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“Pull Yourself Together”: Trauma and Sensory Integration Issues

 

Our bodies have 5 senses and 7 sensory data inputs:

1.Sight

2. Smell

3. Hearing

4. Taste

5. Touch

6. Balance

7. Body Position

All of our senses organize information from inside and outside our body and communicate the “data” to the brain. This organization allows us to know where our body is in time and space, to feel safe in one’s own body, and to perceive our body’s relationship to others and the environment.

A child who has experienced trauma typically has a dysintegration of sensory information that will result in a dysregulation of thinking and emotion. They will not be aware of where their bodies are in time and space, cannot feel safe in their own body, and are unable to make connections to others and the environment.

Stressful sensory input is handled by the lower levels of the brain (brain stem and limbic system) and the body and overseen by the higher, executive level of the brain. If the stressful input is mild, normal coordination between all levels of the brain and the body coordinate smoothly. If the stress is high and overwhelming, the lower levels will “hijack” the higher levels to protect the body. This is called the “fight or flight” reaction to perceived danger. If these two mechanisms are not able to bring the body back into a place of safety, the brain will react by “freezing” or shutting down.

The fight, flight and freeze reactions are designed to allow the higher order areas of the brain to continue operating so that is appears that traumatized children are functioning in some areas of life but there will continue to be gross areas of dysfunction in development. This will manifest in “gaps” between a child’s age and stage of development. They may be 15 years of age chronologically but act like a 5 year old socially and emotionally. Parenting strategies will have to adjust to meet both the 5 year old and the 15 year to close the gap.

Sensory “confusion” will drive traumatized children to be sensory seekers and/or sensory defenders. Sensory seekers look a lot like children diagnosed with attentional deficits. They appear impulsive, can’t sit still, wiggle a lot, touch things, put things in their mouths, tear things apart, easily distracted, etc. These are attempts to get more information about themselves and the world around them. Sensory defenders are quickly overwhelmed by certain sensory information in one or more of the sensory systems: visual, auditory, kinesthetic, oral, and olfactory. They will complain about the brightness of lights, the hum of electric motors, dislike loud noises, be irritated by the feel of clothing on their skins, be picky eaters, sensitive to perfumes and candles, etc. Children can have combinations of both sensory seeking and sensory defending.

There are 4 treatment strategies to help traumatized children with sensory integration issues:

1. Awareness

2. Adaption

3. Exposure

4. Advocacy

Awareness allows parents and children to be aware of their sensory triggers and needs. Adaption provides assistance to the child to get the sensory information they need or takes steps to avoid sensory overload. Exposure, in small increments over time, helps children build tolerance and increase functioning. Advocacy requests support from the child’s academic and social environment so that teachers and friends understand the issues and incorporate adaptations as well.

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sensorycalm:

(via Weighted Blankets for Anxiety Autism Insomnia Soothing Comforting by Mosaic Weighted Blankets in Austin Texas|Seen on NBC Parenthood Show)

Mosaic Weighted Blankets for sensory processing disorders in Autims, ADHD, Trauma and more. 

The Benefits of Mosaic Weighted Blankets® for Anxiety, Stress, and Insomnia

Adults, teens, and children can benefit from weighted blanket therapy. Mosaic Weighted Blankets are a safe and effective non-drug therapy for anyone seeking a solution for loss of sleep and relaxation.

“In psychiatric care, weighted blankets are one of our most powerful tools for helping people who are anxious, upset, and possibly on the verge of losing control,” says Karen Moore, OTR/L, an occupational therapist in Franconia, N.H.

“These blankets work by providing input to the deep pressure touch receptors throughout the body,” Moore says. “Deep pressure touch helps the body relax. Like a firm hug, weighted blankets help us feel secure, grounded, and safe.” Moore says this is the reason many people like to sleep under a comforter even in summer. (Source: Psychology Today)

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Sensory Integration: Shaping Perceptions of the World A newly emerging therapy for alcohol- and drug-exposed children

parentingtoolbox:

By Ira Chasnoff, MD

One of the relatively new common themes emerging in clinical care and research with children exposed to alcohol and drugs during pregnancy is related to deficits in sensory integration. Jean Ayres, an occupational therapist, first introduced the concept of sensory integration – the process by which the brain receives, organizes and interprets information from the environment. The information is received by sensory receptors, such as the eyes, nose, ears, fingers, mouth and skin. Sensations such as movement, body awareness, touch, sight, sound and the pull of gravity make up the overall sensory experience.

Source: https://www.psychologytoday.com/blog/aristotles-child/201405/sensory-integration-shaping-perceptions-the-world

The information that is received from the environment is then sent to the corresponding regions of the brain where it is interpreted and organized. Proper sensory integration helps us to maintain attention and build positive relationships with others and shapes our perception of the world. In children, sensory integration provides a crucial foundation for more complex learning and behavior. All of these things contribute to positive self-esteem as well as the ability to learn and concentrate.

