children can learn to manage their environment, and you can remain calm in the
By Pat Blackwell, Ph.D.
“My shoes don’t feel right.” “This cereal tastes too
crunchy!” “Pleeeease no hair brush!” When my daughter was a preschooler, she
would remove and replace her socks and shoes over and over until the seam of
the sock was placed perfectly across her toes and the tension of the shoes
laces felt “just right.” It nearly drove me insane until I realized that Olivia
was not trying to test me. She was actually and profoundly bothered by sensory
stimuli. In my practice I have shared this story with many exasperated parents
who are experiencing the same situation with their own sensory-sensitive children.
infants, highly sensitive children are colicky and resistant to soothing. They
may even reject their parents’ efforts to hold and play with them. Sleep
problems, feeding issues and irregular “poops” can be very trying for parents. While
typical children may be initially startled by sounds and other sensory stimuli,
they tend to “get used to” or habituate to the stimuli. Sensitive children do
not. They overreact to stimuli and respond with a startle to each presentation
of a loud sound or tickle touch.
toddlers and preschoolers, sensitive children may be very bossy and
controlling. They may react with aggression when children approach. They may
shriek or push other children if the come near their toys; or they become
biters. These children may stay on the periphery of the play yard or class and
not engage with other children. If they do engage, they prefer to be the
chasers and hate being chased. They resist sitting near others in circle time
and wander off. Klutzy and socially inept are adjectives used to describe some
sensitive children because they invade other’s space or run full force into
friends. These negative traits can
take a toll on the child’s social-emotional development and self esteem.
home, sensitive toddlers may be described as “princesses” or “tyrants” who rule
all with their tantrums and bossiness. They need an eternity to get dressed,
reject all but a narrow range of foods (prepared just right, served on the same
plate, with the same spoon, same cup) and resist grooming (hair and teeth brushing).
What these behaviors have in common is self defense and protection. Children
become controlling of their environment to protect themselves from the physical
discomfort of sensory stimulation. But what makes some children so sensitive?
let’s get clinical
Sensory Processing Disorder (SPD) is a highly heritable
neurological condition that impacts the way the brain responds to sensory
stimuli. While it may be a stand alone condition, it often co-occurs with
Attention Deficit Hyperactivity Disorder (ADHD) and Pervasive Developmental
Disorder (or Autism Spectrum Disorders). In fact, children with SPD are often
misdiagnosed with Autism or ADHD or even oppositional defiant disorder when a
sensory issue is the main problem.
SPD is not included in the Diagnostic and Statistical Manual (DSM), the “Bible”
of psychiatric disorders. And many pediatricians and other diagnosticians may
be unaware of it. Effective treatment for SPD does exist, but it must be
provided by a specially trained occupational therapist; Crane Rehab in
Jefferson is a great resource. In severe cases of SPD, a multi-disciplinary
approach including occupational therapy and psychology including a full
developmental evaluation and parenting and school-based behavior plan is
warranted. For older children
treatment with medication may be in order if it co-occurs with ADHD or a
Pervasive Developmental Disorder. Medication is not a treatment for Sensory
Processing Disorder if it occurs alone.
Children with SPD deserve
understanding and treatment. Their difficult behavior must be understood in the
context of their disability. However, limits must be set at home and at school
by patient caregivers who allow some accommodations for children with sensory
issues. Some school-based examples include allowing children to stand during
circle time or eat their lunch outside of the noisy cafeteria.
home, parents can compromise on their expectations regarding dressing and
grooming. My experience with Olivia taught me to add 10 minutes to the morning
routine. I then left my child to
her “shoe business,” breathed deeply and went to my “happy place.”
Understanding and patience make all the difference with a “sensational child.”