Overcoming Sensory Dysfunction (Part II)

Seb has made much progress in overcoming his intolerance for hand dryers, yet he pleads that all the windows in the house be closed whenever the sprinklers are watering the landscaping. It seems he cannot stand for the incessant sizzling sounds of spraying plant drink. He begs us to turn them off.

Our current mitigation plan includes closing all of the downstairs windows while the sprinklers quench the thirst of parched palms. As the summer continues to heat up, open windows cool the house. To optimize the watering schedule, keep the windows open and the house cool, I am about to reprogram the sprinklers to go off at a time when Seb is fast asleep. Meanwhile, we are patient that we’ll soon have a chance to explore potential long-term solutions to help Seb increase his tolerance for treble.

So many interventions are available for toddlers who’ve been diagnosed with ASD, the search for appropriate treatments can be baffling. My wife and I struggle to find appropriate sensory integration therapy, otherwise known as Occupational Therapy (OT), for our son. We sort through services available from public and private agencies. We find the right therapist by calling and interviewing them. Sometimes we need to pay for a trial evaluation. If we think we have a match, then we scramble for funding for frequent sessions, which might include a necessity to endure a grueling 45-day process to obtain pre-approval through our health insurance. Moreover, we know not all interventions are created equal.

Seb is slowly learning to embrace the sounds of life. At the History of Music Museum in Carlsbad, for the first time ever, he picked up the drumsticks.

Shopping for therapies is not like sampling desserts at the end of the frozen foods aisle of Costco. We cannot take one home, try it out, and if we don’t like it, return to Costco the next day to sample another. True, a single session with a therapist might tell us if we’ve bitten into something nasty.

Then again, a single session will not tell us if we have struck it rich and found an effective treatment. Therapies must be explored and tried out over the course of a month or more. Sometimes, we need to put our son on a wait-list that can take more than six months before an evaluation may even be made. Other times, the benefits of a particular therapy are not revealed for as long as a year. For instance, successful parents of ASD kids tell us that hyperbaric oxygen therapy might require almost a year of sessions before a breakthrough occurs. After a lot of time, patience and many payments to the health care provider, they finally experience results.

With various types of sensory integration therapy available, a kid with sensory dysfunction might need one or more of them, depending on his needs and the results of evaluations. Some are more effective for kids on one end of the spectrum, and less effective for those on the other. Some good for small kids, others perfect for big ones. Some more effective for your kid, less effective for mine. Fortunately, a wide range of intensities for sensory integration therapy exist to correct specific deficits in sensory processing.

Sensory Integration Therapies

Here is my brief description of sensory integration therapies that either have worked for our kid or we would like to try in the future:

Fast Forword: Fast Forword is a scientifically designed series of computer-based games that aid a child to process sounds, specifically those associated with language and communication. The program is typically administered by a speech pathologist over the summer, every day for about an hour. If playing computer games on an iMac were not exciting enough, as an incentive to play the games, the administrator of the program Seb took, Wings Speech and Lanugage Center, implemented a token economy. Seb saved his tokens and was rewarded with a small prize at the end of each week.

In one game, a child learns to listen and recognize all of the sounds of a single word. This game has a tic-tac-toe grid of the same drab, blobby shape, for a total of nine blobs. Obviously, the grid is designed to facilitate the player to focus on sounds, rather than on graphic presentations. The game begins by sounding a control word, a word that must be recognized to score points. Our son listens with headphones to the stretched control word. The software stretches and thereby lengthens the word’s sounds. Then each of the nine shapes sounds either the control word or a similarly sounding word. When Seb recognizes the word, he clicks the mouse to acknowledge and scores points. The points measure his progress and help him attain rewards.

Seb and Ashley make monkey bars out of the playground equipment. The goal of sensory integration therapy is to help Seb turn the world into his own personal jungle.

Big Fun Gymnastics: Big Fun Gymnastics is a provider of high-intensity sensory integration therapy. This therapy is administered in professional Olympic quality gymnasiums around the Los Angeles area and Orange County. The therapy incorporates competition-scale gymnastics equipment into exercises. The therapist utilizes balance beams, trampolines, parallel bars and gigantic foam shapes to build obstacle courses intended to challenge a kid with ASD. By training in the gym, our son developed motor planning skills by working through relatively complicated courses. Seb also demonstrated his rotational tolerance by sitting strapped into a swing and spinning like a top for several minutes. Once the therapist stopped the swing from spinning, Seb hopped down and proceeded to run in a straight line across the mat. This intensive sensory integration therapy helped Seb to develop a working memory, which is required to successfully approach and carry out novel, complex and multi-step procedures and routines.

