Mr. Moffat Makomo, OTR
We are extremely thankful to Mr. Moffat Makomo, OTR for writing our blog this month. Mr. Makomo is a Pediatric Occupational Therapist at Manchester University NHS Foundation Trust in the United Kingdom. Prior to his current position, Mr. Makomo served the children of Bermuda for 11 years as an Occupational Therapist at the Bermuda Hospitals Board. He has years of extensive experience and has worked in Cairo Egypt and his home country of Zimbabwe.
Mr. Makomo has recently authored a book aimed at supporting parents of children who are picky eaters. His book, Here comes the Aeroplane!: A GUIDE TO BUILDING INSIGHT WITH YOUR PICKY EATER is available on Amazon in both paperback and Kindle versions. The book focuses on the function of behaviors related to picky eating and problem feeding. It also offers strategies on how to address them by collaborating with the child through parent-child prompted discussions.
What is Sensory Processing?
Sensory processing is how a child interprets and responds to sensory information and can be reflected in their emotional, attentional reactions and conduct. As clinicians, we encounter parents of children and teens who have presented behavioral responses associated with sensory processing. Some of the sensory input can be from our soundings such as touch, smell, taste, sight, and sound. While other kinds of sensory input may be less noticeable, as it originates from within, such as body awareness, movement, and internal state (hunger, thirst, full bowel, and bladder). Some children find everyday activities, such as dressing, grooming, eating, toileting, and showering, overwhelming and distressing. It is important to note that sensory processing difficulties can affect many children and teens.
Oh Wait, There's 8!
I am sure you are aware of the basic 5 senses, but there are actually 8 senses to consider when talking about sensory processing. These are sight, hearing, taste, smell, touch, body awareness, movement, and internal states.
1) Sight
Visual information includes color, shape, orientation, and motion. This helps us to see danger, enjoy the beautiful scenery and navigate and explore our environment. Challenges with visual processing can result in us being easily distracted with vision, preferring dark spaces, and/or avoiding foods of a certain color.
2) Hearing
Auditory processing involves comprehending language, detecting sounds, threats, enjoying music and nature. Challenges with auditory processing can include sensitivity to noises, getting angry listening to eating noises/sounds and blocking our ears in loud spaces.
3) Smell
This sense is responsible for discriminating odors, enhancing detection of odors, filtering out many background odors so that we can enjoy food, detecting bad food, and identifying foul smells. Challenges with olfactory processing include aversion to strong smells, smelling everything, and/or preferring certain smells.
4) Taste
Taste allows us to discriminate between safe and harmful foods. Usually, individuals prefer sweet and salty tastes to sour or bitter tastes. Detecting salt is critical to keeping a regulated and stable internal body environment. Our sense of taste allows us to enjoy food and detect some poisons for us to spit out. Challenges in this area may include only preferring bland foods, and/or disliking teeth brushing because the individual does not like the taste of toothpaste.
5) Touch
Touch allows us to explore our environment by identifying textures or threats on the skin, in the mouth, and on our bodies. Difficulties in this area result in challenges with clothing that have tags, seams, and even wearing socks. It can also result in difficulties with eating certain textures and/or using certain toothbrushes because of the bristles.
6) Movement (Vestibular)
This area contributes to balance and orientation in space. It is the leading system informing us about the movement and position of the head relative to gravity. It also allows us to control our eye movements and what keeps us upright. Challenges can result in overactivity, challenges with eye-tracking, and reading difficulties.
7) Body Positions (Proprioception)
Proprioception is a sense of body position, location, orientation, and movement of the body muscles and joints. This sense provides us with the sense of the relative position of neighboring parts of the body and the effort used to move body parts. It allows us to use the right amount of force to throw a ball, write with a pencil and play with our pet. Challenges with body positioning can result in us being labeled as being aggressive or heavy-handed.
