5 reasons sensory integration should be your lifestlye

At my workplace, we suggest parents to bring their kids to therapy twice a week. We do an individual evaluation so the frequency is not the same for all the kids, but in most cases it turns out to be twice a week. The sensory room is big, has many things and it can be a lot for certain kids to handle. But that’s therapy. And it’s great. But if you ask me, sensory integration should be looked at as lifestyle. No matter if your child is “healthy” (of a typical development), or has some developmental difficulties. Two hours a week is simply not enough. Just knowing a thing or two about what it is and how kids respond to the stimuli can give you a lot of insight into why kids do things the way they do. For instance, why do kids walk on the arm rests and frames of your living room couch, why they slide down 100 times and still want more, why they can spin around in the park for 5 minutes and you want to puke just by looking at them?

  1. If parents knew just a little bit about the SI, it would not be such a mystery and I am sure parenting would be even a bigger joy. It is to me, anyway.
  2. I love seeing my little boy exploring his body. I don’t get all first-time-nervous-mom on him, but I am a relaxed parent as I understand what my baby is going through.
  3. SI is great for your child but is also good for you. Your brain is not as easy to “change” as the child’s, but is not impossible. When I started working in the sensory room I would get nauseas within three to four rounds on the swing and now I can do at least 10. I also couldn’t write texts or read messages on my phone while in the moving bus, and now I have no issues with that whatsoever.
  4. Other than that, as a parent you get more creative because you need to find ways to offer your child the stimuli they need in different ways: e.g. Proprioceptive stimulus can be acquired by jumping, rolling, pressing, bouncing off of something such as a mat.

    20140725-221439-80079267.jpg
    acquired from: kikisclinic.co.uk
  5. Last, but definitely not the least is the fact that one or two hours a week is really not suffice. Can’t emphasize that enough.

And that old excuse “I don’t have so much time to play with my child because I have to ____________ (enter your reason why)” is not applicable any more if you make SI your lifestyle. Because if you live SI, then you do it all the time, becomes a way of living and communicating. But have in mind that even if you apply the SI concepts, you should still be the child’s parent and go for the hour or two of therapy with a professional. Doing it at home does not mean stopping it with the professionals by any means.

And remember, it should be fun! :)

Let’s get dirty: Top 5 sensory summer activities

I love summer for its practicality when it comes to sensory activities and the creativity at this time of the year is endless. Here’s my top 5 sensory activities for the summer season:

1. Water

  • Sea: if you are planning a trip to the coast, this might be a great sensory experience for your child. Not only swimming, but walking through the shallow water, touching the sand or pebbles with bare feet or just splashing it around is good.
  • Bathing in the tub: You can prepare baths for your child in the yard or the balcony like I did with my son. My 4 month old loves to bathe and splash water everywhere. During the hot days I take his tub out in the balcony and give him a coconut oil massage first (as per Indian tradition) and afterwards we dip. If your child is a bit bigger, fill the tub with some plastic balls for the kid to play with while bathing.
  • Color: You can use some food coloring and color the water for your child to play with. Throw in some cups and toys, too. Tea party? Sounds great!

IMG_0448

2. Sand

  • Dry sand: put a lot of sand in a box, hide some small toys that your child loves inside and have him or her search for the toys. Take a cup and slowly sip the sand through your child’s hands, arms, hair, legs and feet. See if they like it in one place more than the other. I worked with a few kids who didn’t like to touch sand or seeds but they loved when I sipped it through their hair.
  • Wet sand: you can of course take molds and make different shapes and build it up to a castle or a road for your child’s favorite car.
  • You can bury your child’s feet or hands in the sand so they feel its heaviness (proprioceptive stimulaiton) or tie up some sand in a bag and around your child’s feet, on top of his shoulders or even around his waist.

20140415-002444.jpg tia sand

3. Foam

  • if your child has a tendency to put their hands in mouth, perhaps you should use an edible version of a shaving foam such as whipped cream. Again, you can color it with food dye for more visual attraction, you can have your child put the foam all over the body, starting with foamy mustache or role play “how does mommy put her facial cream on her face?” or “how does daddy shave his beard?” and continue onto legs and arms. Add some natural scent (orange, lemon…) if you are using an edible version for the olfactory and gustative stimulation.
  • you can dip your plastic toys and give them a nice foamy bath and rinse them in water afterwards.
  • all of these can be done outdoors, while child sitting in a tub or on the pebbles.
  • if you don’t have pebbles around your house, consider using grass or other unstable surfaces such as a balance board.
Girl and a boy playing with shaving foam.  Permission acquired from their parents.
Girl and a boy playing with shaving foam. Permission acquired from their parents.

