Reason 2: SPD produces paradoxical behavior
Updated: Mar 7, 2020
Last summer, while reading all. of. the. books about Sensory Processing Disorder, I kept trying unsuccessfully to view my son through the lens of a single sub-type of the disorder. Was he under or over-sensitive? Sensory-seeking or sensory-avoiding? I felt my confusion mount as I observed his paradoxical behaviors, which didn't seem to fit cleanly into any type of sensory category at all and even worse, appeared contradictory.
What I eventually learned outside of the sphere of books and academic articles, was that T was D) "all of the above". He was under sensitive to the body-based systems and over-sensitive on other sensory dimensions (taste, sound, smell, touch, and sight). This apparent discrepancy was a primary reason that it took us so long to understand what was going on and to start getting help for T and our family.
The best way for me to explain what I mean by "paradoxical behavior" is to illustrate it using examples of my son, with the hope that this will speed you along your path to clarity at a faster clip than my own. I should also add, the good news about sensory stuff, is that once you can identify the unique profile of your child (there are 260,000 of them!), you can set up support systems in your home and begin work with an occupational therapist to help him or her with sensory integration.
Paradox 1: Touch and Embrace
Since he was born, my son has leaned or jerked away from my attempted embraces. Sometimes this was subtle and it appeared he wanted to be put down or to go in a different direction with his body. Other times he would fuss, cry, writhe and twist away, so that he would fall out of my arms, and I had to rush to recover my center of gravity beneath him, like he was a spinning plate that could easily topple.
Although he leaned away from me, T also wanted to be constantly held, carried, or pressed against my body. He would motion to be lifted up, and then would tilt away again. I eventually learned to resist the instinct to wrap my arms around him, and would let him be on me, while I held my arms more open and underneath his bottom, or if sitting, relaxed by my side. T did not learn to hug consistently and voluntarily until about the age of three, when he reached a cognitive milestone where understood that it was a gesture of affection and a social convention.
So while our little guy was avoiding my different types of touches and hugs, he was also constantly seeking physical contact, pushing his body against mine with all his force or climbing into my lap, lifting up his feet, and letting his entire body weight rest against the trunk of my body. He touched my face constantly. To this day, when he is uncomfortable in a new place - like a new friend's home - he will drape his entire body across my lap and if his limbs extend too far beyond the contours of my body, he pulls them back in, so as not to bear any of the weight. If I am standing, he will lean fully against me, to the point that if I move too far in one direction, he will fall to the ground. This has happened more than once, because there is only so much a mother can take.
How is it that my son never wanted to be hugged, kissed, or touched affectionately, yet wanted to be constantly pressed against me and touching my body? Perhaps he was a mercurial cat, one that only climbed onto laps when the owner was distracted with a book and a cup of tea. But this analogy didn't make sense, because his physical contact appeared much more like a hyperactive puppy with no body awareness, full of snot and spit and flailing limbs and random paws.
SPD explanation: T has under-sensitivity in his vestibular and proprioceptive systems and also has over-sensitivity to tactile stimuli. His over-sensitivity to touch makes him shy away from embraces, hugs, kisses, caresses or the light touches that I so enjoy pouring all over my neuro-typical one-year-old. This is particularly true when contact is initiated unexpectedly or offered by someone other than me or his father. At the same time, T doesn't have a good sense of where his body is in space so he craves feeling the sensation of deep pressure and full, deep envelopment. He has poor core and postural control and so - to the extent that he is allowed - will use another's body as a proxy for his own, as a stand-in for his lack of balance and body stability. Another twist, which I will discuss more in the "Reason 3" post I have yet to write, is that this behavior is not consistent across emotional states, contexts, or people in his orbit. He is a smart kid and he knows to resist these behaviors with particular individuals or situations. Because most people don't like being human bean bags. At least I don't.
Solutions: The real solution to this behavior will be long-term occupational therapy to help him with sensory integration. In the meantime, however, I also provide him with deep pressure (bear hugs, laying on top of him, etc.) - anything that doesn't involve him running from another room at top speed unannounced and launching his five-year-old lanky body onto my husband's tweaked back or smashing me to the ground while giving me a hug goodbye. I also always ask permission to kiss or hug my son. As awkward as this may seem, it allows him to feel in control, which for Mr. T, is the name of the game. Nine out of ten times he will say "yes" and I will lay a consensual, sloppy kiss on his smooth freckled cheeks.
