In Chapter 17 (Growing perceptual sensitivity) I made a firm link between difficulties with perceptual sensitivity and insecure attachment; however, insecure attachment isn’t the only reason for such difficulties. Some children who are securely attached still have difficulties with their senses. This was something originally identified by occupational therapist Dr Jean Ayres. She found there to be three groups of children whose sensory perceptions were faulty in quite different ways.
Best known are the children for whom the world is brighter, louder, busier, harder, sharper, steeper and smellier. It is hard to regulate yourself if that is your world. It is hard for parents to feel confident when handling or playing with such a baby. In fact, the biggest impact this kind of sensory difficulty may have is that the bond between parent and child is damaged. These children have a ‘defensive’ response to stimulation.
Often these defensive children grow into children other people describe as ‘difficult’ or as a ‘Mummy’s boy or girl’ or ‘with poor social skills’. Only their parents know a very different child because, at home, these children don’t need to defend themselves against unexpected sensations. But away from their home, life can be very hard. I remember hearing of the behaviour of one poor little boy who had an over-the-top defensive reaction to sound at his end of year concert. As the rest of his class played their recorders he clapped his hands over his ears and screamed, ‘No, no, no!’ A family friend heard the story, suggested an occupational therapist and he is now finding life far more bearable.
The second group of children, and I don’t think I know a child like this so this description is drawn purely from my research into the subject, have the signals from the world outside mixed in with some internal neurological ‘white noise’ of their own. It’s hard to make sense of a world like that, or to know if you can trust what your senses are telling you.
Finally, there is another group of children who register far less than most of us of the world around them. Touch is softer, sounds are less exciting. These are sometimes the ‘easy’ babies who show a slower developmental rate as there is simply not quite enough information flowing in to grow their brains at normal rates. These children are described as ‘sensorily dormant’. These are children who are ‘surprise’ referrals to occupational therapy at the end of the school year. They are so very compliant in the classroom that it is only when the teacher does her end of year testing that she discovers how little they have learned. These children often have lower muscle tone and less expressive, ‘softer’ faces.
Before starting off exploring the world of the child for whom sensations have unpleasant intensity have some strong coffee. Put on some very warm, scratchy clothes that don’t fit you comfortably. Play some music that you don’t like and turn it up too loud. Make the room too bright. Spray some nasty smelling insect repellent around. Quickly throw some objects on the floor and muss any surfaces if you like things to be neat. Now try rocking forward on your toes and imagining yourself looking down to the floor and finding it a bit further away than you had thought. For these children the world is surreal, disorientating and exhausting; and touch, which usually brings such emotional comfort, is emotionally disruptive. This is the most involved case scenario, a child with most senses switched on to ‘extreme’ sensitivity. For some children just one sense may be affected, while for others it’s a small cluster.
Now imagine a world with far less sensation. It is a dreamier place. Imagine a badly managed day spa with rather cloying scents, where the music is bland and too soft, and the masseur doesn’t ever get to the really sore spots. It’s much harder to feel really alert, really energised or engaged, satisfied and successful. And this is the world inhabited by the children who have only a poor registration of sensation.
The hardest world of all to imagine is the world where children have white noise from their own brain leaking into the sensation coming in from the outside world. I guess it would be like living with a waterfall or a freeway in your head. If you suspect this is the case for your child, I’d recommend seeking specialist attention.
In addition to the bombardment or ‘underwhelmed’ state of their senses, these children also experience great fluctuations in how their senses respond: good days, okay days, bad days. This makes an already difficult situation worse. If you are missing an eye you learn to compensate. But if you have an eye that works some of the time, to no particular pattern, it’s much harder to develop a way of compensating.
So why do these fluctuations in sensory receptiveness occur? And how can parents help children for whom this is an issue? There won’t be ‘no reason at all’, but it might take some figuring out. What we do know is that everyone ‘spirals down’ to a lower level of function under stress. Stress tends to show up first wherever we are already weakest. For these children this is in their brain’s ability to understand sensation. And just about any kind of stress can be responsible. The wrong food, not enough sleep, a growth spurt, a distressing failure, a nasty additive, fighting off a tummy bug: many possibilities must be sifted through to find the reasons for bad days.
