2012年5月31日 星期四

Halloween Fun For Children With Sensory Processing Issues


Halloween parties, costumes, masks, and treats--you can't count on any of these being fun for the child with sensory issues! No wonder October 25-31 was chosen to be National Sensory Awareness Week, drawing attention to the 1 in 20 children who have the hidden disability of sensory processing disorder, also known as SPD, or sensory integration dysfunction. Fortunately, you can make Halloween more enjoyable for the child who struggles with sensory issues.

Costumes and masks often involve new sensations against the skin and body that a child may find repulsive. Experiment beforehand with any make-up, masks, wigs, or hats and see if the child can truly tolerate them for a few hours. For a costume, consider working from the basic pieces of a soft, cotton top and bottom, such as a sweatsuit or pieces of clothing purchased at a used clothing store or pulled from his play clothes pile. Add elements and props that he can hold or wear comfortably. Start looking for a costume early, when the selection is best. Purchase a used costume or costume elements through eBay, second hand shops, and Craigs List to keep your costs down because after trying a costume for a few minutes, your child may realize it is too tight, scratchy, or uncomfortable in some other way.

Treats with plenty of sugar and artificial colors and flavors should be limited for all children, but kids with sensory issues are often more sensitive to these substances. Let her gather all her loot post trick or treating and choose the favorites, then have the rest mysteriously disappear overnight (maybe after using them as math counters!). Or hoard it to use a piece at a time as rewards for overcoming challenges, doing extra chores, or use in therapy. If your child has an occupational therapist or speech therapist, speak to this professional about the possibilities. For example, sour candies in particular can be good for helping a child with poor self-regulation who is stuck in the "loose and floppy" mode to become more alert so she can focus and attend to homework or school work.

If your child has food allergies and intolerances, skip the highly processed, sugary treats altogether. Have a party instead of going Trick or Treating, and provide healthy, fun snacks and nonfood items such as stickers, pencils, and small toys.

Offer opportunities to escape from the noise and bustle of a party or trick or treating. A quieter street to walk down or an empty bathroom or bedroom where she can regroup will help her avoid sensory overload. Let her know what to expect from the occasion, from kids jostling her in doorways and running past her on the street to scary sounds and lighting changes like strobe lights at a Halloween party. And consider celebrating Halloween at a nature center, zoo, or cultural center with a quieter, more structured program, or having a small party at home.

You may want to use this opportunity to talk about fears and how to manage them. Books such as Go Away Big Green Monster by Ed Emberley, featuring a monster the younger child constructs then deconstructs as he turns the pages, can help ease anxiety about monsters and other scary creatures.

And if you do not celebrate Halloween, or your child finds it too scary, consider creating an occasion to give her the "just right" challenge of dressing in unfamiliar clothing and using her imagination to pretend she is someone else for a short time. Costumes and dress-up play encourage young children to break out of cause-and-effect, parallel play and graduate to cooperative, imaginative play, which are important developmental skills. Whatever you do on October 31, please be sensory smart and understanding of your child with sensory issues.

Copyright © 2009 Nancy Peske




Nancy Peske is an author and editor and the parent of a child who at age 2 was diagnosed with sensory processing disorder and multiple developmental delays. Coauthor of the award-winning Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, available from Penguin Books, Nancy offers information and support on her blog and website at http://www.sensorysmartparent.com She has been active in the SPD community since 2002.





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Treating the Sensory Problems of Autism


So what is autism? First of all, we must make some distinctions. There are various types of difficulty within the spectrum of disability of which we are speaking. The major distinctions are as follows:

Autism Asperger's syndrome, Rett Syndrom, Childhood Disintegrative Disorder. The most prevalent and commonly known two of these are autism and Asperger's Syndrome.

What do we mean when we say autism is a 'spectrum disorder?'

When the term, 'spectrum disorder' is used it means that there are a range of symptoms, which can be attributed to autism. Any one individual may display any combination of these symptoms, in differing degrees of severity. Therefore an individual at one end of the autistic spectrum may seem very different to an individual at the other end of the spectrum.

Who first discovered autism?

Autism was first recognized in the mid 1940's by a psychiatrist called Leo Kanner. He described a group of children, whom he was treating, who presented with some very unusual symptoms such as; - atypical social development, irregular development of communication and language, and recurring / repetitive and obsessional behaviour with aversion to novelty and refusal to accept change. His first thoughts were that they were suffering some sort of childhood psychiatric disorder.

At around the same time that Kanner was grappling with the problems of these children, a German scientist, Hans Asperger was caring for a group of children whose behaviour also seemed irregular. Asperger suggested that these children were suffering from what he termed 'autistic psychopathy. ' These children experienced remarkably similar symptoms to the children described by Kanner, with a single exception. - Their language development was normal! There is still an ongoing debate as to whether autism and Asperger's syndrome are separable conditions, or whether Asperger's syndrome is merely a mild form of autism.

What is the cause of autism?In the 1960s and 1970s there arose a theory that autism was caused by abnormal family relationships. This led on to the 'refrigerator mother' theory, which claimed that autism in the child was caused by cold, emotionless mothers! (Bettleheim, 1967). However the weight of evidence quickly put this theory to bed as evidence was found to support the idea that the real cause was to be found in abnormalities in the brain. This evidence was quickly followed by findings, which clearly demonstrated that the EEG's of children with autism were, in many cases, atypical and the fact that a large proportion of children also suffered from epilepsy.

From this time, autism has been looked upon as a disorder, which develops as a consequence of abnormal brain development. Recently, evidence has shown that in some cases, the abnormal brain development may be caused by specific genes.

However, we should not forget that genes can only express themselves if the appropriate environmental conditions exist for them to do so and so, we should not rule out additional, environmental causes for autism. We should not forget that autism can also be caused by brain-injury, that an insult to the brain can produce the same effects as can abnormal development of the brain, which may have been caused by genetic and other environmental factors. I have seen too many children who have suffered oxygen starvation at birth, who have gone on to display symptoms of autism. So, it is my view that autism can also be caused by brain-injury.

There are also other possibilities, which can ultimately produce the type of brain dysfunction, which we recognize as autism. There is a great deal of research being carried out at the moment in the area of 'oxidative stress' and methylation and it's effects upon the integrity of neural networks. There is also the debate surrounding mercury levels in vaccines, which is as of yet, unresolved.

The fact is that 'many roads lead to Rome. ' - There are likely to be several factors both genetic and environmental, which can ultimately lead to the type of brain dysfunction, which we call autism.

So, how do we recognize autism?

On a descriptive level, autism involves a dysfunction of the brain's systems, which control communication, socialization, imagination and sensory perception. My theory is that it is the distortions of sensory perception, which are so characteristic of autism, which exacerbates many (but not all) of the other difficulties. Imagine a child suffering from autism who suffers distortions of sensory perception. For instance, the child who suffers distortions of visual perception, might find situations which require eye -contact to be exceptionally threatening, or on the other end of the scale might become obsessive about specific visual stimuli. The child who suffers distortions of tactile perception, might at one end of the spectrum find any situation which requires physical contact to be terrifying, whilst at the other end of the spectrum, they might be a 'sensation seeker' to the point of becoming self -injurious. The child who suffers distortions of auditory perception might at one end of the spectrum, be terrified of sounds of a certain pitch or intensity, whereas at the other end of the spectrum, they might actively seek out, or become obsessive about certain sounds.

Treatment

The question is, what can we do to help redress these distortions of sensory perception. Well, we can learn from the newborn baby. When baby is born, he sleeps for most of the time, only spending short periods of time interacting with this new environment in which he finds himself; - a new environment which bombards his senses with new sights, noises and smells. So he retreats into the safe, calm environment of sleep, which provides the sensory safe haven which up until recently was the sanctuary of the womb. Very gradually, as baby adjusts his sensory system to his new environment, he spends more and more time in the waking world, interacting and learning to communicate, - but he adjusts very gradually!

There is possibly a neurological explanation for this. There are structures within the brain, which act to 'tune' sensory attention. These three structures, which allow us to tune our attention are structures, which enables us to 'tune out' background interference when we wish to selectively attend to something in particular. They also enables us to 'tune in' to another stimulus when we are attending to something completely different. They are the same mechanisms of the brain, which allows us to listen to what our friend is saying to us, even when we are standing in the midst of heavy traffic on a busy road. It is these mechanisms that allow us, even though we are in conversation in a crowded room, to hear our name being spoken by someone else across that room. It is these mechanisms, which allow a mother to sleep though various loud, night-time noises such as her husband snoring, or an airplane passing overhead and yet the instant her new baby stirs, she is woken. It is a remarkable feature of the human brain and it is the responsibility of three structures operating cooperatively - these are the ascending reticular activating formation, the thalamus and the limbic system.

Having made such a bold claim, allow me to furnish you with the evidence to support it. The three structures just mentioned receive sensory information from the sense organs and relay the information to specific areas of the cortex. The thalamus in particular is responsible for controlling the general excitability of the cortex (whether that excitability tunes the cortex up to be overexcited, tunes it down to be under excited, or tunes it inwardly to selectively attend to it's own internal sensory world. ) (Carlson, 2007). The performance of these neurological structures, or in the case of our children, their distorted performance seems to be at the root of the sensory problems faced not only by newborn babies, but the sensory difficulties our children face and yes, as the newborn shows, their performance CAN be influenced, - they can be re-tuned.

