April 05, 2007
Many of you have written to me asking for this information. I do hope this edition gets you going in the right direction.
Before we get started, I do want to say I have, YET AGAIN, written a LENGTHY newsletter...I seem to write ,and then write and write some more, never knowing when to stop!
Now, onto our topic today; ah, yes... our little babies. Boy, are they adorable when they are sleeping, aren't they? But, sometimes, when they are awake, OH they can hit a nerve or two, can't they? Well, I hope to help you recognize signs of SPD in infants and toddlers and lead you to resources that will help explain why, and what you can do right now to make some of the more trying times a little bit easier.
How Did This Happen? Whose To Blame?
Each in-utero and birthing experience is unique. Our natural tendencies as parents are individual and unique. Every environment a child is raised in is unique. Our child's genetic make-up is unique, as is ours. Dare we say, no two newborn and parent combinations are the same? The child brings it's nature, then we nurture based on our own nature and nurture, right? I think THIS, in itself, makes studying WHY 20% of children in the U.S. have SPD so very difficult. There ARE so many factors that influence a child's experience and development, right from day one (conception).In a search for answers, some people ask...
Is it more likely a baby whose mom smoke, drank, or did drugs while pregnant will have a baby with SPD? Yes, it is.
Is it more likely a baby who had birth trauma and/or a lack of oxygen for a period of time will have SPD? Yes, it is.
Is it more likely that a baby who needed extended hospital stays, was premature, was tube fed for a long period of time, had invasive procedures and/or was in the NICU for some time will have SPD? Yes, it is.
Is it also true that if a child was institutionalized or deprived of sensory stimulation and bonding in the first months of life, they will be more likely to have SPD? Yes it is.
It is additionally true that if the parents, siblings or grandparents were suspected of having SPD, the child might too (there IS some genetic component, although scientists have not yet isolated the responsible gene).
BUT, it is ALSO true that a pregnancy can go as expected, a birthing experience go well, the in-utero experiences normal, a family history not indicative of SPD, and a child is STILL born with neurodevelopmental problems. So, this is NOT a blame game. It is what it is. True, there IS a predisposition in the above mentioned examples, but these are NOT always the direct “cause”.
Doing The Best We Can With What We Know
For those of you who have read my I've Been There page, you know that my daughter was NOT meeting developmental milestones (eating, sleeping, self-soothing, etc.) with relative ease or comfort!! She was uncomfortable most of the time, and I, in response to that, was also “uncomfortable”. I knew in my gut, something was different, something was not quite right.I wondered how all the other moms could do this, raising and taking care of such a needy and sensitive child (what I at the time thought was "normal"). Were all children like mine? I wondered some days...where did all the other mothers get the strength? I didn't know taking care of a child was such HARD work! But, then again, I also started to wonder (as time passed and she got a little older)... why IS my daughter doing some of these things? Because, I don't see OTHER children acting this way.
Wait a minute...why are THOSE kids just sleeping right through everything, not clinging to mom every second of the day, allowing other people to hold them, smiling and cooing with their extended family, eating/drinking regular formulas and baby food, not startling and crying with every sound, sleeping in a normal crib all by themselves, taking naps, enjoying being tossed and thrown up in the air, self-soothing, etc.
Darn it! Maybe it is me! What have I done?! What is wrong with me? With her? Will it always be like this? Why is she sucking the life out of me? Why can't I parent effectively? Why am I so emotionally and physically drained by my own child? By everyone around me? Am I a bad mom? Why do I feel like I CAN'T do this? Why do I want to just run away? Why doesn't the pediatrician understand what we are talking about? Why is he saying it is “completely normal”? I KNOW in my heart, THIS is not “normal”. But, HE'S the expert, or so I thought. You see, he had no idea what SPD was (this was 10 years ago...a factor in it, but not an excuse).
It wasn't until I heard about SPD, when my daughter was about two years old, that the light bulb finally came on! No, she was not “normal”...yes, she DID have a disorder that made life more difficult for her! And me. Good, I'm not crazy, and it is NOT my fault. Hmm... actually, I realize that now, but at the time I didn't have any support telling me it wasn't my fault. I was blamed and criticized from day one, and still am to this day by some...the ones who haven't taken the time to learn about, or “believe”, SPD is REAL.
But, you know what? In the end it didn't matter because I knew I was doing the best I could with what I knew. That's all we can really do. The key being, “with what I knew”...THIS is why educating people about SPD is so critically important. I want them to do the best they can with what they know, giving them as much as I possibly can to “know” and work with.
