1 Four Out-of-Sync Children at Home and School NOTE: Mild sensory processing challenges are "differences." More pronounced challenges are "difficulties." Severe challenges are a "disorder." In this book, the "D" in the acronym SPD can stand for all three. (See "A Word about Words," page xxii.) Surely you know a child who is oversensitive, clumsy, picky, fidgety, and out of sync. That child may be your son or daughter, your student or Scout, your nephew or neighbor . . . or the child you were, once upon a time. That child may have sensory processing differences, difficulties, or disorder (SPD), a common, but misunderstood, problem that affects children's behavior, influencing the way they move, learn, communicate, relate to others, and feel about themselves. SPD can stand alone, or it can accompany other physical, cognitive, language, social, and emotional challenges. To illustrate how SPD plays out, here are the stories of four out-of-sync children and the parents struggling to raise them. Perhaps you will recognize familiar signs in the child you know. Whether sensory processing differences are major or minor, the child who is out of sync needs understanding and support, for no child can overcome the obstacles alone. Tommy Tommy is the only son of two adoring parents. They waited a long time before having a child and rejoiced in his arrival. And when they finally got him in their hands, they got a handful. The day after he was born, his wailing in the hospital nursery kept the other infants awake. Once he arrived home, he rarely slept through the night. Although he nursed well and grew rapidly, he adamantly rejected the introduction of solid food and vigorously resisted being weaned. He did not welcome cuddling; in fact, he seemed to hate it. He was a very fussy baby. Today, Tommy is a fussy three-year-old. He is crying because his shoes are too tight, his socks too lumpy. He yanks them off and hurls them away. To prevent a tantrum, his mother lets him wear bedroom slippers to school. She has learned that if it is not shoes and socks that bother him, it is inevitably something else that will trip him up during the day. His parents bend over backward, but pleasing their healthy, attractive child is hard. Everything scares him or makes him miserable. His response to the world is "Oh, no!" He hates the playground, the beach, and the bathtub. He refuses to wear hats or mittens, even on the coldest days. Getting him to eat is a trial. Arranging playdates with other children is a nightmare. Going to the barbershop is a disaster. Wherever they go, people turn away-or stare. His teacher reports that he avoids painting and other messy activities. He fidgets at story time and does not pay attention. He lashes out at his classmates for no apparent reason. He is, however, the world's best block-builder, as long as he is not crowded. Tommy's pediatrician tells his parents nothing is wrong with him, so they should stop worrying and just let him grow. His grandparents say he's spoiled and needs stricter discipline. Friends suggest going on a vacation without him. Tommy's parents wonder if yielding to his whims is wise, but it is the only method that works. They are exhausted, frustrated, and stressed. They cannot understand why he is so different from other children. Vicki Sweet Vicki, a pudgy first-grader, is often in a daze. Her response to the world buzzing around her seems to be "Wait, what?" She does not seem to see where she is going, so she bumps into furniture and stumbles on grass. When she tumbles, she is slow to extend her foot or hand to break the fall. She does not appear to hear ordinary sounds, either. Other six-year-olds may have developed the sense to stop, look, and listen, but Vicki is different. She needs a lot more sensory input than they do to catch on and catch up. In addition, Vicki fatigues easily. A family outing or a trip to the playground quickly wears her out. She says with a sigh, "You go. I don't want to. I'm too pooped." Because of her lethargy, her parents find that getting her out of bed, asking her to put on her coat, or maneuvering her into the car is an ordeal. She takes a long time to carry out simple, familiar movements. In every situation, it is as if she is saying, "What does that sensation mean? How am I supposed to use it?" Nonetheless, she wants to be a ballerina when she grows up. Every day she sprawls in front of the TV to watch her favorite video, The Nutcracker. When her beloved Sugar Plum Fairies begin to dance, she hauls herself up to sway along with them. Her movements, however, do not match the musical rhythm or tempo. Ear-body coordination is not her forte. Vicki begged for ballet lessons, but they have not been going well. She loves her purple tutu but cannot differentiate top from bottom and needs help to get into it. Once attired in tulle, tiara, and slippers, she plops down. She has no idea how to bend her knees in a pliZ or stretch her leg in an arabesque. At dancing school, Vicki usually gets cold feet and clings like taffy to her mother's leg. Vicki's parents disagree on the best way to handle her. Her father picks her up and puts her places-in bed, in the car, on a chair. He also dresses her, as she has trouble orienting her limbs to get into her clothes. He refers to her as his "little noodle." Vicki's mother, on the other hand, believes Vicki will never learn to move with confidence, much less become a ballerina, if she does not learn independence. Her mother says, "I think she would stick to one spot all day if I let her." Although Vicki lacks "oomph" and is definitely not a self-starter, certain kinds of movement will get her on her toes. She becomes livelier after getting into unusual positions-rocking