Inside Outside Treatments that Address Causes

Those  who have struggled though the maze of medical tests and diagnoses know that the differences between pervasive developmental disorders, attention defecits, and autism are sometimes difficult to distinguish.

It is true that a diagnosis can be helpful from a medical point of view or for insurance reimbursement. However, when one focuses on appropriate therapeutic treatment and educational programming, the label is of far less value. An emphasis on physiological status and sensory processing works from the inside out; the focus is on each child, not the diagnosis. That is the premise upon which the DDR was founded.

Inside out treatments ready a child’s body for learning at all levels. A generalist starts by taking a health and developmental history, Many clues are there as to why a child may have had function and lost it or never gained it in the first place. Digestion, neurology, metabolism and the immune system take priority over sensory processing. If any of these systems is off, processing of touch, movement, balance, sound, sight, and interpersonal relationships inevitably suffer. Children with food sensitivities or delayed food allergies can be affected 24 hours a day. When they are functioning as they should, youngsters are “available.” Then services such as speech/language therapy, occupational therapy and behavior modification can yield more consistent results.

Lower level sensory processing of muscles, joints, skin, balance, and movement affect the higher level of senses of listening and looking. Have you ever tried to listen to someone talk when you are too cold or when wearing an angora sweater that itches? Temperature and touch take precedence in the brain over processing language. Normalization of the lower level senses is essential to utilizing hearing and vision to give meaning to one’s world. Adults recognize that young children who have delays need help in processing temperature, touch, and movement. They thus guide their youngsters with gentle structuring such as reminding them to put on their sweaters to go outside or taking them to the bathroom at regular intervals. However, sometimes this well-meaning assistance is still in place after a child’s body is processing more efficiently. By allowing children of all ages to experience the discomfort of cold, the need to urinate or some more negative problem themselves, we empower them to manage their own bodies from the inside out.

The connection between the sensory experience and the cognitive action at a pre-school level lays the foundation for managing themselves and their belongings later in life. Occupational therapy, especially utilizing a sensory integrative approach, is sometimes necessary to bridge the gap for children whose processing is so poor that sensory experiences cause emotional reactions.

Mental health professions are only beginning to understand the relationship between behavior and sensory/regulatory problems. Therapy can calm or activate the inefficient nervous system. Those who are very active may benefit from calming techniques such as a brushing program, wearing weights or having the lights dimmed. Others who appear shy and withdrawn may do well if they are permitted to jump on a mini-tramp or ride a stationary bicycle.

The Alert Program teaches children how to get their engines running at the right speed for a particular task. Teachers can help their students tune their engines up to go to recess or bring them down for reading. This is very different from a behavior management program which works from the outside in. DDR sells an audiotape, a DVD, short booklet and book “Take Five, which describe this program.

As you evaluate all the therapeutic interventions available, consider which ones work from the inside out rather that the outside in. Nutrition, movement therapies, and programs which empower children’s bodies to manage themselves will have a far better effect long-term as the body generalizes what it has learned to novel situations.

Remember the old adage about teaching a man how to fish rather than to feed him dinner? This is what we are all trying to accomplish.

[New Developments: Executive Director’s Column, Fall 1996]

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