Do we have ALL the answers to every disability, every developmental delay, every illness, every disease...no we don't. So, all we can do is do our best, with the knowledge we have, and hope that is enough.
Moving On; Finding Strength
First, we must grieve.Do we face a "loss" when we find out our child has challenging issues that will need extra care and attention? Yes, we surely do! We first, must grieve. It IS a loss...the loss of having the "perfect" child. A loss of our time and patience to care for this child who needs so much. A loss for us and a loss for our child. It's okay to grieve, it is expected, and it is necessary! Don't take this lightly or rush it, it needs to run it's course.
After we have given ourselves permission to feel, to grieve, to question, to be angry...we move on to a higher purpose. How will we accentuate the gifts/the strengths and minimize the difficulties? How will we respond to our baby's needs, to our needs and the blend of the two?
Certainly you are aware of the old "nature vs. nurture" debate. I have to say, I don't chose one or the other...I choose BOTH. I think Dr. Stanley Greenspan is a "genius" for his thoughts and explanations of how the two are not separate, but completely intertwined, and how we need to work to develop the best possible relationship between ourselves and our children based on this! Perhaps, you've heard of his "Floortime" program/concept that is used to address this? If not, I highly recommend you familiarize yourself with it at www.floortime.org (go to the FAQ section) ...for your sake and for the sake of your children.
As of late, it has become increasingly clear to me how nature AND nurture DO indeed affect our child's development and our role as parents. The reason is because we have adolescents and adults coming out of the woodwork like crazy! They are emailing me, they are talking in our SPD Adult SHARE Yahoo Support Group , they are realizing in having their children diagnosed they TOO must have had SPD all along!! It is beautiful and sad at the same time.
These adults, fighting so hard to get through every day with their own SPD issues, are now having to parent children who also have SPD. As if that weren't enough, many will be on opposite ends of the spectrum; the parent may be an avoider, their child a seeker, the parent a seeker, the child an avoider. Some parents are struggling to get their own sensory needs met and controlled, and here comes an even bigger priority, or so it seems ...their children.
For, we ALL know, we can NOT take care of others if we do not take care of ourselves FIRST. This is hard to do when you have a child! I think many of us have the tendency to take care of the child first, especially when they are so demanding and all consuming due to SPD. But, I assure you... if you don't take care of yourself, your own sensory diet and preferences, you're own rest, you're own interests too... life with your child, and in your family will be MUCH more difficult! I don't want you to find out the hard way...please just believe me, if your heart and mind are open and willing. Please!
So, how DO we function with this needy child? How DO we feel competent as parents, caregivers, and professionals? How DO we help
this “challenging child”? First, with true understanding.
A New Perspective On The Old
Nature Vs. Nurture Debate
Enter, Dr. Stanley Greenspan, renowned child psychologist and author of
The Challenging Child
. He says:
"For each of these (developmental) stages, or challenges, a different mix of inborn characteristics and outside influences may produce the desired result. For example, a sensory overloaded, easily distracted infant will have a hard time learning to pay attention to a mother who is a highly verbal, veritable whirlwind of activity. On the other hand, if this child is fortunate enough to have a soothing, comforting father or grandmother who can help him through the early stages until he is a more confident, curious preschooler, his dynamic mom may be just what the doctor ordered at that stage of his development. In our new way of thinking, a child's personality emerges from the dynamic interplay of his or her interactions with key caregivers. These interactions are influenced by nature and nurture. A child brings nature into the interaction with his or her unique traits. Does she love light touch or avoid it? Does he enjoy loud vacuum-cleaner noises, or is he easily overwhelmed by them? Family members and caregivers bring personality, cultural, and family patterns into the interaction. Does a mother feel rejected when her baby turns away from her attempts at wooing? Or does that rejection motivate her to try even harder? Does a father react angrily when his tired, overwhelmed twelve-month-old flails out and hits him on the nose? Or does he redouble his efforts to be soothing? These interactions have a life of their own, and go far beyond the initial contributions of nature and nurture.
At each stage of development, a child has different needs, and there are certain experiences that can promote mastery of that particular stage and certain experiences that may create hurdles. This means that many opportunities arise for parents to influence a child's personality favorably.”
Dr. Greenspan continues with these thoughts in his book, The Challenging Child, 1995, by saying ...
"...Early care, in fact, not only can change a child's behavior and personality, but can also change the way a child's nervous system works. For example, we now know that early in life certain experiences can actually determine how some cells in the nervous system will be use-- for example, for hearing vision, or for other senses. In the same way, certain experiences can enhance a child's emotional flexibility, while others may increase rigid tendencies.