I believe the sensory system of some children with autism is experiencing similar difficulties to that of a newborn, - at one end of the autistic spectrum, the cortex is being over-excited by these structures and the person is overwhelmed and has difficulty accommodating the mass of sensory stimulation within the environment. At the other end of the autistic spectrum, the cortex is being under-excited and the person has trouble in perceiving sensory stimulation from the environment. The question is; - How do we facilitate the re-tuning of this neurological system in individuals who have autism. The newborn retreats into sleep, a self imposed dampening of incoming sensory information. Whilst the child with autism does not do this, many children with autism attempt to withdraw from their environment because they find it so threatening.

We believe at Snowdrop that for the child at the end of the autistic spectrum who is suffering an amplification of sensory stimulation, we should create a setting where he can retreat from a world, which is overwhelming his immature sensory system. This 'adapted environment,' which should be as free as possible from all visual, auditory, tactile and olfactory stimulation will serve as a milieu where his sensory system can re-tune itself. Of course it may just be a single sense like vision, or hearing, or tactility, or any combination of senses, which are causing the difficulties and the environment may be adapted appropriately. The child suffering these difficulties will usually welcome this adapted environment, which is in effect a 'safe haven' for his immature sensory system. He should be given free access to, or placed within the adapted environment as needed and you will notice hopefully that he will relax and begin to enjoy being within its safe confines, where there are no sensory surprises.

This procedure should be continued for as long as necessary, - for several weeks or months. Indeed, some children might always need periods of time within the 'safe haven. ' As the child begins to accept and be at ease in his safe haven, stimulation in whatever sensory modality is causing the difficulties, should begin to be introduced at a very low level, so low in fact that it is hardly noticeable. If the child tolerates this, then it can be used more frequently until it becomes an accepted part of the sensory environment. If the child reacts negatively in any way, then the stimulus is withdrawn and reintroduced at a later date. In this way, we can very gradually begin to build the level of tolerance, which the child has towards the stimulus.

For the child at the other end of the autistic spectrum, the child whose sensory attentional system is not exciting the cortex enough, with the consequence that he is not noticing enough of the stimulation in his sensory environment, the approach needs to be the exact opposite. These are the children who we see producing self-stimulatory behaviour. I believe that this behaviour is an attempt by the nervous system to provide itself with what it needs from the environment, - a sensory message of greater intensity! We see many children with autism 'flapping' their hands in front of their eyes, or becoming visually obsessed by certain toys, movements, colours etc. I propose that this is a reaction by the nervous system to attempt to increase the intensity, frequency and duration of the sensory stimulus due to a problem with perceiving visual stimuli from the environment.

Of course, children with autism display a far greater range of difficulties than a theory, focused upon a malfunctioning sensory - attentional system could explain. I am not attempting to claim that sensory problems on their own are an adequate explanation for every facet of autism, - that would be ridiculous! This is merely a possible explanation of a range of issues experienced by some children who have autism, which could be produced or exacerbated by the child suffering distortions of sensory perception. For instance, the following symptoms within the autistic spectrum could possibly be explained at the sensory level.

Failure to make eye contact. Difficulty in sharing attention with anyone. Avoiding interaction with others. Avoiding physical contact. Seeming disconnected from the environment. Appearing not to notice anything visually. Visual distraction, as though the child is looking at something which you cannot see. Visual obsession with particular features of the environment. Inability to 'switch' visual attention from one feature of the environment to another. General discomfort with the visual environment. Appearing not to hear anything. Auditory distraction, as though listening to something which you cannot hear. Auditory obsession with particular sounds within the environment. Inability to 'switch' auditory attention from one sound within the environment to another. Inability to 'tune out' extraneous sounds in the environment. General discomfort with the auditory environment. Appearing not to feel much sensation. Appearing to bee distracted by tactile stimuli of which you are not aware. Obsession with particular tactile sensations within the environment. Appears unable to 'switch' tactile attention from one sensation to another. General discomfort with the tactile environment. Difficulty in communicating with others.




We believe at Snowdrop, that our sensory re-tuning environments offer the best chance for children to overcome such distortions of sensory perception.





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Book Reviews For "Raising a Sensory Smart Child"


Book Review for "Raising a Sensory Smart Child"

Written by: Lindsey Biel and Nancy Peske

Penguin Books

ISBN: 014-303488

399 pages

$15.00

5 Stars

Biel and Peske share their personal stories dealing with Sensory Integration Dysfunction in order to help other parents cope with sensory integration issues. SI Dysfunction is separate from autism, but often presents with autism and autistic spectrum disorders. In SI Dysfunction, a young child receives sensory input correctly, but misinterprets the information. The most likely cause is a neurological condition, but the authors spend a chapter discussing reasons why SI Dysfunction would present, including genetics, head trauma during birth, and fragile X syndrome.

Biel and Peske explain there are seven senses a young child uses: touch, taste, smell, hearing, vestibular, and proprioception. Vestibular involves one's sense of balance and proprioception involves the compacting/expanding of joints. Without careful integration, a young child might seem a little off and in a child's young development, they might present with speech and developmental delays. When SI Dysfunction presents by itself, a young child will usually make all their physical milestones on time, like sitting and walking, but when it comes time to start to use utensils and start talking, they'll demonstrate delays.

Biel and Penske explain that children with SI Dysfunction have hypo or hyper sensitive symptoms. Hyper means they tend to avoid an activity and hypo means they seek out behaviors to calm themselves down. A hyperactive sensitivity to touch might have a child pulling the tags off his shirt because he can't stand the way it feels against his skin. A hypoactive sensitivity to proprioception might have a child jumping up and down to feel the compression of her joints.

Biel and Penske's explanations are easy to understand and help give the reader a sense of what the dysfunction is, how it's caused, and what to look for in your child.

The book also discusses intervention options and how to best help those children with SI Dysfunction. An occupational therapist plays a crucial role in helping parents and children manage their sensory seeking or avoiding behaviors. Most children with SI Dysfunction can lead productive lives. There is also a list of resources and tips on how to create a sensory diet. A sensory diet is used to manage a child with sensory issues.

Biel and Penske write in a conversational style that's easy to read and understand. The book is full of knowledge for parents who have children with sensory issues. The writing is crisp and sharp. The book is well organized. "Raising a Sensory Smart Child" is a good read to learn more about SI Dysfunction.




StephB likes to read many books and a variety of different genres. StephB is an author at Writing.com which is a site for Creative Writing.





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2012年5月30日 星期三

Bean Bag Chairs Used As Sensory Integration Products


For children with sensory processing disorders, bean bag chairs can be a lifesaver. Most sensory integration products are designed to help children better process sensory information and let them enjoy life safely. Bean chairs are a great sensory integration product that gives children with sensory processing disorders the sensory input they need without costing a lot of money.

These chairs work as sensory integration products by providing a child with the sensory input they need to stay calm. Instead of sitting on a typical hard chair, they can be enveloped by a soft bean bag chair that provides deep pressure sensory input over the whole body. This supportive pressure helps keep the child calm while they do relaxing tasks like reading or watching television. Children can even curl up and nap on beanbag chairs because this deep pressure input is relaxing to them. But these chairs aren't just useful for relaxing children with sensory processing disorders. They can also be used in activities.

Some children with sensory processing disorders need to run and crash into things to provide stimulation. Bean bag chairs are perfect for this because they are soft enough to crash into without hurting the child while still providing the sensory input the child craves. Many children also enjoy being squished by soft materials. Parents or caregivers can place a bean bag on the child's back and apply gentle pressure to give the deep sensory input the child needs. Caregivers can also turn this activity into a game where the child pretends to be a turtle with the bag chair on his or her back. Because of the deep pressure sensory input they provide, bag chairs are perfect for children with sensory processing disorders.




Think that bean bag chairs are right for your child's sensory processing disorders, or want to see some large bean bags? Then check out the beanbags at ComfySacks.com





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Parenting Tips On Sensory Diet For Sensory Integration Disorder


Does your child with autism become sensitive to sounds, smells and is a picky eater? Does your child with another disability become hyperactive, when asked to sit for a long period of time? These are all signs of sensory integration disorder (SID). This article will discuss the sensory diet that is used for children with SID.

Sensory Integration Disorder is the inability of the brain to correctly process information brought in by the senses. SID can show itself in many different ways. A child with SID may be over or under sensitive to sounds, smells, may be a picky eater (does not like the way certain foods feel in their mouth), may not like the way certain clothes feel on their skin. Many children with autism and learning disabilities have sensory integration issues.

Children with SID may also have motor skill issues such as; difficulty with fine and gross motor skills, difficulty imitating movements, or has trouble with balance.

Treatment is usually carried out by a occupational therapist, with experience in treating children with sensory integration disorder. A sensory diet can also be put together, specifically for your child. The diet can be used at home as well as at school.

A sensory diet means that you are including sensory activities, within your child's day; at home and at school. Each child's sensory diet is different, depending on your child's specific SI needs. Ask your child's occupational therapist to help you set up a sensory diet, to meet your child's unique needs.

For Example: If your child becomes hyperactive on a regular basis, or perhaps prone to hitting or pinching, or being silly, or laughs for no reason a sensory diet may help. Giving your child sensory activities on a frequent regular basis, will help him to remain focused and in control more often.

