Understanding Morgan Danger

I'm so relieved I could almost cry. We've finally (though, in retrospect, we were lucky to find out as soon as we did) figured out why Morgan is the way he is. Morgan is a happy lovable child that we once worried was autistic. After undergoing a few comprehensive evaluations via Kids on the Move, we have learned that Morgan most likely has a Sensory Processing Disorder (SPD), specifically he has a Sensory Modulation Disorder (SMD) that exhibits as sensory seeking. I think at this point that's it unlikely he has autism. It's still possible that he could have ADHD because the two disorders have similar symptoms (but different causes). It's also possible he has both since they do sometimes overlap. But for right now (it's too soon to tell precisely since he is very young) I feel fairly certain that Morgan is a Sensory Seeker.

Morgan is also pretty behind in his receptive (understanding) and expressive (talking) communication. Though Morgan is almost 24 months, his receptive communication is closer to a 13-month-old and his expressive an 18-month-old. (He still has the physical and problem-solving capability of a 2-year-old though!) This makes things frustrating for all three of us. But things are improving. He has a speech therapist that is now coming once a month to our home. She helps teach Austin and I strategies to improve Morgan's communication. Right now we're working on doing sign language with most of what we say. We are to say it and sign it at the same time twice. And then help Morgan to do it if he doesn't do it. It's making a difference. Morgan has learned a few new words and signs (cracker, all done, please, and more.)

Since learning about the Sensory Seeking thing and his sensory needs, I have completely changed how I view and approach my son. They call it "reframing" in the books I have been reading. As long as Morgan's "wild" behaviors are blamed on his "personality" or my parenting style, people may see the way he acts as something he or I can control. If his behaviors are "reframed" as symptoms of an underlying neurophysiological disorder, people are likely to view him differently. With reframing, Morgan will cease to be seen as a "hyperactive" "naughty" toddler in need of "more discipline" or "firm parenting" or his behaviors something he'll "grow out of"  or "just a phase."

I can't tell you how relieving it is to hear that it's not all in your head. Your child really is different! And there's a reason for it! And there's things you can do to help! And your child isn't "naughty"! And you're really not a bad parent!

Sensory seeking children aren't usually discovered until the child starts to attend school. In these situations it's apparent that the child's "quirks" make them quite different from the normally developing child. I'm really, REALLY glad that we've discovered this when Morgan is so young. Because his brain is literally still developing, we can help impact how his brain develops

I have bought a few books to help me understand what we're dealing with here. Here is a little of what I've learned: (Information paraphrased or quoted from Sensational Kids)

Sensory processing refers to the way the nervous system receives sensory messages and turns them into responses. Everyone manages sensory messages daily; we respond and act upon the messages sent to us via our 5 senses: sight, sound, smell, touch, and taste.

There are also 2 additional senses: proprioceptive and vestibular. We use these two senses to perceive speed, movement (are we moving or standing still? are objects moving or motionless in relation to our body? what direction are we going?), pressure (how are our muscles moving? how much force is being put on us or how much force are we exerting?), and the position of our bodies in space (are we upright or not? how do your body parts relate to one another?). Proprioception helps integrate touch and movement sensations. (It's what helps you judge the weight of a something, hold a pencil in order to write, climb stairs, etc.)

People who develop typically are able to receive messages from their senses and turn these messages into the appropriate behavioral (adaptive behavior) and physiological responses. (If you see a ball heading toward you and you don't know how to catch, you use your vision, your depth perception, perception of speed and direction, and move your body away from the ball. A person with certain types of SPD would not be able to do that without thinking about it and would likely get struck by the ball.)

People with SPD, however, are unable to organize these messages into appropriate responses, which may interfere with daily routines, activities, and behaviors. There are three different subsets of SPD: Sensory Modulation Disorder (SMD), Sensory-Based Motor Disorder (SBMD), and Sensory Discrimination Disorder (SDD).

SMD "is a problem with turning sensory messages into controlled behaviors that match the nature and intensity of the sensory information" (12). Modulation has to do with regulation of the sensory input.

From The Out-of-Sync Child: "Modulation instantly adjusts and balances the flow of sensory information into the CNS [central nervous system]. The sensory systems need to work in tandem to keep us in sync. Incoming sensations activate sensory receptors in a process called excitation. Excitation promotes connections between sensory input and behavioral input. Excitation is alerting. 'Pay attention!' the sensations insist" (57).

Excitation happens when our senses tell us we are in danger and to respond to this sensory message (sight, sound, touch, etc.) with "fight or flight." We respond to sensory messages such as enjoying the calming sensation of a rocking chair or stopping spinning in circles when we start feeling sick. It's why we freak out if we feel the sensation of what feels like a spider crawling on us. We respond to that sensation by moving and whacking, whether there is a spider there or not.

"The majority of sensations, however, are irrelevant. In a process called inhibition, our brain allows to filter out useless information and focus on what matters at the moment. Without inhibition, we would be extremely distractible, giving full attention to every sensation, useful or not" (57).

