2012年8月31日 星期五

What You Should Know About Tactile Defensiveness and Other Tactile System Disorders

One of the most common sensory disorders is Tactile Defensiveness.  With this condition, a child is over or "hyper" sensitive to different types of touch.  Light touch is one of the most upsetting types of touch to a child with SI dysfunction.  Depending on the intensity of their dysfunction, they may become anywhere from mildly annoyed to completely freaked out by having someone lightly touch them.  A gentle kiss on the cheek may feel like they are having coarse sandpaper rubbed on their face.  They also may dislike feeling sand, grass or dirt on their skin.  Getting dressed may be a struggle as different clothing textures, tags and seams may cause them great discomfort.

Often children with Tactile Defensiveness or touch hypersensitivity will avoid, become fearful of, or are irritated by:

The wind blowing on bare skin
Light touch
Vibrating toys
Barefoot touching of carpet, sand and/or grass
Clothing textures
Tags and seams on clothing
Touching of "messy" things
Changes in temperature

On the other side of the spectrum is a child with Tactile Undersensitivity or "Hyposensitivity".   A tactile undersensitive child need a lot of input to get the touch information he or she needs.  They will often seek out tactile input on their own in sometimes unsafe ways.

A child who is undersensitive to touch may have these difficulties:

Emotional and social  - Craves touch to the extent that friends, family, and even strangers become annoyed and upset.  This could be the baby who constantly needs to be held, or the toddler who is clingy, craving continual physical contact.

Sensory exploration - Makes excessive physical contact with people and objects. Touching other children too forcefully or inappropriately (such as biting or hitting).

Motor - To get more tactile sensory information, he may need to use more of his skin surface to feel he's made contact with an object.

Grooming and dressing - May choose clothing that is, in your opinion, unacceptably tight or loose. He may brush his teeth so hard that he injures his gums.

If you child shows signs of Tactile Defensiveness or Undersensitivity, it's important to get a proper screening by an Occupational Therapist, pediatrician or other licensed professional.  This sensory assessment will help you in seeking out the proper course of treatment and therapy.

Visit [http://www.SensorySmartKid.com] for more information and support regarding Sensory Integration, PDD and other Autism Spectrum Disorders.

Gifted Children - Do They Have Sensory Sensitivities?

They appear to be very organized and efficient.

2012年8月30日 星期四

Living With Sensory Processing Disorder - A Family Affair

I. A child's view on how SPD effects family relationships

Living and coping with a disorder can often consume a child's world. For children with Sensory Processing Disorder (SPD), this can be especially challenging as most children with SPD are seemingly "normal". Many people do not often realize that these normal-looking children could be plagued by such an emotionally, physically and socially taxing disorder. Emily Brout knows all too well how difficult it is to explain her disorder: "Sometimes it is really hard to explain what Sensory Processing Disorder (SPD) is to other people. It's very complicated and it's not even easy for me to understand! Many people don't know anything at all about SPD because there hasn't been a lot written about it or on T.V. So most people have no idea how SPD makes a person like me feel. In fact, there are many people who don't even think SPD is real! That makes me so mad! Why would anybody make this up?"

Having SPD makes family life and social time with friends tough on Emily. "SPD makes me feel like I'm being attacked by noises, smells, and lights every day. Smells can be really bad, and sometimes even make me throw up. It is very hard to sit in the cafeteria with my friends at school and try to hide the fact that I am gagging because of a smell. Noises are the worst for me. Quiet noises that repeat over and over make me really upset, and these noises are part of every day life. My sister and brother get mad at me because I yell at them for noises that they make. Sometimes, I get really sad and don't want to go anywhere. I also lose my temper and get really mad at people. I don't do this on purpose, but my friends and family don't always realize that. I just cannot help it. Every day I struggle to keep myself calm even though I feel scared, mad and upset on and off, all day."

Coping with a special need such as Sensory Processing Disorder can be equally frustrating to both the child and his or her family.

II. A parent's perspective on raising a child with SPD

Emily's mom, psychologist Dr. Jennifer Brout, can identify with trying to cope with raising a child who has a special need and maintaining her family dynamics. "A wise professor once told me 'Your primary goal is to not make things worse'. As I consulted psychologists and psychiatrists alike, I wondered if there were any clinicians who even understood what Sensory Processing Disorder (SPD) was!" said Brout. "My daughter received Occupational Therapy to remediate her symptoms, yet her personality and our family dynamics had already been shaped by the disorder's complications." Dealing with this frustration and lack of help from mental health professionals who had no real treatment for her daughter, Brout often wondered, "was there anyone out there who would understand that I was not simply giving in to my daughter's 'manipulations' because I was a browbeaten mother lacking any savvy?"

Everyday life posed so many difficulties and heartache for Brout, as a parent who had to watch her child struggle with SPD. "Although her other senses were affected, extreme over-reactivity to certain sounds caused my otherwise sociable, empathic sweet-natured little girl to be unpredictably moody and explosive. During toddler hood and early childhood she threw tantrums that lasted for prolonged periods of time. She was extremely clingy, and often appeared sad. Background noises that most people didn't notice set her off into rages." Not being able to ease a child's suffering could leave any parent feeling helpless. Brout remembers one of those moments with Emily, "when she was six years old she looked at me and said 'When I hear bad noises I feel like I'm turning into the Incredible Hulk'. Then she asked intently, 'Mommy, can you fix my brain?' This moment defined the extent to which my daughter was suffering, and how negatively her self-image had been impacted by SPD. What little girl should envision herself as a huge, green, out of control mutant?"

What can a parent do? How can a parent mediate Sensory Processing Disorder within family life?

For parents coping with their child's SPD, Brout offers this advice, "it is helpful to remind yourself that with Occupational Therapy, sensory integration treatment, and as he or she gets older, your child will be able to implement greater control over his or her behavioral reactions to his or her physiological responses. In the meantime, however, regulation (calming the child so that he or she is not over stimulated and agitated) is the first priority." She goes on to suggest that in order to make this shift, "you must allow yourself to dismiss much of what you have been told about parenting, even by mental health professionals, because it does not apply to SPD children. For now, think of your child as one whose body over-reacts to sensory stimuli, and who is deficient in calming down." When faced with an agitated child whose behavior is effecting family life, Brout suggests using the three R's: Regulate, Reason and Reassure

Regulate: "Help your over-responsive child calm down by identifying the source of the sensory stimuli, and shift the focus from any resulting conflict. As a child develops greater language and cognitive skills this process becomes easier. However, even younger children with limited language skills can be regulated. Each child is unique which is why it is essential to consult with a professional."

Reason: "Once your child is calm, review the incident with him focusing on his thought processes. If he cannot identify the stimuli that triggered his actions, try to do it for him by making suggestions. For younger children, you will have to go through this process with relative simplicity and brevity. With enough consistency your child will understand your message, and will also learn that when he or she is over-stimulated, calming down is the first step! Remember, this process is not an over-night cure!"

Reassure: Remind yourself that your child does not like feeling out of control. Reassure him that over time he will gain control, and that you will help him. Let him know that you expect him to try as hard as he can, but protect his self-esteem and self-image by framing the problem as though it were 'a work in progress'. Repairing damaged self-esteem and poor self-image is much more difficult than reshaping a child's misconstrued ideas about the causes and consequences of behavior. No child should see himself as a huge out of control green mutant being that repels others!"

In regard to family dynamics, Dr. Brout states, "the SPD child feels victimized by the overwhelming sensory stimuli generated by family members. However, siblings are also likely to feel victimized having often been the object of the over-responsive child's mood swings and/or aggression. Therefore, it is important to let siblings know that they are not responsible for these problems and that you are doing everything you can to get help for your over-responsive child and for the family. Behavior is not only about actions and consequences. It is about interpersonal relationships and that is especially true in regard to SPD as it affects family functioning."

Jennifer Jo Brout, Ed.M., Psy.D. is a psychologist focused on Sensory Processing Disorders and their application to mental health. She earned an Ed.M. in School Psychology from Columbia University and a Psy.D in School/Clinical Child Psychology from Albert Einstein College of Medicine. Dr. Brout is currently involved with projects at the KID Foundation Research Institute, Duke University, and in association with audiologists and private clinicians throughout the country.

In 2006, Dr. Brout launched Positive Solutions of New York, LLC to support research in psychological conditions, developmental disorders, and learning difficulties related to sensory processing/regulatory disorders through various creative and public service projects.

Sensory Integration Therapy

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The Miracle Cure for Wearing Clothes & Shoes for a Finicky Kid

My son Jeremy will almost be six years old next week. For the first 5 ¾ years of his life, putting his shoes and socks and clothes on was a struggle. It isn't anymore. We've come across a miracle cure!!!

Jeremy was diagnosed this past year with Sensory Integration Disorder. He started having problems in school and so we were referred to a place called Lifeskills, in Winter Park, FL. They work with many kids with challenges and specialize in Sensory issues.

The problems we encountered at home were on a daily basis. Getting him out of bed was a struggle, finding the right breakfast and ultimately, we dreaded getting him dressed every day. Socks and shoes were constantly being pulled off and tossed. Clothes were never soft enough and the tags all had to go. I spent hundreds of dollars finding clothes and shoes that he'd keep on his body. Once, Jeremy struggled so hard with pulling off his coat, he slipped and fell, and bumped his head on a chair. That little incident cost him 15 stitches in his head.

