Wednesday, September 22, 2010

You Know You're Teaching an SPD Kid when....

 This was an original blog post on "Hartley's Life With 3 Boys" and can be found here.
Hartley Steiner is a blogger with 3 boys, one whom is adopted and suffers from SPD, High Functioning Autism, Bi-Polar, and learning disabilities.  She is an advocate for kids with special needs. She has a very large blog following and lots of information and external links can be found on her site.

I am going to re-post her list here because I think it gives you an idea on how Sensory Processing Disorder may affect your child in a typical classroom environment.



You Know You're Teaching an SPD Kiddo When...(a list for teachers and all of us who watch our kids struggle in school)

1. He chews his pencil, both the eraser and the lead, all day long.

2. He can’t seem to stay seated for over 30 seconds.

3. He constantly wants to get a “drink” but really he is just playing in the sink.

4. During circle time he sits virtually on top of the kid next to him.

5. You have to remind him that he cannot touch the hair of the girl next to him—no matter how cool it looks.

6. You implement Handwriting Without Tears program the first day — because you can’t read anything he writes.

7. He wears the same pair of Soft sweatpants (made to look like jeans) every single day.

8. He is the only one in class standing at his desk.

9. He BLURTS out the answers to every question, and talks all through story time.

10. At recess he climbs on the very TIP TOP of the jungle gym, where he is NOT allow.

11. He spends more time under the table than sitting at it.

12. He lit up when he saw the ball pit in the resource room.

13. He refuses to eat in the cafeteria on “Sloppy Joe Day” because it smells awful.

14. The collar, the sleeves, and a strange place directly in the center of his shirt are all dripping with spit from being chewed on all day.

15. Everyone around him gets a HUGE bear hug, whether they like it or not.

16. He covers his ears when you raise your voice to get the children’s attention.

17. His mother came in with two 3 inch binders, labeled and color-coded, lectured you about the DSM-IV and gave you an ear-marked and highlighted copy of The Ultimate Guide to Sensory Processing Disorder

18. During art, he spent most of his time trying to glue his hands together instead of completing the project.

19. He is very proud of being the first kid in the entire school to do the monkey bars backwards.

20. He complains that the lights are too loud for him to concentrate, when you don’t hear a thing.

21. He simply cannot stop himself from using the “off limits” stapler on the teacher’s desk.

22. He knows by memory everything hanging on the classroom walls.

23. He asks you to 'push' him.

24. He can’t keep his hands to himself when standing in line; he is pushing or bumping the entire time but doesn't seem upset by it.

25. He spends his entire recess spinning in circles, but is never dizzy.

26. He is a little too enthusiastic about banging the drum during music class.

27. He takes pride in being the “door opener” or “lunch wagon puller”

28. He can repeat conversations you had with another teacher in the hallway

29. You find things in his desk that don’t belong there; teacher scissors, bingo markers, beads, crayons and other assorted small fun things

30. The bus ride to school seems to wind him UP UP UP— (and so does the bus ride home) no matter how tired you thought he was

Monday, September 13, 2010

Occupational Therapy -with an SI approach

John is attending OT (occupational therapy) two times a week right now at Casa Colina Rehabilitation Hospital.  The therapists working with him are working with a SI (Sensory Integration) approach.  To understand this a bit more, I thought I would define SPD (Sensory Processing Disorder), the treatment, and how it all affects behavior, emotions, social skills, and motor skills.


What is SPD?
First, to understand SPD, we need to look at what Sensory Processing (sometimes called Sensory Integration) is all about.  According to the Sensory Processing Foundation, sensory processing is our nervous systems way of receiving messages from the senses and turning them into appropriate motor and behavioral responses.  If you touch something that is too hot, your nervous system interprets that touch and you react accordingly, realizing it is too hot.  If you hear something that is too soft, you are able to react by turning the volume up because the nervous system interpreted the sense of hearing and sent the message that the volume was too low. 

SPD, or sensory processing disorder, is when the signals do not get interpreted correctly and therefore, responses are not organized appropriately.  The brain receives the sensory information incorrectly and inappropriate responses in behavior, emotions, motor planning, social skills, etc. 

