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I’m Sensing Skepticism… January 7, 2011

Filed under: Schmooper — booksunread @ 3:36 pm

Let’s talk about senses today! Specifically: sensory processing and disorders thereof.  (Salsera, you may now be excused from reading the rest of this entry as you go chase down your eyeballs since you just rolled them so hard they jumped out of your head and rolled away.)  Anyway, Squidgey has been back in PT this fall as he is “behind” on a couple of gross motor skills-jumping with two feet and walking up stairs/walking up stairs in an alternating pattern.

When we went for a checkup this fall, his therapist recommended recommencing weekly PT to work on developing the muscles for these skills-particularly in strengthening his left side which tends to be a bit weaker-a legacy of his right-leaning torticollis.  Insurance-covered indoor playground to break up the monotony of long winter afternoons stuck inside? Sign me up. Can’t hurt, right?  (Salsera’s assessment after she accompanied us to the appointment: “So he’s right handed.”)

And after a couple weeks, Squidgey quickly mastered the jumping thing and could generally do stairs -providing he stopped and took the time to actually walk upright, rather than scrambling up on hands and knees. 

Meanwhile, his therapist noted that he is often a little hard to keep on track, tearing from one exciting thing to the next in the huge therapy gym equipped with trampoline, swing set, bubbles, trucks, tricycles, basketball hoops, bubbles, toys of every shape and size, etc.  I also have this problem at our Mom and Me class-I generally have to keep a firm grip on him to keep him marching along on the current activity, rather than streaking across the gym or pushing ahead to whatever activity  catches his fancy. 

She gently explained that his distraction coupled with the fact that he caught on so quickly to the gross motor stuff suggested to her that it was less of a muscle issue (as it would have taken several weeks for muscle to get stronger),  and maybe more of a sensory issue.  And if there were underlying sensory issues at the root, he would always be falling behind in gross motor unless they were addressed. 

Now, I would consider myself slightly more educated than average about sensory processing disorders in that I’m aware they exist and am familiar with associated behaviors.  And when I think of sensory processing disorders I think of toe walking, hand flapping, losing vocabulary words, epic meltdowns over seemingly nothing, fierce concentration on repetitive tasks, inability to handle changes in routine, limited ability to withstand foods of certain textures, etc.  None of which Squidgey exhibits.  I would say he’s fairly easy going. He rarely melts down and never without an identifiable cause.

But, I’m open minded enough to be willing to be proven right so I took her book recommendation of “Raising a Sensory Smart Child,” and made an appointment with an occupational therapist for assessment over the holidays.  While I was certain it was all bunk, for some reason, I couldn’t bring myself to mention this to anyone. 

I read the first part of Raising a Sensory Smart Child over our Christmas trip and could not find anything that I identified with.  Nope, he doesn’t have any of the quirks described here.  Meanwhile, we were dragging him all over creation, exposing him to new places and people and he not only took it all in stride, he made drastic potty training PROGRESS (rather than the regression I feared). 

I toyed with cancelling the appointment altogether.  I mean, he’s two and a half, how much of an attention span is he expected to have? Especially in an environment packed with tempting things like the PT or Mom and Me gyms.  Yet, the niggling thought that he is easily and by far the most, I guess I will say, “hyper” kid in Mom and Me kept me from doing it.  If they could maybe give me some tips on lowering his excitement and keep him in line, maybe it’d be worth it.  And okay fine, maybe sometimes, very rarely, I notice him walking on his toes for a few steps.  And okay, he does seem to have this weird verbal tick where he annoyingly will repeat something 4 or 5 times until you affirm his statement-“YES, that is a big red fire truck.”

So off we went. I still didn’t even tell Miguel it was an OT appointment, just vaguely said it was kind of an overall year end assessment.  I talked with the therapist for a bit while Squidgey ran around the small room exploring the few items in there.  When he attempted to climb a ladder and shrugged and ran off to do something else when I told him “no,” I smugly thought, “There, see, he listens, he behaves when you ask him to get back in line.  He’s not freaking out.” 

Then we went out to the big gym and I sat back while she put Squidgey through his paces.  It was excruciating to sit back and watch my child, essentially, being judged.  “Yeah, he knows his colors!” I’d cheer silently when he’d hand her the crayon she requested.  “But he’s never done that, we don’t have a toy like that,” I protested in my head as she tried to get him to string wooden beads on a rope.

