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Sensory Integration Dysfunction

Berkeley Parents Network > Reviews > Health & Medical > Sensory Integration Dysfunction



Recommendation for 5-y-o diagnosed with sensory processing disorder

Dec 2006

My 5 year old son was just diagnosed with sensory processing disorder (SPD) (also known as sensory integration dysfunction). Currently undergoing medical evaluation to see if primary or secondary. We need recommendations for a good neuropyschologist in the Bay Area (preferably the east bay) to do recommended pediatric neuropsychiatric testing. Also need recommendations for a good occupational therapist experienced in treating SPD.


I'm a Physical Therapist and a mom, and my recommendation would be to find either a PT or an OT who is specially trained in Sensory integration. You can call up any clinic and ask if they have a therapist specially trained in this area. There's a specific examination and treatment protocol for Sensory integration called SIPT (Sensory Integration Praxis Test) and a therapist can get certified in this. I would want this if my child had sensory integration issues anon
I just wrote a reference for Gina Banks, OT on an earlier post in this newsletter--We love her! She's done great work with our daughter, who has sensory integration issues.

Ongoing OT for 7-year-old with Sensory Integration issues?

March 2006

I am concerned about my almost 7 year old son who is in first grade and has sensory integration dysfunction. I will pick up The Out of Sync Child today, but wanted to ask all of you who might know from experience: Once a child has OT is he then more or less OK? Is the therapy ongoing and the dysfunction something that will be with my child throughout his lifetime? What alternative therapies on top of OT have worked for children out there?

My many thanks to BPN b/c upon reading other discussions of SID I began to see my little boy in the descriptions and pushed for an assessment! He has a mild case which many seasoned professionals missed, while I didn't even know it existed. I am feeling immense relief to have a framework for understanding and now moving forward to meet my sweet and ''spirited'' little boy's needs. I want to encourage any parent who thinks they have a high need baby or are raising a spirited child to seriously consider seeking some sort of evaluation sooner rather than later. It is my (limited and elementary) understanding that my child was expressing his needs through his behaviors from day one. If we'd known sooner it would have taken a lot of the grief and pain out of the equation as we all learned to live together in harmony. Thanks in advance for your answers to my questions at the beginning of this post.
Loving, Living and Learning


Hi, working with an OT is definately helpfull and in some cases can completely alleviate symptoms. How your son reacts to therapy generally determines how long the therapy continues. There is no good quick answer to this. Generally there is a bond that needs strengthening between the primary sensory inputs ie visual,auditory,and vestibular. If this bond can be strengthened, the body will generally find a way to heal itself. In these cases therapy has no need to continue, only monitor progress.

There are a few alternative therapies such as Auditory Integration Therapy and Vestibular Therapies such as horse back riding, and surfing experiences. These have proven successfull on some patients. The most inclusive therapy is The Bolles Method of Sensory Integration developed in by Mary Bolles some 15 years ago combining the three sensory stimulations into one therapy.

Hope this is helpfull, if you need any more information or would like to talk about this please call or e-mail. Sincerely, Bryan McDade, Director Sensory Learning Center SSF


My 11-year-old son has been seeing an OT for about 2 years for mild sensory integration problems. He is doing well, and it's becoming increasingly clear that he'll be a fine adult, but the OT doesn't really get rid of his issues so much as help him understand and manage them. He and his friends are the sort of dorky ones in his class, and the way I see it, when they're grown up, they'll probably all continue to be quirky and have an uneven collection of strengths and weaknesses...just like many of their parents. The OT ought to help you and your child know good strategies for managing various situations that challenge him, and then just keep an eye on things like his self-esteem, and how he's doing socially. It is definitely possible to have unusual wiring and still have a great, full life. been there
The Stockton Record just had a lengthy article on the subject - sorry I can't remember the exact date, but it was within the last two weeks and you can pull it up on-line at www.recordnet.com. brenda

4-y-o diagnosed with SID - what do we do next?