A sample sensory diet is listed below:

At critical points during your child's day:

1. Swinging in a special swing or on a playground

2. Chase games such as tag, or running races

3. Jumping jacks, stretching, sit ups, balance beam

4. Trampoline, tire swing, exercise ball

5. Squeezables such as nerf balls, silly putty etc.

Every half hour if possible; to include the above:

6. Smelling scents game

7. Rubbing/or brushing with a specific type brush (Ask occupational therapist for type of brush to use, and how to do this technique), not to include the stomach.

8. Jump rope

Calming activities that you can use at home:

a. Morning: Bath, brushing, deep pressure.

b. After school: Child's choice (biking, running, skating).

c. Evening: Supper, bath, deep pressure.

Using a sensory diet on a child who has SID, can cause a dramatic improvement in their behavior and ability to focus. The items listed are easy to do at home and school. You may have to advocate for sensory breaks for your child, but remind special education personnel about how much it could benefit your child.




JoAnn Collins is the mother of two adults with disabilities, and has helped families navigate the special education system, as an advocate, for over 15 years. She is a presenter and author of the book "Disability Deception; Lies Disability Educators Tell and How Parents Can Beat Them at Their Own Game." The book has a lot of resources and information to help parents fight for an appropriate education for their child. For a free E newsletter entitled "The Special Education Spotlight" send an E mail to: JoAnn@disabilitydeception.com For more information on the book, testimonials about the book, and a link to more articles go to: http://www.disabilitydeception.com





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Sensory Integration Dysfunction - What Is It, Diagnosis, And Treatment


Is your child with autism over responsive to sensation which shows by withdrawing from touch, or getting upset by loud noises? Or is your child under responsive to sensations which shows by hyperactivity, unawareness of touch or pain, and likes loud sounds? Your child may have sensory integration dysfunction, which could be affecting their education and life. This article will discuss what sensory integration disorder is, and also about diagnosis.

Sensory integration refers to our ability to take in information through our senses (touch, movement, smell, taste, vision, and hearing), interpret that information, and respond to it. Sensory Integration Dysfunction (SID) is the inability of the brain, to correctly process information brought in by the senses. People with SID may misinterpret everyday sensory information such as touch, sound and movement.

Below are a few symptoms of SID:

1. Loves to spin, swing, jump-this may calm them down,

2.Complains that some clothing feels scratchy, or doesn't like tags,

3. Picky eaters-doesn't like how some foods feel in their mouth,

4.Over sensitive to smells or sounds-may sniff people or food-will frequently cover ears to sounds,

5. May have high pain tolerance,

6. Can be impulsive or distractible.

The Star Center puts out a checklist for Sensory Integration Dysfunction. The Star Center calls it Sensory Processing Disorder (SPD). Below are a few items on the checklist:

1. Difficulty eating,

2.Resists cuddling or holding,

3.Easily startled,

4.Over sensitive to stimulation,

5.Difficulty learning new motor tasks,

6.Constant movement,

7.Overreacts to touch noise or smell,

8.Appears clumsy and stumbles a lot, and

9.Avoids visually stimulating environments.

SID could be affecting your child in many different ways. There are two separate types of SID: Sensory Avoiding and Sensory Seeking. Children with sensory avoiding do not like to be touched or cuddled, they are fearful of fast movement, are cautious and unwilling to take risks or try new things, are very pick eaters and do not like to be in loud or busy environments. Children with sensory seeking can have hyperactivity, unawareness of touch or pain, take part in unsafe activities, enjoy sounds that are too loud.

Children with Sensory Integration Dysfunction may also have motor skill problems. These children may have: 1.Poor fine motor skills, 2.Poor gross motor skills, 3.Difficulty imitating movements, 4.Trouble with balance, and 5.A preference for seating activities, such as video games.

To determine if your child has SID, they should be evaluation by a SIPT qualified occupational therapist (OT). Many school districts hire occupational therapists, but may not be SIPT qualified, and therefore not qualified to test in this area. You may need to advocate for your child to have them tested by a SIPT qualified OT.

Treatment for SID is occupational therapy, by a qualified therapist. Check with your school district to see if there OT has experience with Sensory Integration Disorder. If they do not, consider getting an Independent Educational Evaluation (IEE) with a SIPT qualified OT. Make sure that the evaluator makes specific recommendations on amount of therapy needed, goals and objectives.

By understanding what Sensory Integration Dysfunction is, how it is diagnosed and treated you may help your child. SID can negatively affect your child's life, but with proper treatment you child can reach their potential.




JoAnn Collins is the mother of two adults with disabilities, and has helped families navigate the special eduation system, as an advocate, for over 15 years. She is a presenter and author of the book "Disability Deception; Lies Disability Educators Tell and How Parents Can Beat Them at Their Own Game." The book has a lot of resources and information to help parents fight for an appropriate education for their child. For a free E newsletter entitled "The Special Education Spotlight" send an E mail to: JoAnn@disabilitydeception.com For more information on the book, testimonials about the book, and a link to more articles go to: http://www.disabilitydeception.com





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Living With Sensory Processing Disorder - A Family Affair


I. A child's view on how SPD effects family relationships

Living and coping with a disorder can often consume a child's world. For children with Sensory Processing Disorder (SPD), this can be especially challenging as most children with SPD are seemingly "normal". Many people do not often realize that these normal-looking children could be plagued by such an emotionally, physically and socially taxing disorder. Emily Brout knows all too well how difficult it is to explain her disorder: "Sometimes it is really hard to explain what Sensory Processing Disorder (SPD) is to other people. It's very complicated and it's not even easy for me to understand! Many people don't know anything at all about SPD because there hasn't been a lot written about it or on T.V. So most people have no idea how SPD makes a person like me feel. In fact, there are many people who don't even think SPD is real! That makes me so mad! Why would anybody make this up?"

Having SPD makes family life and social time with friends tough on Emily. "SPD makes me feel like I'm being attacked by noises, smells, and lights every day. Smells can be really bad, and sometimes even make me throw up. It is very hard to sit in the cafeteria with my friends at school and try to hide the fact that I am gagging because of a smell. Noises are the worst for me. Quiet noises that repeat over and over make me really upset, and these noises are part of every day life. My sister and brother get mad at me because I yell at them for noises that they make. Sometimes, I get really sad and don't want to go anywhere. I also lose my temper and get really mad at people. I don't do this on purpose, but my friends and family don't always realize that. I just cannot help it. Every day I struggle to keep myself calm even though I feel scared, mad and upset on and off, all day."

Coping with a special need such as Sensory Processing Disorder can be equally frustrating to both the child and his or her family.

II. A parent's perspective on raising a child with SPD

Emily's mom, psychologist Dr. Jennifer Brout, can identify with trying to cope with raising a child who has a special need and maintaining her family dynamics. "A wise professor once told me 'Your primary goal is to not make things worse'. As I consulted psychologists and psychiatrists alike, I wondered if there were any clinicians who even understood what Sensory Processing Disorder (SPD) was!" said Brout. "My daughter received Occupational Therapy to remediate her symptoms, yet her personality and our family dynamics had already been shaped by the disorder's complications." Dealing with this frustration and lack of help from mental health professionals who had no real treatment for her daughter, Brout often wondered, "was there anyone out there who would understand that I was not simply giving in to my daughter's 'manipulations' because I was a browbeaten mother lacking any savvy?"

Everyday life posed so many difficulties and heartache for Brout, as a parent who had to watch her child struggle with SPD. "Although her other senses were affected, extreme over-reactivity to certain sounds caused my otherwise sociable, empathic sweet-natured little girl to be unpredictably moody and explosive. During toddler hood and early childhood she threw tantrums that lasted for prolonged periods of time. She was extremely clingy, and often appeared sad. Background noises that most people didn't notice set her off into rages." Not being able to ease a child's suffering could leave any parent feeling helpless. Brout remembers one of those moments with Emily, "when she was six years old she looked at me and said 'When I hear bad noises I feel like I'm turning into the Incredible Hulk'. Then she asked intently, 'Mommy, can you fix my brain?' This moment defined the extent to which my daughter was suffering, and how negatively her self-image had been impacted by SPD. What little girl should envision herself as a huge, green, out of control mutant?"

What can a parent do? How can a parent mediate Sensory Processing Disorder within family life?

For parents coping with their child's SPD, Brout offers this advice, "it is helpful to remind yourself that with Occupational Therapy, sensory integration treatment, and as he or she gets older, your child will be able to implement greater control over his or her behavioral reactions to his or her physiological responses. In the meantime, however, regulation (calming the child so that he or she is not over stimulated and agitated) is the first priority." She goes on to suggest that in order to make this shift, "you must allow yourself to dismiss much of what you have been told about parenting, even by mental health professionals, because it does not apply to SPD children. For now, think of your child as one whose body over-reacts to sensory stimuli, and who is deficient in calming down." When faced with an agitated child whose behavior is effecting family life, Brout suggests using the three R's: Regulate, Reason and Reassure

Regulate: "Help your over-responsive child calm down by identifying the source of the sensory stimuli, and shift the focus from any resulting conflict. As a child develops greater language and cognitive skills this process becomes easier. However, even younger children with limited language skills can be regulated. Each child is unique which is why it is essential to consult with a professional."

Reason: "Once your child is calm, review the incident with him focusing on his thought processes. If he cannot identify the stimuli that triggered his actions, try to do it for him by making suggestions. For younger children, you will have to go through this process with relative simplicity and brevity. With enough consistency your child will understand your message, and will also learn that when he or she is over-stimulated, calming down is the first step! Remember, this process is not an over-night cure!"