When we entered therapy we outlined the laundry list of issues Jeremy had. The big one for us was getting him dressed. Once the therapist gave us the occupational therapy brush and showed us how to brush his arms and legs up and down and his feet, and then to do joint compressions. This brushing is actually a deep pressure massage with a surgical brush and is followed by joint compressions. An occupational therapist can train you once and you'll use it at home. (You can find an OT by going through the school counselor or through your family doctor). It was only 2 -3 of days of brushing Jeremy a few times a day before Jeremy was able to adjust quickly to his shoes when we put them on in the morning.

It's been like a miracle! Jeremy can now wear clothes and will put on socks and keep them there! He still prefers silky clothes like football jersey's but he will put on socks now and not scream and cry. Before we learned of this type of massage it must have felt like he was putting a wool sweater on during the middle of August.

Learning this technique and others at occupational therapy has been a God send in our lives. We used to dread every morning getting Jeremy up and ready for school. We were late nearly every day depending upon what clothes I could find that would feel comfortable.

Now, Jeremy dresses himself on most days and our greatest concern is what to make him for breakfast. We still struggle occasionally getting him out of bed, but from what I understand, THAT could be a struggle well into his teen years. And as long as we don't to dress him then, I think we'll be fine with that!

Mary Gardner is an executive Communications Consultant and coach. She is parenting a child with SID and is constantly learning and sharing with other moms who are struggling with the same issues. Please feel free to contact mary at mary@marygardner.com if you would like to share your story.

ADHD Comorbid Disorder: Non-Verbal Learning Disorder

2012年8月29日 星期三

Treating the Sensory Problems of Autism

So what is autism? First of all, we must make some distinctions. There are various types of difficulty within the spectrum of disability of which we are speaking. The major distinctions are as follows:

Autism Asperger's syndrome, Rett Syndrom, Childhood Disintegrative Disorder. The most prevalent and commonly known two of these are autism and Asperger's Syndrome.

What do we mean when we say autism is a 'spectrum disorder?'

When the term, 'spectrum disorder' is used it means that there are a range of symptoms, which can be attributed to autism. Any one individual may display any combination of these symptoms, in differing degrees of severity. Therefore an individual at one end of the autistic spectrum may seem very different to an individual at the other end of the spectrum.

Who first discovered autism?

Autism was first recognized in the mid 1940's by a psychiatrist called Leo Kanner. He described a group of children, whom he was treating, who presented with some very unusual symptoms such as; - atypical social development, irregular development of communication and language, and recurring / repetitive and obsessional behaviour with aversion to novelty and refusal to accept change. His first thoughts were that they were suffering some sort of childhood psychiatric disorder.

At around the same time that Kanner was grappling with the problems of these children, a German scientist, Hans Asperger was caring for a group of children whose behaviour also seemed irregular. Asperger suggested that these children were suffering from what he termed 'autistic psychopathy. ' These children experienced remarkably similar symptoms to the children described by Kanner, with a single exception. - Their language development was normal! There is still an ongoing debate as to whether autism and Asperger's syndrome are separable conditions, or whether Asperger's syndrome is merely a mild form of autism.

What is the cause of autism?In the 1960s and 1970s there arose a theory that autism was caused by abnormal family relationships. This led on to the 'refrigerator mother' theory, which claimed that autism in the child was caused by cold, emotionless mothers! (Bettleheim, 1967). However the weight of evidence quickly put this theory to bed as evidence was found to support the idea that the real cause was to be found in abnormalities in the brain. This evidence was quickly followed by findings, which clearly demonstrated that the EEG's of children with autism were, in many cases, atypical and the fact that a large proportion of children also suffered from epilepsy.

From this time, autism has been looked upon as a disorder, which develops as a consequence of abnormal brain development. Recently, evidence has shown that in some cases, the abnormal brain development may be caused by specific genes.

However, we should not forget that genes can only express themselves if the appropriate environmental conditions exist for them to do so and so, we should not rule out additional, environmental causes for autism. We should not forget that autism can also be caused by brain-injury, that an insult to the brain can produce the same effects as can abnormal development of the brain, which may have been caused by genetic and other environmental factors. I have seen too many children who have suffered oxygen starvation at birth, who have gone on to display symptoms of autism. So, it is my view that autism can also be caused by brain-injury.

There are also other possibilities, which can ultimately produce the type of brain dysfunction, which we recognize as autism. There is a great deal of research being carried out at the moment in the area of 'oxidative stress' and methylation and it's effects upon the integrity of neural networks. There is also the debate surrounding mercury levels in vaccines, which is as of yet, unresolved.

The fact is that 'many roads lead to Rome. ' - There are likely to be several factors both genetic and environmental, which can ultimately lead to the type of brain dysfunction, which we call autism.

So, how do we recognize autism?

On a descriptive level, autism involves a dysfunction of the brain's systems, which control communication, socialization, imagination and sensory perception. My theory is that it is the distortions of sensory perception, which are so characteristic of autism, which exacerbates many (but not all) of the other difficulties. Imagine a child suffering from autism who suffers distortions of sensory perception. For instance, the child who suffers distortions of visual perception, might find situations which require eye -contact to be exceptionally threatening, or on the other end of the scale might become obsessive about specific visual stimuli. The child who suffers distortions of tactile perception, might at one end of the spectrum find any situation which requires physical contact to be terrifying, whilst at the other end of the spectrum, they might be a 'sensation seeker' to the point of becoming self -injurious. The child who suffers distortions of auditory perception might at one end of the spectrum, be terrified of sounds of a certain pitch or intensity, whereas at the other end of the spectrum, they might actively seek out, or become obsessive about certain sounds.

The question is, what can we do to help redress these distortions of sensory perception. Well, we can learn from the newborn baby. When baby is born, he sleeps for most of the time, only spending short periods of time interacting with this new environment in which he finds himself; - a new environment which bombards his senses with new sights, noises and smells. So he retreats into the safe, calm environment of sleep, which provides the sensory safe haven which up until recently was the sanctuary of the womb. Very gradually, as baby adjusts his sensory system to his new environment, he spends more and more time in the waking world, interacting and learning to communicate, - but he adjusts very gradually!

There is possibly a neurological explanation for this. There are structures within the brain, which act to 'tune' sensory attention. These three structures, which allow us to tune our attention are structures, which enables us to 'tune out' background interference when we wish to selectively attend to something in particular. They also enables us to 'tune in' to another stimulus when we are attending to something completely different. They are the same mechanisms of the brain, which allows us to listen to what our friend is saying to us, even when we are standing in the midst of heavy traffic on a busy road. It is these mechanisms that allow us, even though we are in conversation in a crowded room, to hear our name being spoken by someone else across that room. It is these mechanisms, which allow a mother to sleep though various loud, night-time noises such as her husband snoring, or an airplane passing overhead and yet the instant her new baby stirs, she is woken. It is a remarkable feature of the human brain and it is the responsibility of three structures operating cooperatively - these are the ascending reticular activating formation, the thalamus and the limbic system.

Having made such a bold claim, allow me to furnish you with the evidence to support it. The three structures just mentioned receive sensory information from the sense organs and relay the information to specific areas of the cortex. The thalamus in particular is responsible for controlling the general excitability of the cortex (whether that excitability tunes the cortex up to be overexcited, tunes it down to be under excited, or tunes it inwardly to selectively attend to it's own internal sensory world. ) (Carlson, 2007). The performance of these neurological structures, or in the case of our children, their distorted performance seems to be at the root of the sensory problems faced not only by newborn babies, but the sensory difficulties our children face and yes, as the newborn shows, their performance CAN be influenced, - they can be re-tuned.

I believe the sensory system of some children with autism is experiencing similar difficulties to that of a newborn, - at one end of the autistic spectrum, the cortex is being over-excited by these structures and the person is overwhelmed and has difficulty accommodating the mass of sensory stimulation within the environment. At the other end of the autistic spectrum, the cortex is being under-excited and the person has trouble in perceiving sensory stimulation from the environment. The question is; - How do we facilitate the re-tuning of this neurological system in individuals who have autism. The newborn retreats into sleep, a self imposed dampening of incoming sensory information. Whilst the child with autism does not do this, many children with autism attempt to withdraw from their environment because they find it so threatening.

We believe at Snowdrop that for the child at the end of the autistic spectrum who is suffering an amplification of sensory stimulation, we should create a setting where he can retreat from a world, which is overwhelming his immature sensory system. This 'adapted environment,' which should be as free as possible from all visual, auditory, tactile and olfactory stimulation will serve as a milieu where his sensory system can re-tune itself. Of course it may just be a single sense like vision, or hearing, or tactility, or any combination of senses, which are causing the difficulties and the environment may be adapted appropriately. The child suffering these difficulties will usually welcome this adapted environment, which is in effect a 'safe haven' for his immature sensory system. He should be given free access to, or placed within the adapted environment as needed and you will notice hopefully that he will relax and begin to enjoy being within its safe confines, where there are no sensory surprises.