Children with both a dormant and defensive response are going to have difficulties learning, attending and behaving. Take the following example of Andrew and Lila.
Four-year-old Andrew screams when he is pushed out of the way by three-year-old Lila. She is running around seeming not to notice the nasty gash on her knee. Observers are all too likely to conclude from watching that Andrew is a ‘wuss’ and that Lila is ‘tough’. And it won’t take long before Andrew and Lila apply those labels to themselves. Working out that sensations differ from person to person requires theory of mind that is beyond most young children, and it is something that some adults have difficulty accepting too.
In fact, what is happening with Andrew is that he can’t make sense of the information coming in from his touch sense. It all feels angry and aggressive and meaningless to him. So he does everything he can to defend himself from experiencing even moderate amounts of tactile information. He’s picky about his clothes: anything textured is experienced by him as rough and scratchy. He washes his hands and face between bites of his honey sandwich as he experiences stickiness as unpleasant and intrusive.
The extra sensory load that Andrew has to deal with means that he has been a poor sleeper since infancy. Even now, every single night, his exhausted parents are unwillingly reminded of the princess and the pea as Andrew finds blankets, sheets, pillow and even his pyjamas can keep him awake or, on bad nights, wake him up.
Generally, an area of discomfort slowly intrudes upon our attention. But Andrew is simply not able to organise touch information into what is important and what isn’t important. He can’t switch any of it off. And because he isn’t able to do that, he has great difficulty learning from his touch sense. Learning to write is going to be very difficult for Andrew as he won’t like to hold a pencil. His parents are dreading the start of school on his behalf as he spends all his time around other kids trying to avoid being touched by them.
Empathising with the sensorily disordered child
It is just so important to get inside your child’s skin if he fits one of these profiles. Without this understanding it’s all too easy to conclude that your child doesn’t like you very much. Such a child might push away a loving hand, cry at the sound of your voice or fail to realise that he has hurt you as he pushes rapidly past. Once in his skin, you can see the vast gulf between the world he perceives and your own, and you can set out to help him normalise his perceptions.
Learning to write is going to be difficult for Lila too, but for the opposite reason. In marked contrast to Andrew, Lila was a good sleeper and pretty much an all-round easy baby. (The words ‘easy baby’ are sometimes a red flag.) She has always amused her parents by her complete obliviousness to temperature. In summer she likes to wear her bright pink gumboots. In winter she would run around naked if she was allowed to. Recently, however, her parents have noticed that she’s rough with other children and animals. She has taken to throwing herself off the bed onto the floor. Even though Lila giggles when she lands, it looks painful to her mum and dad. What’s happening? Lila is beginning to crave much more intense tactile stimulation: her brain is literally starving for sensation.
Her parents are already worrying about her fine motor skills. They have noticed that she has real difficulty doing puzzles that her little sister of two is able to easily complete. Why? Her hands aren’t able to move precisely because she can’t obtain precise sensation from them. She is turning into what therapists call a ‘sensory seeker’. This is a good sign, actually, as Lila is seeking to normalise her dormant tactile system all by herself.
Andrew’s dad is trying to normalise his response to touch by touching Andrew more and ‘getting him used to it’. He wakes him up by tickling him. He lightly messes his hair. Andrew giggles, but also begs his dad to stop. His dad is away for a week, and when he returns his mum says that this has been a much better week for Andrew. He has slept better. He tolerated a smear of honey on his arm while eating a sandwich. He spent a whole hour with his train set by himself.29
The tickling games were triggering a defensive response early in the day, and in their absence, Andrew had a calmer base from which to explore. When Andrew’s dad asks him what games he would like to play, Andrew announces that he would like to be squashed. And deep pressure does have the effect of normalising the tactile system: light touch is stimulating, heavy touch is soothing.
