Separation anxiety disorder

have "fight or flight" responses to sensation, a condition called "sensory defensiveness." They may:

• respond to being touched with aggression or withdrawal

• be afraid of, or become sick with, movement and heights

• be very cautious and unwilling to take risks or try new things

• be uncomfortable in loud or busy environments such as sports events or malls

• be very picky eaters or overly sensitive to food smells

Dyspraxia

These children are clumsy and awkward. They have particular problems with new motor skills and activities. They may have:

• very poor fine motor skills such as handwriting

• very poor gross motor skills such as kicking, catching, or throwing balls

• trouble imitating movements such as "Simon Says"

• trouble with balance, sequences of movements, and bilateral coordination

Treatment

Sensory integration dysfunction is a neurological problem that affects behavior and learning. Medicine cannot cure the problem, but occupational therapy can address the child's underlying problems in processing sensations. A good sensory treatment plan may be a major component in treating the child with SID.

If a child is suspected of having a sensory inte-grative disorder, a qualified occupational or physical therapist can conduct an evaluation. Evaluation usually consists of both standardized testing and structured observations of responses to sensory stimulation, posture, balance, coordination, and eye movements. After carefully analyzing test results and other assessment data along with information from other professionals and parents, the therapist will recommend appropriate treatment.

If therapy is recommended, the child will be guided through activities that challenge the ability to respond appropriately to sensory input by mak ing a successful, organized response. Training of specific skills is not usually the focus of this kind of therapy. Instead, adaptive physical education, movement education, and gymnastics are examples of services that typically focus on specific motor skills training. Such services are important, but they are not the same as therapy using a sensory integrative approach.

The motivation of the child plays a crucial role in the selection of the activities in a sensory inte-grative approach. Most children tend to seek out activities that provide the best sensory experiences at that particular point in their development. it is this active involvement and exploration that enables the child to become a more mature, efficient organizer of sensory information.

The most important step in promoting sensory integration in children is to recognize that it exists and that it plays an important role in the development of a child. By learning more about sensory integration, parents, educators, and caregivers can provide an enriched environment that will foster healthy growth and maturation.

The goal of occupational therapy is to enable children to take part in the normal "job" of childhood, such as playing, enjoying school, eating, dressing, and sleeping—activities that are often a problem for children with SID. Each child is provided with an individualized treatment plan that directly involves parents.

Occupational therapy usually takes place in a large, sensory-enriched gym with lots of swinging, spinning, tactile, visual, auditory, and taste opportunities.

separation anxiety disorder An intense anxiety about being away from home or caregivers that affects a child's ability to function socially and academically. These children have a great need to stay at home or be close to their parents, worrying excessively about their parents when they are apart. When they are together, the child may cling to parents, refuse to go to school, or be afraid to sleep alone. Repeated nightmares about separation and physical symptoms such as stomachaches and headaches are also common in children with separation anxiety disorder. (See also

ANXIETY DISORDERS.)

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