This procedure should be continued for as long as necessary, - for several weeks or months. Indeed, some children might always need periods of time within the 'safe haven. ' As the child begins to accept and be at ease in his safe haven, stimulation in whatever sensory modality is causing the difficulties, should begin to be introduced at a very low level, so low in fact that it is hardly noticeable. If the child tolerates this, then it can be used more frequently until it becomes an accepted part of the sensory environment. If the child reacts negatively in any way, then the stimulus is withdrawn and reintroduced at a later date. In this way, we can very gradually begin to build the level of tolerance, which the child has towards the stimulus.

For the child at the other end of the autistic spectrum, the child whose sensory attentional system is not exciting the cortex enough, with the consequence that he is not noticing enough of the stimulation in his sensory environment, the approach needs to be the exact opposite. These are the children who we see producing self-stimulatory behaviour. I believe that this behaviour is an attempt by the nervous system to provide itself with what it needs from the environment, - a sensory message of greater intensity! We see many children with autism 'flapping' their hands in front of their eyes, or becoming visually obsessed by certain toys, movements, colours etc. I propose that this is a reaction by the nervous system to attempt to increase the intensity, frequency and duration of the sensory stimulus due to a problem with perceiving visual stimuli from the environment.

Of course, children with autism display a far greater range of difficulties than a theory, focused upon a malfunctioning sensory - attentional system could explain. I am not attempting to claim that sensory problems on their own are an adequate explanation for every facet of autism, - that would be ridiculous! This is merely a possible explanation of a range of issues experienced by some children who have autism, which could be produced or exacerbated by the child suffering distortions of sensory perception. For instance, the following symptoms within the autistic spectrum could possibly be explained at the sensory level.

Failure to make eye contact. Difficulty in sharing attention with anyone. Avoiding interaction with others. Avoiding physical contact. Seeming disconnected from the environment. Appearing not to notice anything visually. Visual distraction, as though the child is looking at something which you cannot see. Visual obsession with particular features of the environment. Inability to 'switch' visual attention from one feature of the environment to another. General discomfort with the visual environment. Appearing not to hear anything. Auditory distraction, as though listening to something which you cannot hear. Auditory obsession with particular sounds within the environment. Inability to 'switch' auditory attention from one sound within the environment to another. Inability to 'tune out' extraneous sounds in the environment. General discomfort with the auditory environment. Appearing not to feel much sensation. Appearing to bee distracted by tactile stimuli of which you are not aware. Obsession with particular tactile sensations within the environment. Appears unable to 'switch' tactile attention from one sensation to another. General discomfort with the tactile environment. Difficulty in communicating with others.

We believe at Snowdrop, that our sensory re-tuning environments offer the best chance for children to overcome such distortions of sensory perception.

Parenting Tips On Sensory Diet For Sensory Integration Disorder

Does your child with autism become sensitive to sounds, smells and is a picky eater? Does your child with another disability become hyperactive, when asked to sit for a long period of time? These are all signs of sensory integration disorder (SID). This article will discuss the sensory diet that is used for children with SID.

Sensory Integration Disorder is the inability of the brain to correctly process information brought in by the senses. SID can show itself in many different ways. A child with SID may be over or under sensitive to sounds, smells, may be a picky eater (does not like the way certain foods feel in their mouth), may not like the way certain clothes feel on their skin. Many children with autism and learning disabilities have sensory integration issues.

Children with SID may also have motor skill issues such as; difficulty with fine and gross motor skills, difficulty imitating movements, or has trouble with balance.

Treatment is usually carried out by a occupational therapist, with experience in treating children with sensory integration disorder. A sensory diet can also be put together, specifically for your child. The diet can be used at home as well as at school.

A sensory diet means that you are including sensory activities, within your child's day; at home and at school. Each child's sensory diet is different, depending on your child's specific SI needs. Ask your child's occupational therapist to help you set up a sensory diet, to meet your child's unique needs.

For Example: If your child becomes hyperactive on a regular basis, or perhaps prone to hitting or pinching, or being silly, or laughs for no reason a sensory diet may help. Giving your child sensory activities on a frequent regular basis, will help him to remain focused and in control more often.

A sample sensory diet is listed below:

At critical points during your child's day:

1. Swinging in a special swing or on a playground

2. Chase games such as tag, or running races

3. Jumping jacks, stretching, sit ups, balance beam

4. Trampoline, tire swing, exercise ball

5. Squeezables such as nerf balls, silly putty etc.

Every half hour if possible; to include the above:

6. Smelling scents game

7. Rubbing/or brushing with a specific type brush (Ask occupational therapist for type of brush to use, and how to do this technique), not to include the stomach.

8. Jump rope

Calming activities that you can use at home:

a. Morning: Bath, brushing, deep pressure.

b. After school: Child's choice (biking, running, skating).

c. Evening: Supper, bath, deep pressure.

Using a sensory diet on a child who has SID, can cause a dramatic improvement in their behavior and ability to focus. The items listed are easy to do at home and school. You may have to advocate for sensory breaks for your child, but remind special education personnel about how much it could benefit your child.

SID - Sensory Integration Disorder and Neurofeedback

Sensory Integration Disorder (SID) was discovered by Jean Ayres, Ph.D. about 40 years ago. Symptoms of SID in children are often misinterpreted as psychological problems or just plain bad behavior.

Higher cognitive functions including things such as learning and behavior depend upon having normal sensory integration.

As a psychologist, I am sad to say that when I was in graduate school, (1982 - 1987) that this disorder wasn't talked about much. At this time I am often involved with families who have a child with Sensory Integration Disorder.

Imagine, if you will, that for each of your 5 senses, there is a wire of a different color that leads the information form that particular sense, into your brain. For example, for the information that comes in from your eyes, or your visual senses, you might imagine a red wire; and blue one for hearing (auditory), etc.

Now, assuming that your brain was able to notice what color of "wire" the information was coming from, and knew that the red "wire" was information from your eyes, and blue was from your ears, it would be a fairly straightforward process for keeping things figured out. Someone with SID, however, doesn't experience it quite like this.

When someone is dealing with SID, their brain is getting mixed signals. At times, the red "wire "might be visual information; at other times, it might be the blue "wire" that is shuttling the visual data. Then, there may be times when the red "wire" is carrying both visual and auditory information. Can you see how this might be very confusing for the brain to interpret?

This sounds like a rather complex challenge, does it not? One could argue that it is, I suppose, but I've never been one for building a "case" for difficulty. Instead, I prefer to gather evidence for possibility.

In short, when neurofeedback is helpful for those with SID, it's as though neurofeedback is able to teach the brain to start recognizing the "wires" accurately and stop acting "color blind" when it comes to incoming sensory information. And, why shouldn't everyone's brain learn to clearly interpret sensory information?

Want to know more about the amazing world of Neurofeedback? Click on this link to go to http://www.NeurofeedbackBook.com Dr. Clare Albright is a psychologist and the author of a 168 page book, "Neurofeedback: Transforming Your Life with Brain Biofeedback" and can be reached at (949) 454-0996 http://www.NeurofeedbackBook.com. The pdf version of the book can be downloaded for only $7.99!

2012年8月28日 星期二

Tactile Defensiveness - The Facts About the Wilbarger Brushing Protocol

Many children with Sensory Integration Disorders exhibit symptoms of tactile defensiveness. In layman's terms this simply means that they have hypersensitivity to touch and/or tactile input. This in turn may cause:

-Difficulty transitioning between activities

-Lack of attention or focus

-A fear or resistance to being touched

Your child may benefit from what is commonly known to most parents as "Brushing Therapy". It is known in Occupational Therapy circles as The Wilbarger Deep Pressure and Proprioceptive Technique (DPPT) & Oral Tactile Technique (OTT). It was developed by Dr. Patricia Wilbarger, MEd, OTR, FAOTA, an occupational therapist and clinical psychologist that has been working with sensory processing theories for over 30 years.

When first introduced to this, many parents are a bit skeptical. How can "brushing" my child help them with their sensory integration issues and tactile defensiveness? The theory behind it is that our skin is the human body's largest sensory organ, and therefore it is in constant contact with our nervous system; relaying information that allows us to interact effectively with our environment. Often times, the inability for the human body to process sensory input effectively can cause motor skill delays, tactile defensiveness, or social and emotional difficulties. Brushing therapy seeks to use this connection between the skin and the nervous system to assist kids who may be having difficulty organizing sensory information properly.

It is thankfully, quite simple to implement. The first step in the therapy involves using a soft, plastic, surgical brush which is run over the child's skin, using a very firm pressure, starting at the arms and working down to the feet. The chest and stomach area are always avoided as these are sensitive areas that can cause adverse reactions. There can be some drama at first, until the child becomes accustomed to the therapy, but most children find it pleasurable after a few sessions and may even ask for it when they are feeling "off". Along with the brushing, most practitioners will also prescribe joint compressions. In this phase of the treatment, the therapist or a parent trained by a therapist provides gentle compressions of each of the child's major joints for a count of ten. Finally, the therapist may also suggest the Oral Tactile Technique, or OTT. This technique involves using a finger to swipe along the inside of the child's mouth. This has been found to help with some children who have an issue with what is known as oral defensiveness. If your child is adverse to new foods because of their texture, or has a severe aversion to having their teeth brushed, they may have an issue with oral defensiveness.

