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Thursday, September 8, 2016

A Boy in Constant Motion

When our son was born, he was so calm.  He was adaptable and flexible.  We could take him to restaurants and he just sat there and looked at everyone.  We could keep him out an hour past nap time, and he didn't start crying.  He was what everyone calls an "easy" baby.

Fast forward to 6 months old when he started eating solid food.  Things began to change.  Feeding him was terribly time-consuming.  I would fix him food, put him in the high chair, and he would eat for 2 minutes.  Then, he would scream and scream until I took him out of the high chair.  Of course he wasn't full, so 45 minutes-1 hour later, he would scream and scream until I made him more food and we would do it over again.  He just could not stand to be trapped in the high chair.

By 8 months, he started crawling.  Unlike our daughter, who did minimal crawling, he clearly recognized his new found freedom and he went from calm and content to the mad explorer.  It escalated even further once he could walk...and climb.  I had to clear every surface of decorative items and breakables.  We had to lock every cabinet and drawer.  You couldn't leave a cup, glass, food, etc. lying around.  The cat food and water had to be hidden.  And he was definitely never unsupervised even for a minute.  I basically just tried to ensure he didn't kill himself.  I couldn't even go into the kitchen and leave him in the living room without me.  It seemed intense, but I thought this a phase and in a few months this will pass.

Well, it didn't.  The eating situation didn't get better either.  I resorted to feeding him every time we were in the car, because he was trapped in the car seat and usually seemed to accept eating then.  It wasn't ideal, but it kept him full and more or less happy.

In fact, overall he seemed very happy.  He required a great deal of attention to protect his safety, but he didn't fuss or throw a lot of tantrums.  But as the months went by and eventually the years, it seemed incredible to me that his need to touch things, move around, and explore didn't subside at all.  I probably said, "Don't touch" or "Don't grab" 100+ times a day.

And meal times were nothing short of awful.  He hated having to sit still, he didn't want to eat the food, and when we made him eat, he would shove lots of food in his mouth and gag on it.  So most of the food ended up back on his plate rather than his stomach.  And of course 30 minutes after meal time, he would cry from hunger.

And there were other things.  From the time he could crawl, he began having a hard time falling asleep.  This didn't alarm me.  After all, sleep patterns and hours of sleep varies from child to child. He was perfectly content to sit in his crib for 45 minutes or an hour, talking to himself, singing, etc. until he fell asleep.  And once he was asleep, he slept hard until morning.

He also seemed to have an extreme fear of loud noises that he couldn't control.  If it was his toy that made the noise, that was fine.  But if he heard a motorcycle or a lawn mower, he panicked.  But again, don't most kids hate loud noises?  Our daughter certainly did.

And we also noticed that he didn't seem to be learning tasks that required motor planning.  Everyday, I had to tell him each step for putting his clothes on.  Every night, I had to explain we had to dry him off before putting his PJs on.  And questions I knew he knew the answer to still seemed to solicit "Why" from him everyday.  He probably said "Why" 50+ times a day.

By age 3, I was definitely wondering if there was a developmental issue.  On one hand, his vocabulary and speaking ability was fantastic. He used words like "intimidating" and "pleasant" and "gravity" in regular sentences.  His pediatrician said he looked great and was developing normally. But on the other hand, it could take up to 3 hours to get him to go to sleep at night.  And then 5 hours later, he would be up again.  He threw 45 minute tantrums everyday over minor frustrations.  He was still gagging on food and resisting sitting still for more than 30 seconds.  He couldn't come close to remembering the steps for getting dressed in the morning.  He insisted on having someone hold his hand to go down stairs every single time.  He still grabbed and touched everything even when he had been told 100 times it would hurt him.  He couldn't come close to throwing a ball.  And he regularly ran into walls, fell, and just in general seemed completely unaware of where his body was in the space around him.  But I kept thinking, he's just 3 three.  I'm exhausted and that's probably why I'm looking for something here.  At 3 years and 3 months, I hit my breaking point.  In one week, he ran straight into a concrete wall at school and cut his eye and cheek.  Two days later, the babysitter called while we were out because he had run head first into the bathtub and had a giant knot on his forehead (that lasted for 6 weeks).  Three days later, if I had not been sitting next to him while we were outside, he would have slammed the back of his head into our limestone retaining wall. I just couldn't take it.  I could not watch him constantly to ensure he didn't injure himself.  I had to find out if there was something else we could do.

So I took him to an occupational therapist for an evaluation.  And to my relief the therapist diagnosed him with an under-developed vestibular system and sensory seeking sensory processing issues.  She recommended therapy once a week for at least a year.  Woohoo!   It turned out there was an explanation for these behaviors and there were things we could do to help him.