The older Lila’s sister gets, the more Lila’s mum realises something is not right with Lila. Her most recent discovery is that she doesn’t notice odours. Her mother decided to try to get Lila to tell the difference between different smells. By dabbing different smells onto cotton wool she made up a smell box for Lila to try and pick out different smells. Lila couldn’t smell anything on the cotton wool. Her mother then added different essential oils to the floor of the shower every night: eucalyptus, spearmint, orange. Within a week Lila was saying that the smell was, ‘A bit strong’. Soon afterwards, she found Lila ‘feeling’ different textures with her face. Often the olfactory or smell sense has to come online before the other senses wake up.
The ways that Lila and Andrew behave, although likely to impress the observer as ‘poorly parented’ or ‘naughty’, are only to be expected in children with perceptual difficulties. For Andrew touch information is so overwhelming that it amounts to torture; for Lila, even quite strong sensation is barely registering. And the same child can have both experiences in different sensory domains.
Listed below are questions to help you identify if your child has difficulties organising or receiving sensory information. The questions begin at the infant or baby stage and move on to older children.
Defensiveness:
Did my baby have colic starting at one to two weeks of age?30
Did my baby get very distressed when I lay him down for nappy change, even vomiting in response to being laid flat?
Did my baby ‘startle’ frequently to position changes after four months of age?
Was my baby irritable after six months of age?
Was my baby late to sit (after ten months) and late to crawl (after one year)?
Does my child dislike balancing games, such as walking on garden walls, jumping off steps, being up high on Dad’s shoulders?
Does my child dislike climbing, possibly even on the furniture, but certainly on climbing frames?
Does my child get carsick or sick from any other movement experiences?
Is my child clingy? (This behaviour looks similar to the ambivalently attached child, but it occurs only in new, busy settings, or when the child is asked to climb, jump or balance. If your child is made anxious by new experiences rather than being ‘anxious in general’, suspect general sensory issues.)
Does my child have poor organisational skills, battle with ‘reversibility’ in mathematics and get lost around the school grounds?
Dormancy:
Was my child an easy baby?
Was my baby slow to reach movement milestones such as sitting (after 10 months), crawling (after one year) and walking (after 18 months)?
Does he jump recklessly off high places and seem generally ‘brave’ but at the same time also have poor balance?
Does he spin or twirl obsessively without ever getting dizzy or having his eyes show the classic nystagmus eye movement where the eyes keep moving after the spinning has stopped?
Is he having difficulty moving his eyes along a line of text?
Defensiveness:
Does my baby find it difficult to focus for even a minute on my face at 10 weeks?
Does my baby prefer to look at my mouth rather than my eyes?
Does my baby not show the sustained looking behaviour that normally appears before six months?31
Does my baby get upset when there is a change in someone’s appearance, such as when they change their hairstyle?
Does getting too many new things upset my child? (Most babies and toddlers love new things.)
Do too many bright lights, flashing signs and so on, upset my child?
Does my toddler or child complain of headaches?
Do words and pictures seem to ‘jump’ according to my child?
Does my child complain of headaches after reading, watching television or using the computer?
Do fast movements around my child seem to leave him feeling disoriented?
Does my child avoid eye contact?
Dormancy:
Did my baby not really pay attention to the world around him?
Did my baby refuse to spend time on his tummy, preferring strongly to be on his back?
Did my baby have poor tracking skills and not watch me walking around the room?
Does my child find it difficult to remember what he has read?
Does he strongly prefer playing with ‘big toys’ like rockers and tricycles to playing in sandpits and with puzzles?
Does my child trace letters in order to recognise them? (Don’t stop him from doing this, he is scaffolding his visual sense with his proprioceptive sense. This might be a helpful pattern for you to copy.)
Was your child late (after three years) to identify colours?
Defensiveness:
Did my baby’s skin change colour or did he startle to unexpected and new smells?
