My son had a five word vocabulary on the day of his one year old immunizations. We were at the doctor preparing for the shots and he looked at the wall with the farm painting on it and said, "gog" for dog. It was his 5th word! Immediately after his shots he was extremely fussy. I thought, "He's just irritable from the shots" and I didn't think much about it. He then quit talking and went to pointing and grunting. He acted like he didn't know who I was. I would hide around the house trying to get him to call for me. He just wandered around aimlessly. After about 6 months I got worried and called the doctor to let them know what had been going on. They told me to immediately call Health and Welfare. They sent out developmental specialist and did some testing. He appeared to be fine except for his speech. They set up speech therapy and within 6 months of therapy he was talking up a storm and did not stop. It was a great relief! It was my speech therapist however, that noticed his "W" sitting. Sometimes there is nothing wrong with it but sometimes there is more to it than one thinks. We found out that he sat like that because of low muscle tone (hypotonia) which we began to investigate. He was sitting like this to give himself a bigger base with which to support himself because he has poor core strength.
What's wrong with W-sitting?
By Jean McNamara, PT
ADVANCE for Physical Therapists, 1995
The W-positions is one of many sitting positions that most children
move into and out of while playing, but it’s a four-letter word to
some parents. Why is it presumed to be ok for some children and forbidden
for others?ADVANCE for Physical Therapists, 1995
When playing in these other sitting postures, children develop the trunk control and rotation necessary for midline crossing (reaching across the body) and separation of the two sides of the body. These skills are needed for a child to develop refined motor skills and hand dominance.
W-sitting is not recommended for anyone. Many typically developing children do move through this position during play, but all parents should be aware that the excessive use of this position during the growing years can lead to future orthopedic problems.
Why do children W-sit?
Every child needs to play and children who are challenged motorically like to play as much as anybody. They don’t want to worry about keeping their balance when they’re concentrating on a toy. Children who are frequent W-sitters often rely on this position for added trunk and hip stability to allow easier toy manipulation and play.
When in the W-position, a child is planted in place or "fixed" through the trunk. This allows for play with toys in front, but does not permit trunk rotation and lateral weight shifts (twisting and turning to reach toys on either side). Trunk rotation and weight shifts over one side allow a child to maintain balance while running outside or playing on the playground and are necessary for crossing the midline while writing and doing table top activities.
It’s easy to see why this position appeals to so many children, but continued reliance on W-sitting can prevent a child from developing more mature movement patterns necessary for higher-level skills.
Who should not w-sit?
For many children, W-sitting should always be discouraged. This position is contraindicated (and could be detrimental) for a child if one of the following exists:
 |
There are orthopedic concerns. W-sitting can predispose a child to hip dislocation, so if there is a history of hip dysplasia, or a concern has been raised in the past, this position should be avoided. | |
|
If there is muscle tightness, W-sitting will aggravate it. This position places the hamstrings, hip adductors, internal rotators and heel cords in an extremely shortened range. If a child is prone to tightness or contractures, encourage anther pattern of sitting. | |
|
There are neurologic concerns/developmental delays. If a child has increased muscle tone (hypertonia, spasticity), W-sitting will feed into the abnormal patterns of movement trying to be avoided (by direction of the child’s therapist). Using other sitting postures will aid in the development of more desirable movement patterns. |
W-sitting can also discourage a child from developing a hand preference. Because no trunk rotation can take place when W-sitting, a child is less inclined to reach across the body and instead picks up objects on the right with the right hand, and those placed to the left with the left hand.
Try sitting in various positions. Notice how you got there, got out, and what it took to balance. Many of the movement components you are trying to encourage in a child are used when getting in and out of sitting. Transfers in and out of the Q-position, however, are accomplished through straight-plane (directly forward and backward) movement only. No trunk rotation, weight shifting, or righting reactions are necessary to assume or maintain W-sitting.
How to prevent W-sitting.