Reassure: Remind yourself that your child does not like feeling out of control. Reassure him that over time he will gain control, and that you will help him. Let him know that you expect him to try as hard as he can, but protect his self-esteem and self-image by framing the problem as though it were 'a work in progress'. Repairing damaged self-esteem and poor self-image is much more difficult than reshaping a child's misconstrued ideas about the causes and consequences of behavior. No child should see himself as a huge out of control green mutant being that repels others!"

In regard to family dynamics, Dr. Brout states, "the SPD child feels victimized by the overwhelming sensory stimuli generated by family members. However, siblings are also likely to feel victimized having often been the object of the over-responsive child's mood swings and/or aggression. Therefore, it is important to let siblings know that they are not responsible for these problems and that you are doing everything you can to get help for your over-responsive child and for the family. Behavior is not only about actions and consequences. It is about interpersonal relationships and that is especially true in regard to SPD as it affects family functioning."

___________________________________________________________________________________




Jennifer Jo Brout, Ed.M., Psy.D. is a psychologist focused on Sensory Processing Disorders and their application to mental health. She earned an Ed.M. in School Psychology from Columbia University and a Psy.D in School/Clinical Child Psychology from Albert Einstein College of Medicine. Dr. Brout is currently involved with projects at the KID Foundation Research Institute, Duke University, and in association with audiologists and private clinicians throughout the country.

In 2006, Dr. Brout launched Positive Solutions of New York, LLC to support research in psychological conditions, developmental disorders, and learning difficulties related to sensory processing/regulatory disorders through various creative and public service projects.





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2012年5月29日 星期二

ADHD Comorbid Disorder: Non-Verbal Learning Disorder


It's so easy to associate inattention or hyperactivity with ADHD comorbid disorders, especially when you consider how similar their symptoms are. Take nonverbal learning disorder (NLD), for instance. This fairly common disability goes easily undiagnosed because its most obvious symptoms resemble the non-stop talking often found in children with ADHD.

So what's the difference between a child with nonverbal learning disorder and a child with ADHD? The first thing you should know is that children with NLD are actually very verbal people - they have mature vocabulary, talk "like adults," have excellent reading ability, and demonstrate good rote memory skills. However, they are clearly deficit in the nonverbal arena. As a preschooler, your child might have trouble getting along with other kids, adapting to new situations, and troublesome but minor fine motor problems. For instance, your child might have incomprehensible handwriting.

During elementary school, your child might do fairly well in terms of academics, except for when a subtle symptom of NLD interferes with socialization or non-academic areas. As your child enters middle school or high school, things start to deteriorate as he is faced with more responsibilities. Teachers find him rude and he gets into fights with classmates because he cannot understand nonverbal cues like facial expressions or body language. Your child has difficulties completing homework, reading an assigned chapter, or writing an essay. Yet your child maintains his articulate speech and precocious language.

Children who have NLD are able to make up for the limitations of their disorder. It only starts to get worse once they hit puberty, when they start to suffer from anxiety or alienation. When they become adults, they experience problems setting priorities or picking up on social cues, or undergo mood disorders, which make it difficult for them to maintain relationships or jobs.

Diagnosing NLD involves a series of speech and language tests, neuropsychological tests, and other evaluation procedures. Since the most obvious symptom of NLD is advanced language skills, doctors usually administer the Brown ADD Scales and the Wechsler Intelligence Scale to distinguish NLD from ADHD. Children with NLD usually have 20 verbal IQ points more than their performance IQ scores.

Just like with ADHD, children with NLD will flourish if they receive holistic treatment. Some therapies that benefit NLD sufferers include:

Social skills groups, which teach children how to meet strangers, greet friends, recognize when they are being teased, etc.
Occupational therapy, an approach that improves fine motor skills and balance.
Sensory integration therapy. Some children with NLD tend to be hypersensitive to stimuli or have difficulties processing multi-sensory stimuli. This can make them feel agitated when confronted by distractions and other sensory stimuli. Sensory integration therapy can help them overcome these setbacks and reduce the anxiety caused by encountering strange sensory information.




Dr. Yannick Pauli is an expert on natural approaches to ADHD and the author of the popular self-help home-program The Unritalin Solution. He is Director of the Centre Neurofit in Lausanne, Switzerland and has a passion taking care of children with ADHD. Click on the link for more great information about ADHD Comorbid Disorder.





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Diagnosing Autism and the Differences With Sensory Integration Disorder


When it comes to diagnosing autism, there are many different factors that need to be considered. This is because the autism spectrum disorders have such a vast range of potential symptoms and no two cases are alike. Therefore, it is very easy to mistake autism for another condition. Among the most common mistakes when diagnosing autism is not understanding the difference between being on the spectrum, and sensory integration disorder.

This leads to the question of whether autism spectrum disorder and sensory integration disorder (also known as sensory processing disorder) are the same condition, or at the very least if they are related. Does one exclude the other? To begin, they are considered to be completely separate disorders, but to further understand them, Dr. Lucy Jane Miller performed a study "Quantitative psychophysiologic evaluation of Sensory Processing in children with autistic spectrum disorders", involving 40 high functioning autism or Aspergers Syndrome children who were tested for sensory integration disorder.

Dr Miller's results showed 78 percent of the participating children also displayed notable signs of sensory integration disorder. While, 22 percent of the participants did not show signs. However, a secondary study by the same researchers, "Relations among subtypes of Sensory Modulation Dysfunction" looked into children diagnosed with sensory integration disorder and tested them to see how many also had autism. Within that experiment, zero percent of the participants had autism. The reason that this is interesting is that while children with autism can exist without having sensory integration disorder, the majority show signs of the condition. On the other hand, there is no inclination toward autism in children who have only sensory integration disorder.

Children with both disorders demonstrate challenges with high-level tasks that involve the integration of different areas of the brain. This can include emotional regulation as well as complex sensory functions. However, the key to diagnosing autism as opposed to sensory integration disorder usually lies in the fact that autistic children experience greater problems in the areas of language, empathy, and social skills. Sensory integration disorder children do not experience the same connective breakdowns for controlling emotional empathy and social interaction.

In both disorders, children experience difficulties in tasks that require their brains to make long-distance connections, for example, between the frontal lobes (which coordinate the activities of the brain) and with the cerebellum (which regulates the perceptions and responses within the brain).

If you think that your child may have one or both of these disorders, it is important to speak to your child's pediatrician for autism diagnosing or identification of sensory integration disorder on its own or in combination with autism. If autism or autism alongside sensory integration disorder is the diagnosis, then you will be able to begin talking about the possible treatments available. These treatments can include various medications as well as alternative therapies and may overlap in terms of addressing aspects of both conditions simultaneously. For example many children with autism benefit from sensory integration therapies that also work well for children with sensory integration disorder.




Grab your free copy of Rachel Evans' brand new Autism Newsletter - Overflowing with easy to implement methods to help you and your family find out how to go about diagnosing autism and for information on autism characteristics please visit The Essential Guide To Autism.





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Locating and Understanding the Roots of Physical Tension (Tension Deficit Disorder)


Physical tension (Tension Deficit Disorder) can usually occur due to a malfunction in a motor or sensory system. In most cases, when tension is present, it builds up in muscles and causes varied functional difficulties. From difficulty in motor skills to emotional tension which can break out in different ways.

In most cases, physical tension is mistakenly interpreted by professionals, and the diagnosis can be misleading, for example:

• Continuous and constant tension

• Behavioral difficulties

• Impulsiveness

• Focus and concentration difficulties

• Various learning difficulties such as ADHD-ADD

• Social difficulties

• Low self esteem, self image, and more.

The symptoms that pinpoint to Tension (Tension Deficit Disorder) are:

1. Is there constant movement of limbs noticeable? (arms and/or legs)

2. Is the child active non-stop throughout the day until he falls asleep? (Cannot enter the sleep process gradually, but keeps active up to the stage of increased fatigue and "falls" to sleep.)

3. Is reading found difficult, and/or a slow reader, and/or difficulty in understanding the topic being read, and/or reading as a tiring task?

4. Is there noticeable difficulty in writing fast and clearly, and/or is there a sense of pain in fingers while writing, and/or writing as a tiring task, and/or finding writing a frustrating task?

5. Is emotional hypersensitivity noticeable? (Difficulty modulating the intensity of emotional reactions, and/or impulsiveness, and/or crying is easily triggered, and/or disproportionate reactions to various events.)

6. Are difficulty modulating senses noticeable, and/or hypersensitivity to smells, noises, touch, light and flavors? Is there difficulty being in crowded, noisy or closed spaces?

7. Is difficulty and/or dislike playing ball games noticeable, difficulty playing with a few children at once, slow-moving or clumsy, finding physical activity excessively tiring, feeling tense and maybe anxious after physical activity, trouble getting up vigorously in the morning, not wanting to go to school?

Answering yes to one or more of the upper questions could point out a malfunction in one or more physical systems that are meant to allow easy and enjoyable function. In that case, during specific activity the body creates tension (Tension Deficit Disorder), which leads to the above mentioned difficulties.

If the malfunctioning system is correctly identified, and is trained to a state of matured neural networks, in most cases the mentioned symptoms will improve drastically, and/or disappear

Without medication.

