Recognizing Sensory Processing Disorders (SPD): Guest Post by Jonathan Evans

I regularly receive comments from parents expressing appreciation for the respectful parenting approach I share on my blog (Magda Gerber’s RIE approach). Occasionally, these same parents will then assert that this could not possibly work for their child with high needs or special needs, for any number of reasons. Over the years, I have consulted with many experts on the subject of RIE and children with special needs, and the majority refute that belief.

Dr. Jonathan Evans is one such specialist, and he generously offered to share his insights in this guest post about a subject “dear to his heart”: behavioral and learning difficulties in children and sensory processing:

What Parents Need to Know About Sensory Processing and SPD  

Sensitive observation is a central element of infant expert Magda Gerber’s RIE philosophy. When we practice the RIE principles and are present for our child, our sensitive observation often enables us to better understand what is going on for them, and parenting is extremely rewarding both for child and parent.

However, even in a perfect world where we are completely present and available for our child, there will be moments when we simply don’t understand why they are behaving or reacting a certain way. If these moments become more frequent, then we may find ourselves putting a label on our child’s behaviour. For example, “they’re colicky” or “they are teething”.

Sometimes this is 100% correct. Often, however, we simply don’t know. As our babies turn into toddlers, these difficult moments can multiply. If they start to join up, then we may start to describe them as behaviour issues. If things get really difficult, then our child may be described as being on the ‘spectrum’ or his behaviour may have other labels attached such as Aspergers or ADHD or SPD.

This is a subject very dear to my heart because not only do I specialize in the treatment of children and babies, but my 7 year old Makani has sensory processing disorder (SPD).  It’s all quiet in my house now as both my boys are in bed, but half an hour ago it was chaos – it was the nightly ‘teeth cleaning’ routine for my two boys, and unfortunately we had run out of their toothpaste so it had to be the adult brand.

First my 4 year old, on goes the adult toothpaste. A little bit of a registering from him that it tastes a bit different, but all good and off he goes to mum for a story. Next, my 7 year old. First, a calm explanation of the situation from me as he doesn’t handle surprises well. Then the toothpaste, and as soon as he tastes it things get difficult – tantrum, shouting, feet stamping, spitting out of the toothpaste and general refusal to co-operate in any way. It’s not fun, and I want to shout back at him. I manage to stay calm. I back off and we sit down in the bathroom to discuss the issue, his view, my view etc.

In the end we manage to compromise over a reduction in length of the teeth cleaning for tonight, along with the promise of his usual toothpaste tomorrow and the lining up along the sink of what seems like every vessel in the house that is capable of carrying water. We go at it again, and after an eternity involving all the water vessels and much rinsing and complaining, we are done!

So what have we got here? A naughty child and a good child? An indulged, spoiled 1st born and a meek 2nd child?  These types of questions and the behaviour that prompts them is what I talk to parents about every day that I’m in clinic.

“What is going on inside your child’s head when they are being difficult?”

Sometimes the answer is obvious – hunger, fatigue — but let’s look at a model that will shed light on the behaviours that we can’t explain.

The Sensory Processing Model

input, processing, output - software system

The understanding behind all human and animal behaviour is stimulus and response. There are the 5 senses (hearing, sight, touch, smell, taste) and a sixth, the balance mechanism (vestibular system).

  • We use our senses to gather information about our world
  • We send this information to the brain where it is processed
  • The brain then tells us what action we should take in response

Simple and predictable? Unfortunately not, as everyone processes the same stimuli slightly differently, and this is why we see different responses to the same event. This is true in adults and especially so in children whose brains are still developing.

The term sensory processing disorder (SPD) is used to describe a child who has difficulty processing ‘sensory information’. However, all children will experience situations where they can’t process the information that their brains are receiving. It is only the frequency and severity of these situations that separate these children from those with an ‘official’ SPD diagnosis.

