Is it ADHD or Sensory Processing Disorder?

Two “Look-alikes:” Sensory Processing Disorder and Attention Deficit/Hyperactivity Disorder
by Carol Kranowitz, M.A., author of The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder
Picture Brian. While the other children are settling down to a workbook task, Brian rocks in his seat, whining, “Owwuu,”

And rubs his arm where a classmate grazed him en route to her chair.  Abruptly, he stands and shoves his desk away from passing children. 

The teacher frowns and says,“Sit down, stay put and start working, Brian!” 

He wriggles in his seat and asks, “Um, what are we supposed to do?” 

The teacher replies, “Pay attention!  Page 36, even-numbered questions.” 

He gropes inside his messy desk, finally locates the workbook and drops it.  Retrieving it, he sags to the floor. He plops into the chair again, grips a pencil like a dagger and starts writing—but presses so hard that the point breaks.  He hurls the pencil across the room and screams, “I hate this!” 

Brian is inattentive, impulsive and fidgety. Does he have attention deficit/hyperactivity disorder (ADHD)or sensory processing disorder (SPD)?  Recognizing the differences between these two disorders and providing appropriate treatment can greatly benefit children and adults like Brian. 

Like ADHD, SPD is a neurological problem affecting behavior and learning.  Unlike ADHD, SPD is best treated with occupational therapy using a sensory integration framework. This therapy addresses underlying difficulties in processing sensations that cause inattention and hyperactivity. 

In The Out-of-Sync Child, I define SPD as the “difficulty in how the brain takes in, organizes and uses sensory information, causing a person to have problems interacting effectively in the everyday environment.” Sensory stimulation—too much, too little or the wrong kind—may cause poor motor coordination, incessant movement, attention problems and impulsive behavior as the child strives to get less—or more—sensory input.

Brian’s central nervous system inefficiently processes tactile sensations.  The slightest touch overwhelms him. As a “sensory avoider,” he is over-responsive and cannot regulate, or “modulate,” sensory input. Also, touch stimulation confuses him. As a “sensory jumbler,” Brian cannot discriminate differences among sensations.

How does his SPD play out? Brian cannot interpret how objects feel when they contact his skin. His chair, desk contents, workbook, pencil and classmates bother or befuddle him.  Fidgeting and squirming, he pays a lot of attention to averting ordinary tactile sensations. Meanwhile, he pays scant attention to the teacher’s words or classroom rules.

Imagine Dana, a child who processes movement and balance sensations very slowly. This under-responsive child, or “sensory disregarder,” has difficulty starting or stopping an activity. With encouragement, she eventually settles into a swing, enjoying the movement that helps her nervous system get organized.  However, Dana does not know when to stop. She swings and swings, inattentive to her own body-centered sensations screaming, “Enough!”

Envision Jayson, a “sensory craver” who needs much more action than his peers. An impulsive “bumper and crasher,” he seeks intense, vigorous movement.  Constantly, he rocks, climbs, gets upside down and gyrates, darting from one experience to another. He pays much attention to satisfying his craving for movement and little attention to his mother’s instructions or where he left his shoes. 

Inattention, impulsivity, fidgetiness, constant movement—these are definitely symptoms of SPD.

Now consider this definition for ADHD: a “neurological syndrome characterized by serious and persistent inattention and impulsivity. When constant, fidgety movement (hyperactivity) is an additional characteristic, the syndrome is called ADHD.”

Inattention, impulsivity, fidgetiness, constant movement—these are definitely symptoms of ADHD.  SPD and ADHD are certainly “lookalikes.”  However, they are distinct disorders, and optimum treatment for the two problems is very different.  Before jumping to conclusions, professionals, parents and teachers should consider the whole child to thoughtfully determine the best support.

If the child is frequently, but not always, inattentive, it is useful to observe his or her behavior and ask:  Where, when and how often does his or her inattention occur? What is happening, or not happening, when he or she concentrates well? What is his or her “self-therapy?”

When overloaded, an over-responsive child needs less stimulation. How can we help? We can undo something!

Over-the-counter first aid for this child may be decreasing the offending sensations.  We can make his or her environment softer, dimmer, quieter and calmer. 

Then, we can do something!  Comfort the child with “deep pressure” such as a massage or bear hug. Create a retreat under the dining room table or in a classroom corner with pillows and a sleeping bag to burrow into. Apply deep pressure on skin and muscles to get the child organized and ready to participate and learn. Provide heavywork activities, including pushing a grocery cart, pulling a wagon, lifting weights or carrying a book carton.

Ensure daily outdoor play (movement always helps, so the more recess, the better). Jog together around the block or playground. Offer opportunities for gentle roughhousing. Give the child a rolling pin for pressing dough, a shovel for digging, a bar for chinning, a hammock for swaying, a wad of gum for chewing or a trampoline for jumping.

When “underloaded,” an underresponsive or sensory-seeking child needs extra sensory stimulation. Again, we can do something! Provide sensorymotor experiences like those mentioned above. The under-responsive or seeking child needs them, too, in varying degrees. Similar activities may calm one type of child and invigorate or satisfy another.

Providing just the right sensorymotor input will certainly help a child with SPD. No surprise, sensory-motor input will also help the child with ADHD. Indeed, it will help everyone, because we all require frequent, daily sensory-motor experiences.

A sensory diet may be the best “medicine” for the child experiencing attention problems as a result of SPD.  An occupational therapist can develop an individualized sensory diet with appropriate touch and movement experiences. An approach that excludes medications and includes movement, deep pressure and heavy work never hurts and often helps the inattentive child whose problem is not ADHD but developmentally delayed sensory processing.

 
http://www.nami.org/Template.cfm?Section=ADHD&Template=/ContentManagement/ContentDisplay.cfm&ContentID=106831

To learn more about SPD, contact Carol Kranowitz, M.A., at

CarolKranowitz@out-of-sync-child.com.

Suggested Reading:

Ayres, A.J., Ph.D. (2005). Sensory Integration

and the Child: Understanding Hidden Sensory

Challenges. Los Angeles: Western Psychological

Services.