The most effective (and easiest) way to prevent a problem with W-sitting is to prevent it from becoming a habit it the first place. Anticipate and catch it before the child even learns to W-sit. Children should be placed and taught to assume alternative sitting positions. If a child discovers W-sitting anyway, help him to move to another sitting position, or say, "Fix your legs." It’s very important to be as consistent as possible.
When playing with a child on the floor, hold his knees and feet together when kneeling or creeping on hands and knees. It will be impossible to get into a W-position from there. The child will either sit to one side, or sit back on his feet; he can then be helped to sit over to one side from there (try to encourage sitting over both the right and left sides). These patterns demand a certain amount of trunk rotation and lateral weight shift and should fit with a child’s therapy goals.
If a child is unable to sit alone in any position other than a W, talk with a therapist about supportive seating or alternative positions such as prone and sidelying. Tailor sitting against the couch may be one alternative; a small table and chair is another.
The therapist(s) working with the child will have many other ideas. Caregivers should ask if W-sitting in now, or may in the future, be a problem.
http://www.pediatricservices.com/parents/pc-22.htm
Understanding Your BABY's Sensory Signals
Author: Angie Voss, OTR
A baby
may be given the label "fussy" or "colicky"....often a catch all
diagnosis from a doctor, yet when given this diagnosis or assumption, a very critical component may be missed.
These symptoms of a fussy or colicky baby may be a sign of sensory
processing difficulty and neurobehavioral disorganization (a problem
with self-regulation and state behavior in infants). When these symptoms
are written off as fussy or colicky, sensory processing concerns are
not identified and therefore not addressed. It is not until the child
is beginning to show delays in development, social skills,
self-regulation and emotional development, language, and adaptive skills
that it is then brought to attention again. The unfortunate
part is the very best window of opportunity to address the sensory
pathways in the brain may have been missed, which is between the ages of
birth and 3 years old.
Nerve pathways are pliable in a very young brain, primarily before age 3. This is called neuroplasticity. This is when it is much easier and possible to help change the "hard wiring" in the brain for those struggling with sensory processing issues. Sensory integrative treatment can begin in infancy and in the toddler years. Too many times parents and doctors just say "they will outgrow it" or simply deny the symptoms as a true concern.
Achievement of developmental milestones requires a strong sensory foundation. If the brain is not processing sensory information correctly or is deprived of essential sensory input, a baby will likely have difficulty with self-regulation and/or achievement of developmental milestones....such as sitting,crawling, or walking. Self-regulation for a baby includes sleeping patterns, ability to calm self, eating/breastfeeding, and interaction within the environment. If the brain is over-responsive to sensory input, it can also result in avoidance of sensory input, such as food, touch, movement, and sound. When the brain avoids this critical sensory nutrition, it impacts overall development.
A few examples of sensory signals included in the upcoming book!Nerve pathways are pliable in a very young brain, primarily before age 3. This is called neuroplasticity. This is when it is much easier and possible to help change the "hard wiring" in the brain for those struggling with sensory processing issues. Sensory integrative treatment can begin in infancy and in the toddler years. Too many times parents and doctors just say "they will outgrow it" or simply deny the symptoms as a true concern.
Achievement of developmental milestones requires a strong sensory foundation. If the brain is not processing sensory information correctly or is deprived of essential sensory input, a baby will likely have difficulty with self-regulation and/or achievement of developmental milestones....such as sitting,crawling, or walking. Self-regulation for a baby includes sleeping patterns, ability to calm self, eating/breastfeeding, and interaction within the environment. If the brain is over-responsive to sensory input, it can also result in avoidance of sensory input, such as food, touch, movement, and sound. When the brain avoids this critical sensory nutrition, it impacts overall development.
