*Transcription was AI generated. Thank You for your patience with any complications in quality.
Transcript:
Heidi Lockett
All right. So the name of this presentation is helping children make sense of their world and introduction to sensory processing. And in the description, in the email, you might have seen not for OTs or for non OTs, mostly because a lot of this is, are the basics of sensory processing that sometimes we overlook and just zip right by. And I think it’s good information for people to have. So I love, love doing this and sharing this information. So before we get going, I’m going to give you just a little bit more information about myself and kind of our goals of what we’re talking about today. And if at any point you can’t hear me or something, you might just unmute yourself and jump in in case I, because I can’t see everybody and might not notice if you’re, if you’re raising a hand or something. So a little bit about myself, I’ve been an occupational therapist for coming up on 40 years. And when I say that out loud, I’m like, oh my goodness, how did that happen? For the first 10 years of my career, I worked with adults in all aspects of physical rehabilitation, acute care, acute rehab, home health, skilled nursing facilities, kind of the gamut of adult OT areas. And then for the last almost 30 years, I’ve specialized in pediatrics, specifically working with kids with sensory processing difficulties, kids on the autism spectrum, as well as, you know, school-based and private practice and early intervention. Until January, I was a clinical manager for info in the greater Sacramento area. And then I retired officially from that position, not retired as an OT yet. And I’m thankful and excited to be able to still share some knowledge and be a part of this TheraChat. So our goals or my goals for the TheraChat are we’re going to talk about what the sensory systems are, what is sensory processing. We all know that’s a term that gets tossed around a lot. And sometimes I think there’s just kind of not a really clear understanding of what it is. We’re going to talk about the subtypes of sensory processing. I’m going to talk a lot about self-regulation and co-regulation and what those mean and what that has to do with sensory. Thinking about the question, is it sensory or is it behavior, which is a question that’s thrown out there a lot. And then also we’re going to talk about some important parts of typical child development that can look like sensory processing challenges. And I think most of you hearing, you know, what your professions are, you probably are aware of those. It’s more just kind of bringing light to these little details that sometimes are really easy to overlook, especially I find in school-based therapy services or school-based special education services, you have all ages, right? And sometimes those preschoolers who are only three and a half or four get lumped in with middle schoolers as far as when the eyes on them and behaviorally and what the expectations are. So we’re going to talk about some of those things and expectations at different stages of child development.
Heidi Lockett
Okay. And before I go on, some of you heard this. I am dog sitting my grand dog and she’s sound asleep right now, but if by any chance somebody knocks on my door, she will go nuts. So if a dog suddenly starts to bark, I’m sorry. That is so unprofessional. Anyways, I don’t want to put her out in the backyard because it’s getting really hot. It’s about 90 something. So just one of that little caveat out there. So let’s first chat about what we learned in kindergarten. Think back because it’s been a minute for most of us. Think back to what we learned in kindergarten. How many senses do we have? Anybody want to throw it and just unmute yourself and throw out a number because I can’t see everybody. Five. Five. Naisha, you are correct. That is what we learn in kindergarten. What we’ve learned though is we actually have more than five senses, right? So, but those five senses are vision, auditory, olfactory, which is smell, taste, and our touch or tactile sense. So we learn all about those. Those are our five external body senses, and most people know that. Like we’ve literally learned it in kindergarten. But what we’ve learned is there’s actually more than five. So, you know, wait, there’s more. Are there six? Are there seven? Are there eight? I’m just going to answer the question for you. There are the five external body senses plus three more. So one of the very important ones when we look at sensory processing is the, what I call the sixth sense in the, you know, supernatural world. They talk about the sixth sense and this isn’t that, but our sixth sense in our world of sensory processing is the vestibular sense. And that is our sense of movement. It’s in our inner ear, we have our vestibule and it connects with our brain to tell our body where we are, what we’re doing, if we’re dizzy, if we’re laying down, if we’re spinning, if we are falling, you know, our vestibular sense tells our brain what our head position is basically. And it’s very important for children to be able to have a good vestibular processing. And often kids who either run a lot, so they’re seeking a lot of movement or they don’t want to move at all. Sometimes that’s related to what’s going on in the vestibular system. The OTs will take a close look at that. The seventh area of sensory processing or seventh sense is proprioception. Proprioception is also, along with vestibular, a very important sense. It’s our muscle and joint sense. And it is, it’s kind of broad and in this, you know, less than an hour that we have to talk about, I’m going to give you the basics. So our muscle and joint sense is, of course, where we are in space, how we’re moving our arms and legs and body. It’s what lets you do things without looking. So for instance, since we’re all women on this, I will use this as an example. If you fasten your bra behind your back, your hands use the tactile system, the sense of touch, but use our proprioceptive to know how our two hands are working together.