Karate for All: Seb was recommended for this by his pediatric neurologist. This is a blend of martial art and occupational therapy that combines for an intensive sensory integration therapy. The chops, kicks, rolls, hops and blood-curdling Kiai of this martial art would certainly provide Seb with the kind of stimulation he naturally seeks. The discipline of this sport might help him with his focus. A group class might satisfy a need for our son to participate in community based activities, but individual classes are also available. Karate for All has two locations, one in Tustin and the other in Mission Viejo. If we were residing in any city in Orange County, we would be taking our son to Karate For All to give it a good try.

A Sensory Diet: A promise often made by school occupational therapists and teachers is that an appropriate sensory diet will be implemented in school to help kids with sensory processing dysfunction. A symptom of sensory dysfunction is a short attention span–really short, like, at times, a couple of seconds. Affected kids are easily distracted in a typical classroom. A sensory diet enables the kid to function in a learning environment without being distracted by the multitude of sights and sounds. It helps with reading, listening and otherwise sitting still and following directions in the classroom.

A typical sensory diet includes simple fidget toys that are handed to kids whenever they appear to be ready to bounce around the room. An example of a fidget toy is a balloon filled with sand. Squeezing it is supposed to calm the kid down. As a dad, I do not see a lot of value in fidget toys. While our son was in preschool, we requested that the occupational therapist place a small trampoline in the classroom. Whenever the teacher noticed Seb was walking on his tip-toes, she would encourage him to jump for a few moments and self-medicate with the pressure he was seeking on his lower extremities.

Seb and his pal, Shane, share jokes at the farm fest. Seb was known among his peers for coloring well outside the lines.

Our son had been picking his nose at school and experiencing several bouts of self-induced nose bleeds. These incidents were documented in a communications notebook that we keep for Seb, in which his teacher and all his therapists write highlights of the day. Aside from nosebleeds, other highlights have included fist fights, biting incidents, and benign trampoline exercises. After several problems with our son’s sensory integration in his Kindergarten class, an occupational therapist at one of Seb’s schools implemented what is known as a Drive Thru Menu program.

The Drive Thru Menu program is supposed to teach kids to become aware of the variance of their activity levels in class and regulate their behavior at school. As part of the program, kids are made aware of their bodies. Activity levels and moods are identified in stages as engine levels. If a kid is jumpy, his engine level is high. If a kid is in a daze, his engine level is low. Seb and his classmates were encouraged to review the Drive Thru Menu throughout the day and find ways to recognize and regulate their engine levels. It seems that the Drive Thru Menu program is tailored to the needs of the occupational therapist to efficiently manage a multitude of young children in the classroom without spending more than a few minutes in it.

Surfer’s Healing is probably not for everyone, but it’s one I’d like my son to try. The Surfer’s Healing is a therapy which combines a long board, swell waves and kids with sensory overload. The Surfer’s Healing includes an introduction to the calming power of the ocean, one-on-one surfing lessons, and some excitement for kids with sensory dysfunction. Like most kids, Seb loves the sand. He loves the ocean, and he loves to swim. Since we live within minutes of a few of the world’s renowned beaches: Silver Strand of Coronado, Moonlight Beach of Encinitas, and La Jolla Shores, we are destined to step onto a surfboard and embrace the waves. The Surfer’s Healing schedules multiple destinations throughout the year. Dude, camps fill up quick, so it’s best to sign up as soon as they are announced.

Wheel Hypnosis, the Terror of Little Einsteins (Part I)

One morning, our son, Seb, and I were watching a cartoon together, Disney’s Little Einsteins. The Little Einsteins were traveling through a city of enormous buildings painted with a dazzling array of contrasting colors. Both Seb and I stared at the complicated cacophony of color. The images posed a small-scale brilliance similar to Hundertwasser paintings. We were captivated by the magenta, peach, lime, and scarlet display of architecture.

The Little Einsteins traveled through a city scape that reminded me of Hundertwasser’s 151 Bleeding Houses.

Suddenly, my boy experienced an involuntarily reaction. His body contorted itself, as if a nerve had been pinched. His upper lip went right, his lower lip left. With his face in a grimace, his arms, elbows and wrists twisted into the shape of a pair of pterodactyl wings. He flapped momentarily. I was beside myself as he blurted out, “Turn it off! Turn it off!” Although I quickly flicked off the cartoon, Seb continued to hobble around the room in an awkward manner, unable to right his disfigurement.

Most of us tolerate unusual arrangements and patterns of color, but Seb does not. He is challenged by sensory dysfunction. Sensory dysfunction is an apparent problem, or a host of apparent problems, with the brain’s processing of neurological information acquired via the senses. In other words, it’s an obvious dysfunction exhibited by inappropriate reactions to sensual stimulation. Also known as a Sensory Processing Disorder, it’s an abnormal experience of everyday sights, touches, sounds, scents, and flavors. It can be debilitating to a child’s balance and capacity to plan and carry out movements in response to everyday life. Seb’s innate reaction to seeing the cartoon is a symptom of his brain’s sensory dysfunction.