August 2005

My 4 1/2 year old son was just diagnosed with mild sensory integration dysfunction. We are planning on working with an occupational therapist recommended by his preschool, and possibly a speech and language pathologist. I am confused about what kind of assistance our public school district (Albany) can offer us, given that our son will not be starting kindergarten until next year. All that they have told us thus far is that they do not evaluate children over summer break and that someone will contact me in the Fall. I am interested in hearing from other parents (particularly those in Albany) who have children with the same diagnosis to try to better understand what we're supposed to do now.
Confused


I am the mother of a child in the Albany school district who has some mild sensory integration problems. My experience has been that his school's response to kids like him is very mixed, depending a great deal on who the child's teachers are, and how effectively the parents can advocate for their child. It is possible, however, to get terrific help in Albany. good luck
Albany School District can assist children with SI issues but the child must qualify for special education services first. Unfortunately children can not qualify for Occupational Therapy Services alone. There are several catagories in which a child can qualify for Special education services but OT is not one if them. The primary thing the District looks at is whether or not the condition is educationally or academically based. They will not provide services if it is just developmental or medical. The issue at hand or the delay must interfer with that child's ability to learn in an academic setting. I hope I am making sense.

If your 4 1/2 year old has other delays such as cognitive or speech delay than you can request that the District conduct an assessment to address these issues along with the SI concerns. The Albany SChool District can provide services at the Preschool Level as long as the child qualifies for special education. THe District has no obligation to conduct assessments in the summer or when school is not in session. Once the family signs the consent for assessment there is a 50 day time line in which the assessments must be conducted. I would put your request in writing and send it to the Special Education Dept. The contact person used to be Suzanne Nelson but she has moved on to a new position.

I am wondering what preschool your child attends and who is the OT. ALso, is your child involved in any other programs, such as the REgional Center of the East Bay. There are many fabulous OT out there that address SI issues and I would be happy to refer you to them. I would first seek an assessment through the District so you don't have to pay out of pocket. The District has wonderful OTs at the preschool and elementary school level. Good luck. anonymous


Hi, My son is now a teen; when he was 3 he was diagnosed with add, adhd, autism, borderline cerebral palsy (low tone trunk), major sensory integration deficits, I was told the speech center of his brain had been ''nuked'' and that he didn't have the IQ to learn how to speak.... and that I should have him institutionalized and sign up for adult care asap so he'd qualify for a better placement when he was 18. The stats on a child with such a diagnosis even being mainstreamed by the age of 16 are .05. I was able to have my son mainstreamed by 5 and w/o even needing an IEP by 7. How did I do it? Massive amounts of speech, physical, and occupational therapy, and a low-tech technique called Neurological Brushing, (I also used a meditative-intuitive approach to solving very difficult problems, like one of the speech problems he had that couldn't be solved by eight (count em) speech therapists. I finally gave up and got a psychic reading and the problem was cleared up in (really) five minutes. I learned a huge amount that I would be happy to share with anyone who wants to email me for advice. I want to share what I've received. I now have a calm, sweet, handsome, tall, straight-A, teen who has friends and interests and wisdom and is never EVER going to see a handicapped person as ''less than.'' He's also good at sports--which we would never have believed remotely possible. His child study team wasn't wrong, he just got the remediation support he needed.

Good luck to everyone on this forum. I personally believe special needs kids are truly blessed.


Think my 8-year-old has Sensory Integration Dysfunction

May 2005

I have an 8 year-old son that has some complex problems and we are trying to sort it all out and find out what direction he should go. He has attention issues, speech problems that translate to his written language-( a very hard time expressing himself at times and using the appropriate language to recall an event or story. He has been diagnosed with ADD with other delays. He is in the public system - 2nd grade, 50% resource as well as speech and OT. They want to him to repeat 2nd grade next year, although he has made great progress, his math and spelling skills are excellent, they feel he would do well socially and academically to repeat. He has seen several doctors, does not fall under the category of autistic, aspergers, or ppd. He has been defined as ''globally delayed''- he is highly sensitve to sounds, and as I read the message board and info from a website, he seemed to have a lot of similarities of Sensory Integration Dysfunction. I need some advice as to who we should take him to be tested for and what. I feel so lost because in my heart I feel we have not found out what is really going on so we can help him along. He is a wonderful boy who is athletic and happy in his life- but really struggles at school to keep up. Any advice would help . Thanks
worried mom


To the worried mom who is considering Sensory Integration therapy, I recommend that you get your son an OT eval immediately and get started. SI is the kind of therapy that takes a lot of time (and money!) but is so worth it. It is very global in its impact since it addresses ''traffic control'' issues in the brain and it is completely non-invasive. We see Denise Killingsworth who works out of her home office in Walnut Creek. I very highly recommend her, but if that is too far to travel you can ask her for recommendations.

