Children's developmental disorders - signs and advice for rehabilitation

The materials offered here have been prepared by specialists of the Human Psychology and Development Center 'Sphere', an autonomous non-commercial organization in the city of Bryansk. They are intended for attendees of a training seminar on movement therapy in correcting children's developmental peculiarities (see the information about the seminar in this issue of News Letter). They may be useful for specialists and parents of children with developmental deviations.

Signs of vestibular-bilateral disorders

• on the whole, a child's development is typical but he has difficulties with reading and counting;
• constantly wishing to play outdoor games and remains tireless longer than other children;
• inability to focus the eyes on a moving object or getting 'lost' in the lines when copying a text;
• clumsiness;
• falling more often than children of the same age;
• inability to sit straight, huddling up when sitting at a table;
• having difficulties coping with tasks that involve both arms and sides of the body, for instance, cutting paper with scissors, riding a bicycle, knotting shoelaces, jumping with the arms and legs apart;
• confusing right and left, top and bottom;
• mirroring letters and writing from right to left;
• making sharp and non-rhythmic movements;
• turning with the whole body; looking 'lost' in space.

Signs of gravitational uncertainty

• becoming uneasy when torn from the ground or seeking to keep a vertical position;
• fear of falling and of heights;
• fear of riding an escalator or a lift;
• dislike for rolling over or turning over while lying on the floor;
• dislike for moving toys;
• displeasure with games on children's gym playgrounds;
• avoiding jumping from heights;
• walking stairs slowly, grasping handrails more often than other children;
• fear of climbing oblique surfaces;
• fear of sharp turns and twisting roads when driving in a car;
• making mistakes in assessing spaces and distances;
• felling uneasy when unexpectedly pulled by shoulder in a sitting position;
• avoiding games with unpredictable shifts of those around, such as tag or football;
• looking troubled and insecure when exposed to an open space.

Signs pointing to tactile hypersensitivity

• avoiding being touched by others and physical contacts with them;
• dislike for washing the face and head;
• abhorring the cutting of the hair or nails;
• dislike for being touched;
• negative reaction to being dressed and dislike for certain types or peculiarities of clothes, such as elastic cuffs, seams, long sleeves, etc.
• feeling disturbed when people come close to him;
• feeling disturbed when approached from behind or not seeing what is going on;
• feeling an uncommon need for touching or, on the contrary, avoiding touching certain surfaces or objects;
• dislike for immersing the fingers into sand or paint and touching a glue or similar materials;
• dislike for walking barefoot, especially on sand or grass;
• grumpiness about the texture or temperature of the food.

Signs of developmental dyspraxia

• clumsiness or awkwardness;
• avoiding taking part in sports games;
• finding it difficult to think up new amusements;
• taking unnecessary actions during a game or missing certain steps;
• finding it difficult to begin fulfilling a task;
• inability to finish an undertaking;
• trouble with shifting from one type of action to another;
• inability to put the room or desk in order;
• stumbling over objects and furniture;
• longer time as compared to other children of the same age to learn knotting shoelaces, dressing, playing with a ball, etc.;
• seeking to boss over his mates, trying to get control over a situation or a game;
• being emotionally labile and immature or infantile ('pretending to be a baby');
• stubbornness, inability to cooperate and resort to manipulation.

