Dyspraxia

Dyspraxia is a neurological disorder throughout the brain that results in life-long impaired motor, memory, judgment, processing, and other cognitive skills. Dyspraxia also impacts the immune and central nervous systems. Each dyspraxic person has different abilities and weaknesses as dyspraxia often comes with a variety of comorbidities. The most common of these is Developmental Co-ordiantion Disorder (also known as DCD), a motor-planning-based disorder that impacts fine and gross motor development. 

Early indicators that a child may have Dyspraxia:

   1. Irritable and difficult to comfort from day one

  

   2. Difficulties with feeding, allergic to milk, colicky, needs to be on a restricted diet

  

   3. Has difficulty sleeping, establishing and sticking to a routine,  needs constant adult   

       reassurance

  

   4. Early motor development is delayed, needs help sitting up longer than most kids, needs

       extra help in learning to roll over from side to side, most likely skips crawling and goes 

       right to walking. 

   

  5. Constant high level of motor movement of arms and legs including clapping, hand or 

      foot tapping, wringing of hands, swinging of feet, not being able to sit still longer than 5 

      minutes, flaps hands when running or walking, constantly falling or bumping into things

   

   6. Has behaviors that are repetitive in nature

   

   7. Sensitive to noise levels that are higher than normal such as loud shrill voices, out of 

       the ordinary noises

   

   8. Has continuous problems with their feeding development-spill things, prefer fingers to 

       eating utensils

  

    9. Toilet training is delayed longer than most typically developing children

  10. Avoids toys such as puzzles and Legos (toys that require you to put things together in

        a specific way. 

  

  11. Slower to respond to verbal instructions and needs them broken down into small steps 

        to process, slower in comprehension

  12. Prefers Adult interaction over peer interaction

  13. Does not liked to be touched or wear new clothing-clothes may need to be washed 

        several times to become comfortable for them to wear

  

  14. They have no fear from jumping off of things that are too high and have no sense of 

         danger 

  15.  Fine motor skills are slow to develop such as holding a pencil appropriately, using 

         scissors, and coloring recognizable objects

  16. They do not like playing dress up or engaging in appropriate imaginative play

Triggers for Kids with Autism and Sensory Processing Disorders (SPD)

Sensory Processing disorder described in a way that is easy to understand

Sensory Processing-refers to Autism, but other children without autism have these issues as well.  You can have Sensory Processing Disorders without being Autistic, have ADD, ADHD, or have Aspergers.  It is a disorder that can stand alone, but is often coupled with Autism, Aspergers, ADD, and ADHD.  Sometimes children thought to have ADD and ADHD really have a Sensory Processing Disorder. Have your child tested for both so that they are not placed on unneeded medications. 

Let's follow a sensory input on it's journey through our body and see what happens.   Remember, most of the time this happens without us being aware of it.

First, the sensory input.   A sense receptor is stimulated.   It then sends this to the brain.

Next, we have processing.   Sensory information is organised, interpreted, prioritised, stored and related to previous experiences.

Finally, we have the response.   A response to the sensory input in generated.   This could be a motor (behaviour?) response, and thought, or even an emotion (and we talked about how children with autism have trouble understanding emotion when we looked at the triad).

So, where does it go wrong?   Usually with the processing, so lets look at that in a little more detail.

When we looked at learning styles, I talked about people with autism sometimes needing longer to process information.   This goes for everything, including sensory information.   So, if I have autism, and I put my hand on a hot cooker, my tactile sense sends an alert to my brain, which then takes say fifteen seconds to process the information...Ouch!

We also need to look at prioritising.   When you're watching the TV, your brain automatically "tunes out" all irrelevant information, such as the fridge humming, clock ticking and so on, and allows you to focus on the sound and vision from the TV.   This is the 'ability to screen input' in the pyramid I said I'd come back to.   Your brain can filter out what you don't need.   Now, say someone drops a saucepan in the kitchen, your brain suddenly switches your attention to that noise, so that you can consciously decide whether you need to respond.   Now, although the TV is still on, the volume just as loud, for a short while you're not aware of it.   Your brain has prioritised the saucepan over the TV.

We're back to ancestor Ugg twenty thousand years ago.   This time he's sat round the fire, listening to someone telling a story.   His 'filter' has tuned out the crackling of the fire, the sound of the crickets in the grass, the feel of his clothing on his skin.   Suddenly, an unexpected noise in the night, it could be the lion!   Instantly he's alert, ready for action, fight or flight.

