Ask HN: My child was diagnosed with sensory processing disorder. What to do?

As a mom of a kid with SPD, yes reduce that screen time. We share custody 50/50, and when kiddo returns from the house with unlimited screen time, he is a monster and it can take several days for him to regain the ability to emotionally regulate.

Screen time is free dopamine. It rewards withdrawal and inactivity. For a kid with SPD, just existing in the world is painful due to all of the stimuli. Add "stop hitting people" or whatever and you're saying "ignore the incoming pain and stop redirecting that pain elsewhere." And that's really hard, and kids can do it but it takes effort with very little reward. But then you add the TV, the brain's baseline is "I can get huge rewards for zero effort," and regulation becomes a million times harder.

The bad news is there is no quick fix for any of this. The good news is there are options.

Occupational Therapy has shown promise for us. In the last ~9 months we have seen improvements with our kiddo who too struggles with SPD, and in many of the same ways you have shared.

We are now starting play therapy as well to help get ahead of the anxiety and are working with a therapist that can give our child tools but also us, as parents, tools for the 167 hours a week they are not in therapy.

Find some coping mechanisms that work and roll with them, even if you don't love them. We didn't love bringing a tablet with us to appointments (we like to minimize screen time) but plunk on the headphones, turn on some music and that helps distract them enough for you to talk with a doctor.

Transitions are hard for us as well because they are generally compounded by picky eating. We don't fight the picky eating but just know that if we are all having takeout for dinner, we are probably going to be putting on a pot of water to make pasta, or a pb&j because it works. We always carry snacks and bring favorites with us, even to a dinner party to stay on top of the hanger as best we can.

Sleeping, for us, has has gotten better. Physical activity helps, we have trampoline that takes up a 1/4 of our back yard and its worth the annoyance. But I usually am in the room, at the foot of the bed laying down for our night time routine and that works. A lot of times, for us, we need a midnight snack and then settling back in is no problem, but we had to figure that out as parents not get inputs from our kiddo on it. Blackout curtains, setting the AC low and setting the bedroom up for sleep success have helped.

We have found, for our child, that being in nature is also helpful and helps center them and get them out of the hustle and bustle of the city a bit.

Routine also may help.. the transitions become the norm and then are not unexpected and can help to mitigate those metldowns.

One constant thing we need to remind ourselves as parents is to not fight it or punish them for not aligning with your expectations, its not a behavior issue its they are jumping into that fight or flight lizard brain response for things.

Before you turn down that promotion it may be worth talking with your prospective boss about your situation. If you are just starting to go down this journey with your daughter don't think its never going to change or get better.

In general, I feel that it's important to make your home environment a safe and comfortable environment. If you feel that exposure therapy is needed to help them adjust to the world (probably true, but I'd want to do this on the advice of a psychologist if possible rather than on my own) do that outside your home where you should be making every effort for them to feel safe and comfortable. So absolutely minimize clutter, reduce screen time and look for other options to make your home feel as safe as possible for your child.

Our 7-year old has the same thing. My main advice is to not fret and stay calm as time is the real solution.

For the clinginess, some tactics we've used to account for it is to setup play dates with other kids.

For the meltdowns, we simply ignore them in the moment as best as possible. They settle down eventually.

For the picky eater-ness, he eats what we eat and when he throws tantrums he gets an early bedtime. His body compensates for the extra hunger the next day.

For trouble falling asleep well we're still dealing with that one. We've resolved to just let him read quietly in his room until he's tired and wake him up at a reasonable time.

First off it sounds like you are doing everything right and that you are a good parent who cares and that is awesome. It sounds like you are still in the information gathering phase as to what options and help there is.

Who provided the diagnosis? The pediatrician? Or did you see a developmental pediatrician? And what therapies did they recommend or refer you to? Did they recommend any therapies like occupational therapy and feeding therapy? OTs do a lot of sensory and feeding work so it is a good way to start.

Sensory processing disorder is typically manifest of other developmental autism, ADHD and other developmental delays. So I would consider pursuing and pushing for a referral to get an autism diagnosis and then look into services like ABA. It may be that she is still young that the doctor didn't want to call it autism or may not be qualified to do so. But she is not too young to be evaluated for autism. You mention that she has frequent meltdowns and trouble with transitions which are signs of autism. There are other signs like self soothing (rocking, flapping), rigidity (lining things up), eye contact and trouble communicating, but as it is a spectrum they may not all may be manifest.

With an autism diagnosis you can get more services for her which can include PCA (a paid care provider) to help you. What level of support you can get will depend on where you live in and her needs. If you are in the USA your state should have an Arc which can help you find services and navigate the system. https://thearc.org/. Health insurance should cover ABA therapy. Some communities have center based day programs grouped by age and need which work on getting them ready for school. I think they are fantastic. You can also get home based services as well.

It sounds like you are a concerned and caring patient wanting to do the best for your daughter. The good news is that she is young and the therapies do work. Best to start now before you get into the school systems who are not well equipped.

I have been in your shoes and am still in them so to speak and it does get better. What you learn in helping your daughter will also help you become a great manager/leader.

Also no matter which job you take be sure to set limits on your work. Management is all about setting expectations and leveraging the resources available to you vs being superhuman and doing everything.