Developmental Issues: Sensory Issues in Young Children

We’redeep into Sensory Integration week, so I thought I’d describe some of the remarkable cases I’ve had that have triggered my interest in the area.

I’m a licensed psychologist, and as such, I must fiercely protect the confidentiality of my clients. But some of my cases are so fascinating – and provide such a valuable learning opportunity – I will disguise the identifying information in order to share an important issue with you. Please know that I’d never, ever sacrifice client confidentiality for any reason other than legally or ethically mandated situations. At the same time, there are professionally accepted ways of illustrating important case material, and protecting private information.

Are All the Senses Functioning Properly? First, there was the little two-year-old boy I’ll call “Liev”. Liev lived with his father, 4 siblings, and several foreign nannies. His mother was off on another continent, using drugs. She had abandoned her family.  Father was struggling to deal with the terrible strain of the effects of her behavior on all of them, especially baby Liev. Luckily, the family was well-off, financially. Because father had money, he was used to delegating tasks to others. But he couldn’t “phone in” his parenting responsibilities; he needed to be present with his son. 

His son worried me. At first, we thought Liev was autistic. He constantly waved his hands in front of his face. He didn’t make eye contact. He had constant tantrums. He was very awkward, and seemed to move as if he didn’t see what was in front of him.

Ahhh…that was the key. Nobody thought to ask, until I found it scribbled on a page, deep in his file. Liev was nearly blind.  He had a congenital condition that made him not completely, but nearly, blind. The family had moved from place to place, and in the process, his medical situation had become muddled. The stress of the situation with Mom made things more disorganized.

Once the team recognized his visual impairment, his progress was amazing. I saw him six weeks later, and literally did not recognize him. His occupational and physical therapists helped him use his senses of touch and hearing to move around the room. They got his attention by using touch and sound as well, instead of expecting him to catch their eyes. He listened. He followed directions. All of his “autistic” behaviors vanished.

Sensory Integration “Diagnoses”, or Just Mild “Differences”? Let me also tell you about a little girl I’ll call Leilani. Leilani was referred to me, also at age two, for being “hyper”. She didn’t want to nap, didn’t want to sleep at night, and was constantly “on the go”. She didn’t seem to listen, and her speech was slow to develop. Her parents were exhausted, and they had two other young children to care for as well. There were constant power struggles, tantrums, and now a strain on the marriage. Dad thought Mom was being “too easy” on Leilani. Mom worried “something is just not right”, but had no support in her exploration of that possibility.

Their Early Intervention provider (there’s one in every community, funded by Federal dollars) sent her to an Occupational Therapist (OT). The OT found that Leilani overall had no severe sensory diagnoses, but there were some mild sensory differences that were worth noting.

Leilani was found to have a minor difficulty filtering out noise; when things were noisy in the house, she couldn’t really focus on what was being said. With that information, we helped the family speak quietly to Leilani. Instead of talking loudly over the “din” of the household, we instructed them to try talking in low, quiet tones to her.

The OT also found that Leilani responded well to “heavy play”; she suspected that Leilani needed a great deal of vestibular stimulation in order to get “centered”, regulated, and able to listen and pay attention. The OT demonstrated providing Leilani with very physical playground activities. Swinging was a huge favorite for this little girl. Like many kids with sensory issues, she could swing and spin endlessly, and never get dizzy. After the activities, Leilani was calm and willingly sat down to engage in quiet activities.

The combination of tactics; “low talking” and “heavy play”, utilized throughout the day, resulted in a little girl who shot forward in development. The family saw remarkable improvement in 2-3 weeks.  They especially noticed the improvement in her nighttime sleep if they provided her with at least 45 minutes of “heavy play” at the playground each day.

If you suspect any difficulties like this with your own kids, know that children aged 0 -- 3 (and 0 -- 5 in many communities) qualify for a free developmental evaluation with their local Early Intervention provider. Certainly, your pediatrician should be involved, as well.

I've learned so much from such cases that I analyzed the sensory tendencies of our whole family. It’s helped tremendously. One of our kids is a bit over-sensitive to sounds. So I decided to pick him up first from school, to give him a few quiet minutes in the car before we pick up his sister. He’s much happier to see her now; in the past, it was constant squabbling in the back seat. But now that he can “chill out” in the car, in peace and quiet, for just a few minutes….it makes all the difference in the world.

Stay tuned for Part 2 of my interview with Nancy Peske. She’ll be talking more about how to do the detective work in your own family….who has what sensitivities? How can you help to manage them?