Does my child comment on smells as ‘horrible’ that seem quite mild to me?
Does he refuse to eat some foods on the basis of their smell?
Dormancy:
Does my child seem unaware of even quite strong smells?
Would he even eat or drink something poisonous, having not felt warned by its ‘chemical’ smell?
Research shows that parents often underestimate their child’s degree of tactile defensiveness. If your child is old enough and you think this may be a concern, you might like to ask him how touch affects him.32
Defensiveness:
Did my baby find transitions difficult: such as taking clothes off or putting them on, or getting in or out of the bath?
Was my baby hard to get to sleep and hard to keep asleep, with irregular sleeping patterns?
Did my baby resist cuddling, fuss, cry and seem generally ‘colicky’?
Did my baby have difficulty breastfeeding?
Do I sometimes feel rejected by his moving away from my touch? And even now, cuddles have to be on his terms?
Or is he now almost ‘sticky’ in his need for physical affection and contact? (This means he’s beginning to normalise his touch system.)
Is my child very aware of what is touching his skin: disliking lotions, labels, sock seams, high necklines and some materials and ‘feeling’ temperatures more than most children?
Is my child very fussy about textures and the temperature of food?
Does he hate haircuts and face washes?
Does my child have a substantial personal space that he defends against siblings and classmates?
Does my child prefer baths to showers?
Does my child’s teacher say that he can’t concentrate in class (but you find this difficult to believe as he concentrates for long periods at home)?
Does my child insist that stickiness (such as glue and honey) on his fingers has to be washed off straight away?
Are his fine motor skills poor?
Are my child’s social experiences tainted by his need for personal space and ‘moodiness’, and is he perceived by others in consequence as aggressive?
Is his self-esteem a concern for me?32
Do people often ask me if my child has ADHD?
Dormancy:
Was my baby placid even during immunisation injections?
Does my toddler or child seem not to feel the temperature — hot or cold — or cuts and grazes?
Is he an ‘outside boy’, preferring to play with big toys rather than toys that demand fine motor skills such as Lego and jigsaw puzzles?
Does my child sometimes hurt other children accidentally but seem quite unaware that the contact would have caused them pain?
Does he seem to need more sleep and generally have lower endurance than other children?
Is his self-esteem a concern for me?29
Defensiveness:
Is my baby particularly distracted from face-to-face joy interactions by sounds, even slight ones from a fridge or clock?
Is my baby or toddler frightened by and inclined to cry at noises that he should have become used to, like the vacuum cleaner?
Do electronic toys that suddenly make noises upset him?
Does my child talk a great deal, and especially when I want him to listen to me? In fact, does he seem to actually be talking so as to avoid having to listen to me?
Does my child seem to be hypersensitive to very high pitch sounds and disharmonies and have a strong preference for mid-range sounds, like those made by the cello?
Are special sounds or music required as part of the settling down to sleep routine?
Dormancy:
Is my baby placid in the face of new and startling sounds?
Did my baby not really have a ‘babbling’ stage?
Is it hard to get my child to attend to what I say?
Even if my child seems to have been listening, does he then forget most of what was said? (Children should only be expected to follow three-stage instructions at six years of age.)
Was my child late in talking? Children should have a few single words at one, two-word phrases by two and be talking very much like an adult at three.
Does my child not make noises to match his game — no ‘brooming’ for trucks or ‘zooming’ for aeroplanes?
Does my child find it hard to retell familiar stories at six years of age?
Defensiveness:
Does my baby feel a bit ‘stiff’ to cuddle, as though he is holding himself a little rigid?
Did my baby not enjoy movement experiences like the ‘kick kick’ game, perhaps freezing when his body parts were moved by others?
Did he not enjoy jolly jumpers or being bounced by me?
Is my child bothered by other children bouncing and jumping around, tending to freeze and cling to me under such circumstances?
Is my child ambidextrous, swapping hands halfway through a task?
Does my child loathe going down slides and walking down stairs, or travelling in lifts and on escalators?