A couple of tests, or sensory processing measures, may be applied to a kid to qualify his ability to coordinate his body with sensory input. These sensory processing measures are administered by a registered occupational therapist either at school or in a clinical setting. The kid’s ability is qualified by his responses to typical sensual stimulation. Does he like to flip light switches on and off repeatedly? Does he jump a lot? Does he seem to enjoy sensations that should be painful? The test results might show that a kid can process one sense well enough, and another not at all. To put it simply, the slower, more lacking and otherwise more inappropriate a child’s response to sensual input, the higher the degree of sensory dysfunction he experiences.

Sensory integration therapy may be an effective treatment for sensory dysfunction in toddlers with a comorbid diagnosis of the Autism Spectrum Disorder (ASD). But what is sensory integration therapy and how can it help? Medical experts disagree on what sensory dysfunction is, its causes, and its mitigation requirements, so sensory integration therapy is not always prescribed. As a parent of a kid diagnosed with ASD and sensory dysfunction, I can say that the dysfunction is real.

Why I Watch the Wheel

Children diagnosed with ASD seem to be fixated on the acquisition of certain kinds of sensual data. On one hand, many kids with ASD are fascinated with spinning objects and focus their eyes on the blades of spinning fans, the spokes of spinning wheels, the saw teeth of spinning books, and the gangling edges of spinning television remote controls. I admit, I do not know why kids with ASD are fascinated with spinning things, but I suspect they seek the calming effect of a sort of hypnosis. Our kid will visually simulate the sensation of spinning, as he looks out the corners of his eyes while rotating his head about the neck. At times, he seems to find comfort in spinning himself in circles.

While he has learned that some visual stimulation is pleasing, he is also bothered by other kinds of visual stimulation, like the bright, flashing lights and coordinated sounds of prime-time television. As Seb regressed into autism at a young age, he was disinterested in typical toddler activities, like watching cartoons and other children’s shows. Whenever the television was on, he would look elsewhere or line up and park his toy cars. But, oddly enough, as he defied his autism every night after taking a bath. He would demand that we sit down for an episode of Wheel of Fortune. No doubt Seb was calmed by watching the wheel spin, whether the pointer poked at $350 or to Jackpot. Deep down, of course, I believe Seb just wanted to spend a couple of extra moments with Dad before bedtime.

The Terror of Noise

I am sure you have heard that kids diagnosed with ASD are special. Many of them have a lesser degree of tolerance for unusual noise. Perhaps, they have no tolerance at all and that, for instance, the noise made by hand dryers simply scares the bejesus out of them. While Seb seemed drawn to spinning things, he was violently opposed to harsh sounding things. The noise of an automatic hand dryer absolutely frightened Seb.

But, really, what is the big deal about the sound of a hand dryer frightening someone? I mean, let’s be honest, who enjoys hearing the sound of one of those enamel-coated, wall-mounted hot air blowers? No one. Who hates it? Everyone. Now, who tolerates the sound? Anyone who wants to walk out of a public bathroom without flapping their hands dry. Most people have tolerated this noise long enough for industrial engineers to, at last, once and for all, advance automatic hand drying technology to eliminate the over-the-top air force of a veritable reverse vacuum cleaner.

Seb was so frightened of hand dryers that he would forego Happy Meals to avoid hearing one. Within sight of the Golden Arches, he would run in the opposite direction. Once inside, unfazed, he would scream a bloody war cry out to everyone, all of the McDonald’s employees and customers, against hand dryers. His protests attracted quite a lot of attention. De-sensitizing Seb to the noise of a hand dryer required patience and a willingness to deflect the daggers of scorn being thrown at me by my neighbors. I once carried him from the door of the playground, across the entire restaurant, to the exit door, as he screamed in terror. His sole fear was that he’d have to walk past a restroom. In our wake, a crowd of concerned mothers and annoyed fathers.

Telltale Signs

Symptoms of sensory dysfunction are not always obvious. Our son simply had to be reminded and prompted multiple times to complete simple tasks like dressing or undressing. His attention span seemed to be very short. Telltale signs emerged, making it clear that Seb experienced significant sensory dysfunction. Some of Seb’s behaviors we later recognized as symptoms include walking everywhere on tippy-toes, a penchant for spinning himself in circles, and his habit of repeating again in whispers the things he says out loud. Of course, treatments exist to lengthen short attention spans, and we would have sooner considered feeding our boy drugs than taking him to a sensory integration therapist, if it had not been prescribed by our son’s pediatric neurologist.

What Now?

Someday I would like to be able to say, “Even after all this therapy and effort to help him, maybe Seb was normal. Maybe he did need a little more time to develop than most kids.” Until then, these sensory challenges are difficult to ignore. Once we were able to recognize these telltale signs as symptoms of sensory dysfunction, we needed to act–and fast. Soon I will share some of our mitigation strategies regarding how we have helped Seb develop his processing ability and foster an acceptance of his senses.