Would love some advice about sensory processing issues.

[Rainallnight]

My DD is four, and on the face of it, NT.

However a few issues in combination are making me wonder if she may have some sensory issues.

She has some continence issues and someone in a Facebook group I’m on for that mentioned that some kids have interoception problems - that is, problems with sensing how they’re feeling on the inside.

Here are the things I’m concerned about:

• she does not feel the cold at all, and at this point in the year, is not only not wearing a coat, but is wearing T-shirts and feels perfectly fine.
• she’s hungry all the time, even after what anyone reasonable would say was a LOT of food. I don’t think she can tell when she’s full.
• she can’t seem to tell when a wee is coming and has frequent accidents
• she withholds poo
• she chews a lot, especially when she’s nervous. She’s already chewed right through the top of her school drinks bottle.
• she is very prone to emotional outbursts

Some of this might be normal four year old stuff. But what if it’s not and how do I know?

DP doesn’t even want to think about the fact that there might be an issue but I feel that something’s not right.

She adopted which I’m only mentioning in case it comes up in the replies and I’m accused of drip feeding!

I don’t even know where to start with this. I’d be really grateful for some advice. Thank you.

Your dd is adopted and I suspect her start in life might explain some of her habits now.

I don't know a lot about adoption processes and the support they offer afterwards (although can guess it's little to none).

However, there is no harm in investigating things which might help her overcome some of the anxieties etc she is feeling.

How old was she when you adopted her?

In any case; things I would consider...

Is she genuinely hungry or, due to potential previous neglect, is she worried about where her next meal is coming from hence eating whenever she can access food?

She might still be developmentally much younger due to neglect which would explain continence issues. Ask for a referral to the continence clinic for advice on how to manage this.

Chewing is a known sensory and anxiety response. You can buy chewable jewellery and accessories such as pencil toppers (chewigem is a well known brand) which are much more robust than anything else a child might choose.

Emotional outbursts might be a natural response to traumatic early years and aforementioned developmental immaturity. She's still working out if she's safe with you and it will be a long process to reassure her that she's safe and you're not going anywhere anytime soon.

But don't avoid investigating with health visitor, social worker etc if she still has one as it's much easier to put support in place now and build/change as needed instead of trying to pick up the pieces as she gets older.

@Rainallnight , Oh, and the sen board is a great place for help and advice. This one gets a bit quiet.

Thanks so much for your reply @minisoksmakehardwork. She was removed from her birth parents at birth, so while I’m not minimising any attachment issues etc that may have resulted from that, she didn’t experience abuse and neglect in her early life. After foster care, she came to us when she was 8 months old.

And thanks for the tip - I thought this was the SEN board Where’s the other one?

Some similarities here. My DD never feels cold and has had issues with soiling because of withholding poo. She goes absolutely mad about seams in her socks or having something round her neck (like a scarf or polo neck).

My advice is to get an assessment privately if you can afford it (and it is very ££).

The poo issues for my daughter were not at all psychological and have been brought under control within a month with a change in medication. Sometimes wee incontinence is a side effect of poo issues anyway so you might be able to sort them together.

The sensory things are v manageable in my opinion and I've just made the changes to keep her comfortable.

I suppose one way to look at it is - is she generally happy and cooperative where she can be? If not then I would start to investigate even if it just gives you a better armoury of tools to support her.

You can get private sen assessments I'm sure.

On the adoption thing - I agree it's not necessarily a factor. We know so much more now about sen and some issues are on a spectrum so even if mild it's worth finding out.

Thanks so much, this is really helpful. I suppose the answer is no, not happy and cooperative where she can be.

Can I ask how you went about getting your private assessment?

Thanks

I went to a children's bowel and bladder specialist at the Portland. I went because of the poo issues but they assess bladder and behavioural too. I really recommend it as GP just kept prescribing movicol which, whilst it did no harm, didn't help.

Thanks very much. We’ve been referred to St Thomas’s for her bowel issues. I’m wondering if we need to pay for a private sensory assessment.

I would to be honest if she's not very happy. They probed behavioural issues and her dynamic with me in our assessment and I think it would be immensely valuable to know if there's any SEN as then you can make adjustments that can make all the difference. With my DD they didn't think there was but she's younger than yours so maybe it will present when she's older.

Apart from the wee/poo issue, this describes my daughter at around 5. Like you, I felt there was something not quite right but have only just begun to get close to an ASD diagnosis and she is now 12 and presenting as a textbook girl with ASD who has been masking. I would go with a pp and if you can afford it, go private for advice.