Friday, June 3, 2016

And a Diagnosis for the Boy

Before the Pumpkin got her diagnosis of ADHD, we had a slightly different evaluation done for the Pookie. The Pookie was evaluated to see if he has Sensory Processing Disorder (SPD). He does indeed have sensory issues, but it is not quite at the disorder level.

There were signs of sensory issues since he was a baby, and especially as a toddler.

He always needed strong input to his sense of touch. As a toddler, he didn't just run up and hug me, but instead would throw his whole body into me, full force. Every time. He can't just brush up against something, but bangs into things and people. There is no counting how many times I've had to remind him to "be gentle with Mommy" not because he is trying to hurt me (or anyone), but simply because soft touches don't really compute to him.

He always held his hands over his ears and freak out when there were loud noises, especially sudden ones. This could be difficult to deal with, like in public bathrooms with automated flushers! (I learned to keep a post-it note in my purse to put over the automated sensor while he used the potty, then I'd send him out of the stall before removing the post-it and letting it flush.) There was the jazz-for-kids concert I took them too, where he covered his ears and needed to move to the way back, while I hoped that he/we weren't offending the musicians. And of course the Marvel Universe Live! show we were all so excited about seeing, and within the first 5 minutes of bombs and gun blasts and lights flashing, Londo had to take him out of the entire building. Not just the auditorium, but the entire building! When he needed to go potty, Londo convinced him to go back to the building to use the potty there, but Londo told me that his entire body go more and more tense as they got closer (Londo was carrying him and felt it very clearly).

The lights at the Marvel show were an issue in addition to the noise. Sudden bright lights? Freaks him out. And just in general when there is a lot going on, he is overwhelmed. All those years of tough drop offs are partially to do with his getting overwhelmed when he would walk into a classroom. Too much all at once, especially if a bunch of kids try to run up and greet him. Sensory overload.

And then there is the picky eating. Have I mentioned the picky eating? Huh. I don't think I have. Apparently there is a name for kids who are more than just picky eaters--resistant eaters (it really is a thing). And that is what he is. We have struggled for years with his resistance to try anything new or different, and the handful of things he does eat has dwindled, since he gets tired of foods and/or doesn't like them any more. And no one better dare say to me (again!) that if he's hungry enough, he will eat what we server. Turns out? He won't. He'll just get hungrier and crankier, and I have to deal with that on top of everything else! We've tried a few different approaches and seem to be making progress over the years. It's a taste issue, smell issue (he actually doesn't have a good sense of smell), texture issue and a mouth/tongue mechanics issue.

When anyone says "Smell that!" The Pookie's response is "I can't smell." Not that he can't smell that thing, but he means in general he doesn't really smell things. I don't have a great sense of smell, but I certainly can smell things. He has difficulty either smelling or processing the smells or maybe both. Even when he sticks his nose directly into a flower, he just kind of shrugs like he doesn't really notice the smell.

So that covers the senses, right? Did you know there are a few more? There is also:
- Vestibular - the sense for movement and balance in relation to gravity. This sense tells your brain if you are right-side up, upside down or moving left, right, forward, backward, etc.
- Proprioception - the sense of where your body parts are. This sense is used all the time when you are moving, for example I can walk up stairs without watching my feet because of this sense letting my brain know where my foot is.
- Interoception - the sense for what's going inside your body, such as when you are hungry and when you need to go to the bathroom.

Every one of those senses have all an issue for the Pookie to some degree. They have not been an issue to the degree where he is unable to function in almost all circumstances. But he was having issues in daycare and pre-school, which is when we figured out there is something going on with him.

In daycare, he was just sometimes "difficult" or overwhelmed. But in pre-school, we specifically put him in a pre-school that had a teacher who understood that 4-year-old boys would act like 4-year-old boys! They are active! They like to bump into each other! But by the middle of that year, the teacher pulled me aside and said perhaps there was something more going on. Then things got better... for a while... then they got bad again in the spring. And she pulled me aside again and said she was worried about kindergarten. She recommended that we look into this and try to figure out what was going on with him. When I mentioned we were worried about him being labeled (like with ADHD), she pointed out that if we didn't get him a label, the schools would--and we likely wouldn't be happy with that label (such as bad kid, problem child, etc.).

After getting Londo's buy-in, I went to our pediatrician. While we talked, the Pookie played on the fire engine-shaped examination table, making constant noise and being constantly in motion. The pediatrician asked me, "Is he usually like this?" I looked at the Pookie and said yes, he was. The pediatrician suggested that we get him evaluated for sensory processing disorder, and she gave me some names. (If I haven't mentioned it before, I love our pediatrician!)

There were questionnaires and an evaluation appointment. He has sensory issues, but not quite at the disorder level. We did occupational therapy (OT) for a while, and we learned a lot about sensory diets and ways to calm him down when he was overwhelmed and exercises to help his coordination and crossing the midline and all sorts of things! We bought him special shirts that squeeze his body and fidget toys to help him distract his body so he can focus on learning.

He had an amazing kindergarten teacher, who worked with him and us and the school to put in place a behavioral intervention plan (BIP) to provide goals for him and a path to reach those goals, including tools and accommodations. The teacher and the school met with us and discussed and implemented ideas to help him not get so overwhelmed and to calm down if he got too upset.

He is now in 1st grade, and doing great! Early in the school year, we talked with his 1st grade teacher about his issues and what he might need (fidgets, gum, noise-canceling headphones, a rocking chair for morning meeting/circle time). His teacher uses tools he has seen be successful with kids in his previous classes, and he has also given us ideas for helping the Pookie at home. All in all, the Pookie doing really well with his behavior and in school in general!

He is an amazing, creative kid. He is so interesting and interested in all sorts of things. He is energetic and thoughtful. The sensory issues we can work through. After all, he totally gets it from me! So I understand, and we all work together to get where we need to be in life. Everyone has something, right? Sensory issues? We can deal with that.

No comments: