Sensory Awareness: Looking At the Whole Picture

As human beings, we are hopefully constantly learning and experiencing new things, which we can then incorporate into our senses of who we are and how we move through the world.

The same can be said for child therapists. Every day we have contact with children and parents in the clinical setting means the chance for a moment of learning. It can mean another opportunity for a eye-opening and unexpected experience, which can then enrich the work we do moving forward.

The way that I work as a child therapist has changed and evolved tremendously in the past year. I attribute this in large part to the learning that I’ve been doing about the brain, the central nervous system, and sensory issues.

This past year, we were fortunate to have an occupational therapist come to our clinic, set up an OT program, and help us to incorporate an understanding of these areas -- including how a child regulates, or manages, his or her sensory input (sound, touch, gravity, taste, balance). Our occupational therapist taught me to understand the deep influence this has on a child’s emotions and behaviors.

Take 4-year-old Dylan. He is constantly moving, running, bumping into furniture, climbing up on the table, and jumping off things like the arms of the sofa. If he lands on his head, he just gets up again without seeming hurt at all. He has a very hard time following directions. He also gets frustrated very easily and quickly, to the point of catastrophe – and then, inevitably, there’s a meltdown. We (the caring grownups) then have to help scoop it all up and put back together into the shape of a little boy.

Using a traditional mental health model, Dylan’s symptoms could very easily be chalked up to ADHD. That’s Attention-Deficit Hyperactivity Disorder. For Dylan, the subtype that would apply to him would be “Predominantly Hyperactive-Impulsive Type.” The parent might be coached to provide increased structure and routine at home, use repetition, or use behavioral charts (which might include one sticker for every episode of “good” behavior, as outlined on the chart) and rewards.

I’m not saying any of that is bad or wrong. It’s just not looking at the whole picture. I’m not saying it’s not doing enough. I’m saying we could be doing more.

The whole picture, if you look at Dylan from a sensory perspective, would include consideration of the fact that Dylan is sensory seeking and sensory craving. He wants movement. He wants pressure against his body, the bottom of his feet. He wants to touch a lot of different textures.

Dylan wants the inner-ear stimulation of swinging which allows him to feel calmer. He wants the deep pressure of a hug from grandma that makes him feel more organized and allows him to actually pay attention when she asks him to put his shoes on. And, Dylan wants all of this now.

So, I’ve learned, why not give him what he needs if it helps him to actually feel better and prevent a tantrum or another “catastrophe?”

I’ve incorporated this way of thinking into my work and collaborated with Dylan’s grandmother to give him the stimulation that he needs. If she sees that Dylan is becoming frustrated and upset (or “dysregulated”), she can now recognize it and give him some calming pressure, like squeezing his arms, or giving him a big bear hug while also reassuring him.

And, it works!

I’m just touching on the tip of the iceberg here about looking at the whole picture. I'll be talking more about sensory integration, regulation issues, inner motivation, and ways to help a child improve the way he deals with people and the world outside of himself.