Biel, L., & Peske, N. (2005). Raising a

Sensory Smart Child: The Definitive Handbook

for Helping Your Child with Sensory Integration

Issues. New York: Penguin.

Kranowitz, C. (2005). The Out-of-Sync

Child: Recognizing and Coping with Sensory

Processing Disorder. New York: Perigee.

Kranowitz, C. (2006). The Out-of-Sync

Child Has Fun: Activities for Kids with Sensory

Processing Disorder. New York: Perigee.

Kranowitz, C., & Newman, J. (2010).

Growing an In-Sync Child. New York: Perigee.

Miller, L.J., Ph.D., with Fuller, D.A. (2006).

Sensational Kids: Hope and Help for Children with

Sensory Processing Disorder. New York: Putnam.

Smith, K.A., Ph.D., & Gouze, K.R., Ph.D.

(2004). The Sensory-Sensitive Child: Practical

Solutions for Out-of-Bounds Behavior. New York:

Harper Collins

Self Regulation Should be Fun!

Here is a fun alternative to my highly recommended bubble mountain! Remember...resistive deep breathing is incredibly regulating for the nervous system and works on oral motor development and respiration control for speech and language. ~Angie Voss, OTR 

Rainbow Bubble Snakes  
(http://www.housingaforest.com/rainbow-bubble-snakes/)
 

The best part is they are easy to make and use things that I had laying around my house.  Perfect! All you need is an empty water bottle from your recycling, duct tape, a sock that is missing its match (which we seem to have an abundance of), dish soap and some food coloring.

Start by cutting the bottom of the water bottle off.  Next slide the sock over the bottom of the bottle.  We used colorful duct tape to secure our sock, but you could use a rubber band as well.  I love how quick and easy it was to make.  My kids love making things from our recycling.  Last summer they made their own sprinkler using some of the same materials and it is still the sprinkler of choice.

Pour some dish soap into a shallow container with a little bit of water and gently mix.  Dip the sock covered bubble blower into the solution and gently blow.

We decided to add some color to the bubble snakes with food coloring.  The kids dropped the food coloring onto the sock covered end.  It was a bit messy, but the kids LOVED it!  Lots of fun giggles.

 

Rainbow snakes were definitely a hit in our house!

Please remind your kids to blow air out not suck air in!  If your child sucks in, they will be eating bubbles.  Please be careful when doing this with your kids.  My kids had a blast playing with these bubble snakes.  We did not have any trouble with the kids inhaling, but I have had a few readers mention that their younger kids needed continual reminders.  The fun will quickly end if the bubbles are inhaled!

For more great tips/advice from Angie Voss visit her FB page "Understanding Your Child's Sensory Signals" @ https://www.facebook.com/pages/Understanding-Your-Childs-Sensory-Signals/226232787490900

Climbing Up Slides?

Sensory benefits of climbing slides:
1. Full body proprioception (regulating and organizing for the brain)
2. Motor planning
3. Balance
4. Body in space and body awareness
5. Works on full body flexion which is incredibly important for sensory integration
6. Provides ankle stretches for those who tend to be toe walkers
7. Vestibular input
8. Bilateral coordination
9. Core strength and trunk control
10. Purposeful and meaningful, and fun!
There are all sorts of techniques to keep this safe!
~Angie Voss, OTR

For more great tips/advice from Angie Voss visit her FB page "Understanding Your Child's Sensory Signals" @ https://www.facebook.com/pages/Understanding-Your-Childs-Sensory-Signals/226232787490900

Fun Deep Pressure Sensory Activity

Deep pressure tactile input is one of the most accepted forms of sensory input. It provides calming, organizing, and regulating input for the brain and nervous system. Here is a fun, interactive, and creative activity for you to try with your child...no sensory equipment needed! Find more how-to videos on ASensoryLife.com!~Angie Voss

For more great tips/advice from Angie Voss visit her FB page "Understanding Your Child's Sensory Signals" @ https://www.facebook.com/pages/Understanding-Your-Childs-Sensory-Signals/226232787490900

https://www.youtube.com/watch?feature=player_embedded&v=spvYx1XJrh8

Positive Parenting Is Key for Child with Developmental Disability

  By Ryan Morgenegg, Church News staff writer

• 2 May 2013

After analyzing a variety of studies using parenting styles with children that have developmental disabilities, BYU researchers found a link that clearly demonstrates a beneficial effect from a parenting style called “positive parenting.”  Photo by Keanen Farr.

Article Highlights

• BYU researchers reviewed studies about parenting children with developmental disabilities.
• “Positive parenting” or “authoritative parenting” seems to benefits these children most.
• Positive parenting styles help children with disabilities attain higher levels of independence, language skills, emotional expression, social interaction, and improved temperament.

“The development of a child with a disability depends on his or her ability to engage socially, so parenting takes on a different importance. … The child requires added time, education, coping skills, and family support.” —Tim Smith, BYU researcher

Related Links

• Find resources for mothers of children with disabilities.
• Explore helps for fathers of children with disabilities.
• Learn how raising a child with a disability is a process.