You may also need other interventions, maybe a speech language therapist for example. But if you work fulltime (and so your kid does not spend all his free time at appointments) you won't be able to do everything at once.

I'm sure you can make progress. Good luck! anon


I understand how difficult it is to continue to go to doctors and specialists and still not get the answers you need. Still, I would advise you to continue searching until you find someone who can give you the answers you need. It's really hard to know how to help your child without a correct diagnosis. Right now you are looking at a bunch of puzzle pieces that are all jumbled up and not making sense. Once you find out exactly what is going on with your son, the puzzle will become a clear picture. Best of luck.
heather
Auditory integration therapy with Judy Paton in San Mateo really helped my son's hypersensitivity to sound. Judy is an audiologist but has expertise in all areas of sensory integration therapy. Her info is:
136 N San Mateo Dr
San Mateo, CA 94401-2777
(650) 340-1280
 

An occupational therapist can help with sensory integration, or at least give an assessment that points you in the right direction. The pediatric OTs at Alta Bates- Herrick Outpatient Rehab 510-204-4599 are fabulous. They have a lot of good strategies, including therapeutic listening. In private practice, I recommend Liz Isono (510-717-1300) in Berkeley and Orinda, Gail Gordon and Leanne Williams. Gail and Leanne work in Orinda (925-258-9935).
Betsy
You might be interested in exploring HANDLE. HANDLE is a ''Holistic Approach to NeuroDevelopment and Learning Efficiency.'' Using a nonjudgemental, non academic, observational assessment the HANDLE practitioner acts as a detective to determine the underlying causes for the sensitivities, academic and behavior difficulties your son experiences. A individualized activity program is then developed for you to do with your son at home (about 20-30 minutes max a day) to gently mature and organize his neurological systems so they are able to function more efficienctly, thereby eliminating the need for the perplexing behaviors you describe. The program is regularly updated and fine tuned as neurological systems organize.

I have been a Certified HANDLE Practitioner for 2 years and have a practice in Lafayette. My daughter has benefitted immensely from her HANDLE work. I have worked with many children (and adults) with issues simialar to your son's and have seen them make huge progress, becoming happier and more balanced in their lives. I am always unsure about answering these postings because I don't want my response to sound like an advertisement, I am just simply excited about what this approach can do, gently, respectfully and effectively.

Please look at the website www.learningandgrowth.com and call me if you would like more information email me at sindy[at]learningandgrowth.com. Sindy


''Therapeutic Listening'' for 4-year-old w/ Sensory Integration?

Feb 2005

We've been working with an occupational therapist for our 4-yr-old son's mild to medium Sensory Integration Dysfunction. She is interested in using ''Therapeutic Listening'' with him. I'm hesitant to embark on the additional expense, and also to incorporate a required portion of the program that my son doesn't really seem to like (doesn't like wearing the headphones.) I'm also a bit skeptical. Does anyone have experience with this? Did it work? What did the before and after look like? (ie. what kind of results did you have?


i appreciate your skepticism re therapeutic listening, but it can be really helpful! my daughter was receiving OT for sensory integration issues with good benefits - her OT suggested therapeutic listening and i was resistant. it seemed to be a ''cure-all'' and too good to be true. i only had my daughter listen during her treatment times - within 3 weeks with no other changes my daughter no longer had incontenence problems. she became more outgoing with her peers and was more comfortable taking physical risks. after that, i signed on and did a listening program for about four more months. since then, i've gone to course work on it myself (i also work with kids) and am about to start it with my younger daughter for other learning issues. good luck in your decision. anon.
Hi - We faced the same quandary when our child was 5 or so -- also deemed mild/moderate sensory-challenged and also did not like the headphones (or the music often). I was led to believe the therapeutic listening might help in many ways. I investigated, but found only two kids with experience. Neither case sold me entirely, but both gave me some sense it could be somewhat helpful. Ulitmately we decided we couldn't stand having one more thing to battle over at home. In retrospect I am really glad we did not do it. As my child has been developing (it's now three years later) we are learning so much more about his particular issues/needs. While the sensory issues are real and cannot be discounted, there are bigger issues for him. In any case we continue to have opportunities to address the sensory issues.
I think therapeutic listening can be very beneficial for some kids. My son doesn't do it anymore, though, so if you're concerned about the additional expense, please borrow our fancy headphones and modulated CDs to try out the program. Just email me: sarah

