The little girl at our child care center is 2 years old and was diagnosed with this disorder at approximately age 1. She has much difficulty with tolerating sunlight, baths, clothing and diaper changes. She does not like to be touched and does not want to eat and swallow foods. She is easily over stimulated and will begin knocking at her head with her fist and she will also play repetitively with her thumbs. She dislikes sudden changes in movement or loud noise in the environment.
The challenges that we faced initially was how to comfort her when she was upset. She had always been with mom and a few other family members and then began full-time in our center. We had a difficult time getting her relaxed to be able to take a nap each day. She also would scratch at herself or rub areas of her skin until they would become very irritated and red while she was trying to fall asleep. She would cry when we would change her diaper or need to change her clothing. If we picked her up to console her, she would only cry more. We would offer her foods to experiment with while the other children were eating and often this would precipitate vomiting.
We have done the following to help with some of these issues: We have found that she likes firm touch rather than gentle touch and also if we place a blanket between her and our hand she responds very well to the firm touch. We had mom bring in her soft blankets and an Eeyore( which had mom?s scent) that she lays against to fall asleep. This has solved her skin irritations by rubbing the sheets, etc. We always put on her hat to go outside and keep her in the shaded areas and we have found that she now enjoys going out during playtime. We have continued pet therapy which she was receiving at home. She will actually place her feet on the dog?s body to touch him. Her feet do not seem to be bothered by touch. We attempt to introduce her to toys, artwork, etc in a slow manner. We have also encouraged self-exploration of the foods which she is increasing the amount that she will taste; however, she will still not swallow. There is no known medical reason to why she would not swallow. She will become easily over stimulated and when we find that she is becoming irritable with an activity, we move her away to a quiet area such as the swing, or to a soft rug to be by herself.
Response by Linda King Thomas, OT/L at Durham Therapy Associates
Based on your behavioral description, this child has a Sensory Processing Disorder (SPD) also known as sensory integration dysfunction. This child has an overresponsive response to sensation. Her difficulty with swallowing in the absence of any motor or medical reason could be due to her over sensitivity to sensation.
The main premise with someone who is over responsive to sensation is to
reduce the amount of environmental stimulation when noise, activity, and movement are too stimulating for the individual. Providing heavy work and deep pressure activities are useful to calm an over stimulated nervous system and prepare the individual for activities that may be overwhelming.
Below are some other suggestions:
Slowly introduce her to tactile play, exploring which types of touch she will tolerate ? hard and smooth toys,
bumpy and soft toys and squishy touch like play doh;
Use a heavy blanket for her nap;
Introduce new activities and sensations in a quiet space;
Lighting may be disturbing. Consider alternatives to fluorescent lights. Use
sunglasses or a hat inside if the lights are too bright;
Unexpected touch can be difficult. Approach the child from the front and provide a warning before touching;
Provide quiet areas in the environment such as a pile of pillows in a quiet listening or book area;
A quiet tape of ?easy listening?music, ocean sounds or white noise may be helpful.
If the child is seeing an occupational therapist (OT) request additional information from that professional. The OT can provide specific ideas to address the oral sensitivity and refusal to swallow. If the child is not receiving services, it is important to secure occupational
therapy services through early intervention for this child who is severely affected in her daily life activities by her over sensitivity and defensive reaction to sensation.
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