Some people with SPD may over-react to one of their senses, while others under-react.  Some people are bothered by textures, tags on their clothing, certain foods, loud noises, bright lights, etc.  Some people with SPD have poor posture, low motor planning, low muscle tone, appear klutzy, etc.  Others crave sensations in what appears to be "overdrive", where they can't seem to get enough of a particular texture, swinging on a swing, spinning in circles, etc.

MANY PEOPLE THAT HAVE SPD GET MISDIAGNOSED FOR OTHER PROBLEMS BECAUSE THE BEHAVIORAL, EMOTIONAL, SOCIAL, MOTOR PLANNING, ETC. ARE AFFECTED AND CAN APPEAR AS SOMETHING DIFFERENT.

There have often been times throughout our journey where I have wondered if the "at risk" for autism diganosis or the PDD-NOS diagnosis for John was really just SPD.   Children on the Autistic Spectrum have Sensory Processing problems, so oftentimes, both SPD and an Autistic disorder are present.  I hit a point a long time ago where the actual label didn't matter to me anymore.  I know what John's current needs are and I'm addressing those as they come up.  About 3 months ago, it was obvious that he needed OT above all other help.

OT with an SI (sensory Integration) approach is when an occupational therapist works with the child in a "sensory rich" environment in an OT gym.  The therapist will guide the child through play activities that challenges the child in areas where he/she need improvement.   For John, they are currently working on fine motor skills (buttoning buttons, writing, hand games), motor planning (using yoga positions to challenge him to manipulate his body to match a photo and hold position without falling, using obstacle course where he crawls through tunnels, climbs over obstacles, hits a baseball, kicks a soccer ball, bounces on a trampoline, jumps in a ball pit, swings on a trapeze bar, etc), stengthening posture by having him use his upper body more (this week they had him lying on his stomach on a skateboard and had to use his hands, arms, and upper body to move the skateboard through the bases of baseball).

John has a problem with organization in his brain.  There are days where he becomes over-stimulated through  the day and can no longer organize his body, his responses, etc.  There are times you will see him slumped over in a chair---standing facing the chair, with his head in the chair--- constantly moving to get comfortable or he might appear "tired" where he wants to be carried and slumps over ones shoulder like a young infant.   He sometimes throws his head back and shakes his head so his eyes move back and forth.  These are all signs that his brain is "disorganized" and he can't appropriately focus or react to what is going on around him.    Occupational Therapy teaches him how to regulate himself when he gets that way, as well as helps him learn everyday activities through play therapy.

Saturday, September 11, 2010

Open Doors - Your Child is Not Broken

Earlier this week some friends of ours took us to an Open Doors Presentation.  The topic was "What is Asperger's/High Functioning Autism".   The presenter was a local representative from SELPA and gave the attendees a wonderful, welcoming evening.   Many parents were there and shared where they were on their journey.  Some had just received a diagnosis, some were suspecting that their child may have Asperger's, and some had "almost adult" children with the diagnosis.


The reason people found themselves at the presentation was different for everyone.  Some were there because they had not found support in their families, communities, or even with their current medical circles.  Some were there to learn more about the diagnosis and ways to help their children.  Others were there to find companionship with others who were going through the same thing.  Even others were there because they wanted to guide and help other parents who were just beginning the journey.


While I found the presentation wonderful, I also enjoyed watching the other parents become enlightened through the meeting.  My husband and I have already hit the point where we realize that our son is going to be ok.   He just learns in a different way. There is nothing "wrong" with him and he's not "stupid" or "unteachable".  He just needs to be taught differently.   The acceptance and realization of this really sets you free as a parent of someone on the spectrum.  It is so important that as a parent you relax a bit and let your kid LIVE.  Sure, there are going to be some tough days.  Anyone who has been the parent of someone on the spectrum understands that BUT.... you have to realize how many wonderful days you have, what a blessing things kids are to your life.

