels. Why is it a problem that my son doesn’t hold a crayon well at 27 months? He doesn’t like coloring. So what? Why are you grilling me about how he responds to being toweled off after a shower? So he hugs me hard. He’s a sweet and affectionate toddler! “Well, we think he has SID.”

 

And so, the stack of  soup labels begins to accumulate. For us, there were a lot of actual words rather than letters: One was apraxia, also known as dyspraxia, oral apraxia, verbal dyspraxia, global dyspraxia—it’s important to have as many terms as possible to make mom and dad’s eyes glaze over and keep them doing internet searches til the wee hours—damn it, what keyword will get me to the information I need?!! We also got SPD, which at the time was SID or DSI or maybe SI dysfunction, not to be confused with Semantic Pragmatic Disorder or Semantic Pragmatic Language Disorder which is sort of like autism in that it involves language pragmatics…. I never did quite understand that but I think it didn’t apply even though the SLP said there were pragmatics issues. .. . And of course, it was SID, not SIDS, which is Sudden Infant Death Syndrome.

 

Pass the Ibuprofen.

 

OK, so what else was on the IFSP (individualized family service plan) that would turn into an IEP when he aged out of EI (grew too old for the early intervention program and got an individualized education plan through the school district)? Fine motor delay—they picked that up. Receptive and expressive language processing disorders. Wait—were those disorders, or delays? I wrestled with that one for a long time and finally concluded that apraxia can’t fairly be called a delay. When a later talker finally can string a sentence together and points to his leg and says, “This is my blood song,” I’ll change my mind (translation: “blood stream.” Even at 4, my son was fascinated by the inner workings of the body, and with his word retrieval issues, “stream” became “song”). When does a delay become a disability, and when does a disability become a difference society needs to accept and stop trying to fix?

 

Once you get your cluster of labels, you find they change, or no longer fit. Fun, fun, fun! And then, when your little one begins school, you have to figure out what little boxes to check on the IEP to cover all your child’s issues. Speech Impaired—okay, that works for a language disability. But where does SPD get acknowledged? OHI. Other health impaired. Welcome to the school’s own alphabet soup!

 

It’s so hard when you think you have a handle on “what’s wrong with my child” then you get another soup label pasted onto him and his ever-thickening file, but it’s part of being a special needs parent. You have to remember that underneath it all, your kid is a unique person with his own set of qualities, and aspects of himself that can delight you one day and drive you crazy the next. You need the labels to get services, and you hope that people don’t scoff at your labels and your outsider’s evaluations and secretly think, “Yeah, I’ll tell you what’s really wrong with that kid. A lack of discipline!” Ah yes, the old “bad child, bad parent” diagnosis. This is not a medical or school diagnosis, or a functional diagnosis that a therapist issues. Apparently, any stranger on the street is qualified to issue this diagnosis, and the larger the crowd of onlookers, and the more stressed out you and your child are, the more likely it is that you’ll receive the “bad child, bad parent” diagnosis from some passerby.

 

Labels lead to services at school, and more labels such as OHI. Despite the alphabet soup, kids are still kids.

The upside to all of this craziness is we special needs moms just plain old “get” each other, don’t we? We’ve been there, done that. IEP meeting today? I don’t have to know your child’s diagnosis. I know you’re going to need some emotional support and a pep talk from the rest of us today! Did someone really say to you, “Are you sure it’s not just…behavioral?” I share your primal scream!

 

Being a mom of a kid with labels has another upside. It’s made me become more educated and more curious about other disabilities which helps me to help others. Sometimes, I can’t believe how much I know about autism for someone whose child doesn’t have autism. For years, I’ve been fascinated by the overlap between his symptoms and the symptoms of kids with Asperger’s. Let’s talk about the vacuuming thing… I get that. And the puzzle thing, and the Thomas the Tank Engine thing! And the concrete language thing, the repeating of lines from movies…yep, yep, yep.  Let’s talk giftedness and 2E.  I learn SO much by osmosis when chatting with the SPD moms whose kids are also on the spectrum. Lately, I’ve been learning more about FAS and RAD from another mom, and know that someday I’ll be passing along some ideas and insights to a mom who is dealing with ADHD and bipolar disorder but thinking maybe there there’s RAD going on.

 

Some call us warrior moms but I don’t always feel like fighting, or it seems counterproductive Sometimes, my greatest strength is in being creative, or doing research, or observing, or just forgetting it all and enjoying my child. Maybe we’re the alphabet soup parents, enjoying the richness of our experience, noticing how all the conditions blend together in the bowl but sometimes catch your eye when you dig a spoon in and focus on one or two.

 

How about you? Are you an alphabet soup mom? Have you ever passed along information about a disorder your child doesn’t have but you’ve learned about from another alphabet soup parent?