Relevance for you as a parent

Let’s go back to my boy Makani. Taste is not his only Kryptonite. He also has an Auditory Processing Disorder (APD), and we see difficulties in the other senses as well. If I was unaware of these sensory processing difficulties, then I would consider him very defiant, which would probably have led to one of two parenting options:

1)    Increase the discipline to combat the defiance

2)    Give in and let him do whatever wants

3)    A combination of both

None of these methods is addressing what is going on and, in fact, make matters worse. The third option is disastrous. We see this played out when a Dad (it’s usually Dad) enforces discipline for what he sees as an unruly child, and then Mum tries to dilute the discipline as she senses her connection with her child being permanently broken.

All three of these options create immense stress for the child which hugely influences the brain.

Stress and the Fight/Flight Response

If a child encounters a stimulus that he can’t process easily, how will he respond? In one of two ways: fight or flight. This fight/flight response is hard-wired in humans. In children we will see:

  • Fight – tantrums, shouting, crying, refusal to do something etc.
  • Flight – withdrawal – stopping of movement and hunkering down, avoidance of eye contact, refusing to speak or answer, refusal to do or go somewhere (by peaceful means as opposed to the defiance seen in flight response).

What is vital to know is that a little bit of stress = improved brain performance. A lot of stress and/or continued stress = poorer brain performance. This means that if a child is stressed by a stimulus and isn’t supported appropriately through that situation, then they are likely to get more stressed and less able to handle the next stimulus. Now and then isn’t a problem, but on a continuing basis this can lead to serious problems for that child.

Adaptation

If the overloading stimuli keep coming, then it is 100% certain that the child will adapt his behaviour in expectation of the next unwelcome stimulus. How does an intelligent child do this? He does it by controlling his environment. Can he control it 100%? Of course not, but he gives it his best shot anyway. This is when we start to see some of the following:

  • Continual movement and activity: flitting from one activity to the next, never stopping for one second. The child is trying to fill his brain 100% so that there is no room left for other unwelcome information. If the child initiates the stimulus, then he is in control of it, and it isn’t overwhelming. This is what is generally diagnosed as ADD or ADHD.
  • Ordering and making lists: whether it is dinosaurs, pencils or your desk (if you are an adult), excessive ordering and tidying is a way to control our environment, to block out stimuli and attempt to prevent future change. Diagnosis for this is OCD (Obsessive Compulsive Disorder)
  • Defiance: if I just say ‘no’ to everything, less will happen that is outside of my control. How do we diagnose this behaviour in children? We call it ODD (Oppositional Defiance Disorder).
  • Talking loudly, making lots of noise, shouting, continually interrupting and asking questions. A child who exhibits this behaviour to an extreme is probably trying to drown out noise so they only have to process their own noise. With the interruptions and questions, they are pausing the flow of information to their ears in order to give themselves a chance to catch up and process what has been said. This is a classic APD (Auditory Processing Disorder) trait. I know I have done this myself all through my life, and I only realised it in my 30’s when I started working in this field! (Apologies to past girlfriends for all those arguments in the car when you were giving me directions and I got us lost and blamed you!)
  • ‘Perfect’ behaviour when away from the home and/or when away from parents; poor behaviour at home. This often occurs with kids that have very high levels of stress. They often shut down and go inward when they are out of the home as a defence mechanism, but then they can blow up when they are at home. This is because home is actually the only place they feel safe enough to express their bottled up feelings. Very common is to see school reporting a model child (i.e. one that doesn’t cause any trouble or disruption or says nothing much at all), and this leaves the parent a  bit confused as this isn’t the picture at home at all.

The Apple Doesn’t Fall Far from the Tree

So I have a son with APD, and I have APD. Coincidence? Of course it is. He had a difficult birth, and I was hit on the ear by a cricket ball when I was four. Anyway, this is what I’d like to believe, and definitely those two incidents have affected our ability to process. However, having worked in this field for a while now, I have seen far too many ‘coincidences’.

I mention this because it is very important for parenting. If you or your partner have a similar ‘processing issue’, then both parties are probably creating a lot of stress for each other and winding each other up until one or both explodes. This is a negative downward spiral that must be addressed. Now, it is also likely that if a parent has reached adulthood without realising they have a processing issue, then they are usually very reluctant to look at that. So please don’t bash your partner over the head with an accusation and lay all the problems at their door!

