School, not so much...

Well, during this past summer, we were running together while the boys played on the playground at the nearest elementary school. During this run, I proposed that maybe Liam would enjoy going to public school. I had wanted to give the charter schools in SAISD a try, since upon seeing the kids at the zoo, they were amazingly well behaved! We discussed the open enrollment of that district and he may or may not get in...blah blah blah. So I began to consider maybe giving my old school a try. I automatically assumed that they would provide the necessary structure that Liam so needed.

Several weeks later, we completed his enrollment. Two weeks after (two days before open house night) we received notice that Liam's teacher would be out on maternity leave and he had a long term substitute instead. The first red flag for me. What the heck is going to happen when they must make this transition to this new teacher just a few weeks into the school year? Liam was excited about school. He asked daily when he was going! I, on the otherhand, was terrified about him going. I cried to Mark one night about feeli if I hadn't gotten to spend enough time with him yet!! Everyday for 6 years was NOT enough! He and everyone else softened it for me and Liam's excitement was enough to just make those feelings go away.

Open house night came. We all went together. I was slightly prepared to explain to Liam's teacher/sub about SPD and his sensitivities. But how the hell do you prepare enough for explaining such a complex disorder?! I briefly explained his issues and said that I would meet with him the following week.  The afternoon before he was to begin school, I made a sheet with a letter written as if Liam wrote it, with a visual chart on the other side.  I made enough to give to all teachers that Liam would come into contact with.  The following morning, we all gathered up and went to the school to drop Liam off and to visit briefly with each teacher.  Each seems genuinely excited to know more about the student and to meet Liam.  I was terribly worried about how he would handle music class and lunch and gym.

We went to school to pick him up that afternoon.  He was slightly agitated, so we went to the mall for a little walking around with Mark and to look for shoes.  The following day, the afterschool meltdowns began.  He was angry and aggressive with me and Aedan.  Then he would crash for the entire evening.  He wasn't able to get the sensory diet that he needed, at school.  We had his ARD/IEP meeting the following week to address his speech services.  At that meeting I was able to explain to the principal and the other teacher (nextdoor teacher) about Liam's SPD issues.  They seemed very understanding and encouraged me to come up with solutions to help him in class.  The week following that, Liam began to act up a bit in class.  We explained to him that he was not allowed to misbehave in the class.  That week, I received a call from the school nurse stating that it looked as if Liam was stabbed by a pencil and all she was able to understand from him was something about two other kids and the pencil stuck him.  I was furious and totally ready to pull him out then and there.  They were'nt keeping Liam safe and they weren't stopping fights that he was getting into until the fights were full on fights.  I went up to the school that afternoon.  The teacher said that he hadn't seen any of what happened, but it seemed like it was an accident.  Liam didn't seem to be phased by it.  The teacher/sub also listed out a few kids that Liam needed to avoid, as they were difficult kids.  And that he had three fights that day.  I didn't understand WHY no one called me!! 

So over the next couple of weeks, we kept Liam from school for a couple of days off and on to see if he just needed some time to chill out.  The fights and meltdowns continued and got worse.  The final straw/day for me was when Liam was fighting with his teacher over his backpack when they were coming out of the school.  We waited for the teacher and had a discussion with him and the next door teacher.  I told them that Liam needs much less chaos.  He is shutting down because he can't handle all of the craziness of the current kindergarten class.  We visited the very nice principal and he allowed for Liam to stay in the other teacher's classroom, while remaining on the other teacher's role.

He would begin the following day.

That would also be the day that Mark and I would attend school time with him, observing the class and Liam. 

I arrived with Liam to the new room and he joined the class very easily.  I also got to observe the former classroom.  The teacher was annoyed, sharp, snippy, uninvolved with the kids.  He gave the most boring assignments and did not correct anyone until they were already out of hand.  Truely, kindergarten is no place for a straight, non-nurturing, male teacher.  Those little ones need a firm, grandma teacher!  I totally understood why Liam would not do well in that classroom.  This new classroom was slightly more structured, but as I learned from watching all kindergarten classrooms, it really is just a publically accessed daycare.  Parents need to go to work, want to save some money, so they just enroll their kids in public school.

