Thursday, August 2, 2012

Therapy Thursday {Link Up}


Each week I post about some type of therapy we use, who recommended it, and the reason we are using it.  Remember, I am not a licensed therapist and I am sharing our experiences.  We would love to have you share too.  Follow the directions at the end of this post to link up with us.

Sensory Processing Disorder: Tactile (Touch)

I first heard of sensory processing disorder during a workshop I took as part of James' early intervention program.  The information they were presenting to us and allowing us to experience was truly a light bulb moment for me.   I walked away from that workshop wanting to find out more.  I was beginning to understand why our younger children were behaving in certain ways, like screaming when having their hair washed (and it wasn't because they got shampoo in their eyes).  

For the month of August, I will be highlighting the different senses that Sensory Processing Disorder affects, a checklist of symptoms and some activities we do to help.  Last week we started with proprioception, which is the internal sense of knowing where your body parts are without looking a them.

This week we are introducing the sense of touch or tactile system.  The tactile system is the first sensory system to develop in the womb and is the largest sensory system in the body.  There are millions of receptors  on the outer skin.  Don't forget the receptors inside the ears, nose, throat, mouth, and digestive system, covering the reproductive organs, etc.  You get the idea. 

Let me also say this, there are 2 types of reactions to stimuli with sensory processing disorder: hypersensitivity or hyposensitivity.  Hypersensitivity is a child who is oversensitive to a stimuli and may avoid it.  For example, our sons who are hypersensitive to touch do not like to be bumped accidentally and may scream or lash out.  Hyposensitivity is a child who is undersensitive to a stimuli and may seek it.  For example, we have one son who is hyposensitive to touch and he loves to rub shaving cream or lotion all over his body.  And then you may have a child who has mixed reactions. 

Confused yet?  Hang in there with me for a minute.  Here is the Tactile portion of the complete sensory processing disorder checklist found on Sensory-Processing-Disorder.com.

Signs Of Tactile Dysfunction:

1. Hypersensitivity To Touch (Oversensitive)

__ 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 (Undersensitive):

__ 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

I think my child may have Sensory Processing Disorder, now what?  The Ultimate Guide to Sensory Processing Disorder by Roya Ostavar, Ph.D. has a ton of great information, including Chapter 5: Assessment, Diagnosis, and Treatment - Where to Begin.  She also includes a very thorough (20 pages worth) sample Developmental History Form.  

Then obtain a referral to an Occupational Therapist.  All three of our boys have been treated by an OT at one time or another.  Currently our two youngest sons are receiving treatment 1-2 times a month.  They give us many great ideas of therapies activities to do at home.  For more ideas, The Out-of-Sync Child Has Fun by Carol Stock Kranowitz, M.A. has tons of activities for kids with sensory processing disorder.

A few of our family favorite activities are:

Brushing.  This is a technique that was shown to us by the OT and followed up by her.  We definitely noticed a difference when we were brushing the kids regularly.  Problem is, you need to do it frequently (every couple of hours) for maximum benefit.  Kids can also be hyped up more when this is started, but the desired result is calming.


Deep pressure.  This is another calming strategy.  We use wet suits (over clothing), pressure vests, ankle weights, weighted blankets, wrestling, and wall push-ups to name a few.  Pretty much anything you can think of that gives a heavy touch.  Even filling a backpack up with toys and wearing it around the house.

            
Play-doh or Theraputty.  I hide coins or beads in them for the kids to find.  We sometimes just play with it.  Last summer I made Flubber and Johnathan (pictured above with the ankle weights) could not stand the touch or smell of it, to the point of gagging.

 




We take many trips to the ocean so the kids are used to walking on the sand with bare feet now.  Our youngest, Amada, cannot stand to get wet.  If she has even 1 drop of water on her clothes she has to go change, so this was a good trip to the beach for her.



Shaving cream.  I will warn you...this makes a mess!  I usually try to limit it to in the bathtub otherwise it gets out of hand quickly.  We also go outside and they draw on the sliding glass door with shaving cream, which can then be hosed off.

 



Practice writing our letters or names in a tray of rice.  Play with moon sand inside a plastic container at the table.  You can put hair gel or pudding inside a plastic bag and have the kids feel it without all the mess. We also have a "taggie" blanket with the tags all around it because James, who is our sensory seeker, loves tags.


This was recommended by our OT also.  It is called KT tape (sports players use it to tape up their muscles or injuries).  Using it around James' mouth brings more awareness to that area and helps cut down on the drooling.  He also likes to stuff his food in his mouth when eating (so he can feel the food in his mouth) and this helps with that.




                           
Does your child have Sensory Processing Disorder?  What are some activities you have fun doing with your child?

Now it's your turn to link up.  I would love to hear your stories.  Feel free to copy/paste the Therapy Thursday logo into your post.  I only ask that you provide a link back.  Have fun with it!

~Nicole~

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