Expert: Michelle Fattig - 2/4/2009

Question
Hi!
I'm working as a behavior specialist in an elementary school. In the past I have dealt with children with autism so I somewhat have some experience. However, I have taken on a new case in which I will provide in-home service throught the agency I work for, to a family with a 5 year old boy. He has not been officially diagnosed with autsim but it's almost clear that he is on the spectrum. I am wondering if you can give me any advice on what I can do for him an how I can work with him. His treatment plan includes safety awareness (he runs from his mom when outside, he somehow gets out of his car seat etc.), social skills and his emotional outbursts (temper tantrums, defiance, aggression etc.)
Any advice or ideas?
I would greatly appreciate it!

Answer
I am so very sorry for the delay!  For some reason my computer started sending things to junk mail without notice, so didn't see your question until cleaning up junk mail this morning (Monday chores!).  

For a 5 year old little boy with spectrumy issues that include running, I would start with a sensory evaluation.  If you do not have access to an OT trained in the area, you can start by printing out the questionnaire:

EARLY CHILDHOOD/SCHOOL PARENT QUESTIONNAIRE

Name of Child:  _____________________   Date of Birth: ________  Age: _______
Name of Referrer: __________________   Relationship to Child: ______________
Parent/Guardian: ______________________________________________________
                                              Names         Address            Phone

Date of Referral: ____________
Referral Concern (Please list any concerns about child’s communication, behavior, or development):  _____________________________________________________
______________________________________________________________________
Medical History:
Pregnancy: _____________________________________________________________
Prenatal: ______________________________________________________________
Birth: _________________________________________________________________
History of Chronic Illness, Head Injury, Ear Infections, Hospitalization, or Accident: ______________________________________________________________
_______________________________________________________________________
Mother: ____________________________ Father: ____________________________
Siblings: _______________________________________________________________
Family History (Special Education, Developmental Delays, Learning Disabilities, Mental Health): _________________________________________________________
Who lives with the child: __________________________________________________
How does the child relate with:
Mother _________________ Father __________________ Siblings _______________
Family activities: ________________________________________________________
Does the child experience difficulty with peers, extended family, or social settings?
_______________________________________________________________________
As an infant, did the child experience difficulty with colic or soothing (stiffen or pull away when cuddled or stroked)? ___________________________________________
Communication:            
1) Does he or she respond to his/her name:    Never  Sometimes   Often   Always
    __________________________________________________________________
2)   Does he/she express her needs or wants:  Verbally  Pointing  Pulling  Tantrums
___________________________________________________________________
3)   Does he/she talk like children his/her age? ______________________________
___________________________________________________________________
4)   Does he/she follow simple or complex directions? ________________________
____________________________________________________________________
5)   Have you ever wondered if he/she is deaf? _______________________________
6)   Does he/she seem to hear at times, but not at others? _______________________
7)   Does he/she ever seem lost in own little world or stare off? _________________
_____________________________________________________________________
8)   Does he/she mimic, copy, or like to immitate?  ____________________________
_____________________________________________________________________
9)   Does he/she seem to have lost words, or say fewer words than before? _________
_____________________________________________________________________
Social Concerns:
10)   Does he/she smile at family members? __________________________________
11)    Does he/she smile at strangers or become overly frightened by strangers? ______
____________________________________________________________________
12)    Does he/she prefer to play alone or overly dependent on parent/caregiver for entertainment (you are his favorite/only toy)? ____________________________
____________________________________________________________________
13)    Does he/she get things for self? _______________________________________
14)    Is he/she very independent or overly attached (extreme separation anxiety)? ____
_____________________________________________________________________
15)   Has he/she met milestones early or unevenly? ____________________________
_____________________________________________________________________
16)   Does he/she seem to avoid eye contact or have too much eye contact (watching without mirroring or reacting like a little professor)? _______________________
_____________________________________________________________________
17)    Does he/she often seem “lost in own little world”? ________________________
____________________________________________________________________
18)   Does he/she seem tuned out or uninterested in other children? _______________
____________________________________________________________________
Behavioral Concerns:
19)   Does he/she seem to have excessive tantrums or emotional outburst with little or
    no provocation? ____________________________________________________
20)   Does he/she express frustration or over react to small changes or routine? ______
_____________________________________________________________________
21)   Does he/she demonstrate a lack of understanding in playing with toys (excessive mouthing, banging, lining up, sorting, focus on one part like spinning, or lack of interest)? __________________________________________________________
    _____________________________________________________________________
22)   Does he/she seem to get stuck on things regularly (wants to stick with one activity over any others, watch the same movie over and over, read the same book over and over, or other)? _________________________________________________
____________________________________________________________________
23)   Does he/she have unual attachments to objects? ___________________________
_____________________________________________________________________
24)   Does he/she toe walk or have unusual facial movements/grimacing? __________
_____________________________________________________________________
25)   Does he/she make any unusual hand movements or spin for long periods of time?
_____________________________________________________________________
26)   Does he/she seem overly sensitive to textures or sounds? ___________________
_____________________________________________________________________
If Age Appropriate:
27)   Did he/she babble by 12 months? ______________________________________
28)   Did he/she gesture (point, wave bye bye) by 12 months? ____________________
29)   Did he/she use single words by 16 months? ______________________________
30)   Does he/she seem to have an unusually advanced vocabulary? _______________
31)   Does he/she seem to have an extremely good memory? ____________________
32)   Does he/she demonstrate two-words spontaneously (not echo) phrases by 24 months? _________________________________________________________
33)   Has he/she demonstrated any loss of language or social skills of any kind? _____
_____________________________________________________________________

