By: Dang Uy-Koe, ASP Chair Emeritus
Is your child one who cannot stay still and constantly rocks on his chair? Is he very distractible even with the minutest sounds? Does he refuse certain food textures or is a picky eater, like eating only crunchy food all the time? Does he hum or make sounds while doing something? When he gets upset, does he jump, hit, bang his head, pull hair or bite? Does he throw “mega dramatic” tantrums every time he gets frustrated… and it takes him a long time to calm down?
Our Angel Talker this week explains why no matter how many times you ask your child to stop doing those behaviors, he does not stop; because your child just can’t if he has sensory integration dysfunction.
Lady Suarez is a senior occupational therapy consultant of Therapeutic Intervention for KIDS (THINKids) and Therapy Works. She is also a consultant and a department head in St. Luke’s Medical Center Neurodevelopmental Center.
Sensory Integration (S.I.) is defined as “a neurological process that organizes sensations from one's body and from the environment, and makes it possible to use the body to make adaptive responses within the environment. To do this, the brain must register, select, interpret, compare, and associate sensory information in a flexible, constantly-changing pattern" (Jean Ayres, 1989)
Simply, SI is your ability to organize and modulate sensations to come up with purposeful responses. For example, sensory integration happens very well when you are able to attend and understand what is being discussed in a class. You are able to lead your focus to the teacher and able to disregard other “unnecessary” sensations during that time. A child with SI dysfunction, however, experiences difficulty in organizing and modulating sensations to the point of focusing to the unimportant ones. Instead of attending to the teacher, the child is getting distracted with all the “extra” inputs like aircon sound, decorations in the room, classmates whispering and many more.
In this theory, it is also believed that each individual has different thresholds to sensation and each individual reacts differently as well. One who has low threshold usually reacts to the “slightest” or “smallest” sensation. For example, one can feel the tag of his shirt or some get distracted with the buzzing sound of an appliance. Car sickness is an example of low threshold to movement inputs. Because of this sensitivity, some react aversively to the point of avoiding the sensation.
On the other hand, one who has high threshold needs “increased dosage” for the inputs to register. Some get bruises without them realizing it or some tap others so hard without the intention of pushing or hitting.
“Jayjay” is very sensitive to touch sensation to the point of affecting his feeding. Because he cannot tolerate textured food, he only eats “lugaw” and gags when he eats drier food. “Luke” is very sensitive to sound. He gets distracted with cars passing by outside his home and he has discovered that when he hums while on a task, he does not hear the outside sounds. “Renz” has high threshold to movement sensations and even if he keeps on spinning, he does not get dizzy. So when he is asked to sit down and to stay on his seat, he starts “craving” for that movement sensation and he ends up rocking his chair.
A child with SI issues is like an adult thinking about his family and at the same time thinking about his work and all the deadlines. He also needs to think about being a husband, a father, a brother, an employee, a colleague, a neighbor and a friend. All of these he needs to organize. As an adult, you will be equipped with lessons, experiences, insights, opinions and even suggestions or assistance from others to enable you to adapt. But as a child, how will he manage all of these? So to help your child with SI problems:
1. Understand your child’s sensory needs. Always consider that your child’s reactions are real (not just “arte”). What is not painful for other children maybe painful for your child.
Help your child to gradually tolerate certain sensory inputs or to seek for sensation in a more appropriate manner. Example, instead of running around inside the house, allow him to do biking outside.
2. Encourage your child to self regulate or to be in control of himself. Provide opportunities for him to request and express self; to calm down when he gets upset or even when he gets excited; and to be more independent.
Incorporate waiting in his routine and establish your authority very early. Use a consistent behavior management approach and make sure your approach is consistently being applied by the entire household.
Encourage your child to avoid multi-tasking and set rule on “one task at a time.” Example: ask your child to finish his food first before letting him watch TV or play.
3. Establish structure and organize your child’s routine. If your child knows that there is an established routine, the likelihood of non-compliance is minimized. If he knows that he can only watch TV after eating dinner, he will resist less when it is dinnertime. A rule is a rule.
4. Assess your environment. Is your home conducive for learning - a place that calms down or alerts you? Organize your space and do specific task in a specific area: eating your meals at the dining area only, use the bedroom only for sleeping. Remove toys and TV in his room to avoid ‘alerting’ and ‘distracting’ him when he is about to sleep.
5. Seek help. There is no harm in consulting. We need to remember that when your child just can’t… the parents and family can do something about it.
This article appeared in print and online by Manila Bulletin on 21 October 2012.
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