If you think that your child would benefit from this form of therapy, it is important to seek guidance from an Occupational Therapist. Performing the therapy in a manner other than taught by a trained professional can be, at best, useless and could possibly do more harm then good.

Halloween Fun For Children With Sensory Processing Issues

Halloween parties, costumes, masks, and treats--you can't count on any of these being fun for the child with sensory issues! No wonder October 25-31 was chosen to be National Sensory Awareness Week, drawing attention to the 1 in 20 children who have the hidden disability of sensory processing disorder, also known as SPD, or sensory integration dysfunction. Fortunately, you can make Halloween more enjoyable for the child who struggles with sensory issues.

Costumes and masks often involve new sensations against the skin and body that a child may find repulsive. Experiment beforehand with any make-up, masks, wigs, or hats and see if the child can truly tolerate them for a few hours. For a costume, consider working from the basic pieces of a soft, cotton top and bottom, such as a sweatsuit or pieces of clothing purchased at a used clothing store or pulled from his play clothes pile. Add elements and props that he can hold or wear comfortably. Start looking for a costume early, when the selection is best. Purchase a used costume or costume elements through eBay, second hand shops, and Craigs List to keep your costs down because after trying a costume for a few minutes, your child may realize it is too tight, scratchy, or uncomfortable in some other way.

Treats with plenty of sugar and artificial colors and flavors should be limited for all children, but kids with sensory issues are often more sensitive to these substances. Let her gather all her loot post trick or treating and choose the favorites, then have the rest mysteriously disappear overnight (maybe after using them as math counters!). Or hoard it to use a piece at a time as rewards for overcoming challenges, doing extra chores, or use in therapy. If your child has an occupational therapist or speech therapist, speak to this professional about the possibilities. For example, sour candies in particular can be good for helping a child with poor self-regulation who is stuck in the "loose and floppy" mode to become more alert so she can focus and attend to homework or school work.

If your child has food allergies and intolerances, skip the highly processed, sugary treats altogether. Have a party instead of going Trick or Treating, and provide healthy, fun snacks and nonfood items such as stickers, pencils, and small toys.

Offer opportunities to escape from the noise and bustle of a party or trick or treating. A quieter street to walk down or an empty bathroom or bedroom where she can regroup will help her avoid sensory overload. Let her know what to expect from the occasion, from kids jostling her in doorways and running past her on the street to scary sounds and lighting changes like strobe lights at a Halloween party. And consider celebrating Halloween at a nature center, zoo, or cultural center with a quieter, more structured program, or having a small party at home.

You may want to use this opportunity to talk about fears and how to manage them. Books such as Go Away Big Green Monster by Ed Emberley, featuring a monster the younger child constructs then deconstructs as he turns the pages, can help ease anxiety about monsters and other scary creatures.

And if you do not celebrate Halloween, or your child finds it too scary, consider creating an occasion to give her the "just right" challenge of dressing in unfamiliar clothing and using her imagination to pretend she is someone else for a short time. Costumes and dress-up play encourage young children to break out of cause-and-effect, parallel play and graduate to cooperative, imaginative play, which are important developmental skills. Whatever you do on October 31, please be sensory smart and understanding of your child with sensory issues.

Copyright © 2009 Nancy Peske

Nancy Peske is an author and editor and the parent of a child who at age 2 was diagnosed with sensory processing disorder and multiple developmental delays. Coauthor of the award-winning Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, available from Penguin Books, Nancy offers information and support on her blog and website at http://www.sensorysmartparent.com She has been active in the SPD community since 2002.

Sensory Activities for Autistic Children

Advice For Parents of Children With Sensory Integration Disorder

Some children can overreact when exposed to too much environmental stimuli. This disorder involving the senses is called sensory integration disorder. If your child has difficulty in high stimulation situations and has a high level of anxiety or stress he may be suffering from this disorder. Sensory integration disorder can effect your child's learning development and behavior. It also causes difficulties with processing information from the five classic senses, the sense of movement , and/or the positional sense (proprioception).

This condition is usually diagnosed by an occupational therapist. There is no known cure but many treatments are available. One common sensitivity is to the sense of touch. If your child shows signs of sensitivity to his sense of touch here are some things you can do to make life a little easier for both of you.

1. Choose the fabric for your child's clothing carefully.

Children with SID will find fabrics like wool too scratchy and irritating. Purchase 100% cotton fabrics instead.

2. Be careful when choosing the style of your child's clothing.

Remove any irritating tags on the collar and look for loose fitting clothes.

3. Choose grooming products wisely.

Don't purchase soaps or shampoos with extra additives or dyes. These may be irritating and harsh to your child.

Disorders that may be related to SID

Autism spectrum disorders

Attention-Deficit/Hyperactivity Disorder (ADHD)

Temper Tantrums

Don't worry this disorder is more common than you might think. It's okay. With the right treatment and attention your child will be able to manage herself with this disorder and life can be more peaceful at home.

Ms. Talbert is a mother of three and editor of Healthy Moms - Parenting, Pregnancy, Health and Women's Issues.

She lives in Sacramento, CA with her family.

2012年8月27日 星期一

What Is Attention Deficit Hyperactivity Disorder?

ADHD, what is it exactly? Attention-Deficit Hyperactivity Disorder is a developmental disorder usually causing inattention, distractibility, impulsivity, and hyperactivity in children starting before the age of seven. ADHD is a chronic disorder that occurs in 3-5% of children worldwide.

The controversy surrounding ADHD has been around since the 70's. Some people don't even believe that ADHD is an actual disorder; others believe it has a genetic or physiological basis. Even more controversy surrounds the treatment for ADHD. Treatments include behavior modifications, life-style changes, counseling and stimulant medication.

Now a days anytime a child is hyper parents think it is ADHD. Between 2-16% of kids in school are diagnosed with ADHD and given medication for this disorder. Many kids however are usually misdiagnosed. Many symptoms of ADHD can be attributed to other disorders, many of which can accompany ADHD. Because such combinations of disorders appear together, this can complicate diagnosis. There are five behavioral symptoms that have been attributed to ADHD, but are actually not symptoms of ADHD directly. Many of these symptoms are misdiagnosed as ADHD when in actuality they are their own disorder and should be treated as such. The five problems are Anxiety, depression, disruptive behavior, learning disabilities, and sensory integration disorder.

1. Anxiety is a psychological and physiological state characterized by feelings of worry, apprehension, and fear. Anxiety can be triggered by a person, a place, or even by a feeling. The stimulus can even be unidentifiable outwardly to other people. It's harder to diagnose kids that have anxiety largely due to the fact that kids articulate their feelings much less than adults do. Kids with anxiety usually appear preoccupied or zoned out. This is due to their internal thoughts of worry. Kids with anxiety don't know how to handle or express their anxiety and perceive their threats as uncontrollable and unavoidable.

2. Depression is a mood disorder characterized by feelings of sadness, helplessness, and hopelessness that can result in an aversion to activity. Depression can impair thinking skills, memory, cognitive flexibility, and attention. People who suffer from depression usually seem out of it. They have trouble focusing, become irritable, and have a lack of interest or initiation. Depression has no one single cause. Family history, pessimistic personality, trauma and stress, physical conditions, and other psychological disorders can all be associated with depression. For others depression had not specific trigger or cause. Since children have more difficulty expressing their emotions, it's important to determine depression in children through the evaluation of the child's behavior in several contexts.

3. Disruptive Behavior is where a child will not settle down and becomes troublesome or disorderly. Especially in a school setting this can become a problem where the disruptive student doesn't allow the other students to learn. In some cases kids can be disruptive intentionally, to show off, be funny or look cool. However children that have disruptive behaviors usually feel frustrated and are rebelling against authority to bring attention upon them. These types of kids have not developed adequate self-control, which causes them to act out and ultimately cause distractions for other classmates.

4. Learning disabilities is a classification of disorders where a person has difficulty learning. These disorders have affected the brain's ability to receive and process information therefore making it terribly difficult for the person to learn. Because we do not know what causes this problem within the brain learning disabilities are impossible to cure. However, there are other ways to get around learning disabilities. Intervention and support are the most important options available to someone who have a learning disability. Learning disabilities in children can cause inattentiveness, disruptive behavior, anxiety and depression. There are many learning disabilities such as reading, writing, math disorders, visual perception, auditory processing, nonverbal, dyslexia etc.

5. Sensory Integration Disorder (SID) is a neurological disorder where the person is unable to coordinate sensory information as it comes through the senses. When present in a child, the child may appear inattentive or quite the opposite as hyperactive. This is caused by the child being oversensitive or under sensitive to the sensory stimuli surrounding him/her. A child with a sensory integration disorder may be distressed by loud noises, bright lights, rough textures, or smells; or conversely, may need to handle things, hang upside-down, or shout boisterously.

As you can tell from the descriptions of the each of these disorders, many of the symptoms are the same or very similar. Many of these disorders accompany each other and therefore the person may be dealing with several different disorders at the same time. Because many of these disorders are now affecting children as well its important to evaluate and diagnose properly. This way we can properly treat for the correct disorder and stop over-medicating of our children, which can cause them harm in their future.