Heidi Lockett
Another example is when you go to a step that you’ve never walked on before, you go up to the step, you don’t sit there and go, well, it looks like it’s about six inches tall. So I’m going to lift my right foot up and move forward. And then my left foot, we don’t do that. Our eyes, our vision sees the step or maybe touches it. And then we know exactly how to move smoothly to go up those steps. Same thing with if you’ve gone, you walk up to a chair you’ve never sat in before. You do not sit there and analyze how slowly do I need to lower my body to sit on this chair carefully. You just see it and you sit down smoothly. That’s our proprioception telling our brain and body how to move. And sometimes it gets messed up. Sometimes it gets tripped up. We have no pun intended trip. We’ve all tripped over that curb that we didn’t raise our foot, you know, high enough or sat down in a chair that’s lower than you expected. And you go kerplop, right? Like everybody does that now and then. That is normal proprioception for it to get tripped up once in a while. But in general, if you really think about how smoothly our bodies move through space and our muscles and joints work together, it’s a pretty amazing thing. So that’s the proprioceptive sense. And the other part of it, and you’ll hear this a lot, is that deep proprioceptive input, so deep. pressure or input to our muscles and joints can be very calming for the nervous system. So a lot of times, and we’re gonna talk more about this, but a lot of times in schools, you’ll hear about kids needing heavy work or deep pressure or weighted vests or weighted blankets. That’s all because that input to the proprioceptive system is calming to the nervous system. So it’s a very important part of our sensory processing. And then the eighth sense, which honestly was really only integrated into theories of sensory processing about 10 years ago, which is pretty recent in the world of research and things we do. Interoception are internal body sensations. And we’re gonna talk more about that because it’s one of the newer ones. There’s still a lot of great books out there that talk about sensory processing, but if they were written more than 10 or 12 years ago, they probably say they’re seven senses. They don’t include the eighth, which is interoception. But especially for school-based services, it’s pretty important. So we’re gonna talk more about interoception. So it is our sense of internal sensations, all of them. The whole thought of this has been brought to the forefront of sensory processing by a great OT named Kelly Mahler. You can actually friend her on Facebook and follow her on Facebook. And she posts great things about interoception and she has great conferences. Her book is called Interoception, The Eighth Sensory System. It’s full of information. I own it, but I lent it out to somebody. Otherwise, normally I hold it up to show you, but it’s sometimes easy to find.
Heidi Lockett
I did just look on Amazon and I’m wondering if it’s out of print because right now it says it’s $59, which is ridiculous. It should be 10 or $15. So don’t buy it for $59. But if you ever see an option to buy, it’s a great book that tells us all about interoception. And so just to talk about that a little bit more, honestly, sometimes when I talk about it, I think it’s so basic. Why did it take us until 10 years ago to realize the impact that interoception has on our sensory processing? So it’s things like overeating. Kids or adults will sometimes overeat because they’re not recognizing being full or they’ll under eat because they don’t recognize that they’re hungry. They’ll go to the bathroom constantly because maybe that’s overreactive, even though they don’t have any bladder issues or frequent toileting accidents because they don’t use the toilet enough. They don’t have that internal sense to say, my bladder’s full and I need to go to the bathroom. Sometimes kids with interoception difficulties will not feel or report injuries or bodily aches and pains. That can be, of course, dangerous, right? On the flip side, they could intensely feel pain or be uncomfortable, uncomfortable a lot of the time. Sometimes this leads to big emotions, right? Experiencing big emotions or the flip side, they could seem apathetic because of the way they’re perceiving feelings or not perceiving. A couple other things, you know, it’s things like when we run, our heart beats hard and it heart races and you can feel your heart, right? You can feel when your stomach growls and you know that means you’re hungry. You hopefully can feel when your bladder is full and you need to go to the bathroom. All of those are internal senses that sometimes children cannot accurately pinpoint or feel. And so that can be a big part of what’s happening with children in the school setting. I like this little picture just because hangry is a real thing. Here’s this cute little chihuahua, me before having food, and then me after having food, happy, right? We’re all happy. The funny thing is, I’m going to tell you a little story. I raised three sons. They’re all grown up and married now, but the youngest one was very small for his age and I would get him home from school and his world would fall apart. He was doing fine in school. Teachers didn’t have any concerns. He’d get home and just fall apart. Well, a lot of times when there’s difficulty processing sensory input, sometimes kids hold it together so hard all through the school day, then when they’re home with their trusted parent, they let it all out, right? And they just fall apart and we know that. But in his case, it honestly, well, mostly because I’m his mom, so I was really analyzing everything that he was going through and talking to his teachers. And there really weren’t any red flags about what was going on, but every day after school, he’s falling apart. I finally found out, well, he was in such a hurry for recess at lunch time. He wasn’t eating his food, nor was he bringing it home. He was just tossing it. And I didn’t, and he was very small, so he really needed calories frequently.