Does my toddler panic when a shirt is put on over his head when dressing?
Is my child a perpetual motion machine, seeming to feel a bit ‘lost’ when he’s made to be still?
Dormancy:
Does my baby feel a bit floppy to cuddle, as though his joints are a little looser than they should be?
Does my toddler seem to struggle with moving from one position to the next?
Is my child a crasher, seeming to enjoy walloping into walls, people and the floor?
Is he a thumper who really enjoys banging things together?
Does my child struggle to grade the amount of strength required for a task? Does he pat dogs too hard, hold his pencil too tightly, inadvertently hurt other children and animals in rough play or grind his teeth?
Does my child find it hard to learn new movement skills, particularly ones requiring fine finger movements (doing up buttons, using a knife and fork)?
Does my child have difficulty feeding himself, missing his mouth even with finger-feeding? (A child should be able to feed himself by 14 months.)
Does my child get fatigued faster than other children?
Does my child particularly like wearing tight, heavyweight clothes?
Does he seek out heavy work activities?
Is my child a ‘bit flabby’ even though he isn’t overweight, or is he overweight with noticeably poor muscle tone? (Children with dormant proprioception are at greater risk for obesity because they find less meaning and pleasure in movement — it doesn’t give them that ‘rush’ of oxytocin, and so they tend to move less.)
Sensory systems can be normalised. Even when therapists are involved it is parents who do most of the work. In fact, the work of therapy sometimes builds a bridge between parent and child, and in such cases it is the repaired relationship that may make the biggest contribution to a child’s better sensory perceptual skills. It certainly stands up to examination when you consider the mother’s role in building her baby’s perceptual skills in the first place.
Start by observing your child. What always gets his attention? Is it the ticking clock, the bird flying past, the smell of food? What kind of sensory information most destabilises him? This is likely to be his most ‘hyperactive sense’, and the one you need to be most wary of overloading. What kind of information is he most likely to miss: smells, tastes, sights or sounds? What information does he process most easily? Once this is identified you can work from this strength. The senses feed each other confirmatory information, so the strongest sense can be used to help organise any sense that might be dormant (under-active) or defensive (far too active).
Observe what your child does to calm himself down and which sense he uses to do it, particularly at the end of a school day. Does he move, does he sit and read a book, does he sing or talk to himself? Equally, observe what he does to ‘ready himself for action’, to focus better. Never intrude on such times as he is building self-regulation skills. Make a mental note so that you can ‘scaffold’ him by providing such time regularly in his day. Just as for babies, it’s important for brain growth that your child spends most of his day ‘well-regulated’ rather than dysregulated (feeling ‘out of kilter’ both emotionally and physically).
With this information, deliberately set out to engage with your child as closely as you can. If you have a ‘defensive’ child and you are a spontaneous and exciting kind of parent, this may mean changing your way of relating to him. These children need predictability, slower movements, softer, slower voices. Shouting at an auditory defensive child, for example, is going to distress him rather than help him to comply. Most mothers with children like this actually use soft, almost whispery voices. In general, these children need just ‘one channel of information’ to be stimulated at a time, so try to avoid moving, touching him and talking all at once. Your overall goal is to ‘dampen down’ his need to defend himself against the world, to help him reduce his need to defend himself so he can open up enough to take in information and begin to organise it.
Some gifted children also present very similarly to the defensive child, and, of course, there is going to be some crossover. Children do not fit into neat categories. (There is an excellent free internet resource on giftedness. Type GERRIC into your search engine and then choose the DEEWR Professional Development Package for Teachers.)
