Undisciplined Child or "Sensory Issues"?

I do have a son with sensory issues. I can totally see how people, who don't know me or my child, would assume that there are no discipline and that he is a 'wild child.' Most people see SID as the kids who don't like tags, hate textured foods, react to smells and loud noise, however, there is a whole other spectrum and that is the sensory seeking child, that is who I have. He runs, bounces, crashes, pushes, and bumps into people and things. He never does it out of anger but he is seeking so much input just to calm himself that it appears to be behavioral. My husband and I are having a hard time realizing that he actually can't help what he is doing. I have been correcting and teaching him about having quiet hands and a quiet body for almost 2 years....and with no improvement. It is sad and difficult and I am constantly having to be on radar in case he accidentally hurts someone. I also have to stay with him for part of preschool because of this 'behavior.' I also have to say, from being on the other side, is that us moms pick our battles. My son is soooo physical and needs so much input that I don't correct him on bouncing on the couch or jumping off the kitchen counter, yes you read that correctly, because I am CONSTANTLY correcting him on so many other things. So it may appear that they don't correct him but you have no idea what they may be having to correct and discipline at home and 24/7 with him. SO if he is anything like my son...give them a break...they are probably so exhausted...I am :)

PS I also noticed that you have two girls....boys are a whole different ball game!!

If you would like to read a book, I strongly recommend you read "Sensational Kids," by Lucy Jane Miller, Ph.D., OTR instead of "The Out of Sync Child." "Sensational Kids" is MUCH easier to read, and will give a much better picture of the "major" types of Sensory Processing Disorders.

From Dr. Miller's book: "SPD is a complex brain syndrome that affects the way we experience sensations in taste, touch, sounds, sight, smell, movement, and body awareness. Typical activities for most kids -- eating, dressing, making friends, or responding to a hug -- become daily struggles that may result in social, emotional, or academic problems."

Just to give you a simple, mild example of a sensory issue: One morning you put on a wool sweater and head to work. The sweater is a bit itchy around the neck and you occasionally scratch at it. However, by 1:00pm, you can no longer concentrate on your work or think of anything OTHER than how much that sweater is itching you! You can barely have a phone conversation -- all you can think about is tearing that wool sweater off once you get home. In this example, you are having trouble functioning "correctly" because you are impaired by a sensory issue.

Another example: you cannot tolerate eating sushi. Even thinking about how that raw fish feels cold, slimy and heavy in your mouth makes you shudder. There are some children with SPD that feel this way about eating almost ALL foods. Can you imagine hating the feeling of having food in your mouth?

Another example: you don't know how hot a light bulb is, so you quickly touch it, immediately determining if it is burning hot or not. A child with SPD may not actually "feel" the hottness of that light bulb. For some reason, the child could place his entire palm over the light bulb and not feel it until his skin is searing and burning.

Last example: a "wild child" is running around the playground, plowing into other children and laughing. Some of the other kids are hit so hard they cry. In this example, the "wild child" has SPD and doesn't realize he his hurting other children. In fact, the crashes into the other children actually help his body to feel better, so he keeps it up and seeks for more. He may not have developed the empathy skills he needs to even notice that other children are crying.

I hope this helps you and your husband. I think it's great that you are trying to educate yourself about these issues. SPD and other neurological disorders are not obvious -- so please help your husband understand how hurtful judgment from others can feel to a Mom struggling with children with Sensory issues. Take Care!

I really admire that you're trying to get more information about this instead of judging your SIL as being a bad mom. My son has severe SPD, and I've gotten dirty looks and even very rude comments from other moms. It's very hard raising a kid with SPD. My son is a sensory seeker and like another mom said, he crashes into other people b/c it feels really good to him, and his body needs the contact. I know my friends think I let him get away with a lot, and to the outside world, it probably looks like he's spoiled or horribly behaved, when in reality he's trying very hard to be good. Other posters have described really well what it is like to have this disorder, so I won't add more. I just wantd to commend you for educating yourself; before my son was diagnosed 2 years ago, I had never heard of sensory processing disorder, but now that I have, I never automatically judge another child's behavior. We don't know what someone else is going through, so we should never judge. What your SIL needs is support, and you sound like you really care about her and your nephew.

Sensory Integration Dysfunction (SID, also called sensory processing disorder) is a neurological disorder causing difficulties with processing information from the five senses (vision, auditory, touch, olfaction, and taste), the sense of movement (vestibular system), and/or the positional sense (proprioception). For those with SID, sensory information is sensed, but perceived abnormally. Unlike blindness or deafness, sensory information is received by people with SID; the difference is that information is processed by the brain in an unusual way that may cause distress or confusion.

SID is its own diagnosis, but it can be linked to other neurological conditions, including autism spectrum disorders, attention deficit disorder, dyslexia, Developmental Dyspraxia, Tourette syndrome, multiple sclerosis, and speech delays, among many others. The meaning of SID falls under the DSM-IV criteria for Asperger syndrome. [1]. There is no known cure; however, there are many treatments available.