Anyway, I observed a very tall 6 year old, Liam, isolate himself from all of the other kids, be completely defensive.  I knew in my heart that it wasn't going to work out for him.  There was far too much moving from center to center, too much noise, and the boy who was very threatening to Liam, who fought with Liam daily, was continuing to be threatening, only now it was through the doorway.  Liam expressed to me that was the boy who he "hated".  The other teacher took WAY too long to stop this child from staring daggers at Liam.  Mark characterized him as a small future drug dealer!  And he was right.  That kid needed a slap in the face.  Liam told us later that he always hit and kicked him because he didn't listen!  This kid was creating chaos in the class and Liam was trying to settle it all back down again.  Poor guy.  I guess we need to work on social skills a bit more. 

After my half of the day, observing, Mark went.  He called a few hours in and said that Liam was melting down and they forgot to allow him to go to the other class for music, so he could be with his familiar teacher.  He got into another fight and pushed a little girl this time.  I told him that was enough, he needed to bring him home.  He agreed.  After he came home with Liam, he told me how all of the teachers and administrators were trying to come up with ideas and solutions for him.  And we both agreed that was not what needed to happen.  Nothing there could be as consistent as Liam needed them to be.  They also brought up the "A" word.  They wanted desperately to have Liam diagnosed as Autistic.  I "re-explained" to Mark that he really didn't have all of the symptoms/characteristics listed in the DSV-IV for Autism.  We both really feel that the school wanted to do this for funding purposes.  They wanted to get the funding to make all of the special accomodation for Liam and since Liam's diagnosis is not in the DSM, nor recognized as a disorder yet, they would not get funding for that.  But they could with Autism.  No one actually said that and even in the ARD meeting about his speech services, again, they brought in the school psychologist (who rubbed me wayyyy the wrong way) and tried to convince me to let them do the extensive testing for him.  We withdrew Liam the day after the final meltdown.

I firmly stated to everyone that it was a good try, but Liam needs the one on one that I can provide.  And who better to be his teacher, than his super-intelligent mother?!

So here we are...back to homeschooling.  And he is fortunately able to receive speech services through the district, for free!  Things are working out and Liam is going to do just fine!

I really need to remember that as a mother, I must listen to my feelings...listen to my heart, when it comes to my kids.  My heart is always right.

Proprioceptive Dysfunction

Secondary to the Vestibular Sense is the Proprioceptive Sense.

Liam is a sensory seeker in that he:

• deliberately bumps and crashes into objects in the environment, ie jumps from high places, dives into leaf pile, crashes into people and furniture
• kicks his heels against the floor or chair legs
• modulates his arousal level, by engaging in self-stimulatory activities, such as head banging, nail biting, finger sucking and knuckle cracking
• likes to be TIGHTLY swaddled in a blanket or tucked into bed VERY tightly.
• also likes to be laid upon by us, full body weight of an adult across his body.  This provides almost immediate relaxation for Liam.
• chews constantly on objects, such as shirt collars and cuffs, hood strings, pencils, toys and gum.  He loves chewy foods
• appears to be very agaggressive at times

Liam also displays emotional insecurity within his proprioceptive dysfunction by:

• avoiding participation in ordinary movement experiences, because they make him feel uncomfortable or inadequate.
• becoming rigid, sticking to the activities that he has mastered and resists new physical challenges.
• lacking self-confidence, saying, "I can't do that," even before trying.
• this is seen when he begins hopping and will attempt to flee the area
• if he is forced to try the new physical challenge, he may be set off for the remainder of the day and will reach "total shut-down", if he isn't assisted in calming down.
• becoming timid in unfamiliar situations

We are currently working with Liam in that we explain to him what techniques he can use to self-sooth appropriately and we provide him with appropriate chewing objects.  We also indulge his desire to be squished or wrapped.

Sensory Seeking - Vestibular Sense Dysfunction

It has been found and seen very clearly, that Liam is a sensory seeker (at times...at other times he is very intolerant of movement).  The vestibular system is the unifying system.  It forms the basic relationship of a person to gravity and physical world.  All other types of sensation are processed in reference to this basic vestibular information.  Vestibular input seems to "prime" the entire nervous system to function effectively.  It tells us where our heads and bodies are in relation to the Earth's surface.  It tells us whether we are moving or standing still, whether objects are moving or motionless in relation to our body.  It also informs us what direction we are going in and how fast we are moving.