...Why are some children more difficult than others? Our research, as well as research by many others, such as Jean Ayres, T. Berry Brazelton, Sybil Escalona, and Lois Murphy, has shown that children come into this world with individual differences in physical makeup. Some children, for example, have bodies that just don't feel comfortable, and so they tend to be fussy, irritable, negative, or withdrawn. Even in the early months of life, we have found, babies can reveal unique traits in specific sensory perceptions and in the workings of their motor systems. Contrary to the belief that all of us experience basic sensations similarly, we have found that children vary considerably in how they perceive sights, sounds, touch, odors, and movement patterns. A child may be overly sensitive and overreactive or undersensitive and underreactive to a given sense. One may be best at taking in and decoding information through a certain sense, while another may have difficulty in comprehending information through that sense. We have observed that some children are gifted in their ability to plan complex behaviors and movement patterns, while others find even the most elementary sequencing of motor acts, such as putting their fingers in their mouths, a most perplexing task.”
Lastly, I want to use just ONE (of MANY) examples Dr. Stanley Greenspan uses in his book. This will help you put into real world experiences what he is talking about. Perhaps you can relate?!...
"Let's look again at Jessica. As a baby, she was highly sensitive to touch, sound, and smell. Every time her mother stroked her, she squirmed and cried. It didn't feel good. When anyone tried to brush her hair, give her a bath, or change her diaper, it hurt. She didn't like new clothing because it felt too stiff. Wool sweaters felt too scratchy. Clothes washed with certain detergents had a chemical smell. She wanted only soft, old cotton clothes. Even sounds could be painful. Daddy's deep, melodic voice saying, 'Hey, my little angel!' sounded like a fingernail on a blackboard.
What was her experience with the human world? Pretty unpleasant. Her reaction was to cry, as if to say, 'Leave me alone!' These difficulties played out at every stage of her development. As she got older, she was at times inattentive and easily distracted because she was so sensitive to the array of sounds, sights, and smells coming her way. When she found herself in a busy classroom for the first time, where kids bumped up against her sensitive skin, startled her with yells and screams during recess, and sometimes intruded into the well-defined, protective space she had set out for herself, her reactions ranged from tantrums to fearful avoidance. Jessica, everyone agreed, wasn't an easy child.
While with Jessica and many other children, biology is important, it isn't destiny. We have found that how parents relate to their children can make a huge difference in how youngsters feel about themselves and respond to their world. Imagine, for example, that because of her sensitivities to touch and sound, baby Jessica was easily overloaded and, therefore, fussed much of the time. Her mother, having similar tendencies, reacted to Jessica's long tantrums with irritability and, more often, with anger and intrusiveness. When Jessica's mother was very frustrated, she sometimes withdrew emotionally. Jessica's father also felt frustrated. When his attempts at even gentle play overwhelmed Jessica, he began staying at work longer because he found it hard to face feeling so unsure of himself and his parenting skills.
On the other hand, imagine that her mother and father had been able to “read” Jessica's physical makeup and signals and helped her learn new ways to cope. They found the right voice tone and rhythm, the most soothing touch. They discovered just the right way to hold her to give her a sense of security. Even when Jessica was upset and overwhelmed, they could console her by using firm pressure on her back, arms, and legs, for example. As she got older, they helped her comfort herself by verbalizing her feelings and engaging in certain activities, such as jumping and rhythmic games. Most important, they gradually showed her how to take charge of her own environment. By introducing new experiences in small increments, providing extra security, and encouraging Jessica's initiative, they helped her gradually become more confident and outgoing. Slowly but surely, Jessica was able to explore her world and the people in it. She moved from being easily overwhelmed and cautious to figuring out ways both to calm herself and to master new experiences. She even learned skillful ways to lead her peers into games that she enjoyed and which were not overwhelming for her. Eventually, her own emotional sensitivity became a basis for a developing sense of empathy and compassion for others as well as leadership abilities.. For many children, as they learn to deal with their physical tendencies and become more assertive, empathetic, and flexible, their own physical tendencies may change. Certain types of touch or sound, for example, may become more comfortable.
Parents can make a dramatic difference in how children use their wonderfully different natural abilities."
(Exerpts from The Challenging Child
What Do We Do NOW?