Thousands of research articles have been written praising the effects of positive parenting styles for typically developing children, but only a handful have focused on positive parenting for children with developmental challenges.
Tina Dyches and Tim Smith are faculty members in the Department of Counseling Psychology and Special Education at Brigham Young University’s David O. McKay School of Education. Their research team found and analyzed 14 empirical studies that looked at parenting of children with developmental disabilities such as Down syndrome, intellectual disabilities, and autism. Sister Dyches said, “Our study investigated a subset of kids with developmental disabilities so we could focus on a sample that might, in some ways, be more difficult to parent than those with milder disabilities such as communication disorders and specific learning disabilities.”
A variety of studies analyzed by BYU researchers found a beneficial effect on children with developmental disabilities from a parenting style called “positive parenting” or “authoritative parenting.” Researchers also found that the magnitude of the results did not differ across disability type or the age of the child. “The development of a child with a disability depends on his or her ability to engage socially, so parenting takes on a different importance,” Brother Smith said. “The child requires added time, education, coping skills, and family support.”
The positively parented children in the studies exhibited higher levels of independence, language skills, emotional expression, and social interaction with adults and peers. They also demonstrated improved temperament. To understand the positive parenting style, the three basic parenting styles need explanation:
1. Authoritarian: a parenting style that requires strict obedience by a child. Parents are demanding and seek control of their children’s behavior. Punishment is often given for disobedience. As a result of this style, children may become obedient, respectful, and compliant, but they also may become resentful and unhappy and have low self-esteem and impaired social competence.
2. Permissive: a parent who exhibits this style is lenient and easy going. He or she rarely gives out punishments and is very accepting and nurturing. A permissive parent allows children to make their own choices and tries to be the child’s friend. As a result, children of permissive parents often rank low in happiness and self-regulation scores. These children are also more likely to experience problems with authority and tend to perform poorly in school. Parents experience less stress and confrontation by letting children do whatever they want.
3. Authoritative or positive: a parental style that seeks balance between helping children make good choices and offering guidance and discipline. It respects the child’s self-will but balances it with disciplined conformity. Positive parenting requires frequent eye contact, use of positive affirmations rather than criticism, seeking to understand the child, and responding immediately. As a result of this style, children often develop into happy, self-confident, capable, and successful adults.
Brother Smith said: “In households where positive parenting is applied, the symptoms and severity of the child’s disability are more likely to decrease over time. Research has consistently shown that the earlier and more consistently positive parenting is provided, the greater the child’s development.”
But parenting a child with a developmental disability can be challenging, and instincts may kick in about how to handle the situations that arise. Sister Dyches cautions: “When you think of parenting a child with a developmental disability, it might be more intuitive to be authoritarian and assume that the child can’t figure out things alone. On the other hand, with a child who has a disability such as autism, it may seem easier and less contentious to be more permissive with the child and thereby avoid conflict. But there needs to be a balance. A child with a disability should not be subject to family expectations that he is not currently capable of meeting, nor be the center of a family.”
It is crucial that parents reflect upon their current parenting style and, as necessary, adjust the way they interact with their children to align more closely with authoritative or positive parenting styles. Doing so while their children are young is critical for optimal development of both typically developing children and those with developmental disabilities.
With involvement, the payoff can be enormous. Sister Dyches said, “These positive parenting practices were indeed beneficial for the children with developmental disabilities in many ways—higher levels of independence, language skills, emotional expression, social interaction, and improved temperament.”
The study was published in the November-December 2012 issue of Research in Developmental Disabilities.

Your Child's Sensory Signals....
Holds It Together at School, Then Melts Down at Home

Sensory Explanation:
The school day is full of multi-sensory input, placing great demand and stress on the nervous system. This is especially difficult for those who struggle with sensory modulation and self-regulation. The child tries so hard to follow the rules of the classroom and to please the teacher and staff, as well as meet the social expectations of peers. When the child returns home from a long day of stress on the nervous system, a child may simply need to melt down to let it all out in an environment where the child feels safe, is not judged by others and can be with those who love and respect the sensory differences.
Ideas to Help!
• Respect this as a true sensory signal that the school day was overwhelming and incredibly challenging.
• Try not to lean towards the theory of “Why do they do this at home and not at school? Doesn’t that mean they can control it?"
• Offer a sensory retreat to help unwind and unload the sensory input from the day.
• Provide an indoor swing such as a hammock or cuddle swing, as swinging in slow, rhythmical planes of movement can be very calming and regulating.
• Invert the head.
• Provide full body deep pressure touch.
• Provide opportunities for proprioception.
• Decrease the amount of stimuli for at least an hour when the child gets home from school.
• Refrain from chores, homework, and other demands during the after-school hour.
~Angie Voss, OTR

For more great tips/advice from Angie Voss visit her FB page "Understanding Your Child's Sensory Signals" @ https://www.facebook.com/pages/Understanding-Your-Childs-Sensory-Signals/226232787490900

HAND FLAPPING
Sensory Explanation: This sensory signal is often misunderstood. Flapping of the hands is often a sensory anchor, which is calming and regulating to the brain. Doing this provides proprioception to the arms and hands, which is typically organizing and soothing for the nervous system. Take note if your child does this more often in new and unfamiliar settings or in challenging multi-sensory situations.
Ideas to Help!
• It’s okay to let 'em do it…and be sure to educate those around you about this sensory need. Also provide an explanation so that the child is respected for this.
• Hand flapping is really no different than someone who bites their nails, although for some reason our society accepts that as okay vs. hand flapping.
• Encourage regular doses of joint compression and joint traction via activities such as wheelbarrow walking, hanging from a bar, etc.
• Provide Thera-Putty™, Playdoh®, clay, and/or fidget toys.
• Provide regular doses of deep pressure touch to the arms and hands.
• Try Theraband® activities.
• Compression clothing for the upper body may help.
~Angie Voss, OTR
http://asensorylife.com/sensory-anchors.html

For more great tips/advice from Angie Voss visit her FB page "Understanding Your Child's Sensory Signals" @ https://www.facebook.com/pages/Understanding-Your-Childs-Sensory-Signals/226232787490900

Deep Breaths and Wall Push-Ups at School

My son has one of THE most amazing teachers ever!  He started to show some anger at school because he told on one of his peers for hitting him while they were in line (which was an accident).  Another child hollered, "You're lying!  That's not true!"  The teacher saw and heard my son's anger in response to this child's accusations and very kindly said, "Woah, wait a minute.  Let's all take a deep breath."  So all of the kids in line took deep breaths and then she had them do wall push-ups.  Two very good techniques to calm a revved up nervous system pushing down the cortisol levels and getting some frustrations out.  I LOVED how she had all of the kids do it.  Afterwards she talked to the kids involved to see what was going on. 

Does That REALLY Hurt?

