Sunday, April 13, 2008

Warning: this post is not for the squeamish!

In the wee, small hours of this morning, the kiddo came in to our bedroom to announce that she had just thrown up. She was carrying the "barf bucket" that we'd set next to her pillow last night at bedtime, and sure enough, the paper towels lining the blue, Tupperware bowl were no longer pristine.

Naturally, no parent ever particularly wants to hear the words "I'm going to throw up!" or "I just threw up!" spoken by their child, especially when those words rouse them from a nice, quiet sleep. This invariably leads to a scene similar to the one that has now occurred twice in our household in recent hours: one parent grimly stripping down bed linens, checking stuffed animals for spatter, marching down to the washer with the assorted contaminated items and then scrubbing up the spots on the carpet while the other (looking equally grim) waits for the barfing to subside, provides the necessary comforting and calming (which may involve getting spattered or doused oneself) then strips and cleans up the kiddo, usually involving a shower, thorough tooth-brushing and complete change o' jammies.

There is some good news to the barfing announcement in our family, however. You see, there was a time not too long ago when our kiddo couldn't tell that she was throwing up, either before, during or after the act. The first time she ever threw up (like from a stomach bug, I mean, not just like spitting up as an infant), she was about 16 months old, and she had been sitting on the floor playing with some toys while I sat on the couch a short distance away. She got up, came over to me, and said in this confused and questioning-y sort of way "Mommmmmmmy?" and then proceeded to vomit all over my lap, the couch and herself. She then turned back around, completely calm, and returned to the spot on the floor where she'd been playing, while I sat stunned and dripping. As I was trying to figure out the best way to get to the necessary cleaning supplies - this was going to require a LOT of paper towels at the least - she turned her head to the side and vomited again. (Isn't it weird how a kid can barely have anything in their system, yet somehow manage to yack up gallons upon gallons of stuff that doesn't even resemble anything they had eaten in recent memory?) Once again, she was utterly calm and not in the least concerned about the volcanic eruptions pouring forth from her mouth. She barfed and then went right back to her blocks, wholly unfazed. It was just....weird. No tears, not the least bit upset, certainly not any sort of reaction I'd ever witnessed in a person involuntarily vomiting before.

In the years that followed that first vomiting episode, the kiddo had a few other stomach bugs. As with that first time, she never seemed aware of or bothered by them. More than once, we didn't discover she'd thrown up until the next morning, when we'd walk in to find her sleeping soundly in a bed covered in hours-old, drying ick. (I warned ya - this post is not for the squeamish!) It still seemed odd that throwing up would rank so low on the "child upset-o-meter" but it was the way it was.

It wasn't until the kiddo was three and a half that we learned why she was so under-responsive to the whole vomiting thing. It was at this point that we had her evaluated by an occupational therapist and learned that our kiddo has Sensory Integration Dysfunction, nowadays more commonly known as Sensory Processing Disorder. Basically, this means that her brain doesn't process the information it receives through the various senses in quite the right way. In her case, the kiddo is a sensory seeker, who tends to be under-responsive to sensory stimuli. This would include the "oh my goodness I'm about to barf!" sense. Another, less icky example is that for the longest time, the kiddo's brain didn't register the sensation of being dizzy. She could (and would) spin and spin and spin and never feel dizzy, even when her body would physically react the way anyone's would after such spinning around. She'd be weaving like a drunken sailor and still want to spin (or be spun) some more.

When we first learned of this diagnosis, I did a crash course on SPD. I read every book I could get my hands on about the topic. (If you're interested in learning more about it, my favorite book on the subject is Sensational Kids: Hope and Help for Children with Sensory Processing Disorder by Lucy Jane Miller, PhD. Well written and not too dry, it is comprehensive and easy to read without getting caught up in technical terminology or highly academic language that would go over the average reader's head.) Not every person with SPD has the same issues. Some people go the other way of our kiddo - they are hyper-responsive instead of under-responsive, whether it be to the way clothing feels on their body to noises or lights or commotion. In our world, though, we've got a classic example of a sensory seeker. The kiddo needs more (in some cases, waaaay more) sensory input than the average person to be able to register the different sensations properly. This, as you can imagine, led to some difficulties for her, especially once she was out in the world outside our home (like, say, preschool or church or a shopping mall).

The good news is that occupational therapy is doing wonderful things for the kiddo. In just over a year of OT, she has made some huge improvements. They say that there is the possibility for the brain to "rewire" itself to a certain degree when kids with SPD receive the appropriate OT type help, and we can see that this is true. One example is that now when the kiddo spins and spins, eventually she feels dizzy. Yes, it still takes her brain a lot longer than the average person to recognize the sensation, but two years ago that sensation wasn't there at all. Also, the barfing - she now feels that horrible "I'm gonna barf" feeling, often times with enough advance notice to make it to the bathroom or the barf bucket, and to alert us to the coming ick.

They say that one in every twenty children has some form of SPD. They are finding that many children on the autism spectrum have SPD (though not all children with SPD are on the autism spectrum). Even with this prevalence of SPD, it is still a largely unknown, under-researched and understudied disorder, though there are a few places out there trying to change that. There are people out there too, though, some of them "experts" even, who don't believe that SPD is real, or who think that it is a lot of hype - that the folks who are talking about it are making it up, or blowing "bad behavior" out of proportion, and others who think this is just the "new ADD" or something, like a fad or the latest train to jump on - the latest excuse parents use for the less-than-perfect-appearing behavior of their coddled child(ren). (The kiddo even was evaluated by an occupational therapist who didn't "believe" in SPD and gave us a line of hooey about what the kiddo's supposed issues were. While we knew enough at the time to know that she was full of crap, we still wound up losing several months of OT time because of her, and yes, I'm still angry about that more than two years later.)

To those people, those detractors or disbelievers who think that SPD is a load of bull, well, I say take a look at my child. Look at how she was two years ago, and look at her now. There is no denying the signs, the behaviors and the improvements since she began OT. Otherwise, we never would've gotten that early morning wake-up call about the barfing today. I hope that someday in the not-too-distant future, people know and understand SPD the way they do ADD or dyslexia or any other number of issues that impact children in their formative years, but for now I'm just glad that we know about it and that the kiddo is getting the appropriate services to help her with it and hopefully remove some of the challenges that she might face as she enters elementary school in the fall.

(Oh and PS - the barfing? Not the way I'd have chosen to start off the kiddo's Spring Break from school. Not at all!)

1 comment:

Lylah M. Alphonse said...

Good for you for noticing the signs and getting Kiddo the help she needed! It's amazing what the right therapies can do... and how few kids actually get them.