So what can we do about this?

1)    Make sure you or your partner aren’t making the problem worse. Do you have processing difficulties or relationship issues that are creating a spiral of behaviour within the family?

2)    Now that you know what triggers difficult behaviour, look to identify specific stressful stimuli. Avoid or reduce them wherever possible. If you need more details, Google SPD and APD, and you will find lists of triggers.

3)    Time is your friend. The more time your child gets to process, the less stressed they will be and the more able they are to deal with a situation. So, if they have auditory issues and you are in a noisy shopping complex and you are rushing them, then you’re either going to get a ‘blow up’ or they will withdraw and bottle that stress. It will come out at a later time.

4)    Growing up is also your friend – as a child gets older his brain matures and he is far more capable of dealing with the sensory information that he struggled with a few years earlier. This is usually seen from five to six years upwards. However, if stress levels for the child have been very high, then it will take further years of supportive work to see these improvements.

5)    Appropriate classical music can be very beneficial. This is a topic in itself, and is the basis of the Integrated Listening Systems, a home program for APD & SPD.

6)     Osteopathy and other hands on therapies. Cranial osteopathy is an excellent modality for treating the cranial bones and birth trauma. For most people birth is the most traumatic event that their body will encounter, and this will influence the cranial bones which can in turn influence the brain and its ability to process, especially under stress.

 

Dr. Jonathan Evans is an osteopathic doctor that specializes in children and children’s development. If you wish to read more of his articles on children and children’s health visit his website ionosteo.com and click on Well Child Clinic.

Please note: extreme cases of any of the conditions described should be diagnosed by a specialist.

Jonathan welcomes your comments and “will do his best” to reply to your questions!

(Photo by Luke Wisely on Flickr)

98 Comments

Please share your comments and questions. I read them all and respond to as many as time will allow.

  1. Hello.
    Since my son has been two we’ve been having emulations done on him because of his behavior. No doctors seem to see what I do. But, before I go further, at age one and half my son was diagnosed with retinoblastoma. He unfortunately lost his right eye because the tumor was too large to treat and starting to “seed” . No cancer cells got out of the eye wall and he never needed treatment and he’s now four and a half and cancer free. However, he’s always exhibited odd behavior. If he’s especially he will look to get our attention and curse and hit..he knows this drives us mad. He is an only child and has NEVER been around any children. UNTIL NOW he’s in prek and its for about three hours three days a week. He does well but he doesn’t play with anyone..he smiles and will give one word answers but he can’t communicate with these kids. He’s extremely smart, learned to read at two and is always around adults. He seems very hyper and when he plays by himself he talks out loud while he plays jsut spitting out words that he has heard and not making much sense. Yet, other times he takes the doll and says “he’s going to the store” and he drives him in the car and pretends to go to the store. However he never plays pretend really either..he doesn’t pretend to be someone else. I worry of autism. A few doctors that saw him for an hour didn’t think so but I do. Or I’m not sure I should say. Maybe not. Maybe it’s from the sensory issues from losing the eye? I’m at a loss and need help..thank you so much.

  2. Hi,
    I really need help with my 3yr old son. He is really sweet but has always been high maintenance. He has a 1 yr old brother who is active but typical. My 3 yr old has extreme separation anxiety, needs monumental amounts of attention (and if he doesnt get it behaviors follow). He is extremely hyper and seems to have delayed responses to questions and directions. I have to repeat 5 times and then sometimes still have to touch him gently or make eye contact. He also repeats himself constantly or wants me to repeat consistently (for example: answering his question the same way 5 times or rephrasing his question into my answer.) I try to stay patient but then when I cant take it anymore I lose my patience and my calm and am too firm! So I feel like I alternate btwn two parenting styles and am confusing him! My spouse doesnt understand him at all and thinks I am spoiling/too soft with him. I need help!