Right now as I am writing this, my fingers can feel the touch of the keys as I type, the pressure of the computer on my lap, my back pressing against the chair, the feel of the air from the ceiling fan, the sound of The Wiggles playing in the background, an airplane flying overhead outside, the pressure on my ankles as they touch crossing, my butt sinking into the chair. But except for when I'm deliberately looking for these sensations, I ignore them. They are not important sensations. They don't give me super important input I need to regulate my behavior.

"When exitation and inhibition are balanced, we can make smooth transitions to one state to another.. . Modulation determines how efficiently we self-regulate, in every aspect of our lives" (59).

So since Morgan is sensory seeking, he has a problem with modulation, in other words self-regulating his responses to the sensation stimuli and reacting to that input appropriately.

Self-regulation problems with sensory seeking:
* unusually high arousal and activity levels: always on the go, restless, fidgety, plays aimlessly, quick-tempered, excitable, impossible to sit still
* inattention: short attention span, highly distractible, disorganized, forgetful
* impulsivity: heedlessly energetic, impetuous, lack self-control

You might say this sounds like ADHD. And it IS similar.

Common behaviors in both SPD & ADHD:
* acts impulsively
* extraordinarily active
* seems disorganized
* impatient and demanding
* lacks self-control

The problems have different causes though and different treatments. It'll be more clear as Morgan ages if it's one or the other or both. (ADHD runs in Austin's family pretty strongly, as well as Autism.)

Everyone occasionally has sensory problems; for instance, I am extremely picky about the feel of socks on my feet. I will turn socks inside out so the hem doesn't bother me. Sometimes I'll refuse to wear certain socks if they don't "feel" right. The difference between these type of experiences and someone who has SPD is that sensory difficulties are chronic and disrupt everyday life (academic, social interactions, learning, relationships, movement, etc.) (The important distinction between "normal" behaviors and SPD is the frequently, intensity, and duration of the behavior.) "Children with SPD behave differently from typically developing children because their brains really are different" (13). (Another important thing is that SPD can range from mild to severe. I don't, at this point, think Morgan's is severe.)

Okay, so what is Sensory Seeking? A child who is sensory seeking has a "nearly insatiable craving for sensory experiences and actively seeks sensation, often in ways that are socially unacceptable" (28).

It's true that most children seek sensory input as part of normal development. The difference is a sensory seeker is EXTREME. Like my son.

Morgan exhibits these sensory seeking symptoms (i.e., all of them) daily and has consistently since birth:
  • is constantly on the move (scooting at 3 months, crawling at 5, etc.)
  • likes running, crashing, bashing, jumping, climbing, splashing
  • shows strong preference for excessive spinning, swinging, or rolling (And I do mean excessive. I don't think he would ever get tired of swinging.)
  • constantly touches objects or people (The touching objects thing everyone told me was just a "phase" that Morgan would grow out of. Morgan is almost 2. It's not happening. He still impulsively and compulsively goes around looking for things to touch, grab, or throw.)
  • takes excessive risks during play (climbing onto things, jumping off) aka "thrill seeker" (climbs onto kitchen table, rides his bike off the ottoman, dives off furniture)
  • prefers food with strong flavors/tastes
  • licks, sucks, or chews on nonfood items (Morgan constantly mouths objects [like the toilet plunger handle] still even though he should have "outgrown" that by now)
  • is nearly impossible to take to the movies, church, or other settings that don't allow him to move around (um...yes. Actually it's difficult to take him anywhere. He's just so into everything CONSTANTLY that it's exhausting for Austin and me to go places with him that don't have childproof boundaries)
  • is unable to sit still (except when watching highly engaging children's programs featuring bright colors, music, and dancing)
  • smells or tastes nonfood objects excessively when playing with them
  • gets angry or explosive when required to sit still or stop what he's doing
  • dumps out bins of toys or rummages through them purposelessly (I know kids do this, but the way Morgan compulsively does it is a bit disturbing)
  • rubs against walls and furniture (Morgan likes to turn and face the wall and touch it and kiss it when I'm changing him on the changing table. Austin and I joke he looks like he's getting ready to get a pat-down)
  • bumps into people
  • seeks visually stimulating scenes and screens for lengthy times (a la Wiggles and Backyardigans)
  • is attracted to shiny, spinning objects and bright, flickering lights (loved the ceiling fan as a baby)
  • loves crowds and noisy places
  • touches and feels everything in sight, running hands over furniture and walls, and handling items that other children understand are "no-nos"
  • intensively and impulsively seeks to touch certain surfaces and textures
  • touches and pushes people (he does this without malice; it definitely seems impulsive)
  • enjoys being messy (loves yogurt for that reason)
  • frequently removes socks and shoes
  • has high tolerance for extreme temperatures
  • has high pain tolerance
  • assumes upside-down positions (when Morgan was a baby, he would do this weird thing where he would what kind of looked like the downward dog yoga pose and then raise one arm and wave. I have a picture of it here)
  • deliberately bumps and crashes into objects or people
  • deliberately bangs head on walls, runs into walls, hits self (Morgan will randomly just start hitting himself hard on the head)
  • falls down on purpose
  • enjoys the sound of his voice (yells, screams)

A lot of children are wild sometimes, and some children are also active. A child may have a few of these behaviors. (Morgan has them all.) Again, the difference is the frequency, intensity, and duration of the behaviors. And these behaviors are constant with Morgan. I've seen firsthand the difference. Morgan is just "more." I've been told that my son is "exhausting." Don't I know it! I live with him day in and out people! It's so relieving to find out that I'm not an ill-equipped mother and that it's not my fault that I have such difficulty.