Liam is a crasher, he loves to run while pushing heavy objects (laundry baskets filled with toys or with his brother or sister in them) and crash the object into furniture or the walls.  He once had a plastic container with wheels, and would run all over the house crashing it into EVERYTHING.  He had a difficult time controlling himself in doing this.  At other times, we would observe him being VERY calm, almost sleepy and pleasant following 15 minutes of raking leaves or jumping on the trampoline (and would jump high enough to be able to see over the top of the net enclosure, at least 7 feet above the top of the trampoline base).  In homeschool time, I would activate Liam's attention and focus by having him drive one of his toy cars, quickly around the perimeter of the dining table, then come to sit back down.  Finally, if Liam is having a meltdown/tantrum, we firmly press on his shoulders or give him a squish (very tight bear hug) or quietly ask him to go to his IKEA pod-swing in his room and spin himself around in it very quickly.  This settles him almost immediately.

Liam is very tolerant of fast, rotary movements, spinning, swinging, jumping VERY high in a trampoline, climbing.  He has also taken to assuming upsidedown positions, hanging his head over the side of the couch or bed.  These activities will activate all of Liam's systems.  He will calm when angry, speak when unable to organize his speech, focuses on the task at hand when activated.  He will not, however, go so far and some sensory seekers and place himself in harms way.  He is very cautious, which may be a result of his tactile defensiveness. 

He is also affected by issues with Bilateral Coordination.  This is seen in watching him work with writing or using scissors.  He will use both hands for these tasks.  He has begun to establish a hand preference in writing, he seems to be a left-hand user, however, he will switch to the right at times.  In this, it is said that Liam has difficulty crossing his midline and will have difficulty coordinating both sides of his body when performing tasks.  This issue does seem to be improving, though.

Liam also seems to have characteristics of emotional insecurity.  He does have the "I can't" attitude when it comes to performing a requested task, especially when he hasn't been activated "vestibularily".

The following characteristics can be seen in Liam:

Liam is overresponsive to movements when they are unexpected (ie elevator movement...as a baby, he responded to elevator movement with primal terror, screaming and being completely terrified)

• he can at times be willful and uncooperative

Liam's increased tolerance for movement is characterized by

• the need to keep moving, as much as possible, in order to function.
• he may have trouble focusing on the task at hand
• he becomes more focused if he is able to stand up and walk around for a few seconds
• his craving for intense movement experiences, bouncing on teh furniture, using a rocking chair, turning in a swivel chair, assuming upside-down positions, or placing his head on the floor and pivoting around it.
• being a "thrill-seeker", enjoying fast-moving or spinning playground equipment, or seeking the fast and "scary" rides at an amusement park.
• not getting dizzy, even after twirling or spinning rapidly for a lengthy amount of time.
• enjoying swingin VERY high and/or for long periods of time
• liking seesaws, teeter-totters or trampolines more than other children.

As noted earlier, Liam displays Emotional Insecurity by

• getting easily frustrated and gives up VERY quickly
• is very reluctant to try new activities
• having low tolerance for potentially stressful situations
• having lowered self-esteem
• he responds negatively to compliments and praise
• being irritable in other' company and avoids or withdraws from people
• having difficulty making friends and relating to peers
• this is exaggerated by the fact that his language is poorly developed for his age group

We are also working on these issues with Liam.  When he is activated through movement, it is clear that he can function very highly.  That said, we are attempting to guide Liam to understand that there are appropriate times to use movement to activate his brain!

Auditory Dysfunction

Liam's second Sensory Modulation Disorder characteristic Auditory Overresponsivness.  He is defensive to loud and very soft sounds and sounds at certain pitches.  This defensiveness is characterized by him feeling threatened by sounds that bother him.  They create HIGH anxiety in him.  He hears EVERYTHING!  And startles just as a baby would at unexpected noises or sounds.  This startle reflex is nowhere near the end of the reaction to the sound.  The reaction snowball's into angry, aggressive behavior in Liam.  Since he is constantly alert to sounds and noises, all of his energy is used for this alertness and will interfere in his learning, language development and social interactions. 

As a baby, we noticed this oversensitivity to sounds, especially plastic bags rustling or being excited to hear a train whistle from at least 3 miles away, and FAR before we could hear it.  Liam loves trains.  As a toddler, Liam did not begin many attempts at speech.  He did babble and could totally understand and respond to our speaking to him, however he was not developing his own speech. 

We decided to make an attempt at speech therapy for one school year, it was not yet recognized that Liam had SPD.  In looking back, these speech classes were of no use, because we were not addressing the underlying problem of SPD. 