For me, I hit this realization in February 2009 when I miscarried at 21 weeks.  I didn't naturally go into labor, but when the baby stopped moving, I knew I wasn't pregnant anymore.  I had to go into the hospital and be induced to deliver the baby.  It was the most pro-life experience I ever had.  Yes, it was tough. But, I learned how fragile life is, how big that baby was at only halfway through the pregnancy -- and yet so tiny---, and what a blessing each life is that we are entrusted with.   My journey with my son changed at that moment.   It was not the burden it had been the prior year.  The questions of "is he" or "isn't he" went away.  It didn't matter anymore what the label was.. he was my son and I was going to help him find his way.  He was MY blessing.

For me, Open Doors didn't represent a support group to realize that my son is going to be ok.  For me, this presentation made me realize what I needed to "gear up for battle" in the developmental struggles that will lie ahead.  We touched on kissing, dating, the "sex" talk, masturbation, whether to tell your child about their diagnosis, and learned to laugh together.  Being a parent of a child with special needs still involves parenting your child, but looking at it from a different perspective.  As a parent, you know your child best and you can find the best way to help your child survive in this world.  Your child is working really hard all the time and sometimes you need to remember that he/she is still a child.  There are bad days with "typical" kids too.  Our kids are put under a microscope and every behavior, word, utterance, and movement is studied and the diagnosis is to blame.  However, we as parents need to realize that these kids work HARD, are smart, and may need to learn a bit differently from others, but they also need to be allowed to just be a kid.

Tuesday, September 7, 2010

Where is Thumbkin?

According to The Lotus Tree Sensory Integration Center, praxis is the ability by which we figure out how to use our hands and body in skilled tasks like playing with toys, using a pencil or fork, or building a structure. 

Children with praxis problems have a hard time writing, eating with a utensil (often spilling frequently which leads to a preference to use their hands to eat), playing games like rock, paper, scissors or Where is Thumbkin, putting up fingers to show how old they are,  button a shirt, etc.

As a toddler, John would hold 2 fingers (with the opposite hand) when he wanted to show he was 2 years old.  He couldn't fold the other 3 fingers down, while still holding up the 2 to show his age.  He has ALWAYS used his hands while eating and frequently needs to be reminded to use a fork.  He has very little control of it and is considered a "messy eater".    He had problems building towers out of square blocks and during early intervention, they worked with him stacking first 4 blocks, then 5... and then up to 9.    We put a variety of sponges in the bathtub for him to squeeze and release to help him with the muscles in his hand.  The releasing is important because that is the same muscle used to let go of a block with control when it sits on top of another.   In OT, he has been working on buttoning.

More recently, we noticed he couldn't play hand games.  Last week in Kids Crew, the lesson centered around finding "fair" ways to determine who goes first when playing games.  They learned about picking a number from 1-10, eenie-meenie-minee-moe, bubble gum bubble gum, and rock, paper, scissors.  John was unable to make the "scissors" with his two fingers.

Concurrently, he was learning "Where is Thumbkin" at his My Gym Preschool.  He needed to isolate the thumb, the pinkie, and the pointer finger at different points in the song.  At the end, the teacher showed them that if you put all 3 up together, it means "I Love You".  John struggled that day, and the next day had the problems with Rock, Paper, Scissors in Kids Crew.

All week, John has been practicing holding up each finger, singing the Thumbkin song, and attempting to play Rock, Paper, Scissors.  .... AND THERE HAS BEEN SUCCESS!!!   He's got it figured out.  He's able to do it all now and the hang loose sign (like the sticker on the back of Daddy's truck).  I'm so proud of him.  He had to work through some frustration to get there, but he did it all on his own.  Although we've been working on different aspects of praxis since we started early intervention, we concentrated more on achieving the goals that were set for him, like eating with a fork, building the blocks, etc.  He figured out his own goal this week and conquered it before he had to go back to Kids Crew.  This morning he told me, "Mom, I'm going to show my friends in kids crew that I can do it!"  He's proud too! ;)