The systems that need examination in order to determine whether the Tension (Tension Deficit Disorder) is caused by physical difficulty are:

a. Gross motor skills - the cross limbs ability

b. Fine motor skills, mainly the ability to separate movement between fingers and both hands, both hands at once and each separately.

c. Controlled, exact and conscious eye muscle movement.

d. The entire sensory system (hyper/hypo sensitivity).

e. Conscious use or the respiratory system while performing motor, sensorial, emotional and cognitive tasks and while resting.

f. Grapho motor ability in both hands separately and simultaneously.

g. The ability to integrate between motor skills and breathing, thinking and controlling emotions.

In these examinations (mentioned in detail in the book "Intelligence Integration") the specific cause of the tension (Tension Deficit Disorder) can be found. Finding the physical cause enables a training plan to be built that will release the trainee of physical tension without medication, therefore allowing optimal daily function.




The training program is fully described and detailed at

http://www.intelligence-integration.com

Intelligence Integration gives an opportunity to improve difficulties as: Tension Deficit Disorder Dyslexia Dysgraphia ADD-ADHD Behavioral Difficulties and more, with a simple proses at home environment, without medications





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2012年5月28日 星期一

Sensory Processing Difficulties - Understanding the Family Dilemma


With the diagnosis of Autism Spectrum Disorders on the rise, let's focus on understanding the accompanying sensory processing issues. Although sensory processing difficulties are a symptom of Autism, Sensory Processing Disorder and Asperger's Syndrome, every person can experience processing difficulties throughout life.

Also known as sensory integration, it refers to the way individuals respond to and process sensations. Our brains are constantly processing input from our sense organs (smell, touch, taste, hear, see and feel), even when we sleep. We usually don't notice the process, until it functions adversely. For example, all we need to do to overload our sensory system is navigate a shopping cart through a large grocery or house wares store. The overhead music plays while videos blare, smells rise and blend into one another, fans blow hot or cold air and overly helpful employees repeatedly pop out to greet us while we try desperately to stay in the left part of the brain so that we can get what we came for. Whew! By the time we get through the checkout, trapped between loud videos and beeping registers, we are feeling common symptoms of sensory overload: nervousness, simmering anger, headache and nausea. Now imagine how hard that must be for a small child or someone whose sensory system has difficulty processing the onslaught of stimulation.

Children have not yet developed the brain connections to tell us that they need to get away from the overwhelming stimulation. Instead, they scream, tantrum, run away or have potty accidents. Sensory overload triggers the primitive brain function of fight, flight or freeze and the body reacts without thought. The only goal is to survive, which temporarily hijacks the brain's executive functions, disabling logic, memory (retention and recall) and decision making processes.

For most of us, all we have to do is reduce or eliminate the excess sensory stimulation and the problem is solved. Usually our brains can sort it all, without conscious thought. Unfortunately, this task is much more complicated for someone when sensory processing difficulties are part of a disorder.

The entire family is affected when everyone is held hostage by the anticipation and prevention of rages or ear-piercing shrieks. Even the child feels helpless while he seeks to manipulate his world and the family system to avoid sensory issues. Often seen as behavior problems, these actions may actually help regulate the sensory system and bring it into balance. For the most part, behavior modification techniques do not work; the dysfunctional behavior is the result of a struggling brain process, not a goal-oriented choice.

When a family has a member with sensory processing issues, the choices are to continue living each day feeling powerless in a rage-reaction lifestyle or seek professional help. A neurologist is best qualified to make a diagnosis if Autism or Asperger's Syndrome is suspected. A specially trained pediatric occupational therapist (OT) can diagnose and treat Sensory Processing Disorder. A counselor who has experience with sensory processing issues can address the related anxiety and specific parenting techniques, which brings much needed relief to the family.

Generally, the whole family benefits by getting involved in the change process. An experienced counselor can help re-balance the parental power structure, lessen anxiety and resentment among siblings and coordinate treatment options with the school or daycare facility. Changing the way a brain functions takes time, commitment and active teamwork, which may frustrate parents who want a quick fix.

Lastly, remember to look for support from other parents who live with similar conditions. You can find support groups, information and professional referrals by accessing websites focusing on Sensory Processing Disorder, Asperger's Syndrome and Autism.




Sharon Cuff, MA counsels parents and children in Newtown Square, PA. She has over 25 years experience working with adults and children of all ages, stages and abilities. Call for an appointment at 484-437-0080 and visit her website at http://SharonCuffCounseling.com/





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Is Auditory Processing Disorder Affecting Your Child With Autism in Special Education?


Does your child with autism struggle to understand verbal information? Do you sometimes think that your child must not be listening enough, because they always mix up verbal directions? Have you heard of Auditory Processing Disorder and wonder if your child has it? This article will be discussing APD, diagnosis and possible characteristics of this disorder.

It is important to understand that many disabilities have Co Morbid conditions that may occur with them. For example: a child with Autism may also have Sensory Integration Disorder, ADHD, learning disabilities and also Auditory Processing Disorder. By having knowledge of all disabilities that a child has, you will be able to advocate for appropriate needed special education services.

Auditory Processing Disorder is the inability to attend to, discriminate among, or understand auditory information. Language is developed by children by listening. When auditory skills are weak, the child may experience auditory overload; which makes learning much more of a challenge.

Also much of school learning is done verbally, which puts the child with this disorder at a terrible disadvantage!

Here are a few characteristics and symptoms of APD:

1. Has normal hearing but has difficulty in the reception (receiving) and interpretation of auditory information. Trouble making sense of what he or she hears.

2. May have difficulty staying on task.

3. May look around for visual cues, since they do not understand directions.

4. Responds fairly well in quite situations but may have great difficulty listening in noisy environments.

5. May have difficulty telling the difference between words that sound familiar.

6. May have difficulty remembering information in the order it was said?

7. May be visually alert.

8. May perform poorly on tests requiring verbal language information.

9. May have difficulty working independently.

10. Inconsistent performances.

If your child is showing some of these signs, you may refer them to your special education personnel in your school district, for an Audiological evaluation. Most school districts do not have Audiologists on staff, so they would have to pay for the evaluation for you to take your child to a private Audiologist (if they agree of course-though some hearing officers have given parents Independent Educational Evaluations at public expense, if the school district refuses to evaluate a child in all areas of suspected disability).

A complete Audiological evaluation includes all of the following:

1. Referral

2. Case History

3. Complete Audiological Evaluation

4. AP test battery

5. Results of whether the child has the disorder; and any recommendations for needed special education services or equipment.

Use this information to refer your child for an evaluation if you think that your child may have this disorder. Auditory processing Disorder negatively affects a child's education, but with appropriate special education services and equipment, your child can continue to learn and have a bright future!




JoAnn Collins is the mother of two adults with disabilities, and has helped families navigate the special eduation system, as an advocate, for over 15 years. She is a presenter and author of the book "Disability Deception; Lies Disability Educators Tell and How Parents Can Beat Them at Their Own Game." The book has a lot of resources and information to help parents fight for an appropriate education for their child. For a free E newsletter entitled "The Special Education Spotlight" send an E mail to: JoAnn@disabilitydeception.com. For more information on the book, testimonials about the book, and a link to more articles go to: http://www.disabilitydeception.com.





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Attention Deficit Disorder (ADD/ADHD) and Avoiding the Problem of Medicating a Developing Brain


Attention Deficit Disorder (ADD) appeared first in the 1980 Diagnostic and Statistical Manual of the American Psychological Association. Today ADD means different things to different professionals, depending upon their field, their level of experience and medical knowledge, and their cultural beliefs about how children should act.

Parents are often surprised to learn that there is no particular medical or neurological abnormality present in individuals diagnosed with attention deficit. Instead, the diagnosis depends upon subjective assessments by parents, teachers, or professionals with little or no understanding of the neuroscience of learning and behavior.

In fact, the National Institutes of Health (NIH) issued a consensus statement in 1999 warning that the causes and treatments of ADD are only speculative. In a very real sense, the diagnosis itself is only speculative.

In spite of this, individuals and even very young children who are given a diagnosis of ADD are typically given a prescription for an amphetamine, usually methylphenidate. This amphetamine is very similar to cocaine in terms of its effects on the brain (see Volkow et al, 1995); both drugs compete for the same binding sites on brain cells, both are taken up into the same areas of the brain, and both produce similar psychological effects. Perhaps the major differences are that methylphenidate remains in the brain much longer and the psychological expectations associated with the drug are much different.

Both methylphenidate and cocaine affect the brain by increasing levels of dopamine in the frontal lobes, an area responsible for motor planning, learning, problem solving, impulse control, memory, attention, language, analytical thinking and social behavior, and the striatum, an area responsible for processing and integrating sensory information.

Increased levels of dopamine make the brain feel powerful and happy and can produce addictive behaviors and responses. Elevated levels of dopamine also alter other neurochemicals and affect control muscle movements, sleep/wake cycles, hunger and satiety, arousal, heart rate, blood pressure, and stress responses.

If these altered levels of neurochemicals persist for too long (e.g. several weeks), the brain begins to try to bring the levels back to normal. If a neurochemical has been elevated for too long, the brain will begin to shut down some of the receptors for that neurochemical and will begin to kill off some of the transporters that move the neurochemical through the brain. We call this effect "downregulation."

After about three weeks it is possible to see these architectural changes with the electron microscope; after about four months the changes are significant. Four months on methlyphenidate, for example, will result in the loss of about 75% of the dopamine transporters and 20% of the dopamine receptors in the striatum (Vles et al, 2003). The striatum is an area of the brain critical for sensory processing, learning and memory.