    1. He also doesnt sleep well at all ever!

  3. What wonderful information! As an infant my son was sensitive to noise, easily distracted, overly alert, active, hard to fall asleep. I finally listened to my concerns and realized at age five he was a sensory seeking kiddo who’d always had lower motor skills, needed help and had him tested. He began speech, OT, play therapy and continues both. Now at eight, he’s diagnosed ADHD. I found it hard to see the signs laid out before me before getting professional help. I share this because if you have doubts listen to them and act. Get resources and be an advocate for your child to be their best. It’s a long road, but SO worth it.

  4. Thank you so much for this post. As an ardent follower of RIE, I have been practicing it with my 27 month old from the beginning. However, I’ve been consistently frustrated, feeling like it’s “not been working”. My son exhibits many, many behaviors of SPD, Asperger’s, ODD, ADHD… But is cognitively high-functioning. He was evaluated last month for Autism Spectrum Disorder. The whole month the psychologist was “50/50” but eventually came back deciding that my son is a “perfectly normal, neurotypical two-year-old” because of his cognitive and language abilities. This was very stressful and disappointing for my husband and I because we know this is simply not true and it makes us deeply sad to see how much our son struggles through every day. We desperately want to help him but don’t know how, and so we exhibit the exact parenting traits you spoke of. My husband and my.father both have many traits of my son, but my son is much “worse”. Would you mind advising, in your personal opinion, what we should so from here given the neurotypical diagnosis? Thank you again so much for this article. It gets tiring and worrisome to visit the RIE boards and Facebook groups and see how successful RIE is for other children, but not your own. You begin to doubt yourself and consider finding “harsher” approaches, it is true. I am thankful we have not followed through with that. Thank you.

    Sara

  5. Help! My 3 year old has been completely different to my other three sons. All my friends and family say he is quite odd not in a horrible way but I know exactly what they mean. Since 8-10months old he has thrown tantrums for no reason at all which was constant in public with a lot of people around. As though he couldn’t handle being out of the house then at 13months old he began having meltdowns 20-60mins I would Hugh him, try destracting him… I tried everything but it was as though he was possessed! He would be tensing up fingers curled toes curled head back, scream/growling this would happen sometimes all day with 10mins of him being normally behaved. He can’t acknowledge your there with these meltdowns and they are over nothing 90% of the time the other 10% because he can’t get his own way. He worries me sick. He had a unknown fit February this year I was screaming in hysterics he was asleep the next thing he was fitting doctors checked him over ran loads of test and no know reason for fit?? He laughs and giggles but you can see it’s always delayed and it seems so put on the same if I tickle him he stands staring then puts on this har har… I don’t expect to much from my children but I’m 100% something is not right with my 3year old. He can’t concentrate on anything at all ever. The only time he’s still is if he’s on the toilet or falling to sleep or asleep. When people come to my house he is so hyper he starts swearing on repeat which he don’t do any other time, he literally bounces off the walls and floor and what would hurt me or any of my other children just don’t bother him. He squeals at high pitch and is overally affectionate with strangers wanting hugs and kisses. He don’t look at you but seems to look through you or as though he’s reading writing on your face. I’m getting the blame for this as social services have got involved and taking me to court to remove all children as my three year olds behaviour is uncontrollable infront of social workers etc. To be honest everyday I’m absolutely exhausted with repeating what he says else he goes on a huge meltdown, physically picking him up off furniture because he does flips off them and just don’t feel pain. He can’t stand the texture of fish or meat he physically heaves. He is constantly demanding crisps and chocolate from the moment his eyes open until he falls to sleep. He’s always been fed healthy meals but they have always made him heave. He practically lives on chips, pasta, mash potatoes, baked beans, bread, chocolate cereal, crisps and chocolate. That’s all he will eat. He is so very very clumsy but I am too. He can fall over just standing. He runs into the walls and doors bounces off them onto his bum. He’s always banging his toes but as am I. His eyes have been tested and are said to be fine. He is such a beautiful loving boy who I love with all my heart but what a awful thing for me his mum to be saying, I would change his hyperactivity and showing off as he endangers himself and I have 100 near heart stopping moments with him every day. Also he sleeps with his eyes open. Can anyone help me? I have done ‘positive years parenting course’ and since last year when I began using it consistently behaviour is spiralling out of control but social services have said if I stop using the parenting course then that’s not acceptable…. help a desperate mother

