Oliver Googe plops down in his bean pool one Saturday afternoon. He moves his hands and legs around and allows the dried beans to flow through his fingers. When he’s had enough, his mother, Lea, helps him onto his indoor trampoline. Oliver’s eyes sparkle as he bounces around. A few minutes later, dad Joey hoists Oliver onto a platform swing that’s hanging from the ceiling. From an outsider’s point of view, Oliver is just a 4-year-old who’s having fun, which he is. But the bean pool, trampoline and various other stations in this giant room above his home’s garage are also part of Oliver’s daily sensory diet, a therapy plan designed especially for his sensory processing disorder (SPD).
Lea and Joey knew something had changed in Oliver when he was a year old. He wouldn’t respond to his name, make eye contact or engage in nonverbal communication such as gesturing. He also wouldn’t eat solid foods, and he had no words. When Oliver was 18 months old, he was officially diagnosed with pervasive developmental disorder and SPD. A year ago, when he had his school evaluation for services, the Plano couple learned Oliver qualified as severely autistic.
Oliver attends Frisco ISD’s Early Childhood School and has an hour of private therapy nearly every day. “Unfortunately, we have not made progress with his language,” Lea says. “He will, if prompted, use a couple of modified signs to request certain favorite items. The last few months he has finally made some progress with eating five more new foods, which is pretty amazing since he was eating less than 15 foods. This may be due to all the sensory work we have been doing with him these last three years.”
A child who experiences SPD has difficulty integrating information that comes through their senses (touch, sight, taste, smell and hearing) and problems developing a response to the input, says Alexandra Zigann, an occupational therapist with Jumpstart who contracts with The Hope Center for Autism in Fort Worth.
Two more senses that can be affected by SPD are the vestibular (movement) and proprioceptive (body awareness) senses. The proprioceptive system is related to receptors in the joints and ligaments that allow for good motor control; it tells us where our body is in relation to other items in our environment. The vestibular system involves receptors in our inner ear that provide information on movement; this sense is imperative for balance and coordination. Disconnects involving these senses cause children to over- or underreact to sensory input from the environment, says Tiffany Meier, an independent pediatric occupational therapist who works with Oliver at It’s a Sensory World in Dallas.
It all starts with sensory integration, which occurs when the nervous system takes in sensory input, processes it, organizes it and generates an appropriate motor or behavioral response, says Betsy Williams, an occupational therapist who works with Oliver at TOP Pediatric Therapy in Frisco. “SPD can occur when information going into the central nervous system is not registered or is registered too intensely or not intensely enough,” Williams says.
For example, if someone bumps into a child who’s extremely sensitive to touch, that small bump can actually feel quite painful to the child. Other kids might be sensitive to noise. Sounds such as an air-conditioning unit or wall clock, which many people tune out, become unbearable and can manifest as an attention problem. One mother told Meier that her child always had a meltdown at Target. As it turns out, the child was reacting to the bright fluorescent lights in the store.
SPD affects children of all ages and gender, although it’s seen more often in boys than girls. Children who demonstrate “negative behaviors” in school, such as the inability to remain seated, may be hyporesponsive to movement, which means they have a diminished response to physical or emotional stimuli. As a result, they’re constantly seeking out what their body needs, Zigann says – leading to instances where SPD is sometimes confused with ADHD.
SPD, however, has signs of its own. Kids who have issues with their proprioceptive system are unable to process feedback from their body parts, like knowing when their feet are on the floor or if they’re sitting in a stable chair, Wood says. Parents would notice clumsiness or awkward movements. Additionally, parents might observe unusual behaviors in their children, such as an inability to calm themselves, poor eating or sleeping habits, and delayed gross and fine motor skills, Williams says. The child might be overly on the go or overly sedentary, or have difficulty with transitions or unexpected changes. They might be sensitive to touch and dislike grooming tasks such as brushing teeth or hair. Some children withdraw and avoid the stimuli. These children try to control their environment; they control what they eat, what they wear and where they go in order to feel safe in their own bodies. Other children might respond with aggressive play and function at an out-of-control activity level.
Meier says parents should note whether their child has an appropriate reaction to certain activities and if he or she has a hard time transitioning from one activity to another. “I usually talk to parents who just have a feeling that something is not right with their child but have not been able to find a category or a diagnosis that fits their child,” Williams says.
The treatment goal for SPD is to get kids comfortable in their own skin: teach them how to tolerate certain things, how to calm down, how to self-regulate, how to deal with anxiety issues surrounding new things and how to get sensory experiences that are calming. Therapists and parents accomplish this by “feeding” the child a sensory diet – exposing them to senses they may have previously avoided and giving them more access to senses they seek out. In addition to Oliver’s therapy sessions, the Googes have set up the sensory room in their house for Oliver to use daily, but simple, inexpensive things can also be put into play.
“Oliver’s favorite thing is the bean pool. It’s just dried beans – probably about 50 pounds of it,” mom Lea says about the blow-up baby pool. This station in Oliver’s sensory room helps him process tactile input. “Our tactile system receptors are all over our skin. Our tactile sense helps us feel safe and gives us a boundary between our body and the environment,” Williams says.
Oliver is always on the go, but he didn’t initially have the balance and strength to jump. Enter Oliver’s trampoline. It’s a good tool for proprioceptive input, which tells our body its position in space. Added bonuses of the trampoline are that it helps Oliver’s posture, which in turn aids his ability to eat. Since his core is strengthened through trampoline play, Oliver is able to sit up and chew and digest his food properly. In fact, Meier encourages parents to make sure kids have their sensory needs met before they go to school each day; her own children jump on their beds when they wake up each morning.
Heavy activities such as pushing or pulling – where the child is using their entire body – can be calming to children with SPD, Meier says, as can crashing onto the couch or into a foam pit. (Lea tossed foam scraps she purchased at an upholstery shop into an inexpensive duvet to create Oliver’s crash pit.) Weighted vests and hugging the child tightly in a blanket are other options.
Oliver and other children with SPD can get vestibular input by swinging, so Oliver’s sensory room has an interchangeable swing system with a platform swing and a hammock-type swing. “When Oliver swings rotationally, we are activating both hemispheres of the brain and helping build a right/left connection,” Williams says. “Linear movement on the swing is typically calming to Oliver.” Meier adds that Oliver still isn’t processing the swinging movement enough, so he has to swing a lot to fill that need. How can you tell if your child isn’t processing? If they aren’t getting dizzy, she says.
If the child is sensitive to touch, one simple solution is tagless shirts, socks and pants. Finger paints and playing with shaving cream are other options. Meier also suggests therapeutic brushing (brushing the child’s entire body), which fills that input need as well. “The list of suggestions could be endless,” Zigann says. “That’s why it’s important to discuss with an occupational therapist what suggestions are appropriate for each child.”