- Excessive crying and irritability
- Difficult to sooth or calm
- Feeding difficulties
- Lack of alertness
- Arched back
- Avoids social interaction
- Dislikes being touched or held
- Dislikes bathing
- Dislikes diaper changes
- Dislikes clothing changes
- Dislikes swinging or movement
- Dislikes tummy time
- Frequent hiccups
Sensory Anchors
Information Source: Your Essential Guide to Understanding Sensory Processing Disorder ~Angie Voss, OTR
A sensory anchor is
a behavior or often repetitive activity which helps the brain feel
good. It is a sensory signal indicating the child is feeling
dysregulated or needs a dose of a "feel good" sensation that is calming
and soothing. For our sensory kiddos, the world can be a scary,
unpredictable, disorganizing, and often an uncomfortable place to be.
When the child discovers a sensory based activity that feels good to
them, they tend to do it over and over. And this is typically a sensory
anchor from a sensory system which is soothing and calming to the child.
For instance, lining toys up, this can be visually soothing, similar
to looking at spinning objects or following a line with the eyes. Toe
walking provides proprioceptive feedback, which can be very calming and
regulating as well. We all seek out sensory activities which as soothing
and regulating, our sensory kiddos tend to take this to a whole new
level.
A sensory anchor helps the child feel grounded, in control of the moment, and a sense of brain organization and regulation. Here are some examples of possible sensory anchors.....
For further information and details on precautions and ideas to help as well as a list of over 200 possible sensory signals and/or sensory anchors, refer to Understanding Your Child's Sensory Signals.
It is very important to respect these sensory signals and let the child do it!
I do realize that some children perseverate and become fixated on a sensory anchor...and this is when you come into play! Encourage and transition to a FUN heavy/hard work play activity, movement activity, or tactile activity which will also help the brain regulate and feel good! Or possibly find an alternative purposeful activity related to the sense they are using to anchor (such as using scented markers for a child who enjoying smelling things to regulate, or a labyrinth maze for those who enjoy visual input) The bubble mountain is a great choice as well! Also, be sure to give the child a warning that it will be time to move on to something else if the child becomes stuck in the sensory anchor activity.
A sensory anchor helps the child feel grounded, in control of the moment, and a sense of brain organization and regulation. Here are some examples of possible sensory anchors.....
- Lining toys/objects up
- Following a line or straight surface with the eyes
- Looking at a spinning object
- Hand flapping
- Toe walking* (refer to Understanding Your Child's Sensory Signals for precautions on this topic)
- Making repetitive mouth sounds
- Chewing on a non-food object
- Smelling objects or a new environment/room
- And many, many more!
For further information and details on precautions and ideas to help as well as a list of over 200 possible sensory signals and/or sensory anchors, refer to Understanding Your Child's Sensory Signals.
It is very important to respect these sensory signals and let the child do it!
I do realize that some children perseverate and become fixated on a sensory anchor...and this is when you come into play! Encourage and transition to a FUN heavy/hard work play activity, movement activity, or tactile activity which will also help the brain regulate and feel good! Or possibly find an alternative purposeful activity related to the sense they are using to anchor (such as using scented markers for a child who enjoying smelling things to regulate, or a labyrinth maze for those who enjoy visual input) The bubble mountain is a great choice as well! Also, be sure to give the child a warning that it will be time to move on to something else if the child becomes stuck in the sensory anchor activity.
SENSORY INTEGRATION
Andrew seems to
have some "sensory issues" that we try to address.
He seems more aware and relaxed after jumping on his little trampoline,
swimming in the pool or swinging outside.
I try to have him "sensorized" (my word for when Andrew is done with sensory activities)
before his sessions and the therapists are trying to incorporate it into his "break" times.
There are some occupational therapists that are trained in this area.
I would suggest you try some of their techniques. There are many things you can do that don't require purchasing things. My speech therapist and occupational therapist from the Early Intervention Program helped train my family and therapists how to use the activities below to "ready" Andrew's senses to learn. Once he performs some of these activities, he is more prepared to sit down, relax, and focus on his lessons.
He seems more aware and relaxed after jumping on his little trampoline,
swimming in the pool or swinging outside.
I try to have him "sensorized" (my word for when Andrew is done with sensory activities)
before his sessions and the therapists are trying to incorporate it into his "break" times.
