What is Sensory Integration?

Post by: Sandra Wasserman
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Everyday we receive a great deal of information from our senses.  We use this information to organize our behavior and successfully interact in the world.  What happens if one or more of our senses are not being interpreted properly?  A child with vague or hazy feedback about his sense of touch, body position, or movement and gravity is in a world totally foreign to ours.  You would not feel the usual security, safety, and fun that other children experience.  When the process of sensory integration is disordered, a number of problems in learning, motor development, or behavior may be observed.

Do Children with ADD/ADHD Sometimes Have Sensory Problems?

Post by: Sandra Wasserman
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Children with Attention Deficit Disorder (ADD) and children with Attention Deficit Hyper-Activity Disorder (ADHD) can have difficulties in thress sensory areas:  Tactile or touch, proprioceptive (or spatial relationships), and vestibular (balanced movements).

Tactile refers to the sense of touch.  Children who have problems in this area often don't like things touching them.  This can include materials of clothing - such as tags in shirts.  It can include aversions to getting their hair cut or taking baths.  Children who have tactile difficulties sometimes don't like messy play, such as getting their hands in clay, paint, or play dough. 

The proprioceptive system relates to the position of the body in space.  It allows us to know what our body parts are doing, how fast or slow we need to move, and how much pressure to use.  Children with difficulties in this sensory area often appear clumsy and uncoordinated.  These children often hug too hard, or throw the ball too hard.  If this sensory area is not treated, it can impact the child's self-esteem.  Children with proprioceptive sensory problems may start thinking of themselves as "I'm terrible at sports", or "no one likes me" - both negative statements.  Essentially, without treatment, these children have trouble "fitting in" with children that have well-developed proprioceptive systems.

The third sensory issue often seen in children with ADD/ADHD children is the vestibular system.  The vestibular system helps with balanced movement.  The vestibular system provides our brain with information about our environment.  It tells us where we are in space.  Its also involved with the right / left movements and with balance.  Children with vestibular problems are typically clumsy in their movements.  Clumsiness can be a barrier to developing normal social relationships with other children.

As one can see, a child with ADD / ADHD poses a lot of challenges for the child and for the family.  Understanding what makes your child behave in a certain way will help you meet those challenges.

Nonverbal Learning & Disabilities

Post by: Sandra Wasserman
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There is no typical picture of a child with a learning disability.  Nonverbal Learning Disability (NLD) children are known to have excellent auditory or phonology conceptual abilities at the sound level of processing.  In addition, short term and long term auditory memory are areas of strength.  However, deficits can be noted during early development in the motor planning of the speech / language process.  As the Nonverbal Learning Disabled child develops language skills, often the rhythm of language is an area of weakness, as is the "give and take" of language.  Grammar content and structure, syntax and pragmatics, and semantics are also areas of weakness.

Auditory attention and concentration with verbal material are strengths for NLD children, but they are not as proficient when working on tasks that require either sustained tactile or visual attention.  Rote verbal memory skills can be well developed, but they have more difficulty recalling pictorial or visual information, particularly with only a brief exposure.  Perceptual visual deficits are often present in NLD children.  They can perform simple motor tasks, but have difficulty with complex tasks that involve both thought and motor activity.

My interest in NLD came from our son, who was diagnosed with NLD in elementary school.  As parents, we worked through the struggles and through the accomplishments of our son.  We noticed early on that in school, he is good at word decoding, and that spelling (memorization) comes easily, as does memory for rote material.  However, he struggles with activities that involve fine motor control and motor planning - including handwriting, cutting with scissors, or tying shoelaces.  However, with patience and perseverance, he is slowly mastering these skills.  We now see him less frustrated, and more confident and happy with himself.

Children with NLD can have difficulty with other academic subjects, such as reading comprehension, computational mathematics, and science.  Some children may misread operational signs and may mis-align numbers in columnar operations.  Our son is actually very good at math, however he has difficulty attending to visual details, and as a result, he makes procedural errors.  He knows how to add and subtract - but he has difficulty sometimes seeing the addition/subtraction sign properly, or lining up numbers properly - which result in incorrect answers and poor test scores.  As a result, we have him highlight the mathematical signs, or draw lines for the columns between numbers.  These extra tasks seem to help him focus better on the details.

Children with NLD are impacted in their social relationships.  They may misinterpret body language or tone of voice.  Most children acquire the ability to perceive these subtle cues in the environment, but children with NLD often don't perceive these subtle cues.  Learning how to judge the limits of a situation, or understanding concepts of personal space are social skills that are normally grasped intuitively through observation - they are not directly taught to children.  With my son, and other NLD children, both Play Therapy or a social skills group are great tools to help children learn and acquire social skills.

I wrote this blog to provide other parents with a knowledge base in order to advocate for their child in effecting the appropriate accommodations and modifications in school.  As a family, your planning should encompass school, as well as social and family issues.  There is additional assistance available to children diagonosed with NLD in the school setting.  Some special services to be considered are:

  • Occupational Therapy - to develop fine motor and visual motor integration skills
  • Early Speech / Language Therapy - since very young children with NLD may have difficulty with the motor planning involved in speech production
  • Social Skills Groups - to help teach nonverbal behavior and to promote specific problem-solving strategies
  • Play Therapy- to help the child express / explore their feelings non-verbally through sand work, puppets, and other therapeutic play activities.  Children that know they are struggling often compound their frustration by keeping it bottled up inside.  Teaching children how to communicate more effectively is an integral part of boosting their self-esteem, and their self-confidence.

Resources:

  • http://www.nldline.com offers an information packet and a calendar on NLD related events
  • NLD Hotline (831) 624-3542
  • NLD-In-Common: List server which parents can join and talk to other parents interested in this subject.  To join, go to:  http://www.onelist.com and click on the "New Member" button.
  • Share Support, Inc. (sponsors an annual NLD symposium and four newsletters):  P.O. Box 2379, Danville, CA 94526; (925) 820-4079