Feeding

Sensory Processing Disorder: It’s Not… Something You Outgrow

STAR Admin — Mon, 23 Oct 2017 20:56:59 +0000

Sensory Processing Disorder: It’s Not… Something You Outgrow STAR Admin Mon, 10/23/2017 - 20:56

The “Terrible-Twos”. Separation anxiety. Night terrors. These conditions are closely associated with childhood. They can cause misery to child, caregiver and family alike. They bring distress, angst, loss of sleep, and unfortunately, sometimes the need for professional intervention. What these childhood conditions generally share as a group is the tendency for people to “outgrow” them as they age. In general, we view “childhood conditions” as just that – issues we need only worry about with children. Sensory Processing Disorder (SPD) is also a condition most commonly associated with children. But is that accurate? Do children grow out of SPD, like the childhood conditions listed above?

SPD is not an “acquired” condition – meaning that a person does not suddenly develop SPD as the result of illness or injury. SPD is there from very early in life (potentially in-utero), and if it goes unchecked, can create a whole host of issues. For example, children with SPD often present with significant feeding issues that can impact their growth, physical health, bowel and bladder functions, and even brain development. We also know that sensory problems in childhood are correlated with an array of childhood psychiatric symptoms (e.g. anxiety, ADHD, ASD) and difficulties with social-emotional and behavioral functioning (Miller, Neilsen, Schoen, & Brett-Green, 2009). But what every parent wants to know is, “Will my child just outgrow this?” Unfortunately, the answer – like the condition itself – is complex. We simply do not have evidence that children can “outgrow” SPD if it is left untreated. In fact, there is evidence to the contrary. Research has shown a strong correlation between SPD symptoms in childhood and adulthood (Rosenthal, M.Z., 2013). But what does that mean, exactly? If SPD is left unchecked, without intervention, what can that look like in an adult?

One of the areas hit hardest by SPD is emotional functioning. It is often the driving force behind a family seeking help. Chronic emotional dysregulation in a child can impact daily functioning, social-emotional development, school performance, and family quality-of-life. The impact of SPD on emotional functioning has long been understood (Amthauer, Miller, Brett-Green, Coll, Schoen, 2004). Social and emotional responses rely heavily on the brain’s ability to make sense of sensory information. Inaccurate information from processing deficits results in aversive emotional reactions from which maladaptive behaviors grow. A person’s behaviors, and other people’s reactions to those behaviors, influence an individual’s sense of self (Rosenthal, M.Z., presentation, 2013). For a child, this may mean feeling out of control, “different”, or unable to trust themselves. These feelings may further develop into signs of anxiety or depression. For adults, the picture does not improve. There is evidence that links some mental health disorders with sensory over-responsivity (SOR), a subtype of SPD. Reports of significant SOR in childhood has been associated with adulthood depressive symptoms, anxiety symptoms, negative emotions, poor self-concept, neuroticism, and inattention. Adulthood SOR has been linked to higher incidences of depressive symptoms, anxiety disorders, introversion, negative emotions and poor self-concept (Rosenthal, M.Z., 2013; Kinnealey & Fuiek, 1999).

So, is that it, then? A diagnosis of SPD translates to an adulthood of social-emotional strife? No, of course not. Many factors go into both a child’s and an adult’s ability to improve and manage their SPD and the impact it has on their life. Some factors are obvious: a safe and supportive home life, proper nutrition, adequate sleep, early identification, and appropriate intervention. Others are harder to pin down: temperament (the hard-wired part of personality), genetic disposition, intrinsic motivation, and relationships with others are just a few of the “it” factors that impact how SPD presents itself and the effect it has on life as a person ages. And even though research in the field continues to grow and uncover some of the many mysteries of SPD, researchers have not yet discovered “secret sauce” – how to predict what exact constellation of interventions are needed at key moments in development. What we do know is that not addressing SPD and the problems associated with it can have significant negative outcomes.

As it stands today, many more resources are available to young children with SPD and their families than to adolescents and adults with SPD. The vast majority of sensory-trained clinicians are pediatric-based (usually that means 0-12 years). Services are most accessible through sensory trained Occupational Therapists (OTs) providing early intervention and school-based therapies. The field narrows considerably once a child ages out of these options, but narrow does not mean non-existent.