There are some occupational therapists that are trained in this area.
I would suggest you try some of their techniques. There are many things you can do that don't require purchasing things. My speech therapist and occupational therapist from the Early Intervention Program helped train my family and therapists how to use the activities below to "ready" Andrew's senses to learn. Once he performs some of these activities, he is more prepared to sit down, relax, and focus on his lessons.
Let me know of any
suggestions that you have that I can pass on to other parents.
PRESENTING PROBLEMS SEEN IN CHILDREN WITH SUSPECTED
SENSORY INTEGRATION DISORDERS
(For identification of sensory system dysfunction,
several symptoms must occur together.)
INFANCY
Irritable baby
Low muscle tone
Poor sleep cycles
May dislike being on back
May startle easily
Slow development - or less than normal quality of movement
TODDLER
(above may continue with addition of the following)
Short attention span
Clumsiness
Poor Articulation
Overly upset by slight injury
Fear of walking on some surfaces
Fear of slides, other movements
Very messy eater
Slow language development
Rejects many foods because of texture
CHILDHOOD - Pre-K to 3rd grade
(above may continue with addition of the following)
Fine motor problems (i.e., handwriting, cutting, coloring)
Hyperactivity
Poor social skills
Impulsiveness
Cries easily
Dislikes textures (i.e., finger-painting, food)
Difficulties in gross motor activities
Falls easily
Often accidentally breaks toys during play
Strong dislike for certain types of clothing
MIDDLE CHILDHOOD - 4TH - 6TH grade
(above may continue with addition to the following)
Increased academic problems/attention
Behavioral problems
Poorly organized or compulsively organized
Reversals in writing and reading
Trouble keeping up with peers in activities
PREADOLESCENCE
(above may continue with addition to the following)
Organization problems
Trouble finishing homework/attention
Immature in physical skills and social relationships
More pronounced behavioral problems (i.e., acts out, picks fights)
Loses or forgets things
Often socially isolated
Chooses individual sports (i.e., running, swimming)
Chooses heavy contact sports (i.e., football, soccer)
Avoids team sports (i.e., basketball, baseball)
May be overly emotional
Information taken from: Frames of Reference for Pediatric Occupational Therapy,
Paula Kramer, Jim Hinojosa.
SENSORY INTEGRATION DISORDERS
(For identification of sensory system dysfunction,
several symptoms must occur together.)
INFANCY
Irritable baby
Low muscle tone
Poor sleep cycles
May dislike being on back
May startle easily
Slow development - or less than normal quality of movement
TODDLER
(above may continue with addition of the following)
Short attention span
Clumsiness
Poor Articulation
Overly upset by slight injury
Fear of walking on some surfaces
Fear of slides, other movements
Very messy eater
Slow language development
Rejects many foods because of texture
CHILDHOOD - Pre-K to 3rd grade
(above may continue with addition of the following)
Fine motor problems (i.e., handwriting, cutting, coloring)
Hyperactivity
Poor social skills
Impulsiveness
Cries easily
Dislikes textures (i.e., finger-painting, food)
Difficulties in gross motor activities
Falls easily
Often accidentally breaks toys during play
Strong dislike for certain types of clothing
MIDDLE CHILDHOOD - 4TH - 6TH grade
(above may continue with addition to the following)
Increased academic problems/attention
Behavioral problems
Poorly organized or compulsively organized
Reversals in writing and reading
Trouble keeping up with peers in activities
PREADOLESCENCE
(above may continue with addition to the following)
Organization problems
Trouble finishing homework/attention
Immature in physical skills and social relationships
More pronounced behavioral problems (i.e., acts out, picks fights)
Loses or forgets things
Often socially isolated
Chooses individual sports (i.e., running, swimming)
Chooses heavy contact sports (i.e., football, soccer)
Avoids team sports (i.e., basketball, baseball)
May be overly emotional
Information taken from: Frames of Reference for Pediatric Occupational Therapy,
Paula Kramer, Jim Hinojosa.