How to rehabilitate vestibular-bilateral disorders

• The motional experience is extremely important for a child. Take some time every day for outdoor games, such as rocking, sliding, jumping and other active movements.
• Encourage your child to make not passive but independent active movements that he initiate and regulate on his own.
• Use exercises requiring speed and fast movements, especially with shifting directions, which tend to stimulate and inspire a child.
• Especially beneficial are exercises with slow rhythmical movements, such as rocking, swaying, as they quieten a child.
• Watch your child's reactions to various kinds of motional activity, trying to notice what encourages him to action and what quietens him.
• Never spin your child too fast or too long.
• Try to encourage your child to engage in various activities, such as reading, playing, colouring, doing it in a prone position with support on his elbows.
• Encourage your child when he wishes to engage in an activity that requires maintaining a balance, for instance, skating, riding a bicycle, wrestling, etc.
• Include bilateral games in your schedule, that is, games involving the both sides of the body, such as jumps with a jump rope, swimming, rowing, playing a musical instrument, etc.
• Try an activity stimulating coordination of the movements of eyes, head and arms, such as target shooting, playing with a ball, throwing objects, table tennis, etc.
• Include exercises on a swinging oblique plane; use large inflatable balls for sitting and lying; use a rocking chair.
• The following is beneficial for a child: sliding, rolling over, rocking, spinning, riding a bicycle, walking on uneven surfaces (sand beaches, boards, logs, grass, water), horse riding, balancing, rowing and 'row your boat' exercises, sitting in T position.

How to rehabilitate gravitational uncertainty

The most important thing you can do is to realize the reality of the problem, to understand and accept your child's reactions in various situations. To see in your child's a behavioral or emotion disorder means only to aggravate the situation.

• Help your child to adapt gradually to the activities that provoke his fear. For instance, if your child is afraid of swings, you are to begin with swings in which his feet can touch the ground or get him sitting on your lap and swing together.
• Sometimes what helps a child to feel safer is additional proprioceptive stimulation or the feeling of pressure on his muscles, joints or body. For instance, if your child is afraid of walking stairs, try to support him by his hips softly pressing on them. Sometimes it is a better way than just to hold his hand.
• A soft to-and-fro movement is endured better than rotation. Help your child to move with a speed and in a direction comfortable for him.
• Such children are especially troubled by a back bend. Do not try to make your child do it until he is ready to become reconciled with these sensations.
• Involvement in a game and development of imagination can divert a child from unpleasant physical components of the situation and give him courage.
• Try to have your child close his eyes when engaged in an activity of which he is not afraid: it helps 'to tune' the feeling of his body's position in space.
• Sometimes, in order to increase a child's feeling of safety during movement or climbing, it is useful to apply a weight bearing, for instance, to his hands or ankles, or for him to carry a small rucksack filled with rice or beans.
• Do not hurry up your child when he tries to take actions scaring him.
• When going to take part in an event or activity, such as a barbeque in a strange park, come to the place beforehand so that the child could look around and get accustomed to the setting and objects. In this way he will cope with fear much easier.
• It is very beneficial for a child to roll on the floor, lying on a skateboard or use it to go down an oblique surface in a head-down position.
• It is also beneficial to use a rocking chair and to jump on a tightly inflated pillow or ball.

How to correct tactile hypersensitivity

Do not try to make a hypersensitive child overcome his negative reactions to touches by trying to persuade him that it is not the right way to behave. A denial of the problem will not remove it. On the contrary, it will instill in the child the feeling of guilt and aggravate his condition.

• A light, tickling touch usually irritates more than a continued strong pressure. Touch your child with the whole palm, not just your fingertips. This way you will be able to weaken the irritation.
• When children in school stand in line, your child may feel better standing in the end or in the very beginning of the line. In group games, in which children are to stand in a circle, it will be easier for him to stand behind the children, not between them. Explain to the teacher that light touches by people passing by may irritate your child and provoke in him a burst of aggression and emotions.
• A prolonged tangible pressure normally 'overrides' irritating tactile sensations. That is why we spontaneously rub a bruise. A strong massage and the sandwich technique (when a child is carefully laid between pillows) are examples of actions appeasing one's excessive sensitivity to touches.
• Pay attention to the kind of fabric, clothes, toys and everyday situations, for instance, the need to pass through a crowd in a large shop, which can provoke negative reactions in your child. If the problem remains acute, try to avoid such irritating factors (for instance, let your child ware clothes made of a fabric he likes; do not come to crowded places).
• Try to introduce your child gradually to various tactile sensations through games, washing, meals, etc. It will be easier for your child to assimilate a new experience if he himself begins initiating games instead of suddenly finding himself in face of potentially dangerous or unfamiliar situations, subdued to the pressure from an adult. Show everything on oneself and turn your actions into a game. Encourage your child's imagination. Do not speed up the developments; do not force your child to participate.
• Support your child's wish to get a new tactile experience. Tactile sensations received by your child through participation in any action are more beneficial than those he receives in a passive condition.
• 'Hard work', when a child helps to carry a bag with purchases or linen from a laundry, or puts on a moderately heavy rucksack or plays games where he has to push or pull something or to jump, provides his nervous system with certain sensations which normally quieten or organize his tactile hypersensitive system - and all this will quieten and organize his brain.
• At first glance, it may seem that your child tries to manipulate you and to spoil purposefully the life of those around him. Trust him when he complains at inconveniences. It is most likely that he really suffers. It also helps to explain to relatives and teachers that your child reacts negatively not to their attention but to his own feelings caused by others' touches.
• A child will benefit from the following actions and exercises: rubbing materials of various textures on his skin, playing with water, painting with water, drawing with your finger on your child's back or arm, playing with sand, with a 'black box' for feeling objects, asking your child to describe the objects he is touching, licking stickers, 'gluing' envelops with his tong, working with dough and various fillings, touching various seeds, chestnuts, egg yolks, worms, flies and pets; making a 'sandwich of people' (when a child is put between pillows), oiling various layers of the 'sandwich' with sponges, brushes, etc.