2.9 year-old diagnosed with Sensory Integration Dysfunction

January 2005

My son, 2.9 years old, has been diagnosed with Sensory Integration Dysfunction. At 3 he will ''graduate'' from speech and occupational therapy services from the Regional Center, and now I'm looking for ways to support and help him. He has a particularly hard time with very sensitive ears, which makes preschool a challenge for him. He copes with sensory overload by going off in the corner with hands over ears. He also tries to counter the environmental noise with his own voice, talking and singing to himself. He often avoids contact with other kids because he is afraid they will cry or shout. Has anyone experienced this problem, and have you found ways to help? Unfortunately, staying at home with him is not an option; he needs to be in full-time care. Have you found any therapies, devices, schools, etc, which help such a (wonderful, bright, delightful, but struggling) child? Thanks!
Want to help my son


Have you tried the HANDLE Institute? there's a local practicioner in Lafayette named Sindy Williamson at 925 - 962 - 9506. She would 'stressed nervous systems can't learn' and need to be gentled into different, more functional pathways. Gentle exercises to retrain and soothe the brain(my words). It's worth a try. Bonnie
Please look into the HANDLE method. Our son has had some great success with this therapy. There are some great local practioners who work with this method. www.handle.org anon
Our 8 year was just given the same diagnosis and she has dropped out of not only gymastics but also ballet, soccer, violin and many other activities that require coordination and group interation (that might not be part of your son's issue). We found the SECOND ''Out of Sync Child'' book to be useful because they give easy/at home activities to enhance your child's weak spots. We also go with what our daughter enjoys -- swimming and walking (long walks). We found that pushing her was a waste of time and, at a certain point, embarassing to her. But if your son is open to trying again, the World Dance Center at the top of Solano has a very vibrant, positive and non-judgemental brazilian dance/capeoria program. There is also drumming at Ashkanaz. At Marin Elementary there is an OT on-site, but with budget cuts around the corner I'm not sure he'll be there as much next year.

13-month-old with sensory integration problems

Oct 2004

I've just been told that my 13-month-old son has sensory integration problems. Although he is a loving and sweet boy, he certainly has been a very difficult baby -- long bouts of screaming, difficult to soothe, inability to self soothe, inability to fall or stay asleep, tactile defensiveness, developmental delays, and so on. Although I've found a lot of information on this disorder in older children and in preemies, I can't find anything about what to do with a baby such as my son -- not an infant, but not yet a toddler. Has anyone else in this community been told that their baby has this disorder? And if so, what resources have helped you -- and what have you done to help your child? Thanks. Weary Parent


Ah, I feel your pain! My daughter (now 9 & 1/2) was also a ''colicky'', easily overwhelmed, tactiley/auditorily/visually sensitive baby. It can be so frustrating to be at a new mom's group, playground etc. and watch other little ones having a great time while yours is withdrawing or careening out of control. It wasn't until she was 3 &1/2 that I heard about sensory integration dysfunction and got her help that she needed. Now, I'm passionate about helping ''quirky kids'' with their sensory issues.

First off, please realize that all 13 month olds have very disorganized neural systems. They are all figuring out how to ''integrate'' all of the information - it just comes easier for some - so, please realize that 13 months is very early to be saying that someone has sensory integration issues.

That being said, whatever is going on with your son, there are specific activites that you can try which could help him feel more comfortable in his body and make you both a lot happier. ''The Out of Sync Child'' by Carol Stock Kranowitz, which is available in libraries and most book stores is an excellent first stop for info on sensory integration dysfunction. She offers many suggested activities and is very good at explaining neurological concepts in a very down to earth fashion.

