SPD and Tantrums

by Essie
(St. Louis, MO)

My 9 year old son has ADHD Inattentive type and mild SPD. He does great at school. Has a hard time with picking up social cues, but he is in a class with tolerant kids.

He did some OT a few years ago (How Does Your Engine Run and a Listening System). The headphones did not really seem to help but the OT seemed to be helpful (no big whistles or AHA moments). His "engine" seems to build up through out the day and at home in the evenings or on weekends, then he decompresses with tantrums.

We try to get a sensory diet in, but we have not had much luck with it. We are told he had proprioceptive and vestibular issues.

How can we create something or times at home for him to find healthier ways to decompress? He is resistant to "skills" and claims they do not help. His tantrums are not violent, but disturbing for his younger brother to witness and we are afraid if we do not find something soon, his teen years are just going to get worse.

Please help. He is such a good kid and he feels so out of control and embarrassed when he tantrums.

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Aug 17, 2018

by: SPD

You are absolutely right when you express concern that if these tantrums continue, the teenage and adult years will be extremely difficult for your son and anyone who lives with him. Your child is prepubescent and this tantrum (self regulation) issue, if left untreated, can destroy relationships with friends, family and eventually at his jobs too.

I can see you love him very much and feel he is a good boy, except for these tantrums. You and he both will need to become very active participants in his therapy and he needs to be accountable and willing to participate in his own recovery. You will need to insist, as a loving parent.

He is hanging on to his emotions in class, but by the time he gets home is falling apart and having tantrums.

I know it didn't work as well a few years ago, but he is old enough now for the How Does Your Engine Run program to really work well... IF you and he are both committed to making it work and using these tools every single day. This program can really become a very useful Life Skill for him.

A few years ago, maybe he was not ready. Now, he is embarrassed and sees he is out of control. You can take control, and get him started, until he is ready to be in control of himself. Consider, and insist if you must, some of the strategies to help him decompress upon arrival at home, you will find in that article.

And absolutely have set, clear rules about tantrums in front of your family. This would be a loving, yet clear way to help him learn to remove himself from your presence until he feels better. And while he is in his room, or other safe place you designate, he can and should be working through the options he chooses in his How Does Your Engine Run program, to make himself feel better.

You can begin immediately addressing the underlying regulatory issue that is causing him to tantrum and feel out of control. With his vestibular, proprioceptive and regulation issues, he needs a whole lot of heavy muscle movements in his day.

Consider the new Astronaut Training Program by Vital Links, you can do at home, to
help with his vestibular/balance issues. A simple chore chart with responsibilities he fulfills daily can help him to get more of a sensory diet that is targeted for his needs.

How about taking out the trash? Unloading groceries from the car? Carrying the laundry basket. Washing the car, the dog or the porch? There is a huge list of every day activities he could use to help himself feel better, in the Heavy Movement Activities in that book.

You will also find an extensive list included in the article Heavy Work Activities on this site.

The thing is... he really is the loving sweet boy you know. That is him. What is overshadowing your beloved child, is a disorder, a regulation (interoceptive sense) disorder that causes him to not be in control of his feelings, emotions or reactions. And this disorder, along with his vestibular and proprioceptive issues can be worked on, improved and he can have a very happy life. He doesn't have the tools and strategies to do that, or he has been resisting utilizing the tools he learned.

Please don't allow him to make these decisions to refuse treatment. He doesn't realize, like you and I do, that this will negatively impact the rest of his life. Smile, nod, then insist for his own well being. I do believe you love him enough to be able to be strong for him, when he needs you to be.

Your submission has left me with a lot of unanswered questions in my mind. Ones that I would like you to ponder and/or answer for me. I think these questions are important for you to move forward and help your son! The honest answers...

- How long was he in OT?

- Why did it stop?

- What was helpful specifically? What wasn't?

- Why did/does a sensory diet not work... who isn't insisting on it? (you said, "we try but...")

- What activities are in his sensory diet?

- What tools DOES he, do you, use successfully? How can those be expanded?

- What does he specifically do during his tantrums? What do they look like?

- What "input" is he using to help calm himself down?

- What is he seeking? Avoiding?

- What appears to set him off?

- When he was in OT... did you watch the sessions? Talk to the therapist before and after (or during) about what she was working on, any concerns you had, how, what to do at home, etc.? Did you understand what she explained? Did she explain things?

- Were you involved in setting and meeting his goals?

- And, the BIG question... can he get back into OT now? At minimum, it sounds like he needs a "tune-up". Maybe a different OT? Are you both ready to be VERY involved in his therapy and make this better? More manageable?

His OT, his sensory diet, the therapies and companion programs are indeed his "medicine". He needs this medicine! Think of it as a medical condition that requires pills 3x/day... insulin shots for diabetes, for example. I know you would make sure he took those, no matter how much he didn't like it, to keep his blood sugar regulated. Do the same with his sensory diet, his therapy, etc... to keep his nervous system regulated. He needs you to insist!

Oct 25, 2007
More Info
by: Essie

I appreciate your comments and suggestions. SPD seems to be so "gray" in a world of black and white. He was doing OT for 2 years. He did the Auditory/Listening program for 9 months. We stopped after his tantrums increased and we tried several different CD's. It may be time to go back, but I am thinking maybe a new OT.

He does not remember his sessions and I got some feedback after, but was never in his sessions (I had a younger sib with me). He cannot tell me what helps him feel better or he will not tell me. Fortunately, or unfortunately, he keeps it "together" for therapy and his OT never saw him lose it. He was an easy kid to deal with for her.

His tantrums range from refusal to move from a spot to crying and blaming others for his bad feelings for 30 minutes to 2 hours. He does not seek anything consistant and we have been using wall push ups, wheel barrow walk and army crawl. We just installed a pull up bar and I am trying to figure out a safe place to "crash". He refuses to go out and kick a ball or swing. We have no clue what sets him off. I guess social things at school and his own frustration... We are guessing. I appreciate your feedback and any ideas.
Yes, it does seem to be time to get back into OT! Good plan. Also, I am concerned about his previous therapist and whether it was a "right fit"... so, finding a new one really might be a good idea. He should have made greater progress, you should have known more regarding therapeutic interventions, his Listening Therapy may have needed better monitoring so you wouldn't have had to give it up.

Two more thoughts. It is not at all uncommon for behaviors to worsen before they get better when in therapy. This is a sign, really, that neurological changes are indeed working. I know it is hard, but usually necessary. Don't assume it isn't working... your OT should have told you that too.

Also, know that one possible reason he doesn't want to go outside and kick a ball or swing may be related to motor planning issues or vestibular processing issues... both related to his SPD.

But, YES... do get him back into OT and get as involved as you possibly can during the sessions and talking to the OT before and after. Communication, monitoring and very active involvement on both your parts, as well as the OT will be critical!

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