So... can we control the “nature” part of our child? No, we can't. BUT, can we control the “nurture” part based on a child's nature, as well as our own combination of nature and nurture? We surely can! And we will have to strive to do so if we want our children to be the best they can be, given the cards they were dealt. It is our responsibility to respond to our children in the best way we know how. And I want to help you “know how”! This will be the best gift you can give your child...responding to their individual needs and “nature”...for every child IS different! They will thank you in their own way someday.As previously mentioned, I have become acutely aware of parents who are just now realizing they have SPD while trying to raise a child who ALSO has SPD. Given the nature of Sensory Processing Disorders, any moment in time can present challenges for EITHER the parent OR the child, OR both. This interplay is one that will be important to dissect down the road with professionals at your side. This newsletter just isn't long enough to do that here, nor could I without knowing the family dynamics as well as the child's specific SPD symptomology.
So...what I DO want to share with you are the specific ways we can help our infants/toddlers from an OT, SPD perspective. What should we be on alert for, what should we be evaluating, what should we do to help a child best take in, interpret, integrate, and respond appropriately to all senses from day one?
To answer/do this, we MUST have a thorough understanding of both proper development and the signs of potential delays/difficulties regarding our children. Specifically, with SPD, we must also understand “normal” sensory motor development. This is a LOT to learn in one edition of the newsletter, and I know I would lose you if I tried. So, I will attempt to sum it up, then direct you to further resources that will help you understand further.
The first thing I want to make sure you have looked at is the Developmental Checklist . This will give you a good start as to the signs we look for to tell us whether something is not "right"/not on "target".
We all need to understand that sensory motor development is on a continuum and has specific stages that one goes through. They are like building blocks...you must have the foundation before you can put another block on, then another, then another. There is a certain “order” to things and age ranges within which a child should be reaching each of these milestones and stages. If a building block does NOT happen, or is not "sturdy" enough, the rest may not be able to balance on top of the one before.
With this in mind, we know, for example...
a child can not crawl before he can pick his head up or coordinate the two sides of his body.
a child can not learn and explore toys if everything he touches hurts.
a child can not relate to and interact with others if he can not process facial expressions or language.
a child will not be able to concentrate on any sensory motor task if he can not filter out background noises or does not feel feedback from his body.
a child can not sit upright at his desk and write legibly using the fine muscles of his hand if he does not have trunk and shoulder stability.
I think you get the point.
So, once we are aware of the developmental milestones, we must also be aware if a child is struggling to meet any of them, or even if he attempts to skip some of them. It is also important to note that often times a child may be developing properly within the time frame of each milestone, but the QUALITY is poor. This IS a significant sign of SPD, and must also be paid attention to. All of this is where our keen observational skills as doctors, parents, therapists, teachers, and family members come into play. This is also where our “gut instincts” tend to come in. It is not about comparing our children to other children, because each child will develop differently and at different rates...some will be late, some early, some on time, and some will struggle with only certain ones. It is about honestly looking at our child and seeing if there are indications that this child needs some extra help... something is really getting in their way or ours.
Infants and toddlers have specific milestones and tasks that they MUST be able to accomplish to move on to bigger and better things developmentally. If they are NOT able to tolerate sensory input in an adaptive and functional way, their future learning, self-esteem, and life skills are in jeopardy ...and so is the family's functioning. We must heed the warnings! Now is the time, while the nervous system is at it's prime for proper long-term development. Don't wait, trust your gut as well as the knowledge you have gained, and continue to learn.
If you get nothing else from this edition of the newsletter, I want you to know THIS...
IF a child's LACK OF DEVELOPMENT of certain skills and ability to learn, interact in the world with caregivers, peers, and play, OR THE QUALITY of skill development is poor, a professional should be contacted, particularly IF these interfere with and impact daily functioning. Every child is different and develops at different rates within a certain timetable. If mastery is difficult, and daily life is significantly impacted for both the child and the family, then red flags should be raised and an evaluation sought.
For proper development, an infant/toddler must be able to self-soothe, tolerate eating/drinking, sleep, play, explore, learn, and progress developmentally with relative ease and comfort. If he is NOT, then professional help is indeed warranted.
The Signs And Symptoms Of SPD
In Infants And Toddlers
If you are concerned about a particular child, please take a look at, and fill out, the BRAND NEW
SPD Symptom Checklist For Infants And Toddlers
, or pass it along to someone you think may need it... another parent, another professional, your pediatrician, a family member, a day care; anyone you think needs to know these signs. I hope they will understand, I hope they will meet you with an open mind, I hope they will listen to YOU, I hope they will help you help these children. We just can't wait another day!
In an upcoming issue of the SPD Companion, we will discuss solutions and treatment more in depth. But, for now, the links and resources I am providing at the end will get you started with the basics and some things to start learning about and doing right NOW while you await a potential evaluation or, even, prevent the need for one... Education first, THEN treatment.