If you need more specific information, I am a pediatric physical therapist and do work with kids with sensory integration issues and would be happy to talk with you further. Best of luck! sara


I would suggest the Feldenkrais Method. Mary Spire, an experienced Feldenkrais Practitioner, is in Berkeley and I know she has worked with infants and children with Sensory Integration Dysfunction. Her website is http://www.optimalmoves.com/index.htm Amy
My sympathies to you. We went through 2.5 years of OT/PT/ST through the regional center to address gross motor and speech delays and SI. Our 4 yo is now ''normal''! I don't know if all that therapy was worth it, but putting the extra attention on her and hearing from professionals helped us understand her unique needs. We all have SI issues to some extent and the SI issues small children have can be minimized overtime through gradual exposure. It's not rocket science although you may think that from all technical OT words! It's not the end of the world, but it sure feels that way when you're starting out. good luck! Linda
What you are looking for is an occupational therapist who works with babies and who does sensory integration therapy. There are lots of fun things to do with children of all ages to help with SID. Do you have the book ''The Out of Sync Child''? I wouldn't take the labels that people try to give kids that seriously but DO use them as much as you can for insurance purposes! good luck!
Our son was diagnosed at around the same age with sensory integration issues (tactile and oral defensiveness), and earlier with global dev. delays. We found a great O.T., whom I've mentioned here before (Susan Campodonico at Herrick Rehab.). We did the Wilbarger (sp.?) brushing protocol which helped, but you have to do it every 2 hours (or at regular intervals as recommended by your OT). I forget how long we did it for, but every so often we still use it for a week or two depending upon what's going on. Also, Cindy Ng (415-203-8156) works with infants, very young children as well, and if you're a Regional Center client, she is a vendor. She's worked with us lately and is a wonderful and experienced OT. It IS exhausting, we are still exhausted, and our son is now 5 yrs. old, but in the long run it has been worth all the effort for him, and us. Hang in there. Still Exhausted
Hi. I'm a Physical Threapist. I know of this disorder and there are very good therapists, both Physical and Occupational that are specially trained for this disorder. You should take your child to one of these. They should be SIPT trained. That stands for Sensory Integration Praxis Test. This is a special test for children with sensory integration problems. The therapist should then be trained how to treat children with this problem. I think they offer this training through USC or somewhere in So. CA, because my friend, who's a Ocuupational Therapist went through it, but she treats children in NY. I work with Geriatrics, but I'm willing to give more advice about this. Jodi
Dear Weary Parent,
I am an occupational therapist who works with children with sensory regulatory and processing difficulties (often called Sensory Integration Dysfunction). It is true that the majority of resources available focus on older kids and/or premature babies, which can make finding general information specific to your son's age group challenging. Nonetheless, explanations that seem geared to older kids can be adapted, with a little creative thinking and support as needed, to infants. The best overall primer that I have found thus far is called ''The Out of Sync Child'', by Carol Stock Kranowitz. While it definitely has some limitations, it outlines these types of difficulties in a clear and manageable fashion, and is directed towards parents and teachers. If you haven't already seen it, it may be a good place to start.

As is the case with your son, children with sensory regulatory difficulties tend to face these challenges from an early age. Frequently this goes unrecognized, as all infants are learning to manage their regulation to some degree. When something is recognized, infants are frequently labeled cholicky without further exploration into why. That you have discovered this about your child at such a young age is wonderful, as early intervention can be quite powerful. As every child is unique both in temperament and in specific sensory profile, the management of sensory regulatory and processing difficulties is, when applied appropriately, equally unique. LJ


Resources for 4 year-old with sensory integration problem

Jan 2004

We are discovering that our 4 year-old son may have a sensory integration problem and might benefit from OT. I'm interested to hear recommendations for private OT's as well as those who provide services in the Albany, Berkeley, El Cerrito/Kensington public schools. We are unlikely to be able to afford private services for very long and want to find what's best for him in the public schools. Does anyone know of public school programs directed toward all students as opposed to just kids in special education? I've heard of a program in the Albany schools in which an OT goes into classrooms and teaches all the kids about things like coping with frustration and/or intense feelings, regulating activity level, managing need for high/low activity, regulating attention, etc. Also, what about names of specific teachers in the public schools who understand SI problems and how to address them? I'm also wanting recommendations for dance/movement/gymnastics type classes that could help my son develop his gross motor skills without leaving him feeling discouraged. He's a kid who is very active and loves to try new things but is uncoordinated and lacking muscle strength in isolated areas (mostly his upper body). I've had him in gymnastics and some other classes and he always ends up getting frustrated and responds by avoiding the activities and running around the room exploring instead or using the equipment in ways that aren't allowed. He's acutely aware of his difficulties and constantly compares himself to other kids (maybe just a normal 4 year-old thing?). The other day he overheard me talking to a mom about her son's gymnastics class and he told me, ''I want to take gymnastics again!'' only to tell me later that night that he'd changed his mind because, ''they are all better than I am.'' Sigh. anonymous