The creative or gifted child who displays Dubrowski’s ‘over-excitabilities’ — the hallmarks of giftedness involving talking at a great speed, jiggling madly with excitement, imagining whole forests of wild ideas — is equally likely to feel bombarded by sensory stimulation. This is not due to problems with sensory perception but from a heightened response to what they perceive. The environmental management ideas discussed below may be useful for helping gifted and creative children, but it is important to recognise that for these children this ‘over-excitability’ is part and parcel of their temperament. Help them find ways to order and use sensory information, but also accept that they will still whirl like a dervish when a new dinosaur is discovered.33
Defensive behaviours are also a feature of autism. If a child shows these defensive responses to sensations and also is not responding to his name or responding to your emotions and prefers objects to people then you need to suspect autism and get a professional opinion very quickly. (If you’ve read the description of the development of empathy and theory of mind in parts Two and Four, and thought, ‘This isn’t my child’, again, I would recommend a visit to a paediatrician.) Early intervention with autistic children helps tremendously.34
If you have a child who fits the ‘dormant’ profile most of the time, and your own style is equally low key, you may need to develop a higher energy way of relating to wake him up to the world. You may find that he has one sensory channel that is more alerting, and you can use this to prompt him into really paying attention.
And from there you can begin playing the kind of games that help normalise sensory systems. The rules are simple: make sure it is fun and follow your child’s lead. Never push; never force. When a parent pushes a child and they become overwhelmed by sensory information it is not just bad for the relationship, but for the child’s growing brain. And to speed up learning, it has to be fun. Keep the oxytocin flowing with lots of laughter.
The ideas listed in the following pages are intended to be a general guide and a good starting point. Once you know what you are looking for you will find that together you and your child generate the most satisfying and therapeutic games.
Start by checking whether your child has a physical problem such as an ear infection, because the vestibular nerve runs through the ear. Play games that build the vestibular system: rocking, rolling, twirling. The same games are used to ‘normalise’ sensation in dormancy and defensiveness.
Play rolling games like ‘There were four in the bed and the little one said, roll over, roll over’. Help your baby or child to roll, starting with quarter rolls and then back again.
Encourage hanging upside down. When your baby has good head control, sit him on your lap, then lean back a little and bring him upright again. With an older child, encourage him to swing sitting up on a bar, and then slowly encourage him to hang upside down with his eyes closed. Two old tyres hung closely together on a rope will allow your child to lie inside them and twirl. This normalises the vestibular system as it mimics the time spent in that position in the womb. Your child must be in charge of the movement. If you force the twirling or spinning you will make him feel very ill and worsen the situation.29
Holding your baby close, dance in a rocking motion to music with a steady beat. Rock an older child over a gym ball, with him in charge of the rocking.
Sing to your baby, or sing with your toddler. Whatever stimulates the ear will also stimulate the vestibular nerve, so sing, sing, sing!
Rockers, seesaws, gym balls, scooter boards, barrels and giant saucers are all excellent for this purpose. The static playground equipment is not recommended for children with vestibular difficulties as it doesn’t re-create the early experience of being rocked by Mum as a baby.
How do you know it is working?
Initially there may be a brief regression to younger behaviour. You will know things are getting better when you see the flicker of nystagmus (eyes keep moving after the spinning has stopped) starting; and when the child takes over the therapy and spins, climbs, rocks and takes ‘balance risks’ of his own accord.
First of all, have your child’s eyesight and eye health checked.
Bear in mind that visual difficulties increase the likelihood that your child could be injured by a ball. Consider protective eyewear for sport.
Make the environment as visually simple as you can. Think about keeping the number of toys out at any one time to a minimum: the one toy for each child rule is very useful here. For both defensive and dormant children you are aiming to increase visual attention: to ‘tolerate’ looking for longer periods and to sharpen focus.
Find a noisy and intriguing toy that your baby loves, such as a flashing star on the end of a wand, or a rattle, and play ‘Where’s it gone? Here it is!’ games.
All games where your child gets the opportunity to track a moving object with his eyes are great. Encourage your baby to watch it move around the room. Roll balls and have your crawler chase them.
Lie a child on his back and have him swipe at or try to catch a suspended object or even your hand. This game gets very giggly.
Toys that operate by blowing and blowing bubbles are great for helping children focus close up.35 For older children play ‘puff ball’ with straws and a ping pong ball — on a flat surface the children must blow the ball through the straw towards a goal. This is also a game you can play in teams — a team must defend their nominated sides of a table.
