Sensory Integration Inspiration

The new book Love, Jean: Inspiration for Families Living With Dysfunction of Sensory Integration promises to be a treat for anyone interested in DSI. It features letters written by A. Jean Ayres, pioneer in the field of sensory integration, to her nephew, Philip Erwin; Erwin’s own stories about his struggle with sensory integration; and ideas for parents from therapist Zoe Mailloux. Below are samples from each of the book’s three voices.

[The following are excerpts from the book "Love, Jean: Inspiration for Families Living With Dysfunction of Sensory Integration” by A. Jean Ayres, Philip R. Erwin, Zoe Mailloux; published by Crestport Press; May 2004; $15.95US; 0-9725098-1-X. Copyright © 2004 Philip R. Erwin.]

+ + +

A. Jean Ayres Baker
Torrance, CA

October 22, 1975

Dear Phil:

I was delighted to get your letter of October 19 and I found its contents most encouraging.

The fact that you can notice improvement in coordination as a result of the activities indicates that your nervous system can change in a positive direction. If it has changed that much in a few months, it will probably change some more in the coming months. I am particularly pleased with your report of reduced nausea when swinging on the platform swing. That means your brain is modulating the vestibular input better. As it becomes better modulated, you will be able to tolerate more movement; more movement will, in turn, help your nervous system to work better. It is like breaking a vicious circle.

Glad to hear the football is working out well. I don't think I gave you very good directions for using it, but you seem to have done well with what I said. Here is a more explicit set of directions. The objective is to get your brain to send automatic messages to the muscles that make your trunk muscles contract just enough to keep your center of gravity on the ball. I suspect those automatic movements don't come through very automatically with you. You may have to help them by thinking about rotating your trunk a little and consciously doing it when you find yourself beginning to roll to one side, or bending your trunk if you start to go forward or backward. The best way to do that is to first position yourself on the ball so that you are close to being able to balance, then put one hand on the floor. Then try not to use your hand to help you balance, just to keep you from falling off, but try to balance by wiggling your trunk. If it doesn't come naturally, explore movements a little bit by deliberately moving your trunk one way or another to see the effect.

Another way of getting those reactions is by nailing a piece of wood about 2" x 2" on the bottom of a larger piece of wood. Then get on top of the wood on your hands and knees and rock the board back and forth in different directions.

Something else you might try sometime is a jumping board. I don't use one because it is difficult to get one light enough for me to carry around but sturdy enough to hold up. Put a piece of 2 x 4 crosswise at either end of a long, narrow board that has a spring to it, then jump on it. Maybe a 2 x 6 would be better for a 14 year old.

Incidentally, many parents have reported growth spurts as a result of sensory integrative therapy. You might be interested in keeping track of your growth rate.

Blowing on a tin whistle while on the platform swing (which is mostly for balancing rather than swinging) is a good idea. The automatic system often comes in better if the consciousness is directed elsewhere.

Love, Jean

Magical Footwear

By Philip R. Erwin

Change did not occur overnight. Instead I was transformed in several ways over several months. Previously I had viscerally disliked balancing and climbing on things. I spent most of my free time in non-physical, non-competitive activities and private games of imagination. Solitude was fine with me.

One day I got new sneakers. It had been a very snowy winter, meaning that I couldn't spend much time out of doors. One day it thawed and I went outside to play. I picked up my long-unused lacrosse stick and used it to toss a tennis ball against the garage door. To my utter amazement and elation I actually caught it!

I then felt an overwhelming urge to climb the big tree in the backyard. I clambered up it with ease. Great shoes, I thought. But then I felt an urgent need to climb every tree on the large property where I walked my dog. I needed to get on the roof of the garage. I felt compelled to swing and climb on the structures at the playground at the school in back of our house. I needed to ride my bike. For the first time in my life I felt as if I had a physical presence on the planet. For the first time in my life I didn't feel puny. We were well beyond good footwear. Something inside me was changing.

My final year at the prep school was dismal. At every turn I was presented evidence that I was a substandard misfit. But my skills at coping effectively with these assaults were bolstered, I believe, by two things. First, I had been reassured that my failure to thrive in the school was not entirely my fault and was not necessarily my only destiny: hope was evident. Second, I felt better about myself because the therapies I was receiving were enabling me to cope with all of the stimulation — good and bad — in a more organized fashion. The world had gradually become a less hostile place for me. And great changes were on the horizon.

Will My Child Be OK?

By Zoe Mailloux

Some of the common questions parents ask when they find out that their child has sensory integration dysfunction are, "Will it go away?", "Will he grow out of it?", "Will therapy cure the problem?", and similar questions that ultimately ask what the future holds. In reality, all parents worry about their children's future, knowing that accidents, drug abuse, or simply making poor choices can mean the difference between a bright and bleak existence. However, parents of children with dysfunction in sensory integration are right to be concerned about how this "invisible problem" might limit their children's potential.