Every time I take my son to OT I learn something new from his wonderful therapist.  I have a 4 year old son who hates getting his hair cut, washed or even dried after a bath.  When I was drying his hair the other day, he was crying and saying, "ow, ow, ow" as he does everytime I dry his hair.  I stopped and turned his face to look at mine and said, "Does that REALLY hurt?"  He cried, "Yes!"  So I talked to the therapist and she told me that some kids are VERY sensitive and if their hair is rubbed so that it goes against the grain (their hair follicles going in the opposite direction) it can cause them pain.  So I tried it and by golly, he was okay as long as I was rubbing his hair in the right direction.

The Vestibular System

The Human Balance System

Good balance is often taken for granted.

Most people don’t find it difficult to walk across a gravel driveway, transition from walking on a sidewalk to grass, or get out of bed in the middle of the night without stumbling. However, with impaired balance such activities can be extremely fatiguing and sometimes dangerous. Symptoms that accompany the unsteadiness can include dizziness, vertigo, hearing and vision problems, and difficulty with concentration and memory.

What is balance?

Balance is the ability to maintain the body’s center of mass over its base of support.¹ A properly functioning balance system allows humans to see clearly while moving, identify orientation with respect to gravity, determine direction and speed of movement, and make automatic postural adjustments to maintain posture and stability in various conditions and activities.
Balance is achieved and maintained by a complex set of sensorimotor control systems that include sensory input from vision (sight), proprioception (touch), and the vestibular system (motion, equilibrium, spatial orientation); integration of that sensory input; and motor output to the eye and body muscles. Injury, disease, or the aging process can affect one or more of these components.

Sensory input

Maintaining balance depends on information received by the brain from three peripheral sources: eyes, muscles and joints, and vestibular organs (Figure 1). All three of these sources send information to the brain in the form of nerve impulses from special nerve endings called sensory receptors.

Input from the eyes

Sensory receptors in the retina are called rods and cones. When light strikes the rods and cones, they send impulses to the brain that provide visual cues identifying how a person is oriented relative to other objects. For example, as a pedestrian walks along a city street, the surrounding buildings appear vertically aligned, and each storefront passed first moves into and then beyond the range of peripheral vision.

Input from the muscles and joints

Proprioceptive information from the skin, muscles, and joints involves sensory receptors that are sensitive to stretch or pressure in the surrounding tissues. For example, increased pressure is felt in the front part of the soles of the feet when a standing person leans forward. With any movement of the legs, arms, and other body parts, sensory receptors respond by sending impulses to the brain.  The sensory impulses originating in the neck and ankles are especially important. Proprioceptive cues from the neck indicate the direction in which the head is turned. Cues from the ankles indicate the body’s movement or sway relative to both the standing surface (floor or ground) and the quality of that surface (for example, hard, soft, slippery, or uneven).

Input from the vestibular system

Sensory information about motion, equilibrium, and spatial orientation is provided by the vestibular apparatus, which in each ear includes the utricle, saccule, and three semicircular canals. The utricle and saccule detect gravity (vertical orientation) and linear movement. The semicircular canals, which detect rotational movement, are located at right angles to each other and are filled with a fluid called endolymph. When the head rotates in the direction sensed by a particular canal, the endolymphatic fluid within it lags behind because of inertia and exerts pressure against the canal’s sensory receptor. The receptor then sends impulses to the brain about movement. When the vestibular organs on both sides of the head are functioning properly, they send symmetrical impulses to the brain. (Impulses originating from the right side are consistent with impulses originating from the left side.)

Integration of sensory input

Balance information provided by the peripheral sensory organs—eyes, muscles and joints, and the two sides of the vestibular system—is sent to the brain stem. There, it is sorted out and integrated with learned information contributed by the cerebellum (the coordination center of the brain) and the cerebral cortex (the thinking and memory center). The cerebellum provides information about automatic movements that have been learned through repeated exposure to certain motions. For example, by repeatedly practicing serving a ball, a tennis player learns to optimize balance control during that movement. Contributions from the cerebral cortex include previously learned information; for example, because icy sidewalks are slippery, one is required to use a different pattern of movement in order to safely navigate them.  

Processing of conflicting sensory input

A person can become disoriented if the sensory input received from his or her eyes, muscles and joints, or vestibular organs sources conflicts with one another. For example, this may occur when a person is standing next to a bus that is pulling away from the curb. The visual image of the large rolling bus may create an illusion for the pedestrian that he or she—rather than the bus—is moving. However, at the same time the proprioceptive information from his muscles and joints indicates that he is not actually moving. Sensory information provided by the vestibular organs may help override this sensory conflict. In addition, higher level thinking and memory might compel the person to glance away from the moving bus to look down in order to seek visual confirmation that his body is not moving relative to the pavement.

Motor output

As sensory integration takes place, the brain stem transmits impulses to the muscles that control movements of the eyes, head and neck, trunk, and legs, thus allowing a person to both maintain balance and have clear vision while moving.  

Motor output to the muscles and joints

A baby learns to balance through practice and repetition as impulses sent from the sensory receptors to the brain stem and then out to the muscles form a new pathway. With repetition, it becomes easier for these impulses to travel along that nerve pathway—a process called facilitation—and the baby is able to maintain balance during any activity. Strong evidence exists suggesting that such synaptic reorganization occurs throughout a person’s lifetime of adjusting to changing environments or health conditions. This pathway facilitation is the reason dancers and athletes practice so arduously. Even very complex movements become nearly automatic over a period of time. For example, when a person is turning cartwheels in a park, impulses transmitted from the brain stem inform the cerebral cortex that this particular activity is appropriately accompanied by the sight of the park whirling in circles. With more practice, the brain learns to interpret a whirling visual field as normal during this type of body rotation. Alternatively, dancers learn that in order to maintain balance while performing a series of pirouettes, they must keep their eyes fixed on one spot in the distance as long as possible while rotating their body.

Motor output to the eyes

The vestibular system sends motor control signals via the nervous system to the muscles of the eyes with an automatic function called the vestibulo-ocular reflex. When the head is not moving, the number of impulses from the vestibular organs on the right side is equal to the number of impulses coming from the left side. When the head turns toward the right, the number of impulses from the right ear increases and the number from the left ear decreases. The difference in impulses sent from each side controls eye movements and stabilizes the gaze during active head movements (e.g., while running or watching a hockey game) and passive head movements (e.g., while sitting in a car that is accelerating or decelerating).