Chiropractic Fundamentals - Neurological Integration in Children

Foot position

Postural control

Sensory Processing Difficulties - Understanding the Family Dilemma

With the diagnosis of Autism Spectrum Disorders on the rise, let's focus on understanding the accompanying sensory processing issues. Although sensory processing difficulties are a symptom of Autism, Sensory Processing Disorder and Asperger's Syndrome, every person can experience processing difficulties throughout life.

Also known as sensory integration, it refers to the way individuals respond to and process sensations. Our brains are constantly processing input from our sense organs (smell, touch, taste, hear, see and feel), even when we sleep. We usually don't notice the process, until it functions adversely. For example, all we need to do to overload our sensory system is navigate a shopping cart through a large grocery or house wares store. The overhead music plays while videos blare, smells rise and blend into one another, fans blow hot or cold air and overly helpful employees repeatedly pop out to greet us while we try desperately to stay in the left part of the brain so that we can get what we came for. Whew! By the time we get through the checkout, trapped between loud videos and beeping registers, we are feeling common symptoms of sensory overload: nervousness, simmering anger, headache and nausea. Now imagine how hard that must be for a small child or someone whose sensory system has difficulty processing the onslaught of stimulation.

Children have not yet developed the brain connections to tell us that they need to get away from the overwhelming stimulation. Instead, they scream, tantrum, run away or have potty accidents. Sensory overload triggers the primitive brain function of fight, flight or freeze and the body reacts without thought. The only goal is to survive, which temporarily hijacks the brain's executive functions, disabling logic, memory (retention and recall) and decision making processes.

For most of us, all we have to do is reduce or eliminate the excess sensory stimulation and the problem is solved. Usually our brains can sort it all, without conscious thought. Unfortunately, this task is much more complicated for someone when sensory processing difficulties are part of a disorder.

The entire family is affected when everyone is held hostage by the anticipation and prevention of rages or ear-piercing shrieks. Even the child feels helpless while he seeks to manipulate his world and the family system to avoid sensory issues. Often seen as behavior problems, these actions may actually help regulate the sensory system and bring it into balance. For the most part, behavior modification techniques do not work; the dysfunctional behavior is the result of a struggling brain process, not a goal-oriented choice.

When a family has a member with sensory processing issues, the choices are to continue living each day feeling powerless in a rage-reaction lifestyle or seek professional help. A neurologist is best qualified to make a diagnosis if Autism or Asperger's Syndrome is suspected. A specially trained pediatric occupational therapist (OT) can diagnose and treat Sensory Processing Disorder. A counselor who has experience with sensory processing issues can address the related anxiety and specific parenting techniques, which brings much needed relief to the family.

Generally, the whole family benefits by getting involved in the change process. An experienced counselor can help re-balance the parental power structure, lessen anxiety and resentment among siblings and coordinate treatment options with the school or daycare facility. Changing the way a brain functions takes time, commitment and active teamwork, which may frustrate parents who want a quick fix.

Lastly, remember to look for support from other parents who live with similar conditions. You can find support groups, information and professional referrals by accessing websites focusing on Sensory Processing Disorder, Asperger's Syndrome and Autism.

Sharon Cuff, MA counsels parents and children in Newtown Square, PA. She has over 25 years experience working with adults and children of all ages, stages and abilities. Call for an appointment at 484-437-0080 and visit her website at http://SharonCuffCounseling.com/

2012年8月26日 星期日

Teenagers and Sensory Processing Disorder: The Special Challenges

Teens with sensory processing disorder have special challenges because of the stage of development they're in and the fact that until now, their sensory issues may have gone unaddressed.

1. Finding the right OT can be difficult. Few occupational therapists are trained or experienced in working with teenagers who have sensory processing disorder. Play-based SI therapy may seem silly and embarrassing to teens.

3. Need for independence. Teenagers need to have their independence respected, so being told, "You need to do X, Y, and Z to manage your sensory issues" usually doesn't go over very well!

4. Desire to fit in. Even teenagers who don't feel the need to have a lot of friends or be conformist want to have some friends they feel they fit in with. Sensory challenges can embarrass them and may make them feel isolated, and different in a negative way.

What's a parent, teacher, or therapist to do?

2. Talk about sensory issues positively. Reassure your teenager that sensory issues are simply a difference in brain wiring that can have advantages but that can also be controlled and addressed to make life a little easier. Explain what SPD is and why in some cases, it's good to be extra sensitive or to crave certain sensations, and that people with sensory issues often have other gifts as well, such as the ability to "think in pictures." Then explain that there are "tricks" you and/or an OT can teach them to "make their lives easier." Everyone wants his life to be a little easier! Acknowledge how hard your teen has to work to be organized or tolerate certain sensations and praise her for her efforts.

3. Offer accommodations and sensory diet ideas for him or her to choose from. Present accommodations and activities to teenagers and let them decide which they would like to use. Honor and respect their choices and encourage them to engage in collaborative problem solving with you. If they don't want to be seen doing a brushing protocol for tactile issues, can they do it discreetly in the bathroom at school? If all the kids are wearing loose clothes and they prefer them tight, can the teen wear tight clothing, such as bicycle shorts, underneath looser clothes that seem more stylish?

4.Help your teen with sensory issues to feel okay as he is and find a group of peers he's comfortable with. Practical solutions for grooming, picky eating, and dressing, and encouraging talks about the upside of being different, can help your teen with sensory issues feel more comfortable among his peers. However, he may also feel better about himself if he expands his group of friends. Encourage your teen to develop hobbies and engage in new activities from individualized sports that don't require high levels of skill and competitiveness to enjoy them to groups that engage in the arts, community service, spiritual growth, etc. Extracurricular activities can help kids find their "tribe" and feel the power to make a difference in the world as well.

5. Accept that your child may be more emotionally sensitive at this stage. Be alert to signs of increased anxiety and depression and consult a medical health professional with any concerns you have. Remember, addressing sensory issues will reduce overall anxiety that can lead to mild or moderate depression (when you feel you can't manage your discomfort, over time, you can develop depression). Don't forget some of the most effective treatments for mild or moderate anxiety and depression include physical exercise, time spent outdoors, meditation, and breathing exercises. Mindfulness practices from yoga and tai chi to tai kwan do and karate can help, too.

Above all, never forget that kids with sensory issues need a "just right" challenge, a balance of accommodations to make them more comfortable and challenges that take them out of their comfort zone. Sensory diet activities for teenagers help them to develop a higher tolerance for situations and activities they'll encounter in life, and over time, retrain their brains to process sensory information more typically. Be creative and encouraging in setting up a sensory diet for a teenager, and always be collaborative to respect the teen's need for independence.

Finally, if you're a parent frustrated by trying to get your teenager's sensory issues under control, consider joining an in-person or online support group or creating one. Knowing that you aren't alone, and having practical and emotional support from other parents going through the same experiences with their teen, can help you enormously at this stage of your child's development.

Nancy Peske is the coauthor of the book Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues. Learn more about sensory issues at http://www.sensorysmartparent.com and visit Raising a Sensory Smart Child on Facebook.

What You Need to Know About Autism Spectrum Disorder - FAQs

What is Autism Spectrum Disorder?

Autism Spectrum Disorders (ASDs) is a disability that causes a hindrance to the patient's mental development. This is usually manifested by difficulties interacting socially and by delayed faculty developments. Autism can manifest as early as age three.

What are the different types of Autism?

There are five types of Autism Spectrum Disorder namely:

Asperger's syndrome - This is the mildest form of autism disorder. This is characterized by severe obsession about a single object or topic. When they become obsessive about it, they will try to study everything related to that object and they will not stop discussing it for a long time. Males are more likely to be affected by this syndrome.

Rett syndrome - It is a neurodevelopmental disorder in the brain that affects not only the social skills of the person but also his physical traits. This is characterized as having small hands and feet, decreased rate of growth and repeated body movements. People who are affected by this syndrome have no verbal skills.

Pervasive developmental disorder - This Autism Spectrum disorder is the middle ground between those diagnosed with Asperger's syndrome and Autistic disorder. It means that the person affected is not as good as a person with Asperger's syndrome but not as bad a person diagnosed with Autistic disorder.

Childhood disintegrative disorder - This disorder is very rare. It is characterized by normal to stopped development. A person with childhood disintegrative disorder develops on a normal pace at early age and stops at one point. An abrupt stop in the development makes them lose most areas of function.

Autistic disorder - This includes mental retardation and seizures. People with autistic disorder shows signs of repetitive movements and language malfunction.

What causes Autism Spectrum Disorder?

Some types of Autism Spectrum Disorder are considered as 'idiopathic' or originating from an unknown cause. Though a lot of factors relates to autism such as genes, vaccines and parenting, they are just correlation which does not actually pinpoint a cause.

Can Autism be passed on?

Though genetic play a big part in autism disorders, there no scientific proof to validate that claim. However, it is safe to assume that greater risks of Autism Spectrum Disorders can be expected from families with such history.

Does poor nutrition affect Autism?

Yes, poor nutrition definitely affects Autism. However, the same can be said about healthy people. Nutrition affects all aspects of health, whether you are in peak form or not. But poor nutrition does not cause autism.

What are the treatments available for people with Autism Spectrum Disorder?

1. Behavioral training - This type of training induces self help and positive reinforcements. This training includes Special Education and sensory integration.

2. Different therapies - Depending on the type of Autism Spectrum Disorder, the person affected may be needing physical, speech and occupational therapy. It targets different function areas to work properly.

