Occupational therapists who know about SI use simple techniques to retrain the body’s sensory apparatus. These can include brushing and joint compression, exercises that improve and strengthen the sensory part of the nervous system, and targeted work on specific sensory difficulties. Much SI work does not require any special devices, or employs inexpensive items like stretchy strips of rubber for arm exercises or weighted vests for calming. Many SI specialists do use occupational therapy equipment, such as scooter boards, huge therapy balls for improving balance, and prone-position swings.
One area in which SI techniques really shine is helping children with eating problems. If your child limits her food choices to a very few items, sensory problems can be at the root of this potentially unhealthy behavior. Certain textures and tastes may simply be unbearable. It is possible to desensitize the nerve endings in the mouth and throat enough to permit eating more types of food, and even desensitizing the taste buds a bit can be done.
SI specialists recommend making a sensory diet part of the classroom and home environment for children with difficulties. This means building experiences with different types of textures, tastes, smells, and physical sensations into daily activities. The Out-of-Sync Child, by Carol Stock Kranowitz, which is listed in the appendix, can provide some suggestions for home exercises.
SI therapists can also teach patients how to use self-calming activities and devices when they are reaching the point of sensory overload. Parents can be trained on the signs of sensory difficulties and on how to initiate these activities.
Speech Therapy
Speech defects such as apraxia, dyspraxia, stuttering, or cluttering occur slightly more often in people with bipolar disorder. However, as far as medical science knows, these are a separate problem.
If your child has problems with producing understandable speech, he should be evaluated as early as possible. Speech therapy can be tremendously helpful. Provide his speech therapist with information about bipolar disorders in children so that his behavior will be better understood, and provide suggestions for structuring speech sessions to minimize behavior problems and maximize compliance. Token economies and other reward systems are widely used by speech therapists, and can help a lot. Short, frequent sessions may be more effective than long, infrequent ones. Your child may perform better in one-on-one sessions than in a speech group. Also, as at home and in the classroom, the rules for speech time should be clearly delineated.
Problems with prosody (speech flow and conversational skills) and volume are seen rather often in bipolar children. Children with these difficulties are less likely to be referred to a speech and language specialist than are children who cannot produce certain sounds or who stutter, but they can benefit nonetheless from speech therapy. Make sure the evaluator or therapist your child sees for these difficulties knows these topics well–not all speech specialists have expertise in these areas.
Prosody problems lend themselves best to group work. If your child’s speech is consistently too loud or too soft, one-on-one work seems to be most effective, often using a tape recorder and other tools in order to encourage self-observation and to build skills for assessing and using proper speech volume.
Last reviewed: By John M. Grohol, Psy.D. on 12 Jun 2007
