Parents often ask for a list of common sensory symptoms to see if they can be related to their child’s behaviors and difficulties. This is a list I created for children starting with infancy (yes, 1-2 months of age included!) and ending around the 4-5 year old age range. This is not an “all inclusive” or definitive list, but it should surely send you on your way to explore the possibility that your child may have sensory processing difficulties. If a group of these symptoms stand out to you, or if even one symptom stands out strongly to you, I recommend taking this list to your pediatrician and talking to him or her about your concerns. You can also contact a local occupational therapist who has additional sensory training and ask them questions, to see if a full evaluation would be warranted. I will continue this list of symptoms next week to include all school-aged children (kindergarten and up). By tuning in to this podcast, you will get more detailed information and explanations of symptoms in this age range!

SENSORY INTEGRATION CHECKLIST PATTERNS TO OBSERVE

ALL CHILDREN EXHIBIT SOME OF THE FOLLOWING BEHAVIORS AT TIMES, IT IS IMPORTANT TO SEPARATE THE OCCASIONAL FROM THE PERSISTENT BEHAVIORS AND NOT WORRY ABOUT AN ISOLATED INCIDENT, WHICH COULD BE TOTALLY INSIGNIFICANT FOR THE CHILD AS A WHOLE.

IN INFANCY:

• Trouble with nursing and sucking or digesting
• Resistance to cuddling and body contact
• Cries with car rides or needs excessive movement to calm or fall asleep
• Excessive crying and irritability
• Lack of response to sounds; excessive response to sounds
• Trouble following movements with eyes
• Absence of creeping or crawling
• Delay in sitting, standing or walking
• Delay in learning to talk

IN PRE-SCHOOL YEARS:

• Inability to follow directions
• Impulsive and uncontrolled behavior
• Can’t sit still in circle time
• Constant fidgeting, shifting body weight or lying on the floor vs. sitting upright
• Poor sense of rhythm; uneven walk
• Fear of swings and slides, or excessive craving for this type of intense movement
• Plays rough with others; heavy hands vs. gentle hands with people or toys
• Frequent falls and tendency to bump into things
• Purposeless hyperactivity
• Unusual quietness and inactivity
• Excessive craving for sweets
• Poor eating habits
• Constant interruption and persistent talking
• Excessive repetition in speaking
• Tendency to be fearless, climbing counters and large playground equipment with no concern for safety

Please feel free to contact our office if you have any questions related to the above symptoms. Our office staff would be happy to assist you in determining the need for an occupational therapy evaluation.

Pediatric Potentials, Inc.

407-322-3962

www.pediatricpotentials.com

Listen Now

This week I had Dr. Mark Roque, an Orlando-based pediatrician speak to us about his experiences with sensory processing disorders and how he handles this in his medical practice. Many thanks to him for his time and great insight!

He admitted he didn’t hear much about sensory processing or sensory integration problems when he first became a doctor and that they didn’t teach about this or learning disabilities in school. He noticed some sensory symptoms in his son, such as being hypersensitive to sounds, disliking the feeling of tags in his clothes, and being afraid of the feeling of his body moving in 3-dimensional space. Dr. Roque felt helpless as a father and needed to refer to outside professionals that he trusted. He found support with his son’s school, the field of psychology, occupational therapy and speech therapy.

He stated that with the use of auditory integration training (Therapeutic Listening) at home, and occupational therapy to address his sensory processing difficulties, his son made great gains that could not be considered a placebo effect. His son’s motor planning skills greatly improved, affecting his ability to tie his shoes, get dressed, and climb or swing on playground equipment without fear. He stated that his therapy helped him with his motor skills as well as his confidence and how he fit in socially with others.

As a pediatrician, Dr. Roque stated that when he hears from a parent that a child is having a hard time behaviorally or at school, he asks them to return for a follow-up visit so he can spend more time with the parents to assess the problems (usually 30-45 minutes). In the last few months, he has had several parents report sensory problems. One child was petrified of loud sounds and needed to turn his shirts inside out because he couldn’t stand the feeling of them. Another child was thought to have cerebral palsy (CP). Once this child was treated for fine motor coordination difficulties, his handwriting greatly improved to where Dr. Roque was able to see measurable improvements and his ability to complete everyday living activities was much easier.

Dr. Roque stated that the feedback from parents in his office has been very positive, as children who have received sensory integration therapy have symptoms that are almost completely diminished, and that are now more manageable and appropriate when looking at the child as a whole. He stated that these kids are unique and seem to see the world differently; they make you laugh; they are fun; and they make you think! He also stated that sensory therapy is not a quick cure and parents need to follow through.

His recommendation for parents who think their child may have sensory processing problems is to “find someone you can trust”, as information out there, especially on the internet, can be good or bad. He also stated not to be afraid to be vocal and don’t worry about hurting your doctor’s feelings by getting a second opinion.

Dr. Mark Roque is a Pediatrician at Lake Mary Pediatrics in the Orlando area of Florida, who has been practicing locally for over seven years. He grew up in the Lake Mary area, and was a graduate of Lake Mary High School. Dr. Roque received a BS degree from the University of Florida in Microbiology. He attended Eastern Virginia Medical School in Norfolk, VA and completed his residency in Pediatrics at the Medical University of South Carolina. Upon graduation Dr. Roque returned home to practice General Pediatrics in Lake Mary, FL. He is board certified in General Pediatrics and a fellow of the American Academy of Pediatrics. You can find his medical group on the internet, email a question to one of the four doctors in this practice, or call the office directly at 407-323-3550.

