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From:
"Catherine Watson Genna, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 18 May 1995 00:56:22 -0400
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Phyllis,
You didn't miss anything!  The work on this field was barely begun when you
had your son.  One lone Occupational therapist names Jean Ayre was noticing
many developmentally delayed or learing disabled kids had a constellation of
symptoms related to deficits in sensory processing.  There is a society which
provides information and books (Sensory Integration International) and a very
good introductory booklet entitled Sensabilities is available from Therapy
Skill Builders 800-228-0752.  (Therapy Skill Builders also publishes my
favorite book on sucking and swallowing disorders in newborns).
        In a nutshell:  Info from our senses is our interface with the world.
 If this info is not processed correctly, it can be misinterpreted as
threatening, giving rise to a flight, fright or fight response.  These
responses further isolate the child from learning through sensorimotor
functions (the sole basis of learning in the first 2 years according to
Piaget).  Senses include the 5 we always think about, as well as
proprioception (deep muscle and joint sensations that tell us where our body
is in space) as well as kinesthesia (the feeling of movement).  When these are
distorted, you can see how the child can have difficulty tolerating certain
movements or sensations and how motor responses such as equilibrium reactions
and speech get delayed or distorted as well.  If you don't know where your
hand is, it is pretty hard to aim it accurately.... This motor difficulty is
known as dyspraxia, or motor planning dysfunction.  A child with dyspraxia
will be clumsy and disorganized, may use vision to compensate for the poor
kinesthesia and proprioception. You should have seen my Vinny (8) trying to
get up on the examining table at the pediatrician's office without using the
step.  He tried to jump onto the table backward while craning his neck to see
behind him, and he was only jumping a 6th of the height necessary and was not
propelling himself backward.  He even asked me "how do you do this?"  I had to
show him what the motions felt like by explaining what to do while I lifted
him up and back onto the table.  After that, and bracing his hands on the
table behind him so he could find it, he managed to get up there.  He has
similar difficulty imitating a dance step or getting out of a van, though he
looks normal enough going about his everyday activities.
        Since these problems are subtle, there is no early screening method,
though some practitioners are working on this problem.  There are specific
diagnostic tests for toddlers or preschoolers, but no definitive signs in
infancy have been identified.  I would tend to suspect this problem when a
baby is extremely irritable, picky, has lousy oral motor skills, gets
disorganized easily, and seems slightly hypotonic (floppy).  The sweating and
vomiting reflects imperfect control of autonomic functions. (My son sucked
much harder when I tried to break the suction, too.  Interesting.) The caveat
here is that most infants seem hypotonic once the physiologic flexion
decreases at about 2 mos, and some kids just have more demanding, irritable
personalities.
        The good news is that children will seek the kind of stimulation they
need to improve.  Vestibular (spinning and swinging) stimulation is especially
helpful for these kids.  For infants this translates into being carried in a
sling or other carrier while mom goes about her business.  You can pat
yourself on the back for attachment parenting your son, listening to his cues
(I'm sure your doctor was scandalized that you fed him for so long, so often,
twentysomething years ago.)  Once childhood and school are past, people with
SI problems tend to do well, they find ways to do less of what is problematic
and more of what comes easily.  SI therapy seeks to provide the environment
and equipment for the child to get the kind of stimulation he needs to improve
both the input (sensory processing) and output (motor planning and tone).  SI
therapists need to be patient and nurturing, to help the child conquer their
instinctive reactions to sensation.  My son really enjoys his therapy, though
it is very hard work for him.  He does things like climb a rope ladder and
jump off onto huge foam filled bags; pull up on a bar swing, fly through the
air, and land in a tiretube covered with a sleeping bag; swing on his belly in
a sling-swing, while trying to hold his hands and feet up like superman; hold
onto a spinning and swinging pommelhorse shaped swing, starting out on top,
then letting his body slide underneathe, then falling on the foam.  All these
things are designed to facilitate certain body postures, tone, strength and
stability while stimulating vestibular and propriceptive and deep touch
systems.  It seems to work, we have done this for 2 years, and there have been
greater improvements in both fine and gross motor skills than with regular
physical and occupational therapy for the previous 4 years.
        It's nice to have some answers, isn't it?  I could write about this
forever, but I've hogged enough bandwidth here!
Catherine Watson Genna, IBCLC

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