©Michelle Fattig, Flower by the Water Publishing PO Box 579 Genoa, Nebraska 68640 www.anniebooks.com
Adapted Questionnaire: Recommendations National Autistic Society: What should health professionals look out for when parents express concerns? And ToM “Seeing leads to knowing.” (Baron-Cohen, 2000, p.

Checklist for Autism in Young Children (Susan Mayes, PhD, Penn State College of Medicine) PROBLEMS WITH SOCIAL INTERACTION
__(1) Social isolation withdrawn, aloof, avoids contact with others, or prefers to play alone rather than with peers parallel play along side but not with peers difficulty establishing friendships
__(2) Limited reciprocal interaction limited social smile or eye contact (looks away, looks through people, looks at speaker’s mouth, needs tobe prompted to make eye contact, or does not make eye contact when communicating) limited sharing and showing (e.g., does not show a toy to an adult, seek recognition, or share an experience or accomplishment with others) excessively rigid play with peers (dictates play according to his/her peculiar and repetitive interests and rules) enjoys physical or sensory play with others (e.g., tickling, chasing) but has limited reciprocal social interaction (e.g., does not play social games or games involving turn taking)
__(3) Self-absorbed self-absorbed or in own world (e.g., engages in self-stimulating behaviors, talks to self, or fantasizes excessively about things such as movies or cartoons) oblivious to the presence of others or unresponsive to the social overtures of others
__(4) Socially indiscriminate behavior inappropriately talks to or hugs strangers invades personal space (gets too close to or touches others)no stranger/separation anxiety when young (not wary of strangers or upset if separated from parents) socially inappropriate, insensitive comments or behaviors (picks nose in public, asks personal questions)
__(5) Problems with social skills does not appropriately initiate or sustain peer interaction though may interact well with adults poor social reasoning (difficulty understanding social cues/comments, facial expressions, body language) wants to have friends but does not know how to make friends
PERSEVERATION
__(6) Narrow or unusual range of interests and play behaviors obsessive preoccupations or extreme fixation on things such as certain movies or TV shows (reenacts or watches the same movies over and over), computer games, letters, shapes, numbers, counting, objects or topics (e.g., trains, dinosaurs, NASCAR, maps, planes, electricity, Yu-Gi-Oh, cartoon characters, etc.) unusual attachment to and holding or hoarding objects (e.g., small figures, string, other______)
__(7) Stereotyped and repetitive playrepetitive play (e.g., excessively lines up, sorts, spins, or throws objects; opens and closes things repeatedly; plays with the same toys without variation; draws the same pictures repeatedly; other_____) disinterest in toys or lack of normal and varied imaginative playunusual preoccupation with parts of objects (e.g., repetitively spins wheels on a toy)
__(8) Upset with change distressed by change (e.g., change in routine or schedule, parent takes a different car route home from school, furniture or child’s toys are moved, seasonal change in clothing, other______) difficulty with transitions (e.g., from one activity to another) extreme need to finish what he/she starts idiosyncratic or ritualized patterns (e.g., drinks only from a certain cup, wears only certain clothes, insists that food be arranged a certain way on a plate, other_____)insists that things be in a certain location or a certain way (e.g., doors must be closed, coats zipped, etc.) insists on doing things the same way every time overly precise and inflexible, upset if someone breaks a “rule,” rigid and literal thinking
__(9) Stereotypies (unusual repetitive movements such as hand flapping when excited, toe walking, bodyrocking, head shaking, body tensing, teeth clenching, teeth grinding while awake, finger movements, facial grimacing, repeatedly running back and forth, twirling or spinning, pacing, playing with saliva, skin picking)
SOMATOSENSORY DISTURBANCE
__(10) Excessive atypical craving and love of spinning, tickling, climbing, rocking, swinging, bouncing, jumping
__(11) Unresponsive at times to verbal input (not react when name called or spoken to, hearing questioned)
__(12) Hypersensitivity unusual hypersensitivity to some sounds (e.g., distress or covering ears in response to loud noise, motors, vacuum cleaner, hair dryer, baby crying, sirens, clapping, alarms, toilet flushing, people singing) unusual hypersensitivity to smell, light, or temperature
__(13) Distress with commotion or crowds (uncomfortable/anxious in large groups, theatres, cafeterias, parties)
__(14) Extreme fascination with spinning or repetitive movements (e.g., revolving fans, Wheel of Fortune, running water), linear patterns (e.g., credits on TV, window blinds), minute details, lights, shiny surfaces
__(15) Abnormal sensory inspection excessively smells, mouths, chews, licks, or rubs inanimate objects or surfaces repetitively