Sensory Strategies for Handwriting Skills

                                                 
                                                          

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Lewis is a 5-year old child who has recently joined pre-school. According to his parents he is very active, energetic and friendly boy who likes running in ground, spinning, jumping, watching Doctor Who and talking to everyone. After working with Lewis for a week, his class teacher discovered some unique habits, characteristics and behaviours of him which were as follows:

• While sitting in his chair or writing he slouches without him knowing about it. Likes wandering in the classroom and “always on a go”. He cannot sit for more than 10-12 minutes in his place.
• Doesn’t like playing with Lego or construction toys.
• Easily distracted by background sounds or outside noise (e.g., bird chirping or vehicle passing by)
• Gets confused with letters and numbers while reading and writing
• He is right handed but often uses left hand to write.
• While writing he goes out of space without realising it.

When these observations were discussed with school OT, she strongly recommended him for Sensory Integration assessment as all above stated features were part of sensory difficulties which were interfering in his handwriting, self-care, fine motor skills and day to day activities.

Handwriting is an important functional task for school aged children and primary way to express thoughts, ideas and knowledge, and emotions. Composing stories, expressing own emotions, copying numbers, from the blackboard, completing school assignments, writing formal letters, or applications all needs precise handwriting skill. 

According to Case-smith (1992), children began to draw and scribble on paper as soon as they are able to grasp a writing tool. The development of writing process in early years includes scribbling, drawing lines and circles.

During 7-8 years they learn to use the different functional tool such as

knife and fork, scissors, pencils, zippers, buttons, brooms. They learn to plan and sequence actions which are the important part of motor planning. 

Developing ideas, for building blocks, construction toys, Legos, sand castles, are taken enthusiastically. All these experiences of childhood enable a developing brain to work efficiently and organise incoming sensory information received from different sense organs.

However, for an atypically growing child these opportunities and playful scenarios are sensory challenges. They may experience stress in the case in the course of the day to day tasks related to fine motor, gross motor and handwriting skills.

These children are reluctant to write, easily tired, seen slouching in their chair, their desk is often disorganised, may drop things in hand and may display behavioural issues due to frustration, the anger of not being able to accomplish tasks in hand and other sensory difficulties.

DIY Sensory Feel & Find Me Box

                               
                                         

                               (Developmental Age: 5 years onwards)

We all are very much in love with different sensory activities as they are engaging, fascinating and nurturing,keeping us calm, alert and organised in our day to day accomplishments. Besides activating (alerting sensory activities) or relaxing (calming sensory activities) different sense organs, these tasks improve self-regulation, fine motor coordination, eye-hand coordination, laterality and dexterity.

At the same time, sensory fun can rescue our ASD, ADHD and SPD children from meltdowns, anxieties or sensory overloads due to their nature and character. 

Why do ASD kids get Anxious ? 6 Core Strategies

                                                      

14-year old Jack diagnosed with Asperger’s Syndrome came to attend Occupational Therapy (OT)  session in school's OT room. Jack loves OT as he feels that he doesn’t have to study in this lesson and he can learn and do fun activities. However, this time, when he came to attend a lesson, he was seen worried and unfocused while carrying out tasks. On being asked,the reason of consistent worry, it was found that he has to come to school by public transport (bus) whole next week along with his class friend, as his father has gone on an official tour and mother doesn't know driving.

A thought of travelling in the bus made Jack extremely anxious because of which he couldn’t focus even on tasks he like. Waiting for the bus, getting on it, asking for a ticket from bus driver (new person), standing along with new unknown people, being touched by people which creates defensiveness while bus is moving, hearing different sounds (people talking, vehicles on road, baby crying, music), smell of various deodorants, are some of challenges which made Jack so nervous! 

Above mentioned experiences are just so normal for anyone of us and do not affect any typically growing adolescent, however, for a child like Jack they are big reasons of worry!

Children with or without autism display anxiety during the day to day situations. Getting separated from the parents (separation anxiety) is most common cause of nervousness among typically and atypically developing children. Recent research at the University of Amsterdam suggests that 40% of children and adolescents with ASD have anxiety issues.

Every day most of us face situations that can cause anxiety or nervousness such as getting late for school or office, getting stuck in traffic jam, before examination or interview or even not being able to understand a simple joke that others find funny. 
We simply know how to cope with such situations, either by informing office staff that we are running late or ignoring joke that we do not understand. However, for autistic or learning disabled adult and child coping with stress, anxiety or frustration can be a great challenge.

“My 5-year old son with Autism gets nervous easily in school and public places. He often starts crying in malls and I feel embarrassed. Is there anything I can do to help him?"

This is a common question heard from parents of children diagnosed with Autism Spectrum Disorder (ASD), Sensory Processing Disorder (SPD), Learning Disabled (LD) and ADHD. Anxiety is not uncommon to anyone of us, however, atypically developing children display extreme nervousness in ordinary situations too.
As per anecdote reports, many children with autism will receive the another diagnosis at some point of development. The additional diagnosis is mostly related to (Simonoff, et al). 

So what triggers anxiety in children?             Dr Chuck Edington (2010) suggested common triggers of anxiety at home and school setting are, Unstructured Timing, Academic situations, sensory issues, social situations and Routines. Other factors of anxiety can be homework, examination, meeting a new person, fear of rejection from peers, or health concerns. 

Children with autism commonly display self-stimulatory behaviours (stemming) such as hand flapping, finger flicking (hand mannerisms), chewing and mouthing things, watching spinning objects, rocking body back and forth while sitting, nail biting or hand biting which, if not stopped can be self-injurious in nature.
Stemming helps them to calm down and reduce anxiety. Children having under-responsiveness (hypo-sensitivity) towards touch or hearing lack danger awareness which can lead to self-harming behaviour. 

For highly anxious children sensory stimulation (stimming) as a way of shutting down their thoughts, anxiety and related stress. It works as a medium of shifting one's own attention to physical stimulatory behaviour that is more engaging.

There is no causal relationship between anxiety and over-responsiveness (hyper-sensitivity) established through researchers, however, it is commonly observed, that children with over-sensitivity often react negatively to noisy and visually complex environments. 

Shutting their ears in public places, displaying temper tantrums, meltdowns during recess, trying to avoid hair cutting or dental check-ups by any means, being avoidant to bathing or tooth-brushing are some of the behavioural patterns of ASD child with anxiety.

To resolve the problem, parents need to be carried out some ‘detective’ work to find out possible reasons for anxiety.