Downregulation can have significant effects on the developing brain long after the drug has been withdrawn. Early exposure to methylphenidate, for example, has been linked to decreased interest in sex, food, emotional experiences, and novelty, and an increase in anxiety and stress levels in adolescence and adulthood (Bolanos, et al, 2003).

Of course, the brain can also "upregulate" by growing more transporters or receptors or making the remaining receptorsor more sensitive. However, upregulatio takes time.

It is dangerous to abruptly stop taking a medication after downregulation has occurred, so following a weaning schedule is recommended. The speed at which an individual is weaned from a drug like methylpheidate is based on the length of time they have been taking the medication and the dosage that they were receiving. A physician familiar with the neurological properties of the drug should be consulted before attempting to wean someone off such a drug.

Regardless of the problems associated with medications used to "treat" attention deficit, the question remains as to why a child is having problems paying attention. There are a host of metabolic, immunological, neurolgoical sensory and psychological causes of inattention including: metabolic disorders, allergies, toxins, sleep disorders, vitamin or fatty-acid deficiencies, thyroid disorders, diabetes, depression, boredom intolerance, high intelligence, high creativity, frontal lobe dysfunction, auditory or vestibular processing disorders, and learning disabilities.

Correctly identifying the underlying cause of inattention can help parents and medical professionals avoid the problems of exposing a developing brain to medications that alter neurochemicals, produce downregulation or create long-term side effects that may be far more serious than inattention.




The author, Michelle L. MacAlpine, Ph.D., is a cognitive developmental neuroscientist specializing in the assessment and treatment of sensory processing disorders, attention deficit, and developmental, academic and cognitive delays.

More information can be found at http://www.braintraining.com

ARTICLE REFERENCES
Volkow ND, Ding YS, Fowler JS, Wang GJ, Logan J, Gatley JS, Dewey S, Ashby C, Liebermann J, Hitzemann R, et al. 1995 "Is methylphenidate like cocaine? Studies on their pharmacokinetics and distribution in the human brain." Arch Gen Psychiatry. 52(6):456-63.

Vles JS, Feron FJ, Hendriksen JG, Jolles J, van Kroonenburgh MJ, Weber WE. 2003 "Methylphenidate down-regulates the dopamine receptor and transporter system in children with attention deficit hyperkinetic disorder (ADHD)." Neuropediatrics. Apr;34(2):77-80.

Bolanos CA, Barrot M, Berton O, Wallace-Black D, Nestler EJ. 2003."Methylphenidate treatment during pre- and periadolescence alters behavioral responses to emotional stimuli at adulthood." Biol Psychiatry. 54(12):1317-29





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2012年5月27日 星期日

What Is Attention Deficit Hyperactivity Disorder?


ADHD, what is it exactly? Attention-Deficit Hyperactivity Disorder is a developmental disorder usually causing inattention, distractibility, impulsivity, and hyperactivity in children starting before the age of seven. ADHD is a chronic disorder that occurs in 3-5% of children worldwide.

The controversy surrounding ADHD has been around since the 70's. Some people don't even believe that ADHD is an actual disorder; others believe it has a genetic or physiological basis. Even more controversy surrounds the treatment for ADHD. Treatments include behavior modifications, life-style changes, counseling and stimulant medication.

Now a days anytime a child is hyper parents think it is ADHD. Between 2-16% of kids in school are diagnosed with ADHD and given medication for this disorder. Many kids however are usually misdiagnosed. Many symptoms of ADHD can be attributed to other disorders, many of which can accompany ADHD. Because such combinations of disorders appear together, this can complicate diagnosis. There are five behavioral symptoms that have been attributed to ADHD, but are actually not symptoms of ADHD directly. Many of these symptoms are misdiagnosed as ADHD when in actuality they are their own disorder and should be treated as such. The five problems are Anxiety, depression, disruptive behavior, learning disabilities, and sensory integration disorder.

1. Anxiety is a psychological and physiological state characterized by feelings of worry, apprehension, and fear. Anxiety can be triggered by a person, a place, or even by a feeling. The stimulus can even be unidentifiable outwardly to other people. It's harder to diagnose kids that have anxiety largely due to the fact that kids articulate their feelings much less than adults do. Kids with anxiety usually appear preoccupied or zoned out. This is due to their internal thoughts of worry. Kids with anxiety don't know how to handle or express their anxiety and perceive their threats as uncontrollable and unavoidable.

2. Depression is a mood disorder characterized by feelings of sadness, helplessness, and hopelessness that can result in an aversion to activity. Depression can impair thinking skills, memory, cognitive flexibility, and attention. People who suffer from depression usually seem out of it. They have trouble focusing, become irritable, and have a lack of interest or initiation. Depression has no one single cause. Family history, pessimistic personality, trauma and stress, physical conditions, and other psychological disorders can all be associated with depression. For others depression had not specific trigger or cause. Since children have more difficulty expressing their emotions, it's important to determine depression in children through the evaluation of the child's behavior in several contexts.

3. Disruptive Behavior is where a child will not settle down and becomes troublesome or disorderly. Especially in a school setting this can become a problem where the disruptive student doesn't allow the other students to learn. In some cases kids can be disruptive intentionally, to show off, be funny or look cool. However children that have disruptive behaviors usually feel frustrated and are rebelling against authority to bring attention upon them. These types of kids have not developed adequate self-control, which causes them to act out and ultimately cause distractions for other classmates.

4. Learning disabilities is a classification of disorders where a person has difficulty learning. These disorders have affected the brain's ability to receive and process information therefore making it terribly difficult for the person to learn. Because we do not know what causes this problem within the brain learning disabilities are impossible to cure. However, there are other ways to get around learning disabilities. Intervention and support are the most important options available to someone who have a learning disability. Learning disabilities in children can cause inattentiveness, disruptive behavior, anxiety and depression. There are many learning disabilities such as reading, writing, math disorders, visual perception, auditory processing, nonverbal, dyslexia etc.

5. Sensory Integration Disorder (SID) is a neurological disorder where the person is unable to coordinate sensory information as it comes through the senses. When present in a child, the child may appear inattentive or quite the opposite as hyperactive. This is caused by the child being oversensitive or under sensitive to the sensory stimuli surrounding him/her. A child with a sensory integration disorder may be distressed by loud noises, bright lights, rough textures, or smells; or conversely, may need to handle things, hang upside-down, or shout boisterously.

As you can tell from the descriptions of the each of these disorders, many of the symptoms are the same or very similar. Many of these disorders accompany each other and therefore the person may be dealing with several different disorders at the same time. Because many of these disorders are now affecting children as well its important to evaluate and diagnose properly. This way we can properly treat for the correct disorder and stop over-medicating of our children, which can cause them harm in their future.




http://www.universalhealthinfo.com
http://www.universalhealthinfo.com/ADHD.html





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2012年5月26日 星期六

Children with Sensory Needs - The Misunderstood Five Percent of the General Population


Many children, perhaps your own, exhibit difficulty processing sensory information including: touch, taste, smell, vision, and hearing. As many as 5% of the school age population exhibit characteristics of sensory processing disorder (SPD), sometimes known as sensory integration disorder.

Further, many children with autism, ADHD (attention-deficit/hyperactivity disorder), learning disabilities have SPD coexisting or underlying these conditions. Research has shown that as many as 40% of children with ADHD display symptoms of SPD.

If you are a parent of a child with special needs, perhaps you are struggling with the added stresses this can have on the family.


Your family relationships may be affected.
Siblings may be envious of the extra attention provided to the child with special needs.
Mothers may feel that fathers are not involved.
Fathers may feel unfairly blamed, when in their opinion, they are struggling to support the family.
Extended relatives, while intending to provide support, may instead offer conflicting advice, or just not understand the needs of the child and the family.
An already tight family budget may be stretched even greater to cover the added expenses associated with providing the best possible care for the child with special needs, and the family as a whole.

Only by sharing information and working together can we have adequate recognition and support for those impacted by SPD. Search the internet. Resources exist on the internet through non-proft foundations, and parent connections groups. It is my hope that all children grow up with the courage and wisdom to share their natural talents for the betterment of the world,

...express understanding and respect for humanity

...appreciate and extend the work done by previous generations of people.




Christopher R. Auer, MA is the author of Parenting a Child with Sensory Processing Disorder: A Family Guide to Understanding and Supporting Your Sensory Sensitive Child (New Harbinger, 2006) Additional information at http://www.spdresources.com or email spdresources@comcast.net





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2012年5月25日 星期五

Attention Deficit Disorder (ADD/ADHD) and Avoiding the Problem of Medicating a Developing Brain


Attention Deficit Disorder (ADD) appeared first in the 1980 Diagnostic and Statistical Manual of the American Psychological Association. Today ADD means different things to different professionals, depending upon their field, their level of experience and medical knowledge, and their cultural beliefs about how children should act.

Parents are often surprised to learn that there is no particular medical or neurological abnormality present in individuals diagnosed with attention deficit. Instead, the diagnosis depends upon subjective assessments by parents, teachers, or professionals with little or no understanding of the neuroscience of learning and behavior.

In fact, the National Institutes of Health (NIH) issued a consensus statement in 1999 warning that the causes and treatments of ADD are only speculative. In a very real sense, the diagnosis itself is only speculative.