visually scrutinizes objects or finger movements close to eyesplaces ears against things that vibrate or hum or presses objects against face to an unusual degree
__(16) Tactile defensiveness or extreme dislike of: being touched or hugged touching certain things or getting hands dirty or stickywater on self or clothes having face washed, teeth brushed, hair combed, or nails cut walking in bare feet clothing that is tight, seams in clothes, or certain textures of clothing
__(17) High tolerance for pain (e.g., does not cry when hurt or does not respond normally to painful stimuli)
__(18) Sleep disturbance (e.g., difficulty falling asleep, waking during the night, waking early in the morning)
__(19) Feeding problems very picky eater, limited food preferences, insists on eating only a few foods hypersensitivity to textures (e.g., lumps in food) retains food in mouth without swallowing eats inedible substancesother peculiar eating patterns (e.g., eats only one brand, color, or shape of a food, other____)
ATYPICAL COMMUNICATION AND DEVELOPMENT
__(20) Language regression or slowing at approximately 1 to 2 years of age (e.g., speaking a few words at one year but then losing speech or normal early language development and later language is delayed)
__(21) Visual-motor skills (e.g., assembling puzzles, building with Legos, operating the VCR) significantly higher than language skills during the preschool years or walking at a much earlier age than talking
__(22) Communication impairment absent or limited communicative speech but gestures to communicate (e.g., pulls an adult by the handand leads to what wants, hands an object to an adult for assistance, brings a cup to an adult for a drink)communicates verbally with others only when stressed or needing somethingdifficulty with reciprocal conversational speech (initiating and sustaining conversations, listening and responding to what others say), talks at people, or one-sided conversations on topics of interest to self
__(23) Atypical vocalizations or speech unusual voice quality or modulation (e.g., high pitch, sing song voice, lack of intonation, etc.) screeches or makes other odd noises (e.g., growls, hums, etc.) unusual repetitive vocalizations and sounds idiosyncratic jargon as if talking in own language echolalia (inappropriately mimics what others say, such as repeating instead of answering a question)sporadic speech (says a word or phrase once and rarely or never says it again) excessively recites from movies, cartoons, commercials, etc. uses rote or memorized phrases that are excessive, out of context, or not relevant makes pronoun substitutions (e.g., says “you” when meaning “I”) excessively repetitive speech and questionsidiosyncratic thoughts and speech (makes up words, nonsensical speech, unique views and perceptions)
__(24) Special abilities that are significantly higher than other abilities exceptional rote memory (e.g., at an unusually young age, identifies numbers, letters, shapes, logos, andcolors; sings or hums tunes; memorizes car routes; counts; recites the alphabet; reads; spells; etc.) phenomenal vocabulary or ability to memorize movies, books, or factual information remarkable ability to mimic movie or cartoon characters outstanding visual-mechanical skills (e.g., at an unusually young age, assembles puzzles, matches shapes, operates a computer or VCR, figures out how things work, complex constructions with Legos) remarkable artistic or musical talent extremely well-developed gross motor skills with delayed development in other areas (in contrast to high- functioning children with autism who often have writing or coordination problems)
MOOD DISTURBANCE
__(25) Overreactivity, irritability, low frustration tolerance, agitation, tantrums, meltdowns, explosiveness,aggression, or self-injurious behavior (distressed by minor events or occurrences most children can tolerate, such as intrusions, activity interruptions, proximity, confinement, performance demands, writingtasks, or when things are not the way the child thinks they should be)
__(26) Moodiness and emotional lability (the cause for mood changes may not always apparent, such aslaughter or distress for no apparent reason)
__(27) Difficulty showing and recognizing emotions, emotionally unresponsive in some situations, lack of empathy or emotional reciprocity (e.g., does not respond appropriately or provide comfort whensomeone is hurt or sad), or misinterprets the emotions or responses of others
__(28) Unusual fears, such as fear of elevators, steps, toilets, balloons, vacuums, tornadoes, other_____
PROBLEMS WITH ATTENTION AND SAFETY
__(29) Selective attention, ability to hyperfocus on activities, objects, or topics of interest to self (e.g., lines up toys, spins wheels, watches the same movie, assembles puzzles, builds with Legos, or draws pictures for long periods of time), but is inattentive, impulsive, and fidgety at other times
__(30) Limited safety awareness, fearless, or oblivious to danger (e.g., unsafe climbing, wanders about house at night, runs off by self, goes into traffic or water, walks off with strangers)