3. Parental Support and training - This is particularly important when it comes to treating Autism disorders. Parents need to employ special care to make their child feel understood and cared for.

4. Medicines - This is used to tone down some symptoms of autism like stress, anxiety and obsessive-compulsive disorders.

If you are looking for information about autism spectrum disorder, we can help you out in understanding this concept. To learn more information about this disorder, this website can help you out on your concern.

Sensory Loss in Older Adults - Vision - Behavioral Approaches For Caregivers

As we age, our sensory systems gradually lose their sharpness. Because our brain requires a minimal amount of input to remain alert and functioning, sensory loss for older adults puts them at risk for sensory deprivation. Severe sensory impairments, such as in vision or hearing, may result in behavior similar to dementia and psychosis, such as increased disorientation and confusion. Added restrictions, such as confinement to bed or a Geri-chair, increases this risk. With nothing to show the passage of time, or changes in the environment, the sensory deprived person may resort to repetitive problem behaviors (calling out, chanting, rhythmic pounding/rocking) as an attempt to reduce the sense of deprivation and to create internal stimulation/sensations.

This article is the first in a series of three articles that discuss the prominent sensory changes that accompany aging, and considers the necessary behavioral adjustments or accommodations that should be made by professional, paraprofessional, and family caregivers who interact with older adults. Though the medical conditions are not reviewed in depth, the purpose of this article is to introduce many of the behavioral health insights, principles, and approaches that should influence our caregiving roles. This article addresses age-related visual changes.

A. The changes in vision that accompany aging include:

1. A loss of elasticity of the lens; this means the person is no longer able to focus or accommodate to changes in lighting conditions. (Starting in our 40's, glasses are needed to see fine print). It also means the older person cannot adjust to sudden changes in lighting, resulting in an uneasiness when leaving a bright room to enter a dark hallway, or finding seats in the dark in recreation rooms, or theater. Going in the reverse direction can be equally difficult: from a dark room to a bright area.

2. Decreased pupil size; the light reaching the retina is reduced, requiring more light to see. This results in the need for lighting 3x to 4x what younger people need to see clearly

3. A loss of transparency; with age, there is a yellowing of the lens in the eyes, making color discrimination more difficult, especially blue and green. Warmer colors, such as reds and yellows are perceived best, explaining why bright colors are preferred.

4. More susceptibility to glare, and longer time is needed to recover from the effects of glare;

5. Eye diseases and disorders, such as cataracts causing a clouding of the lens; glaucoma, resulting from increased pressure of fluids in the eye, damaging the optic nerve and impairing vision. Glaucoma, the number one cause of blindness in U.S., in advanced stages results in yellow halos around images. Macular degeneration may occur, where vision is distorted, and images appear different sizes or different shapes, and are missing a central element. Visual disorders may be secondary to stroke, in which the eye can see the image but the brain cannot interpret the images. Diabetes may result in disrupted blood flow to the retina, causing diabetic retinopathy and a loss of vision, and blindness, in extreme cases.

B. What are the effects of visual loss on the older adult?

1. An increased dependency on others;

2. A sharply reduced quality of life (changes in activities in daily living and instrumental activities of daily living, reduced connection with outside world);

3. And, a fearfulness and reduced tendency to venture outside.

C. What are the effects of vision changes on demented elderly?

1. With the losses in visual acuity, other problems in cognitive functioning are heightened, such as difficulty processing unfamiliar faces and settings;

2. Because the person with dementia already has difficulty learning new behaviors, he or she is less able to learn new habits to compensate for the visual losses (e.g., learning to use visual aids to identify articles of clothing or other possessions;

3. There is likely to be an increased disorientation and confusion, as the search for structure and external cues is strained.

The following principles apply to caregiving approaches with older adults who have diminished sensory function. Increased sensitivity and insight to the needs of these individuals improves their quality of life and improves our effectiveness:

1. Observe the behavior of the person, and look for cues and signs of pain or discomfort;

2. Help the person work through the emotional impact of the sensory changes, allowing expression, acceptance, and support of the grief and sadness accompanying these losses;

3. Do not try to fix the unpleasantness; acceptance and support goes a longer way toward healing than a quick fix or a patronizing attitude;

4. Reduce excess disability by maximizing whatever functioning is still left, such as proper eyeglass prescriptions, or functioning hearing aids;

5. Consider assistive devices (phone amplifiers, large text books, headphones, and the Braille Institute for a variety of useful visual aids).

Approaches for impairments in vision:

1. Address the person before you touch him or her, identify yourself, let him or her know when you are leaving, speak normally, and do not shout;

2. Describe his or her surroundings to help orient and familiarize the person to the environment, tell him or her location of belongings, and if things have been moved;

3. Use as much contrast as possible, e.g., red objects on white background is better than black on a gray background, or blue on green background, (consider switch plates on walls, toothbrushes, combs);

4. Avoid moving quickly from a bright room to a darkened room, or v.v. Make sure the visually-impaired person takes the time for the pupils to adapt to the changes in lighting;

5. Introduce yourself every time you come into contact with the person, and explain what you are going to do because there are no visual cues;

6. Help to identify others in their environment with colored clothing, name tags with large print, etc.

7. Clean eyeglasses regularly, provide adequate lighting, and avoid glare;

8. Provide night lights, and arrange furnishings in the environment for safety and ease of mobility.

Even with normal aging, functioning of our five senses is not like it was when we were younger adults. This article offers caregivers who work with visually-impaired older adults some insights into the special needs and adjustments that will turn unpleasant, frustrating situations into more caring, helpful, and sensitive interactions. By integrating these behavioral approaches in the delivery of the health care with older adults, we can favorably impact the management of these conditions.

Copyright 2008 Concept Healthcare, LLC

Joseph M. Casciani, PhD, is a geropsychologist who has devoted his professional career to working with older adults and their caregivers. His company, Concept Healthcare, http://www.cohealth.org, offers online resources to integrate behavioral health approaches in the health care of older adults.

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Ravencon Panels I AM Doing: Next Week’s Schedule

So, Ravencon is next weekend (so I PROBABLY won’t be doing a post next weekend for that reason, but there is a chance; more on that later), which means I’ve run out of time for the series on Ravencon Panels (I’m NOT Doing) so I can talk about the Ravencon Panels I AM doing.

The schedule may still change (I’ve been at enough conventions to know that schedules sometimes get altered minutes before the panel begins, though I haven’t known Ravencon to be quite that bad), but it’s as set as it ever is.  So, if you’re at the convention and want to find me, here are the panels I’m on (complete with current room locations (the most likely thing to change), Amazon links to my fellow panelists, and the panel descriptions:

I. Swords Not Required
Location:  Room G
Time:  Friday, 6pm-7pm
Guests:  Nancy Northcott, Jeanne Adams, Charles E. Gannon, and myself (Moderating).

Panelists discuss ways to arm characters in fantasy worlds without always relying on swords.

(Yes, I’m moderating my first panel at my first pro-appearance at a convention.  Gulp)

II. Mythology as the Basis for Speculative Fiction
Location:  Room 8
Time:  Friday, 10pm-11pm
Guests:  Mercedes Lackey, Bishop O’Connell (moderating), Christopher L. Smith, Jennifer R. Povey, and myself

Our panelists take a look at mythologies around the world; discussing their similarities and why some of them are so appealing to modern speculative fiction authors. Should myths be updated for a modern audience, or do you respect them as canon and hold to their roots? Does an understanding of mythology make better speculative fiction, and what is its current role within SF writing?

III.  Using Tropes to Tell Stories
Location:  Room 8
Time:  Saturday, 9am-10am
Guests:  Jim Bernheimer (moderating), R.S. Belcher, Bishop O’Connell, and myself

Cliches in fantasy and science fiction are a big no-no… except when they aren’t. The internet contains a lot of rants against tropes, but are tropes really that bad? What happens to a fantasy story that tries to avoid every trope? Is such a story revolutionary or unmarketable? Is it even doable? Panelists discuss the use and avoidance of tropes in developing storylines. What are the most-used tropes in SF/F? Why are they so overused? Are they always bad? Are there ways they can be twisted to say new things about the genre?

IV.  Building Worlds for Fiction
Location:  Room G
Time:  Saturday, 11am-12pm
Guests:  Dave Joria, Rob Balder, Mark Wandrey (moderator), and myself

Building a comprehensive world—whether it is for a novel, comic, or serial—can be a huge challenge. Join our panelists as they discuss tools, strategies, and both successes and failures in world-building.

V.  Self-Publishing 2017
Location:  Room G
Time:  Saturday, 3pm-4pm
Guests:  Philippa “Pip” Ballentine, Alex Matsuo (Moderating), Toi Thomas, Thomas A. Mays, and myself

VI.  Mechanics of Magic in Fantasy & SF
Location:  Room E
Time:  5-6pm
Guests:  Joe Wetmore, myself, Jeanne Adams, Nancy Northcott (Moderating)

Does a magical system for a story need rules? Costs, unintended consequences, social factors? What about reliability issues? How can we avoid worn-out tropes? How should magic in an RPG and story differ? Is some of the tech in SF “magic” and should the same considerations apply?

So that’s six panels, including a couple alongside the guests of honor.  Not bad for my first convention as a pro.