Before finding this out I really did feel inferior and that there was something wrong with me because I was having SUCH a hard time as a mother. It's true that the PPD didn't help in the first 9 months, but things have just been getting increasingly difficult (even after the PPD went away). (I'm not saying that parenting isn't hard in general. I think parenting is hard no matter who your child is or what type of parent you are.) I felt like such a failure as a parent. Austin and I seriously considered not having any more children because Morgan is just SO much. Knowing that he is different (and different isn't bad to me!) and most importantly WHY has really helped us as a family. 

Sensory seeking does not affect Morgan's mental capacity. His brain may work differently, but he is smart and capable of learning. (He is quite smart actually, just not in the speaking and communication department. He is great at problem solving and learning from observation.)

Since Morgan is just a toddler it hasn't really caused that many "problems" besides people telling me I need to provide "more firm discipline" which usually means corporal punishment, which I don't, as a principle, believe is appropriate, especially for a toddler who is behind on language and communication. (Furthermore, it doesn't and WON'T work with Morgan. This is not a behavioral problem that I can "discipline" him out of.) But if he doesn't learn to self-regulate, it could lead to him being labeled as "aggressive," "troublemaker," "dangerous," "mean," "invasive." Sure it's cute when an unfamiliar toddler runs up to you and sits in your lap and starts jabbering away. It's less cute when an older child does the same thing. Same with a toddler greeting someone by pushing them down. More socially acceptable for a toddler to do that than a first-grader.

I'm glad that we've found this out now so people won't shun or negatively label my child. I've read the stories of what happens if sensory seekers aren't given appropriate outlets for their sensory seeking. These children will think they are "bad," "stupid," and suffer from low self-esteem. They may also struggle with school and thus be put at risk for getting behind academically.

The key is for Morgan to learn self-regulation. With treatment, Morgan can learn how to meet his sensory needs so he can self-regulate.Treatment will help Morgan process his senses, so they work together appropriately. If he engages in activities that provide the intensity, duration, and quality of sensory experience his brain is craving, his adaptive behavior will improve. This will help ensure future success in social interactions and at school. Treatment will also ensure a healthy self-esteem and improve family relationships.

So what do we do to help Morgan learn to self-regulate? We provide him with appropriate sensory sensations so he can get his needs met! They call this a "sensory diet." We've just started working with an occupational therapist, and I've bought these books to help. One thing we've been doing is tossing Morgan in a blanket, putting pressure on his joints and muscles, using multiple sensory input for communication (signing, eye contact, singing, touching him), and providing plenty of outlets for rough-and-tumble play. We plan to get him appropriate things to chew on (they make something called "chewy stix"), provide plenty of physical activity, get him weighted blankets and vests, and get him other appropriate toys and activities. It does make a difference. Morgan is more calm on days that I provide him with a good "sensory diet."

So our "treatment" consists of providing Morgan with relationships that accept his level of needed activity and his desire for sensory input, with an environment that encourages safe and appropriate sensory activities, and tasks for him to do that provide him with sensory input. When he gets older, we'll want to be sure we put him in a school that provides plenty of variety of sensory activities (especially physical activity).

Austin and I are optimistic. This doesn't in one bit change how we feel about our son. It just makes me understand him better and have more patience with him. I am really glad we called Kids on the Move. We are seeing improvements in his communication and his behavior. Right now we're working on improving his vocabulary, helping him understand that he can't always have instant gratification, and working to get him to stop hurting himself when he's upset.

Oh, and another clarification, we aren't trying to "fix" our son. Morgan doesn't need to be fixed. We love him for who he is, an active, happy, energetic, curious, smart boy. We just want to make sure that he can learn and grow and have healthy, happy social relationships and be in charge of his sensory needs and not the other way around. :)

Comments

Alice said…
Wow Tracie... thank you for sharing what you've been learning about Morgan and what you're all doing to help him grow and develop. Morgan is certainly with the right Mom & Dad! I love you!
Mom B
Mark Beckstrom said…
That was an amazing blog post - I learned a lot - can't wait to see Morgan again - make sure we learn a few signs to we can "talk" with him on Skye - so glad you and Austin are his parents. Much love - Dad B
Ditto to the in-laws. Morgan is in the right hands. You are amazing. I think you are generally approaching this in the best and most positive way possible.
Kimberlee Pyne said…
My younger brother has SMD. He is 22 years old now. If you have any question I would be happy to talk to you. Love ya!

Popular posts from this blog

Apple Taste Test 2013

Anxiety

Tracie's Journal #2