The coordinated balance system

The human balance system involves a complex set of sensorimotor-control systems. Its interlacing feedback mechanisms can be disrupted by damage to one or more components through injury, disease, or the aging process. Impaired balance can be accompanied by other symptoms such as dizziness, vertigo, vision problems, nausea, fatigue, and concentration difficulties.
The complexity of the human balance system creates challenges in diagnosing and treating the underlying cause of imbalance. Vestibular dysfunction as a cause of imbalance offers a particularly intricate challenge because of the vestibular system’s interaction with cognitive functioning,² and the degree of influence it has on the control of eye movements and posture.
http://vestibular.org/understanding-vestibular-disorder/human-balance-system 

Sensory Diet

Calming Activities

If a child is over stimulated, the following activities may help to calm him.

• Sucking yogurt through a straw
• Rocking in rocking chair
• Swinging
• Wrapping in heavy blanket
• Quiet space or tent play
• Rolling or kneading play dough
• Mixing in a bowl
• Listening to music on headphones
• Carrying books or other objects up and down stairs
• Washing windows, mirrors, or tables
• Eating healthy, crunchy foods like carrots
• Swimming, taking baths
• Bear hugging
• Painting with water
• Vibrating pillows/massagers
• Finding objects hidden in bucket full of uncooked beans or beads
  

  Energizing Activities

  When a sensory kid needs to be aroused, wake up his senses by trying some of these activities.
• Jumping on trampoline
• Pushing or pulling heavy items
• Sitting on a “wiggle” seat pillow (one of many sensory integration products available)
• Squeezing squishy balls with hand
• Bouncing on therapy or other large ball
• Spinning in rotating chair or on swing
• Eating chewy foods
• Chewing bubble gum (only if age appropriate)
• Pillow squishing, making child into sandwich
• Taking a shower

Other Organizing Activities

These activities may work in both cases, depending on the child.

• Doing handstands against wall or pushups
• Animal walking
• Climbing/pulling up on monkey bars
• Carrying heavy items
• Wearing heavy back pack
• Blowing bubbles
• Tumbling
• Sleeping bag rolling
• Pushing a cart or wagon filled with toys
• Lying on belly to watch TV or play video game

Taken from https://suite.io/karen-plumley/15192g6

Crossing Midline

http://nspt4kids.com/parenting/help-your-child-develop-the-crossing-the-midline-skill/

"W" Sitting

http://www.pediatricservices.com/parents/pc-22.htm

SPD Foundation

http://www.sinetwork.org/about-sensory-processing-disorder.html

Sensory Tools--Polk Elementary

http://polkdhsd7.sharpschool.com/staff_directory/p_b_s_behavior_intervention/tier_2_interventions/sensory_tools/

The Gifted and Sensory Connection by Angie Voss

The Gifted and Sensory Connection
Written By: Angie Voss, OTR

Although there is not much research on this connection, I do know through my clinical experience the number of gifted children I worked with over the years has been well over 50%...and I do not think this was just a coincidence! I strongly believe this percentage is much higher, yet many children are consumed and over-powered by the sensory component, that they are simply unable to "show us" their incredibly gifted minds.

As many of you know, my son has sensory differences...and he is also in the highly gifted category. It has been a remarkable journey, and I learn more every single day through his life experiences. He has such a complex and fascinating brain, connected to sensory systems that are in overdrive and hyper-aware of everything. Yet on the same note, emotional intensity on the inside, with a strong "wall" and barrier on the outside not letting it show.


I want to share some of my thoughts on this topic...all which are based on my clinical experience, sensory integration knowledge and education, and my personal experience with my son. I have included a few links at the bottom of this page if you are interested in learning more about some of the findings and research on the connection between sensory differences and those intellectually gifted.

---

Similar Traits and Overlap Between Sensory Processing Challenges and Giftedness:

• The limbic system is very intense and reactive (self-regulation and emotions)
• The brain is processing and utilizing more pathways and connections than a neurotypical brain (no wonder why the sensory systems are often in overload!)
• A very strong need to succeed, and a fear of failing or making mistakes
• A heightened awareness of sensory input, some sensory systems being more heightened than others
• An acute awareness of "the big picture"...understanding very complex concepts of life at a much younger age 
• Emotional development often lags behind the intellectual development (although parents/teachers/caregivers often expect more from them simply based on the giftedness)
• Rigid and narrow interests
• Difficulty with change and transitions
• Difficulty with social interaction, often prefers to be alone
• Delayed or lacking in social graces and reading social cues
• Very focused and preoccupied with specific cognitive skills

The Importance of Sensory Tools and Strategies for the Gifted Brain!

The fidget that saved the day!

Never underestimate the power of a sensory tool...
Since preschool we had sensory strategies and tools in place to help my son succeed and to help self-regulate throughout the school day. One of the mainstays was a fidget...he never let it go, literally. It was in his hand CONSTANTLY and needed it, I mean needed it. Of course the teachers he had knew this and respected it. Well, in 3rd grade during the yearly standardized testing, the test administrators did not allow him to have the fidget. Nothing was said to his teacher and Dillon didn't tell me either...I only found out when I saw the test results. He scored in the average category...which for Dillon was so incredibly not accurate    
(I promise I am not bragging)...he scored in the 99th percentile in absolutely everything he ever tested in. I simply asked him..."Hey bud, was the test extra tough this year?"...he said, in one sentence... "The test person did not let me have my fidget". You guessed it...mama bear sure jumped on this one! The next day I went straight to the principal and told him of the situation. I insisted that he would be given the opportunity to retake the test with the agreed upon sensory tool. He allowed it...and guess what...the scores right back through the roof! 

http://asensorylife.com/the-gifted-and-sensory-connection.html

For more great tips/advice from Angie Voss visit her FB page "Understanding Your Child's Sensory Signals" @ https://www.facebook.com/pages/Understanding-Your-Childs-Sensory-Signals/226232787490900