THE LEARNING BLOCKS OF
SENSORY INTEGRATION DEVELOPMENT
Level 4 - Academic Readiness (By 6 years)
Complex Motor Skills
Regulating Attention & Organized Behavior
Specialization of Body & Brain
Visualization
Self- Esteem & Self-Control
Level - 3 Perceptual-Motor Skills (By 3 years)
Auditory & Visual Perception
Eye-Hand Coordination (Pencil Skills)
Visual-Motor Integration
Purposeful Activity
Level 2 - Perceptual-Motor Foundations (By 1 year)
Body Percept (Body Awareness)
Bilateral Coordination
Lateralization (hand preference)
Motor Planning (Praxis)
Level 1 - Primary Sensory Systems (By 2 months)
Tactile Sense (Touch)
Vestibular Sense (Balance & Movement)
Proprioceptive Sense (Body Position)
Visual & Auditory Sense Illustration taken from The Out-of-Sync-Child, Carol Stock Kranowitz, M.A.
SENSORY INTEGRATION DEVELOPMENT
Level 4 - Academic Readiness (By 6 years)
Complex Motor Skills
Regulating Attention & Organized Behavior
Specialization of Body & Brain
Visualization
Self- Esteem & Self-Control
Level - 3 Perceptual-Motor Skills (By 3 years)
Auditory & Visual Perception
Eye-Hand Coordination (Pencil Skills)
Visual-Motor Integration
Purposeful Activity
Level 2 - Perceptual-Motor Foundations (By 1 year)
Body Percept (Body Awareness)
Bilateral Coordination
Lateralization (hand preference)
Motor Planning (Praxis)
Level 1 - Primary Sensory Systems (By 2 months)
Tactile Sense (Touch)
Vestibular Sense (Balance & Movement)
Proprioceptive Sense (Body Position)
Visual & Auditory Sense Illustration taken from The Out-of-Sync-Child, Carol Stock Kranowitz, M.A.
PROPRIOCEPTIVE
SYSTEM
Marching,
jumping skipping crawling -Imitation of gross motor movements (remembering
use only age appropriate skills), Demonstration of actions named, following
locative directions (in, out, on top, under, around. Through. Next to, in
front, in back).
Wall push-ups/push-ups, sit-ups, etc.-Discuss sequence of events, ("First we are doing push-ups, and finally we will find our seats.").
Sitting in a bean bag-Great for story time, Use during listening activities.
Obstacle Course-Imitation of gross motor movements, Demonstration of actions named, Describing actions , Following locative directions (in, out, on top, under, through, next, in front,/back).
Wheelbarrow walking-Let individuals race each other, Talk about locatives "Who was in front/behind?"
Moving chairs/desks-Rearrange room/chairs using prepositions ("Put your chair next to Cathy's chair."), Describing where they want to move their chair using prepositions/locatives.
Tug-o-war-Following directions (simple or complex), Following directions involving adjectives/adverbs, Sing songs.
Wall push-ups/push-ups, sit-ups, etc.-Discuss sequence of events, ("First we are doing push-ups, and finally we will find our seats.").
Sitting in a bean bag-Great for story time, Use during listening activities.
Obstacle Course-Imitation of gross motor movements, Demonstration of actions named, Describing actions , Following locative directions (in, out, on top, under, through, next, in front,/back).
Wheelbarrow walking-Let individuals race each other, Talk about locatives "Who was in front/behind?"
Moving chairs/desks-Rearrange room/chairs using prepositions ("Put your chair next to Cathy's chair."), Describing where they want to move their chair using prepositions/locatives.
Tug-o-war-Following directions (simple or complex), Following directions involving adjectives/adverbs, Sing songs.
FOR
THE MOUTH
Chewing
on plastic tubing, twizzlers, tootsie rolls-Great during story time or for
listening activities.
Chewing gum-Use only in controlled situations (only at given times).
Eating crunchy snacks, pretzels/popcorn/nuts/chips-
Great to do before articulation/speech activities-wakes up the mouth.