There is a growing number of sensory-trained therapists specializing in the adolescent and adult populations, and their unique set of needs. Exploration and use of sensory equipment is still common with these older populations. But instead of the focus being on play themes, imagination and games as it is with children, OTs put more focus on the adolescent and adult client actively engaging at a more cognitive level, with attention to understanding what SPD is, and bringing a client’s attention to what and how different sensory experiences affect them emotionally and physiologically. Biological markers such as heart rate, breathing patterns, and muscle tension are used to help a client become aware of how their system processes certain sensory-based experiences. Older clients work on recognizing their own sensory constellation, what is comforting, and what is dysregulating. Then, with an OTs guidance, they apply this knowledge to their own real-world occupations by developing plans and strategies for support implementation, compensations, and regulating sensory experiences. Treatment may occur weekly or on a consultative basis depending on the needs of the client. Although the current number of adolescent and adult sensory specialists is far lower than those of their pediatric-focused colleagues, the number is steadily increasing as awareness of the unique needs and presentations of adolescent and adult populations grows. And OTs are not alone. More and more mental health providers are recognizing the connection between SPD and emotional well-being and are seeking out training and consultation from sensory-based OTs.

Laughter. Contentment. Hope. Joy. These conditions are not closely associated with a particular age or developmental stage, but instead with an individual empowered through understanding and addressing their SPD.

If you are looking for SPD treatment for yourself or your child fill out a child or adult intake form now to be treated at STAR Institute Treatment Center or search our Treatment Directory to find services in your area.

Mim Ochsenbein, MSW, OTR/L has been a practicing pediatric occupational therapist for over 20 years. She has received advanced training in sensory processing (STAR Institute Intensive Mentorships, SIPT certification), listening therapy (Therapeutic Listening), feeding therapy (SOS) and infant massage (CIMI). Mim received her MSW in 2012. Her work with children and youth has occurred in a variety of settings including early intervention, school based, clinic based, mental health and private practice. In her role as STAR Insitute’s Director of Education, Mim creates and teaches STAR Institute trainings, oversees SPD University, and provides educational programming and resources for clients and families.

by Mim Ochsenbein, MSW, OTR/L

Adults and SPD

Sensory Processing Disorder

How I Use Bubbles to Take the Struggle out of Mealtime - for Big Kids & Little Kids

STAR Admin — Mon, 20 Mar 2017 14:32:28 +0000

How I Use Bubbles to Take the Struggle out of Mealtime - for Big Kids & Little Kids STAR Admin Mon, 03/20/2017 - 14:32

We have been getting asked a lot lately why we use bubbles before our feeding therapy sessions. The short answer is that kids like bubbles a lot more than doing deep breathing exercises.

There are actually several different reasons why we use bubbles. Here are a few of the main reasons:

We know that if we take 5-6 deep breaths, we can decrease our stress hormones (adrenaline), by increasing our endorphins (the ‘feel good’ chemicals). If we have a lot of adrenaline at mealtime, the adrenaline tells our brain to turn off our appetite. This reaction goes way back to our ancestors. If you are running away from a tiger in the jungle, you don’t have time to stop and think about the fact that you missed lunch, you just need to run! Kids who are stressed are also not going to be very interested in eating.
Blowing bubbles and other blowing games, are great ways to start working on oral motor skills. We can practice moving our lips, controlling our breath, and using the mirror to watch what our body is doing. Using bubble whistles is also great motivation for children to start putting things in their mouth and figuring out what that feels like.
Bubbles are also a pretty fun transition activity. For many of the kids, coming to the table, or mealtime in general, is the hardest part of their day. Transitioning to something that they like is a helpful way to get them to the table. Certainly, some children don’t like bubbles. For these kids, we sometimes use pinwheels, blow bubbles with large straws in a bucket of soapy water, or blow cotton balls through a maze with straws. The actual bubbles aren’t the key – it is the deep breathing and the fun activity.

The coolest part of bubbles, is when we do ‘big kid’ bubbles. We save bottles from sauces and dressings, run them through the dishwasher, then cut off the bottom of the container. This makes a plastic ‘tube’ that we can use to make giant bubbles.

These bubbles really give us the opportunity to work on breath control, moving slowly and touching wet things. You also get some major deep breathing, in through your nose, out through your mouth, when blowing a giant bubble!

Here is the recipe we use for our ‘big kid’ bubbles:

In an 8 oz bottle combine:

2 oz glycerine
1 oz dish soap

Fill the bottle to the top with water. When you are ready to blow bubbles, you can pour a thin layer of the bubble solution in a bowl or pan. Mixing bowls with a flat bottom or 8x8 baking pans work great!