Heidi Lockett
And it turned out, he got home from school and was just hungry and he would just start to fall apart. And I would just be feeding him high protein snacks. Here’s some cheese, here’s some peanut butter, you know, just giving it, getting some protein in him and a glass of milk and a big glass of water because kids get dehydrated. And guess what? Within about 15 minutes of the food hitting him, all was right with his world. And he was fine. He truly was hangry and he couldn’t tell me that he felt hungry. And I think that happens a lot. I hear time and time about kids who don’t eat because they’re afraid they’re going to miss recess or they have, you know, they’re buying lunch at school and they don’t like the food and they’re, they’re hangry. And honest to goodness, I, most of us could probably say it’s happened to each of us. And, and so should be the first thing. It’s not really an issue with sensory processing as much as it is just realizing our body needs nutrition and hydration. So now we’re going to really dive into talking about what is sensory processing. The term sensory processing, or just sensory, gets thrown around so much. Most of us can walk into any store that sells toys and see a toy that’s labeled sensory. Well, what does that mean? What, you know, toys, it’s really a buzzword, right? That, that toy makers have found, oh, let’s label sensory and it’ll sell better because everybody wants to have good, good educational toys that provide for kids sensory needs. Well, the reality is if toys. are interactive and involve playing, most of them are sensory, right? I mean, something where they’re just sitting still is not sensory, but toys in general tend to have sensory components. But it really always drives me crazy that they’ve used it as a marketing, no offense page, who’s our marketing specialist, but use it as a marketing ploy to sell more things, calling it sensory. What sensory processing really is, and it’s also called sensory integration. That was the original term coined by Dr. Gene Ayers way back in the 60s and 70s. And then Lucy Jane Miller is another occupational therapist who really worked hard in the 90s to change the term to sensory processing because it’s a little more user friendly. And she was right. I think that people even non OTs embrace the word sensory processing, but what is it? What does it mean? So it’s a neurological function of processing the sensory input from all of our sensory systems and our body and responding appropriately to that sensation. And when there’s consistent challenges with any aspect of sensory processing, it can be identified by a trained occupational therapist as sensory processing disorder. But we can have challenges with sensory processing and we all have differences with sensory processing. No two of us are alike. And that doesn’t mean it’s a disorder. It’s just how we are and, and the certain things that we, that make us who we are. It’s, it’s considered a disorder when really it’s impacting a person’s ability to function in their daily life, whether that’s a child at school or whether it’s an adult in their work life.
Heidi Lockett
And sometimes we see if a person has challenges with sensory processing, they might feel bombarded by information, kind of like on this slide. And that’s why I put this together. Cause it’s got a busy background. It’s got a lot of words. It’s got a harder, harder to read font. And that can be very overwhelming. Kids are like that a lot with Classrooms where the classrooms just have so many cute decorations all over the wall and work samples and and the whiteboard or chalkboard and You know writing all over and signs and reminders to this and i’ve gone in things hanging from the ceiling That can be really challenging even for kids that don’t have challenges with sensory processing But it just can be really challenging especially if there are challenges In in the different sensory areas some kids might crave very intense sensory experiences Like a teeter totter, which we don’t see a lot of those on a lot of playgrounds Um, but it’s a can be a very intense sensation Um, and the flip side is they might might stray away from any intense, you know avoid intense sensory experiences They might be unaware of sensations that others feel right? So like bumping into kids or Or even hitting might be that they don’t even Understand that it could be hurtful if they themselves are not registering that as hurtful They also might Sensory motor systems such as a weak body kind of that low tone low posture Clumsiness or awkwardness or delayed motor skills those can all be due to other things as well Right, so it takes some good detective work on the occupational therapist um Assessment to really identify what it is, but those can all be parts of um of difficulties with sensory processing It can also contribute to emotional behavioral social attentional or motoric problems Those secondary problems can take on many forms and look different depending on the child and the family context Um, just an aside. I thought of this as I said emotional with interoception Emotions are a huge part of that when we feel sad or angry or hurt We get a feeling inside, right? You you know, like feeling sad you might feel about to cry Or or angry or scared or anxious. You might have a tummy ache, right? Your child can maybe tell that you that they have a tummy ache their tummy hurts before they could really Articulate that they are anxious or afraid um, and so we have to look closely at what all those different pieces are that the child’s experiencing and long story short is The world can be a challenging place We also do need to look closely at the child and the either the classroom context or the family context. I Think it’s different different locations, but in california three-year-olds move into the school district Out of early intervention into the school district. We have these little three-year-olds Who were not using utensils to feed themselves and everybody thought it was a fine motor problem Came to find out it was the cultural background from where their family was from they didn’t use utensils until they were much older another one is um is Drinking from a cup an open cup or a sippy cup,