Diagnosis is increasing by developmental pediatricians, pediatric neurologists, and child psychologists. While it is not included in the American Psychiatric Association's Diagnostic and Statistical Manual as a discrete diagnosis, Regulatory-Sensory Processing Disorder is an accepted diagnosis in Stanley Greenspan’s Diagnostic Manual for Infancy and Early Childhood and the Zero to Three’s Diagnostic Classification.

Contents [hide]
1 Classifications
1.1 Sensory modulation
1.1.1 Sensory Modulation Problems
2 Hyposensitivities and hypersensitivities
3 Relation to other disorders
3.1 Autism spectrum disorders
3.2 Other disorders
4 Sensory integration therapy
5 Alternative views
6 References
7 Further reading

[edit] Classifications
There are now three types of Sensory Processing Dysfunction, as classified by Stanley I. Greenspan as supported by the research of Lucy J. Miller, Ph.D., OTR. These new terms are meant to increase understanding between Occupational Therapists and other professionals who frequently encounter SID and physicians and other health professionals who approach sensory integration dysfunction from a more neurobiological vantage.

This understanding is critical as physicians are responsible for diagnosing SPD, which is a necessary step in accessing reimbursement (eventually from insurance companies) for professional services to treat SPD.

Sensory Processing Dysfunction is being used as a global umbrella term that includes all forms of this disorder, including three primary diagnostic groups:

Type I - Sensory Modulation Disorder
Type II - Sensory Based Motor Disorder
Type III - Sensory Discrimination Disorder
Type I - Sensory Modulation Disorder (SMD). Over, or under responding to sensory stimuli or seeking sensory stimulation. This group may include a fearful and/or anxious pattern, negative and/or stubborn behaviors, self-absorbed behaviors that are difficult to engage or creative or actively seeking sensation.

Type II - Sensory Based Motor Disorder (SBMD). Shows motor output that is disorganized as a result of incorrect processing of sensory information.

Type III - Sensory Discrimination Disorder (SDD). Sensory discrimination or postural control challenges and/or dyspraxia seen in inattentiveness, disorganization, poor school performance.

This information is adapted from research and publications by: Lucy, J. Miller, Ph.D., OTR, Marie Anzalone, Sc.D., OTR, Sharon A. Cermak, Ed.D., OTR/L, Shelly J. ,Lane, Ph.D, OTR, Beth Osten, M.S,m OTR/L, Serena Wieder, Ph.D., Stanley I. Greenspan, M.D..

[edit] Sensory modulation
Sensory modulation refers to a complex central nervous system process by which neural messages that convey information about the intensity, frequency, duration, complexity, and novelty of sensory stimuli are adjusted.

Behaviorally, this is manifested in the tendency to generate responses that are appropriately graded in relation to incoming sensations, neither underreacting nor overreacting to them.

[edit] Sensory Modulation Problems
Sensory registration problems - This refers to the process by which the central nervous system attends to stimuli. This usually involves an orienting response. Sensory registration problems are characterized by failure to notice stimuli that ordinarily are salient to most people.
Sensory defensiveness - A condition characterized by over-responsivity in one or more systems.
Gravitational insecurity - A sensory modulation condition in which there is a tendency to react negatively and fearfully to movement experiences, particularly those involving a change in head position and movement backward or upward through space.
(Case-Smith, (2005)

[edit] Hyposensitivities and hypersensitivities
Sensory integration disorders vary between individuals in their characteristics and intensity. Some people are so mildly afflicted, the disorder is barely noticeable, while others are so impaired they have trouble with daily functioning.

Children can be born hypersensitive or hyposensitive to varying degrees and may have trouble in one sensory modality, a few, or all of them. Hypersensitivity is also known as sensory defensiveness. Examples of hypersensitivity include feeling pain from clothing rubbing against skin, an inability to tolerate normal lighting in a room, a dislike of being touched (especially light touch) and discomfort when one looks directly into the eyes of another person.

Hyposensitivity is characterized by an unusually high tolerance for environmental stimuli. A child with hyposensitivity might appear restless and seek sensory stimulation.

In treating sensory dysfunctions, a "just right" challenge is used: giving the child just the right amount of challenge to motivate him and stimulate changes in the way the system processes sensory information but not so much as to make him shut down or go into sensory overload.

The "just right" challenge is absent if the activity and the child's perception of activity do not match. In addition, deep pressure is often calming for children who have sensory dysfunctions. It is recommended that therapists use a variety of tactile materials, a quiet, subdued voice, and slow, linear movements, tailoring the approach to the child's unique sensory needs.

While occupational therapy sessions focus on increasing a child's ability to tolerate a variety of sensory experiences, both the activities and environment should be assessed for a "just right" fit with the child. Overwhelming environmental stimuli such as flickering fluorescent lighting and bothersome clothing tags should be eliminated whenever possible to increase the child's comfort and ability to engage productively. Meanwhile, the occupational therapist and parents should jointly create a "sensory diet," a term coined by occupational therapist Anna Jean Ayres.

