Saturday, November 10, 2012

the why of what they do

Every parent that deals with sensory issues knows what a meltdown is. Now this is something that most parents may think they have experienced, often it is only a milder version a tantrum. Let's not misunderstand normal behavioural issues as a meltdown as believe me some kids have insane behavioural issues but a meltdown has some different components things to look out for:

Pre meltdown
  • small fractious moments usually occur before a meltdown, a child may seem unreasonable about small things. Something that doesn't normally set them off will become a major issue.
  • look at their body language take notice of (physical movements, [are they clumsy, falling over, jerky] emotional temperature [responses to situations and interactions are disproportionate to the expected norm for them], vocal temperature [their voice may change they may get louder often more whiny and bossy, or may start making noises] 

During the meltdown

From my experience I have noticed the following:
  • physical reactions (hitting, kicking, running, pushing, throwing)
  • emotional component (usually appearing angry, extreme versions of emotions, lack of ability to be able to engage in a discussion about their behaviour)
  • vocal component (usually crying, yelling, demanding, screaming)
  • normal coping techniques have no effect (breathing, counting, space, talking to them)
  • discipline will have no effect
  • if you leave the situation often it may not change their behaviour

Post meltdown

This is often a fragile time
  • it is good to offer a cool/hot drink and some food, meltdowns can be exhausting
  • some quiet space or activity to allow them to regroup
  • this is the time once they have recovered to discuss what happened
Another concept which is as fluid as anything is the idea of a neurological threshold:

"Neurological thresholds refer to the amount of stimuli required for a neuron or neuron system to respond. When the nervous system responds really quickly to a sensory stimulus, we say there is a low threshold and when the nervous system responds more slowly than expected, we say there is a high threshold for responding. All of us need a balance between low and high thresholds so that we notice just enough things to keep aware and attentive, but not so many things that we become overloaded with information and feel distracted.

At the extreme ends of the neurological threshold are habituation (related to high thresholds) and sensitization (related to low thresholds). Habituation refers to the process of recognizing familiar stimuli that do not require additional attention (Dunn, 2000). For young children, habituation is essential so they might focus their attention on the activity at hand. Without this process, children would be constantly distracted by the variety of stimuli that are present in the environment.

Sensitization is the process that enhances the awareness of important stimuli. It is significant to development because it allows the child to remain attentive to the environment while engaged in play or other learning. The ability to modulate (organize/ balance information from all sources) responses of the nervous system (i.e., balance between habituation and sensitization) permits the young child to generate appropriate responses to stimuli in the environment.

References: (Baranek & Berkson, 1994; Dunn, 1997a) (Dunn, 1994, 2000; McIntosh, Miller, Shyu, & Hagerman, 1999; Wilbarger, 1995)

In the context of a child's life and emotional regulation, at times the amount of stimuli required for optimal arousal (the place where we are ready to learn and engage) can change from day to day. Meaning that a behaviour or stimuli one day will not cause a meltdown can cause a meltdown tomorrow. Simply because their threshold is much lower or higher as the case may be. So for example after a trying day at school a child may have a low threshold or high threshold and will be primed for a meltdown.

The goal for any child would be to allow a child to be able to receive and interpret their world is such a way that they can stay in the state of optimal arousal. This means that us as parents needs to pay particular attention to allowing our child to experience many things and use tools to facilitate this process, particularly important for each child to be able to learn in the school environment or to feel comfortable at home.

Often (honestly) we can not quite figure it out why they have a meltdown, partly because sometime the lead up was at school. However prevention is an amazing tool. Providing extra sensory tools during trying times can help such as after school and getting ready for school some suggestions that I heard recently in a conference include the following (and some from my own experience)

  • An electric toothbrush can be calming
  • Routines and schedules (doesn't matter what form)
  • providing sensory diet activities that are needed
  • removing any sensory things that overload your child such as noise, smell and sight
  • keeping them well fed, plenty of water and enough sleep works wonders

Getting down to the latest revelations:

The primary goal for sensory processing is to enable your child to achieve an optimal level of how they are feeling not too much, not too little. It is an insane process and one that unfortunately is worked out through trial and error, this information I have found helpful. There are two types of nervous systems discussed: 

Parasympathetic nervous system: This is where our nervous remains most of the time and when we are at “ready state” for learning, social interaction, and alert and awake.  

Sympathetic nervous system: The state of “fight or flight”.  This part of our nervous system is intended for safety and the ability to react to a perceived dangerous situation.

The issues with these two states is that in children especially (without any sensory processing issues) are prone to fluctations in moods and behaviour. Part of their development is learning to regulate their emotions. Often they feel out of control of their world, then add in any other stresses we can see why they don't cope so well. 

What can occur is the child feeling particularly out of control, not understanding their environment or their body. This is a scary experience for anyone. Let alone if you add in any communication issues and other mental health issues. Secondly once they are in the place that their senses are overwhelmed they will feel on the edge and it takes not much at all to send them into a full scale melt down.

So how do we know what type of state our children are in? Another blog article suggests these are signs of the fight or flight state.
"There are many different manifestations of “fight or flight” but some common responses may be:
  • Hitting, kicking, biting, spitting, pushing (especially while standing in line or in new challenging/overwhelming situations or activities)
  • Trying to run or escape from the situation
  • Trying to hide under something like a desk, table, or chair 
  • Burying themselves in a teacher’s arms, avoiding all eye contact, or trying to curl up in a ball on the floor or at their desk
  • Covering ears or eyes
  • Crying or screaming
  • Hiding in the closet, under couch cushions, or under covers in bed
  • Shutting down completely and not speaking or responding
  • Even falling asleep unexpectedly"

Consider these as signs that your child is trying to avoid stimulas and struggling to cope with their environment. Taking cues from their behaviour, it is important to remove stimulas in an attempt to avert a full scale meltdowns. If you consider the list above, if they are covering their eyes or ears it could be an auditory or visual issue, if they are psychically reacting it could be a tactile issue.  As I was told yesterday "there is always a reason for their behaviour".  

Sometimes and this is not that uncommon we are clueless as to why and what our child is experiencing. Aside from sensory activities and a sensory diet, yesterday I discovered this tool called a Motivation Assessment Scale that can help in the classroom or at home to assess why things are happening. It is worth investigating to see if you can identify the cause and redirect the behaviour or eliminate it all together (wouldn't that be nice). Another topic that has raised my interest is the idea of preventative breaks which has been discussed in an article by Sue Larkey. I also plan to include some of the resources I got from the latest conference I attended.

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