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  • What are sensory processing differences?

    Sensory processing differences are when a child has trouble handling the information their senses take in—things like sound, touch, taste, sight, and smell. Besides these common senses, there are also two other less well known ones that can be affected—proprioception, or a sense of body awareness, and vestibular sense, which involves movement, balance, and coordination.

    Kids with sensory processing differences experience too much or too little stimulation through these senses. They may also have difficulty integrating sensory information—for example things that they see and hear simultaneously, like a person speaking—might seem out of sync for them.
    Note: These problems are sometimes referred to as sensory processing disorder (SPD), even though psychiatrists don’t consider it an actual clinical diagnosis.

    Signs to look for:

    Hypersensitive kids are extremely reactive to sensory stimulation, and can find it overwhelming.

    They may:
    • Refuse to wear clothing because it feels scratchy or irritating—even after cutting out all the tags and labels-or shoes because they feel “too tight.”
    • Be unable to tolerate bright lights and loud noises like ambulance sirens
    • Be distracted by background noises that others don’t seem to hear Be fearful of surprise touch, avoid hugs and cuddling even with familiar adults
    • Be overly fearful of swings and playground equipment Often have trouble understanding where their body is in relation to other objects or people
    • Bump into things and appear clumsy Have trouble sensing the amount of force they’re applying; so for example, they may rip the paper when erasing, pinch too hard or slam objects down.

    Hyposensitive kids are under-sensitive, which makes them want to seek out more sensory stimulation.

    They may:
    • Have a constant need to touch people or textures, even when it’s not socially acceptable Not understand personal space even when kids the same age are old enough to understand it
    • Have an extremely high tolerance for pain Not understand their own strength
    • Be very fidgety and unable to sit still Love jumping, bumping and crashing activities Enjoy deep pressure like tight bear hugs
    • Crave fast, spinning and/or intense movement Love being tossed in the air and jumping on furniture and trampolines.

    Mood swings and extreme behaviors:

    Kids with sensory differences sometimes exhibit extreme behaviors like screaming, and throwing violent tantrums all because the physical sensations involved are overwhelming to them.

    They may have surprisingly wild mood swings as a reaction to a change in the environment. For instance, a first-grader might be fine in a quiet setting with a calm adult. But place her in a grocery store filled with an overload of visual and auditory stimulation and she might melt down, i.e. have a severe tantrum and isn’t likely to stop, whatever a caregiver might do, until she is exhausted.

    In addition to this “shutting down” because of sensory overload, a child might also lash out, or become aggressive. Or she might flee—a fight-or-flight response. If a child dashes out across the playground or parking lot, oblivious to the danger, it may be because she is heading away from something upsetting, which may not be apparent to the rest of us, or toward an environment or sensation that will calm her system.

    Therapy:

    Occupational therapists (or OTs) are the specialists who work with kids who have sensory differences. Your child may be referred to an OT at his school, or you may want to find one who is in private practice. OTs engage kids in physical activities that are designed to regulate their sensory input, to make them feel more comfortable, secure, and able to focus.

    There are no scientifically sound studies proving that the work occupational therapists do with kids who have sensory processing challenges is effective. But many parents have found that the therapies and exercises help kids to feel better and function better. “It works like a reset button,” one mom reports.

    Every child’s sensory differences will be different, so before therapy can begin the OT will need to evaluate your child through tests and by observing him and talking to teachers and caregivers. Then the OT will come up with a sensory treatment plan, sometimes called a “sensory diet,” that is custom-made for your kid’s needs.

    More on this topic here: https://childmind.org/article/sensory-processing-faq/

  • CDC Guidelines have changed for the first time since 2004. What does this mean for you and your child?

    What are the CDC (Center for Disease Control) guidelines used for?

    Developmental Milestones have served as an educational tool for parents and medical professionals to set reasonable expectations and goals as their child grows. They are age based, and also serve as a guide in socialization, play and interaction, appropriate to a child’s level of skill and understanding.

    Why did they change? what are some changes? 

    The most notable change is that previously published milestones were based on the 50th percentile (average for age milestone). Now the 75th percentile (majority of children within the milestone) are the baseline and therefore many milestones shifted expectations to an older age. For example, understanding “no” was previously published at the 9-month level and now is listed at 12 months, with an expanded description (“pauses briefly or stops when you say it”). “Eats with a spoon” was previously listed at 18 months and is now at 24 months. 

    Concerns have been voiced that with the newer, later dates some delays may be missed. However, it’s important for parents and professionals to understand that the new ages represent when most (or three quarters) of children achieve these skills, not half as commonly published before.

    Social-emotional development changes were also emphasized in this new update.

    With the increased understanding and awareness of autism in early childhood, it has become recognized that children with autism may have delays in social engagement and communication from an early age. Prior milestone lists did not offer many social-emotional milestones. In contrast, the new cdc guidelines give extra attention to including markers of social development in order to aid in the early identification of this developmental condition.

    Wait, why was crawling was removed as a milestone? 

    There were also concerns with exclusions of some milestones, such as crawling. Real-world data shows a vast variance in the appearance of the crawling milestone. Thus, crawling is frequently excluded entirely from guidelines since many children skip this skill without any adverse consequences.

    What does MST think about the changes in milestones?

    Montclair Speech Therapy, although acknowledges these changes, do not necessarily agree with all of them. For example, crawling is seen as a key vital step for some children. The adverse consequences are challenges related to the vestibular system, upper extremity weakness as children are not weight bearing to gain proximal strength. Crawling also helps to promote crossing the midline, coordination, and vision. For speech purposes, lowering the count word of 50 words from 24 months to 30 months is concerning. Parents rely on these milestones in order to reach out for help or communicate their concerns. Early intervention can have waitlists, and if parents reach out at 30 months, instead of 24, they may lose on receiving one on one therapy in their home environment, or in a clinical setting. We encourage and advise all individuals to reach out as soon as possible if you feel your child is demonstrating delays rather than use the “wait and see” approach.

    What does this mean for you as a parent or guardian? 

    You know your child best. If you are worried your child is delayed, it is key to reach out to your pediatrician and also to contact the early intervention state department at 888-653-4463 (statewide, toll free).

    The CDC milestones checklist is a helpful tool and can be found on the cdc website, along with the milestones for all the various ages.


    Source References: CDC’s Developmental Milestones
    Understanding Updated Developmental Milestones