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Don't mistake sensory issues for behavior issues

Maureen used to be obsessed with baseball -- and then she had children. After she welcomed her son, Charlie, and his extra chromosome, she discovered her passion for writing about Down syndrome and disability-related issues.

With two...

Behavioral or medical issue? Know the signs

Incessant finger chewing. Alarming head banging. Repetitive kicking. These all sound like elements of a typical toddler temper tantrum, right? Sometimes, children actually may be battling sensory issues.
Toddler with sensory issues

Sensory Processing Disorder (SPD) has been called a neurological "traffic jam" by one of the most famous occupational therapists, A. Jean Ayres, Ph.D.

SPD prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. Often, this means a child's behavior is compensating for an emotional, neurological need for something more than what they’re getting, via any of the five senses (i.e., sight, sound, touch, smell, taste).

My son, Charlie, has Down syndrome. We first noticed what we mistook for a behavior issue when he was just 14 months. We took a six-hour road trip, and our cherub gnawed on his fingers and yelled the entire time.

No, really. The. Entire. Time. We arrived at our vacation destination exhausted, frustrated and hard of hearing.

From fingers to chewy tube — who knew?

Charlie with chewy tube

I'll play the New Parent Card with this one: We decided Charlie must just resort to the chewing/yelling combination whenever he wanted attention.

Thankfully, we know other parents who are smarter than we are. While hearing another mother's story of learning about her child's sensory issues, suddenly, our situation made sense. Charlie’s gnawing and yelling coincided with being restrained somewhere, whether it was the high chair, the car seat or his crib.

We tried handing him the red chewy tube our speech therapist had recommended long ago to help strengthen his oral motor skills. Miraculously, he grasped the chewy tube and chewed vigorously on it, no longer interested in his fingers or the yelling (oh, thank God and all of heaven above).

Sounds simple, but it took us two years to figure it out.

Tips for identifying a sensory issue

While diagnosing a “Sensory Processing Disorder” or “sensory integration” disorder can be complex, here are several simple tips from Erin Rockman, OTR/L (occupational therapist), who has helped us with Charlie. Naturally, these shouldn't replace consulting your child's pediatrician.

First questions to ask:

  1. Does the child’s action disrupt your life? For example, do you avoid certain places because of noises, crowds or smells?
  2. Does the action occur with everyone? For example, if a child’s actions only occur with parents and not at school or day care or with grandparents, the action is likely behavioral.
  3. Does the child stop the action when given a reward? “If a child is having a meltdown because of a sensory issue, then a sticker or cookie typically will not fix the situation,” Rockman explains. “The child may need some specific interventions to help regulate [his or her] sensory system.”

In Rockman’s experience, she has met children with a wide range of issues, including:

  • Taste or texture (e.g., food aversions or sensitivities) 
  • Sound (e.g., noise sensitivities) 
  • Feel (e.g., “tactile defensiveness,” or sensitivities to clothing)

In addition, children may have vestibular and proprioceptive seeking behaviors, which Rockman says occur “when a child seeks a lot of movement as compared to his/her peers… or avoids movement, as well, for example resists swinging or playing on a playground.”

While sensory issues often occur when a child has an existing diagnosis (e.g., autism, Down syndrome), they also can occur in a child with no known medical condition, Rockman says.

Next steps

If you suspect a child has a sensory issue, Rockman advises discussing your thoughts with the child’s pediatrician and seeking an occupational therapy (OT) referral for an evaluation.

What should parents avoid? “Don’t rely on the therapy sessions alone to improve a child's sensory processing behaviors,” Rockman advises. “It is most effective when a sensory diet is carried over at home consistently. A therapist will provide a sensory diet based on a child's individual needs, and parents need to take an active role.”

Image credit: Maureen Wallace

More about Sensory Processing Disorder

Sensory Processing Disorder help: What is a sensory diet?
Travel tips for kids with Sensory Processing Disorder
Create a sensory tool kit

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