Sensory Processing Issues

If you follow us on Facebook, you know that a lot of Aidan's autism “symptoms” relate to his sensory issues. If it's too loud or his clothes feel wrong or the lights are flickering or food tastes funny or feels funny then we might be headed for a meltdown. Sometimes he'll scoot around on the floor with his head down or spin in circles. These are all manifestations of what is sometimes called “sensory processing disorder”. A child doesn't have to be autistic to have sensory processing disorder, but most kids with autism do have some form of sensory processing issues. A lot of the autistic child's “stimming” comes as a result of their difficulties with sensory integration. Repetitive or stereotyped activities (flapping, spinning, lining up toys, headbanging, etc) are often a child's way of fulfilling sensory needs. Meltdowns are a child's reaction to sensory overload in many cases.

Imagine yourself at work in an important meeting. The chair you sit in feels more like the wood plank park bench which pinches your bottom and is uncomfortable to sit on for more than a couple of minutes and the back just doesn't feel right. You have gloves on your hands which make it difficult to receive enough stimulation to be able to type or write correctly. There are bright lights shining and maybe even flickering in your eyes making it hard to see your boss as he tries to talk to you during this meeting. There is loud music coming from outside the room as the janitor cleans, and someone is crackling paper right next to you and a fly is buzzing around your head incessantly. It's super cold in the room so you're shivering. You took a drink of what you thought was water because your mouth was dry and it tasted like lemon juice and now your mouth is puckered because it tasted so bad. What did your boss just ask you to write down?! You have no idea because every sense is being inundated with too much input. Your boss fusses at you for staring at him like he has two heads and you try to explain but are so distracted the words just won't come out because you can't think of what you need to say. He begins to get more angry which only frustrates you more until finally you lash out angrily at him, and since you can't speak coherently it just comes out as violent screaming and babbling. This is a day in the world of a child with autism or sensory processing disorder. It might not always be this severe, some days are worse than others, but every little thing makes it impossible to focus and may even be painful. For Aidan it sometimes means he needs earmuffs or sunglasses or to avoid certain places (Lowe's and Logans for example) all together.

Other children are the opposite – they need sensory input because they are hypo-sensitive. These are the children who bang their head against the wall, flap their hands, make loud noises, spin around in circles, or other “hyperactive” or strange behaviors. They may have meltdowns because they feel like they are floating or some other strange sensation. Deep pressure therapy can help these kids, or a sensory swing.

Aidan has a combination of both hyper-sensitivity and hypo-sensitivity and they can switch back and forth on him with no warning. One day every little sound hurts his ears and distracts him and he has to speak loudly himself just to be able to hear himself over every other sound in his environment. The next day he needs auditory input and everything has to be at the highest volume possible. Usually he can't express to me exactly what sensory input or avoidance he needs. Some days I'm not sure if his behavior is typical little boy acting out or if it's fulfilling a sensory need. I've asked him before about spinning or crawling on the floor with his head down or not acting right at school. Sometimes he tells me that his brain was itching or he needed to get the mad out or some other strange response.

Sensory processing disorder may look very different from one child to the next. One person might have to have all the tags cut out of their clothing and only be able to wear sweatpants and socks with no seams. Another might have poor sensory awareness of his muscles and joints and be extremely “klutzy” or a “spaz”. Yet another might have little to no reaction to pain, cold, hot, or other tactile sensations.

There are different therapies for children with Sensory Processing Disorder, usually falling under the auspice of “Occupational Therapy” and quite often NOT covered by insurance since SPD isn't a recognized syndrome in the DSM-IV (the diagnostic manual used by psychiatrists), and autism is considered by most insurance companies to be an educational rather than a neurological issue. At Aidan's school they have a separate room called a “sensory room” which has dim lights, cool air, soothing music, and lots of sensory input toys such as a ball pit, scarves, beanbags, and a trampoline.

Does your child (autistic or not) have sensory processing issues? SPD Foundation has a checklist available on their site to help you determine if it's possible.

Next time you see a child acting out or strangely, stop and take a look around you. Could it be too loud or bright or could they be feeling hypo-sensitive and need more input? Don't assume that a child is misbehaving out of poor discipline or lack of attention. While this may be the case sometimes, making this assumption can be disastrous and hurtful not only to the child, but also to a struggling parent who is trying to finish an errand while not offending or annoying those around them who simply assume they have a naughty or spoiled child and are a bad parent.

Meltdowns 101

A lot of people outside the autism community seem to be confused or misinformed or uninformed about meltdowns in autistic children (and adults for that matter). I know that when Aidan has a meltdown, I make myself stop and say “Okay, is this a meltdown or just a tantrum?” It's usually pretty easy to tell the difference. Sometimes a meltdown will start as a tantrum but devolve into a meltdown, usually because Aidan's communication skills aren't enough and he gets frustrated, or because whatever caused the tantrum was just a trigger for a meltdown (like the straw that broke the camel's back – more about this later). A meltdown can happen for any number of reasons, and it's often difficult to tell what that reason is – I try to go back after an unexpected meltdown (it's not possible to do so DURING) and figure out what triggered it. If and when possible I'll try to defuse the situation before the meltdown happens, but this isn't always possible. Just like the bombs on television always have digital clocks on them, all autistic kids have bright, easy to see, obvious warning signs, right? Wrong. Sometimes I can see it coming, but unfortunately it's usually too late by the time I do.

What does a meltdown look like?

For Aidan, a meltdown may start with a very aggravated look on his face, widened eyes, clenched teeth, and balled up fists. He'll often growl at me or grunt, and usually at this point is beyond speaking to me, especially not to tell me what's wrong. This then progresses beyond aggression into violence – at this point if I look at his eyes, it's almost like Aidan's not in there at all, he's been taken over by this crazy little rabid animal for the time being. He begins screaming at me and then attacks me. I can try to walk away or place him in his room to do his thing by himself, but inevitably Aidan will pursue me. He will punch me, scratch or claw me, kick me, throw whatever is available at me, headbutt me, and attempt to bite me. His whole body is completely tensed up, his back frequently arched. He's chipped my teeth, broken Jeremy's glasses, damaged his own toys, thrown furniture, and always leaves claw marks and bruises all over me. It can last anywhere from 5 minutes up to an hour (we've never seen one longer than that, thank goodness, although he has had multiple meltdowns in one day). A meltdown doesn't stop as suddenly as it starts. Eventually Aidan slowly calms down, stops hitting me or trying to hurt me, moves from screaming and growling into crying and sobbing, and his body relaxes. He'll hide his eyes at this point, a lot of times he'll cover his ears, and sometimes he'll let me rub his back but usually he doesn't want anyone to touch him. If I try to talk to him about it, it's going to either make him cry harder or ramp the meltdown back up. He's usually very very tired after a meltdown and doesn't talk much at all.

What causes a meltdown?

Often a meltdown seems like a mystery. There are any number of triggers for a meltdown, and what may seem to be the cause of a meltdown this time, might not so much as phase Aidan next time. Or something that never bothered Aidan before suddenly sets him off unexpectedly. This is a pretty good sign that what set him off was a trigger but not the cause. Think of it like the old metaphor of the straw that broke the camel's back; a combination of sensory overload, physical discomfort, frustrations, disappointments, or surprises comes together to confuse Aidan's brain and he doesn't have the vocabulary or self-control to handle it calmly or at least ask for help to fix the situation. Sensory overload for Aidan is usually sound related, although it can be lights or any number of other sensory input – think of it kind of like how a strobe light can cause a seizure. Physical discomfort we've discovered after the fact has been from toothaches, tummy aches, sore throats, and even from being given milk at school (his tummy is very sensitive to milk products). Frustrations could be caused by a game not working for him or a friend not doing what he wanted or expected. Also, Aidan has a very strong sense of “justice” which isn't always logical, but if you punish him for something that he feels was not wrong or that he wasn't told there was a rule against, he will go into a tail spin.

Can't this just be “disciplined” out of him?

If Aidan is just throwing a tantrum, or if he's winding up toward a meltdown but still has some control over his behavior, then yes, discipline or even distractions can help the situation. But if Aidan loses control over and unmet need or discomfort, and I punish him instead of figuring out what his problem is, then I'm only going to make Aidan even more out of control. Basically I'm punishing him for trying to communicate that something is wrong in the only way he knows how at the moment. Some days his verbal skills are worse than others. Especially if Aidan is fighting off being sick, his ability to tell me something wrong can be diminished by various factors, and if I try to punish him into acting the way I want him to, I'm just going to make things worse.

So what do I do now that I know?

For a long time I had no idea whether Aidan was having a tantrum or a meltdown. I would try to punish him and only make things worse. Without the experience I have now with Aidan, I wouldn't know what to do in the event of a meltdown. Now, if I judge that Aidan isn't throwing a tantrum but has completely left the building when it comes to his ability to control his behaviors, then my only option is to make sure he's in a safe place (out of reach of things that can get broken or could hurt him), and try to restrain him enough to keep him from hurting himself or me. It's exhausting for everyone involved, and god forbid it happens in public. I think the hardest thing to explain to people without experience in the world of autism, is that aggression and meltdowns and the behaviors associated with them, are not signs of a spoiled or bratty child, or of bad parenting – they are simply symptoms of a disorder.

I invite your questions, comments, and suggestions (so long as they are constructive and in the spirit of learning and cooperation).

Aidan moves to a new school... or, why first year kindergarten teachers shouldn't have autistic children in their classroom...r

It's been an excruciating and stressful process, which has taken nearly a month (maybe more) to straighten out, but Aidan is now happily ensconced at his new school. Let's hope this time is more successful.

Because I registered Aidan late at Creekside Elementary (here in Limestone County), he was placed in a classroom with a FIRST YEAR TEACHER. Okay, seriously, who is this fair to? Aidan did alright at first, he made lots of friends, and came home singing songs and did his work. He adored his special ed teacher, Ms. Matsos (thank God for her, or things would have been a million times worse!), but she could only spend so much time with him, since she's got a lot of other students to tend to.

Aidan has a lot of issues with sensory overload, and I made sure that his kindergarten teacher (Ms. Hayes), Ms. Matsos, and the principal (Mr. Scott) all knew about these issues. Sounds are really his weakness, and he has to put a lot of effort into ignoring all the little noises you and I are able to filter out with no issue. I know some smells bother him, and he hasn't really told me about whether certain lights bother him, but who knows. We send his iPod to school with him everyday in case he needs time out and some different sensory input, and you'd think Ms. Hayes would learn pretty quickly when Aidan needs a chance to escape.

A couple weeks into school, they started DIBELS testing. This is basic reading skills competency for kindergartners. Aidan had been doing fine up until this point, with really very few problems. As far as I can guess, this change of schedule and routine really threw him off and the problems started.

Now anyone who's been around Aidan a lot, knows that when he's trying to ignore the world around him and focus on the task at hand (school work, TV, playing with trains, Lego's, etc.), if you touch him or speak to him, he lashes out. He just has a hard time with the sensory input. At school there are even more noises to try to filter out, and even more to focus on. Of course, kindergartners aren't great at staying out of personal space, or leaving other kids alone, and they all sit at group tables together. What does this mean for Aidan? It means that he starts hitting kids or pulling their hair or whatever reaction he feels is necessary when they break his focus or he goes into sensory overload. He had been having problems with pickup in the afternoon because it was too loud, and we changed that situation, but you can't exactly pull a kid out of the classroom every time he gets overwhelmed.

At least twice a week I was being called by the principal, or having to go the Principal's office to pick Aidan up because he had hit another student, or worse had hit his teacher. Kindergarten children should not be spending the day in ISS (in school suspension). But Aidan realized that the office was quiet, and there weren't other students there to invade his space or make irritating noises. So he continued acting out, because for him that wasn't a punishment. And it felt wrong to punish him for reacting the only way he knew how to a highly uncomfortable situation - he just doesn't have the coping skills to deal with it any other way.

Finally, Mr. Scott (the principal at Creekside) recommended that we consider placing Aidan at a different school that could better provide for his needs as a child with autism. Johnson Elementary, which is about the same distance from our house, just in a different direction, has a self-contained autism unit, with several aides to help the children one-on-one, and one of the best autism teachers in the state.

What an opportunity!

We were hesitant at first. Aidan is super-smart (highest reading level in his kindergarten class!), and very high-functioning - would these kids who were much lower-functioning make it harder for him to progress? Would he be overwhelmed by their behavior? If we didn't move him, what could we do for him?

Fortunately, Limestone County spent the majority of their stimulus money on their autism programs. In fact, they have a nationally renowned behaviorist from Auburn on retainer for the year - Dr. Babcock. He's odd, but he's very intuitive and has been working with autistic children for a very long time. We had the chance to sit down with him, as well as two of the special ed coordinators from the school board, and the autism teacher at Johnson (Ms. Enloe, who is amazing). Dr. Babcock also went over and spoke to Ms. Matsos about Aidan, and also observed him for a little while to get an idea of Aidan's behavior. Apparently, it is very rare for Dr. Babcock to recommend for a child to go to the autism unit, but he told us without a doubt that this was where Aidan belonged (heck, we asked God for a clear direction, I guess he thought he'd better make it crystal clear!). He feared that if we didn't move Aidan, he would develop a school phobia - he didn't want Aidan to feel like he had to act out to escape the discomfort of the regular classroom.