In spite of this, individuals and even very young children who are given a diagnosis of ADD are typically given a prescription for an amphetamine, usually methylphenidate. This amphetamine is very similar to cocaine in terms of its effects on the brain (see Volkow et al, 1995); both drugs compete for the same binding sites on brain cells, both are taken up into the same areas of the brain, and both produce similar psychological effects. Perhaps the major differences are that methylphenidate remains in the brain much longer and the psychological expectations associated with the drug are much different.

Both methylphenidate and cocaine affect the brain by increasing levels of dopamine in the frontal lobes, an area responsible for motor planning, learning, problem solving, impulse control, memory, attention, language, analytical thinking and social behavior, and the striatum, an area responsible for processing and integrating sensory information.

Increased levels of dopamine make the brain feel powerful and happy and can produce addictive behaviors and responses. Elevated levels of dopamine also alter other neurochemicals and affect control muscle movements, sleep/wake cycles, hunger and satiety, arousal, heart rate, blood pressure, and stress responses.

If these altered levels of neurochemicals persist for too long (e.g. several weeks), the brain begins to try to bring the levels back to normal. If a neurochemical has been elevated for too long, the brain will begin to shut down some of the receptors for that neurochemical and will begin to kill off some of the transporters that move the neurochemical through the brain. We call this effect "downregulation."

After about three weeks it is possible to see these architectural changes with the electron microscope; after about four months the changes are significant. Four months on methlyphenidate, for example, will result in the loss of about 75% of the dopamine transporters and 20% of the dopamine receptors in the striatum (Vles et al, 2003). The striatum is an area of the brain critical for sensory processing, learning and memory.

Downregulation can have significant effects on the developing brain long after the drug has been withdrawn. Early exposure to methylphenidate, for example, has been linked to decreased interest in sex, food, emotional experiences, and novelty, and an increase in anxiety and stress levels in adolescence and adulthood (Bolanos, et al, 2003).

Of course, the brain can also "upregulate" by growing more transporters or receptors or making the remaining receptorsor more sensitive. However, upregulatio takes time.

It is dangerous to abruptly stop taking a medication after downregulation has occurred, so following a weaning schedule is recommended. The speed at which an individual is weaned from a drug like methylpheidate is based on the length of time they have been taking the medication and the dosage that they were receiving. A physician familiar with the neurological properties of the drug should be consulted before attempting to wean someone off such a drug.

Regardless of the problems associated with medications used to "treat" attention deficit, the question remains as to why a child is having problems paying attention. There are a host of metabolic, immunological, neurolgoical sensory and psychological causes of inattention including: metabolic disorders, allergies, toxins, sleep disorders, vitamin or fatty-acid deficiencies, thyroid disorders, diabetes, depression, boredom intolerance, high intelligence, high creativity, frontal lobe dysfunction, auditory or vestibular processing disorders, and learning disabilities.

Correctly identifying the underlying cause of inattention can help parents and medical professionals avoid the problems of exposing a developing brain to medications that alter neurochemicals, produce downregulation or create long-term side effects that may be far more serious than inattention.




The author, Michelle L. MacAlpine, Ph.D., is a cognitive developmental neuroscientist specializing in the assessment and treatment of sensory processing disorders, attention deficit, and developmental, academic and cognitive delays.

More information can be found at http://www.braintraining.com

ARTICLE REFERENCES
Volkow ND, Ding YS, Fowler JS, Wang GJ, Logan J, Gatley JS, Dewey S, Ashby C, Liebermann J, Hitzemann R, et al. 1995 "Is methylphenidate like cocaine? Studies on their pharmacokinetics and distribution in the human brain." Arch Gen Psychiatry. 52(6):456-63.

Vles JS, Feron FJ, Hendriksen JG, Jolles J, van Kroonenburgh MJ, Weber WE. 2003 "Methylphenidate down-regulates the dopamine receptor and transporter system in children with attention deficit hyperkinetic disorder (ADHD)." Neuropediatrics. Apr;34(2):77-80.

Bolanos CA, Barrot M, Berton O, Wallace-Black D, Nestler EJ. 2003."Methylphenidate treatment during pre- and periadolescence alters behavioral responses to emotional stimuli at adulthood." Biol Psychiatry. 54(12):1317-29





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Parenting a Child with Sensory Integration Disorder


After suffering another incredibly stressful morning trying to get my 5 ½ year old son dressed, I've come to the conclusion that there must be other families who go through the same frustration every morning. Most just wouldn't believe that we have it different than anyone else who has young kids. When I'm talking to someone about Jeremy, my stress shows but the explanation is too long so I don't usually elaborate. Their usual answer is "sounds like a typical 5 year old". I guess I've grown used to that. What is harder is to hear from other people who are trying to be helpful that we have a "discipline problem." They offer their typical advice of how to reign a child in and get them to behave.

The fact of the matter is, is that he is NOT a typical 5 year old! Oh, Jeremy loves to play instead of work, throw rocks and finds an empty box utterly fascinating, but the day to day events of our lives, the usually mundane things, are stressful and incredibly different.

This morning was supposed to be a lot of fun. We all woke up early to take a trip to Miami to see my husband's family. It's a 3 day weekend so we wanted to get an early start on Saturday morning so we could enjoy the afternoon in Miami. My husband got up and made coffee, I wrapped about 6 gifts that we're bringing and Jeremy started pulling out clothes and toys he wanted to bring.

I encouraged him to bring the clothes and toys into his room but instead more and more toys got dragged into our living room. When it was time to sit down and eat his breakfast, his favorite of 'waffles and cream', the battle started. Normally, a good tactic is to put a clock in front of him so he can see how much time he has. Today we didn't do that because we were not thinking about the exact moment we had to leave like we do every day for school. That was a BAD CHOICE on my part. I should have showed him the exact time he needed to have eaten and gotten dressed by. Then we should have marched out the door. Unfortunately, we had to pack our suitcases and pack the car.

When Jeremy got to the table ate a few strawberries and milk and got up. My insistence of him sitting and eating finally got ugly after about 15 minutes. While I was running around trying to get everyone ready to go out of town; I continued to put him back in his seat and demand that he eat. I sat with him for about 5 minutes and he didn't eat. I told him he could get a star for his chart if he ate, and got dressed. He started whining and crying so I took a star away from his chart that we've created. On one trip to the bedroom he started playing with a tractor. When I found him again ( I was now taking a shower) he wanted to bring the tractor to the table. I told him NO and to get back to eat. He was screaming and crying because now he wanted the tractor and then he said that "you are the only mommy in the world who is mean to me every day". That is when I told him that if he said that one more time he would get his mouth washed out with soap. (This works wonders for those awful things that kids tend to say sometimes but If I could live without ever doing anything drastic like this, I would!!!)

That stopped the complaining about how "mean" I am but the whining continued. I had to finish feeding him myself in between his tears. He finally finished eating after about 45 minutes. I had turned off the TV by this time of course. I've learned that having the TV on or light music can easily overwhelm Jeremy.

Next, getting him dressed was no easy feat. The first shirt I put on didn't feel comfortable. This was a brand new pre washed long sleeve t-shirt from Osh Kosh. It's darling, but unfortunately, new clothes rarely stay on my son. He prefers old and soft. Many of his very favorite clothes and shoes have spots and tears, but they are the only ones that I can get him to stay in. This morning was no different. I put on Gap underwear, Osh Kosh Jeans and the Osh Kosh t-shirt. After he was completely dressed, he started screaming and wailing about the shirt being too small and the pants being too big. So, off the clothes came! And it wasn't just a calm, "mommy I'm taking off these clothes", it was a screaming crying whining fit accompanied by throwing his clothes across the room which landed on my husband's face as he was walking across the room. At least today he didn't RUN when it was time to get him dressed. That is the typical scenario. He races across the room when it's time to take off his pajamas or time to get changed any time. I can't figure out why! I don't know if that is his body having an automatic reaction to change, or if it's a behavior issue. But it's something that we want to work on in occupational therapy.

Because I already know the drill, that nothing I can say or do will make him keep clothes on when he doesn't want to wear something, I went to the drawer and brought out the old favorites. The yellow long sleeve t-shirt with the #63 and the army looking pants that are soft and comfy. If you see Jeremy out of his school uniform, this is more than likely the outfit he'll be in.

I think of all of the hundreds of dollars that I've wasted by buying clothes that don't quite feel right. I think of the dozens of pairs of shoes that he has kicked and screamed about. I have thrown out piles of socks that just didn't have the seam in the right place. Getting Jeremy dressed to go anywhere, is a struggle nearly every single day.

Recently, the school had a second hand sale on uniforms. I felt like I struck gold by finding the oldest shirts in the school. To me, that means, the SOFTEST and that is perfect for my kid! He is 5 years old, and he wants to wear size 12 shirts. They are big and don't cling to him. Also, discovering the GAP undershirts has been a miracle in our lives. My friend Diane has a red head boy (I believe red heads are more sensitive) and they recommended the GAP undershirts.

I remember trying to get Jeremy dressed at age 2 was no different than now. He went to the Montessori school and because it was pre-school, they weren't particular on the time we arrived. Many, many mornings Jeremy would fight and scream when I had to get him dressed. He would have been perfectly happy staying at home watching TV all day. He would be completely happy just doing that every day of his life. But, fortunately for him, he has two incredibly active parents who rarely ever sit around and watch TV. We have our traditional "Friday night movie night" but we don't watch TV much during the week.