Heidi Lockett
right? So it really you have to look at before I jump to oh, there’s a sensory issue or there’s a fine motor issue I’m really looking at the whole context of the child on the flip side just to go on that same note with classrooms I once well several times i’ve been in classrooms that are very warm and the lights are down low And the kids are falling asleep and the teachers like they won’t pay attention. They’re just putting their heads down on the desk Come to find out that teacher Runs really cold. So she’s got the heater up, but she also gets very overstimulated So she had the lights turned down though Sometimes that can be very calming if you have a very active class Those are great things turn the lights down though But if you have a class that’s falling asleep more than one kid, right? It might be they’re just too hot They haven’t had enough water to drink or the lights are just too low or the calming music is putting them to sleep, right? it depends on where their baseline is and where the pendulum is swinging for them and all teachers Obviously, they have different sensory processing than the children in their classroom And sometimes the setting is just not working for the child And so we need to look at that or what works for the child doesn’t work for the teacher And um, i’ve i’ve had that occur many times and that’s a process of helping everybody look at What do we need and what are the kids we’re working with need? Um, okay. So before I talk more about that, I am going to just share a little more about sensory processing. Current research and knowledge suggests that there are six subtypes of sensory processing disorder. Almost all individuals with SPD have a combination of symptoms from one, more than one subtype. It’s not so easy to just say it’s this one or that one. I’m going to show you a chart that shows the three major patterns and the six subtypes of sensory processing disorder. This was created by Dr. Lucy Jane Miller. And she, um, it’s very helpful, but I will tell you that OTs will spend like a week long continuing education course learning about this. So I am only showing it to you not to teach it to you really, but more to broaden your view of how complex sensory processing can be. We’ve got, you know, the sensory modulation disorder, which is what we talk a lot about in school, whether you’re over responsive or under responsive or craving movement, got sensory based motor disorders, which involves motor planning and posture. Have you ever seen kids that seem just fine and they suddenly fall off their chair, right? That goes to that proprioceptive and vestibular processing and can lead to postural disorders or they’re very low tone, but they don’t have a reason, a medical reason for being low tone. And then also just discriminating between all the sensory input from all the different senses. So this is not important for you at all to know, except to realize, Oh, sensory processing is more involved than just saying, Oh, it’s sensory, which is what we hear a lot.
Heidi Lockett
So the next thing we’re going to talk about, what is sensory regulation? So that is a huge piece of kids being in school all day long and as I’ve talked about all of this, I realized I skipped over one piece. Most of us work with children on the autism spectrum and it’s something like 90% of kids with autism also have difficulty processing sensory input. We know that that is a huge part of autism but all kids with autism don’t have difficulties with sensory processing and all kids with difficulties with sensory processing don’t have autism and I get that question a lot from teachers and from parents. Do you think they have autism? Well it’s definitely worth an assessment but if we really pinpoint specific areas of processing that are difficult we can address those and it’s not autism. So I think that’s just an important thing to keep in the back of your mind. So difficulties with sensory regulation is a really common component and it’s under that sensory modulation category and the one thing to remember when we look at sensory regulation is learning sensory or achieving good sensory regulation is also a part of typical child development and living daily life. So we all need to work on our sensory regulation. Difficulties with it can sometimes look like bad behavior or emotional difficulties. Often the nervous system can go into a fight or flight mode which of course is our protective mechanism to keep us safe but if we are not in a dangerous situation we don’t need to be in fight or flight and if your sensory processing is causing that like maybe don’t like the way something feels or touch that’s when we see it a lot. We also see it a lot with our auditory system being defensive to loud noises. It puts you into fight or flight. On that note before I move on I am going to say we see a lot of auditory defensiveness and sometimes when I really go over that with teachers and parents sometimes it is all because of the unexpected noises that causes the child to go into fight or flight and if they know they’re coming then they are fine with it and then if that’s the case it’s not really auditory defensiveness. It is really just their protective mechanism of keeping themselves safe. So a fire drill alarm is a perfect example. If a child is sitting paying attention well at the desk working on whatever they’re supposed to be working on and that sometimes they are crazy loud depending on where you are close to the speaker the fire alarm goes off. It is very scary and make you jump and you know for a little one make them run one over under safety but if you if they know it’s coming which I know that defeats the purpose of the fire drill but I’m just saying that if they know it’s coming they can prepare their body for it.