16 Comments

Filed under diagnoses, IEP, labels, OT, prognosis for kids with SPD, sensory integration dysfunction, sensory processing disorder, sensory processing disorder diagnosis, sensory processing disorder symptoms

Brain Differences Are Real! How YOU Can Retrain the Brain of Your Child Who Has Sensory Issues

The brains of people with ADHD, autism, and/or sensory processing disorder are different from the brains of neurotypical people. There’s reams of evidence this is true, including a new report on visual processing differences and ADHD. Whenever I hear people say ADHD or sensory issues aren’t real, or that some kids don’t have autism and are just the victims of bad parenting, I wish I had a portable brain scanner to whip out to show people WE ARE NOT MAKING THIS STUFF UP! (Forgive my crankiness–I hear so many of your stories about ignorant people who are convinced it’s all nonsense and I share your frustration!)

For those of you who have already accepted this fundamental reality about different brains, please remember that brains are retrainable, or plastic so there is reason to be optimistic, although it may not feel that way on your worst days. How does brain retraining work? As the saying goes, “When neurons fire, they rewire.” That means that when a neuron is stimulated and sends out an electrical signal to another neuron, a bridge between them forms. When the stimulus is repeated, the bridge is strengthened. In time, that bridge becomes very strong. That’s why we see that after a sensory smart OT does the same activity, hand over hand, with our child again and again, one day, he just “gets it” and doesn’t need cueing or demonstrating anymore. In fact, the stronger the neural network of bridges, the easier it is for him to translate the original skill to a new activity. He can blow a bubble off of a bubble wand  AND blow out a birthday cake candle.

Kids with sensory issues may need lots of practice to acquire skills such as bubble blowing. Have your sensory smart OT assign you homework--activities you can practice with your child, as part of a sensory diet, to retrain her brain.

Retraining the brain is easiest with babies, toddlers, and preschoolers, but we can retrain the brain at any age as long as any damage to the brain is not too severe. Even then, our brains are marvelous at rerouting signals so that we can make do with what we have.

What this means for us as parents is that we help our children develop more typical sensory processing, better self-regulation, and new skills through repetition and practice. Talk to your OT regularly about what she is doing with your child to build new neural networks and follow through with “homework.” My son’s marvelous sensory smart OT, Lindsey Biel, showed me how to stand over him, cueing him to keep his legs together using my own legs, and count off to jumping over three stuffed animals lain on the floor, in sequence. “1-2-3 jump–legs together! 1-2-3 jump–legs together, that’s right!” Every week, we had homework to do. It was fun and easy to work into our home routine (especially because Lindsey is a huge advocate of sensory diet activities that combine with everyday life easily). I learned that this follow through was as important as a musician practicing between lessons. Just a few minutes of each activity a few times a day helped tremendously. In fact, my son had so much fun he would often try activities on his own, or point to the equipment (it helped that he is a sensory seeker so jumping and the like always held great appeal–I know you parents of sensory avoiders have it a bit harder!).

If you haven’t done OT homework at all, or in a while, make a plan for yourself to learn what to do with your child and work on it every day, even if only for a few minutes. You can do it, and it’s fun!

Leave a comment

Filed under A.D.D. and A.D.H.D., helping your child with SPD at home, Lindsey Biel, occupational therapy, organizational issues, OT, Practical tips for sensory issues, sensory diet, sensory integration dysfunction, sensory processing disorder

Strategies to Help Kids with SPD or Autism Focus in the Classroom

Here’s a wonderful blogpiece from National Autism Resources on helping kids focus in the classroom CLICK HERE.

It’s fascinating to see how much difference and inflatable cushion or fidgets can make. There’s a Canadian company called Kid Companions that sells chewable jewelry and you can also find nontoxic chewables, and hand fidgets and inflatable cushions, in catalogues such as Southpaw Enterprises.

Wintertime is especially challenging because kids don’t spend as much time outdoors running around and using playground equipment. Encourage your child at recess time to kick a snow or ice pile, carry snow and make snow forts and snow men, and of course, shovel! But then too, check with him or her, the teacher, and the school OT to ensure your child is getting enough sensory diet activities throughout the day to stay focused in the classroom.

Leave a comment

Filed under affordable sensory items, autism and sensory issues, classroom accommodations sensory, heavy work, OT, playground issues, recess, schools, sensory diet, sensory diet at school, sensory seeking

New to SPD? First Order of Business: BREATHE

I absolutely loved Hartley Steiner’s blogpiece on what you need to do once you learn your child has sensory processing disorder. Over the years on the many online support group forums I’ve read, I’ve noticed that the typical chain of events is that the parent

1) knows something’s “off” or wrong,

2) seeks help,

3) gets told by well-meaning people that she’s “worrying too much” and second-guesses herself,

4) eventually comes across a description of SPD and thinks, oh wow, THAT is the missing piece,

5) stands there stunned, upset that there really IS something wrong, thrilled that she finally has some answers, confused by what to do next, sad because her illusion that her kid has no problems after all has just been shattered.

 

I always say that first, just take a deep breath and recognize that you are more empowered now than you were yesterday. You have more knowledge, and you’re going to build upon it. Your child is already benefitting from your hard work and diligence in finding answers. If you simply start there, feeling good about what you’ve already done to help your child, the fear starts to dissipate.

Know that there is a LOT of support. People can be incredibly generous in sharing ideas, giving feedback, and offering encouragement. If you can, join an in person support group for parents of kids with SPD (try The SPD Foundation’s Parent Connections). If not, join an online support group such as the ones through www.yahoogroups.com (SID_DSI_AllAboutKids, sensoryintegrationgroup, sensoryintegrationdysfunction, and SID_DSI). Heck, do both!

There are so many resources out there–don’t get overwhelmed. Learn just a little each day. Poke around my website, sensorysmartparent.com, and check my award-winning book, Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, coauthored with Lindsey Biel, OTR/L. Don’t feel pressured to become an expert overnight or “inhale” every book on the topic (as I did years ago–talk about information overload!). Focus on what’s most important to you: Your child’s tantrums in public or school? Her picky eating? Bedtime battles? As you start to implement some practical solutions (there’s a HUGE section on them in my book and lots of info on my site as well), you’ll start to realize you really can help your child with her sensory issues. And I promise, it gets much better!

 


Leave a comment

Filed under books on SPD, online support groups, OT, Practical tips for sensory issues, Raising a Sensory Smart Child, sensory processing disorder diagnosis

Finding a Sensory Smart OT

I’m a big believer in the value of a Sensory Smart OT. If you are looking for a private pediatric OT who can work with your child, be sure you find one who is trained and experienced in working with kids with SPD (not all have). Here’s how to start finding one.

A sensory smart OT is trained & experienced in helping kids with SPD

While some of the OTs who work for school districts or early intervention programs, also known as Birth to Three programs and by other names depending on the state, are sensory smart, not all are. What’s more, after your child has “aged out” of EI, the services are only provided if the focus is on school-related skills. If your 4 year old’s sensory-based sleep problems or picky eating are making family life difficult, know that it is not a school district OT’s job to address those very real issues.

Private OT can be very expensive out of pocket. A good sensory smart OT should know how to code her interventions to get insurance coverage from various carriers but of course, if you don’t have insurance, have a high deductible, or have limits on the number of sessions and need more, it can be costly. What if you were to work with an excellent sensory smart OT, ask her lots of questions and observe her sessions, and carry over the types of activities yourself, doing “homework”? I think you should be doing this anyway if you can (some kids will do more for an OT or in a sensory gym than they will for you at home or in the park). But if you carry over the OT activities and ensure that your OT has set up a workable sensory diet for home and for school, then you may be able to work with her on a consultation basis. So, for instance, if your child is going to start a new activity, or transfer to a new school, she might be able to come out and assess the situation or consult by phone.

Then too, make sure your OT has a copy of the revised and updated Raising a Sensory Smart Child. The book is chock full of ideas and strategies for kids with sensory processing disorder. Having worked with your child, and drawing on her training and experience, she can be an incredible asset even if you can’t afford regular OT sessions.

4 Comments

Filed under evaluations, OT, Raising a Sensory Smart Child, sensory integration dysfunction, sensory processing disorder

Helping Kids with SPD at school especially with handwriting

While this Pedia Staff interview with my coauthor Lindsey Biel, OTR/L is aimed at professionals, her straightforward way of explaining how she helps kids with handwriting, and setting up accommodations for helping kids with SPD (sensory processing disorder) at school, and more are helpful for any parent.

Does your child receive OT for handwriting? Remember, handwriting and composing written work are two different skills. Your child may need the two separated out from each other in order if her poor handwriting abilities are holding her back from expressing her thoughts “in writing.”

This week I got an ultra ergonomic keyboard and mouse and dictation software to help reduce the stress on my hands from keyboarding. I stopped handwriting anything other than short grocery lists long ago, and yet I am a full-time writer. Perhaps that’s why I totally get why kids need the skills of handwriting and composing separated out, not mushed together as if they were one thing! Ask your school about handwriting help via occupational therapy services and ask for an evaluation (follow up your request in writing by certified mail to ensure they follow through promptly). Ask about keyboarding and assistive technology, and an IEP accommodation that allows the child to dictate her answers.

Leave a comment

Filed under handwriting, Lindsey Biel, OT, Practical tips for sensory issues, Raising a Sensory Smart Child, schools, sensory integration dysfunction, sensory processing disorder, special education