Our 7 year old daughter was diagnosed with SI when she was about 3 years old. First, I recommend reading Out-of-Sync Child. Also, activities such as gymnastics (even though he is resistant) and swimming. Both activities were extremely helpful for our daughter. She also saw an OT at Children's Hospital for a short period of time. Our experience with that OT wasn't that great, but I do know that there are really good ones out there. One in particular is Rose Stamm (El Cerrito). She is extremely knowledgeable and is also trained to do Cranial Sacral Therapy (CST)which I also recommend. If you are unfamiliar, CST is a non-invasive type of hands-on system balancing therapy. I think of it as bio-feedback like, but it has to do with the cranial sacral fluid which circulates through our bodies. If you are skeptical, you should try it first yourself. You will be amazed at how you feel afterwards. Overall, rest assured that your child is not the only one out there with SI, and you are smart to start addressing it now. Please feel free to email me if you have any further questions. Julie
Also Recommended: Kristine Hubner Levin

Improving my child's learning environment

Oct 2003

I would be interested to know of any occupational therapists in the Bay Area specializing in sensory integration, who can visit my child's classroom, observe, and make suggestions on improving the learning environment. Also, I have heard that equine therapy is particularly useful for children who did not have appropriate early childhood sensory stimulation. Has anyone found a resource they could recommend? Finally, is there a parent who has had Love and Logic Parenting training and who would be willing to share the experience? Many thanks! Needing some resources


Recommended: Hippotherapy (3)

Other advice:

Hi. I am a Pediatric Physical Therapist that loves working with kids who have sensory integration issues. I have experience teaching kids, parents and teachers about ''sensory diet'' and how to modify home and school environments. Much of this work is based on an approach called ''The Alert Program'', which teaches kids how to self-regulate. I'd be happy to speak with you further regarding this, or refer you to helpful written material if you are interested.

Regarding equine or ''hippotherapy'' - it's great stuff, and wonderful for kids with sensory issues. Xenophon in Orinda does a great job. They run from May through October. They usually have a waiting list, but put your name on it - things can open up more quickly than you think 925)377-0174. There is also a program in Nicasio, which is apparently free - I have no idea what it is like - call Julie, coordinator at 415)662-2488. I have heard of a program that recently started in the Oakland Hills (maybe Joaquin Miller?). Best of luck to you. sara


Preschool suggests assessment for sensory integration

Dec 2001

My son is 4-1/2 and his preschool suggests that he might not be ready for kindergarten next fall, although they aren't sure. They have suggested that we get a neurological and psychological evaluation, as well as an assessment of his success/lack thereof in sensory integration. His pediatrician suggests that we might also consider getting an "Individual Education Plan" done for him. If anyone has had a similar experience and found good people or services to provide one or all of these results, we'd really appreciate hearing names/numbers. Thanks!


My son , who is now 5 (birthday in late Nov.) will be going into kindergarten next Fall. We decided to wait and send him to preschool for the third year. At first, I wondered if we had somehow "shorted" him, since many of his peers went on. But now I am certain we did the right thing for him. He has been in speech therapy for 2 years, through our school district (Albany). An IEP was done for him 2 years ago, in which is became clear that his speech was the major issue (this is covered under the ADA, so he is under Special Ed, though his "disability" is minor compared with many). The good part is that all this is free, as long as you are in the public school system. In fact, having the IEP and being in special ed entitles your child to services that the State (through the district) MUST provide for your child. You didn't say which district you are in, but if you are in Albany, feel free to contact me for more specifics on our district's process.