Paradox 2: Eating
By the age of four, my son avoided eating most foods and would often flee the table or have meltdowns during mealtimes. He seemed to panic around the concept of eating. At the same time, he spent much of the day asking for "snacks". Oddly, these "snacks" would be the same foods we had offered at a mealtime, which he had summarily refused. You may think, Well of course he was asking for things to eat, he was hungry! But the strange thing was, when I gave him things like chips, pretzels, popcorn - the crunchy, dry things his mouth could tolerate and keep track of - he would let half of it fall out of his mouth and quickly lose interest. This baffled me.
SPD explanation: Soon after I started occupational therapy with T in D.C., the therapist pointed out to me that my son was an "oral regulator"- he uses chewing, sucking, or putting things in his mouth to soothe himself. Turns out, he was not asking for snacks solely to fill his belly, but rather to calm himself down. When I looked at it through the lens of sensory input and self-regulation, this made total sense. T had always had something in his mouth, usually a pacifier, which he hadn't really been without since he was two weeks old and I forced it on him, in an attempt to stop the incessant crying. To this day, he sleeps surrounded by a bevy of "binks" that he rotates in and out of his mouth instinctively, sucking and chewing while sleeping throughout the night. It was around the time that my husband and I started trying to reduce the binky use at four years old, that T started constantly asking for snacks. He was simply trying to replace the oral stimuli of the pacifier with another thing he could put into his mouth - food.
So what about the meal-time-specific issues? This is kind of a doozy, and one that is still a struggle. Surprise, surprise, this challenge also has to do with sensory challenges, although involving different systems. As I mentioned before, T doesn't know where his body is in space, has poor sense of balance, and as a baby and toddler avoided developing core strength and postural control because of the discomfort it gave him. This makes it very, very difficult for him to keep his body upright and motionless, producing a wiggly, distracted, boy who falls out of his chair and uses one leg to stabilize himself, and often resembles a child with ADHD. Imagine this child, struggling to sit still in addition to trying to overcome his over-sensitivity to taste, texture, and smell. It was simply too much to ask his body and he basically stopped eating at mealtimes.
Like the smart boy that he was, though, he continued to request "snacks" because it was a synonym for "not having to sit at the table" unbeknownst to us. During snack times we were "less formal" (truthfully, we were just giving up at this point) and would allow him to eat in the car seat or on the couch, just sighing as we watched him crunch food and spray crumbs into every crack and crevice. It now makes sense that he preferred the car seat and the couch, as both supported his upright posture, neither required core strength he didn't have, and both the contained seat and the plush pillows would allow him to sink in and feel the contours of his body.
Solutions: On the home front, we started replacing "snacks" with things like "chewelry", gum, rubber straws on water bottles, and continued allowing him pacifiers when he wasn't at school. (Dentist be damned, we had bigger, more devastating fish to fry in our family at the time).
In terms of the vestibular and proprioceptive issue - this has been more challenging for us. At first we used a bouncy peanut and fidget spinners to provide sensory input and movement while eating at the table. This worked for a while, but now we are in feeding therapy with our Michigan occupational therapist and explicitly working on T sitting at the table during "family-style-ish" meals so that he can have maximum exposure to new foods. The sitting continues to be incredibly difficult for him. Our big win is that he can sit about 8-10 minutes eating as long as one of the parents is directly next to him encouraging and co-regulating with him. As soon as he is alone at the table, he is up and about, poking his brother, checking on the living room, running his fingers over a mirror... On most days, and because we have a one-year-old and we also have to serve and eat food (because, life), T uses an ipad after he finishes his "learning" portion of the meal. The ipad helps him stay in his seat and distract himself from sensory issues enough that he will consume sufficient calories. It's a work in progress. From my understanding the sensory integration therapy at OT will help his body feel more safe and stable at the table, but as I mentioned before, this is a long haul.
