Some kids ultra-sensitive to socks, shirt seams, tags

How about that? I just found this interesting article, again...on sensory issues.

Early intervention can help with sensory overload

In some homes, a child's sock is simply that: A child's sock.

But in homes like Kelly Chirdo's, it is not.

The little ball of cloth is an instigator of tears, a symbol of lost time and sometimes the cause of a missed school bus or activity.

Kelly's 10-year-old daughter, Macy, simply cannot bear most socks. Or tags in the back of her shirts. Or seams in her clothes.

The socks must be seamless (or turned inside out) and the tags must be cut out, or the clothing won't get worn. Period.

"At first I thought, oh, she is a diva," says Chirdo of Irondequoit, recalling how Macy's early, insistent arrival caused an unplanned home birth. "Then I realized that this wasn't attitude, these things really bother her."

As it turns out, these things — and sometimes many more — bother an awful lot of kids.

"We got talking about this one day and found four people on our staff have the same problem," says Lisa Revell, an Irondequoit office manager whose 12-year-old son, Joe was, as a preschooler, "a horrible nightmare" when it came to sock seams and height, tags, winter boots and most other aspects of dressing.

And it isn't just clothing issues. Some kids have all senses on high alert: Pillows must always feel cool. Foods can't have lumps or other textures. Noises can't be borne, or else they must be heard loudly. Collar points or sleeves grow ragged from chewing or sucking. Hugs can be unbearable or must be given to the point of breathlessness.

On top of it all, the behaviors can be there one day, gone the next, roaring back a day later.

The good news is that the problem has gained enough notice to earn several names and various treatments.

The not-so-good news is that between pricey evaluations, arguing clinicians and conflicting diagnoses, finding the right help requires time and patience from parents run ragged by searching for seamless socks, tagless shirts and linens that magically stay chilled all night long.

Of all the labels for these behaviors — sensory defensiveness, sensory integration, sensory integration dysfunction, tactile sensitivity, tactile sensory defensiveness — only one fails to generate much in an Internet search.

This is because "pervasive hypersensitivity disorder" (PHD) is the creation of Brighton psychologist Matthew Rosen, who believes the problem needs its own name in order to separate it from disorders it resembles but does not mirror.

"These are kids who act kind of like the princess and the pea. They feel things strongly, are very passionate, critical deep thinkers," Rosen explains. "But they often are misdiagnosed. Like attention deficit disorder kids, they are squirmy, they are inattentive, they can be impulsive, they can be distracted. And like oppositional defiant disorder kids, they're gonna be cranky and oppositional."

Some differences, for example, are that a child with PHD may be squirmy simply because of discomfort, inattentive from intense pondering how to fix his situation, or oppositional from plain old feeling bad.

Rosen believes that some children with PHD can have that and nothing else, and with time and understanding can grow out of it, as Macy Chirdo appears to be doing. "It's stayed mostly to clothes," says her mother. "She has a few outfits she'll wear. No belts, nothing at the waist. She's still very perceptive and sensitive and intense. That's it, and that's who she is."

More often, experts find, PHD is a red flag alerting parents and pediatricians to other disorders.

By first grade, Joseph Moore of Webster was exhibiting many behaviors that Rosen lists for PHD, from chewing and sucking on the collars of his shirts and "turtling" (pulling his shirt over his kneecaps and putting his head into the neckhole) to rejecting most shoes and clothes, disrobing wherever possible.

"Oh my Lord, it was a struggle just to do the basics," says his mother, Susan Macaluso, who was also struggling with well-meaning observers who none-too-subtly hinted that poor discipline was to blame.

After trying two medications, talking to Rosen and discovering bipolar disorder in the family history, Macaluso learned that Joseph did not have ADD or ADHD, but a mix of bipolar and PHD. A third medication plus regular therapy caused "remarkable" change, she says. Joseph still prefers loose clothing, "but he's otherwise just a regular kid."

Revell, too, found her son's grade-school hypersensitivity was just a piece of a larger puzzle initially thought to be OCD, or obsessive-compulsive disorder, but was actually ADHD. Talk therapy, medications and time have gotten rid of most of the problem.

"We learned to pick our battles and let the rest go," she says. "He's a super-sensitive kid. So, OK."

The road to learning exactly what's wrong and how to fix it is long even for parents familiar with childhood disabilities.

Even though Karen Boltwood works for Board of Cooperative Educational Services as a para-educator for autistic children, she's struggled for 11 years to understand her son Benjamin's tantrums, unsoothable anxiety and acute fear responses when confronted with clothing tags, shoes, foods, swingsets and other elements of childhood.

"At this point, it's better, it's mostly down to social issues," says Boltwood, of Webster. "But we're at the point where it's like, 'We don't care what you call it, we just want to fix it.'"

Pediatricians and therapists say this requires understanding some basics.

For one, says Rosen, "Bad parenting does not cause this. This is how some kids are wired."

Ruth Goldberg, also a Brighton therapist, agrees: "These kids aren't here to make your life miserable. They're genuinely unhappy. Their behavior is communication with you — you can learn from it."

Another basic: Because this is easily mistaken for other disorders, a full evaluation is necessary. Start with your pediatrician, Goldberg advises, and ask around for a good occupational therapist. "They're the real experts in this."

Then prepare to take notes. There are several kinds of sensory issues a child can have, says Angela Sallerson, an occupational therapist for 36 years who focuses on pediatric patients, "and there's no blood test, no way to pick it apart easily."

The key, she says, is acting quickly on unusual behaviors and getting the right diagnosis.

"Early intervention is it with kids. Labels and letters can be frightening, but they're not the death sentence they used to feel like. You need a behavioral plan for the child and the parent. And if you treat it, it does get better."

Original article at http://www.democratandchronicle.com/apps/pbcs.dll/article?AID=/20060816/LIVING/608160337/1032