Combine vestibular and visual stimulation by playing catch and throwing while a child is swinging, or grab playfully at baby’s feet while someone else moves him.
Books that have pop-out bits, books that make noises and books with different textures all encourage looking and touching and listening, which supports the development of visual attention.
How do you know it is working?
You will feel that your child is paying far more attention to you and that you are more strongly and deeply connected to him. You will also see an improvement in his length of attention.
The ‘smell’ part of sensory problems is a surprisingly important marker of dormancy or defensiveness. Barbara Knickerbocker, the occupational therapist who sorted children into ‘dormant and defensive’ felt that it was the first system that needed to be normalised for children who also had auditory and tactile issues.29 While this might sound rather extraordinary, the value of smell to improving mood, attention, planning and alertness is now well researched.36, 37 In addition, children with ADHD have been shown to have ‘sharper noses’ than their peers. The significance of this is unclear, but perhaps it is another example of where therapists have been significantly ahead of the research in simply doing ‘what works’.38
Create ‘smell match’ games. You could use essential oils such as lavender and eucalyptus to dab on your child’s soft toys, but make sure the oil has dried before the child is given them to play with. Then challenge him to match his toys according to smell. You could also try scratch and sniff stickers or create ‘smell jars’ (small jars into which you have put herbs or spices or essential oil or dish detergent or perfume — anything that smells.)
Ask your child to guess what’s for dinner based on the smell, ask him to hunt out a smell in a room (hide a teddy that has been liberally doused in essential oil) and talk about smells with him.
How do you know it’s working?
The dormant child will become aware of smells and the defensive child will not be so affronted by them. But you should also see improvements to his tactile and auditory sensory issues.
Skin conditions like eczema can also cause defensive behaviours, so finding the right treatment for your child’s eczema is important for learning and social experiences too.
When interacting with a child with a touch disorder, always stay in front of him so he can see what you are doing.
Light touch is the most uncomfortable for the defensive child and won’t even impact on the dormant child. Heavy touch engages the other senses as well and so helps to normalise the touch system. Games that involve your child being squashed, squeezed and squished work extremely quickly, sometimes instantaneously. This is perhaps one of the most ‘magic’ experiences you can have with sensory therapy: a child who had been very uncomfortable in their skin becoming visibly more calm every second. It is hard to forget one boy with tactile dormancy who enjoyed having a gym ball rolled over him and asked for it to be made heavier and heavier until he finally begged both the therapist and his mother to sit on the ball together. ‘Aaaah!’ he said, as though relieved of a great weight rather than lying beneath one, because, finally, a touch sensation had registered.
Start with finding the kind of touch your child enjoys and supplying it. Before bed is a good time, as sleeping difficulties come with the territory. It might be heavy touch (weighted blankets or pyjamas, heavy rolling with a gym ball, heavy compression down through the shoulders) or it might be hard touch (having their body and limbs brushed with a hard hairbrush or rubbed firmly with a rough towel). With the dormant child, brushing is good place to start: for the defensive child, however, it could be torture.
For the defensive child introduce the more challenging kinds of touch experience as ‘fun’ and pull back as soon as he requests. He will simply become more defensive if you do not. Finger painting with paint, foam or coloured glue is a good place to start, as is sand and water play, play dough and textured play dough.
Trying to reduce defensiveness to touch around the mouth usually needs to wait until last. Games that involve blowing (like blowing bubbles and straw paintings), sucking (trying to suck up different kinds of drink) and chewing are all helpful because they all encourage increasingly precise movements to build better sensation.
How do you know it is working?
As the touch system normalises children ‘stuff in’ as many tactile experiences as they can, just in the same way the eight month old does. It’s catch-up time! You may also notice changes to the way the child relates to others. For example, it can be a time of upheaval in class pecking orders (and even within families) as the child is more able to claim ‘equal rights’ with other children.