Many people with autism seem to lack this filter, so their brains can become overloaded with a deluge of sensory input.   If you just pause to think about how much sensory information your brain is filtering out right now, its astounding.   You have seven senses, all dealing with multiple inputs.   The touch of your clothes on your skin, the chair under your bottom, your hand on the computer mouse or keyboard, your feet on the ground, and that's just tactile!   How many sounds are there, smells, how much clutter is around your computer?   Imagine if you couldn't just ignore it.   Would you be able to concentrate to read these words?

You can try a little exercise to see what its like.   Get family members to rub your arms or legs and chat as they do so, how well can you read these words with all that going on?

Going back to processing, lets also think about 'related to previous experiences'.   When we looked at imagination in the triad, we learned this is something that some people with autism have difficulties with.   If that's the case, then surely every input would be like that dropped saucepan, demanding your conscious attention, making you jump, triggering that 'fight or flight' response just in case.

OK, so that's how SI works in us, and already we've seen where some of the issues are for people with autism, and we haven't even got to the senses themselves dysfunctioning yet!   Well, that's where we're going next.

We all need a certain level of sensory stimulation in order to feel 'normal', to feel grounded.   That's why sensory deprivation affects us so much.   When we don't get enough, we consciously or not seek it out.   If you're in a classroom, listening to a teacher, without thinking about it you may chew your pen or fingernails, twiddle your hair or touch your face and lips (all tactile), or maybe you'll swing back on your chair, stimulating your vestibular sense (and maybe a bit of proprioception).

If you're at home, doing the ironing, you may pop the radio or TV on for a bit of background noise, or hum a little song to yourself.   Too little stimulation and your brain is 'starved'.

Of course, too much stimulation and your brain becomes overloaded, if you have teenagers in the house you'll know what that's like!   Three different stereos playing loudly, the TV blaring, loud voices talking excitedly, this is when you'll take yourself off for a bit of 'peace and quiet' or shout "turn that racket off, I can't hear myself think!", maybe along with an appropriate expletive.

There are other factors that affect our ability to cope with sensory stimulation too, like tiredness or illness.   If you're well rested, you'll probably cope better with the noise children make than if you are tired.

So, basic equation, too little stimulation of a sense, we seek more out.   Too much stimulation of a sense, we try to reduce the input.

Now, for people with autism, their senses can be over sensitive (hyper), or under sensitive (hypo).

• If a sense is over sensitive, their tolerance for sensory input through that particular sense will be greatly reduced.   Normal sensory information will 'overload' them.   They will try and reduce the input.
• If a sense is under sensitive, their brain will be 'starved' of sensory information, they will seek out stimulation of that sense.   They have to do this, in order to 'feel normal'.   The same as we do.   But without the understanding of social rules that we have.

Seven Senses

http://www.visualsupportsandbeyond.co.uk/why/sensory.html Now we'll have a look at the seven senses and some of the things we see children doing in those areas when their senses are over or under sensitive.   It is by looking at these things we can build up a picture of a child's sensory profile and how it affects their behaviour and learning.   Not all people have difficulties with all their senses, but most have some degree of sensory processing impairment.

Situated in our inner ear, this is our sense of balance, of where we are and how we are moving (including speed) in relation to the pull of gravity.   We need it to keep our balance and maintain our posture. If our vestibular sense is over sensitive, we need to reduce and avoid the input.   Things we see in children are; Difficulties with activities which involve movement, such as sports. Car sickness. Hating the head not being in an upright position. Difficulty with walking or crawling on uneven surfaces. If the vestibular sense is under sensitive, then we need to seek out sensory input and stimulate it.   We see; The need for rocking, spinning and swinging. Lots of running around and jumping. Happy to spend hours on a trampoline, bouncing on furniture etc.

Our body awareness system, tells where the different parts of our body are and how they are moving in relation to each other.   It is situated in our joints and muscles and tells us what parts of our body are doing even when we can't see them. If our proprioceptive sense is over sensitive we need to reduce and avoid the input.   We see; Difficulties with fine motor skills. Placing the body in strange positions (ones that reduce proprioceptive input). Maybe turning the whole body to look at things rather than just turning the head. If it is under sensitive, we see; Low muscle tone. Weak grasp (may drop things). Stumbles or falls over a lot. May stand too close to people due to not understanding personal body space. May bump into people or objects. And again the strange body positions, this time ones that stimulate the proprioceptive sense. Enjoying trampolining, with lots of moving around and interesting postures.