Eat sour/bitter/spicy snacks-Great to do before articulation/speech activities wakes up the mouth.
Chewing gum-Use only in controlled situations (only at given times).
Eating crunchy snacks, pretzels/popcorn/nuts/chips-
Great to do before articulation/speech activities-wakes up the mouth.
Eat sour/bitter/spicy snacks-Great to do before articulation/speech activities wakes up the mouth.
VESTIBULAR SYSTEM
Ring
Around the Rosie- Locatives & descriptives (next to, around, up, down, fast,
slow)
Following directions. Turn-taking
London bridges- Locatives & descriptives (under, in, out, around, in front of, behind, fast, slow)
Sitting on a move-n-sit, a rocking chair, - Great for story time. Or a Ther-a-ball
Erasing the chalkboard in a rhythmically motion- Imitating actions following directions Describing actions using adjectives.
Exercises such as picking up cherries, jumping jacks, windmills, toe touches- Discuss body parts-great for identifying/labeling.
Following a sequence of events (1st, 2nd , 3rd ).
Stretching exercises (reaching for the sky, reaching for toes, side to side)- Great relaxation exercises for the children with dysfluent speech.
Discuss adjectives/locatives.
Swinging- Great for very structured one-to-one activities.
Increased eye contact. Turn taking. Use of requests for "More", "Fast", Slow", etc.
Following directions. Turn-taking
London bridges- Locatives & descriptives (under, in, out, around, in front of, behind, fast, slow)
Sitting on a move-n-sit, a rocking chair, - Great for story time. Or a Ther-a-ball
Erasing the chalkboard in a rhythmically motion- Imitating actions following directions Describing actions using adjectives.
Exercises such as picking up cherries, jumping jacks, windmills, toe touches- Discuss body parts-great for identifying/labeling.
Following a sequence of events (1st, 2nd , 3rd ).
Stretching exercises (reaching for the sky, reaching for toes, side to side)- Great relaxation exercises for the children with dysfluent speech.
Discuss adjectives/locatives.
Swinging- Great for very structured one-to-one activities.
Increased eye contact. Turn taking. Use of requests for "More", "Fast", Slow", etc.
TACTILE SYSTEM
Lotion/Hand
sanitizer- Imitation of movements (gross & fine motor)
Identifying/labeling body parts. Following directions.
Textured toys- Great for pretend play.
Fidgets- Great during story time or listening activities.
Finger painting with various mediums- Imitating strokes, circles, letters, etc.
Following directions. Requesting for supplies "I need more paint/shaving cream."
Describing the feel of the medium "It's sticky/squishy/soft."
No Bake activities (Trail mix, Chex mix, Pudding, etc.)- Following directions & sequence of events. Describing actions. Following locative directions.
Sensory boxes for hands and feet- Encourage pretend play.
Use cup, bowls, spoons to incorporate functional use of objects.
Follow locative commands (in, out, next to, under, in front of, etc)
Labeling objects in box using stereognosis (Naming by just touching objects)
Identifying objects using attributes named ("Find the squishy, soft, round objects.")
Identifying/labeling body parts. Following directions.
Textured toys- Great for pretend play.
Fidgets- Great during story time or listening activities.
Finger painting with various mediums- Imitating strokes, circles, letters, etc.
Following directions. Requesting for supplies "I need more paint/shaving cream."
Describing the feel of the medium "It's sticky/squishy/soft."
No Bake activities (Trail mix, Chex mix, Pudding, etc.)- Following directions & sequence of events. Describing actions. Following locative directions.
Sensory boxes for hands and feet- Encourage pretend play.
Use cup, bowls, spoons to incorporate functional use of objects.
Follow locative commands (in, out, next to, under, in front of, etc)
Labeling objects in box using stereognosis (Naming by just touching objects)
Identifying objects using attributes named ("Find the squishy, soft, round objects.")
Taken from: Madore Family's Autism Resource Site
http://www.angelfire.com/tx5/autism/sensoryintegration.html
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