For most children, sensory integration develops in the course of ordinary childhood activities. However, prenatal alcohol or drug exposure or lack of stimulation in the early years of development can damage the parts of the brain responsible for sensory integration. An infant who is neglected or has limited opportunities for human interaction, movement, play and exploration is likely to develop sensory integration problems. Sensory integration dysfunction can result when babies are unable to explore their surroundings, are left alone in their cribs for long periods of time, and do not receive the nurturing touch of a caretaker. Likewise, these problems can occur in children who have been hospitalized early or for long periods of time, or in those who have suffered from some sort of trauma and disruption in their developmental process. These life factors are not uncommon in children born into a home in which substance abuse and violence are integral components of the environment.

Children who are experiencing sensory integration difficulties are not intentionally misbehaving. They are simply trying to gain the input that their body needs or avoid extra stimulation in order to function properly. Children with sensory processing problems often feel uncomfortable in their own skin, agitated or out of sorts. That is why it is not uncommon for the children to receive a diagnosis of attention deficit hyperactivity disorder (ADHD) as they reach school age. These children are often intelligent but struggle to control their body and their need for sensory inputs. It is important to remember that the sensory needs of these children are just that – needs. Trying to diminish the needs for these behaviors will not be effective, but finding adaptable ways to satisfy the sensory needs of the child is helpful.

It is important that assessment of sensory integration capabilities be evaluated in children with prenatal alcohol or drug exposure. Some signs that a child may be experiencing difficulty with sensory integration include:

• Clumsy behaviors

• Over sensitivity to sounds, sights, smell, touch or movement

• Under reactivity to sounds, sights, smell, touch or movement

• Distractibility

• Hard to calm down

• Difficulty during transitions and adapting to changes in routine

• Picky when eating – particularly sensitive to the texture or feel of foods

• Resistant to touching things – e.g., resists going barefoot in the grass, playing in sand

• Defensive to light touch

• Agitation when spinning or roughhousing

• Excessive seeking out of spinning or swinging movements

• Tendency to exhibit rocking or swaying body movements

• Increased excitation during play to the point that he cannot calm down

• Distractibility when eating in a noisy environment

• Easily tired

• Weakness in various muscles

• Fear or intolerance of sounds – e.g., holds hands over ears to protect himself from sounds

• Awareness of noises that others do not notice

• Difficulties with teeth brushing, hair washing and/or bathing

• Sensitivities to clothing textures and/or needs tags cut out of clothing

• Overly fearful or avoidant of situations or people

• Impulsivity or exhibiting “daredevil” behaviors

• Difficulty falling or staying asleep.

Of course, many of these difficulties fall into the range of normal behavior, but it is when they cluster or are more frequent and more disruptive than what would be normally expected that they may indicate significant problems.

An occupational therapist, trained in sensory integration assessment and treatment, can evaluate a child and provide these services. Children with prenatal alcohol or drug exposure often suffer early neglect and trauma; sensory integration is a very helpful approach from both perspectives. It often is quite amazing to see the improvement in children’s daily behavior and functioning when they receive this specialized form of treatment.

Note from Ron Huxley: “I posted this some time ago on this blog but thought it timely, for me, to reblog it. I am teaching a class today on Parenting The Drug Exposed Child. Hope it helps others too…”

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Sensory Integration: Shaping Perceptions of the World A newly emerging therapy for alcohol- and drug-exposed children

By Ira Chasnoff, MD

One of the relatively new common themes emerging in clinical care and research with children exposed to alcohol and drugs during pregnancy is related to deficits in sensory integration. Jean Ayres, an occupational therapist, first introduced the concept of sensory integration – the process by which the brain receives, organizes and interprets information from the environment. The information is received by sensory receptors, such as the eyes, nose, ears, fingers, mouth and skin. Sensations such as movement, body awareness, touch, sight, sound and the pull of gravity make up the overall sensory experience.

Source: https://www.psychologytoday.com/blog/aristotles-child/201405/sensory-integration-shaping-perceptions-the-world

The information that is received from the environment is then sent to the corresponding regions of the brain where it is interpreted and organized. Proper sensory integration helps us to maintain attention and build positive relationships with others and shapes our perception of the world. In children, sensory integration provides a crucial foundation for more complex learning and behavior. All of these things contribute to positive self-esteem as well as the ability to learn and concentrate.