Sensory Processing Disorder Checklist: Signs And Symptoms Of Dysfunction
The purpose of this sensory processing disorder checklist is to help parents and professionals who interact with children become educated about particular signs of sensory processing dysfunction.
It is not to be used as the absolute diagnostic criteria for labeling children with sensory processing disorder. But rather, as an educational tool and checklist for your own knowledge. Professionals who can diagnose this disorder have their own tools in addition to checklists to observe and test for sensory integration dysfunction.
As you go through this list, you may say, "Wow, my child has so many of these characteristics/behaviors, he must have a sensory processing disorder!!"
That MAY be true, and I want you to take it very seriously if you find a host of these to be characteristic of your child. But, then use this as a guide to speak with your doctor and an Occupational Therapist so you can clearly explain why you think your child may need help.
Or, you may go through the list and say,
"No big deal, so my child has some of these behaviors/characteristics, doesn't every child?"
Well, this may be true too and your child's behavior may fluctuate from day to day.
What we need to be concerned with is which symptoms your child shows, which category they are having difficulty with, how much it interferes with their or other's lives and what kind of impact it is having on their level of functioning. They may have a lot in one category and none in another or some in all categories. This will help target diagnosis and treatment.
Lastly, you may go through the list and say,
"Oh my gosh, that is what I have been dealing with my whole life".
Then I say, I'm so sorry you never got the help you needed! Perhaps we can start to work on it now.
Identifying and understanding this disorder is HUGE!
Please understand the "Five Caveats" that Carol Stock Kranowitz points out in her book, "The Out-Of-Sync Child " (1995), about using a checklist such as this. She writes:

1. "The child with sensory dysfunction does not necessarily exhibit every characteristic. Thus, the child with vestibular dysfunction may have poor balance but good muscle tone."
2. "Sometimes the child will show characteristics of a dysfunction one day but not the next. For instance, the child with proprioceptive problems may trip over every bump in the pavement on Friday yet score every soccer goal on Saturday. Inconsistency is a hallmark of every neurological dysfunction. "

3. "The child may exhibit characteristics of a particular dysfunction yet not have that dysfunction. For example, the child who typically withdraws from being touched may seem to be hypersensitive to tactile stimulation but may, instead, have an emotional problem."

4. "The child may be both hypersensitive and hyposensitive. For instance, the child may be extremely sensitive to light touch, jerking away from a soft pat on the shoulder, while being rather indifferent to the deep pain of an inoculation."

5. "Everyone has some sensory integration problems now and then, because no one is well regulated all the time. All kinds of stimuli can temporarily disrupt normal functioning of the brain, either by overloading it with, or by depriving it of, sensory stimulation."

Tactile Sense: input from the skin receptors about touch, pressure, temperature, pain, and movement of the hairs on the skin.

Signs Of Tactile Dysfunction:


1. Hypersensitivity To Touch (Tactile Defensiveness)

__ becomes fearful, anxious or aggressive with light or unexpected touch

__ as an infant, did/does not like to be held or cuddled; may arch back, cry, and pull away

__ distressed when diaper is being, or needs to be, changed

__ appears fearful of, or avoids standing in close proximity to other people or peers (especially in lines)

__ becomes frightened when touched from behind or by someone/something they can not see (such as under a blanket)

__ complains about having hair brushed; may be very picky about using a particular brush

__ bothered by rough bed sheets (i.e., if old and "bumpy")

__ avoids group situations for fear of the unexpected touch

__ resists friendly or affectionate touch from anyone besides parents or siblings (and sometimes them too!)

__ dislikes kisses, will "wipe off" place where kissed

__ prefers hugs

__ a raindrop, water from the shower, or wind blowing on the skin may feel like torture and produce adverse and avoidance reactions

__ may overreact to minor cuts, scrapes, and or bug bites

__ avoids touching certain textures of material (blankets, rugs, stuffed animals)

__ refuses to wear new or stiff clothes, clothes with rough textures, turtlenecks, jeans, hats, or belts, etc.

__ avoids using hands for play

__ avoids/dislikes/aversive to "messy play", i.e., sand, mud, water, glue, glitter, playdoh, slime, shaving cream/funny foam etc.

