Preparing for Daily Transitions Helps Children with Special Needs

Back in the day when I was a student teacher in a kindergarten classroom, I learned a lot of songs and games to use to help my students transition from one activity to the next.  They were fun ways of getting the children to pay attention and do what was needed to clean up and get ready for the next thing.  Like spraying magical dust upon them, it worked miraculously!  At the time, I had no idea what I was doing was assisting the children with transitions by providing them a secure routine which they understood and knew what was expected of them.  In my new teacher mind, I was simply doing what I knew worked to keep those thirty little munchkins from chaos!

Children do not like chaos!

As a parent of a child with special needs, I truly learned that children don’t like chaos any more than anyone else.  Since their worlds are mostly controlled by the adults in their lives, they might feel like the world around them is chaotic when things suddenly seem to happen and everything changes quickly – too quickly - and they don’t know why or what is going on.  These changes are transitions.  Every day we go through multiple transitions; some go smoothly and some knock us around a bit.

It only goes to reason that if all children can feel the world around them is moving quickly and unpredictably, how much more so does the child who processes things slowly or differently.  For the child with Auditory Processing Disorder or Mixed Receptive Expressive Language Disorder, language may be less than 50% understandable at times. Noises and movement in the environment may make things seem encroaching upon a child and always worrying that they just don’t understand can make the world seem out of control – chaotic.  So when a transition, a change from one activity or place to another, is suddenly thrust into the middle of an already somewhat chaotic feeling world, it can simply be too much.  The child understandably reacts with a meltdown.

Case Scenario:

When our daughter was very little, before we realized the significance of transitions, she would cry, get scared, panic, and grab me with such intensity her fingernails would embed into my skin.  In our adult minds it made no sense.  We had told her we were going to the store.  So when we put her shoes on and put her in the car, why did she suddenly freak out?  If we had only stopped to think about how it might have seemed from her point of view, we wouldn’t have been so shocked, and we would have been able to prevent it.  Eventually, with the help of our occupational therapist, we did.

From her point of view, she was sitting playing nicely with her toys in the comfort of her living room.  She heard some blah, blah, blah talking, but who knows what that was.  Then we came with shoes and put them on her feet.  She never had to wear shoes in the living room before, so that seemed weird. Besides, shoes aren’t comfortable.  Somewhere in the recesses of her mind she remembered wearing shoes before and it involved going outdoors, but maybe she sort of remembers this and maybe she doesn’t.  Suddenly we are picking her up and putting her in the car.  She was in the middle of playing and she didn’t want to stop playing.  She hates car rides because they are loud and sometimes there are weird smells.  Cars stop and go and things whiz past outside.  Moreover, she doesn’t want to go anywhere: home is predictable, usual, has the same sounds, smells, people, etc.  Other places are stressful, loud, smell funny, and may be too cold or too hot.  Even more frightening, what if people try to talk to her?  What if they touch her?  What will be expected of her?  Leaving home is always stressful and she wasn’t prepared.

Preparing for Transitions Does Wonders!

So we learned how to best prepare her for transitions.  We learned to use picture cards to show her the car and the store.  We told her we would be going in the car to the store.  We gave her time to process this information.  We helped her put away her toys.  We made sure she had her special blanket and her special chew toys.  We showed her the pictures again.  We encouraged her to repeat to us what we were doing. We reassured her that she was safe and we would be with her with our words and with pictures of us at the store with her safely sitting in the cart seat with her blanket and mommy beside her.  Yes, it took some time.  Yes, we had to plan and prepare for transitions.  It was well worth it!  They went smoother and without meltdowns – visibly she was still stressed, but they weren’t full-on panic meltdowns.

She still had to deal with the stress of being in the car and at the store.  She had to feel the panic when the cashier made eye contact and tried to talk to her.  We also learned sensory calming techniques to help with these things as well – her special blanket with scents on the corners and a vibrating chew toy or spicy candy, rubbing her hands, and speaking for her to the cashier (yes, she is a sweetheart – do I swipe my card here?) while comforting her all helped significantly.

It Gets Better With Time:

Okay, for all you poor panicked souls who are fearful that life will always be this difficult with your young, sensory sensitive child who processes things differently; I have some hope to offer.  This scenario I just described was our daughter at 2-3 years of age.  Today, at 11 years old, she is nothing like this!  She rides well in the car, she loves to go shopping, and she mostly does well responding to the cashiers.  She still hates to be rushed (she needs time to emotionally prepare she tells us) and wants to be told exactly what and when we are doing things.  Mostly we can tell her in words, but if it is a long list or complicated, we usually draw/write a flow chart or list.  And I have not had fingernails or teeth embedded into my skin for at least 7 years!

Suspecting Auditory Processing Disorder in Young Children

Lately I have come across a number of people who are new to auditory processing disorder.  These are people who have very small children who exhibit signs that might be indicative of Auditory Processing Disorder (APD).  I remember when my daughter was young and we knew something was not working right for her, but we weren’t sure what to do about it.  It was a scary, stressful time.

When our daughter was two, we noticed that not only did she not speak, but she didn’t seem to understand anything we told her.  She has a twin brother and he was speaking in sentences, telling us stories, and in every way communicating well.  We wanted to believe that she was just a late bloomer, but when she started tantruming from frustration, screaming from noises we could barely hear, and staring glazedly into space – absolutely checking out from reality – we knew something was not right. (When looking back on it, we realized that she actually exhibited signs as early as a newborn, but we didn’t know at the time what we were looking at.)

I started keeping a diary of her life.  I wrote down what she did or didn’t do that seemed unusual to me.  It didn’t take long to see a pattern emerge.  She didn’t understand what people said.  She was afraid of noises and voices.  She not only spaced out regularly, she did other odd things like smell everything, put things in her mouth, keep food stored in her cheeks, walk with her arms out at right angles, stand with her head on the ground down between her legs, play with her tongue in her mouth, constantly wiggle her fingers, not make eye contact, and try to avoid all people other than her immediate family. 

So I started researching and found out about our state’s infant and early childhood program.  It is a program that provides services such as speech therapy, occupational therapy, etc. to infants and children below the age of three.  They sent an evaluator to our home and decided that our daughter qualified for their services, so we started speech therapy and occupational therapy.

From our occupational therapist, we learned about Sensory Processing Disorder and started a sensory diet for our daughter.  This included physical activities as well as special foods that seemed to calm her and help her to not space out so much.  With a strong sensory diet, she made better eye contact, didn’t tantrum or space out so much, did less odd behaviors, and in general was a much happier and accessible child.

Our speech therapist was working actively on trying to get our daughter to speak and to better understand the spoken language.  I felt there had to be a reason that she didn’t understand, so we went to an audiologist to get her hearing testing.  Her ability to hear sounds was completely normal; she had no hearing loss.  So I started to research and found a disorder called Auditory Processing Disorder.  Our daughter seemed to fit this description perfectly.

I contacted a leading specialist in APD and set up a consultation appointment.  What I found out was that she was too young to be officially tested, but he was more than willing to look over my diary of her and meet her for some informal evaluations.  It didn’t take long for him to believe that she most likely did indeed have APD and that although he could not formally give her such a diagnosis, he felt it was accurate to believe she did have it, and we should start working towards helping her as much as possible.  He gave us a lot of information as well as some techniques to use with her such as always making eye contact, speaking in clear short phrases rather than sentences, watching for signs of stress in her particularly in noisy environments, and to realize that she will most likely not be able to understand what is being said if multiple people are talking at the same time- such as in a restaurant or at a family gathering.

With this information, we informed our speech therapist and occupational therapist who immediately researched Auditory Processing Disorder and tried to incorporate their new knowledge into their therapy.  Our occupational therapist started our daughter on a listening therapy program and our speech therapist introduced us to the use of picture cards to assist with communication.  Both of these things proved to be extremely useful.

At age three, our daughter transitioned into the school district’s early childhood special education program.  She went three mornings a week where she had access to a special education teacher, speech therapist, occupational therapist, physical therapist, and direct instruction and experience in socialization.  Although it was stressful for her to go, she did show great improvement by going there – particularly in socializing.

So this was our start to living with Auditory Processing Disorder (and Sensory Processing Disorder).  If I could give any advice to parents of young children who are exhibiting signs that something just isn’t right, I would say start a diary.  Write down what your child is doing or not doing that seems distressing or odd.  In time, you will see patterns.  You can use these patterns to access the services and help you need.  If you live in the United States, contact your state’s infant and early child program if your child is under the age of three; your pediatrician or local school district should be able to give you the contact information.  If your child is aged three or older, contact your local school district.  These agencies have specialists that can help get you started on the path to helping your child.