Monday 10 December 2018

Dear David Coleman: I'm worried my son won't wear his school uniform in September

David Coleman

David Coleman

Clinical psychologist David Coleman offers parenting advice in his weekly column.

Q. My son is starting school in September. He will be five in October and is an intelligent sociable little boy. My concern however, is that the school has a uniform and he is very particular about what he will, or will not wear. He only wears tracksuit bottoms (he won't even wear jeans) and t-shirts or cotton tops with no collar or buttons. If I try to put anything on him outside of this he gets upset. The school requires shirt, tie, jumper and trousers. How am I going to convince him he has to wear these clothes for school?

David replies: It sounds like your son may have some kind of sensory issue. Sensory integration is about the connection between our bodies and our brains. We receive lots of information about the world from our senses of touch, taste, smell, hearing, sight and so on. That information allows us to know where our bodies are (in a physical space) and what if anything, is impacting on our bodies.

So, when our sensory information is well-integrated, we can, for example, tell that we are standing on a slope and so need to lean a little forward to stay balanced. We can also tell that it is hot and that we might be wearing too many clothes as our body is getting too warm.

If a child has difficulty with any aspect of their sensory integration, then their brain may not be able to either accept all of the sensory information it is receiving (and so feels overloaded), or it can't process all of the information (and so gets confused). Either of these kinds of situations can appear as a special sensitivity to particular kinds of sensory information.

I'll put my hand up and acknowledge that I am not a specialist when it comes to understanding sensory integration and the needs of children with sensory sensitivities. I recommend that you bring your son to meet an occupational therapist (OT), to get a better understanding of his sensory issues with certain clothes.

However, I'll give you my layman's understanding of what might be happening for your son. We all have touch receptors on our skin that give us information about texture, temperature, pressure and so on. This allows us to tell if something feels wet, or sticky, or painful, for example.

Most children who are able to process this information without difficulty, are typically not bothered by the array of sensory information that they get from clothes. They may be aware of a tightness caused by a cuff or a collar, for example. Or they may notice that some fabrics feels rougher or smoother than others. Importantly, however, this feedback doesn't bother them.

Children with sensory issues, though, may experience this same sensory feedback as unpleasant or distressing. This is where an OT can give you advice and guidance about things that you can do with your son to help him with his particular sensitivities.

As a start, however, it is worth checking with the school to see if there is anything they can do to support your son. For example, they may have a tracksuit uniform (as many schools uses tracksuits for the reception classes) that your son might be allowed wear everyday.

There might also be something that you can do, perhaps to address discomfort from things like tags on the clothes, or seams, that can be especially irritating for some children.

Another potential strategy, "deep pressure", can help children with tactile issues. Deep pressure involves administering a massage, giving your child something like a "bear" hug, or wrapping him snugly in a blanket, at the time that he is bothered by the texture of clothes.

However, you really need the advice of an OT to discover if these might be useful techniques for your son, specifically, and about how to use these, or other, strategies safely and effectively.

As is hopefully clear from what I have written so far, I think your son needs a full OT assessment and you then need the OT support to help your son to decrease his sensory sensitivities and improve his overall sensory processing. I would expect that an OT could help you to introduce tactile experiences for your son, in a gradual way that will allow him to overcome the irritation he currently experiences with certain clothes and textures.



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