For most children, sensory integration develops in the course of ordinary childhood activities. However, prenatal alcohol or drug exposure or lack of stimulation in the early years of development can damage the parts of the brain responsible for sensory integration. An infant who is neglected or has limited opportunities for human interaction, movement, play and exploration is likely to develop sensory integration problems. Sensory integration dysfunction can result when babies are unable to explore their surroundings, are left alone in their cribs for long periods of time, and do not receive the nurturing touch of a caretaker. Likewise, these problems can occur in children who have been hospitalized early or for long periods of time, or in those who have suffered from some sort of trauma and disruption in their developmental process. These life factors are not uncommon in children born into a home in which substance abuse and violence are integral components of the environment.

Children who are experiencing sensory integration difficulties are not intentionally misbehaving. They are simply trying to gain the input that their body needs or avoid extra stimulation in order to function properly. Children with sensory processing problems often feel uncomfortable in their own skin, agitated or out of sorts. That is why it is not uncommon for the children to receive a diagnosis of attention deficit hyperactivity disorder (ADHD) as they reach school age. These children are often intelligent but struggle to control their body and their need for sensory inputs. It is important to remember that the sensory needs of these children are just that – needs. Trying to diminish the needs for these behaviors will not be effective, but finding adaptable ways to satisfy the sensory needs of the child is helpful.

It is important that assessment of sensory integration capabilities be evaluated in children with prenatal alcohol or drug exposure. Some signs that a child may be experiencing difficulty with sensory integration include:

• Clumsy behaviors

• Over sensitivity to sounds, sights, smell, touch or movement

• Under reactivity to sounds, sights, smell, touch or movement

• Distractibility

• Hard to calm down

• Difficulty during transitions and adapting to changes in routine

• Picky when eating – particularly sensitive to the texture or feel of foods

• Resistant to touching things – e.g., resists going barefoot in the grass, playing in sand

• Defensive to light touch

• Agitation when spinning or roughhousing

• Excessive seeking out of spinning or swinging movements

• Tendency to exhibit rocking or swaying body movements

• Increased excitation during play to the point that he cannot calm down

• Distractibility when eating in a noisy environment

• Easily tired

• Weakness in various muscles

• Fear or intolerance of sounds – e.g., holds hands over ears to protect himself from sounds

• Awareness of noises that others do not notice

• Difficulties with teeth brushing, hair washing and/or bathing

• Sensitivities to clothing textures and/or needs tags cut out of clothing

• Overly fearful or avoidant of situations or people

• Impulsivity or exhibiting “daredevil” behaviors

• Difficulty falling or staying asleep.

Of course, many of these difficulties fall into the range of normal behavior, but it is when they cluster or are more frequent and more disruptive than what would be normally expected that they may indicate significant problems.

An occupational therapist, trained in sensory integration assessment and treatment, can evaluate a child and provide these services. Children with prenatal alcohol or drug exposure often suffer early neglect and trauma; sensory integration is a very helpful approach from both perspectives. It often is quite amazing to see the improvement in children’s daily behavior and functioning when they receive this specialized form of treatment.

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Cool Down Cubes to Manage Anger in Children

Cool Down Cubes 

 

I have several students on my caseload who struggle with anger management and emotional regulation. I loved this idea for Cool Down Cubes from Entirely Elementary and decided to make a set of my own. 

Supplies: 
Plastic ice cubes – I purchased a bag of 30 from Bed Bath & Beyond for less than $4
Container – The one pictured came from the Dollar Store
Permanent maker 

Using a permanent marker write a safe “cool down” strategy on each ice cube. For example: count to ten, walk away, talk to a friend, take three deep breaths, etc. I also left a few of the cubes blank so that the students could come up with their own strategies. The original post suggested placing the ice cubes in the freezer for an additional “cool” effect. That’s it! Easy right?

 
I have used the Cool Down Cubes in both individual and group settings to discuss ways to “cool-off" when angry and have gotten a great response from students.

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The 101 on Fidgets:

I think of a fidget as any small item or toy that helps keep one’s hands busy and helps them focus while completing an activity. Almost anything can be a sensory fidget. Even basic household items or small party favor toys can make great fidgets. You can make your own fidgets, or buy them from catalogs, online or even in local stores such as Target, a party store, a craft store, or the dollar store.

A Toy or a Tool?
I have found fidgets to be a very helpful tool for me for many years. When I was much younger, I was taught that fidgets were to be used as a tool, and not like a toy. A tool is something that can help one focus, while a toy can distract both the individual playing with the fidget and others around them. This can be a hard thing for an individual to understand as some of the best fidgets that I have found are indeed toys, but they make great tools.

Let Ron Huxley help your child succeed at home and school. Click the Get Parenting Answers in the nav bar.

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neuromorphogenesis:

Breakthrough study reveals biological basis for sensory processing disorders in kids

Sensory processing disorders (SPD) are more prevalent in children than autism and as common as attention deficit hyperactivity disorder, yet it receives far less attention partly because it’s never been recognized as a distinct disease.

In a groundbreaking new study from UC San Francisco, researchers have found that children affected with SPD have quantifiable differences in brain structure, for the first time showing a biological basis for the disease that sets it apart from other neurodevelopmental disorders.

