Thursday, December 13, 2012

The Plague of Tics

I alluded to the fact that Geri has some "tics." I sometimes call them "-isms", because some of them seem to be "blindisms" or "adoptedisms", but they boil down to uncontrolled, repetitive behaviors that she has a hard time reigning in. I suspect lots of adopted kids, who have suffered neglect or trauma, have some of these types of behaviors, and I know for a fact that a lot of blind or otherwise disabled kids have them, too. That's without throwing the Autism spectrum into the equation, which is characterized, in part, by the tics.

I wanted to share our experiences with Geri's tics because I think it does two things - 1) gives people in our circle of life a platform for understanding our daughter, so they don't think she's nuts or having a seizure or something and 2) gives a bit more info to people who might be dealing with something similar, as I can share what we have found that works for her and possible interpretations. There's a lot more to these behaviors than meets the eye.

When Geri came home, she had some tics. Over time, with lots of sensory input and PT and sensory therapy and brushies and squishees and redirection from us, that stuff subsided a great deal. However, following her cornea transplant, a lot of it has come back. We've seen this before, actually, that a change in her vision leads quickly to an uptick in tics. This time, it's been fairly marked and dramatic.

She has started rocking again. No, not blasting White Snake in her room late at night. It's more like she's throwing herself against her seat for the sensation of smacking into it. She hits herself in the head. She squeals and shrieks. She pulls at her clothing, flails her arms and contorts. She pulls at her tongue and lips. Shoves both hands into her mouth. Honestly, it can look pretty fricking weird. I suspect that people who see this think she's either possessed or massively autistic/retarded. Maybe they think she's psycho.

Then they think I'm psycho, because my response is to tell her to go pick up my bag and bring it to me. Then I tell her to put it back. Then I ask her to bring it to me again. Then I hand her something to throw in the garbage. Or I throw out something random like "Say 'mommy, I'm hungry.'" and proceed to give her crackers.

Here's what we've figured out about these fits. First, there's always a trigger. It's almost never totally random or out of nowhere. It may look that way, but that's until you decode it. When she's messing with her mouth, it's because she's hungry. Sometimes, when she starts rocking in her seat it's because she wants to get down. Much of the time, it's linked to overstimulation. There's too much input, often visual input, for her to process. Many times, it's linked to a specific frustration, like being told "no" or that she can't have or do something she wants. It's her way of throwing a fit, the equivalent of laying on the floor and screaming and kicking her feet. It just looks a hell of a lot more bizarre.

Geri's sensory system is, to say the least, ill equipped for the world in which she lives. She started off at a deficit, because of her blindness, and then she was severely understimulated in the orphanage. We also suspect that she was quickly moved from almost zero stimulation in the infant room to the highly stimulating environment of six or seven toddlers running around in the toddler room at about the age of three. So after three years of nothing, she got tossed right into the deep end. Blind. She has every right to have a sensory processing deficit, honestly.

Which is where carrying my diaper bag around comes in. There are lots of ways to deal with a sensory problem, depending on the nature of the problem itself, and "heavy work" is a good one. Moving, lifting, carrying, pulling or pushing something heavy provides tons of proprioceptive input that stabilizes and calms the sensory system. It releases endorphins, which give a kick of feel-good to the brain, and gets some of that energy worked off. When she is spun up, it's the best possible response. It also calms and focuses her almost immediately to be given a simple, easy-to-understand task. When she's feeling loopy, it seems to ground her and give her a sense of purpose that settles her mind to be given something to do. I kid you not, telling her to throw something away for me can end a fit instantly.

And, to be honest, I'm already seeing the tics begin to subside. If we were consistently using brushies and squishies it might be moving faster, although I somewhat doubt that. She doesn't respond to the brushies and squishies as if they are helpful. One of her therapists told me that, in the world of sensory integration, you can tell if you are doing what your child needs because they respond happily. "If she's smiling, you are giving her exactly what she needed." When I brush her, she just seems to tolerate it. But as soon as I hand her something heavy and tell her where to take it, she grins from ear to ear.

So, if you see us out and about and I'm pulling all the chairs out from the table and making her push them back in, there's a reason. And it's not just because I'm some sadist who likes to give her child a Sysiphean task.

1 comment:

  1. Totally agree with everything from the triggers to ways to combat. Rex used to tic (or stim) for hours each day when he was first home. Now, if I add it up throughout the day from small instances, it's probably less than 15 minutes per day. Heavy work was a very big help for him in the early months. Now he responds well to pressure and by that I really mean either Craig or I or both of us giving him a top to bottom massage that is going to look like we are hurting him to outsiders. Meanwhile he smiles, giggles, exhales with big succulent sighs like he's saying, "Thank you for this input. It feels so good. I am relieved."