Development Health issues Worries: sensory integration sensory processing textures
by Finisterre
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Sensory issues - problems with textures
It seems that quite a few ex-prems develop sensory processing and integration disorders - some need a lot of sensation to keep them happy (sensory-seeking) and some find sensory input overwhelming (sensory-sensitive or sensory-avoiding). I’m sure it’s not just a premmie issue, but it does help make sense of what can otherwise seem like odd behaviour in a toddler. You can read more about sensory issues here.
Recently I responded to a request on a prem forum for suggestions about how to help a child who struggled to deal with certain textures, with the following:
We had an OT visit us for 6 weeks in late 2008 (when Talia was nearly 18 months corrected) as part of the Play and Learning programme, and she did some work with textures. Some things Talia coped with, other things she would not go near, she was sensory-sensitive or sensory-avoiding. Here are a few of the things the OT did which you could try:
1. Put a mix of different dry pasta shapes in a big bowl or plastic tub, and then put in some of your child’s favourite small toys (semi-hidden), so that they have to fish through the pasta to get the toys out. Also works with popcorn, bits of packing foam etc.
2. Invest in or borrow a water table (or sand & water table), and spend some time putting things in and out of water, pouring, splashing etc. This was a huge hit with Talia, and lead to her picking up “wet” things like cut fruit which she had previously refused to touch. The OT also brought shaving cream to put in the water table, we found Talia disliked that almost as much as she liked the water but it may have also been the smell of it. We subsequently bought our own water table and it has been one of her favourite play activities since, even in the middle of winter she wants to play with it!
3. Vibration. We had a cat’s toy which the cat never liked, a little fake mouse with a string you pull to make it vibrate across the floor for the cat to chase. We would pull the string then give it to Talia to hold while it vibrated, to get her used to a different sort of stimulation. The OT had a different toy which had the same effect but it wasn’t as cute as our mouse!
Good luck and I hope you see some improvement over time as your child gets used to different textures and sensory experiences.
Fine Motor and Play Activity Ideas for 12 month olds
I found another of those handouts from the OT department of the State Child Development Centre! Again this is not specifically for prems but just gives some ideas of things you can be doing with your child. Don’t panic if your baby’s development is delayed at this point, Talia wasn’t doing many of these things at 12 months corrected, but she caught up the following year. And if you need help at this point, KEMH will refer you on to physio etc after your 12 month corrected check up - or you can go private if you don’t want to wait that long.
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Babies learn through exploration about themselves and their surroundings. By 12 months old most children do things over and over again becuase that’s the way they understand how things work. Doing things repetitively also builds their confidence and strengthens the connections in their brain’s development.
Their individual personality will favour some types of play more than others. Follow your child’s lead in this, by giving choices within the playtime.
Their memory skills are also developing so they know that when you leave, you still exist and they know they don’t want you to go. This is why babies often get upset when you are out of sight.
At 12 months old (corrected age/full term) babies can usually do most of the following:
Play/Social Skills
- indicate wants and show toys
- show affection to familiar people
- show likes/dislikes and test parent’s reactions
- simple imaginiateive play - likes repetitive play
- explore
- start of no - resistive phase
- wave bye-bye
- know name and simple commands with gestures
- clap hands in imitation
Fine motor/perceptual skills
- pincer grip and poke with index finger
- stoop and recover objects
- show preference for one hand
- imitate scribbbling by end of 12 months
- variety of positions - sitting, crawling, standing - walking
- good visual memory noticing details
- aware of ends and means
- not mouthing objects as much
- post objects
- supinates forearm (ie can move hands to be palms up)
- voluntary release ie throws objects
- builds tower of two blocks
- removes pegs
Activities of Daily Living
- finger feeds
- holds spoon
- drinks from cup (held)
- co-operates with dressing
- sleeps 12-14 hours and naps
Activities that encourage Play & Development at 12 months
- push along toys
- toys that pull apart eg blocks/nesting/stacking toys
- large puzzles
- ball skills with large ball
- shakers
- hide and seek; peek-a-boo play
- screw toys
- pointing and looking at pictures in books together. Understanding the names of familiar objects in books
- action rhymes
- simple pretend play eg puppets, simple dress ups (eg hat on head), cuddling a doll, kissing a doll, feeding teddy or mummy, play “ta” games
- mirror games
- posting toys
- crayons for scribbling
Published by the Occupational Therapy Department, State Child Development Centre 2007
Talking with your child (if they are using words)
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- Respond to all your chidl’s attempts at communication (ie interpret all the time eg if s/he says “eeeurgh” and you know think that means s/he wants a ball, respond as if they had asked you for a ball)
- Use lots of new words. Repeat the new words.
- Keep it simple. Use short sentences (2-3 words).
eg Here’s teddy. Nice teddy. Give teddy a hug.
eg It’s hot. Don’t burn. It’s hot. Too hot.