As far as the sensory integration piece goes, this is something new that has entered our lives this fall. We always knew (and his preschool teachers would comment upon) that he moved a little differently than others and had some trouble with small motor skills (cutting with scissors, threading beads, etc) that led to mostly avoiding those tasks until recently. Our wonderful speech therapist recommended that he have an occupation therapy evaluation by the district O.T. He concluded that my son has mild sensory integration dysfunction, and we are now working at home on a home-based o.t. program that involves alot of fun big and small motor skills. For more specific info on the program they're adapting, get the book "The Out-Of-Synch Child" --there's also a website for this book as well (the author is Carole Kranowitz, I think). From there, you can find links to other sites that deal with this issue. I've found it tremendously helpful to finally have a diagnosis I can work with. More than that, though, the o.t. work has been amazing--we've been doing it for less than 2 mos, and my son can now draw, write his name, hold a pencil correctly (most of the time) and cut with scissors. We do alot of work with sewing cards, eyedroppers, etc, as well as working with his bigger muscles to build tone and flexibility (so he can modulate his muscles). I highly recommend that you consider having the evaluation done now, as well as looking at having him stay an extra year at preschool if that's warranted. The jump between kindergarten and first grade is significant, so even if kindergarten looks like it would work, consider whether he will be ready for 1st grade when it comes around. We are also supplementing this last year with taking Lawrence Hall of Science classes after school, so my son can get used to a more academic environment. Best luck with figuring out what's best with your son. -Roxane


First, let me point out that there is no evidence to suggest that starting kindergarten early is a good thing. Giving your child an extra year could be the difference in an awesome school expirience, and a traumatic school expirience. You local school district could be a good place to start in looking for the testing. Rachel

4 year old not coping with group situations

March 2001

I have a very sensitive 4 year old who does not handle group situations well and a pediatrician recommended Sensory Integration therapy with an occupational therapist to help him cope. He does not have any coordination or developmental problems, has friends and is doing well in pre-school. The problems arise at social events outside his normal routine, for example friends' birthday parties, school parties, and visits to our friends' homes. He is frightened, and will cling, cry and refuse to eat or use the bathroom. Has anyone had experience with Sensory Integration therapy? Does it work for a child who is very stressed by social situations? Does it work at all? Does anyone have advice about other coping methods? Thanks. Theresa


What a wise pediatrician you have to recommend OT for helping your easily overwhelmed 4-year-old. It could well be a sensory integration problem, and if so, this is a great time to start addressing it. Other responders will recommend pediatricians who can assess your son; I believe Bruce Berman has a good reputation in this area. A great book to start you out is *The Out-of-Sync Child.*

If you are as lucky as we were, your health insurance will direct you to the Oakland Easter Seals office, where you'll find Rita Montez, a truly awesome occupational therapist for children. She also works at an organization called Therapy Link for Children out in the eastern regions of the Bay Area.

Our journey in this area has been a real learning experience for me, characterized by almost universally fun activities that have brought about often profound change and growth for my child, and deepened my understanding of him as an individual as well as my understanding of the complex developmental processes of children in general. The more involved you become, the more progress he will make and the more enjoyable it will be for your whole family.

On a less "therapeutic" level, you might check out the classic *Raising Your Spirited Child* for strategies on helping him prepare for these high-stress situations. Best wishes -- Letitia


First off, b-day parties etc. are often very overwhelming, so it could be just a developmental thing, but...if this has become a major problem, or you have a nagging feeling about your son - check it out for piece of mind. A great book to read is "The Out of Sync Child by Carol Kranowitz - you'll find it at most major bookstores. Lots of info on Sensory Integration, checklists to help you determine if you should be concerned, ideas for home intervention, etc.

Oh yes, we have had a very good experience Sensory Integration Therapy My daughter (now 6) seemed to be doing just fine - articulate, fine in one on one situation, a little clumsy. We sent her to preschool when she was 3 yrs old because she was very excited about the concept of it - and she became absolutely overwhelmed, withdrawn, inarticulate, spacey. We had her evaluated by a physical therapist first, and she did have gross and fine motor delays (I'm actually a Physical Therapist, but at the time was working strictly with adults, so I didn't really "see" it in my own child), but traditional PT was only so helpful. We then took her to an OT (Denise Killingsworth in Walnut Creek - a great help) for sensory integration therapy and what a difference! We started seeing major changes, more comfort around crowds, less anxious, etc. within a few weeks. One of the pieces that was also a problem for my daughter was auditory defensiveness (noisy setting amplify to an almost unbearable decible level), which could also be a piece of your puzzle - there's things that can be done for that too.

The therapy is really fun for the kids - spinning, swinging, bouncing etc. Not all OT's or PTs are trained in this - you need to be very specific when you are looking for a therapist. It's nice that your MD mentioned it - there are many camps that scoff at the theory, even though its been around since the 70's and many, many people have been helped by it.

