| Getting it Together The Children's Therapy Center Newsletter Alice in Dentist Land by Teri Allen, OTR Alice seems like a pretty ordinary kid. She is 4 (and a half!). She loves to play, tease her brother Joe and wear hats. She already recognizes the letters of the alphabet and her favorite color is purple. But, Alice is not an ordinary kid at the dentist's office. She screams, throws tantrums and refuses to let anyone look in her mouth. Nothing seems to work, not rewards or punishment. Everyone dreads Alice's dental checkups, most of all, Alice! What is the cause of this behavior? Is Alice spoiled? Poorly disciplined? Maybe she had a bad experience when younger. Well.... maybe. But, lets consider another possibility. It could be that Alice interprets sensory input from her body or the world around her, differently than most children. A visit to the dentist consists of many different kinds of sensory input. Let's review them. • SMELLS - There are different smells at the dentist office than at home or preschool. Smells of disinfectant, toothpaste, mouthwash and fluoride. That doesn't count the cologne the hygienist is wearing and the other kid in the waiting room who smells like his sand box. • MOVEMENT - "What movement?", you might be saying. Alice will have to sit in that big chair, lean back and often the height of the chair is adjusted or it is tipped backwards. She may not be moving, but she is being moved. • SOUNDS - There are doors opening and closing and water running in the sinks. The sound of a drill in the room next door can be heard. The dentist's shoes squeak as he walks across the freshly waxed floors and what about the hygienist's voice? She has a higher pitch to her voice than Mom does. • VISION - Those are pretty bright lights on the ceiling. Alice could close her eyes but, if she does she won't be able to see what is happening and that is pretty scary! • TOUCH- First, they might want to put that chap stick stuff on her lips to keep them from drying out, but it feels pretty sticky. That funny napkin under her chin is scratchy. And that lady wants to put one hand on her chin and her fingers in Alice's mouth. Well, that should be enough to convince us that Alice experiences a lot of unfamiliar or unusual sensory experiences at the dentist office. Alice as well as some other children find this very threatening. They react and behave as though they are fighting for their lives. They find these unfamiliar sensations so noxious or threatening, that reasoning with them or offering rewards just doesn't work. So what are the people in Dentist Land to do? First they need to try and determine if Alice is genuinely feeling threatened or just misbehaving. Asking a few questions about other behaviors may help answer this question. A "yes" to any of the questions below suggests the possibility that Alice's nervous system is not processing sensory input the same way as most other children. It is likely that the sensory experiences in Dentist Land feel like a real threat to her safety. Does Alice seem to notice smells or complain about smells that don't get other's attention? Is she fearful on elevators, escalators, or carnival rides or does she get car sick? Does she avoid active physical play or playground equipment? Does she cover her ears with loud or unusual sounds or notice sounds that others do not? Is she overly sensitive to bright lights or sunshine? Will Alice brush her teeth and/or let her parents assist? Is she a picky eater? Does she get upset or resist grooming activities (face washing, hair cuts or combing)? Does she complain about how her clothes, shoes or socks feel? Does she over or under react to pain? Some modifications in Dentist Land might improve Alice's cooperation. • Consider the use of products with minimal odor, or kid friendly smells such as bubble gum. Vanilla and banana are smells that are commonly liked by all and can be calming. • If Alice has good verbal skills, ask permission to move her in the chair, or verbally prepare her for it. Lying backwards is often a very threatening position. You might consider doing the exam while she is sitting or slightly reclining. The exam might not be as efficient, but it's a beginning! • Keep noise to a minimum. Lower your voice and talk in a softer tone. You might consider scheduling her at a time when your office is not busy. • If lights seems to be an issue, you could have Mom bring a ball cap or visor or offer sunglasses! • Avoid standing "over" Alice. Sitting on a stool at her height will feel less threatening. Do not touch her unexpectedly or approach her from the back. Verbally prepare her every time you must touch her. If these ideas do not help, it is time to refer Alice to an Occupational or Physical therapist trained in treating children from a sensory integration framework. Treatment can have a significant impact on these sensory processing issues. |
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| CHILDREN'S THERAPY CENTER of Battle Creek, MI |
helping your child succeed!
| CHILDREN'S THERAPY CENTER of Battle Creek, MI |
helping your child succeed!