Remember... first, trust your gut. Then evaluate whether the child can tolerate sensory input (how, when, how much, what types), then evaluate the severity (timing, duration, and frequency of difficulties), next get an evaluation if indicated, and lastly, start treatment. A BASIC understanding of sensory processing and sensory processing disorder has to come first, so the treatment will make sense and be effective. (Don't misunderstand... You WILL learn SO MUCH more once you start active treatment with an OT...you don't have to know it ALL now, just the basics.)
- You can not help the child UNLESS you understand the basic concepts behind SPD.
- You can't educate others UNTIL you understand it yourself.
- You can't help your child until you have your OWN sensory needs understood and accommodated for.
- You can't expect the professionals to make your child “better” unless you understand and are invested in this as well.
It is a dynamic interplay between nature and nurture. We MUST understand this, and be willing to do the best we can with what we know! THAT makes a great parent, professional, and/or caregiver, and THIS knowledge will be the most effective tool you'll have in making a bright, loving future, one with tremendous potential for one more child!
Resources For Helping Infants And Toddlers
Would YOU like to find out more about the five different types of challenging children wrapped up in an inspiringly positive twist, and SPECIFIC, PROVEN STRATEGIES to best help them (and yourself)? Then I HIGHLY suggest you get your hands on Dr. Stanley Greenspan's book The Challenging Child. (Honestly, it was the second book I read after I read The Out-of-Sync Child and it helped me tremendously!)Stanley Greenspan is one of the best in his field and has contributed true brilliance to child psychology and development. I have compiled this book and other great books by him for you to take a look at too...they are priceless really. Check them out at:
The Sensory Store: Dr. Stanley Greenspan Books
Another book that turns parenting an SPD child (or shall we say, “spirited child”) into a positive experience is also a tremendous favorite of mine (EVERY parent should read this one!!)...
Raising Your Spirited Child, by Mary Sheedy Kurcinka
OUR role in talking to our children, understanding our children, and talking to others about our children is critically important for fostering good self-esteem and an honest understaning. This book will help you do it right!
Raising Your Spirited Child, plus other books I highly recommend can be found at:
The Sensory Store: Books About Infant And Toddler SPD
The additional resources you will need to begin helping and understanding infants and toddlers, diagnosed or undiagnosed, with SPD are:
Dr. Stanley Greenspan's Website (biography, courses, trainings, and publications)
Books On Infants, Babies, Picky Eating, Fussy Babies And More
The Importance Of, And How To Provide Sensory Stimulation For Infants / Toddlers
Suggestions For Infant Play Activities
Sensory Toys For Infants, Babies, and Toddlers
Toys For Infant Stimulation
Suggested Gross Motor Activities For Toddlers
Early Intervention FAQ's And Resources
Do you think your child might have SPD? Then THIS is the place to start... The Step-By-Step-Guide
Do you need to find an Occupational Therapist to evaluate (or treat) your child? Then THIS is the article to read... Finding An OT For SPD
www.ChildDevelopmentMedia.com
And don't forget...SPDParentSHARE.com for resources and support in your local area (MANY local groups have been added recently!)
The bottom line is this... We must pay close attention to the milestones our child needs to achieve, how and when they are achieving them, the quality of their movements, interactions and learning experiences. We MUST take responsibility for our own part in our child's development. Whether we struggle with our own SPD issues or not, it is our job to help our children as best we can, as best we know how.
You must seek as much information as you can regarding "normal" development, and know that if your child is not progressing in all areas with quality and within the proper ranges of time, an early intervention referral should be sought.
After looking at the pages I have referred to I do hope you find a place to start NOW to help understand and influence your baby's development. Just remember, the time is NOW, while they are young, to pay attention to developmental red flags.
Think of it this way... playing, eating, sleeping, self-soothing, learning, communicating and regulating their arousal levels ARE their "occupation", their JOB... these all help them engage in their world and lay the foundation for further, more refined skills. If they can not meet the "job requirements", then they will need additional help.
Please pay attention to these areas and find them the help they need if quality or timing are not as they should be. Denial will not help our children. Simly put, if you are concerned...get an evaluation. The sooner we treat them, the better the chances are that they will overcome their difficulties or obstacles, and the more at peace we will be knowing we did the best we could with what we knew. Like I always say...education is key, knowledge is power! True? Isn't this how you all got here? Trying to educate yourselves about SPD? Aha! ...my point exactly.
Keep your eyes, hearts, and mind open. You never know when you will find yourself BLESSED with an SPD child... YOU can "save" them, IF you take action!