Understanding your Child's Needs
Tools for figuring out your child's social communication, emotional and sensory needs
The Individual
Your first step will be understand your child's Social Communication, Emotional & Sensory Needs.
Whether you have a diagnosis or notice specific challenges, it is critical to understand your child. Each child is unique and while sensory & social differences may result in common difficulties or challenging behaviour they may not have the same cause. Parents, teachers, professional assessments and therapists can observe the child to understand the underlying causes of the challenges and behaviour you are witnessing.
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While a diagnosis can help confirm the challenges, provide legal & equality protections and qualify the child for some support, there is no one size fits all treatment or path. So just getting a diagnosis is not sufficient to know what to do. Therefore, the place to start is with a strong understanding of the child and their needs. Below you will find the three key areas you need to consider. If there are any co-morbidities (i.e. ADHD) or medical conditions (i.e. gastrointestinal, epilepsy) to consider, you can add these too. Importantly, don't forget to include your child's interests, strengths, skills and unique gifts as these are important tools for developing social-emotional confidence and competencies.
Determine the child's communication stage
Use SCERTS and Speech & Language Therapists
Identify different states of Emotional Regulation: Engaged & Safe, Fight/Flight or Immobilised
Use SCERTS and an A-B-C (Antecedant, Behaviour, Consequence) chart to assess behaviour and determine emotional state
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Environmental stress, inability to predict other's intentions and anxiety are common factors to consider
Interpret body & sensory signals of dis-regulation
Test for allergies & medical conditions
See an Occupational Therapist to assess sensory needs
Once you've observed your child or received professional evaluations, its useful to summarise your findings in a child profile.
Social Communication
Identify communication partner stage
The SCERTS framework utilises a worksheet for identifying the Communication Stage. You can find this worksheet in link above.
It is best to use the SCERTS framework with a trained professional or having attended an in person or online training. The Autism UK website has links to SCERTS content and guides:
Packet 1: The SCERTS Model Introduction, Application & Assessment
Packet 2: SCERTS in ACTION Implementation Steps
Below is a high-level overview:
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1) At social partner stage - you want them to fall in love with the social world and need to be their rock. They will show a range of non-verbal communication and the attachment between you and the child will grow. They will soothe when you attend to their needs.
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2) At language partner stage - you want to witness them communicating using simple language, pictures or sign/makaton, securing your attention and using noun/people + verb combinations (i.e., "Mom, man riding bike" while using his finger to point).
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3) At conversational partner stage - you want to see them communicating with many partners in many settings, for many different reasons (e.i, sharing stories, emotions, asking for help, playing, etc.)
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Sometimes we can assume a child is already at conversational partner stage, but they are actually at language partner stage as their focus remains on objects and not the social world around them. Topics may be very self directed with little awareness for social norms of conversation; nevertheless, they could have excellent expressive language.
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Additionally, Consulting a Speech and Language Therapist can help identify specific challenges/needs that the child has, such as low tongue muscle tone, trouble with letter pronunciation, etc.
Emotional
Is your child feeling safe & ready to engage, stressed & anxious or shutdown & disengaged?
This is often the trickiest one to understand. Going back to the Polyvagal Theory, Porges identified three states that individuals are in at any given time:
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1) feeling safe and engaging with the world around them
2) in danger and ready to respond with mobilised fight or flight
3) immobized/shutdown.
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The critical point is how the person is perceiving the world, not cognitively, but at a physical level. Are they feeling fearful? Phobias for example are non-rational and no matter how much someone may tell you the tiny spider won't harm you, you may still be in a state of fear or anxiety.
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There are common responses to fear which align with the Polyvagal Theory.
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1) Friend - utilise a friend to help, we need to perceive the individual as safe (i.e. child crying for his/her mother). This utilises the newer mammalian vagal nerve associated with the sympathetic nervous system
2) Fight/Flight - body deems that a friend is not available and activates sympathetic nervous system.
3) Freeze/Faint - if body deems that Fight/Flight is not going to avert the danger then freezing is a better strategy as immobilisation could make prey less of a target (think of the spiders or rolly-pollies that appear dead under threat). This activates the older part of our vagal nerve often referred to as the reptilian brain.
4) Feign - a person may go along with a situation (i.e. a victim going along with their captor in the hope of pleasing them). They may mask or pretend that they are ok. These are immobilisation responses to fear.
5) Figure - worry, obsesses, plan - try to think out of their fear, but the underlying stess/anxiety remains.
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Try to identify which state your child is in and what is the stressor that is eliciting that response.
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ANXIETY is often the root of challenging behaviour.
It can be useful to keep track of challenging episodes using the ABC Model. Antecedent-Behaviour-Consequence. Remember behaviour serves a purpose!
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Your goal is to try to uncover what is causing the anxiety, i.e. what stressors are present in the child's life.
Body & Sensory
Identify allergies, bodily discomforts and sensory needs
Proper nutrition, sleep, digestion and exercise are necessary for a healthy body. Take a look at your lifestyle and determine whether your child is getting the rest and nutrition they need. With allergies on the rise, it is important to identify any sensitivities to gluten, casein, nut, sesame, etc. that may be causing problems. Does the child's immune system seem strong or weak? Is there a gastrointestinal condition?
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There is new research on the link between the gut-brain which is shedding light on the importance of a healthy gut for emotional well-being. Incidentally, this is the vagus nerve that we've already identified as a key player in emotional regulation.
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In terms of sensory, an imbalance in any of the senses could cause difficulties and challenges for the child and idiosyncratic/challenging behaviour. For example, stimming is considered a regulatory behaviour, putting hands over ears is need to block out sound, pushing up against people could be a need for more pressure (propioception).
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An Occupational Therapist can assess your child and identify any hyper/hypo sensitivities.
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While you wait for an OT appointment, these books are recommended and can help you begin to understand what your child's sensory signals mean.