girl playing with water

4. Barefoot

  • summer is a great time to be barefoot. There is very less chance your child will get a cold due to walking barefoot in the summer season. Exactly the opposite, walking barefoot could do a lot of good to your child so use at least this season for that. If your home heating system is good enough, you can have your child barefoot even during the winter inside your home.
  • opportunities are endless: walking on the sand, pebbles, small stones and if you are brave enough, you can have the child walk on the pine tree needles (be careful, some insects like to hide in there!), shallow part of the sea or lake and through the grass!

t n t in grass

  • you can have your child be barefoot in a park too, if you find that socially acceptable.

tia barefoot in park

 

5. Indulge

  • Flavors: seasonal fruit, Popsicles
  • Smells: woods, fruits, flowers, Mediterranean herbs
  • Hot & Cold: You can give your child some ice (be careful!) to play with, see it melt or spread it on his body. You can also dye it with some food colors for more visual fun. To make it even better, use some fruits to color it and you ask the child to lick it as Popsicle. On the other extreme, no, I am not suggesting you should have your child play with fire, but let them feel the warmth by walking barefoot in the sun (don’t let them burn their feet though! Concrete floor and stone can get pretty hot so be careful. Try it yourself before letting your kids do it). Let them put some ice on a hot surface (again, be careful and always around your child for safety measures!) and see it melt. Let them see you cook and try putting their hand high above the cooking pot so they feel the vapor but can’t get hurt. Can’t emphasize the safety measures enough for these ideas!

Summer is great because even if your child spills something, it will get fried quickly. Oops! Lapsus calami. I meant, dried! This just tells you what temperatures we’re currently having in Croatia. Kids can spend most of their time outdoors and enjoy the natural sensory play. I’ll keep adding activities as I do them myself with my niece, nephew and son.

Until then… stay hydrated!

What’s the point?

A mother of a boy with autism asked me once right there in the middle of a session: “What’s the point of him swinging so much, I can do that with him in the park?” As I went deeper and deeper into explaining the concepts of sensory integration and why her son needed the vestibular input and how swinging would help him in school, a parallel train of thought started unwinding in my head. Does this lady see the big picture here? There she was, a gorgeous, polished and relatively young mother of this boy. She was always very polite and in the mood for at least a small talk. She rarely stayed in the sensory room but when she had questions, she would stay inside and I would take some time from the session to talk to her and make these concepts a little bit more close to her. So, after many years of explanations from my boss, and a couple of extra years of explanations from me, she kept asking the same question: “Why are you letting him swing so much, I can go to the park and let him swing there for free.” Now, let me just be clear about this, she was definitely not a stingy lady, just the opposite. So, for all those who can’t see the forest for the trees… What’s the point of sensory integration therapy?

Sensory integration has practically one ultimate goal, with small goals in between. The ultimate goal is to help children with any kind of developmental disorder or delay learn. When a child has sensory deficits, they find learning to be very tiring, tough, uninteresting etc. One very important goal that helps us getting to the learning process is the (self)regulation. This is a very tricky one. It is the one that is very individual and rarely you will find a nice and simple equation to get to the regulation and self-regulation point in a child. One day jumping and rolling on the floor will be a bingo, but tomorrow that might cause a tantrum.

Piaget nicely indicated that play is the work of children. They learn a lot better when actively participating as oppose to being told what to do. So, what’s a better way of helping children in their journey to the land of knowledge than the sensory smart play. I follow the child’s interests, observe their sensory appetite and I try using that to help them learn new things; whether a skill, or a word. Some children can only function and learn while getting their stimuli whereas some children are ok with being stimulated first and then afterwards successfully getting the task done. So, in order to get the cognitive tasks done which are on a higher level, we need to sort the basics that our body needs first.

http://www.zoneintraining.com/wp-content/uploads/2008/01/pyramid.jpg
http://www.zoneintraining.com/wp-content/uploads/2008/01/pyramid.jpg

I’ll try making this even more clear. In order to successfully learn, you need to be ok with your sensory self. You don’t need to be perfect and rarely somebody is. But people and children with a more substantial sensory disorder will find learning very tough. However, we can learn to compensate our sensory deficits to be able to function normally with every day challenges (taking a shower, putting clothes on and getting out of the house, getting a haircut, sitting in a class, having coffee in a crowded mall, cooking a spicy dish, reading a book, writing a paper, etc.). So, this is the big picture: settling the sensory basics for the higher cognitive tasks such as learning.

