Sensory Integration and Older Children and Teens : Helpful Activities and Accommodations
Sensory integration dysfunction can continue to affect older children and teens. Recommendations for sensory integration activities and accommodations suitable for teens are provided in this exclusive interview with Nancy Mucklow
Interview by Allison Martin
Why does sensory integration functioning matter to older children and teens? Isn't it just an issue for young children?
I think currently the schools and the OT profession have circled the wagons around young children, focusing on early intervention. Early intervention is without question the best plan. However, most children with Asperger syndrome, Tourette's Syndrome, PPD-NOS, and ADD-like syndromes don't even get diagnosed until they are 9 or 10, or sometimes even older. By then, they have pretty strong ideas about things. They can be stubborn. If they don't think something makes sense, they won't do it.
Basically, older children need to understand why they need therapy (or accommodations), what it's for, how it works, and most of all, why it matters to them. And we know from years of neurological research that when children aren't engaged in what they are doing, they don't learn. So if they're not engaged, then it's all a waste of time and money.
Do sensory integration issues get better as children grow older?
I'm not an OT. But the brain is a marvellous thing, and research shows that it teaches itself all the time. Even if there were no such thing as occupational therapy, many, many children with sensory issues would eventually teach themselves around some or even most of their issues by the time they are adults. Not all children, but many. The problem is that it will take a long time. In the meantime, the child lives a confused and unhappy life. This confusion and unhappiness can take over the young adult life as well.
Perhaps a better question to ask is: Does sensory integration therapy get harder to do with children as they grow older? I think the answer is yes. OT administered by an adult (usually female) can feel very babyish to a young teen who wants to be independent. They start refusing to do things, they shrug, mumble, and go through the motions without trying if they don't see what's in it for them.
So then, do we abandon children with sensory issues after a certain age and just cross our fingers that the problems will go away? Or do we give the children themselves the information and tools they need to make informed decisions? Do we, in effect, hand over the reigns?
How does coping with sensory integration disorder and therapy change as children become teens?
Older children and young teens are far, far more aware of their differences from others than younger children. As a former middle school teacher, I would say that Grades 6-8 are the cruelest years. Children become so self-conscious at that age that they harm others to boost themselves. The risks of depression and dropping out in the subsequent teen years are high. Older children who are sensation seekers are also at risk of substance abuse. These are big, big issues. So it's important for these children to take ownership of their sensory issues, understand how their own senses work, have strategies in mind, and take control.
What are some activities teens might do for sensory integration issues?
Teens have to explore, try things out, weigh pros and cons, and make their own decisions themselves. That's the whole point. Each child has his/her own mix of hyper- and hyposensitive senses and his/her own history. In the book, we refer to these as their players on their sensory team. Children have to get to know their own team and tailor their coaching to those players. Nobody - not even the world's best OT - is going to know your team better than you.
The activities I listed in the book are those that older children and young teens are most likely to want to do. There are no embarrassing, icky, babyish, or awkward activities. But still, some are social activities (clubs, classes, groups, etc.), and some are solo activities. Some are big and out in the open, and some are small and covert (hidden). Some are recognized sports (trampoline, martial arts), and some are just little tricks that work (chair pushups, finger stretches). Personality, preferences, and skill levels will affect what a child chooses to do.
Moreover, some OT activities that work really well in a clinical practice with small children might not be something a young teen would want to do of his/her own choosing. Take brushing (Wilbarger protocol), for example. It's a great technique, very helpful for about 50% of SPD children. However, it has to be done by another person. You can't "brush" yourself. So a young teen can't do it on his/her own. Meanwhile, brushing by someone else might be experienced as being embarrassing. For some teens, that is a big X beside that activity. They don't want adults running the show or touching them. And adults need to accept that decision. So instead of the Wilgarger protocol, that teen could use loufahs and sprays in the shower to get a similar type of sensory stimulation once a day.
Having said all that one activity set deserves a lot of attention: the Mouth Tools. These activities are so unnoticeable to others and so effective that every young teen should have his/her own preferred set handy.
What types of accommodations might teens with sensory integration issues use?
Accommodations are tricky, because accommodation means "different." At this age, nobody wants to stand out.
One trick to making accommodations work is to make them a lifestyle choice. I know of one young teen who decided her entire wardrobe would comprise three colors: red, black, and white. This way, she was always guaranteed that her clothes would match without wasting time in the morning. Everything was cotton, fleece, or another smooth, soft fabric. Since she would only buy three colors, she found used clothing shops were the best place to shop. This meant she always bought pre-washed clothes that were extra soft. To her friends, she was just a quirky, original, and creative dresser. In reality, she created an interesting lifestyle that accommodated her need for soft clothes and her dislike of mental clutter.
If a child has to wear sunglasses in class to deal with bright lights, then that teen might want to consider what else to wear to go with the sunglasses. Remember the kid with the curly hair in That 70s Show that always wore sunglasses? He had an understated cynical coolness about him that needed those shades! The lifestyle is part of the package.
With accommodations, it's a case of transforming "different" into "unique, creative lifestyle." That way, accommodations feel good in more ways than one.