The sensory diet is a schedule of daily activities that gives the child the sensory fuel his body needs to get into an organized state and stay there. According to SI theory, rather than just relying on individual treatment sessions, ensuring that a carefully designed program of sensory input throughout the day is implemented at home and at school can create profound, lasting changes in the child's nervous system.

Parents can help their child by realizing that play is an important part of their child's development. Therapy involves working with an occupational therapist and the child will engage in activities that provide vestibular, proprioceptive and tactile stimulation. Therapy is individualized to meet the child's specific needs for development. Emphasis is put on automatic sensory processes in the course of a goal-directed activity. The children are engaged in therapy as play which may include activities such as: finger painting, using Play-Doh type modeling clay, swinging, playing in bins of rice or water, climbing, etc.

[edit] Relation to other disorders

[edit] Autism spectrum disorders
Unusual responses to sensory stimuli are more common and prominent in autistic children, though there is no good evidence that sensory symptoms differentiate autism from other developmental disorders.[1] Differences are greater for under-responsivity (for example, walking into things) than for over-responsivity (for example, distress from loud noises) or for seeking (for example, rhythmic movements).[2] The responses may be more common in children: a pair of studies found that autistic children had impaired tactile perception while autistic adults did not.[3]

[edit] Other disorders
Some argue that sensory related disorders may be misdiagnosed as Attention-Deficit/Hyperactivity Disorder (ADHD) but they can coexist, as well as emotional problems, aggressiveness and speech-related disorders such as apraxia. Sensory processing, they argue, is foundational, like the roots of a tree, and gives rise to a myriad of behaviors and symptoms such as hyperactivity and speech delay.

For example, a child with an under-responsive vestibular system may need extra input to his "motion sensor" in order to achieve a state of quiet alertness; to get this input, the child might fidget or run around, appearing ostensibly to be hyperactive, when in fact, he suffers from a sensory related disorder

Researchers have described a treatable inherited sensory overstimulation disorder that meets diagnostic criteria for both attention deficit disorder and sensory integration dysfunction.[4]

from wikipedia

Hope it helps answer something.
Kris

I second "The Out of Sync Child". Check with your local library, too, since I know ours carries a whole bunch of books on this topic. If they have not sought out an OT evaluation (by a pediatric Occupational Therapist) they might do so in the future. Once he begins treatment you should start to notice a change in behavior once his sensory needs are correctly met and his little system begins to learn how to more correctly process sensory information.

Three Cheers to you, Aunt, for trying to learn more about his issues! That is awesome.

I think it is very brave of you to be very honest about what you are thinking. I am a mother of a child who has Sensory Processing Disorder, and believe me, I would have loved the opportunity to explain what SPD means for our family. SPD is under the umbrella of Autism Spectrum Disorder, and as you can imagine, that is quite a blow for a parent to hear. I trust that you have been supportive to your brother and sister-in-law in light of their child's diagnosis. We found that our family was very dismissive of the diagnosis, that our son was just being a boy, and maybe we should be more consistent with our parenting. That is really the last thing that anyone should say to a SPD parent! I understand that you feel the need to protect your children from their son who can be overly rough. Our son was like that too, and our friends with children began to withdraw. From our experience, this behavior lasted until kindergarten, so hopefully you can find an arrangement until his behavior is manageable. My son has had years of occupational and behavior therapy, and is one of the hardest working little boys around. Please keep this in mind when you see your nephew acting up, he and his parents are doing all they can. You are a great aunt for asking these questions before judging (unlike my family!), and he is lucky to have you in his family!

Also, I want to add that traditional parenting methods do not work for kids with SPD. For example, my son was a picky eater as a toddler. I followed other parents' and pediatrician's advice, that he will eat if he's hungry and don't worry about it. One of his senses that didn't work correctly, was his sense of hunger. He just didn't know when he was hungry. He would often go an entire day without anything to eat, and because I didn't force him, and the next morning he would thow up bile because his stomach was so empty. Another example, is timeouts/sticker charts, etc. He could spend the entire day in time-out and still cannot control his behavior. Whatever sensory issue is out of sync is stronger than any consequence. Occupational therapy will help with this. Once he develops core strength, he will be able to modulate himself more, and be more in control of his body. Please email me if you have any questions, it took me a LONG time before I understood this all!

Check out the book "The Out-of-sync Child" by Carol Stock Kranowitz, M.A. I think it will help you understand what your nephew and his parents are facing. The author does a good job of explaining SID.

Sensory Processing Disorder....it is a real disorder, not an excuse. Although there are ways of working with your child, occupational therapy and what not, that can help them function more smoothly out in the world. You may have thought they were lax, when in reality they were being understanding or forgiving because they know that their child has problems with whatever it was they were doing/not doing. It is better if they address it prior to K, but it can be a hard diagnosis to come to. The child is just "different", difficult.....it is hard to put a finger on why and other diagnoses just don't fit for one reason or another.

My son has SPD, and it is very real.

Here is some info for you:

http://www.spdfoundation.net/

http://www.time.com/time/magazine/article/0,9171,###-###-...