Paradox 3: Motion and Movement
From the moment he could walk, my son was in constant motion and seeking out things like jumping, swinging, crashing, kicking, and running at all times. At the same time, he seemed to despise every organized activity that involved gross motor skills and physical distance from one of his parents.
My son has always had two speeds - manic motion or soundly asleep. So logically, we thought sports would be a good outlet for what we (as naive and perhaps optimistic first-time parents) thought was an abundance of little boy energy. We tried swimming lessons because he loved the water and had always loved baths. They were an epic failure. T clung to my husband the entire time, refused to participate and whined and twisted away, when asked to try. He literally would not leave my husband's body. After only three lessons, we abandoned them. We tried a pre-K soccer team because T had liked kicking balls with us in the backyard. However, when we tried an organized team, with one of his friends from the neighborhood, he hated it. T simply refused to participate in any of the drills or games, regardless of my encouragement and cajoling. Instead, he ran off and looked for sticks or threw himself on the ground, cried, waited for snack and then refused to eat it. We gave up a third of the way through the season.
We tried dance lessons because he loved jumping around to music, but he couldn't follow any of the prescribed actions, activities, or circle activities. About ten minutes into each class he would enlist another willing child participant to race out into the hallway or sneak behind the auditorium stage. I tried to hold his hand as we did the motions together, while the other parents stood on the sidelines, chatting, sipping their coffee or looking at their phones. To my astonishment and confusion, they were still living their lives like normal people.
SPD Explanation: Because of T's challenges with balance and knowing where his body was in space, he was quite delayed in his gross motor planning (executing ideas with his body in a coordinated way). This was something we hadn't realized, because he simply opted out of anything that required this - building, climbing, organized games at school, etc. We were confused because with us, in an open-ended, low pressure context, he had sought out crashing/smashing against a ball, feeling the water against his skin, or the movement of dance. However, because of his delays, he hated being asked to complete specific motions that he had trouble mastering. This was compounded by the fact that he was watching other children execute these skills without a problem. He couldn't make his body do what he wanted and he knew it.
Solutions: We threw in the towel on organized sports (for now) and try to do sensory input activities that he enjoys, without the pressure of organized movement or activities. This was ( and likely will be) a hard one for me, since sports like soccer and skiing were a huge part of my life growing up. My husband played football in high school and loved it. This is one of those, "accept the kid you have" aspects of parenting that I work on every day. Oh and additionally, occupational therapy is helping with this.
Paradox 4: Sound
When I discovered fairly recently that T is oversensitive to auditory stimuli, it was utterly counter-intuitive. From the moment he emerged from my body, he was making an inordinate amount of noise. Screaming his way through his first four months, then morphing into a baby and toddler that couldn't control his volume - screaming, shouting, smashing things - like a little whirling dervish with a wake of destruction in his path. So the idea that he was sensitive to sound had never crossed my mind. For example, he never put his hands over his ears when I did things like grind coffee, use the Vitamix, blowdry my hair (the five times I accomplished this since he was born), or when a siren rang out or the train rumbled by at the nearby metro station.
However, once T had made enough progress with occupational therapy, he started identifying sensory input accurately and began to articulate what was bothering him. Only now at five years old, has he started putting his hands over his ears to signal discomfort. We have started using noise cancelling headphones in certain situations like museums or when we grind the coffee. Now I notice his pupils dilate and his brow furrows when any loud or unfamiliar sound occurs. It kind of broke my heart when T told me a few weeks after we arrived in Michigan that he "never really slept well in (our town outside D.C.) because of all the noise and light". Small town in Michigan it is.
Solution: You know the drill. Go see a professional. Because parents, this shit is for real.
In summary, friends, even though these will likely not be your son or daughter's paradoxes, hopefully this will give you a few ideas of what seemingly contradictory behaviors look like in "real life". Don't let confusion or complexity stop you from getting the help you need. My best advice would be to follow your gut instinct if your kid seems "not typical" and find medical providers and a support team that will believe your gut and not simply try and find reasons to dismiss your worries. There are professionals who know a lot about this sensory stuff. You got this.