How to correct developmental dyspraxia

Let these children develop at their own rate, protecting them from external pressure and serious failures.

• Tactile, space-body and motional sensations are needed for a child to help him feel his body and understand how to move in space. He needs to do motional tasks stimulating these feelings.
• For a child to master new actions it is necessary to encourage him verbally and in the beginning to help him fulfil a new task.
• It is also necessary to divide the tasks into small steps making it easier for him to cope with them. It will enable the child to feel his powers and to raise his self-assessment.
• The child needs tasks making him clamber, squeeze under objects or through them; tunnels, horizontal bars, obstacle courses will help a child to develop basic skills for controlling his body when moving and to realize how it is done.
• It is beneficial to play Do as I Do' games or copying the movements of fingers and arms/legs to music (children's dances with such movements as stamping their feet, clapping and other movements that require observation and imitation).
• Children also need games that develop regulation, control, attention and planning (without visual prompting).
• Plan together with your child his actions dividing them into consecutive steps (for instance, what should be done to prepare a sandwich, to wrap up a gift, to make a homemade article, etc.). Give your child well-wishing help.
• Help your child to calculate time. Stimulate him for actions for which it is necessary to calculate time, place and direction of movement (to hit a flying (rolling) ball, to jump with a jump rope, etc.)
• Encourage your child to master new tasks and games and use game equipment for new purposes; test various positions and directions by playing various swings, clambering in new directions.

Find out what it is easier for your child to do - imitation, fulfilling verbal instructions, arranging sequences, new ideas - and what it is more difficult for him to do. Use the child's strengths to make for his weaknesses.

How to develop the proprioceptive system

• To lift and carry a heavy load (packages with foodstuffs and drinks, bags, linen baskets).
• 'Push-pull' - to pull and push a cart with foodstuffs, to push a pram, to draw a vacuum cleaner, a rake, to push heavy boxes, to tow a sledge with the child's friends.
• To hang on a horizontal bar. To move along bars in a hanging position.
• "Ants' Path" - to carry on the back a sack with rice and or beans. To play We Carry a Heavy Shell game.
• To warm up the joints using the technique of stretching and bending.
• 'Squeezing the body' - to sit down on the floor behind the child's back, your legs astride, then to embrace him with your legs, grapple the child's knees, press them to his chest and strongly squeeze them. Hold your child strongly, swaying him to-and-fro.
• "Bear's embrace" - strong embraces of all the relatives.
• Opening doors.
• 'Back to Back' - two children sit on the floor, pressing their backs against each other. Ask them to set their feet against the floor and rise supporting each other
• 'Bulldozer' - one child sits in a large carton box while the other push it on the floor or a floor-mat with his head, shoulders, back and feet.
• Wrestling with adults on the floor (do not forget to let the child win!).