__ will be distressed by dirty hands and want to wipe or wash them frequently

__ excessively ticklish

__ distressed by seams in socks and may refuse to wear them

__ distressed by clothes rubbing on skin; may want to wear shorts and short sleeves year round, toddlers may prefer to be naked and pull diapers and clothes off constantly

__ or, may want to wear long sleeve shirts and long pants year round to avoid having skin exposed

__ distressed about having face washed

__ distressed about having hair, toenails, or fingernails cut

__ resists brushing teeth and is extremely fearful of the dentist

__ is a picky eater, only eating certain tastes and textures; mixed textures tend to be avoided as well as hot or cold foods; resists trying new foods

__ may refuse to walk barefoot on grass or sand

__ may walk on toes only


2. Hyposensitivity To Touch (Under-Responsive):

__ may crave touch, needs to touch everything and everyone

__ is not aware of being touched/bumped unless done with extreme force or intensity

__ is not bothered by injuries, like cuts and bruises, and shows no distress with shots (may even say they love getting shots!)

__ may not be aware that hands or face are dirty or feel his/her nose running

__ may be self-abusive; pinching, biting, or banging his own head

__ mouths objects excessively

__ frequently hurts other children or pets while playing

__ repeatedly touches surfaces or objects that are soothing (i.e., blanket)

__ seeks out surfaces and textures that provide strong tactile feedback

__ thoroughly enjoys and seeks out messy play

__ craves vibrating or strong sensory input

__ has a preference and craving for excessively spicy, sweet, sour, or salty foods


3. Poor Tactile Perception And Discrimination:

__ has difficulty with fine motor tasks such as buttoning, zipping, and fastening clothes

__ may not be able to identify which part of their body was touched if they were not looking

__ may be afraid of the dark

__ may be a messy dresser; looks disheveled, does not notice pants are twisted, shirt is half un tucked, shoes are untied, one pant leg is up and one is down, etc.

__ has difficulty using scissors, crayons, or silverware

__ continues to mouth objects to explore them even after age two

__ has difficulty figuring out physical characteristics of objects; shape, size, texture, temperature, weight, etc.

__ may not be able to identify objects by feel, uses vision to help; such as, reaching into backpack or desk to retrieve an item

Vestibular Sense: input from the inner ear about equilibrium, gravitational changes, movement experiences, and position in space.

Signs Of Vestibular Dysfunction:

1. Hypersensitivity To Movement (Over-Responsive):


__ avoids/dislikes playground equipment; i.e., swings, ladders, slides, or merry-go-rounds

__ prefers sedentary tasks, moves slowly and cautiously, avoids taking risks, and may appear "wimpy"

__ avoids/dislikes elevators and escalators; may prefer sitting while they are on them or, actually get motion sickness from them

__ may physically cling to an adult they trust

__ may appear terrified of falling even when there is no real risk of it

__ afraid of heights, even the height of a curb or step

__ fearful of feet leaving the ground

__ fearful of going up or down stairs or walking on uneven surfaces

__ afraid of being tipped upside down, sideways or backwards; will strongly resist getting hair washed over the sink

__ startles if someone else moves them; i.e., pushing his/her chair closer to the table

__ as an infant, may never have liked baby swings or jumpers

__ may be fearful of, and have difficulty riding a bike, jumping, hopping, or balancing on one foot (especially if eyes are closed)