Heidi Lockett
A really good example for at home I often hear parents say oh they’re scared of the vacuum or scared of the blender. Well if you tell them I’m going to turn the vacuum on now it’s going to be noisy and you turn it on a lot of times they will not have that fight or flight response because they’re expecting it and if you ask for them to help with it it’s even better because then they’re participating and taking part in it. So again the occupational therapists really need to do some good detective work to know well is it really a sensory defensiveness over responsivity as we call it or is it just that they were caught by surprise. Okay so another thing that I just love this slide I just have to include it every time because children are not always allowed the independence to choose to do what they actually need and that alone can lead to poor sense self-regulation and perceived behavior difficulties. So this picture of course this little one it has an umbrella and they’ve got rain boots on they’re prepared to be playing out in the rain right and we know kids who just wear tennis shoes to the school are not prepared to go stomping in pedals but most kids are drawn to stomping in pedals they see it they want to run they want to jump it brings joy to them for one thing and it is fun and it is really good sensory input and you know what would happen they’d have somebody the teacher or adult in their life saying no no no no we can’t get wet come back no no we’re not going to do that stay in line but their body is saying oh I really want to go do that and so you know what I would do is well we can’t jump in the pedal because we can’t get wet that’s true but we can jump like hop like bunnies the rest of the way back to the classroom not in the puddles right like down the hallway when we’re inside or something like that so they get the sensory input that their body suddenly was craving but they’re not getting in trouble for getting all wet and I just think that’s important to keep in mind that sometimes when children you know they have to follow all the rules all day long different people’s rules all day long sometimes they just don’t get that input and movement that their body needs So we’re going to talk a little, I’m going to give all of you a turn if you want to chime in with anything because I have been talking, talking, talking. What do you do to make sense of the sensory input from the world around you? We all have differences in how we process sensory input and how we self-regulate. So what you need to regulate might be different from what the child you’re working with needs. And I think we need to look at our own sensory processing before we can really help the child. I gave you the example of the teacher in the classroom where it was really warm and low lights and slow music. But what are some things you do not even during the workday, just on your own? Like if you’re driving late at night and you’re tired, what might you do? Or staying awake and alert during a boring meeting such as listening to me talk for an hour.
Heidi Lockett
Does anybody want to pop in and share what you might do to stay alert and awake? Don’t be shy and I can’t see you. So you can just unmute and start talking. Thank you.
Speaker 3
If I’m driving late at night, and this has happened many a time, and I’m by myself feeling just very drowsy, I’ll often open the windows and sometimes slap myself on the cheeks if necessary. And that seems to help a little bit.
Heidi Lockett
Yeah. Thank you for sharing, Wendy. Anybody else? And the kitty cat. There’s Wendy’s kitty cat. Anybody else?
Speaker 2
Um, something like, um, I’ll use taste. I’ll like wake up my mouth, um, when I’m driving late at night, like a lemon drop or peppermint or something like that, or sometimes even like, uh, um, an oil that I’ll put on my wrists. Uh-huh. Like I have a great scent. I think I do a lot of stuff, scent oriented.
Heidi Lockett
So and those are great examples and with the like essential oils and things, some are very calming. So you just need to know what you’re using, you know, for things like if you’re driving late at night. But yes, some can be very alerting. I love the lemon drop or the peppermint. Those are great ideas. Rolling down the window, putting air on. What about chewing gum? Anybody do that? That’s something I would do. I would chew gum. Chewing gum goes back to that proprioceptive input because it gives you deep pressure through your jaw, which can help you pay attention. And then music. Music is a great sensory regulator, right? We all know that lullabies are called lullabies for a reason because they help babies fall asleep, right? But we kind of don’t think about it, how much it can help us regulate our own sensory processing. So, you know, if you’re driving late at night and you might turn on something with a big beat, something you can sing to, you’re probably not going to play instrumental calm music, you know, classical music, right? It’s something you really need to have it be alerting to your nervous system. And what about like fabrics, things you might choose to wear or not wear? Anything?