Listen Now

Praxis, motor planning and dyspraxia…whose making any sense here?!

I know these terms can be confusing and sound so technical, but these are the terms that describe why so many sensory kids are often misunderstood! I am going to break these terms down for you in this episode, so you can understand them and how they relate to sensory processing.

Let’s start with the term praxis.Praxis is the fancy medical term used to describe motor planning. It is defined as the ability to quickly and efficiently take in sensory information, process it and respond.

Dyspraxia is defined as “difficulty with motor planning”. Just to throw you off, there is also the term called apraxia which means that motor planning is almost absent. This is a term that was adopted most often by speech and language pathologists many years ago, relating to a child’s oral skills.

Praxis involves taking in directions or coming up with an idea, and then initiating and completing a new motor task. Integrated information from the sense of touch, balance and movement, vision and hearing are necessary for good motor planning. Individuals with motor planning problems have to think harder to complete new motor tasks because of poor information from the sensory systems. As a result of their need to work harder they might appear stubborn, lazy, defiant, defensive, clumsy, or inconsistent in their behaviors or actions. Some children may get very tired, give up, appear perseverative, and show a strong need to control their environment or act out due to frustration from having these difficulties.
Here are different types of praxis that may or may not be seen in your sensory child:

• Praxis on Verbal Command: the ability to easily process and follow verbal instructions.
• Postural Praxis: the ability to imitate positioning your body easily for gross motor movements, sports or games. This is seen often in the pre-k and kindergarten population, when the younger kids have a hard time keeping up with their peers when singing songs and learning the body movements for these songs.
• Sequencing Praxis: the ability to know how to get things done in order and complete them in an efficient manner, like being able to complete the steps of getting dressed or making a sandwich.
• Oral Praxis: the ability to organize sequenced movements of the mouth, affecting speech, drooling, feeding blowing (bubbles or whistles) and sometimes reading (to sequence sounds in order to sound out words properly). Information from the sense of touch is especially important for good oral praxis, as we need to feel our mouth, lips and tongue in order to use them properly.
• Constructional Praxis: this is a task which requires three dimensional manipulation. Difficulty with this type of praxis results in kids showing frustration when playing with blocks, frequent breaking of toys (as the toys just don’t move the way they expect) and difficulty dressing dolls, completing art projects and assembling toys that come with instructions.

Listen to this episode for more clarification and examples, as I can imagine you may have lingering questions.

Feel free to ask questions on this site at any time, I am here to help

Listen Now

This is an important topic because once you understand how sensory processing works, you will know how to handle certain sensory symptoms or problems better, and then there won’t be such a mismatch when you communicate with your child, have to teach a child, or live with someone who has sensory processing difficulties.

Here are some key points to understand:

• Sensory processing happens in the BRAIN STEM.
• The BRAIN STEM is the “RELAY STATION” or “FILTER” for sensory information to come in and out of the body.
• The cortex of the brain is the highest part of the brain that interprets information, makes sense of the information and tells our body how to respond. This is the intelligent part of our brain, for example, where our IQ comes from.
• The BRAIN STEM is only a filter for this information, which is an AUTOMATIC FUNCTION OF THE BRAIN.
• There is no intelligence associated with sensory processing. Therefore, it does not matter how smart a person is; the question is whether or not the brain stem gets the information to the right part of the brain without any problems along the way.

When the brain stem does not receive and send off sensory information correctly, it is often due to the nerve impulses from each of our senses being either “under-responsive” or “over-responsive” in nature.

When the nervous system is “under-responsive”, it results in slow and sluggish responses, much like watching dud fireworks, so the messages do not make it to the correct part of the brain. These messages get lost in transit, as they were not strong enough to get very far. Under-responsive can also be called “hypo-responsive” or “hypo-sensitive”. Kids with under-responsive systems may have anxiety or frustration, they can be withdrawn or self-conscious, they may lack safety awareness as they may not register pain or the feeling of hot water quickly enough to respond, or they may appear hyperactive as they try hard to stimulate their senses in a stronger way in order to feel satisfied internally.

When the nervous system is “over-responsive”, it results in too many sensory messages being sent to a particular part of the brain, resulting in an overwhelming or exaggerated response. These responses are often called “traffic jams”, as they can back up or flood the nervous system, much like too many cars can back up a highway around rush hour. These traffic jams cause resistance, frustration, defiance and all sorts of behavioral outbursts in people, as their bodies are so overwhelmed internally at the moment that they cannot take any more stimulation, like: rules; being disciplined; and not being allowed to control their environment or make their own decisions.

When sensory information from each of our senses comes into our body, it enters the brain stem through our neurological or nervous system pathways and then the brain stem decides what to do with it:

-it filters it out if it is not important (like fluorescent lighting, the sound of an air conditioning unit in a building, or the feeling of your clothes on your skin long after you have dressed yourself in the morning).

-or, it sends it to the cortex of the brain so our body can attend to it, make sense of it and do something in response (like the attention we give to a bug landing on our arm, a fire alarm, or  someone telling us we just won a prize).

Good sensory processing is suppose to happen automatically and it is needed in order for all of us to pay attention, have good behaviors or self-control, learn easily, follow directions, and be a well-adjusted person in society. Tune into this episode to hear more on how sensory processing works and examples of what it’s like to be under or over-responsive to all types of sensory stimulation!

Listen Now