My Favorite Informational Website on SPD--Symptoms Checklist

(http://www.sensory-processing-disorder.com/)

Signs Of Tactile Dysfunction:

 

 1. Hypersensitivity To Touch (Tactile Defensiveness)

__ becomes fearful, anxious or aggressive with light or unexpected touch

__ as an infant, did/does not like to be held or cuddled; may arch back, cry, and pull away

__ distressed when diaper is being, or needs to be, changed

__ appears fearful of, or avoids standing in close proximity to other people or peers (especially in lines)

__ becomes frightened when touched from behind or by someone/something they can not see (such as under a blanket)

__ complains about having hair brushed; may be very picky about using a particular brush

__ bothered by rough bed sheets (i.e., if old and "bumpy")

__ avoids group situations for fear of the unexpected touch

__ resists friendly or affectionate touch from anyone besides parents or siblings (and sometimes them too!)

__ dislikes kisses, will "wipe off" place where kissed

__ prefers hugs

__ a raindrop, water from the shower, or wind blowing on the skin may feel like torture and produce adverse and avoidance reactions

__ may overreact to minor cuts, scrapes, and or bug bites

__ avoids touching certain textures of material (blankets, rugs, stuffed animals)

__ refuses to wear new or stiff clothes, clothes with rough textures, turtlenecks, jeans, hats, or belts, etc.

__ avoids using hands for play

__ avoids/dislikes/aversive to "messy play", i.e., sand, mud, water, glue, glitter, playdoh, slime, shaving cream/funny foam etc.

__ will be distressed by dirty hands and want to wipe or wash them frequently

__ excessively ticklish

__ distressed by seams in socks and may refuse to wear them

__ distressed by clothes rubbing on skin; may want to wear shorts and short sleeves year round, toddlers may prefer to be naked and pull diapers and clothes off constantly

__ or, may want to wear long sleeve shirts and long pants year round to avoid having skin exposed

__ distressed about having face washed

__ distressed about having hair, toenails, or fingernails cut

__ resists brushing teeth and is extremely fearful of the dentist

__ is a picky eater, only eating certain tastes and textures; mixed textures tend to be avoided as well as hot or cold foods; resists trying new foods

__ may refuse to walk barefoot on grass or sand

__ may walk on toes only


2. Hyposensitivity To Touch (Under-Responsive):

__ may crave touch, needs to touch everything and everyone

__ is not aware of being touched/bumped unless done with extreme force or intensity

__ is not bothered by injuries, like cuts and bruises, and shows no distress with shots (may even say they love getting shots!)

__ may not be aware that hands or face are dirty or feel his/her nose running

__ may be self-abusive; pinching, biting, or banging his own head

__ mouths objects excessively

__ frequently hurts other children or pets while playing

__ repeatedly touches surfaces or objects that are soothing (i.e., blanket)

__ seeks out surfaces and textures that provide strong tactile feedback

__ thoroughly enjoys and seeks out messy play

__ craves vibrating or strong sensory input

__ has a preference and craving for excessively spicy, sweet, sour, or salty foods

 

3. Poor Tactile Perception And Discrimination:

 

__ has difficulty with fine motor tasks such as buttoning, zipping, and fastening clothes

__ may not be able to identify which part of their body was touched if they were not looking

__ may be afraid of the dark

__ may be a messy dresser; looks disheveled, does not notice pants are twisted, shirt is half un tucked, shoes are untied, one pant leg is up and one is down, etc.

__ has difficulty using scissors, crayons, or silverware

__ continues to mouth objects to explore them even after age two

__ has difficulty figuring out physical characteristics of objects; shape, size, texture, temperature, weight, etc.

__ may not be able to identify objects by feel, uses vision to help; such as, reaching into backpack or desk to retrieve an item

---

Vestibular Sense: input from the inner ear about equilibrium, gravitational changes, movement experiences, and position in space.

 

Signs Of Vestibular Dysfunction:

1. Hypersensitivity To Movement (Over-Responsive):

__ avoids/dislikes playground equipment; i.e., swings, ladders, slides, or merry-go-rounds

__ prefers sedentary tasks, moves slowly and cautiously, avoids taking risks, and may appear "wimpy"

__ avoids/dislikes elevators and escalators; may prefer sitting while they are on them or, actually get motion sickness from them

__ may physically cling to an adult they trust

__ may appear terrified of falling even when there is no real risk of it

__ afraid of heights, even the height of a curb or step

__ fearful of feet leaving the ground

__ fearful of going up or down stairs or walking on uneven surfaces

__ afraid of being tipped upside down, sideways or backwards; will strongly resist getting hair washed over the sink

__ startles if someone else moves them; i.e., pushing his/her chair closer to the table

__ as an infant, may never have liked baby swings or jumpers

__ may be fearful of, and have difficulty riding a bike, jumping, hopping, or balancing on one foot (especially if eyes are closed)

__ may have disliked being placed on stomach as an infant

__ loses balance easily and may appear clumsy

__ fearful of activities which require good balance

__ avoids rapid or rotating movements

 

2. Hyposensitivity To Movement (Under-Responsive):

 

__ in constant motion, can't seem to sit still

__ craves fast, spinning, and/or intense movement experiences

__ loves being tossed in the air

__ could spin for hours and never appear to be dizzy

__ loves the fast, intense, and/or scary rides at amusement parks

__ always jumping on furniture, trampolines, spinning in a swivel chair, or getting into upside down positions

__ loves to swing as high as possible and for long periods of time

__ is a "thrill-seeker"; dangerous at times

__ always running, jumping, hopping etc. instead of walking

__ rocks body, shakes leg, or head while sitting

__ likes sudden or quick movements, such as, going over a big bump in the car or on a bike

 

3. Poor Muscle Tone And/Or Coordination:

 