There are still quite a few panels that I’m NOT doing that are on topics I’m interested in.  I mean, I made up a schedule for myself, and if I did all the panels I’m scheduled for AND went to all the other panels I’m interested in, I would have a grand total of one one-hour break during the entire weekend (not happening; while I’ll be poking my nose into some of those panels as a fan, I’d wear myself out AND starve for the weekend if I tried going to all of them).  Unfortunately, if I haven’t gotten to those panel topics on this blog by now, I’m probably not going to any time soon, as I’m going to move into the Ravencon panel topics I will have actually been on.

I’d been trying to get The Merrimack Event done by Ravencon itself, but the cover art is going to be late (among other issues) and I don’t know if I’ll be able to finish building the book in time, even if it shows up between now and then.  I haven’t been talking about the possibility that often because, without the book cover, I don’t have anything I can show you guys… so maybe, if I DO get a blog post out next week, it will be with a Surprise! Book Release! Announcement.  (Heck, I don’t have anything scheduled for Sunday, currently, even if I’ll still be at the hotel… if the cover art comes in, and everything else is ready, I might spend the day putting the book together).  If not… well, it’s not like I asked Ravencon to fit a Book Launch into the schedule… (I thought about it, but thankfully didn’t; that would have been a mess).

And then, the next weekend following the convention, maybe I’ll start a new series:  Ravencon Panels (I DID Do):  My Final (?) Words.

Edit:  The convention is now over, and comments are closed because spambots keep trying to spam the comment section.

Ravencon Panels (I’m Not Doing): One Man’s Villain Is Another Man’s Hero

This is the fifth in my series of blogs on panels at Ravencon I’m NOT doing.  For further explanation, see my earlier blog here.  (I noted last week I had apparently been cut from several of the panels I was originally scheduled for; well, the program guide has been… well, not quite finalized, because these sorts of things tend to change at the last minute, but close enough — they’ve made a PDF of the schedule public here. In the end I was put back on some of those I originally feared I had been cut from, and should now be on listed on six panels, which (assuming nothing changes) I’ll mention next week.

One Man’s Villain is Another Man’s Hero

Here is the Ravencon write-up for this panel:

Twirling mustaches and obvious evil plans are a thing of the past. Today’s villains and heroes are as complicated as the world we live in. Discuss with our panelists what makes the difference between villain and hero, and how thin that line can be.

Once again, we’ve got an interesting topic.  Now, I’m not sure you’ll find many complex villains in my own novels (I try to focus on developing the heroes at the start of a series, with the villain getting more development later in the series.  Unfortunately, it’s still very early in all of the series I’ve released, so my best villains haven’t shown up yet.  That’s partly why I didn’t sign up for this panel), but I do know something about the topic nonetheless.

It’s actually fairly easy to advise people on how to make a complex villain.  “Give your villain a sympathetic back story,” and “everyone is a hero in their own story; your villain must think he’s doing the right thing” are things I’ve repeatedly heard.  That seems to just be common sense… although (a) common sense is not common and (b) sometimes the story you’re writing doesn’t make it easy to show your villain’s point of view.

There’s also the matter that, well, there have been plenty of popular stories with popular villains who aren’t exactly complex.  While a powerful force of nature and a great danger to all of the people of Middle Earth, Sauron is a fairly straight-forward villain who didn’t need a sympathetic back story to become the main villain of Lord of the Rings (now, he did GET an interesting backstory when the Silmarillion was released, but that wasn’t published until almost twenty years after Sauron was introduced to the reading public).  While the now-non-canon expanded universe did eventually fill out his story, Boba Fett was a villain who became a cultural icon from his physical appearance alone.  His past was a mystery (some people actually think his character was weakened when it was filled in), his motivations were unclear, he had a tiny role, and yet he developed a fan following as big as many of the major villains of the series. (In fact, much of the backstory for him was created BECAUSE he became so popular, if I understand things correctly)

And the villain doesn’t have to be a person.  A “villain” can be a natural disaster, for example, or simply surviving alone in the wilderness.  While not typical of fantasy or science fiction (my main genre), there have been a number of stories where the big struggle is surviving against the odds, and those odds aren’t someone else at all. It can, though — one of the biggest hits in recent years is The Martian, which features a struggle to survive in an alien landscape.  Mars itself is the villain of the story… well, sort of.  “The elements of Mars,” perhaps?

But this topic is specifically about creating a complex villain, and saying (effectively) “give them a sympathetic back story” might not be enough help. It’s a great piece of advice; if you’ve ever seen Batman: The Animated Series, their sympathetic treatment of Mr. Freeze took a Batman villain often considered a comic laughingstock and made him into a major villain that many people could hope succeeded some day.  In fact, I’d argue that series is a virtual blueprint for creating sympathetic villains.  But just that line itself — “Give them a sympathetic back story” — is, well, not enough.

It’s too generic of a piece of advice, and honestly it isn’t always true.  I’ve read many an amateur effort at writing (thanks to my background in fanfiction) where the writer tries too hard at giving the villain a sympathetic back story, and while the villain may be “sympathetic” (or not; if the ‘excuse’ for becoming a villain is too weak, it feels like “Really? That’s it?  That’s why this guy is trying to take over the world?”), but if you make things go too far your villain can appear… well, pathetic, not sympathetic.  So perhaps just “try and give them a sympathetic backstory” isn’t the best piece of advice.

So, what else can you use to make your villain seem complex? Well, how about using other techniques for making a villain compelling and complex.

In the Lord of the Rings, we know next to nothing about Saruman’s back story… except that he was supposed to be a good guy, in fact a leader of good guys, who turned traitor when he thought he was going to lose.  As a villain, he is more complex and compelling than Sauron.  It’s a common technique for the creation of a villain; TV Tropes refers to it (using wrestling parlance, of all things) a “Face-Heel Turn.”

One of the best-known villains in the world of mystery novels has almost no backstory, sympathetic or not, but he is thought to be complex and compelling because, well, he’s basically a villainous version of Sherlock Holmes (I am, of course, referring to Moriarty).

If your villain has a complex, intricate plan, and your reader can follow along with it (even if they may not know the villain’s true end goal), that can make them seem complex and compelling. It’s a method a lot of television shows with a-plot\b-plot formats (the episode has a specific “a” plot that is the focus of that episode’s story, but there’s also elements from an overall seasonal “b” plot) use.

So, there are many ways to create a complex and compelling villain… if you need one.

The panel is officially described as:

So, let’s cover some of these rules, shall we?

The panel description mentions:

A.  One POV per Scene:

B.  Don’t Use Adverbs:

Ravencon Panels (I’m Not Doing): Gearing Up For War

This panel is described in the (still just a draft) write-up as “Depending on the time period, terrain, and the nature of the fight, you’re going to need different kinds of kit. We’ll discuss how human beings prepare for battle physically and mentally — and what that says about their society.” I really feel under-qualified for the topic of mental and physical preparation, and I don’t even want to touch the one about what these preparations “say about society” (talk about a land mine for those of us who try to maintain politically neutral public faces!).

But discussing military kit? That I can do, if only from the perspective of a military history buff who’s done enough research into this topic to know (at one time) what people were supposed to receive in a few historic kits by heart. (Okay, so, um, my focus was the history of the US Sailing Navy, but sailors needed kits, too!  And it has been a while since I last studied this, so don’t test me; I probably can’t recite everything from memory, any more)

Now, one of the things to remember is that, until the last century or so, a soldier’s “kit” was largely theoretical. Some bureaucrat somewhere would write up a list of what was supposed to be in a soldier’s kit and set a budget (usually below what was actually needed) for obtaining these supplies; some lesser bureaucrat elsewhere would receive the money to put these kits together, skim some of it off the top, and then toss it down the chain. Each toss down the chain to the next layer of government usually meant less money for each kit, to the point that soldiers and sailors rarely received much the kit they were assigned.

But, for the sake of our sanity, let’s talk about what was SUPPOSED to be issued to soldiers and sailors throughout the various eras we have records for… and we have records, in some cases, dating back to Roman times.  Sometimes the government paid for these kits, sometimes the soldier or sailor were responsible for paying for these things themselves; sometimes the kit was required to fit a uniform standard and design, and sometimes the soldier or sailor (or, especially, feudal lords\knights) could customize or fit themselves out on their own, and sometimes some things were provided and you had to pay for others.  Usually, the only ‘advantage’ of paying for your own kit is the ability to customize things.

Regardless, whether you were a Roman Soldier or a member of the modern military, there are several things which are common to every soldier’s (or sailor’s) kits:

Some form of weaponry.  Whether that’s swords, spears, bows and arrows, or firearms, you would get a weapon (sometimes more than one).  At times in history, the weapons would not actually be issued with the kit, but handed out right before battle; regardless a weapon of some type should be considered part of the kit.

Body armor.  Note that this isn’t always a part of your kit; early Roman infantry soldiers wore none to increase speed and ease of movement (and as a cost-cutting measure), though later on various different types of armor were developed and issued.  Sailors from the Napoleanic era certainly didn’t wear armor into battle (though Spanish officers sometimes did).  Frequently, armor was something the soldier would have to pay for out of his own pocket (or get docked out of his pay), as it often had to be custom-fit to the person wearing it.  Today, soldiers are usually issued body armor (bulletproof vests) as part of their kit, though occasionally soldiers may purchase “civilian” gear if the issued equipment is defective or insufficient and replacement gear is slow to arrive (this is technically not permitted in the US Army, but the rule has been relaxed and\or ignored at various times of crisis).