One of the reasons SPD has been overlooked until now is that it often occurs in children who also have ADHD or autism, and the disorders have not been listed in the Diagnostic and Statistical Manual used by psychiatrists and psychologists.

“Until now, SPD hasn’t had a known biological underpinning,” said senior author Pratik Mukherjee, MD, PhD, a professor of radiology and biomedical imaging and bioengineering at UCSF. “Our findings point the way to establishing a biological basis for the disease that can be easily measured and used as a diagnostic tool,” Mukherjee said.

The work is published in the open access online journal NeuroImage:Clinical.

‘Out of Sync’ Kids

Sensory processing disorders affect 5 to 16 percent of school-aged children.

Children with SPD struggle with how to process stimulation, which can cause a wide range of symptoms including hypersensitivity to sound, sight and touch, poor fine motor skills and easy distractibility. Some SPD children cannot tolerate the sound of a vacuum, while others can’t hold a pencil or struggle with social interaction. Furthermore, a sound that one day is an irritant can the next day be sought out.  The disease can be baffling for parents and has been a source of much controversy for clinicians, according to the researchers.

“Most people don’t know how to support these kids because they don’t fall into a traditional clinical group,” said Elysa Marco, MD, who led the study along with postdoctoral fellow Julia Owen, PhD. Marco is a cognitive and behavioral child neurologist at UCSF Benioff Children’s Hospital, ranked among the nation’s best and one of California’s top-ranked centers for neurology and other specialties, according to the 2013-2014 U.S. News & World Report Best Children’s Hospitals survey.

“Sometimes they are called the ‘out of sync’ kids. Their language is good, but they seem to have trouble with just about everything else, especially emotional regulation and distraction. In the real world, they’re just less able to process information efficiently, and they get left out and bullied,” said Marco, who treats affected children in her cognitive and behavioral neurology clinic.

“If we can better understand these kids who are falling through the cracks, we will not only help a whole lot of families, but we will better understand sensory processing in general. This work is laying the foundation for expanding our research and clinical evaluation of children with a wide range of neurodevelopmental challenges – stretching beyond autism and ADHD,” she said.

Imaging the Brain’s White Matter

In the study, researchers used an advanced form of MRI called diffusion tensor imaging (DTI), which measures the microscopic movement of water molecules within the brain in order to give information about the brain’s white matter tracts. DTI shows the direction of the white matter fibers and the integrity of the white matter. The brain’s white matter is essential for perceiving, thinking and learning.

The study examined 16 boys, between the ages of eight and 11, with SPD but without a diagnosis of autism or prematurity, and compared the results with 24 typically developing boys who were matched for age, gender, right- or left-handedness and IQ. The patients’ and control subjects’ behaviors were first characterized using a parent report measure of sensory behavior called the Sensory Profile. 

The imaging detected abnormal white matter tracts in the SPD subjects, primarily involving areas in the back of the brain, that serve as connections for the auditory, visual and somatosensory (tactile) systems involved in sensory processing, including their connections between the left and right halves of the brain. 

“These are tracts that are emblematic of someone with problems with sensory processing,” said Mukherjee. “More frontal anterior white matter tracts are typically involved in children with only ADHD or autistic spectrum disorders. The abnormalities we found are focused in a different region of the brain, indicating SPD may be neuroanatomically distinct.” 

The researchers found a strong correlation between the micro-structural abnormalities in the white matter of the posterior cerebral tracts focused on sensory processing and the auditory, multisensory and inattention scores reported by parents in the Sensory Profile. The strongest correlation was for auditory processing, with other correlations observed for multi-sensory integration, vision, tactile and inattention.

The abnormal microstructure of sensory white matter tracts shown by DTI in kids with SPD likely alters the timing of sensory transmission so that processing of sensory stimuli and integrating information across multiple senses becomes difficult or impossible.

“We are just at the beginning, because people didn’t believe this existed,” said Marco. “This is absolutely the first structural imaging comparison of kids with research diagnosed sensory processing disorder and typically developing kids. It shows it is a brain-based disorder and gives us a way to evaluate them in clinic.”

Future studies need to be done, she said, to research the many children affected by sensory processing differences who have a known genetic disorder or brain injury related to prematurity.

Image1: These brain images, taken with DTI, show water diffusion within the white matter of children with sensory processing disorders.  Row FA: The blue areas show white matter where water diffusion was less directional than in typical children, indicating impaired white matter microstructure.  Row MD: The red areas show white matter where the overall rate of water diffusion was higher than in typical children, also indicating abnormal white matter.  Row RD: The red areas show white matter where SPD children have higher rates of water diffusion perpendicular to the axonal fibers, indicating a loss of integrity of the fiber bundles comprising the white matter tracts.