Jeremy does get to go to After Care at school if he's had good behavior the day before. There, they run around the fields, play ball, climb on the jungle gym, have snacks and play with their friends. He loves it! I find that it's the best place for him since he races the kids and exerts more energy there than anywhere else. The hardest part is when it's time to go. What else? He runs away! My mom has found it completely embarrassing because he doesn't pay attention when it's time to come. He just continues playing and then runs to the other side of the field where he can't even hear us yell for him.

By reading books like "The Out of Sync Child" and talking with other mom's I've found a few things that work in this situation. First of all, when you get there, allow the child 5 minutes or 10 minutes to play. Tell him/her that he has 5 minutes and then it's time to go. For Jeremy, he then gets time to transition to the next activity. And the expectation is set. Our new rule is that he is able to achieve a star for his chart at this point. If he comes immediately after the 5 minutes is up, he can get a star for that which when added up every day can determine whether or not he gets to go to after care the next day. He needs to get 5 stars a day - for getting out of bed quickly, for eating and taking his plate to the sink, for making his bed, for getting dressed (almost) by himself, brushing his teeth and hair, etc. He has the chance to earn 3 stars in the morning. Several of the above list is combined into one section for instance: putting dishes in sink and making bed = one star.

The chart system is working for us pretty well. He gets stars taken away for negative attitudes or whining. One day he ripped all of the bad and the good extra stars down. He didn't realize he also ripped the good ones down. Jeremy can earn EXTRA stars for having excellent behavior like the day he had such a great attitude one morning. I was so pleased and so proud of him that he got to go to After Care that day even though he didn't have enough stars the day before. The extra stars can accumulate to 20 and then he gets to go to Toys R Us to buy a toy. So far, he has only a couple of extra stars for good behavior.. and believe me.. I'm looking!

It's hard for Jeremy's self esteem to have these problems. He's gotten in trouble nearly every single day at school. He's come home many times saying, "I'm a bad kid, I'm a bad kid", which really rips out my heart! The system of putting their "apple or acorn" in the yellow, or red basket brings a reputation of "bad behavior". Jeremy has also had his apple on the teachers' desk many times. If he gets bad behavior like this, they take him out of recess. They'll take him out for 5-10 minutes or even the whole time! When I learned this, I freaked out! Jeremy NEEDS activity in order for his brain to FUNCTION correctly. By taking him out of free time outside, they're just hurting the situation. I caused a stink about that at the school and I think they've made some adjustments. The school counselor is now involved and helping to guide the teachers in working with Jeremy. It's truly been a collaborative effort.

Jeremy has also been slow to finish his work. We had him professionally evaluated and it was also discovered that he has auditory processing disorder. This doesn't allow him to process more than one thing at a time. He can hear well, but he can't focus on more than one thing at a time. It doesn't allow him to hear people calling his name if he is immersed in another activity. Next summer, he'll be doing a 10 day intensive program for auditory processing which includes 2 hours in the morning and 3 hours in the afternoon. He'll be listening to headphones which somehow reprogram his brain to hear more than one thing at a time. I am really looking forward to this time to see if we can correct some of the behavior that he has.

We've found a few things that can work for Jeremy in regards to his behavior at school. First of all, Jeremy is OFF of all sugar. He used to have waffles with syrup every morning and all of the sugar gave him too much energy and he was bouncing off the walls! We finally realized that sugar has adverse effects so he now gets little if any sugar in the morning. We even prefer milk over orange juice since fruit has sugar in it.

Next, Jeremy has to take time to exercise in the morning. We put a mini trampoline in our living room and he bounces a few hundred times in the morning before school. If we have time, my husband will take him out to ride his bike before school or run around the field and play Frisbee. On mornings that he doesn't get to exercise, he seems to be more talkative and figity at school.

I've had to explained to Jeremy that sugar is "poison" to his brain. It makes him react in such a negative way where he throws fits and disobeys. I seem to automatically know when he's had sugar! When he acts like this and I know he's not overtired, I automatically ask if he's had sugar!? Usually, the answer is yes and so then I require him to start bouncing on the trampoline to get the energy out.

Jeremy might also have ADHD, which is a possibility since he was a preemie and upwards of 40% of preemies have ADHD. I went to one doctor and within about 1 minute he was telling me that Jeremy had ADHD and would require medicine! That appalled my husband and I was quite put off myself. Even if Jeremy does have ADHD, we're not going to put him on medication without trying to find every other way to manage it first. Besides occupational therapy, we've heard of other therapies that families have used and have had great success. Besides monitoring diet, they've used biofeedback and also some sort of testing of the electrodes in the body to eliminate toxins. I may have those details wrong, but we haven't gone down that road yet. Right now, Jeremy is in Tae Kwan Do 2 times a week. There, they teach self discipline, self esteem, leadership and focus. These are all qualities that I want for Jeremy.

If anyone could have told us where we'd end up even 6 months after we started down this path, I wouldn't have been able to handle it all at once. When we first discovered it, people came out of the woodwork to tell us their discoveries and what they went through. A friend from high school confided in me about her family situation and how they dealt with it. It was hard on her husband to imagine that their kid, coming from two "over achiever " parents, would have developmental problems. I could relate to that of course, but when she started telling me that her child couldn't stand loud noises and would cover his ears and cry and scream, I couldn't relate to THAT. She also told me that it'd be best for Jeremy to repeat kindergarten and at the time, it was a thought that I couldn't bear. We've since determined that Jeremy will repeat kindergarten next year. Coming to that conclusion took a lot of time and was a result of visiting numerous pre schools, talking with our own principal, vice principal, other parents, his teacher and the counselor. It was our principal who encouraged us not to do anything rash. I trusted her and I kept him in school and made the decision early on to repeat next year.

Other parents of kids of SID children had other stories. One parent's child had low motor skills and didn't want to swing or play with other kids. That was completely OPPOSITE of Jeremy. I did meet one mom at a workshop for parents with kids of SID who is very similar to Jeremy. He's a "crasher" and needs just as much physical stimulation as Jeremy. We laugh over the fact that we TELL our kids to jump on the couch... instead of getting off of them. So, little by little, with more reading and more talking, I found we all had one thing in common: MAJOR FRUSTRATION!

My friend from high school also had some of the same issues I was facing at home. My husband, who is a complete overachiever, couldn't deal with the fact that it was recommended that Jeremy go on medication. He absolutely REFUSED to even consider the possibility and so this would create lots of tension. My resolve was to find a solution, whatever that was. I was dealing with the teachers and with Jeremy every day, not just in the morning or at bed time. When I took Jeremy to school, the stress stopped for my husband, but not for me or his teachers. After speaking with numerous wives, I've discovered that the husbands don't believe it, or WANT to believe it. It appears that because men feel that they must be strong in every situation and must handle many obstacles in life, and that having a son that is facing problems is just too much to bear. Most of the dads of the boys with SID are in denial at first. The wives tend to have to deal with finding out what the issues are all by themselves by researching, talking and finding solutions. Many of the husbands fight the wives to the end until the wife finally convinces her mate to "just speak with an expert". In one case I know, the father uses the excuse, "he's just like I was" so he assumes it is okay. Meanwhile, everyone including his wife is going crazy having to deal with his child. My friend is of the mindset that if there IS help available, then she's going to get it! In reality, many of these men are right, because the kid IS just like them... and if there would have been help for their own mothers way back when, then the moms more than likely would have taken it instead of suffering through it and of course it would have made everything easier on the child. They could have learned tactics that would have helped them manage their actions, their bodies and their behavior.

My husband finally came around when he was able to speak with the Occupational Therapist where we got Jeremy evaluated. They promised to do whatever possible to work with Jeremy to correct many of these issues. The whole topic of using medication to help Jeremy hasn't come around for a while, but I know that my husband will be open to it if we have to do it. He's had to deal with Jeremy while I've been out of town and it nearly put him over the edge.

We're really just starting on this journey to getting the help we need. I've discovered many successes through trial and error. I've found that having a chart that rewards Jeremy for his chores and responsibilities for the day motivates him better than punishment. Tae Kwan Do has been fantastic to improve his self esteem. Talking with the teacher on an almost daily basis alerting her with new research I've found or discoveries that have happened has really helped. Daily massages on his feet, legs, back and hands are helping the stimulation of his skin so he doesn't freak out quite as bad when putting on socks and shoes. Teaching him to breathe himself through frustrations is an ongoing process and educating him about what to feed his body to it works correctly has helped me just as much!

Had I known what it would take to parent a child with Sensory Integration Disorder, then I would have said that I didn't have what it took. And I probably would have been right. My stress level has been through the roof ever since I had Jeremy but in reality finding out that he had something that was actually diagnosed gave me the power back! I knew that if I educated myself, our situation would improve and indeed it has.

I'm now able to understand that I need to implement complete structure in order for him to function at his best. That structure does include plenty of free or down time, but when it's time to do something or go some where, I put on my "drill sergeant" hat to get him to perform. It goes against my nature to be that firm, but I've learned that in order for our family to function, then I have to do what I have to do.

Please feel free to share your stories with me or to reach out for support. Perhaps if several of us can reach out to others to help, then others will be able to educate their spouses, their teachers and their friends.




Mary Gardner is an executive communications consultant and lifestyle coach. She is the mommy of Jeremy, a precious and active 5 year old boy who has Sensory Integration issues. Mary can be reached at mary@marygardner.com





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