forward and backward while on all fours, hanging over the edge of her bed upside-down, and swinging on her tummy. While she cannot yet pump, she loves to be pushed on the playground swing for a long time-and when she stops, she is never dizzy, as other children might be. Being pushed passively arouses Vicki, as does actively pushing something heavy. Occasionally, she crams books into her doll carriage and shoves it around the house. She volunteers to push the grocery cart and carry bags into the house. She also enjoys pulling her big sister in a wagon. After pushing and pulling weighty loads, she has some energy for half an hour or so and then sinks back into her customary lethargy. At school, Vicki mostly sits. Her teacher says, "Vicki has difficulty socializing and getting involved in classroom activities. It's like her batteries are low. She needs a jump start just to get going. Then she loses interest and gives up easily." Vicki's behavior mystifies her parents. Their experiences with their two other active children have not prepared them to deal with her differences. Paul Paul is an extremely shy ten-year-old. He moves awkwardly, has poor posture and balance, and falls frequently. He lacks the know-how to play, and when he's in a group with other children, he usually watches dolefully or shuffles away. At their grandparents' house one Sunday afternoon, Paul's twelve-year-old cousin, Prescott, invites Paul to play marbles and shoot baskets with him. Paul gives the activities a halfhearted try, shrugs, and turns away. "I can't do that," he says. "Anyway, what's the point?" Paul dislikes school. Sometimes he asks to stay home and his parents let him. He says he does not want to go to school because he's different from all the other kids. He says he is no good at anything, and everyone laughs at him. Paul's teacher notes that he has a long attention span and an above-average reading ability. She wonders why a child with so much information to share becomes paralyzed when he has to write a paper. True, his handwriting is laborious, and his papers are crumpled and full of erasure holes. True, he has a "death grip" on pencils, fixes his elbow to his ribs, and sticks his tongue out when he writes. True, he often slips off the chair when he is concentrating hard on written work. His handwriting skills, she hopes, will improve with more practice. She says he just needs to get organized so that he can pay more attention to his assignments and do neater work. His parents wonder why he is a misfit at school, because he has always fit right into their sedate lifestyle. Paul is a modest child, rarely seeking attention. He can spend hours slumped over his baseball cards, completely self-absorbed. Paul's parents think he is the perfect child. They observe that he is different from other kids, who are loud and mischievous. He never makes trouble, although he is somewhat clumsy, often dropping dishes and breaking toys that require simple manipulation. But then his parents are somewhat clumsy, too, and have come to believe that physical prowess is unimportant. They are glad that their son is quiet, well-mannered, and bookish, just like them. Something, however, is getting in his way. His parents have no idea what. Sebastian Sebastian, eight, fidgets constantly. At school, he riffles book pages, twiddles with markers, taps rulers, and snaps pencils. He clicks his teeth and chews his collar. Sebastian's eyes dart, knees bounce, feet tap, and fingers flap his earlobes. He tips his desk chair way back and then brings it forward with a jolt. He squirms in his seat, sitting on his feet or squeezing his knees to his chest. He jumps out of his seat every chance he gets to sharpen his pencil or pitch a wadded paper toward the wastebasket. His nonstop activity distracts his classmates and teacher. He used to twirl the lanyard with his latchkey around his finger. Once he let go accidentally and it whirled across the room and hit the window. Now he hands the lanyard over to his teacher every morning so it won't annoy or hurt anyone. Every child seeks sensory stimulation, but Sebastian's craving for sensations is different. "More, more, more!" He is the child who has "gotta touch" and "gotta move," even when it should be clear that touching and moving at that moment is inappropriate. One day the teacher is preparing a science lesson. She lays out white glue, laundry borax, and water-the ingredients to make a pliable substance called "stretchy gook." Sebastian is interested and hovers nearby, twitching his fingers and hopping from foot to foot. The teacher says, "Please don't touch a thing until the other kids join us," but he reaches forward and knocks over the bottle of glue, spilling it across the table. "Sebastian! You did it again!" the teacher says. "I didn't mean to!" Sebastian cries. He shakes his head vigorously and jumps up and down. "Oh," he moans, "why do I always get in trouble?" "Oh," moans the teacher, mopping up the mess, "what shall I do with you?" Why are Tommy, Vicki, Paul, and Sebastian out of sync? Their parents, teachers, and pediatricians do not know what to think. The children have no identified disabilities, such as autism, cerebral palsy, or impaired eyesight. They seem to have everything going for them: they are healthy, intelligent, and dearly loved. Yet they struggle with the basic skills of managing their responses to ordinary sensations, of planning and organizing their actions, and of regulating their attention and activity levels. Their common problem is SPD. Excerpted from The Out-Of-Sync Child, Third Edition: Recognizing and Coping with Sensory Processing Differences by Carol Kranowitz All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
