May 14, 2009
Sensing a problem
Children with sensory processing disorder may face problems with day-to-day activities. JUNE CHEONG finds out more
Call it a mother's instinct. Housewife Patricia Tan knew her son Zachary was different from the time he was one year old.
'He was a very good baby. He didn't cry very much, but he also didn't laugh very much. He also didn't babble.
'What worried me was that he hardly made eye contact and was always in a world of his own,' Mrs Tan, 41, said.
Zachary continued to display erratic behaviour like throwing tantrums for long periods of time for no reason and refusing to walk on sand during a trip to the beach.
When he was 20 months old, Mrs Tan got a private psychologist to observe him at home. He was diagnosed with sensory processing disorder (SPD).
This is a neurological condition whereby a person is unable to process information obtained through his senses in order to make a meaningful response.
He can get frustrated just, say, buttoning a shirt or from the flickering of lights in a room.
'When children can't integrate environmental stimuli, they manifest that in their behaviour, such as crying inconsolably,' said Ms DanaKae Bonahoom, a developmental specialist and the director of SmartStart, a child development school in California.
Ms Jaclyn Tan, an occupational therapist at Ozworks Therapy, said: 'Everyone needs a well integrated sensory system to perform everyday activities.
'Children with SPD can show signs like difficulties with attention or emotion. Some kids may be clumsy or have difficulty lacing up their shoes if they're not well-integrated in terms of joint movement and balance.'
Zachary is now six. Mrs Tan, who is married to Dr Terence Tan, 40, a paediatrician, has three other children: Timothy, 13, Elizabeth, 11, and Gabrielle, four.
Mrs Tan said: 'Having older children helped, because I could make comparisons in their growth stages. Like all mothers, when you find out there's something supposedly wrong with your child, your whole world crashes.'
Feelings of denial, anger, frustration and guilt clouded her mind and it took her more than six months to accept Zachary's condition.
She learnt more about SPD through the Internet and from psychologists she consulted. She bought scores of books and read voraciously on the neurological condition.
Mrs Tan said of her frustrations during the first year of Zachary's diagnosis: 'I got differing opinions from professionals, family and friends. I didn't meet mothers of children with SPD so I didn't know if I was doing the right thing.'
Two months after his diagnosis, Zachary went for occupational therapy. Twice a week, the tiny tot would learn how to regulate his responses to external stimuli and the therapist would teach him how to crawl or move in various ways.
He also underwent speech therapy sessions for a year. The occupational and speech therapy sessions cost between $90 and $120 each time.
At home, Mrs Tan plays with Zachary using textured items like soya beans and play dough to train his tactile system. She even installed a trampoline in the house to keep him active. Zachary also goes swimming, to a gym for kids and has recently started tennis lessons.
Mrs Tan said: 'Early intervention is the key. Children like Zachary need a lot of movement.'
Asked how therapy has improved his condition, she said: 'He's now more sociable and emotionally connected to us. There are no more tantrums and he can voice his feelings.'
So heartened is she by how he has blossomed that she plans to set up an SPD parental support group. She set up an informal one at his kindergarten, St James Church Kindergarten.
She said: 'It's humbling parenting a child with SPD because you have to be always aware of his condition. You have to be your child's voice and be his bridge to the outside world.'
They are not spoilt brats
Homemaker Audrey Chia got high blood pressure from looking after her two boys, Matthew and Gabriel, both of whom suffer from sensory processing disorder (SPD).
However, she is quick to emphasise that Matthew, seven, and Gabriel, four, are not spoilt brats even though they often threw tantrums in public when they were younger.
Ms Chia, 37, said matter of factly: 'They would have 10 or 12 meltdowns in a day.'
Children with SPD can get frustrated coping with everyday activities.
SPD is commonly diagnosed in children but adults who are afflicted, but have never been treated, also experience symptoms.
According to American charity organisation The SPD Foundation, untreated adults may continue being affected by their inability to interpret sensory messages and experience difficulty at work and in relationships. Even children who have received therapy may profit from continued counselling as they grow older and reach new developmental milestones like starting college.
A child with SPD, who usually has high IQ, may be affected in one or more of his senses. For hearing, he may be under-sensitive or over-sensitive to sounds and noises. A child whose proprioception - or sense of where his body is or is moving towards - is faulty may be clumsy or move about constantly.
Symptoms of SPD in infants or toddlers include resistance to cuddling, inconsolable tantrums, a floppy or stiff body, motor delays and discomfort in clothes.
As not all medical professionals here know of or recognise SPD, it is usually up to parents to monitor their children for symptoms.
Ms DanaKae Bonahoom, the director of SmartStart, a child development school in California, said: 'School-age children with SPD may fidget and have problems with attention and sitting upright or still. It usually means they get into trouble more.'
After visits to primary schools here last month, she said teachers here should observe their students' body movements more carefully to identify children with SPD so they can be sent for therapy instead of detention for bad behaviour they are unable to control.
She said: 'Don't look at their behaviour or personality. Look at what that child's body is saying.'
Early intervention is crucial.
Ms Jaclyn Tan, an occupational therapist at Ozworks Therapy, said: 'When children are older, some behaviours are pretty set. If we can't rectify their behaviour, we teach them to compensate for it.
Treatment usually involves occupational therapy and play-based programmes to help the child's sensory system mature through constant exposure to stimuli. Parents should be involved and give lots of sensory stimulation at home.
Indeed, therapy has helped both Matthew and Gabriel. The former has become more focused while the latter has learnt to express himself and his affections more.
Ms Bonahoom said: 'The child has to know his cognition and sensory system will mature and that his parents will love him through it all.'