Speaker 2
I feel everything going through stores. My daughter always says stop touching everything, because if it’s not soft, I can’t. I can’t. I’m cutting tags out of things. I love this stuff that doesn’t have a tag that just has the writing right in the fabric.
Heidi Lockett
I love that example, Maxine, because you know what? Years ago, everything had a tag and then now more and more clothing manufacturers are doing tagless and look at that, isn’t that great? It’s really meeting sensory needs of people who are fully functional, right? This part of differences with sensory processing isn’t stopping anybody from being an independent human being, but boy, isn’t life better if you don’t have something rubbing on the back of your neck if you are sensitive to that, right? So it’s great. You mentioned essential oils. So the next one on here is fragrance preferences and essential oils can be very helpful with that. But even outside of that, now I have a lot of allergies to artificial fragrances, so most candles I cannot tolerate. That’s an allergy, right? So I want nothing more than to get away from a room where there is a candle burning that has a scent. I will get an instant sore throat. That’s not a sensory processing issue. That is, well, it’s not even an, it’s an intolerance. My allergist has assured me that artificial fragrances you actually aren’t allergic to because they’re artificial, but you can have an intolerance to it, which I do. But some fragrances like vanilla can be very calming. Cinnamon is very alerting. So those are things to keep in mind in different environments. And then the last thing I was going to mention is memories of sensory experiences can influence how we respond to that input in the future. And I address this a lot with the children I work with, because if they have had a scary experience, whether it’s their perceived fright or really it was scary. So it could be a traumatic thing that truly was traumatic or something that caused a trauma response in them because they just didn’t know what to expect. It’s their reality, right? But how they respond to that same situation in the future can be really influenced by that. So some examples are haircuts. You know, we take these little boys to go get their haircut when they’re one or two and they bring out the buzzy clippers. That can be really scary if you don’t know what to expect. And then they cry and they get upset. And then the parent doesn’t take them to get a haircut for like three months because the parents afraid to take them back. And then all they have is that memory of how horrible that was. It was scary. And so for that instance, I recommend that parents do some happy visits, right? And same thing with the dentist. Happy visits where they go in, they just say, hi, they’re not getting their haircut. They just go in. They maybe talk to the hairstylist. They maybe see the clippers. They might just even go in and get a sticker if you have, you know, the hairstylist on your side for getting through this and then go in for just a short haircut. We’re not going to do the whole thing. We’re just going to do the back or just going to do the bangs or something like that and come back in a week and finish it off. So they have happy memories and pretty soon they are able to trust in the situation, right?
Heidi Lockett
They’re going to trust that it’s safe and it’s not going to be traumatic. It pains me to know when, when I hear stories about parents who hold their screaming child down while they get their haircut, because do they need a haircut? Yeah, but do we really need them to be a traumatic experience? No, right? We need to find a way to make it a happy experience and happy memory so that they’re not always looking back on how scary it was. Same thing with foods. You can eat, you know, fruit and vegetables are wonderful, but their nature and they can taste different one from the other, right? So you might have a peach that tastes like candy. It’s so yummy. Or you might have a peach that tastes sour and it’s not quite ripe. And if that first peach that a child eats is the sour one, why would they want a second one? Right? And why would they trust you to give you a yummy one? So it really takes a lot of kind of work and again, I know I’ve said it many times, but detective work to find out what is the diff… is it just that they really had a bad experience so they’re just not trusting doing it again? Or is it truly a sensory processing difficulty? So like in the area of taste or texture with food, I always look at, well, what’s their previous experience with these things that they’re saying they don’t like? Because maybe it truly was a negative experience. And so they’re protecting themselves. Everything in their nervous system says protect. I don’t want to experience that. And then it takes building up that trust for whatever that area is. Okay. So I want to spend some time talking about co-regulation. We talked about self-regulation, sensory regulation. One of the best things I think that’s come out of recent research. Oh, you need to go? Oh, okay. Thank you so much. You’re welcome. This will be recorded if you catch the end of it. I would love to.
Speaker 2
now. Okay, I always love to. Bye, everybody.