An “entrenching tool” (aka, a shovel) were part of most soldiers kits (though not most sailors, as you obviously aren’t going to be digging through your wooden ship’s decking; in its place, however, sailors were issued tools for splicing rope or similar Naval tasks).  A soldier needed his shovel to be able to dig out camp latrines, dig in temporary fortifications and trenches, and more.  Plus, they could work as a backup weapon in a pinch.

Usually, soldiers were also issued clothing.  This could be something as simple as basic livery to go over your armor, or multiple types of uniform for use in different times of the year and on different occasions.  This can include not just the obvious uniform pieces, but also things like socks, shoes, underwear, belts, etc.

A water containment device (whether that’s a waterskin, a canteen, or something else).

Cooking gear of some sort.  You might not have the tools for gourmet cooking on hand, but some way to build a fire and hold food over that fire is quite handy.  You also need some method of eating food given to you, so a bowl for soups and stews, a spoon, a knife, a fork if they’ve been invented… that kind of thing.

An axe or saw for cutting wood.  Because you need some way of getting fuel for those cooking fires.

A satchel\backpack\bag of some kind.  Because you’ve got a lot of gear you need to carry around.

Bedding.  This could be anything from just a simple blanket to a full-on kit for a tent, a sleeping bag, a rain tarp, and more.  The most original bit of bedding kit I recall is from the American Civil War, where soldiers were each issued HALF of a two-person tent; if your buddy lost his gear, you were out of luck.

Frequently, sewing supplies were a part of a soldier’s kit.  Soldiers and sailors were responsible for the maintenance of their clothing, so having a needle and thread were handy.  Plus, it gave you something to do in your downtime.  Macramé may popularly be thought to have its origins in the fringe work of arabic carpets, and in modern times is often stereotypically found in some hippie peacenik fashions, but making it was an extremely popular hobby among 17th, 18th, and 19th century sailors.

Finally, most soldiers starting out get a small supply of consumables — some hard tack biscuits or similar emergency rations, a half-a pint of rum a day (usually watered down into grog on shipboard), gunpowder when needed to support a black powder weapon, oils for maintaining equipment, soaps for keeping clean, etc.  How regularly these consumables were replaced (or whether they were replaced at all) varied from army to army.

Specific parts of the military might get special items, as well.  For example, if you were in the horse cavalry, you’d probably get special gear for your horse (while I know this is true, I’m fuzzy on the particulars of what would be issued).  Scouts might be issued some form of looking glass (binoculars, special sights, etc.).  Etc.

Of course, even if the military provides all of that, there were still things soldiers and sailors loved to add to their kit whenever possible.  Games (such as chess sets), cards, small musical instruments, and other material designed for entertainment were often more of a necessity than the shovels, cooking gear, and spare underwear, but rarely would any government service give them to their soldiers for free.

And if you’re a writer, you may need to add a few more unusual items to the kit, depending on genre.  I mean, if you’re writing a sword and sorcery, any magical characters may require certain components for ammo.  In certain science fiction universes (think Star Trek), some sort of portable sensor (think tricorder) would likely be a part of your kit.  That sort of thing.

As a writer, you may never need to let your readers know everything that’s in your fictional character’s kit, but it’s generally a good idea to keep track of the resources your character has as a writer.  Otherwise, you might wind up in a situation where your character has a ridiculous number of little-used items (like, say, Bat Shark-Repellant) that can turn the whole thing into a joke.  And it’s a good idea to get some idea of how much a soldier can store on themselves — it’s probably more than you think, but less than you want — while composing your characters’ kits.

Of course, like every other bit of writing advice you might receive, it’s not a hard and fast rule.  After all, the 1960s Batman is still a popular cultural icon, Bat Shark-Repellant and all…

Edit:  Comments closed due to multiple spam attempts.  E-mail me if you want it re-opened.

Edit:  Comments closed because of multiple spam attempts.

A few recommendations for further reading:

(For Free)

Roman Dress

Sengoku Daimyo

Rosalie’s Medieval Woman

The Viking Answer Lady

(For Bookstores\Libraries)

The Tough Guide to Fantasyland by Diane Wynne Jones

1001 Inventions That Changed the World by Jack Challoner

Book of Old-Time Trades and Tools

Edit:  Comments closed due to spam attempts.

Ravencon Panels (I’m Not Doing): Imposter Syndrome

Catching Up….

A new year, and I’m back to work on my regular blog.  My (ir)regular Sunday Blogs will be returning, soon, but there are a few things that came up during my absence I think I should mention first:

  1.  I did manage to complete the anthology submission I was preparing that prompted me to suspend the Sunday blogs.  I’m hoping it will make it in to said anthology, but if it doesn’t I’ll probably self-publish it under Fennec Fox Press.
  2. Some software issues have cropped up on this blog regarding some of the plug-ins.  I need to contact my ISP before I can start these fixes, and I’m not sure how long they will take or if they can even fix it.  Don’t be surprised if there are temporary outages as I get this sorted out, or if certain features appear and disappear.  I might also test a few new themes that have become available, so don’t be surprised if the blog changes appearance a few times over the course of the next couple weeks.
  3. I’ve also had hardware issues; my laptop has been on the fritz (it’s taken to overheating at irregular intervals), so I took advantage of some Black Friday\Cyber Monday Sales and bought a new one.  The new laptop is here and running, and has all the software I need to make it go, but until recently I couldn’t transfer my files over easily.  I’ve just got the tools needed to make this transition, but there WILL be  a transition period.  I write this blog on my laptop, so it might take some time away from writing my next blog entry.
  4. My original plan was to try and get In Division Imperiled out by Ravencon (which, if you’ve forgotten, I will be appearing at as a guest).  This plan is looking less and less likely, as I’m far behind on my writing (having to set the project aside for a time in order to complete the anthology entry in time).  At the very least I wanted to have the cover art to show, but my cover artist is too busy to take on the job right now.  I might consider another artist, but I’d prefer someone who works in a similar style as the old covers.  I have a list of other artists who I’ve been considering for other projects, and one or two have similar art styles, but so far none of the ones I’ve checked out are free, either.  I’m still looking… and writing.
  5. One option I’m considering is to finally push The Merrimack Event out the door.  That would likely mean further delay for In Division Imperiled, but as it’s already a complete manuscript it would be easy for me to get everything done in time of Ravencon.  I haven’t made any moves in this direction, yet, but it’s something I’m thinking about.
  6. There’s been news in the world of self-publishing over the past few months I might comment on (for example, the closing of All Romance eBooks\Omnilit, an eBook retailer which (fortunately, it turns out) I had never puzzled out how to list my books on).  I’ve been too busy to comment on it when it was new news, however, and I’m not sure I want to bother with it now.  But maybe I’ll talk about them if new events come up.
  7. For Christmas, among other more practical gifts, I recieved a pair of toy fennec foxes (stuffed animals. two different sizes).  I’m thinking of making them mascots for Fennec Fox Press, but I need names for them.  Any suggestions would be nice.
  8. I badly need to update the convention calender.  It’s not been updated in over half a year, so a lot of data in it is missing or outdated.  Again, it’s something that will eat time away from the time I have to write my Sunday Blog, but I’m not going to fiddle with it until I can fix the plug-in issue and complete the new laptop transition mentioned above.

Well, that’s what I’ve got time to write about this week.  I may go into more details on one or two of the topics mentioned, above, or (more likely) I’ll come up with something else to talk about, but while it may be even more irregular than usual, I’m resuming my “regular” Sunday Blog starting now.


By Ben Axelson | NYUP,

The shooting happened at 1:56 a.m. Monday outside a friend’s apartment building. Police were also questioning a fourth person who may have been in the SUV with the three men.
No arrests have been made and the investigation is ongoing.

“These people came here to flee violence and war, and they end up in the wrong place and get killed,” Bickett told the D&C.


What ya Doing for the Winter Solstice?

The original concept of yin and yang
came from the observation of nature and the
environment. “Yin” originally referred to the
shady side of a slope while “yang” referred to the
sunny side. Some examples include heaven and
earth, day and night, water and fire, active and
passive, male and female, and hot and cold. All
things have yin and yang properties.

Building Power

Lately we been hearing and seeing a lot of mixed
marshal arts, including “The ultimate fighting
championship” made popular by the Gracie brothers.
Although it is a ruff sport the athletes who are
fighting are in top condition- mentally,
physically and hopefully spiritually. Some may
find it violent but I don’t I get energy from watching the sport.

web design by sli Studios


Christine has a very deep understanding of biomechanics and the how the muscles of the body are structured and impact movement. I went to her with three issues, calf cramping and pain while running, lack of hip rotation negatively impacting my golf swing and neck pain when cycling.

Very quickly she identified a variety of tight joints and muscles as well as some poor posture habits. Once we began treatment the results were immediate and I have realized incremental improvement with every session I have with her. I highly recommend Christine’s services.

Norman L., - Sports Massage. Results: Immediate and Incremental Improvement with each session