Now that we have the understanding of Liam's issues, we are more able to help him be more functional and make adaptations to his surroundings to be more apt to tolerate all sounds.  The following list shows the characteristics of his Auditory Dysfunction:

Liam has a hard time modulating his behavior and is

• usually distressed by loud noises, including voices
• he will become very angry and sometimes violent if he hears shouting or at the slamming of a cabinet or any other loud noise. 
• It causes him to feel as if he is in danger, when he is clearly not.
• distressed by sudden noises, thunder, fire alarms, sirens, balloons popping
• He is also distressed at the 'possibility' of these sounds happening
• distressed by tinny or metallic sounds, such as those coming from a xylophone or clinking silverware
• distressed by high-pitched sounds, such as those coming from violins, sopranos and screeching chalk
• distressed by sounds that do not bother others, ie a toilet flushing, distant church bells, or soft background noise.

We are working hard with Liam to be able to respond more appropriately to all sudden, loud or high pitched sounds that irritate him.  We are guiding him to understand that he is not in danger and to discriminate between danger and what isn't dangerous and to respond to sounds that bother him by covering his ears with his hands.

Liam has difficulty with receptive language and

• is usually only able to follow one or two instructions in a sequence
• looks to others before responding
• will misinterpret questions and requests
• has some issues with discriminating sounds, especially consonants at the ends of words

As well, he especially has issues with expressive language and

• has been a late talker
• has difficulty putting thoughts into spoken language (and becomes very angry when he cannot express himself)
• sometimes talks "off topic" (ie talks about his new shirt when others are discussing zoo animals or a soccer game)
• has difficulty "closing circles of communication" (ie responding to others' questions and comments on demand)
• has difficulty correcting or revising what he has said so that others can understand
• has a weak vocabulary
• uses immature sentence structure (poor grammar and syntax)
• has a limited imagination in fantasy play

Liam has difficulty with his speech and articulation and

• is sometimes unable to speak clearly enough to be understood
• sometimes speaks very softly
• usually speaks hesitantly or without fluency or rhythm

In general, Liam is

• very tired at the end of the day
• can have little motivation or interest in academic work
• has slightly lowered self esteem
• shy and tends to withdraw from social situations
• greatly improves his ability to speak while or after experiencing intense movement (spinning/running/swinging/jumping)

In identifying these attributes, we are more able to help Liam to lessen his defensiveness.  In school we hope to help his teacher understand what his needs are.  Liam will benefit from being in a quieter classroom, placing him far away from bubbling fish tanks, air conditioners, doorways, and near visual cues to help him supplement the auditory information he may miss.  We will also place Liam back into speech classes and deliver the knowledge of SPD and his auditory defensiveness to the Speech/Language Pathologist in school.  We also hope to activate his speech through movement...active movement primes the pump and speech begins to flow.

Sensory Processing Dysfunction

Liam has a less than normal ability to take in sensory information from the signals his body sends him and signals from the environment around him to organize the information and use it to function in his daily life. He has ineffective processing of tactile (touch sense), vestibular (movement sense), proprioceptive (position sense) and auditory (hearing sense) sensations.

Most people have five functioning (external) senses: Sight (Visual), Hearing (Auditory), Smell (Olfactory), Taste (Gustatory), and Touch (Tactile). We also have three additional senses that are hidden (and not in a 6th sense way of thinking…ha!). The additional hidden (Internal) senses are Interoceptive (Internal Organs…hunger, thirst, digestion, body temperature, sleep, mood, heart rate, etc), Vestibular (Movement…spinning sensations, falling sensations, being moved or pushed) and finally Proprioceptive (Body Position and Orientation…body awareness and muscle control).

When these senses are activated, the central nervous system (nerves, spinal cord and brain) processes them as information and the person acts appropriately in regards to the stimuli. On the other hand, in Liam, the nervous system has some sort of “disconnect” or disruption between the sensory stimuli received and the reaction or output given. His sensory neurons don’t send effective messages into the central nervous system and the motor neurons don’t’ send effective messages out to his body to have appropriate behavioral responses.