8) Internal States (Interoception)
Interoception provides a sense of what our internal organs are feeling. It allows us to detect hunger, thirst, need to excrete urine, or have a bowel movement. It also detects responses that guide regulation, including hunger, heart rate, respiration, and elimination. It allows us to label our emotions based on the responses of our internal organs (i.e., our heart rate, breathing, and pulse). Challenges can result in mislabelling of emotions and confusing hunger with emotions and vice versa. It can also result in challenges with toilet training.
So, Where Does Goldilocks Come Into The Picture?
The Goldilocks and the Three Bears story can highlight how “just right” for one person can be different from another. The classical story of Goldilocks speaks to how sensory sensitivity to certain input can differ from one person to the other. Goldilocks wandered into the woods and ended up reaching the bear’s house. At times when children are overwhelmed with sensory information, they can wander, get confused, and even get into trouble at school as they end up in the wrong place at the wrong time. Once she arrived at the bears’ house, Goldilocks made herself at home and began indulging in the bears’ comforts. She preferred a certain temperature for the porridge, size, and texture of the chair, as well as the texture and firmness of the bed. This speaks to people’s preferences in how they experience the world.
What Does Sensory Processing Difficulties Look Like in Children?
Occasional sensory sensitivities, avoidance, and sensory-seeking behaviors are normal parts of developing children’s functioning. However, some children have emotional, attentional, and social-emotional responses associated with sensory processing that impact their day-to-day activities. Although there is no official DSM-V diagnosis of Sensory Processing Disorder (SPD), sensory processing difficulties are real and can impact children negatively at home, school, and in the community. This, therefore, impacts their attention, tolerance, awareness, and availability in the learning environment. It can also impact their social participation, motor skills, self-esteem, and emotional regulation, resulting in the child requiring external support in the learning environment.
What Can I Do to Help?
So, what can parents do to help kids who might be exhibiting sensory processing challenges? Here is a list of my top seven questions to ask to create a sense of well-being, health, and happiness. Engaging in these strategies can help to prevent the conduct, socioemotional and attentional responses to sensory processing difficulties from worsening and can even help to set your child up for a lifetime of success.
- Ask yourself: “Can I do something to change my child’s attention to the problem?” Consider using things like a tooth-brushing app, clothes that appeal to their interests, or loose, soft, seamless items that meet their sensory specifications to help them attend to what they wear.
- Ask yourself: “Are there any sensory strategies that have helped in the past?” Try deep massage, audiobooks, aromatherapy, etc.
- Ask yourself: “Can my child do something to affect their emotional regulation at the moment?” Perhaps playing their favorite upbeat music or brightening (or dimming) the lighting in the room would get them in the mood to get dressed. Addressing the meltdown first is essential.
- Ask yourself: “What could I change about the routine to make it easier for my child?” Try dressing after breakfast rather than before – this slight change may make a difference. You could also try to give your child the responsibility of doing a clothes-oriented chore like washing or putting away their clothes.
- Ask yourself: “Is there something about our relationship that I could use to motivate my child?” Letting your child wear what’s comfortable and not telling them what looks best may help them get dressed quickly.
- Ask yourself: “What in our environment could I change?” It may help to install hooks in his closet, so they needn’t fuss with hangers, or to set up labeled bins (e.g., T-shirts, Socks, etc.) instead of a visually confusing jumble in a dresser drawer. A dressing schedule posted on the wall may be useful too.
- Ask yourself: “Can I add or subtract a task to change the situation?” Have your child lay out their clothes the night before or use a visual schedule and check off each item when they put it on.
These tips can be implemented in all activities of daily living, such as eating, toileting, grooming (e.g., teeth brushing, hair brushing, haircutting, nail cutting), bathing/showering, dressing, sleep, play, and social participation. You can also discuss with your health practitioner for a referral to a specialist sensory trained Occupational Therapist.
References
- Kranowitz, C. S. (2006). The out-of-sync child has fun: Activities for kids with sensory processing disorder. TarcherPerigee, Revised edition.
Thanks for your blog, nice to read. Do not stop.