Dip the cut side of your bubble blower into the bubble solution, then take a deep breath in through your nose. Put the top of the bubble blower to your mouth, then slowly blow out through your mouth. If you get the table super wet with bubble solution, the bubbles will stick on the table. You can also get your hands wet to hold the bubbles or stick your fingers through the bubble. Your bubble will pop if you go too fast, or if your hand or the table isn’t wet enough.

Enjoy!

*Information presented in this article is used with written permission from Dr. Kay A. Toomey and is not authorized for copy, use or modification. Copyright SOS Feeding Solutions 2017.

Learn More About How to Know if Your Child Has a Feeding Problem

Read about more about Picky Eaters vs Problem Feeders

Read about feeding Red Flags

Lindsay Beckerman, MOT, OTR/L - Feeding Specialist

Lindsay received her Masters in Occupational Therapy from The Ohio State University. During her graduate studies, she received a graduate assistant scholarship where she trained under Dr. Jane Case-Smith in a multidisciplinary Autism diagnostic clinic and collaborated with a special needs preschool to provide OT services embedded within the classroom curriculum. Prior to employment at STAR, Lindsay worked as an occupational therapist at a pediatric psychiatric hospital, working primarily with school aged children with an Autism diagnosis in addition to a psychiatric diagnosis in their residential and school setting and in a sensory-based outpatient clinic. Additionally, she has completed the STAR Institute Intensive Mentorship Program and trained under Kay A. Toomey, PhD using the SOS Approach to Feeding. Lindsay joined the STAR Institute team to work I as part of a multidisciplinary team and to expand her knowledge and clinical reasoning skills with the support of experienced mentors.

by Lindsay Beckerman, MOT, OTR/L

Feeding

Sensory Processing Disorder

Does My Picky Eater Need Feeding Therapy Or Will They Grow Out of It?

STAR Admin — Fri, 03 Mar 2017 16:18:36 +0000

Does My Picky Eater Need Feeding Therapy Or Will They Grow Out of It? STAR Admin Fri, 03/03/2017 - 16:18

As a feeding therapist, I get asked this question all of the time. The tricky part, is that research tells us that many kids are picky at some point in their life. About 50% of parents rate their toddlers (ages of 19-24 months), as a picky eater (Carruth, B., et.al., 2004). Between the ages of 2 ½ to 4 ½, 30% of parents rate their child as a picky eater (Dubois et.al., 2007). Fortunately, about half of the picky eaters do grow out of it. The tough part, is figuring out which kids will grow out of it, and which kids need some help.

In our clinic, we have created a few different handouts for parents to help them figure out if their child is going through a stage, or if their child has some skill deficits that are making it hard for their child to eat. Here are a few red flags for kids who probably need some help.

Ongoing poor weight gain (dropping percentiles, or losing weight)
Frequent choking, gagging, or coughing during meals
Avoids all foods of a specific texture (crunchy foods, soft foods, purees, etc.) or a nutrition group (meats, fruits, vegetables, etc.)
Eats less than 20 foods
Your child has a NG-tube, G-tube, or GJ-tube
Mealtimes are consistently a battle
Children who have difficulty transitioning to purees by 10 months, aren’t accepting table foods by 12 months, still eating only baby foods after 16 months, or haven’t transitioned to drinking something out of a cup by 16 months.

Read about more Red Flags

Sometimes, kids have more subtle problems at mealtimes, which can still mean that they don’t have the skills that they need to eat an age appropriate diet. Here are some ways to identify these kids.

Your child has a hard time sitting at the table for meals
Your child eats meals separately from the rest of the family
Your child can only eat with a distraction (a screen, toy, or book)
Your child is very brand specific about which foods they will eat, or their food needs to be prepared in a very specific way
Your child gets very upset when any new foods are presented at the meal

Read about more about Picky Eaters vs Problem Feeders

If this described your child, the good news is that there are lots of places that can help! Feeding therapy can be really fun, and it gives families and picky eaters some new ways to learn about food. To learn more about how to help your child eat and grow better, check out SOS Feeding Solutions at STAR Institute for SPD. Always remember, there is hope and help for picky eaters in feeding therapy with a sensory and play based approach!

Learn More About How to Know if Your Child Has a Feeding Problem

Lindsay Beckerman, MOT, OTR/L - Feeding Specialist

by Lindsay Beckerman, MOT, OTR/L

Feeding

Sensory Processing Disorder