If you are raising a child with ADHD, you understand John’s challenges. John has a hard time getting ready for school in the morning. He is nine years old, with ADHD and Sensory Processing Disorder (SPD). He doesn’t take his ADHD medication when he first gets up, and his mom often finds him on the bedroom floor, distracted by a poster on the wall or a dust bunny under his bed.
John’s mom raises her voice to get him moving. John feels overwhelmed. He rushes to get dressed, but his clothes feel uncomfortable and he can’t find the right pair of socks: “They all feel funny on my toes.” As things get tense, John’s ADHD and SPD symptoms worsen, and he becomes even more distracted and anxious. Neither his mom nor John know what to do.
SPD and ADHD
A child with SPD finds it hard to process and act upon the information received through his senses: sounds, sights, movement, touch, smell, and taste. SPD can be a stand-alone disorder, or it may coexist with other disorders, such as ADHD.
Since SPD inhibits a child’s ability to filter out unimportant sensory information, the condition leaves ADHD children prone to distractibility and anxiety. SPD symptoms are different from child to child. One may be over-responsive to sensations, finding physical contact, clothing, light, or sound overwhelming. Another may be under-responsive to sensation, needing lots of sensory input in order to process it. Some children have both conditions.
Sensory Organizing is a system I’ve devised to help parents determine and prioritize their child’s needs, and create an environment that taps into his strengths and lessens his challenges. Here are some of my suggestions. Consult with an occupational therapist for other ideas that might work for your child.
> Prioritize tasks and routines into steps — short and simple ones. A morning bathroom routine could be: wash face, brush teeth, comb hair. Putting clean laundry away can be summarized: bring laundry to room, separate clothes into groups, put clothes into bins as marked.
> A parent should minimize the sounds, sights, and other stimuli around the child who is overwhelmed by sensory information. When a child goes to a music concert, give him earplugs to soften the sound. This will help him adjust to a large concert venue with lots of people. If a child is sensitive to smells, give him a piece of gum or a mint before going into a place with many different odors. At home, experiment with aromatherapy to help your child grow accustomed to stronger smells.
> Create “sensory zones” in a playroom for kids who need lots of sensory input. Give them soft fabric blocks they can stack and “crash” into, a rice bin in which to dig for things with their hands. Taking “sensory breaks” may improve a child’s focus when he gets back to work.
> For that child with in-the-middle sensitivity, having small amounts of sensory input can improve attention during tasks that require sustained mental focus. Sitting on a disk-seat cushion when eating dinner allows for movement, and chewing gum or listening to music can sharpen focus.
Change the Environment
Parents can tailor the stimuli in a child’s environment to meet his sensory needs. My son hated putting clean clothes away and picking out clothes for school. When I looked in his jam-packed dresser drawers, I understood why. By switching to an individual bin system, with each bin holding one type of clothing and labeled with a photo, my son could manage his clothes without becoming overwhelmed or frustrated. It calmed him down.
Creating a structure for tasks given to ADHD/SPD kids shows them the steps that aren’t obvious to see and do. This helps them stay focused and get things done. External structure helps them prioritize the information that is coming at them. Some ways to create external structure are:
> Eliminate extra stuff in the child’s environment during times of transition. Storing toys and books in bins with wheels enables you to move them into a closet or out of the room at night.
> Use visual aids to underscore important information. A five-step homework plan, with three segments of work time and two breaks, gives kids a map to help them stay on task.
Tools for John
Here’s what worked for the nine-year-old:
EATING: John’s mom made a breakfast menu with fewer meal choices. This helped John decide what to eat and have more time to enjoy it.
DRESSING: John’s mom turned the downstairs bathroom into a dressing room. It was next to the kitchen, so he could finish up breakfast and avoid going back up to his bedroom, where he was exposed to distractions.
WARDROBE: John’s mom simplified the morning dressing routine by buying a small plastic drawer unit with six drawers. Clothes for the week were picked out on Sunday night, and put into drawers labeled with the days of the school week. The last drawer became the extra sock drawer. Mom also bought a hamper for PJs, an extra toothbrush and tube of toothpaste, and a hairbrush.
MORNING TASKS: To support the new routine and help John stay on task, John’s mom posted a three-step routine on the bathroom wall in pictures and words.
1) Wash face, brush teeth, and brush hair; 2) PJs off and into hamper; 3) Take clothes out from drawer and get dressed.
This new morning routine worked for John and his family. By using sensory supports, and by prioritizing the information for him, mornings were less stressful for everyone.