This is our sense of smell, it is processed through chemical receptors in the nose and gives us information about our immediate environment.   Smell is a sense that is often neglected and forgotten about, but can be quite powerful.   Have you ever had a smell trigger a memory that 'takes you back'?   It a quite a strange, emotionally charged feeling, which is fine when you understand emotions! In the over sensitive group we often see; Smells being intensified and overpowering. Toiletting problems (if you've ever taken a strong whiff of smelling salts, you know how painfull a strong smell can be.   Now imagine that every time you sat on the loo, you'd be reluctant to go too!). A dislike of individuals with distinctive perfumes, shampoos, and smokers. Wearing the same clothes all the time (we often can't smell ourselves, but fresh laundry can smell quite strong, depending on the detergeents and conditioners used). Fleeing from smells and people. Sometimes even self-injurious behaviour (SIB) in reposnse to smells, especially to the head and nose. If its under sensitive, we may see; Seeking out or failure to notice strong odours. Smelling or licking self, other people or objects. Smearing of faeces, earing it or putting it up the nose.

Our sense of sight is situated in the retina of the eye, and is activated by light.   It helps us to define objects, people, colours, contrast and spatial bounderies. People with over sensitive sight report; Distorted vision occurs and objects and bright lights can jump around. Fragmentation of images as a consequence of too many sources. Focusing on a particular details (such as sand grains) can be more pleasurable than looking at something as a whole. It is less overloading to simply look down at the floor all of the time. A fascination with stripes, patterns, wheels, spinning, twirling etc. Some sources of light, particularly flourescent lighting, can appear to flash like a strobe light and be painful. People with under sensitive sight say; They may see things darker than they really are, and lose features or lines. For some they may concentrate on peripheral vision because their central vision is blurred, while others say that a main object is magnified and things on the periphery become blurred. They may have poor depth perception, leading to problems with throwing and catching, and general clumsiness. Some are attracted to lights. They may look very intensely at people. Often we see children moving fingers or objects in front of their eyes, sometimes while looking at a bright light. They may be fascinated with reflections and brightly coloured objects. They could be afraid of heights and travelling at speed. Some report having difficulty with certain colours.

As with the vestibular sense, our hearing is situated in our inner ear.   It informs us about sounds in our environment and is the most commonly recognised aspect of sensory impairment. Over sensitive hearing can lead to; The volume of noise being magnified and surrounding sounds distorted and muddled. An inability to cut our certain sounds (like ticking clocks) leading to difficulties concentrating. Covering the ears a lot, especially in response to sudden noises. Sleep difficulties. A dislike of active, noisy animals such as dogs. Being scared of thunderstorms, crowds and haircuts. Needing to make repetitive or droning noises to drown out other sounds, or using 'white noise' such as a TV or radio tuned to static or a fan for the same reason. Attacking, hiding and breaking the sources of noises, such as telephones and bells. If hearing is under sensitive, we may see; Not acknowledging some sounds. Enjoying nosiy places such as kitchens or swimming pools. Tearing paper, crumpling it, throwing objects that break noisily. 'Homing in' on sources of noise, such as a washing machine starting it's spin cycle, Making loud, rhythmic noises. A hearing impairment can have a direct effect of communication and balance.

Our sense of touch is situated on our skin.   It tells us about touch, pressure, pain levels and helps us to distinguish temperature.   Touch is a significant component of social development. People with an over sensitive sense of touch may; Resist being touched, as it may be painful. Dislike having anything on their hands or feet. Dislike the wind, showers, and hair brushing, washing, drying or cutting. Hate tight clothing, certain textures or types of clothing, or prefer to be naked. Avoid getting messy. Dislike certain textures of food, or food with more than one texture (like meat in sauce). Avoid people altogether, as they always insist on touching! Overreact to heat, cold and pain. If it's under sensitive, they may; Love cuddles, maybe holding others too tightly for too long. Have a high pain and temperature threshold. Self-harm. Enjoy heavy objects on top of them. Like pressure, tight clothing. Mouth objects, biting them to gain sensation. Love the feeling of resistance you get from water. Enjoy and often initiate rough and tumble play.

