Adjusting from Womb to the World – A Sensory Perspective

www.otasa.org.za 

From the moment of conception your baby is developing on a sensory level.  As early as three weeks gestation their tactile system is already emerging and by five months all the sensory systems are in place and functioning.

The sensory systems:

  1. Tactile – touch
  2. Gustatory – oral (taste)
  3. Auditory – hearing
  4. Visual – sight
  5. Olfactory – Smell

And our two “hidden senses”

  1. Vestibular -balance and movement
  2. Proprioceptive – position of body

 

All of which have their sensory organs/receptors, the neural pathway to follow and the specific part of the Central Nervous System (brain and spinal /column) where they are interpreted.  Our sensory systems form the basis for all learning as they link us to the outside world.

In-utero is not only a safe environment but is specifically “designed” for optimal growth and development.  There is very little visual input and the taste environment is predictable.  Constant deep pressure keeps baby in a flexed, contained and midline position (foetal position), together with gentle rocking motion, muffled background noise and steady white noise which makes them feel secure and protected.

At birth, the baby is suddenly bombarded with new forms of sensory input and requires time to adapt.

 

We try to recreate the womb environment through:

  • Rocking
  • Singing or speaking
  • Playing white noise
  • Dimming the lights
  • Swaddling

From a very young age we can see some babies are already finding difficulty with processing sensory input and might be labelled as fussy or colicky.  Here are some signs:

  • Poor sleeping patterns
  • Cry often and seem uneasy
  • Difficult to console
  • Dislike bath time, having their nappies or clothing changed
  • Poor feeding – arch their backs, don’t latch or suck well
  • Excessive hiccups or yawning
  • Don’t interact easily
  • Don’t like different movements and positions

As they grow older, we become more aware of their sensory difficulties and it becomes evident that they can be divided into two main groups:

  • Sensory seekers: Crave extra sensory input and are hypo-sensitive
  • Sensory avoiders: Hyper-sensitive and experience input as too much/too extreme

In everyday life, children’s sensory likes and dislikes affect their choices in activities they engage in. They often don’t know how to modulate themselves, (cope with the sensory input) and can become over-excited or have a “meltdown”.  Their response may seem completely out of context to others but is so real and “traumatic” for them.

 

Let’s consider the main areas or activities where sensory issues could be seen:

Morning routines can be daunting with all the rushing around in preparation for the day.  Getting dressed (clothing too tight, too loose, tags and sock seams irritating), brushing of teeth and hair are all filled with sensory overload for a child who is sensory-sensitive.

 

Playground trips are not always pleasant experiences.  Some children find the large apparatus where their feet need to leave the ground fear provoking or the rotating equipment to cause queasiness.  The sun can be too bright for their eyes, the sand under their feet or the dust on their hands may make them feel uncomfortable and wanting to find the nearest bathroom to wash their hands.  Others send poor mom’s heart into overdrive watching her child rush around, hang upside down, perform stunts and behave as though he/she hasn’t a fear in the world, while others appear clumsy and accident prone.

Children with Sensory Processing Difficulties hate bath-time.  Splashing water, washing hair or being washed can cause these children to cry or rush out of mom/dads reach.  The hairdryer hasn’t even been taken out the drawer yet and your child is off down the passage covering their ears.

 

Meal times can be a challenge in terms of deciding what to cook; some children will only eat a certain texture, gag or refuse to swallow the food.  Other children have distinct food preference related to smell or taste.  So, we look for foods that our child will tolerate and often cook the same meals or have to make him/her a separate dish.

 

Social interaction, these children can be viewed as a bit different, the class bully or don’t realize when they are invading someone’s personal space.  They avoid giving hugs even to familiar people or may squeeze too tightly.  Your child may be the one who speaks too loudly or struggles with their emotions.

 

School, it is in the classroom environment with all the sensory inputs and so many people that problems are often identified. These children often have meltdowns at home after school as they have kept themselves “together” the whole day.  Some will retreat to their room for quiet time, others are emotional or over-excited.

 

As parents, there are a few steps that can be taken to help our children to better cope:

  • Visual schedules/day plans help with routine and structure, decreasing anxiety.
  • Keep things organized and predictable.
  • Prepare your child for what is to come in advance.
  • Understand your own sensory likes/dislikes and your response to them.
  • Be patient and understanding, knowing when to enforce things and when to let slide.
  • Don’t punish your child for behavior which stems from a sensory aspect; work on how to direct their emotional outburst into more appropriate behaviour.
  • Give control back to them – let them brush their own hair, teeth or dress themselves.
  • Find what they tolerate in terms of clothing and buy the same item in a different colour or larger size for next year.
  • Include in daily tasks and empower them – meal preparation allows for tactile and taste input.
  • Take shopping, they can push the trolley and help carry bags (gives proprioceptive input which helps calm).
  • Ensure you are ready before your child wakes up so that you can be fully focused on them; this prevents rushing which increases anxiety. Extra time may be needed to deal with repeated outfit changes or meltdowns.
  • Set-up a safe corner where they can go when feeling overwhelmed.

 

It is not to say all children with the above necessarily have a Sensory Processing Disorder.  One needs to take into consideration the degree/intensity and frequency that they exhibit these behaviors and if there is a pattern that can be identified, in which case it might be worth considering an assessment by an Occupational Therapist.  They will be able to assist your child, help you to understand them better and learn how to best handle a situation through means of therapy sessions and a “sensory diet”, which can be implemented at home or carried over to school.

This article focuses on how sensory information is perceived by our children and the effects it has on emotions and behaviour. There is however, another component of sensory processing and that is how sensory information is used to plan and execute motor skills.  Difficulties in motor planning can be seen in feeding difficulties (coordinating the suck, swallow and breathe sequence used by baby while breastfeeding), crawling delays, clumsy/uncoordinated movements, poor ball skills and problems taking part in sports.

OTASA (The Occupational Therapy Association of South Africa) is a non-profit professional organisation representing the interests of occupational therapists and occupational therapy assistants across South Africa.

Our main goal is to further the practice of Occupational Therapy, and we take pride in representing the profession.

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