Monday, September 6, 2010

John Update

It's been so long since I updated the blog, so I thought I would write about what John has been up to.  First of all, John will be turning 5 in November and we have kept him in preschool this year.  He is attending two schools.  La Verne Parent Participation is a co-op preschool that he attended last year and is continuing for 2 days a week this year.  He stays for an additional 2 hours in the afternoon for a pre-K program.  On the other days, John is attending the "Little Learners" program located in the local My Gym facilities.  He goes for 3 hours and it's a great setting for him because the equipment in the room gives him a little bit of self-directed OT (complete with ball pit, trapeze bars, balance beam, monkey bars, slides, bridges, tunnels, trampoline, etc.)

Last September, John visited with Autistic Specialist, Dr. Bauman, at Casa Colina and she recommended a few things for us since John wasn't qualifying for services.  To address the problem of separating from me, potty training issues, and behavioral issues in the home, we hired a therapist to come in the home.  For most of the year, she came weekly and helped John work on conversation skills, feelings, changes in feelings, writing his name, a few exercises for body awareness, and set up monthly and yearly goals for him.

After months of working together, we realized together that what John needed more than anything else was OT.  He was excelling when it came to one-on-one activities and has been reading for a year.  Sensory problems and lack of body awareness seemed to be the reason for most of the problems we were encountering (which we had known for years, but finally were able to get the appropriate program for him).  We had an OT evaluation, which resulted in a recommendation of 2 times a week.  While we waited on the waiting list for therapy, our in-home therapist worked with the OT to come up with activities we could do in the home to help John.

Once we started OT, we changed his in-home to just once a month.  It's great to continue having someone help with goal setting, charting progress, and recommending new programs.  There are a couple of huge things that helped John make leaps and bounds and I'll detail them below.

BASEBALL
John discovered Major League Baseball this year.  After going to a minor league Quakes game, he was hooked.  He follows the stats, the scoreboard, the game, the players, etc.  He quickly became an Angel fan and a rowdy Dodger fan.  What is so significant about this is that prior to baseball, John would not play ball (any kind of ball), wouldn't play catch, couldn't catch a ball, etc. Since baseball, something clicked in John's head, and he started surpassing his monthly/yearly goals.   He is obsessed with dates, scores, and stats.  Every morning, he is up before anyone else and he is on the computer checking MLB.com and checking the scores.  He gives us the update on who won, what inning the home runs were scored in, and what player hit them.   To him, Dodgers are the "right team" and everyone else is the "wrong team".    He has attended about 15-20 major league games so far this season and last night went to batting practice at the Dodger game and came home with an official MLB baseball that a Giants fan gave him.  He turned to my husband and said, "Daddy, some Giants fans are nice!"  Yes, John, there are some. ;)    (to quote my husband's Facebook status today). 

CASA COLINA KIDS CREW
Casa Colina has this amazing program to teach social skills.  It's an 8-week class that John is about 5 weeks into.  John has learned and applied each lesson he has learned at this class and it's such a delight to watch.  The first week was about greetings and salutations.  The second week concentrated on body awareness while talking to others.  They discussed body position (direction facing while talking), eye contact, etc.  The third week they talked about personal space and used the concept of being a "space invader" when they got too close to someone else.  John took this lesson to heart and spent the next week self-regulating himself.  He didn't like the idea of being a space invader.  He'd put his feet on me an then ask, "is this a space invader"?    Every lesson concentrates on social awareness and skills that are used during everyday communication.    It has proven to be so useful for John and is something I'm so glad was recommended to us.  We have 3 weeks left of the program. 

NOW THAT SCHOOL IS BACK IN
From the first day of school, I realized how much we've progressed over this last year.  John is a different kid this year at school.  He is social with the other kids, stays with the group, able to hold focus and attention, and learning to write his numbers. (since he has had very low fine motor skills, controlling a pencil is difficult.)   I can't wait to see where this next year takes him developmentally.  This journey we've been on has been very tough at times, but it has also been one of the most rewarding things our family has been through too.   This next year is going to be a big year for John.  We've come so far and I'm so proud of my little guy.