And just an FYI… If you ask me, sensory integration, yes, it can be a therapy, but I would rather if parents and adults used it as a lifestyle. Think, breathe and live (and play!) in a sensory way. Don’t wait for those one or two hours a week for your OT to work with your child and help them regulate. Talk to your child’s therapists, learn from them about your child’s sensory needs and implement them all the time: while the child is eating, when the child needs to brush his teeth and go to bed, on your way to the preschool, etc. I don’t think a parent should necessarily acquire a role of a therapist, actually better if not, if possible. But, hopefully you play with your child anyway, why not making it sensory friendly in your own home or a park. So, to answer the question that a patient’s mother asked: if I let your child swing as much as his brain needs, that will regulate him and thus he will learn better. And yes, I would love it if you would take him to the park to swing more, whenever the boy wants and needs (I only assume his biggest need would be before and after his classes).

A cranky baby? – behind the scene

  • “My baby cries a lot.”
  • “My baby doesn’t want to eat (solids).”
  • “My baby doesn’t like to get dressed.”
  • “It’s impossible to put my baby to sleep.”
  • “My baby doesn’t like to ride in a car.”
  • “My baby doesn’t like to spend time on her tummy.”

All of these are frequent examples of children’s reactions to sensory stimuli from the environment. To explain it a little bit: there may be many reasons for a baby to cry constantly or not to be able to sleep and it is up to us to find a pattern in the activities that preceded the negative reactions: e.g. bathing, dressing, feeding, going out in the sun etc. It can also be a reaction to an absence of a stimulus. For example: a baby or a child will not be able to fall asleep until he or she gets enough of proprioceptive stimuli (e.g. when we tightly hold the baby in hands). Children who have some oral motor and sensory difficulties will most likely have difficulties breastfeeding (sucking) or will have difficulties chewing their food, especially the solid, chewy items. Also, they might be irritated by the smell or the texture of the food. Furthermore, if a baby is hypersensitive to touch, she might cry while you try changing her clothes and might even be bothered by the etiquette or different materials in her clothes. Children who are hypersensitive to the vestibular stimuli most likely will not enjoy the car rides, while the children on the opposite side of the spectrum love the rides, swinging, walking on a beam (or couch armrest) and other unstable surfaces. Concerning the tummy time, if a child has a vestibular problem, they will probably not want to have their heads in a position towards the floor. If they have low muscle tone, they might have an issue holding their heads up or they might have a problem with their shoulder girdle.

Let me make this more clean with an example of a boy I worked with. He was 9 months old when he came to me and the reason his mom brought him was that he did not sit by himself. So, in our first meeting, I put the boy down on a mat and waited to see his spontaneous movements, reactions and motor skills. He did not want to turn to his tummy. I tried using the toys to get him to turn and stay like that, but he would immediately start to cry very intensely. Putting him into a side sitting position also scared him a bit and he would continue to cry. He didn’t even want to have his fists on the ground in front of himself. But, while he was on his back, he would hold a toy in his hands. After getting to know his motor skills, I took a look at his sensory profile since children until the age of 7 are very sensory oriented. I noticed this boy was hypersensitive to tactile stimuli on his fists and that was the reason he was not using the side sitting. The boy did not want to put his hands onto the floor which prevented him from getting and being in this position. Also, he did not want to have his head face the floor. While on the tummy or on all fours where head needs to be in that position tell us there might have been some vestibular difficulty. The vestibular system gives us information about the head position. When I realized what his sensory difficulties were, I started working with him on a swing – we would swing forward-backward as the linear swinging regulated him.This way we worked and played without any tears.

It is important to know what preceded some negative reaction your child had and look at the situation through sensory glasses. For example, if your child doesn’t like to get dressed and you only manage to put some clothes onto your baby while somebody is holding her or singing, take it as a clue that your baby needs more proprioceptive or auditory stimuli to get regulated. You can give your baby some deep pressures all around his body, especially the joints as if you were trying to reach their bones. Do not squeeze your baby or pinch or lightly caress, just give deep and relaxing pressure with your whole palm. Then, try to get your baby dressed. Any difference in his or her behavior now? If not, check if your baby has a preference in materials and textures or is she or he bothered by the etiquette on the clothes or if the clothes are too cold (after giving a warm bath, clothes can sometimes appear cold).

Što se potencijalno krije iza bebinog negodovanja?