I could go on and on - if you would like to discuss it further, feel free to e-mail me and best of luck with your son. It's always a little scarey when someone suggests anything not quite normal might be going on with your kid - even if it's not a "big deal". The good news is, if he has sensory integration issues, there's lots of great stuff you can do. Sara


There's a book out called The Out-of-Sync Child" (I forget the author's name) that explains the dysfunction in great detail and readable prose. The idea is that some kids are either over or under sensitive to certain stimuli, which makes it harder for them to do regular every day things easily.... in a range diverse as getting along with others, tying shoes, paying attention in class, etc. Occupational therapy is meant to be very helpful -- if the OT is trained in SI Dysfunction. I found the book at Border's Books, Amazon.com probably has it too. Heather

Highly active 4/1/2 year old

April 2000

My 4/1/2 year old son is overwhelming me by his pure physicality. He is constantly climbing the furniture, me, my husband, jumping, rolling over things, etc(while a real dawdler when it comes to walking from point A to B.) We try to take him to parks a lot, and he is taking gymnastics now once a week, but things are still the same at home. I try very hard to point out the toy chest of unused toys, and engage him, but he'd much rather race through the house and throw his body all around on the sofa and chairs, jump from a table, etc. This stuff is not okay, as a rule, but he does it anyway. If I give him a timeout, I'll find him in his room teetering on the top of his sister's crib. He *can* sit still, when it involved a computer CD or a TV show, two things I'd like to keep to a minimum. Even my 2 year old daughter says, "Mommy is not a climbing structure", she's heard it so much. Any ideas besides more gymnastics? Should I allow him one chair that he can do his thing on!


If your 4 1/2-year-old is getting a wide variety of excercise in his daily life and *still* overwhelming you with his high level of energy, I think you need to consider broader measures to help him work it out. The problem might be what we treat our kid for, Sensory Integration Dysfunction. SID kids might be excessively energetic, or unusually low-energy. The baseline issue is that sensory input (the five "distant" senses that we're familiar with -- sight, hearing, taste, etc. -- plus "near" senses such as vestibular [balance] and proprioceptive [what are my muscles doing right now]) does not reach the brain in an integrated fashion, so that a complete "picture" of the body moving through space is not formed. Therefore this can take many forms of physically dysfunctional behavior or activity/inactivity.

The good news is that virtually everything I've seen so far in addressing this problem is sort of win-win, that is, it's stuff that is fun and that any kid might enjoy. Our child tended to be low-energy with hyper-energy bursts, and his balance wasn't so hot (trips alot). Some of the things we do in that regard involve spinning him -- you can go to the park and do the tire swing, or also I hung up a hammock from a single hook -- like a loop -- and I spin him a lot in that. The spinning can and should involve a *somewhat* abrupt change of directions -- depending on whether he's well-supported in pillows in the hammock, or not so well-supported out on the spinning tire, I stop the spin direction and reverse it. His body should not ever flop around: the idea here is that of a spinning bottle of fluid as metaphor for cerebrospinal fluid. When the bottle is stopped from spinning, the fluid sloshes against the other side of the bottle; in the body, this stimulates the sensory input in the nerves, helping them to mature and become more coordinated.

This is only one example; there is a huge range of activities that can help your kid. We also had delays in fine-motor skills and problems with visual perception. Other kids I know have benefitted enormously from a "brushing down" once or twice a day -- the parents or therapists use a soft-bristled brush that is stroked "in the direction fur grows". This seems to provide the body with extra overall stimulation that calms the kid down. The more in-home "gym" equipment you can provide, the better. If that means assigning one chair as the "jumping" chair, great! Or get a little trampoline.

You might think about taking your kid to a developmental specialist; I hear often about Dr. Bruce Berman, but we did not use him. Try to avoid the doctors who are inclined toward a ADD/ADHD diagnosis (hyperactivity) as long as you can; if you can keep your kid off Ritalin & other drugs, he will be better off in the long run (in my opinion). We do regular "occupational" therapy visits at Easter Seals in Oakland and have been very happy with their therepist's insights into what goes on with our kid.

A book that we found really helpful is *The Out-of-Sync Child*. It can help you identify what "flavor" of SID issues your kid might have and offer ideas for the kind of input he needs to help him gain control over his body. Keeping a journal of activities he's engaged in with overall assessment of "good" days vs. "bad" days is a good way to get a handle on things too, i.e., what activities consistently help this particular kid? Good luck!


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