Heidi Lockett
So, co-regulation is such an important thing that a lot of different disciplines use. And I will say, I think just more recently, it’s really become a part of addressing sensory processing. When a child is upset for any reason, like I was just sharing some of those reasons before, they need a trusted adult to be their calm. And I love that because if you think of yourself when you’re working with children that you are going to be their calm, it helps you remember, it’s not about me, it’s not about how I’m feeling going through this, but I’m going to be their calm, I’m going to let them borrow my calm. When a child is experiencing sensory or emotional dysregulation, they can reach a regulated state quickest when they can co-regulate with a trusted adult, right? If it is all up to them, they are just going to keep staying dysregulated. They need that adult, whether it’s a therapist or a teacher or a parent, an aide, whoever it is to help co-regulate with them, let them know they’re okay and that they aren’t alone and you can offer that calm presence. Children are watching you for an example of how to respond. They’re watching all of us for how to respond. They want and they need to connect with their parents, their teachers, their providers, their caregivers, any adult in their life, even older siblings. An example is that fire alarm going off. If a fire alarm goes off and they see the teacher or the adult that they’re with going, oh my gosh, oh my gosh, it’s a fire alarm, hurry, everybody out, out, out, out, out. In frantic, they are going to feel very frantic. They need that calm presence of everybody line up, we’re going to go out to the playground too and line up and they need to feel that, but I think what’s overlooked a lot, a fire alarm is a really common big example, right? But what about a child who just can’t self-regulate because they are a little visually defensive, like the lights are too bright and they can’t tell you about it, or they haven’t gotten enough movement and they are really craving movement and they really can’t articulate it. So it really takes some careful detective work in looking at what does that child needing from me to co-regulate. If a child feels that they’ve gotten some negative responses, they don’t feel good about themselves in that situation and they will not, they’ll refuse, they’ll not want to, whatever it is, they’ll not want to do that math assignment, they’ll not want to play that game. If they don’t feel like they did a good job, they very possibly won’t want to do it. So having an adult who can co-regulate and help them through it is very helpful. There is a child psychologist named Mona Delahook, who is one of my favorites. She’s also on Facebook and you can follow her and see her works. She actually, not long after she published her second book, which is a parenting book, she actually had a brain aneurysm, which is very severe and she’s still going through rehab for that.
Heidi Lockett
But all of her books and research were done before that. I’m thankful she seems to be getting back to where she was. So that’s great because she is a huge blessing to our school-based community as far as helping us work with kids. So I have a couple quotes that I just, I can’t say it better. I just love to share, but about the co-regulation in order to self-regulate. So one thing she says is before they can build the capacity for self-regulation, children need to have sustained experiences of emotional co-regulation with a caring adult or adults. And key to this is sustained experiences. It’s not just a one-time deal. You need to really build that trust and that relationship with them. Another piece is this quote, and another thing from Mona is this quote in her book, Beyond Behaviors, children need adults for co-regulation. We know that children who have a weak foundation of emotional regulation require human assistance to find their way back to being regulated. When adults offer this kind of help, we are engaging in emotional regulation, attuning to and supporting another person through our presence. Our interactions with children influence how they make sense of the world. Once a child feels safe in mind and body, the possibilities for learning and growth increase, expanding a child’s tolerance for new experiences, sensations, feelings, and ideas. I just will backtrack a little bit. You might remember that the title of this was helping children make sense of their world, and that is a phrase that I’ve used for years. From 2006 to 2016, I owned a private practice in Folsom, California, and that was kind of the tagline, helping children make sense of their world was the tagline for my business on my business cards and things like that. When I read Mona’s book, Beyond Behaviors, and I read this, I’m like, oh, it’s such a simple phrase, but we’re kindred spirits, I feel like, and she just puts things in a great perspective. So I highly recommend her. Another thing that through the years, and this has been decades, this question keeps coming up, is it sensory or is it behavior? I’m guessing most of you have had that question yourself. Those of you who are speech therapists, oh, my goodness, you know, it often comes up because you’re really trying to help the child function better in therapy and participate. And you’ll be happy to know I add this third part, or is it communication? I think we always need to look at what is the child trying to communicate with you? So my answer to this common question isn’t sensory or behavior or communication is yes to all three questions. It can be a domino effect. It can be all three. The child can be attempting to communicate what is right or not right with their world, and sometimes the way they communicate that is an undesired behavior that we don’t want, like hitting or running, reloping, but could it have a sensory basis?