- Keep it fun! Add new animal sounds. Continue songs, rhymes and games. Share lots of books.
- Use gesture (body movements) as well as words.
- Try not to correct how they are talking - it will improve with practice.
- Speak more slowly and a little louder than usual.
Later:
- Expand on what your child has said - follow their focus and add new words.
- Explain why they can and can’t do things in simple language
Sensory Processing
SENSORY PROCESSING
Sensory processing involves the registration, organization and modulation of different kinds of sensations entering the brain at the same time. It relies on the brain having an intact modulation system to attend to relevant information and inhibit (dampen down) other irrelevant information.
Most people are aware of the main five senses which give us information about what is happening in our environments. They are the senses of:
• Touch
• Taste
• Smell
• Hearing
• Sight
However, there are also two other senses that provide us with information about what our own bodies are doing. These are the senses of
• Movement (vestibular)
• Body position (proprioceptive)
When children have sensory processing difficulties (usually identified by an Occupational Therapist) it can affect things like their attention, fine motor skills, gross motor skills as well as how other children and adults perceive them.
How does sensory processing work???
Each of the sensations mentioned above have receptors within our bodies that register sensory input, for example, our receptors for touch are located within the skin, our receptors for movement are located in our inner ear and our receptors for body position are located in our muscles and joints. Once this sensory input is registered it then travels to the brain to be interpreted. There is never just one form of sensory input being registered, it is usually lots at once e.g. even when we are sitting still there are usually lights on, some sort of background noise and the texture of what we are sitting on etc. Hence the brain needs to sort out what input is appropriate and what is not at any point in time.
For example, if a child is sitting in class and they hear noise in the corridor, they initially attend to it by turning to see what it is, but after a while they will get use to it and are no longer distracted. However, for a child with sensory processing difficulties, if their modulation system is not working properly, the child may continue to attend to this noise even though there are more important things going on in class. This is why children with sensory processing difficulties find it particularly hard to work in a classroom situation as there are lots of sensory distractions.
Problems tend to be at either the registration phase or the modulation phase.
Children with sensory processing difficulties are usually one of 4 types
• Sensory sensitive
• Sensory avoiding
• Poor registration
• Sensory seeking
SENSORY SENSITIVE/DEFENSIVE
This type of child often receives too much information for their systems to cope with. The information is not being registered appropriately and hence is being given too much attention. This type of child comes across as:
• Fussy
• A complainer
• Distractible
• Cannot tolerate being too close to others and may push or bite them
• Cannot tolerate a normal amount of background noise
SENSORY AVOIDING
This child also receives too much sensory input to cope with but actively tries to avoid it. A child displaying these types of behaviours will actively try and avoid too much input by doing things like:
• Covering their ears
• Humming to themselves
• Choosing a quieter place to work
POOR REGISTRATION
This type of child is not receiving enough sensory information (either through the receptors for touch, taste, sound, movement, body position, smell or sight). They need a lot more sensory input than other children in order to concentrate and feel alert. However, they are not the type of children to seek out this input, hence they come across as having/being:
• Poor attention
• Lacking in motivation
• Uninterested
• Withdrawn
• Overly tired
• Apathetic
SENSORY SEEKING
This type of child is also not receiving enough sensory information (either through the receptors for touch, taste, sound, movement, body position, smell or sight). They also need a lot more input than other children to concentrate and remain alert but they do go about getting this input - hence the term SEEKERS. This type of child comes across as:
• Not being able to sit still in their chair at school
• Active
• Fidgety
• Excitable
• Standing close to or up against people
• Hums to self or talks to self during classtime
Development Milestone moments: language development speech
by Finisterre
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She can talk the talk…
(Warning: contains serious mummy bragging!)
What an amazing difference a year makes.
At one corrected (15 months actual) last year, we thought she might possibly be trying to say “cat” - but it was neither clear (”tat”) nor consistent (”tat” sometimes referred to random non-catlike objects) so we weren’t sure.
As it turned out, she was trying to say cat. Since then, her progress has been astounding.
This week we had her 2 year corrected review, and at 27 months of age her results are almost unbelievable.
Language development - 98th percentile for corrected age - 92nd percentile for chronological age, “representing a developmental age equivalent to 31 months for receptive communication and between 37 and 39 months for expressive language skills.”
Things she has said in the past week that made me stop and write them down I was so impressed:
- Oscar sitting on the chair, on the pillow
- There’s another little corn tin
- That’s pretty groovy
- No want Talia’s rocking horse at Mothers’ Group, no want Talia’s rocking horse with Talia’s friends
- Mum draw pink octopus like this octopus
- No want lying down
- No want talk to daddy
- There’s a beetle inside treasure box
- There’s a lizard up on the branch
- Mum washed Talia’s dog and bones ‘jamas
- That’s very good Talia
We have not only caught up with language, we’ve kissed the language delay goodbye and leap-frogged quite a few full-termer friends!