This post on Sensory Processing Disorder: Sensation Seeking & ‘Antisocial Behaviour’ is the 3rd in the series of our journey with Sensory Integration Therapy and I hope it can help others in some way:
Sensory Processing Disorder & Our Boy With Down Syndrome
Sensory Processing & Sensation Avoidance
Please also see Potty Training A Child Who Has Zero Interest
Our little boy is now 4 years old. He has Down Syndrome and has already come so far in life – I see a level of determination in him that I don’t think I quite witnessed to the same extent in our other two kids. Like all children, he finds some things easier than others and has also exhibited his fair share of antisocial behaviours: he’s bitten, thrown things (often called casting), ground his teeth incessantly, hit out at people, pinched, ripped up books, decided to sing rather than get on with eating his dinner…
Now I know people say ‘oh it’s a phase, it will pass’, (or worse) ‘well he does have Down Syndrome’. The trouble was that all the ‘usual’ techniques weren’t as effective as we would have liked (techniques such as eye contact with a firm ‘no’, time out, consistency etc. you know, the usual Super Nanny ‘stuff’.). Then nursery suggested if he wanted to rip paper, then maybe he should have free access to paper he WAS allowed to rip, or if he wanted to throw things, to give him a ball and a bucket – this is exactly the same advice we’d been given from the occupational therapists too.
But this simply didn’t work. There was something else going on…
So we took another approach and banned the items in question unless he was supervised and made sure he was fully occupied with other stuff – so no unsupervised access to paper products or books / throwable items for a weeks or so, just to break the cycle. But this was exhausting for us and not really a long term solution. Even though the cycle did ‘break’, the problem would re-emerge a few days / weeks later, or he’d develop a new ‘phase’…
It wasn’t until we started Sensory Integration Therapy for him that we started to understand what was going on a bit more and to see a huge improvement. Yes we still get the odd seeking behavior but it isn’t a major feature of our day any more. He almost never bites or pinches and only hits if he’s frustrated when his brother and sister are annoying him and won’t back off (so more understandable!). Even his siblings say he’s definitely improved!
Interestingly the therapist we worked with also believed in not allowing free access to the sensations he was seeking and explained it like this:
‘Generally when people talk about ‘seeking’, or ‘stimming’, it’s when a child has found an intense sensory experience. At times they can become so caught up in the sensory sensation that they shut out any thing else occurring within their immediate environment.
If you were to look at how this is manifesting at a behavioural level, the presentation is often socially inappropriate. So, they may for example be engaging in rocking back and forth, vocalise loudly, stare intensely at an object, try to position their head so it is upside down, so they get a rush of sensory feedback to their head etc. Ultimately their body is telling them that it’s numb, it hasn’t got enough sensory information to be able to function adequately and so needs to be topped up.
I think it is important to address the real issue. If the body is saying it needs more sensory information to know where it is in space and time and to be able to organise itself internally and in relation to its physical environment, then we need to help this process occur, but within a socially appropriate context. That’s why it’s useful to remove the inappropriate interactions and replace and address the sensory seeking behaviour with a more appropriate stimulus.’
So what were we advised to do that was different to what we were doing already?
As soon as he starts any seeking behaviour, we respond to his immediate need for sensory input by engaging him in an alerting and stimulating activity, followed by 1-2 calming activities. He does comply but if he didn’t, I’d get round this by getting him to do them on the way to go and get something he wants (e.g. a favourite toy / a treat of some kind). Bribery all the way with this I say!
1 x Alerting Activites (within his tolerance level – watching out for him getting over excited, ‘discombobulated’, clumsy, unfocussed, irritated, unco-operative…)
e.g.
- 10 jumps / big bounces on a ball / jumps on a trampoline (or less if he doesn’t tolerate it)
- Crawl across the room
- Crab walk on hands and feet across the room
- Bunny hops or frog jumps across the room
- Carry something heavy (pile of books / bag filled with bags of rice etc) from one room to another…
- Help lift shopping out of bags
Followed by
1-2 Calming Activities
e.g.
- Roll him on his front over a gym ball x 20 (as long as he’s enjoying it ok), encouraging him to push off the floor with his hands and then back the other way from his feet.
- Get him to push against a wall.
- Push a toy buggy filled with something heavy
- Lie on his tummy on a skate board and work his way across the room
- Crawl slowly over sofa cushions scattered on the floor
- Controlled tug of war sitting on the floor (matching his pull) using a tea towel.
And ending with deep body squeezes (firm pressure to his shoulders, arms, hands, trunk, legs, feet).
