Awesome Guy

Sensory Processing Disorders

It's the reason why Declan wears noise-blocking headphones on the subway and in movie theatres, and leaves noisy birthday parties early (AVOIDING LOUD SOUNDS).  It's the reason he lays his body upside down on the stairs, asks to be held up by his feet, and repeatedly spins around on our office desk chair (SEEKING VESTBULAR INPUT).  It's the reason he eats lots of crunchy foods and avoids lots of smooth, creamy foods (SEEKING AND AVOIDING PROPRIOCEPTION).  It's the reason he cannot see the shoes that are his in the line of family shoes at the garage door, or cannot find the child hiding just their face behind the potted plant during hide and seek (VISUAL DISCRIMINATION).  It's the reason he loves to hurl his body onto the couch or lay under all of the couch's cushions (SEEKING PROPRIOCEPTION), and one of the reasons he insists on putting on and taking of his pants without unbuttoning them (AVOIDING FINE MOTOR PROPRIOCEPTION).  Its also the reason that he ducks away from the brush when we brush his hair (AVOIDING CERTAIN KINDS OF TOUCH).  It is called a sensory processing disorder, and it is now listed in the DSM V under neurological diagnoses.

Declan's Early Intervention OT was the first to introduce us to sensory processing disorders.  Until then, I had never heard of such a thing, and frankly, I was skeptical.  What exactly is it? Why had I never heard of it? It took me years to begin to understand what exactly it is.  Lindsay Biel, author of Raising a Sensory Smart Child, describes it well:

"We all learn through our senses. Sensory processing is how we transform sensory information from within our own bodies and the external environment into messages we can act on. It’s tempting to think of senses (touch, sight, sound, movement, body awareness, taste, and smell) as separate channels of information, but they work together to give us a reliable picture of the world and our place in it.

Right now your senses are working together. You hear background sounds and feel your clothing, chair, and the floor beneath your feet. You resist gravity to stay seated. You see letters on the screen. You filter out unimportant sensory input so you can make sense of what you are reading. If you occasionally lose focus because your shirt label is itchy, you may have a mild sensory issue. If you keep sliding off your chair, look away when you hear any noise, feel like your shirt is hurting you, or the words you are reading pulsate, you may have sensory processing disorder, also known as sensory integration dysfunction. Sensory issues affect all kinds of people—from those with developmental delays, attention and learning problems, autistic spectrum disorders and other diagnoses to those without any other issues."

When Declan's sensory needs are not addressed, he is unable to focus.  Think of it as being so cold that you cannot concentrate or do your work until you do something to change that condition.  That is why Declan has something called a sensory diet in place at school.  It is a steady stream of activities that he engages in in order to be able to remain focused on his school work.  To learn more about sensory diets, take a look at Lindsay Biel's informative website:

http://sensorysmarts.com/index.html

Music Therapy

We met our first music therapist when Declan was in the hospital for his first round of surgeries.  Skeptical when she first walked into the room, I was fast won over by her ability to engage and calm him.  They sang together as she played on her guitar, she gave him instruments to play along, and one time, after hearing that Dec was taking piano lessons at home, she arranged to have a keyboard brought to his bed.  What was so interesting about her work was the way that she was so completely tuned into Declan.  Rather than guiding him, she would "lead from behind," and let Declan's choices and actions guide her.  For many subsequent visits, we actually sought her out and invited her to visit Declan in his room.  The pediatric floor at NYU Langone actually has a full time music therapist whose job is to not only engage children in positive, fun, and meaningful ways, but also to promote wellness, help manage stressful situations, alleviate pain, help patients to express themselves, and to promote rehabilitation.  We now have a music therapist come to our home to work with Declan once a week.  I am still learning a lot about the effects of music on the brain, but from my more recent research and experience, I am learning that music can have a positive effect on so many issues that occur with people with special needs.  Judy, Declan's music teacher from Connecticut Music Therapy, tends to work with Declan on his auditory processing, expressive and receptive language, executive function, sensory integration, memory, and sequencing, while also teaching him to read music and learn to play different instruments.