So, I took Aidan the next day to visit the classroom, with the hopes that if he liked it, we could get him enrolled the following Monday. This was the plan, and I was told by the special ed coordinator that it was clear for us to do this. We were delayed by a week because Ms. Enloe was going to be out on training, but when she returned then we'd start Aidan there and have his IEP meeting on his first day.

This is where the tangled mess that had me so stressed out really got even messier. Jeremy and I showed up Monday morning with Aidan who they took to the classroom. Ms. Matsos, Ms. Enloe, Dr. Lewis (Johnson's principal - who I don't like), and Ms. Simmons (a kindergarten teacher at Johnson) met with us. Instead of coming up with an IEP, they (Dr. Lewis and Ms. Enloe, but mostly Dr. Lewis) started back-pedaling. Oh, we didn't know about any of this, we don't have enough info to do an IEP, we don't know enough about his behavior, we didn't know this decision was final, are we sure he should be at Johnson, I thought Dr. Babcock was supposed to make a behavior plan first, that meeting wasn't official, let's step back and think about this. I went into mama bear mode. I was ready to slash some throats and take some heads. We left that day without accomplishing anything. They said he could stay the rest of that day, but should return to Creekside until further notice. The principal would attempt to contact the special ed coordinator. We had to wait until Friday after next to hear from Dr. Babcock. Who cares if we're shoving an already miserable little boy back into an uncomfortable and unproductive environment? It's convenient for us.

Thank goodness Ms. Matsos told Mr. Scott. About an hour after the disastrous meeting, my cell phone rang and it was Ms. Baccus (the special ed coordinator). She said Mr. Scott had called her and said the meeting hadn't gone well. I told her what had happened, and she confirmed that it was not THEIR decision to make, and that the decision had already been made and emails had been sent two weeks before. She said not to get upset because it would be taken care of. She called me back again and said we could go ahead and transfer Aidan from Creekside to Johnson, that he would finish out the week at Johnson, and on Thursday we'd have the IEP meeting, and she would be there to ensure that things were done properly and Aidan wasn't shuffled to the side again for the sake of bureaucracy.

So Aidan started his second week at Johnson yesterday. They've been working on handwriting, and numbers, and when he behaves for a certain amount of time he gets to go the sensory integration room. He calls it the nursery room for some reason - he loves it. It has quiet music, and dim lighting, and all kinds of interesting toys like a ball pit and a tent, and eventually a swing. He seems so much happier.

Right now they're observing his behavior, and letting him acclimate to the new school and environment. He's getting used to the new schedule and people, and then once they've gotten to know him, he'll start spending time in the regular kindergarten classroom, with an aide. Eventually, he'll spend the majority of his day in there with an aide. The plan is that next year he'll be back at Creekside and we'll try the whole kindergarten thing again. Considering he's got the maturity of a 4 year old right now, then next year he should fit right in. And you can be sure, I won't allow them to place him with an inexperienced teacher again.

Aidan's Rocket Adventure

Aidan went to the Space and Rocket Center today with his Maw-Maw, Paw-Paw, Great-Grandma, Great-Grandpa, and Uncle Matt. I worried about him - I won't lie. I know how he reacts to loud places and lots of people. Besides - the place is boring if you ask me! But he did great according to Maw-Maw. He had his difficult moments of course, but we've been working with him, giving him tools to cope with his difficulties. Impatience was an issue, but that's obviously a normal 5 year old issue. On the other hand, he really wasn't sure about the Davidson Center (this is where the house the gigantic Saturn V rocket that took us to the moon). Every so often someone would push the button and the sound of the rocket launch would echo through the massive building. Apparently once he was able to push the button himself he handled things a bit better.

What did surprise me was his enjoyment of the Mars ride. Again his tools helped him. Mom told him how it would sound and feel (to the best of her ability). She let him talk to some older kids who had already ridden it, and they assured him it was fun and were nice enough to let him go ahead of them so he could see the ride from the outside. It's one of those where you get in and the box just rocks around a whole lot but you have a big screen inside that makes you feel like a whole lot more is going on - sort of virtual reality I guess. Then the facilitator showed Aidan where the button was to stop the ride if he needed to get off (or anyone else did for that matter) and the ride started. At first he might have been a little scared, but he had a blast overall. And I'm glad.

This weekend he gets to stay with Maw-Maw and Paw-Paw while Jeremy and I go to Atlanta for a much needed vacation. He'll be staying with them for 3 nights. I know he'll be fine - and so will I! See you when we get back!