In the end the diagnosis was this: he doesn’t seem to have problems avoiding or seeking out any type of sensory input, however he has trouble regulating all the sensory inputs when they get inside-hence the high arousal.  He also is low on body awareness which means he does stuff like trip as he’s running towards a goal because he doesn’t register the fact that the mat it’s sitting on means he needs to take a step up.  And finally, that his motor planning needs work as he was unable to figure out that he needed to move his rope-holding hand from below to above the bead to let it slide down the rope.

At this point, I just don’t know what to think.  A big part of me thinks this stuff is very subjective.  Not that there isn’t such a thing as clear and legitimate SPD, but I am kind of skeptical that it’s as widespread as maybe it’s diagnosed.  I look at all these symptoms and it’s like fortune telling or horoscope writing-it’s broad enough that you can find relatable parts in it and you ignore the stuff that doesn’t fit at all.  And then you’re all, yeah that’s totally my life! Amazing!  And there’s a bit of self fulfilling prophesy where you look for these specific behaviors and then that’s all you can notice.

Sensory Input 
I keep coming back to: he’s two and a half.  And his spazy-ness, if you will, doesn’t happen at home and other places, just in environments that are pretty much by their very nature, exciting to kids-Mom and Me, the PT gym, the park.  At home, he plays quietly by himself or watches tv for long stretches at a time.  And he’s not completely out of control nor does he freak out when you tell him no, he comes back into line. 

Not to mention, he comes by a short of attention span pretty honestly.  If ADD had been a standard diagnosis when we were kids, no doubt Miguel and I would have been labeled with it.  Miguel as an adult still has a raging case of limited attention span.

BUT his reaction to the fun places is not necessarily in line with other kids of his age-he’s definitely more excited and harder to manage I would say.  I am the one red faced and sweating, wrestling my kid down to sit in circle time while everyone else’s angels are sitting quietly with their spider fingers ready to go.  I was kind of embarrassed at Mom and Me when Squidgey cut off another kid to crash over a wedge mat and his mom said “Wow, somebody had their Wheaties this morning,” rather snottily I thought.  But maybe she’s just a bitch. 

Body Awareness
I do have to stay one step behind him at Mom and Me as they run across the floor to keep him from crashing into the other kids. He tends not to run in a straight line and he seems entirely unaware he’s veering into their path.  He sometimes has trouble locating things that are like, right by his feet, or just behind him.  I have to watch him like a hawk at parks because he will step off a jungle gym in to space at openings where there’s a fireman’s pole or other obstacle he’s not old enough for.

It takes a serious knock for him not to get up and just brush off a fall.  We thought it was just because we made it a point not to make a big deal out of him hurting himself.  But maybe he’s not really feeling the full impact of the pain.  He does like jumping into his play tent and crashing to the floor or flopping roughly in to the dog bed-maybe he’s doing that crashing to generate sensory stimulation.

BUT again: two and a half, how much coordination is he expected to have? And some people just aren’t the most coordinated in the world.  In my day, we called that “clumsy.”  Also, he’s a little boy, which is typically associated with rough and tumble play.

Motor Planning
Okay, so he couldn’t do the whole bead thing. He doesn’t draw a straight vertical or horizontal line.

BUT is he really expected to immediately master a task he’s never seen before?  I’ve never particularly noticed that he has trouble “getting” toys, in fact I’m usually impressed how he keeps trying till he figures shit out.  He does well with puzzles, even ones he’s never seen before.

********
So yeah, I don’t know.  On the one hand, I’m kind of like yeah, no.  I think we’re stretching the definitions to fit his behaviors and let’s not forget, that this place is a business. A diagnosis means 3-6 months of revenue from my insurance company. On the other hand, I don’t want to be in denial because I don’t want my kid to be “not normal.”  And really, can it hurt to focus more on developing new skills through therapy?

I do know that just typing this all out makes my stomach twist. It makes me anxious that this is just the tip of the iceberg and before I know it he will be tiptoeing around flapping his hands in his own world all the time.  I find myself watching him thinking “wait, did he just flap his hands in excitement when I said I’d get something off a shelf for him?” or “is he on his toes?”  Last night I was watching him fidget in and out of his chair while watching tv and I was thinking “oh my god, he can’t sit still.”  I hate how it makes me look at him differently and analyze every action for signs that it’s “abnormal.”

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