And finally we come to our sense of taste.   It is processed through chemical receptors in the tongue, and allows us to detect sweet, sour, bitter, salty and spicy. If it's over sensitive, we may find; Some flavours and foods becoming too strong and overpowering. Resistive eating. Using the tip of the tongue for tasting. Gagging or vomiting when presented with certain foods (can also be smell). Preferring bland foods. Hating fizzy drinks (can also be tactile). Hating chewing.   The bit where the food is in the mouth is too aversive, so it goes in and straight down. And in under sensitive we may see; A love of strong and spicy foods. Eating everything, soil, grass, faeces. Mouthing and licking objects and people. Loving mixed foods, such as sweet and sour. Regurgitating food and eating it again

Internal Regulation (The Interoceptive Sense):

 Internal:

__ becoming too hot or too cold sooner than others in the same environments; may not appear to ever get cold/hot, may not be able to maintain body temperature effectively 

__ difficulty in extreme temperatures or going from one extreme to another (i.e., winter, summer, going from air conditioning to outside heat, a heated house to the cold outside) 

__ respiration that is too fast, too slow, or cannot switch from one to the other easily as the body demands an appropriate respiratory response 

__ heart rate that speeds up or slows down too fast or too slow based on the demands imposed on it 

__ respiration and heart rate that takes longer than what is expected to slow down during or after exertion or fear 

__ severe/several mood swings throughout the day (angry to happy in short periods of time, perhaps without visible cause) 

__ unpredictable state of arousal or inability to control arousal level (hyper to lethargic, quickly, vacillating between the two; over stimulated to under stimulated, within hours or days, depending on activity and setting, etc.)

__ frequent constipation or diarrhea, or mixed during the same day or over a few days 

__ difficulty with potty training; does not seem to know when he/she has to go (i.e., cannot feel the necessary sensation that bowel or bladder are full 

__ unable to regulate thirst; always thirsty, never thirsty, or oscillates back and forth 

__ unable to regulate hunger; eats all the time, won't eat at all, unable to feel full/hungry 

__ unable to regulate appetite; has little to no appetite and/or will be "starving" one minute then full two bites later, then back to hungry again (prone to eating disorders and/or failure to thrive) 

Social, Emotional, Play, And Self-Regulation Dysfunction:

Social:

__ difficulty getting along with peers 

__ prefers playing by self with objects or toys rather than with people 

__ does not interact reciprocally with peers or adults; hard to have a "meaningful" two-way conversation 

__ self-abusive or abusive to others 

__ others have a hard time interpreting child's cues, needs, or emotions 

__ does not seek out connections with familiar people 

Emotional:

__ difficulty accepting changes in routine (to the point of tantrums) 

__ gets easily frustrated 

__ often impulsive 

__ functions best in small group or individually 

__ variable and quickly changing moods; prone to outbursts and tantrums 

__ prefers to play on the outside, away from groups, or just be an observer

__ avoids eye contact 

__ difficulty appropriately making needs known 

Play:

__ difficulty with imitative play (over 10 months) 

__ wanders aimlessly without purposeful play or exploration (over 15 months)

__ needs adult guidance to play, difficulty playing independently (over 18 months) 

__ participates in repetitive play for hours; i.e., lining up toys cars, blocks, watching one movie over and over etc.

Self-Regulation:

__ excessive irritability, fussiness or colic as an infant 

__ can't calm or soothe self through pacifier, comfort object, or caregiver

__ can't go from sleeping to awake without distress 

__ requires excessive help from caregiver to fall asleep; i.e., rubbing back or head, rocking, long walks, or car rides

Auditory-Language Processing Dysfunction:

Language/sound 

__ unable to locate the source of a sound 

__ difficulty identifying people's voices 

__ difficulty discriminating between sounds/words; i.e., "dare" and "dear"

__ difficulty filtering out other sounds while trying to pay attention to one person talking 

__ bothered by loud, sudden, metallic, or high-pitched sounds 

__ difficulty attending to, understanding, and remembering what is said or read; often asks for directions to be repeated and may only be able to understand or follow two sequential directions at a time 

__ looks at others to/for reassurance before answering 

__ difficulty putting ideas into words (written or verbal) 

__ often talks out of turn or "off topic" 

__ if not understood, has difficulty re-phrasing; may get frustrated, angry, and give up 

__ difficulty reading, especially out loud (may also be dyslexic) 

__ difficulty articulating and speaking clearly 

__ ability to speak often improves after intense movement