When a parent seeks and finds help for their child's sensory integration problems, I always feel that half the battle has been won. Clearly one of the most debilitating aspects of these disorders is the fact that they are little known and largely misunderstood. Whenever possible, helping the child to understand what is going on in his nervous system seems to be a positive step. The most common emotion I encounter from both parents and children upon learning about sensory integration dysfunction is relief. A great burden is lifted and there is often a sense of validation when there is a name for a previously confusing and vague condition. In addition, feelings of guilt are commonly alleviated, since parents and children alike often feel at fault for the problem. Well-informed and astute parents help their children a great deal as they learn to recognize how problems in sensory integration function are affecting learning, behavior, skill development, and social interactions.

Dysfunction in sensory integration is often referred to as a type of "inefficiency" of processes that occur in the brain and nervous system. Sensory integration functions typically occur automatically, fluidly, and subconsciously for most people. Some parents become alarmed to think that there might be a problem in their child's brain. However, sensory integration difficulties are not like the problems usually associated with "brain damage" or trauma. In most cases, the structures of the brain and nervous system are probably intact. It is more likely that the "messages" sent from one part of the brain and nervous system to another are not as clear, fast, or complete as expected.

One thing that is well documented about the structures and functions of the brain and nervous system is that they are "changeable," especially in a young person. The word "plastic" or "plasticity" is used to describe this characteristic of the brain. The fact that the brain is plastic allows us to be affected by the experiences we have, especially in early development, in both potentially positive and negative ways. We talked earlier about children whose development was affected by conditions of deprivation (such as in crowded orphanages) and that these children can make great gains when given more optimal developmental opportunities. The same principle is at work for children with dysfunction in sensory integration. They will often need individualized opportunities for experiences that will help their brains and nervous systems send and interpret messages more efficiently.

As important as sensory integration function is, it is still only part of what determines our success or failure in life. Intelligence, personality, drive, temperament, and persistence are all characteristics that will play an important role in whether or not any individual leads a satisfying and productive life. The most important thing a parent can do for a child with a sensory integration disorder is to ensure that this problem does not interfere with that process. This is accomplished by a combination of integration and understanding.

— ZOE MAILLOUX, MA, OTR, FAOTA. Ms. Mailloux is nationally and internationally recognized within the profession of occupational therapy in the area of sensory integration theory and practice. She is currently the Director of Administration at Pediatric Therapy Network, a non-profit children's therapy center serving over 1000 children and their families. She was a research assistant to Dr. A. Jean Ayres from 1978 to 1984 and was involved in many clinical and research projects with Dr. Ayres. In addition, she has published numerous journal articles and textbook chapters on these topics. Ms. Mailloux was the chairperson of the Sensory Integration Special Interest Section of the American Occupational Therapy Association from 1993 to 1996 and was named a fellow of this organization in 1993.

Reprinted from Love, Jean: Inspiration for Families Living With Dysfunction of Sensory Integration by A. Jean Ayres, Philip R. Erwin, Zoe Mailloux; published by Crestport Press; May 2004; $15.95US; 0-9725098-1-X. Copyright © 2004 Philip R. Erwin.

On Impulse Control

by Terri Mauro

"Impulse control" is something of an oxymoron — if it could be controlled, it wouldn't be an impulse. Webster's defines impulse as "a sudden spontaneous inclination or incitement to some usually unpremeditated action; a propensity or natural tendency usually other than rational." If there is no premeditation or rational thought involved in an action, it's unlikely that rules and regulations and punishments are going to have much effect on it, alas. Trying to control an impulse is like trying to put lightning in a bottle.

Acting thoughtlessly is different in that it implies that thought could influence the action. If a child is deliberately acting without thinking, then discipline may be effective. If the child is acting out of hostility, or just can't be bothered with the rules, or takes the easiest way out, or is following a bad influence, or is just overwhelmed by expectations ... then there are obvious behavior modifications to be made, incentives to be offered, consequences to be delivered. But if there is truly no thought at all — if an otherwise good-natured child who wants to follow the rules does things for reasons that appear to confound him or her as well — then you're going to have to get creative.

Truly impulsive behavior can be a matter of brain wiring — the part of the brain where the rules are stored and the part of the brain where impulsive ideas arise communicate poorly or not at all. It can be a matter of sensory processing — a child's sensory defensiveness or need for sensory input is so strong as to override any other considerations. Or it could be a combination, which makes life really interesting. A few books that might be helpful in figuring this stuff out are The Challenging Child by Stanley Greenspan (see the chapter on the Active/Aggressive Child, which deals with impulsivity), The Out-Of-Sync Child by Carol Stock Kranowitz, Raising Your Spirited Child by Mary Sheedy Kurcinka, and Smart Moves by Carla Hannaford.

Truly impulsive behavior will not respond to discipline. All the time outs and spankings and consequences in the world will not change it; you'll only convince your child that he's bad no matter what he tries to do, and you don't want that. About the best you can do is control his environment so that he has fewer opportunities for destructive impulses, and then hope that therapy will improve his brain's ability to sustain acceptable behavior. The books above give many more suggestions than I want to get into here, but on a very basic level: Observe what happens before your child behaves impulsively, and try to avoid that. Does he hit somebody who gets too close to him? Have the teacher put him at the front of the line, or move his desk a little further away, or seat him at the head of a table instead of sandwiched between children. If he acts up in a crowded and noisy situation like the mall, then don't take him there. If he slams doors, hold the door for him. If you know certain things lead to certain reactions, be his brain for him and give him a warning right on the spot.

