Sunday, December 5, 2010

What You Accept, You Teach.... Riiiiiiight.

I just read the first example from "The Out-of-Sync Child" on Amazon and I started crying. That is my son, to a "T."

My 3yr old was born with progressive hearing loss. We spent the first 5 months of his life dealing with "Colic" and I even had his pediatrician suggest that I was just suffering from PPD.  My son wouldn't sleep. He was only happy when we would swing him jettison style those first 5 months. He wouldn't lay around much, always had to be swaddled and/or held, and was a constant nurser.  He didn't like food when we introduced it, but loved the bottle especially after he got teeth.

As a toddler, my son remained a severe fuss-pot. We picked up the term "spirited child" around 1yr old, and it stuck for over a year.  Jace was quick to stand, around 4mo's, but was slow to crawl, sit up and walk. He received hearing aids around 14mo's old and hated them, always taking them off and hiding them.  He received his first cochlear implant in Sept, 2009, and hated it. We even lost one because he refused to leave it on.  He wouldn't eat solid foods, especially those that required chewing, until well past his 2nd birthday.

It wasn't until we began working with a speech therapist almost a year ago that we had any inclination from ANY of his providers or evaluators (he'd been eval'd by the local school board for early intervention services and eval'd by the state for disability benefits) that we had our first suggestion of potential OT issues. In fact, she was certain he had sensory integration issues, and consulted her pediatric OT husband for further information.  We moved 5 months later, and my son had a second implant, so the sensory issues were taken off the burners completely over the next 5 months.

Now my son is in preschool, and we have had our second comment about sensory issues, partially because I brought up our prior SLP's thoughts on the subject. We had another eval by an OT, who said that other than low core-muscle tone, my son seemed fine. "just work on the W-sitting, and other than that he seems OK. No follow up required."  Two weeks later I got an email from my son's preschool teacher telling me he has been throwing himself on the ground, banging his head, and biting his hands.  She said they'd started putting him in time out, but wanted to know if I was seeing this behavior, and if I was, how was I dealing with it?  My first instinct was panic: these people are going to think I beat my child! I thought. Then I reflected, and let the teacher know that I think this is just another phase of my son's sensory issues. As an infant he needed to swing and would flail out with his back like a steel rod when he was unhappy (all the time!); as a toddler he would head butt and body slam a caregiver; now he has turned to the floor/wall/himself for that deep-pressure input he needs. He loved to stack cups and blocks, we call him our little engineer because the manipulative and sorting things are his specialty. However, all other toys are played with aggressively, with lots of banging, slamming, running into things, and other hard-use ways of playing.

I never had a name for what he was dealing with until now. Proprioceptive Dysfunction, a type of Sensory Processing Disorder, which is characterized by sensory-seeking behavior. I never had the time to deal with the sensory issues during our battle with the hearing loss but now the sensory issues are at the forefront, and I seem to be the only one taking it seriously. To his providers, I'm overreacting. To my parents, I'm giving him the attention he wants. In fact,  I just got into an argument with my dad yesterday because he told me "what you accept you teach" in response to my worriedly venting about the head-banging and hand-biting. I asked him what he thought I should do, spank him (sarcastic!), and told my dad that I would not hit to teach that hitting/biting is not OK. He claimed that I should simply walk away; that the banging/biting would hurt and my son would naturally stop if he wasn't getting that attention. This was an idea I could agree with...

So today, in Target, I walked away the instant my son threw himself on the ground. Guess what... my son banged his forehead so much and so hard in that 1-2 minutes that he now has cuts and rugburn on his forehead. My parents' response? "Bet he won't do that very many more times." No, because I won't let him. He would have gone on and on until he was bloody, and they just do not understand that. They seem to have given up on the "mommy factor" (he throws fits more for me because I'm mom) and now they think that it's because I accept this behavior. Maybe they are right, but I refuse to let my son hurt himself. I refuse to walk away from a 3yr old who can't communicate feelings yet (still working on speech/language). I have to believe that trying to reason with him and help him deal with his feelings WILL prove to be the better alternative to pain or spankings.

But am I wrong?

5 comments:

  1. So much probably has to do with not being able to communicate as well as he wants.
    Has a lot of this come up since you were told he was on the verge of a vocabulary explosion?