Take a look at the video below about music therapy.  It was created by the Berklee College of Music:

Bruce is Knitting

 
It is a typical school night.  Dinner is on the stove, the kids are reluctantly doing their homework, and the buzzer from the laundry washing machine is sounding repeatedly.  I run upstairs to transfer the wet clothes into the dryer and the phone rings.  I answer and find that I need to run downstairs to pull up the calendar on my computer to confirm the doctor's appointment I am being reminded about.  I type in the appointment, check on dinner again, and on the way back up to the laundry room, acknowledge our dog. Bruce, now one, still likely does not have a handle on the flurry that is our household.  Our old soul sits there, seemingly exhausted just by watching us, and wags his tail back at me.  Declan, attempting to do his homework without my help, is losing focus as he listens to me talk to the dog.  As I run back up the stairs, I hear him engage his furry companion.  I will have to go help him get back on track I think.  When Tova meets me in the upstairs hallway to ask me a question, we hear the ruckus of Declan's play downstairs.  He is playing with Bruce, but I wonder if he is encouraging the wrong behaviors again.  He has a tendency to get the dog all wound up by waving his hand around Bruce's mouth.  "Don't do that Dec," we have explained in the past.  "It will encourage Bruce to nip at us, and we don't want him to think that it's okay."  Enthused by the initiative one time, Declan made a sign that read "No Biting," and hung it above the spot where Bruce likes to sit.  When Bruce proceeded to eat the sign, Declan simply could not contain his laughter.  The moment, it seemed, was the absolute height of humor for him.  Since then, nipping and biting have been popular topics for him to mull over, and every once in a while, he will test whether Bruce will still take the bait.  This time, he seemed to be doing just that, and predictably, we got the newsflash.  As Tova and I spoke upstairs, we could hear Declan yelling something up to us.  While we could tell from his tone that he was distressed in some way, we could not quite make out what he was saying.  "What Dec?" Tova called after him, moving closer to the top of the stairs.  Declan, meeting us half way up the stairs informed us with a very serious and concerned face, "Bruce is knitting again!"

Tova and I looked at each other, trying to hold in the smiles, both knowing right away that he was using the word "knitting" in place of "nipping."  We know that Declan has difficulty processing the words that he hears and that often, his speech reflects it.  In moments like these, it takes everything we have not to collapse into our own fits of laughter, as the image of our 90 lb newfie/lab mix secretly knitting scarves behind our backs is just too much to resist.  

To learn more about auditory processing disorder, take a look at this excerpt from the website http://kidshealth.org/

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is a complex problem affecting about 5% of school-aged children. These kids can't process the information they hear in the same way as others because their ears and brain don't fully coordinate. Something adversely affects the way the brain recognizes and interprets sounds, most notably the sounds composing speech.  Kids with APD often do not recognize subtle differences between sounds in words, even when the sounds are loud and clear enough to be heard. These kinds of problems typically occur in background noise, which is a natural listening environment. So kids with APD have the basic difficulty of understanding any speech signal presented under less than optimal conditions.

 

What is assistive technology? Why should you be interested?

If you are a teacher or a parent, assistive technology is something you should learn about right away.  I believe that most children benefit from having information presented to them through a variety of modalities (i.e. auditory, visual, kinesthetic, tactile).  Different kinds of technology can do this.  But lets just start with the computer and the variety of software and websites that are out there.  Once you begin to look, you will see that the possibilities are endless. 

Let me show you an example of one of my favorite teaching tools.  Because Declan has an auditory processing disorder, and we know that he learns best with visuals, we are constantly looking for different visually appealing ways to represent the information we are trying to teach him.  Comic Life is an application that is available for both Mac and PC, and is incredibly easy to use.  Using comics (speech bubbles and thought bubbles) is not new to the special education world.  In fact, two incredible educators have been using them for some time.  Carol Grey, author of Comic Strip Conversations, and Jed Baker, author of The Social Skills Picture Book, have done some incredible work using comics to teach social skills to children who have trouble reading and understanding social cues.  If you have not already seen their work, I highly recommend taking a look!

We use comic strips for teaching so many different things.  Among them are social skills, house rules, how to get packed in the morning, and what good readers do.  Below is an example: