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Thursday, Aug. 28, 2003

Finding a sense of balance in the face of DSI

A private care center for special-needs children becomes an urban sanctuary


By CAROL HUI-AKIYAMA
Special to The Japan Times

Every day, at a musk-melon-colored building near Okayama Station, children gather to play in a rather unusual-looking indoor playground. Guru Guru Meron Shima (Twirly Melon Island) is a privately-run day-care center for autistic and other special-needs children that started up in July. It is also, most likely, the best-equipped sensory therapy room in Japan.

News photo
Rio Akiyama tries out the sensory therapy swing with occupational therapist Kayano Wakamatsu at Twirly Melon Island in Okayama.

Sensory integration therapy is used by some health workers to help children with sensory integration disorder (DSI). Children with this disorder have difficulties processing sensory information, and this causes problems with learning, development and behavior. Though the condition is most common in autistic children, what's often less known is that seemingly normal children can also suffer from sensory problems.

California-based Dr. Jean Ayres, who developed sensory therapy in the 1960s, divided sensory activities into three major areas: those that help children overcome the fear of touch; those that help children overcome gravitational insecurity to improve balance and coordination; and more physically intensive activities for improving body awareness and strengthening muscle tone.

Sensory therapy is all about playing. At Melon Island, children are free to choose what they'd like to play with, but all the equipment helps to integrate the senses and improve motor coordination. Most children are first attracted to the special swings dangling from the ceiling. Unlike playground swings, which move back and forth as well as up and down at the same time, sensory therapy swings are limited to one motion at a time -- up and down, backward and forward, sideways, or circular. Reducing motion to one type at a time allows a child to become comfortable with movement. Children are also encouraged to ride the equipment in various ways to use different muscles -- standing, sitting, or on their backs and stomachs.

"Many children have weak trunk muscles from not having crept or crawled as infants," explains Kayano Wakamatsu, occupational therapist-in-charge, referring to a tendency among DSI children to avoid activities where their stomachs or knees have to touch the floor.

Sometimes Wakamatsu complicates the swinging by asking children to knock over a pile of cardboard bricks placed within their reach.

"To perform an additional action while swinging requires motor planning, where the brain must organize various parts of the body to do different things at the same time," she explains.

A new law enacted last April gives parents of children with diagnosed disabilities a monthly stipend to use on therapy. Many children who attend Melon Island utilize this subsidy. However, undiagnosed children can also attend by first consulting with Wakamatsu. This is where Melon Island steps in to help -- it charges only a nominal fee where parents have no subsidy to fall back on.

Wakamatsu says that many children in Japan have unaddressed sensory problems. "They look and behave normally, but these kids suffer a great deal more stress just sitting in a classroom and listening than an integrated child," she explains.

Children with sensory problems are more likely to refuse to go to school and more susceptible to bullying. But recognizing sensory integration problems is no easy task.

As a mother, I know this from experience. Before he turned three, my son Rio did simple calculations on his fingers, and had memorized half-a-dozen children's books in English, which he then translated into Japanese. That was the genius Rio. But there was also the obsessive Rio who had to walk the same shopping routine every day, and threw tantrums if he could not read the letters and numbers on the license plate of every parked car along the way. Then there was the hyperactive Rio who never sat down on trains or for meals; and the anxious Rio who fled from parks where the other children were playing boisterously.

First I looked into ADHD (attention deficit hyperaction disorder), simply because there was abundant information on the topic. But it didn't quite fit my son. Rio spent long periods playing with trains and absorbs himself in his books. Next I looked into Asperger's Syndrome, high-functioning autism, with hallmarks that include the rapid absorption of concrete knowledge but difficulty with abstract thought and social relationships. It described Rio better, but my son was actually very empathetic (he once put a Band-Aid on a butterfly with a broken wing).

Then I picked up a copy of Carol Kranowitz's "The Out-Of-Sync Child" -- and cried. In her experience as a preschool music teacher working with more than 1,000 children, Kranowitz was intrigued by the fact that there always seemed to be a few who didn't fit in. That prompted her to research DSI and write a parent-friendly book about it.

My husband and I experimented with some recommended activities from the book. The results were dramatic and immediate. We bought a hammering toy, which most children enjoy at around 18 months. Rio never wanted it because he didn't know how to bang. At 3 1/2, he finally tried to hammer -- first with apprehension, then with excitement. Being able to use his muscles to grip and bang gave Rio confidence.

We stimulated his sense of touch by making him play with substances of various textures, such as play-dough, and a mixture of corn starch and water. We stimulated his oral skills by brushing the insides of his mouth, and by placing chocolate syrup on the corners of his upper lip and making him lick it to increase tongue movement. We gave him mouth toys, like whistles and harmonicas.

This January, he received five sessions of private therapy at Pediatric Therapy Network in Torrance, Calif. There, he overcame gravitional insecurity to be able to swing and sing songs at the same time. With an experienced occupational therapist who broke down seemingly simple tasks into single action components, his motor coordination improved.

The child who once woke up at night, terrified, begging not to go to preschool, became eager to attend preschool where he could show off his new skills. He still has bad periods and much to master, but sensory therapy has transformed my son from a frustrated, anxious boy to a confident, happy one.

For general information, go to www.sensoryintegrationhelp.com; dsi-general@lists.sensoryintegrationhelp.com is a mailing list of parents experienced in sensory therapy at home; affordable sensory toys are available from www.pfot.com; "The Out-of-Sync Child" can be ordered on www.amazon.com


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