Liam has what is called Sensory Processing Dysfunction (SPD). It is defined as the inability to use information received through the senses in order to function smoothly in daily life. It is an umbrella term to cover a variety of neurological dysfunctions or disabilities. The subtypes of SPD are Sensory Modulation Disorder (Sensory Over-Responsivity, Sensory Under-Responsivity and Sensory Seeking), Sensory Discrimination Disorder and Sensory Based Motor Disorder (Postural Disorder and Dyspraxia). Basically, when the processing of the senses is unorganized, the brain cannot do its most important job of organizing sensory messages. Liam cannot respond to sensory information to behave in a meaningful, consistent way. He may also have a difficulty using sensory information to plan and carry out actions that he needs to do. Therefore he has a difficult time learning. All of Liam’s sensory issues have existed from even before his birth. They have carried on to the present time and encompass his speech learning and self regulation (behavior control). In order to develop normally and learn normally, a person must have organized senses. If the senses are disorganized, again, the person cannot learn normally.

His inability to function smoothly is not because he won’t, it’s because he can’t.

Liam has several issues with sensory processing, some are less severe than others. Some have been more severe in the past and he has overcome them. Luckily, as Liam grows older and learns the accommodations that he needs to activate when he notices a sensory issue happening, he will be able to function normally as a normal kid and normal adult. SPD is fully recoverable with the proper exercises, activities and treatments. Liam only experiences issues with four of the senses, Auditory, Tactile, Vestibular and Proprioceptive. And only very slightly has issues with Olfactory sensations.

The first and very obvious issue that Liam has is Tactile Dysfunction. Most people who meet and spend any time with him can see this very quickly.

Liam will:

• Respond negatively (and aggressively) to light touch, to him, it feels as if he has been scratched or punctured.

• Respond negatively (and aggressively) to the possibility of being touched lightly, therefore avoids closeness with most other people.

• Respond negatively (and aggressively) to being touched by surprise. (eg, he will kick and thrash inappropriately if his brother is lying next to him and accidentally touches him with his foot.)

• Show fight or flight behavior when his face is touched or washed, when receiving a haircut or a shampoo or if patted on the head. (bath time is a challenge and he appears very rude if an adult pats him on the head; he runs off)

• Respond very negatively to gnats or mosquitoes (the light, itchy touch, feels like needles to him…he will go running screaming “OUCH OUCH OUCH!!”

• Seem very over responsive to physical pain, very overdramatic over a minor scratch or splinter. Removal of a splinter seems as if we are attempting to remove his entire foot.

• Also respond in the way above to any dissimilar and unexpected touch sensations.

• Hates surprises

• Severely hates having fingernails trimmed.

• Rubs off the sensation of a kiss, prefers hugs.

• Be very distracted, inattentive and fidgety.

• React with fight or flight to friendly touches or pats from anyone unfamiliar (usually anyone other than us, his parents).

• Curl or protect his hands to avoid some touch sensations.

• Be unusually fast to hurry to remove a very tiny bit of dirt or water from himself or his clothes. (most who have spent any time with him have seen this, although he is and has gotten much better at tolerating this, in past years he would simply strip completely naked at the moment of getting a tiny bit of water on himself…running around yelling “ewwwww wet, wet!!!!.)

• Avoid sticky textures (gloop, reward stickers, glue, etc) and would become tearful or aggressive at the idea. (flight response to anyone wanting to place a sticker on his shirt)

• Stand still or move against others (traffic) during any group activities to keep constant visual tab on others (to avoid being unexpectedly touched).

• Treat pets roughly.

• Arm himself with anything seen as a weapon (stick, car to throw, etc mainly at Aedan)

• Has difficulty forming warm attachments to others.

• And finally, Liam exhibits stubborn, rigid, inflexible, willful, verbally and physically pushy and otherwise “difficult” behaviors for no apparent reason, when it is actually an adversive response to a “Liam offensive” tactile stimuli.

All of these things that affect him, wouldn’t normally affect most people in the way it does him. To Liam, a light touch, unexpected touch or sticky sensation feels as if he’s being punctured with a knife or like his skin is peeling off. He is over-responsive to touch. His nervous system is over-responsive to touch. The disconnect is that his brain and nerves are inaccurately telling him that these sensations are DANGEROUS. And he is reacting accordingly. Seeing a giant bear walking toward you while camping, your brain tells you that this situation is dangerous. The visual stimuli (sensory input) is the bear, your nervous system (your brain and knowledge within) tells you this is bad, you fight or flight (the reaction). To Liam, sticky sensations, light touch, unexpected touch, etc tell Liam that he is in danger, so he reacts aggressively. We are currently working with him to find the best way to tell himself otherwise.

More to come...