Start by ensuring that his ears are healthy, as ear infections and hearing loss can lead to these same behaviours.
Use a soft and calm voice to speak, and keep the environment mostly quiet. For the defensive child this will reduce the chance of a defensive response and for the dormant child it will assist him to pick out and focus on the sounds you want him to hear.
Put him in charge of the noise. Let him bang away on the pots and pans, make scraping sounds with a shovel, sing songs with him where he gets to ‘turn the music up or down’, and hammer or jump on bubble wrap.
Use books with ‘sound buttons’ to stimulate listening and remembering.
Put music or sounds (like white noise or wave music) into his going to sleep routine.
Talk about sounds with him as they happen, like birdsong and vehicle noises. Play games where you try and pinpoint just where the noise has come from, and then see if you can work out together what made the noise. Finally, play games to do with the sequence in which noises happen. (This is the normal developmental sequence — where is it, what is it, what’s the order in which it happened.) Some of the sound remembering games could include:
singing nursery rhymes with one line missing and asking your child to spot what was missing. (Further refinements here including missing just one word or eventually just a sound.)
making ‘mistakes’ when reading well-known books. Start by missing out words at the end of rhyming sentences, as they are the easiest to spot
playing tapping games where you copy your child’s rhythm and he copies yours
making up barrier games together, such as making up two sets of cards which can be put together to create different pictures: for example, an ‘identikit photo’ kit, or a garden or a beach scene. One person gives a set of instructions and the other person has to try and remember all the instructions to re-create the same picture
remembering and retelling jokes to build memory and rhythm, which build an awareness of movement through time and space.
How do you know it is working?
As your child improves his auditory skills, he will begin to use them in everyday life. He will refer to his favourite stories and music. In independent play he will begin to make more of the zooming and brooming noises and also ‘voices’ for his toys. He will be able to remember and act on more of what you say.
Again, the same activities work to help both the defensive and dormant child. The proprioceptive receptors are deep within the body, in our joints and muscles. They are activated by being stretched or squashed by movement, or by carrying heavy weight. So therapy to normalise children with problems in this area requires these elements.
From my observations there appears to be more and more children with proprioceptive difficulties. It seems logical to link that increase to the decreasing amount of time children spend in heavy work or even heavy play. Toys are mostly made of lightweight plastic. Trampolines have been replaced with indoor play stations. Parents need to deliberately return these elements to children’s lives.
Rock your baby from side to side or compress his shoulder joints gently when he is rocking backwards and forwards preparatory to crawling.
Encourage children to wear a weighted backpack or even a weighted vest.
Wrap your child up tightly in a sheet or blanket and then play that he is a caterpillar hatching from a cocoon or a dragon hatching from an egg made of heavy pillows.
Make objects your child likes to shift heavier — for example, tape phone books under chairs.
Play wheelbarrows and wheel your child along.
Encourage your child to push back against your hand with his feet or his hands.
Play ‘Angel in the Snow’. Just as it sounds, this game is one where your child lies on his back in the snow, and by moving his arms and legs makes a shape that looks a great deal like a winged and skirted angel. There is no snow in most of Australia, but this game can be played on any surface to build body awareness in children from about five upwards. Ask your child to lie on his back. Help him get absolutely symmetrical, his legs together, his arms down by his sides. Now ask him to move one leg, keeping it pressed to the ground and moving it out to the side. And then bring it in again. Now an arm, keeping it on the ground but sweeping it around all the way to above the head, and then back down again. When your child is able to do these movements easily and return to a symmetrical position, ask him to do two or three or four together. You can then start asking him to move his right leg and left arm. And then in different combinations. Finally, ask him to do various combinations with his eyes closed.
Delay teaching handwriting to your child until his proprioceptive system has greatly improved.
How do you know if it is helping?
Your child will begin to seem a lot more comfortable in his skin and, as a result, in himself. Rather than missing many environmental cues, or being made timid by them, his movements will seem less at odds with the events around him.