Matt Mielnick - Understanding Sensory Processing Disorders in Children: A Guide for Parents and Professionals

UNDERSTANDING SENSORY PROCESSING DISORDERS IN CHILDREN

A Guide for Parents and Professionals

Matt Mielnick

Jessica Kingsley Publishers
London and Philadelphia

CONTENTS

PREFACE

This is a little book. From the moment I decided to write it my objectives were clear: Present an explanation of Sensory Processing Disorder in language that was as clear to a parent or a new student as it was to a professional, without being condescendingand then get out of the way! For sure, there are many informative, often scholarly works on this topic that require a considerable amount of time and study before you can begin to understand their complex ideas, and yet, the material is so compelling that its focused reading audience is willing to commit considerable effort in their determination to raise their level of understanding. If they are students or experienced professionals then their preliminary studies have already prepared them for the level and vocabulary of the discourse. What a different experience this describes than that of a distraught parent of a child with atypical behaviors, desperate for an explanation, and often faulting themselves for not fully understanding the science and medicine described in primary texts and in the professional reports written about their child.

I have a different story to tell. I have evaluated over a thousand young children as part of the process of determining their eligibility to receive occupational therapy services through Early Intervention and Preschool entitlement programs. As part of each of these evaluations I routinely take the time to explain to parents how I understand our sensory system to work, and how inefficiencies in key parts of this system can have profound impacts on a childs behaviors. I have tried to consistently use direct, down-to-earth language, as well as easy-to-relate-to examples and metaphors. When my explanation inevitably collides with those big three-hundred-dollar technical words, I do my best to define them and explain how they might be relevant to the problems their child is reportedly experiencing.

Heres the part thats most gratifying. At the conclusion of these discussions the parent often has a sheen of recognition on their face. Many times Ive been told that my explanation made sense for the first time, and that they were able to recognize their child in one or more of the various sensory descriptions I offered, even after their own efforts to research the subject and do the suggested readings about sensory processing had thwarted them.

As rewarding an experience as this is, its also not uncommon to get a follow-up phone call within a day or two from that same parent. As compelling and clear as the explanation seemed to be at the time, they found it frustrating when they tried to communicate what I had said to them to their husband, other family members, or close friends. As such, they were perhaps somewhat better prepared to deal with their childs issues, but just as isolated as before. It reminds me of when I have a particularly lucid dream and the exhilaration it offers. But try as I might, I cant remember any of the details of that dream on the morning after.

This is my morning-after book.

CHAPTER 1

INTRODUCTION TO THE SENSORY SYSTEM

You dont see things as they are. You see things as you are.

Talmud

I find it helpful to start with the most basic of questions: What do we know about this wondrous body we occupy? My explanation would go something like this: We all start off as the new product of a living seed and a living egg. This new microscopic entity, in most cases already quite hearty, quickly starts to develop according to a genetic plan, guided by the most basic instincts to survive and to reproduce. Within a few weeks, and then months, a network of discrete but highly integrated systems evolves to meet the demands of those instincts and perform the most basic of our bodily functions. A chain of digestive organs breaks down and conveys our food along a canal in which the altered product can be processed and used for its nutritional value. The respiratory system takes in essential gases from the atmosphere and captures them in our lungs until oxygen can be absorbed into the bloodstream, and other gases can be released outside of our body. The bloodstream then circulates through an extensive network of vessels, delivering the life-giving oxygen on a cellular level, pumped continuously by the mechanical workings of the heart. A waste management system claims the final products of digestion and eliminates unwanted solid and liquid wastes. Our muscles, bones, and connective elastic tissues form a hinged armature that enables us to meet truly impressive mobility challenges, covered and protected by a pliable but durable outer layer of skin. Theres an electrical system of sorts that sends purposeful signals from our brain along a highway of nerves that animates these structures to run, walk, jump, dance, and shoot baskets.

And of course theres the brain. The brain sits in the governors mansion and makes executive decisions about how all of these organs and organ systems should work together as we engage with the world on a moment-to-moment basis. It does so by interpreting information it receives about our environment via these nerve paths, and then offers a response, which is then sent to parts of our body to be acted upon. The staggering importance of the computer in todays world is a convenient and accurate metaphor for this amazing organ. The computer evaluates and processes inputted data, categorizes it, draws conclusions about how the data is relevant to its goals, and then issues directives to all of the component systems connected to it that serve at its command. But just as the computer requires someone to input the data that it needs to accomplish its impressive work, neither can the brain take all the credit for collecting information about the world we move through. For this it relies on another bodily systeman integrated partnership of antennae and receptors, all hooked up to the mainframe, and incessantly collecting and delivering information 24/7. Unlike the other physical systems mentioned above that tend to their specific duties discreetly inside our body, this other system is pointed outwards. It is our interface with the world, armed with a squad of investigators, reporters, and sentries. It is the keystroke on an otherwise blank document. And in order to accomplish its work, it enlists the entire surface area of our skin, our joints, our muscles, nerve pathways, and those fascinating facial features that other people most immediately recognize us by (after all, were not just a bunch of pretty faces). It is nothing less than our bodys ambassador to the world, a sensory system that moves us forward with rewards of pleasure and protects us with signals of cautionthe same five senses that we first learn about in elementary school (plus a few other equally important, but curiously less celebrated, sense mechanisms).

Its interesting that we dont typically regard each of the individual sense organs, and the magic they perform, as part of a highly sophisticated, integrated network that collects and processes the information for everything we know about our world. First, we tend to only give credit to those obvious external structureswe smell with our nose, see with our eyes, hear with our ears, taste with our tongue, and feel with our fingersas though the process of each distinct sensory experience begins and ends with each of these body parts. Of course the truth of the matter is that these distinctive structures are only the hardware components, each acting basically as an antenna to collect this vital external information about our environment. The information must then be transmitted along specific neural pathways to the brain. The brains job is then to identify and decode this information on a cellular level (make sense of it) and then generate an appropriate response.