  • “Moja beba jako puno plače“.
  • “Moja beba ne želi jesti (krutu hranu)”.
  • “Moja beba se ne voli oblačiti“.
  • “Moju bebu je nemoguće uspavati“.
  • “Moja beba se ne voli voziti u autu”.
  • “Moja beba ne voli biti na trbuhu“.

Sve su to česti primjeri reakcija na osjetilne podražaje iz okoline. Da ukratko obrazložim; može biti mnogo razloga za bebin konstantni plač ili nemogućnost spavanja te bi trebalo pronaći uzorak u tome što prethodi tim radnjama: oblačenje, kupanje, hranjenje, izlazak na sunce itd. Može biti i odsutnost nekog podražaja. Na primjer: beba, odnosno dijete, neće moći zaspati dok ne dobije dovoljno proprioceptivnog podražaja (npr. čvrstog dodira na površinu cijelog tijela kao kada bebu nosimo u naručju). Djeca koja imaju problem oralne motorike i senzorike, teško će sisati majčino mlijeko ili bočicu ili žvakati krutu, pogotovo žilaviju hranu. Također, možda ih smeta intezivan miris hrane ili njena tekstura. Zatim, ako je beba taktilno preosjetljiva, plakat će za vrijeme skidanja i oblačenja te će ju možda smetati i etikete ili neki drugačiji materijali. Djeca koja su vestibularno preosjetljiva neće uživati ili se brzo i lako opustiti za vrijeme vožnje u autu, dok će djeca hiposenzitivna na vestibularni podražaj uživati u vožnjama, ljuljanju, hodanju po gredi (rukovatu od kauča), nestabilnim podlogama itd. Što se tiče boravka na trbuhu, ako je problem vestibularni, onda neka djeca neće htjeti imati glavu u položaju prema podu. Ako je problem niskog mišićnog tonusa, možda im je teško držati glavu gore ili ima možda problem ramenog obruča.

Primjer: Radila sam s jednim dječakom od 9 mjeseci koji je došao na pokazne vježbice jer još nije samostalno sjedio. Na prvom sastanku s njim, kada sam ga stavila na strunjaču i pričekala da vidim spontane kretnje, reakcije i motoriku, nikako se nije okretao na trbuh. Koristeći igračke pokušala sam ga motivirati na boravak na trbuhu, ali nije se htio niti okrenuti, a kamoli boraviti dulje. Odmah bi počeo intezivno plakati. Postavljanje u bočni sjed ga je također dosta plašio te bi i dalje dječak jako plakao. Ručice nije htio držati ispred sebe u bočnom sjedu, ali dok je bio na leđima, ipak bi držao igračku u rukama. Nakon upoznavanja njegove motorike, pogledala sam ga i kroz senzoričke naočale jer su djeca do sedme godine života izrazito senzorička bića. Ispitujući dječakovu senzoriku vidjela sam da dječak ima hipersenzitivno taktilno odstupanje na šakicama te je to razlog njegove nemogućnosti da samostalno zauzme bočni sjed. Jednostavno nije htio držati ručice na podlozi, što je neophodno za ovaj položaj. No, problem je bio i u položaju glave. Dok je na trbuhu i u četveronožnom položaju gdje glava treba gledati prema dolje, možda postoji i vestibularno odstupanje. Vestibularni sustav nam daje informaciju o položaju glave. Kada sam otkrila koja su njegova senzorna odstupanja, krenula sam izvoditi vježbice i položaje na ljuljački koju sam ljuljala naprijed – natrag (linerano ljuljanje) koje je dječaka organiziralo i reguliralo te smo na taj način bez suza postizali sve položaje.

Važno je otkriti što je prethodilo nekakvoj negativnoj reakciji Vašeg djeteta i pogledati situaciju kroz senzorna načela. Na primjer, ako se Vaše dijete ne voli oblačiti i jedino kada Vam to uspijeva je dok bebicu netko drži ili pjeva, uzmite to kao znak da bebici možda treba više proprioceptivnog ili auditivnog podražaja za regulaciju. Možete bebici priuštiti duboke pritiske po tijelu, pogotovo po zglobovima, kao da želite prodrijeti ispod kože do kosti. Nemojte bebu štipati ili lagano dodirivati, samo dajte smirene i duboke pritiske cijelim dlanom. Nakon toga pokušajte s oblačenjem. Ako to nije pomoglo, pogledajte što je još prethodilo plakanju. Ima li razlike u ponašanju s obzirom na različite materijale odjeće? Smeta li Vašu bebu etiketa na robici, temperatura odjeće (npr. iz tople kupke u hladan bodi).