__ has a limp, "floppy" body

__ frequently slumps, lies down, and/or leans head on hand or arm while working at his/her desk

__ difficulty simultaneously lifting head, arms, and legs off the floor while lying on stomach ("superman" position)

__ often sits in a "W sit" position on the floor to stabilize body
__ fatigues easily!

__ compensates for "looseness" by grasping objects tightly

__ difficulty turning doorknobs, handles, opening and closing items

__ difficulty catching him/her self if falling

__ difficulty getting dressed and doing fasteners, zippers, and buttons

__ may have never crawled as an baby

__ has poor body awareness; bumps into things, knocks things over, trips, and/or appears clumsy

__ poor gross motor skills; jumping, catching a ball, jumping jacks, climbing a ladder etc.

__ poor fine motor skills; difficulty using "tools", such as pencils, silverware, combs, scissors etc.

__ may appear ambidextrous, frequently switching hands for coloring, cutting, writing etc.; does not have an established hand preference/dominance by 4 or 5 years old

__ has difficulty licking an ice cream cone

__ seems to be unsure about how to move body during movement, for example, stepping over something

__ difficulty learning exercise or dance steps

---

Proprioceptive Sense: input from the muscles and joints about body position, weight, pressure, stretch, movement, and changes in position in space.

 

Signs Of Proprioceptive Dysfunction:

 

1. Sensory Seeking Behaviors:

 

__ seeks out jumping, bumping, and crashing activities

__ stomps feet when walking

__ kicks his/her feet on floor or chair while sitting at desk/table

__ bites or sucks on fingers and/or frequently cracks his/her knuckles

__ loves to be tightly wrapped in many or weighted blankets, especially at bedtime

__ prefers clothes (and belts, hoods, shoelaces) to be as tight as possible

__ loves/seeks out "squishing" activities

__ enjoys bear hugs
__ excessive banging on/with toys and objects

__ loves "roughhousing" and tackling/wrestling games

__ frequently falls on floor intentionally

__ would jump on a trampoline for hours on end

__ grinds his/her teeth throughout the day

__ loves pushing/pulling/dragging objects

__ loves jumping off furniture or from high places

__ frequently hits, bumps or pushes other children

__ chews on pens, straws, shirt sleeves etc.

2. Difficulty With "Grading Of Movement":

 

__ misjudges how much to flex and extend muscles during tasks/activities (i.e., putting arms into sleeves or climbing)

__ difficulty regulating pressure when writing/drawing; may be too light to see or so hard the tip of writing utensil breaks

__ written work is messy and he/she often rips the paper when erasing

__ always seems to be breaking objects and toys

__ misjudges the weight of an object, such as a glass of juice, picking it up with too much force sending it flying or spilling, or with too little force and complaining about objects being too heavy

__ may not understand the idea of "heavy" or "light"; would not be able to hold two objects and tell you which weighs more

__ seems to do everything with too much force; i.e., walking, slamming doors, pressing things too hard, slamming objects down

__ plays with animals with too much force, often hurting them

---

Signs Of Auditory Dysfunction: (no diagnosed hearing problem)

 

1. Hypersensitivity To Sounds (Auditory Defensiveness):

 

__ distracted by sounds not normally noticed by others; i.e., humming of lights or refrigerators, fans, heaters, or clocks ticking
__ fearful of the sound of a flushing toilet (especially in public bathrooms), vacuum, hairdryer, squeaky shoes, or a dog barking
__ started with or distracted by loud or unexpected sounds
__ bothered/distracted by background environmental sounds; i.e., lawn mowing or outside construction
__ frequently asks people to be quiet; i.e., stop making noise, talking, or singing
__ runs away, cries, and/or covers ears with loud or unexpected sounds
__ may refuse to go to movie theaters, parades, skating rinks, musical concerts etc.
__ may decide whether they like certain people by the sound of their voice

 

2. Hyposensitivity To Sounds (Under-Registers):

 

__ often does not respond to verbal cues or to name being called
__ appears to "make noise for noise's sake"
__ loves excessively loud music or TV
__ seems to have difficulty understanding or remembering what was said
__ appears oblivious to certain sounds
__ appears confused about where a sound is coming from
__ talks self through a task, often out loud
__ had little or no vocalizing or babbling as an infant
__ needs directions repeated often, or will say, "What?" frequently

---

Signs Of Oral Input Dysfunction:

 

1. Hypersensitivity To Oral Input (Oral Defensiveness):

 

__ picky eater, often with extreme food preferences; i.e., limited repertoire of foods, picky about brands, resistive to trying new foods or restaurants, and may not eat at other people's houses)
__ may only eat "soft" or pureed foods past 24 months of age
__ may gag with textured foods
__ has difficulty with sucking, chewing, and swallowing; may choke or have a fear of choking
__ resists/refuses/extremely fearful of going to the dentist or having dental work done
__ may only eat hot or cold foods
__ refuses to lick envelopes, stamps, or stickers because of their taste
__ dislikes or complains about toothpaste and mouthwash
__ avoids seasoned, spicy, sweet, sour or salty foods; prefers bland foods

 

2. Hyposensitivity To Oral Input (Under-Registers)

 

__ may lick, taste, or chew on inedible objects
__ prefers foods with intense flavor; i.e., excessively spicy, sweet, sour, or salty
__ excessive drooling past the teething stage
__ frequently chews on hair, shirt, or fingers
__ constantly putting objects in mouth past the toddler years
__ acts as if all foods taste the same
__ can never get enough condiments or seasonings on his/her food
__ loves vibrating toothbrushes and even trips to the dentist

---

Signs Of Olfactory Dysfunction (Smells):

 

1. Hypersensitivity To Smells (Over-Responsive):

 

__ reacts negatively to, or dislikes smells which do not usually bother, or get noticed, by other people
__ tells other people (or talks about) how bad or funny they smell
__ refuses to eat certain foods because of their smell
__ offended and/or nauseated by bathroom odors or personal hygiene smells
__ bothered/irritated by smell of perfume or cologne
__ bothered by household or cooking smells
__ may refuse to play at someone's house because of the way it smells
__ decides whether he/she likes someone or some place by the way it smells

 