So what is the vestibular system you might ask? The vestibular sensory system provides the leading contribution to the sense of balance and spatial orientation for the purpose of contribution to the sense of balance and spatial orientation for the purpose of coordinating movement with balance.  It's a combination of the inner ear organs and the cerebellum working together to tell your body how to be stable and move within space.  It's the root of all fine and gross motor skill development.  Without the vestibular system, gross motor and fine motor skills don't continue to develop normally either.

What is sensory seeking?  What is sensory processing?  Well, in short, his brain isn't very efficient at processing certain sensations.  And his body is telling him to keep seeking more and more stimulation to get enough data to help his brain develop properly.  It explains his constant movement and need to touch and need to ask why.

So would it develop on his own?  Perhaps.  But in the meantime, he would run into walls, gag on food, struggle to hold a crayon, struggle to throw a ball, struggle to keep up with his playmates on the playground.  Even at three it was becoming obvious that he was aware that he couldn't do the same things his classmates could and he was selecting activities he knew he could do.  This was causing him to not engage with his peers and consequently, his social skills with his peers were delayed as well.  So I wasn't willing to wait and see.

In the past six months with therapy and changes in our household, our son and life has improved significantly.  The therapist recommended dressing him in compression clothing (like Under Armor).  This made a huge difference immediately.  His teachers at school called his new shirts "miracle shirts."  When he's wearing the compression shirts, he feels safe and is much more capable of sitting still and listening.  He can focus on the teacher's instruction.  (We even took him to 2 movies this summer, which I never thought would happen.)  We put a compression sheet on his bed and began giving him 1/2 a children's melatonin every night, and suddenly he could go to sleep easily and stay asleep!  Not only could he sleep, he was sleeping longer at night and at nap time than he had ever slept in his life.  I started wondering how much of his developmental issues had been caused just from lack of sleep.  He started taking Omega 3 fish oil everyday and his long tantrums went away immediately.  We put a stool under his feet at the dinner table, so he didn't feel like he was falling out of his chair and low and behold he can actually stay in his chair for a meal now.  Too bad I didn't understand that one a few years ago.  We're still working on the gagging thing, but it has improved.  He uses a tool called a Z-Vibe that vibrates inside his mouth to wake up the feelings in his mouth so that he can tell when he has too much food in his mouth.  With the help of therapy, he can hold a crayon and color an entire picture now.  He doesn't run into walls and fall nearly as often as he used to.  I can leave him unsupervised now while I do something in another room.  He doesn't cry when we take him to school.  In fact, he is eager to do "challenging" work at school now instead of just cleaning the tables and the floors (which was his preference before).  He can dress himself without instruction from me, and he even gets the clothes on correctly most of the time.  He walks downstairs without someone holding his hand.  He tells me he's smart now.  He is much more engaged with his peers and confident with adults.  When we play sports in the backyard as a family, he plays too instead just pushing his lawnmower.  He's just a different kid.

We still have at least 6 more months of therapy and more work to do at home, but I feel so much more confident that he will be capable of keeping up with his peers in school physically and academically.  Intelligence wasn't his issue, but his lack of motor skills was sending him down a path at age 3 of feeling like he wasn't as capable as other kids. It might have also given teachers the impression that he was a behavior problem and therefore, not as intelligent as other kids.  Or that he had ADHD, because he was hyperactive.  It was definitely putting him on the path to thinking he was a problem, that he wasn't as capable, and that he should isolate instead of participate.

I share our story because it might sound familiar to you and help your family or someone you know.  But I also share it for this reason.  Despite how exhausting our son's sensory-seeking behavior has been, I feel fortunate that he is sensory-seeking.  Because he was so exhausting, it pushed me to seek help.  Some kids with these very same issues are under-stimulated, and rather than appearing hyper and in constant motion, they appear quiet, shy, and uncoordinated.  They may have crawled and walked late.  Parents and teachers think they are just shy...that they weren't blessed with athletic ability.  But no, the child just feels like they can't keep up with their peers and rather than try and fail, they just don't participate.  They don't want to play sports.  They might not even want to play on the playground.  And they generally have a look of muscle weakness and poor coordination.  That's not normal.  And even if the child develops physically later on, the damage to their self-esteem is already done.

As a side note, sensory processing disorder is broad and includes a lot of different issues.  The diagnosis is also a bit controversial.  Not all doctors agree on the root causes and issues.  There is definitely overlap in the diagnosis of SPD and autism and SPD and ADHD.  It's possible to have just SPD, too.  But from my perspective, the behaviors are there either way.  And it there is something you can do to improve the behaviors, that should be the parent's focus.

Here are some resources I have found helpful on the subject:

https://www.spdstar.org/
http://www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html
https://www.sensorysmarts.com/signs_of_spd.html
http://childmind.org/article/sensory-processing-issues-explained/
https://funandfunction.com
https://www.amazon.com/Out-Sync-Child-Carol-Kranowitz-ebook/dp/B00261OOVM

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