    My middle son (the one with pervasive developmental delay) was like this when he was on the verge of breakthroughs in vocabulary and communication. And though his issues are different, he has lots of sensory issues.
    It was explained something like this:
    he's using so much of his energy to deal with the issues he currently faces, so new stuff is just overload.

    I wonder if Jace- who relies on his eyes and physical sensations to be his "ears" and his hand to be his "voice" just HAS to block out other sensation because it's overwhelming him?
    Headbanging and self biting usually become "meditative" and calming to kids with sensory issues.

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  2. Oh! Some things that helped with B- bear hug him til he calms down. Or if he's totally wound up, an exercise like spinning in circles, swinging on a swing (like as high and fast as is safe!)
    time out wasn't super effective because once B was wound up, he would just get destructive.
    Baths helped. A few times, he even got the cold shower treatment.
    At school, he gets isolated (with supervision) sometimes in the gym where he can just get some energy out.

    I wonder if school can give him some sensory stuff in time out? Clay or a tactile object to fiddle with.

    Also, we used to make B lay down in a dark room with a cool washcloth on his face, pretty much depriving all sensation, until he calmed down.

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  3. I agree, a lot of the fit throwing comes from communication gaps. The problem is that once he's in a fit, he inflicts pain on himself and won't stop on his own.

    We've been using bear hugs, deep pressure on the arms and shoulders, a even lay on him. My biggest concern is distinguishing when I'm responding to his sensory needs and trying NOT to respond to the tantrums. Its become a very fuzzy line, hence my parents' slightly unwelcome input. I never know which I'm dealing with until we are in the throws of a fit, and it always happens pretty suddenly. There are some times when I know a fit is going to happen (certain stimuli) but when I don't expect it, my reaction is varied, which I'm sure leads to confusion for Jace.

    Jace does need down time every day in order to function. At school, he gets quiet corner time pretty much every day. They thought it was linked to his old nap time, but now I'm convinced its linked to this. He also becomes overstimulated pretty easily in groups, leading to outward unintentional aggression. We have to find a quiet area to regroup after about 45 minutes when we are at events or in crowded areas.

    I have heard another version of that theory, it went something like this: He's spending so much of his day at school and in public regulating himself that he is overloaded. When he gets home, he is free to be himself.
    That knowledge keeps me from losing my mind (and my cool), I think. Jace isn't always rough and unmanageable. Most of the day he's a good, normal 3yr old. But when he becomes out of sorts, its beyond the range of "normal" tantrums and reactions. :(

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  4. So familiar! B was so similar!

    One thing that helps- regardless of whether the episode is tantrum or sensory, make your response exactly the same for both.
    Complete emotional detatchment from momma becomes essential in BOTH circumstances.
    Whatever the issue, remove him from the situation, regroup, THEN continue.
    Yes- a pain when you just want to get the shopping at Target done and you don't know if it's the stimulation or the fact that he can't have candy causing the trouble.
    I use to take Ben to the bathroom (sometimes the car if he was WAY out of sorts) and either bear hug without emotional expression (no soothing, no talking) or put him in his car seat (safe place) to exhaust his episode, before finishig shopping. Before I released him, I would communicate to him that we were NOT going to behave like that.

    Does Jace know any of the emotion signs? (tired, hungry, sad, angry, happy, excited)
    does he know "yes" and "no" signs?
    If he does, you can use "no grumpy, yes happy"

    if you ever need to vent or bounce ideas, email me! Oh, I have SO been there!

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  5. Sorry for the delay.
    I've started using time outs with limited sensory input. I will squeeze his arms as we walk to the time out spot (which admittedly gives me an outlet for my frustration, too) and then I sit him down and tell him to stop crying and doing _____ is a "no-no". Oddly, the time outs seem to be helping a little. He hates it, and while the frequency hasn't decreased, its taken the stress off of me and he's over the tantrum a little quicker.

    Jace knows a few basic emotions (happy, sad/crying, excited, scared) and I'm trying to incorporate them. however, he does not understand the concept of "_____ makes Mommy sad and we should do ____ instead." That's far more complex a sentence for him. We are still in the 1-2yr old communication level, where 3-word phrases are key to successful communication.

    We are going to be potty training the week after Christmas, so we shall see how this whole behavior/sensory issue plays out during that time. I'm hoping that he will enjoy understanding that he can control when he goes potty WITHOUT coming to the conclusion that he can use it as a punishment tool to Mommy.

    Its all about keeping your cool, right?! ohm!

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