2. Hyposensitivity To Smells (Under-Responsive):

 

__ has difficulty discriminating unpleasant odors
__ may drink or eat things that are poisonous because they do not notice the noxious smell
__ unable to identify smells from scratch 'n sniff stickers
__ does not notice odors that others usually complain about
__ fails to notice or ignores unpleasant odors
__ makes excessive use of smelling when introduced to objects, people, or places
__ uses smell to interact with objects

---

Signs Of Visual Input Dysfunction (No Diagnosed Visual Deficit):

 

1. Hypersensitivity To Visual Input (Over-Responsiveness)

 

__ sensitive to bright lights; will squint, cover eyes, cry and/or get headaches from the light
__ has difficulty keeping eyes focused on task/activity he/she is working on for an appropriate amount of time
__ easily distracted by other visual stimuli in the room; i.e., movement, decorations, toys, windows, doorways etc.
__ has difficulty in bright colorful rooms or a dimly lit room
__ rubs his/her eyes, has watery eyes or gets headaches after reading or watching TV
__ avoids eye contact
__ enjoys playing in the dark

 

2. Hyposensitivity To Visual Input (Under-Responsive Or Difficulty With Tracking, Discrimination, Or Perception):

 

__ has difficulty telling the difference between similar printed letters or figures; i.e., p & q, b & d, + and x, or square and rectangle
__ has a hard time seeing the "big picture"; i.e., focuses on the details or patterns within the picture
__ has difficulty locating items among other items; i.e., papers on a desk, clothes in a drawer, items on a grocery shelf, or toys in a bin/toy box
__ often loses place when copying from a book or the chalkboard
__ difficulty controlling eye movement to track and follow moving objects
__ has difficulty telling the difference between different colors, shapes, and sizes
__ often loses his/her place while reading or doing math problems
__ makes reversals in words or letters when copying, or reads words backwards; i.e., "was" for "saw" and "no" for "on" after first grade
__ complains about "seeing double"
__ difficulty finding differences in pictures, words, symbols, or objects
__ difficulty with consistent spacing and size of letters during writing and/or lining up numbers in math problems
__ difficulty with jigsaw puzzles, copying shapes, and/or cutting/tracing along a line
__ tends to write at a slant (up or down hill) on a page
__ confuses left and right
__ fatigues easily with schoolwork
__ difficulty judging spatial relationships in the environment; i.e., bumps into objects/people or missteps on curbs and stairs

---

Auditory-Language Processing Dysfunction:

 

__ unable to locate the source of a sound
__ difficulty identifying people's voices
__ difficulty discriminating between sounds/words; i.e., "dare" and "dear"
__ difficulty filtering out other sounds while trying to pay attention to one person talking
__ bothered by loud, sudden, metallic, or high-pitched sounds
__ difficulty attending to, understanding, and remembering what is said or read; often asks for directions to be repeated and may only be able to understand or follow two sequential directions at a time
__ looks at others to/for reassurance before answering
__ difficulty putting ideas into words (written or verbal)
__ often talks out of turn or "off topic"
__ if not understood, has difficulty re-phrasing; may get frustrated, angry, and give up
__ difficulty reading, especially out loud (may also be dyslexic)
__ difficulty articulating and speaking clearly
__ ability to speak often improves after intense movement

---

Social, Emotional, Play, And Self-Regulation Dysfunction:

 

Social:

 

__ difficulty getting along with peers
__ prefers playing by self with objects or toys rather than with people
__ does not interact reciprocally with peers or adults; hard to have a "meaningful" two-way conversation
__ self-abusive or abusive to others
__ others have a hard time interpreting child's cues, needs, or emotions
__ does not seek out connections with familiar people

 

Emotional:

 

__ difficulty accepting changes in routine (to the point of tantrums)
__ gets easily frustrated
__ often impulsive
__ functions best in small group or individually
__ variable and quickly changing moods; prone to outbursts and tantrums
__ prefers to play on the outside, away from groups, or just be an observer
__ avoids eye contact
__ difficulty appropriately making needs known

Play:

__ difficulty with imitative play (over 10 months)
__ wanders aimlessly without purposeful play or exploration (over 15 months)
__ needs adult guidance to play, difficulty playing independently (over 18 months)
__ participates in repetitive play for hours; i.e., lining up toys cars, blocks, watching one movie over and over etc.

Self-Regulation:

__ excessive irritability, fussiness or colic as an infant
__ can't calm or soothe self through pacifier, comfort object, or caregiver
__ can't go from sleeping to awake without distress
__ requires excessive help from caregiver to fall asleep; i.e., rubbing back or head, rocking, long walks, or car rides

Internal  Regulation (The Interoceptive Sense):

__ becoming too hot or too cold sooner than others in the same environments; may not appear to ever get cold/hot, may not be able to maintain body temperature effectively
__ difficulty in extreme temperatures or going from one extreme to another (i.e., winter, summer, going from air conditioning to outside heat, a heated house to the cold outside)
__ respiration that is too fast, too slow, or cannot switch from one to the other easily as the body demands an appropriate respiratory response
__ heart rate that speeds up or slows down too fast or too slow based on the demands imposed on it
__ respiration and heart rate that takes longer than what is expected to slow down during or after exertion or fear
__ severe/several mood swings throughout the day (angry to happy in short periods of time, perhaps without visible cause)
__ unpredictable state of arousal or inability to control arousal level (hyper to lethargic, quickly, vacillating between the two; over stimulated to under stimulated, within hours or days, depending on activity and setting, etc.)
__ frequent constipation or diarrhea, or mixed during the same day or over a few days
__ difficulty with potty training; does not seem to know when he/she has to go (i.e., cannot feel the necessary sensation that bowel or bladder are full
__ unable to regulate thirst; always thirsty, never thirsty, or oscillates back and forth
__ unable to regulate hunger; eats all the time, won't eat at all, unable to feel full/hungry
__ unable to regulate appetite; has little to no appetite and/or will be "starving" one minute then full two bites later, then back to hungry again (prone to eating disorders and/or failure to thrive)