__ may have disliked being placed on stomach as an infant

__ loses balance easily and may appear clumsy

__ fearful of activities which require good balance

__ avoids rapid or rotating movements

2. Hyposensitivity To Movement (Under-Responsive):

__ in constant motion, can't seem to sit still

__ craves fast, spinning, and/or intense movement experiences

__ loves being tossed in the air

__ could spin for hours and never appear to be dizzy

__ loves the fast, intense, and/or scary rides at amusement parks

__ always jumping on furniture, trampolines, spinning in a swivel chair, or getting into upside down positions

__ loves to swing as high as possible and for long periods of time

__ is a "thrill-seeker"; dangerous at times

__ always running, jumping, hopping etc. instead of walking

__ rocks body, shakes leg, or head while sitting

__ likes sudden or quick movements, such as, going over a big bump in the car or on a bike

3. Poor Muscle Tone And/Or Coordination:

__ has a limp, "floppy" body

__ frequently slumps, lies down, and/or leans head on hand or arm while working at his/her desk

__ difficulty simultaneously lifting head, arms, and legs off the floor while lying on stomach ("superman" position)

__ often sits in a "W sit" position on the floor to stabilize body

__ fatigues easily!

__ compensates for "looseness" by grasping objects tightly

__ difficulty turning doorknobs, handles, opening and closing items

__ difficulty catching him/her self if falling

__ difficulty getting dressed and doing fasteners, zippers, and buttons

__ may have never crawled as an baby

__ has poor body awareness; bumps into things, knocks things over, trips, and/or appears clumsy

__ poor gross motor skills; jumping, catching a ball, jumping jacks, climbing a ladder etc.

__ poor fine motor skills; difficulty using "tools", such as pencils, silverware, combs, scissors etc.

__ may appear ambidextrous, frequently switching hands for coloring, cutting, writing etc.; does not have an established hand preference/dominance by 4 or 5 years old

__ has difficulty licking an ice cream cone

__ seems to be unsure about how to move body during movement, for example, stepping over something

__ difficulty learning exercise or dance steps

Proprioceptive Sense: input from the muscles and joints about body position, weight, pressure, stretch, movement, and changes in position in space.

Signs Of Proprioceptive Dysfunction:

1. Sensory Seeking Behaviors:

__ seeks out jumping, bumping, and crashing activities

__ stomps feet when walking

__ kicks his/her feet on floor or chair while sitting at desk/table

__ bites or sucks on fingers and/or frequently cracks his/her knuckles

__ loves to be tightly wrapped in many or weighted blankets, especially at bedtime

__ prefers clothes (and belts, hoods, shoelaces) to be as tight as possible

__ loves/seeks out "squishing" activities

__ enjoys bear hugs

__ excessive banging on/with toys and objects

__ loves "roughhousing" and tackling/wrestling games

__ frequently falls on floor intentionally

__ would jump on a trampoline for hours on end

__ grinds his/her teeth throughout the day

__ loves pushing/pulling/dragging objects

__ loves jumping off furniture or from high places

__ frequently hits, bumps or pushes other children

__ chews on pens, straws, shirt sleeves etc.


2. Difficulty With "Grading Of Movement":


__ misjudges how much to flex and extend muscles during tasks/activities (i.e., putting arms into sleeves or climbing)

__ difficulty regulating pressure when writing/drawing; may be too light to see or so hard the tip of writing utensil breaks

__ written work is messy and he/she often rips the paper when erasing

__ always seems to be breaking objects and toys

__ misjudges the weight of an object, such as a glass of juice, picking it up with too much force sending it flying or spilling, or with too little force and complaining about objects being too heavy

__ may not understand the idea of "heavy" or "light"; would not be able to hold two objects and tell you which weighs more

__ seems to do everything with too much force; i.e., walking, slamming doors, pressing things too hard, slamming objects down

__ plays with animals with too much force, often hurting them

Signs Of Auditory Dysfunction: (no diagnosed hearing problem)

1. Hypersensitivity To Sounds (Auditory Defensiveness):

__ distracted by sounds not normally noticed by others; i.e., humming of lights or refrigerators, fans, heaters, or clocks ticking
__ fearful of the sound of a flushing toilet (especially in public bathrooms), vacuum, hairdryer, squeaky shoes, or a dog barking
__ started with or distracted by loud or unexpected sounds
__ bothered/distracted by background environmental sounds; i.e., lawn mowing or outside construction
__ frequently asks people to be quiet; i.e., stop making noise, talking, or singing
__ runs away, cries, and/or covers ears with loud or unexpected sounds
__ may refuse to go to movie theaters, parades, skating rinks, musical concerts etc.
__ may decide whether they like certain people by the sound of their voice

2. Hyposensitivity To Sounds (Under-Registers):

__ often does not respond to verbal cues or to name being called
__ appears to "make noise for noise's sake"
__ loves excessively loud music or TV
__ seems to have difficulty understanding or remembering what was said
__ appears oblivious to certain sounds
__ appears confused about where a sound is coming from
__ talks self through a task, often out loud
__ had little or no vocalizing or babbling as an infant
__ needs directions repeated often, or will say, "What?" frequently

Signs Of Oral Input Dysfunction:

1. Hypersensitivity To Oral Input (Oral Defensiveness):

__ picky eater, often with extreme food preferences; i.e., limited repertoire of foods, picky about brands, resistive to trying new foods or restaurants, and may not eat at other people's houses)
__ may only eat "soft" or pureed foods past 24 months of age
__ may gag with textured foods
__ has difficulty with sucking, chewing, and swallowing; may choke or have a fear of choking
__ resists/refuses/extremely fearful of going to the dentist or having dental work done
__ may only eat hot or cold foods
__ refuses to lick envelopes, stamps, or stickers because of their taste
__ dislikes or complains about toothpaste and mouthwash
__ avoids seasoned, spicy, sweet, sour or salty foods; prefers bland foods

2. Hyposensitivity To Oral Input (Under-Registers)

__ may lick, taste, or chew on inedible objects
__ prefers foods with intense flavor; i.e., excessively spicy, sweet, sour, or salty
__ excessive drooling past the teething stage
__ frequently chews on hair, shirt, or fingers
__ constantly putting objects in mouth past the toddler years
__ acts as if all foods taste the same
__ can never get enough condiments or seasonings on his/her food
__ loves vibrating toothbrushes and even trips to the dentist

Signs Of Olfactory Dysfunction (Smells):

1. Hypersensitivity To Smells (Over-Responsive):

__ reacts negatively to, or dislikes smells which do not usually bother, or get noticed, by other people
__ tells other people (or talks about) how bad or funny they smell
__ refuses to eat certain foods because of their smell
__ offended and/or nauseated by bathroom odors or personal hygiene smells
__ bothered/irritated by smell of perfume or cologne
__ bothered by household or cooking smells
__ may refuse to play at someone's house because of the way it smells
__ decides whether he/she likes someone or some place by the way it smells

2. Hyposensitivity To Smells (Under-Responsive):

__ has difficulty discriminating unpleasant odors
__ may drink or eat things that are poisonous because they do not notice the noxious smell
__ unable to identify smells from scratch 'n sniff stickers
__ does not notice odors that others usually complain about
__ fails to notice or ignores unpleasant odors
__ makes excessive use of smelling when introduced to objects, people, or places
__ uses smell to interact with objects

Signs Of Visual Input Dysfunction (No Diagnosed Visual Deficit):

1. Hypersensitivity To Visual Input (Over-Responsiveness)


__ sensitive to bright lights; will squint, cover eyes, cry and/or get headaches from the light
__ has difficulty keeping eyes focused on task/activity he/she is working on for an appropriate amount of time
__ easily distracted by other visual stimuli in the room; i.e., movement, decorations, toys, windows, doorways etc.
__ has difficulty in bright colorful rooms or a dimly lit room
__ rubs his/her eyes, has watery eyes or gets headaches after reading or watching TV
__ avoids eye contact
__ enjoys playing in the dark

2. Hyposensitivity To Visual Input (Under-Responsive Or Difficulty With Tracking, Discrimination, Or Perception):

__ has difficulty telling the difference between similar printed letters or figures; i.e., p & q, b & d, + and x, or square and rectangle
__ has a hard time seeing the "big picture"; i.e., focuses on the details or patterns within the picture
__ has difficulty locating items among other items; i.e., papers on a desk, clothes in a drawer, items on a grocery shelf, or toys in a bin/toy box
__ often loses place when copying from a book or the chalkboard
__ difficulty controlling eye movement to track and follow moving objects
__ has difficulty telling the difference between different colors, shapes, and sizes
__ often loses his/her place while reading or doing math problems
__ makes reversals in words or letters when copying, or reads words backwards; i.e., "was" for "saw" and "no" for "on" after first grade
__ complains about "seeing double"
__ difficulty finding differences in pictures, words, symbols, or objects
__ difficulty with consistent spacing and size of letters during writing and/or lining up numbers in math problems
__ difficulty with jigsaw puzzles, copying shapes, and/or cutting/tracing along a line
__ tends to write at a slant (up or down hill) on a page
__ confuses left and right
__ fatigues easily with schoolwork
__ difficulty judging spatial relationships in the environment; i.e., bumps into objects/people or missteps on curbs and stairs

Auditory-Language Processing Dysfunction:

__ unable to locate the source of a sound
__ difficulty identifying people's voices
__ difficulty discriminating between sounds/words; i.e., "dare" and "dear"
__ difficulty filtering out other sounds while trying to pay attention to one person talking
__ bothered by loud, sudden, metallic, or high-pitched sounds
__ difficulty attending to, understanding, and remembering what is said or read; often asks for directions to be repeated and may only be able to understand or follow two sequential directions at a time
__ looks at others to/for reassurance before answering
__ difficulty putting ideas into words (written or verbal)
__ often talks out of turn or "off topic"
__ if not understood, has difficulty re-phrasing; may get frustrated, angry, and give up
__ difficulty reading, especially out loud (may also be dyslexic)
__ difficulty articulating and speaking clearly
__ ability to speak often improves after intense movement

Social, Emotional, Play, And Self-Regulation Dysfunction:

Social:

__ difficulty getting along with peers
__ prefers playing by self with objects or toys rather than with people
__ does not interact reciprocally with peers or adults; hard to have a "meaningful" two-way conversation
__ self-abusive or abusive to others
__ others have a hard time interpreting child's cues, needs, or emotions
__ does not seek out connections with familiar people

Emotional:

__ difficulty accepting changes in routine (to the point of tantrums)
__ gets easily frustrated
__ often impulsive
__ functions best in small group or individually
__ variable and quickly changing moods; prone to outbursts and tantrums
__ prefers to play on the outside, away from groups, or just be an observer
__ avoids eye contact
__ difficulty appropriately making needs known

Play:

__ difficulty with imitative play (over 10 months)
__ wanders aimlessly without purposeful play or exploration (over 15 months)
__ needs adult guidance to play, difficulty playing independently (over 18 months)
__ participates in repetitive play for hours; i.e., lining up toys cars, blocks, watching one movie over and over etc.

Self-Regulation:

__ excessive irritability, fussiness or colic as an infant
__ can't calm or soothe self through pacifier, comfort object, or caregiver
__ can't go from sleeping to awake without distress
__ requires excessive help from caregiver to fall asleep; i.e., rubbing back or head, rocking, long walks, or car rides

Internal  Regulation (The Interoceptive Sense):

__ becoming too hot or too cold sooner than others in the same environments; may not appear to ever get cold/hot, may not be able to maintain body temperature effectively
__ difficulty in extreme temperatures or going from one extreme to another (i.e., winter, summer, going from air conditioning to outside heat, a heated house to the cold outside)
__ respiration that is too fast, too slow, or cannot switch from one to the other easily as the body demands an appropriate respiratory response
__ heart rate that speeds up or slows down too fast or too slow based on the demands imposed on it
__ respiration and heart rate that takes longer than what is expected to slow down during or after exertion or fear
__ severe/several mood swings throughout the day (angry to happy in short periods of time, perhaps without visible cause)
__ unpredictable state of arousal or inability to control arousal level (hyper to lethargic, quickly, vacillating between the two; over stimulated to under stimulated, within hours or days, depending on activity and setting, etc.)
__ frequent constipation or diarrhea, or mixed during the same day or over a few days
__ difficulty with potty training; does not seem to know when he/she has to go (i.e., cannot feel the necessary sensation that bowel or bladder are full
__ unable to regulate thirst; always thirsty, never thirsty, or oscillates back and forth
__ unable to regulate hunger; eats all the time, won't eat at all, unable to feel full/hungry
__ unable to regulate appetite; has little to no appetite and/or will be "starving" one minute then full two bites later, then back to hungry again (prone to eating disorders and/or failure to thrive)

Sorry it is so long!  But it will help if mom or main caregiver complete the information to target the sensory issues that are "setting him off" or if it seems to be more of a learned flight or fight behavior.

Some very good book are available on daily social skills curriculum and on sensor integration activities.  I have written daily curriculum for teachers involving research based therapy activities to target academic, social language, and sensory activities that can be provided by a teacher, para, parent or other.  If you'd like sample curriculum please privately send you email and I can send you copies as an attachment.  

A really good book I am reading right now is called 'Autism in the school-aged child' which has many great suggestions.  There are a plethora of wonderful books and guides out there.  Again, if you'd like more specifics please privately send your email and I can provide a list.  You may check with your school system's media library for what is currently available. Taming Tommy's Tantrums is a book I wrote specfically to reduce acting out behaviors through the understanding of sensory and social language needs.  

I hope this is helpful.  Another free resource is located at:

www.interventioncentral.com for free printouts and guides

also:

www.anniebooks.com

Please let me know if there is anything else that I can provide, and again I apologize for my computer "hiding" your question!  Have a lovely day, and do not hesitate to email via this site or through anniebooks.com if you would like for me to send the daily curriculum examples. They are designed so as to provide the teacher a daily curriculum, but could easily be implemented as a supplemental by parents or paras to increase success behaviorally, sensory, socially, and academically.  Best wishes!  Michelle