Heidi Lockett
So we really need to look before we just call something sensory or behavior or communication. Could it possibly be all three? Most of the many, well, I’m just going to say most of the time, I try to not have absolutes, but really most of the time when I see behaviors, there is like a sensory component or a communication component that is just leading to frustration for that child and resulting in a behavior. Another thing we hear so much, sometimes I hear staff in school say, oh, just behave, or parents will say, oh, just behave, right? It’s so easy to just say, just behave, and in their exasperation, oh, just behave. You know, I’ve told you this before. Well, many children who can’t behave themselves simply don’t have the developmental capacity yet. We need to look at where they are on their developmental continuum, not what they’re expected to do for their age, but where they are developmentally. So here’s another quote from Mona Delta hook. The ability to behave and live up to adult expectations is a process unique to each child. Rather than thinking that children should simply try harder, we can look at the ability to self-control, which comes from their relationships, sensory processing, and unique social and emotional development. It’s all of those things, right? All of that. We need to constantly look at a child’s developmental stage, where they are before we set expectations, not just assuming they should be able to do this, or they should be able to behave like this. We really want to look at their developmental expectations. And on that note, I like to share some surprising milestones of typical development. I know you all know these things already. You know a lot about child development. I like to pull these out as a good reminder of what’s considered typical, because sometimes it’s the things that we don’t like at all. So emerging between age 24 and 30 months. So two to two and a half frustration tantrums peak, right? It’s called the terrible twos for a reason. And they should be called terrific twos because so many good things come out of the twos, but frustration tantrums peak. So it’s led to that terrible twos name. They display dependent behavior. They get more clingy and whiny. They fatigue easily. They doddle and procrastinate. They develop sudden fears, sometimes of large animals, which I think is very unique. This is from the Hawaii early learning profile assessment. And that’s very specific to large animal fears. They can feel more shyness with strangers and feel strongly possessive of loved ones. Those things all make for a child to be clingy and more needy. But guess what? That’s good typical development if they’re between 24 and 30 months. And I’ve had parents when I was doing early intervention say, they just have a tantrum. They don’t like anything. Well, we need to look closely at why they’re tantruming.
Heidi Lockett
But if they’re between this age frame, it’s actually pretty typical strong development. And then going a little bit older at that preschool to early kindergarten age, emerging at age five to five and a half years, waits appropriately for attention in groups situations, acts upon helpful criticism presented by authority, understands and practices good safety procedures, and then even older emerging at 5.8 to six years old, expressing feelings in a controlled manner and behaves in a courteous manner to others. Well, those are all things. I often am in preschool settings, seeing that those expectations are put on the preschoolers and they just aren’t developmentally ready. They need to be learning. It needs to be a learning situation for sure. And instruction on this, but the expectations, they’re just not there yet. Some of them are, but not all. I need a drink of water. too much talking. So I think it’s very helpful to keep typical child development in mind, especially when teachers or parents are getting frustrated and to gently coach them for what is, what are good expectations. So what’s next? Honestly, I love this picture of this little one climbing up a big, big play structure. And you know, that’s really good. A child, we have to be mindful of what a child is capable of when we’re setting expectations. Obviously, we wouldn’t expect a child who I’m not going to even say age, because it’s not about age, right? But a child who doesn’t have the ability to climb and crawl yet, we wouldn’t want them going on this big ladder. We wouldn’t want a child who doesn’t like the way things feel on their hands. Or if they don’t have good postural control to be doing this, we have to look at what a child is capable of before we set our expectations. And then of course, address the needs of the child in that order that they would benefit from. I have often, you know, kindergarten teachers, they won’t write and they’re not even, they’re not even coloring yet, because they’re not there with, with coloring and holding prance. So we need to look at what they’re able to do. Okay, so really quick, and I realized I’m talking too long, I am going to, I see some things in the chat. Chris, you’d like to have access to the behavioral expectations, hang it in the office. And you know what? Oh my gosh, you could have so many more, right? So many more we could add to that. And then, you know, sorry, my, my thing showed that I should have two more showing on my chat, but now it’s not showing. So if you put something in the chat, let me know. I am going to get past this screen here to our last one. Thank you for participating. And I’m going to stop screen sharing and have some time for questions and answers. So that’s a lot of information. I’m assuming a lot of it was probably review for many of you. My, my hope and goal is just that it brings to light how some things definitely are sensory processing related and some things aren’t.
Heidi Lockett
And it takes some good detective work to figure, figure it out. So any questions or examples you want to share? No. Were there two more things on the chat that I missed after Chris’s? Because it said there were five and then there were three. So, you know, the only one I can see is from Nyesha. It says, good afternoon. That’s, that’s all I can see. And yes. Yeah. So I, I saw those as well. So I don’t know what, what, what it was. But anyways, what I’ve said for the last five years is technology is great until it’s not, you know, it told me there’s five and there’s three, but whatever. But it’s great to be able to meet on zoom to, to share this information. There are a lot of sensory processing resources out there for sure. You’re welcome to email me [email protected]. I, you know, or talk to any occupational therapist in your world. I just think it’s really important to be good detectives and look at the whole child and what is going on. Well, with that said, I’ll let you all get on with your afternoons and hope you all have a great new school year.