  6. The other thing, he’s obsessed with cars no one can touch his cars he has them lined up on his quilt when he sleeps. He always has cars in his pockets or hands. He’s particularly obsessed with black cars. If another child tries to touch his cars he screams or physically attacks

  7. My 13 yrs old son has been diagnosed as Borderline ASD(Asperger), ADHD, is OCD and ODD, everything you’ve written on this page fits him 100 % , except he had to be pulled out of public school 3 yrs ago from his behavior, and the school resulted to isolate him in the office closet, no P.E., Music, Lunch, Recess, Library, strictly isolating. He has to constantly have at least 2-3 things going at once. He says he hates his family members, everything is my fault, I’m dumb and don’t understand anything.I live in Tennessee and there are not any options that I know of. I want and need to help him. He is never on the same sleep routine, preferring nights over days. Can’t be in any room in the house alone and/or without me.Can’t eat any foods without a utensil, and you have to wash your hands and everything before you prepare it, and no one else can prepare it, and he won’t do anything for himself.Please Help Me. (931)837-2133

    1. HElyssa also has to have wipes for everything, his tablet,remotes,chair,table,bed,the door handles, his toys, the toilet, a new hand towel every single time he washes his hands, which is 50x a day.

      1. HE fears to be alone,can’t be without me ever!No one else other than me can cook for him. He will not eat leftovers, or food if he thinks someone breathed on it.

        1. HE does not play well with others.Is aggressive, physical,demanding,loud, rude,and selfish.Has never been able to communicate well with anyone.Has been willing/able to say hello when prompted,and very rarely says he cares for or loves us.I am a single mother, and he has gotten dominant since my father passed over a yr ago.

          1. HE also hates huge and kisses, since he was 1 yrs old.His physical is hitting,punching,stabbing,squeezing, kicking,anything that inflicts pain, or a negative response.Then he laughs and is excited.
            He mentioned when he was 7 yrs old that voices in his head tell him to do bad things, but he don’t want to.
            He also almost beat a kitten to death when he was 7.
            He says he hates kids because they are dumb, touch his stuff, and don’t shut up.
            He yells, and curses every day.
            When he was 3 he endured frontal-lobe damage
            and was held overnight in the hospital.

  8. He is intelligence, and was always finished his work, and tests before the entire class, as well as A/B honor roll.
    He refuses to be told what to do. Will beat you if you try to force him.

  9. I don’t know if this is related or not, my sister has a 20 years old girl, non verbal. She usually is very happy and nice. She tends to hug people even strangers a lot. Recently when she goes to somewhere she likes e.g dance lesson, friend’s house, etc. she wont leave. She sits and does not listen at all. If you want to take her hand and force her she would not listen at all. She just doesnt move at all. This has become very difficult for the parents. What can we do?

    1. It’s common for toddlers to exert their will that way, or sometimes they just get stuck because transitioning from one activity to the next is difficult for them. I would calmly and kindly pick her up and help her to leave when she’s unable to do it on her own.

  10. avatar Hillary Jones says:

    Do you have other articles that I could read? I thoroughly enjoyed reading Dr. Evans article. I have a bright, happy and oh so very loud, very active three year old boy (in comparison to other toddlers he comes in contact with). He has no problem having a tantrum or meltdown either. I have also noticed in myself in recent years that I am “sensitive” to auditory stimuli and become agitated as my response to the auditory stimuli. I would really be interested in reading more about the connection between birth and SPD. My three year old son was an emergency inducement due to oligohydraminos (dangerously low amniotic fluid). He came into the world via myself pushing and the use of the vaccuum suction as he needed assistance coming out of the birth canal. The vacuum suction was apparent as his head was briefly shaped by the pressure of the suction. I wanted to know if that would be similar to what was mentioned in the article’s 6th bullet point.

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