…Then we engage him in a one to one activity of his choice for about 5 minutes minimum if we can. As some of you will know, seeking behaviours can happen at any time and it’s not always easy to stop what you’re doing and have a mini sensory workout! So we just do the best we can and if I’m cooking and can’t stop properly, I’ll get him to do some jumps and then give him a big calm bear hug, kiss his nose and set him up with a book by himself or something I know he’ll enjoy. At least it’s something and he feels I’ve paid him some attention. Though the need for this has decreased significantly and isn’t on a daily basis!
On top of these mini sensory workouts, we’ve been advised to do 3 ten minute daily sensory workouts to help him improve his sensory processing in general. The theory is as I explained in my first post on sensory integration therapy here, as we provide him with regular sensory input, his sensory needs will change (including any seeking behaviours!).
We’ve been advised to do these bigger sensory workouts calmly and slowly in a quiet room, with dimmed lighting to minimise sensory overload and to calm his system:
- 1 alerting activity
- 3-4 calming activities with more of a focus on weightbearing exercises (pressure up through arms and feet). If he seems excitable at any moment, we’ve been told to stop and do some push/pull activities (e.g. row row row your boat).
- Finish with deep pressure squeezes to ensure that his body is fully calm.
So just to recap – we do a quick mini sensory workout in response to any seeking or antisocial behaviours and the bigger ten minute work outs in addition to those…
It goes without saying that I can only talk about our experience, what we’ve been advised to do and the effect that it’s had on our son, but I can’t tell you how impressed I’ve been with it. Yes you all have to be ‘on it’ and committed to change but as time goes on it takes less and less time.
What’s emerged is a much happier, more engaged and more ‘normally’ behaved little boy. For me that’s worth every second…
A fabulous book to read on Sensory Processing Disorder is The Out Of Sync Child by Carol Stock Kranowitz
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Wow! I should have come across this post a long time ago! My little boy with Down Syndrome who recently turned 3 has been attending OT for almost a year now. When he started he was already in the habit of throwing toys and whatever his hands get hold of. His OT has been doing manipulative activities and the like with him for a long time and she’s got me into thinking that my son will eventually outgrow his habit of throwing. Up until now no improvement has happened. We recently got another OT for my son and I am embarrassed to hear how little my son could do. His habit of throwing has gotten in the way of his acquiring new skills. I’ve observed also that he’s started hitting me on the face more often. When angered he will bite his caregiver and when unable to do this he would cry relentlessly. He knows all sorts of pain infliction when he is angry (pinch, scratching etc.). I’m wondering why his OTs hadn’t recognized he may have a sensory processing disorder. Thank you for this post. I have an idea now why my son is behaving in such a way.
Hi Armi,
It’s definitely a process to work on changing behaviour BUT if everyone works together, then the antisocial side of things does improve. It’s a case of providing stimulation and calming strategies to help them regulate their sensory needs, but in a socially acceptable way. Our son has improved hugely. We don’t tolerate any anti-social behaviour at all though. Have a read of the other posts I wrote, and hopefully you’ll find some helpful pointers there based on what’s helped us. We now have a curious, energetic boy who is reading and writing, socially interacts with his peers and others, and is very keen to learn. Not perfect by any stretch, but definitely on the road to progress!
This is such an interesting read for me on so many levels. As a teacher, as an art therapist, and a children’s worker for sensory education. What stood out mostly though is how things have changed in the last few years since I’ve been out of the field. We went a lot by multiple sensory options and free choice to sensory interaction in short bursts. This was very time consuming for all involved. So completely see the more difficult side. The main thing though is the improvement in him that you’re all seeing!! So pleased for this. Keep me updated with how you’re getting on would love to see more of these posts! #bigfatlinky
Thank you so much for reading and commenting. I think what you describe is still very much how things are though I think there are some different views and approaches emerging. I think it is still time consuming to offer a comprehensive and bespoke sensory diet but with this approach (and others) the needs dramatically reduce over time and hence becomes far less time consuming. It’s obviously very different for each child and what time and resources are available for them. I do firmly believe that it’s so worth putting in the leg work with this though.
Great post. Our 10 year old has diagnosis of ADHD and ASD with a Specific Learning Difficulty (Reading). He will often jump up and down repeatedly, skips rather than walks, torments his brothers until they physically retaliate. He will also attempt to trip or hit them as they walk past.
He does repeated arm and leg movements, normally when excited eg watching a soccer match.
From reading this post it seems some of these behaviours could be sensory related.
Thanks so much for sharing.
Hi Alan, thank you for reading and commenting. I’m interested to hear about your boy’s reading difficulties – when I was writing a guest post for DownsSide Up (http://www.downssideup.com/2015/03/guest-post-power-of-puzzles.html) on visual processing and was doing some related research, I’m amazed that any of us can read at all really! It’s such a complicated process but it seems that most of it is ‘trainable’ to a greater extent than I realised. The body is an intriguing machine!! Maybe you could ask your GP to refer him to the Occupational Therapists for a sensory assessment?