Monday, April 19, 2010

Alphabet Soup

There is a term in the special needs world (or is it just for mental illness?) called "co-morbidity". It basically means conditions that occur together. As in; bipolar with comorbid ADHD. But the word, to me, means - the other thing he's going to die from. I mean, co-morbid? Does anyone else think it's weird?

Anyway, back to the topic. Bipolar can occur with other complications, is my point. Things like attention disorders, anxiety disorders, conduct disorder, learning disabilities, and even autism. Parents sometimes refer to this as the "alphabet soup" effect. This can happen before you even know it. You start going to professionals to get help with bipolar disorder and suddenly your child is diagnosed with BP, OCD, ODD, ADHD, SID, NLD, and ASD. See where the alphabet soup term comes from?

My personal feeling about it is to leave kids with as few labels as possible. Many many of these conditions have overlapping symptoms. There is no doubt in my mind that Taz has very clear signs of bipolar disorder. That is his primary diagnosis, even though he would fall into the category of some others. The only other condition I acknowledge separately (for Taz specifically. I absolutely acknowledge autism as a whole other diagnosis) is SID, or Sensory Integration Disorder. Also known as Sensory Processing Disorder, a term I like better. Taz, literally, has trouble processing sensory stimulus. Although it often occurs with Bipolar and many other things, for us, it's an entirely different diagnosis from the bipolar.

I wanted to give SID it's own post because it effects our everyday life, just like bipolar does. The ways this presents for Taz are:

- Sensory craving; this is a boy who swims in sand. You think I'm joking but he literally does the breast stroke on his belly in the sand. He rolls in it, dumps it on his head, and covers himself in it. Anything can be a sensory experience for Taz. He loves squeezy balls, gak, gummy worms, spiky balls, rice and beans in a bucket, and all that good tactile stuff.

- Ironically, after swimming in the sand, the next day he might scream about a small wet spot on his shirt and want to change it immediately.

- Gross-motor sensory seeking; Taz loves crashing, jumping, rolling, clapping, and stomping. This is called proprioceptive input. Every morning when he wakes up, the first thing Taz does is stomp around the house clapping his hands and making strange noises. My theory is that he's giving himself the sensory input he needs because he's wound up and it helps him get the pent up energy out. It also organizes his system so he can get ready for the day.

- Ironically, Taz is also very cautious. It's pretty weird, to me, that he has no problem crashing head first on the couch pillows but then won't climb up a ladder on a playscape. He is very insecure when he's off the ground. He is extremely afraid of heights. This is called vestibular or gravitational sensitivity. It takes a long time to coax him to try new activities involving being off the ground. He goes to private OT once a week and we are working on this, but I don't think rock climbing or rappelling will ever be in his future.

- Noise sensitivity; Taz hates loud noises. He is so scared of alarms he won't even walk by our home alarm system on the wall. Sudden noises scare him and he has a tough time recovering. Ironically (there are lots of contradictions with Taz), he is the loudest person I know. Therapists think he drowns out noises he doesn't like with his own voice. That's why when Chica cries or when I vacuum, Taz will yell as loud as he can (giving everyone else a headache).

- Pushing; this is one of Taz's favorite things to do. Push things around. It's one of the main ways he gets the sensory input he needs. I find if he's really wound up, I take him outside and have him push Chica in the stroller, or his car (the kind he used to sit to ride when he was littler) up and down our bumpy road. It works. While we're renovating our new house and basically living in two houses I've taken some of Taz's toys to the new house so he would play while we work. One day we were outside our old house and despite there being a multitude of toys in the yard, including slides, climbing equipment, dump trucks, balls, etc...Taz paced around saying what me push? over and over until we went inside because it got so annoying.

- Rocking; Oh the rocking! Let's see. How can I make this clear? Taz is always rocking. This happens in several ways. Every night, since he was a baby, Taz has rocked himself to sleep. (Remember, I didn't have him until he was 14 months old, he's adopted from foster care. He started rocking long before he came to us). He lies on his back, he holds his stuffed cow on his face, and he rocks violently side to side for at least 15 minutes, usually longer, until he falls asleep. That's one way. Another way he rocks is with his head. We call this the "Stevie Wonder". He literally does exactly what Stevie Wonder does when he sings. Taz rocks his head side to side, usually when he's happy. I've seen him do it at school during circle time, in the car, in front of a fan, listening to music, pretty much whenever he is not crashing or pushing. The last way I've seen him rock is when he's agitated and anxious. This is usually when he's also depressed. He will stand near me and sway his body back and forth while whining or just being overall anxious. He will also lie down on the couch and do the rocking motion like he does when he goes to sleep anytime he's coming down from a rage or being upset. I think it calms him down. Sometimes we even tell him to go rock on the couch so that he'll calm down.

- Ironically (yes, again), he hates swings!

Taz playing in a whirlpool at our childrens science museum.

Our psychologist initially thought Taz was on the autism spectrum because of all this sensory stuff. And he does have some autistic traits. But not enough to qualify for the diagnosis.

So...does anyone else's kid(s) have sensory needs?


  1. my son was never diagnosed with sensory issues - i even had an OT test him and he "tested out" - excelling at it - but i know he does. like taz, he will yell as loud as he can when the vacuum or blender comes on and many other things that you talk about.

  2. My son used to rock at daycare when he was overwhelmed. It really freaked the teachers out. The sensory issues look different now - they are more like what I see out my window right now - him riding a 4 wheeler back and forth through the back yard. He loves forward motion. It soothes him.

  3. I didn't realize how many sensory issues I had until I started working at a special needs summer camp. My brother too. I don't eat sandwiches because I can't stand the texture, I HATE loud noises (when I was little I used to lose it when they blew the lunch whistle, so my mother had them come over, warn me, let me cover my ears and then have them blow the whistle from the other side of the room) All these little things that used to make me feel sort of "different" i just sort of embrace now. I don't feel like it's me being "weird" but it's that my body processes certain things differently.

    and co-morbidity. I hate that term. I remember researching ADHD before I got diagnosed (I have ADHD and OCD) the term is just scary.

  4. My son has a hard time with loud noises, crowds, and food textures and flavors. Poor thing has vomited when trying to eat a single bite of a carrot. He also can't wear certain clothing, he only wears sweat pants and certain tops.

  5. Great post!

    The fact that Taz likes to crash, jump, roll, etc, is proprioception -- done to help self regulate. The fact that he is affraid to try new things is about predictablity (something our kiddos don't have when their senses out of sync) and climbing high is about vestibular -- balance (not as in he can't balance, but as in his sense is off, getting reliable vestibular information is unpredictable).

    Sounds like you have your hands full and that Taz and my son Gabriel have a lot in common! My son has Bipolar, High Functioning Autism and SPD. We have dozens of co-morbids too, but they are all symptoms, in my view, of the bigger issues. He is adopted from foster care as well, and I was placed with him at 14 months old...small world. :)

    Thanks for sharing!
    Author of This is Gabriel Making Sense of School

  6. SPD was Carter's first diagnosis. He's an odd mix, avoiding input in some senses and seeking input in others. It can be exhausting, but he manages it MUCH better now, at age 7, than he did when he was Taz's age.

    Carter is also extremely cautious and doesn't like to climb, doesn't like to be lifted, and generally feels insecure unless he's standing on the ground. BUT, the crashing, slamming, spinning, banging, etc., is endless. He broke the doors at PetSmart the other day. He wasn't trying to be destructive; he was just on the move. My husband and I use this phrase as our shorthand: The dervish is whirling. And it's exactly like that.