This is micromanaging, and it's not a lot of fun. But it's more fun than banging your head against the wall trying to control the uncontrollable. Your hope is that with therapy and maturity, your child will either no longer need this or will be able to do it himself.

On Counting to Three

by Terri Mauro

Given the success of 1-2-3 Magic, the popular parenting book by Thomas W. Phelan, Ph.D., many parents have found disciplinary success in giving their child a three-count before delivering consequences for disobedience. Other parents may feel that counting to three is too generous — they want kids to listen now. One warning's plenty. Teachers don't count to three, bosses don't count to three, why should parents? Depending on the child, either of these strategies may be effective ... or disastrous.

Some children may actually need longer than a count of three. An expectation of immediate action is completely unreasonable for them. If you know, or suspect, that your child has a neurological problem that makes it difficult to translate language into action (such as auditory processing, motor planning, or sensory integration problems), you may want to consider giving him a more appropriate time frame in which to do what's asked; that may mean counting, or giving escalating warnings, or setting a timer, or talking him through the transition, or just physically helping him along. Some folks may see this as a sign of weak parenting, but if it results in the thing being done in a way that satisfies both grown-up and child, with a minimum of fuss and argument, I'd say it's just being realistic. Again, I'm not saying this is true for ALL kids or MOST kids; but if you know your child needs extra time to process things, you can't expect them to snap to when you want it.

With my son, who has FAE, sensory-integration problems, and difficulties with attention and impulse control, I've found that giving him a count of 10 will almost always result in him doing what I want. I have no consequence after 10; I've never needed one. It's enough time for him to hear me, understand what I want, disengage from what he's concentrating on, and plan a course of action. He can't do that in 3. He sure can't do that in 1. If he can't do that in 10, he looks me in the eye (which is hard for him) and asks for more time. He never ignores the count.

With time and age and therapy, he is getting more and more able to respond without my having to count. But when he's really concentrating on something, or when the thing I'm asking is challenging to his fine or gross motor abilities, I still give him the 10-count. This is a case where the end does justify the means.

On Adopting Older Children

What to Watch Out for
When You Bring Post-Institutionalized Kids Home

by Eileen Haas-Linde

[Parents who bring older children home from Eastern European orphanages face challenges right away -- if not serious ones like attachment disorder or learning disabilities, practical ones like car doors opening at high speeds and all property becoming community property. Here, a veteran of older-child adoption recalls the little things no one ever warned her about.]

+ + +

Anything with a button will be pushed, repeatedly. (My six-year-old daughter kept pushing the call button for the stewardess on the plane.) They will figure out your VCR and your remote control within minutes.

That also goes for handles. Make sure that the car door is locked, or it will be opened in traffic. She turned on all the burners on the stove. She opened the emergency door on the back of the school bus, while the bus was in traffic! She would just go out the front door if we didn't watch her constantly. Watch them in the bathroom, because they will either not wipe at all, or they will use a huge amount of toilet paper and stop up the toilet.

Put away things that you don't want to be touched. They don't understand "mine." (Or be prepared to see your six-year-old wearing your makeup and your jewelry!)

Do NOT put all of their clothes in their closet. They will not want to wear the corduroy pants a second time if they see a sundress hanging there, even if it is 10 below zero. They will probably have difficulty managing toys with small parts that have to be organized or put back in the box. Try not to let people overwhelm them with gifts.

Kids may be terrified that they won't be fed. Mine didn't understand the process of cooking and that food wasn't immediately available. I had bowls of fruit out, and they would eat eight oranges at a sitting. I had to give my older daughter something to eat (like a chicken leg, or a hot dog) the second that we got home, and then have dinner with us later. Eventually I was able to phase out that extra meal. She even got upset if I stopped for gas on the way home -- she was afraid that I would forget to feed her! And every time we went out, she packed herself a little snack with a drink (even when we went to the grocery store). We did not take them to stores (other than grocery stores) for about two years, seriously. I just bought clothes for them, and brought them home. I even bought shoes in several sizes, and returned the ones that didn't fit. It saved me a lot of aggravation.

Do not be alarmed by aggressive behavior. My daughter had a black eye when she left the orphanage, but she had given some pretty good ones back (it looked like she had managed to get to every boy before she left). It may take a little time for them to realize that is NOT okay here, because it has been a way of life for them for so long.

Finally, don't be afraid to set limits with other adults. Friends and relatives don't understand attachment. I had to take my daughter to work one day, and she was sitting on co-workers laps, etc. You want to try to avoid these situations whenever possible.

I miss those early years. It was like the Wild West, but it was fun!

copyright (c) 2004 by Eileen Haas-Linde