Tuesday, June 1, 2010

Push me, pull me, leave me alone: What is wrong with hugging on your own terms?

[This is Part II of the occupation therapy evaluation. For Part I, the evaluation experience itself and the crazy-making fixation on "school readiness," click here.]

The Evaluation Report: Are You Gonna Hug My Way?

Today we received the evaluation reports. Among the thick stack of papers was the occupational therapist's evaluation, in which the topic Sensory Issues was labeled in bold.

Having been involved in John's Early Intervention services for well over 10 months now, I have learned to be wary of these occupational therapists and their infatuation with 'sensory issues.' His first therapist kept mentioning them, even when he blatantly proved her wrong as she was speaking. It was a classic case of entering a situation with preconceived notions and refusing to let go of them despite all evidence to the contrary. (Such as: on separate occasions she spoke of his difficulty eating highly flavored foods while he chomped feta cheese, garlic chicken, and drank a full glass of grapefruit juice right in front of her.)

In this evaluation report, the OT makes her concern with sensory issues as a general topic clear, while unfortunately muddying the understanding of them for the general population. Clear, because they're in bold and larger type than anything else. Muddy, because the description is confusing: "Many children fluctuate between sensory sensitivity and sensory seeking behaviors and others may be sensitive to certain sensations but seek other ones. Each child's patterns may be highly unique and individual, and it is not uncommon for those patterns to change depending upon the context the child is in."

And this is different from being a regular human being how, exactly? It's very hard to read this language as other than "Kids like some things. Other things annoy them. Different things annoy different kids, and sometimes whether or not a kid is annoyed will depend on the circumstances." What can one say about this explanation except that hey, most of us have slightly more self-awareness than a head of cabbage.

Here's an example of the sort of thing this evaluation concentrates on. With the exception of our current occupational therapist, all the ones I've met have had a thing about "tolerating imposed touch." They will poke John, push him, and prod him repeatedly, sometimes trying to push him over to see how he corrects himself. And then they act surprised when he eventually gets pissed off. Wouldn't you? I don't tolerate imposed touch very well. Hell, I'm pregnant and people are constantly putting their hands on my belly. I know exactly how John feels because mostly I want to punch them. In addition, he will "tolerate" this touch from some therapists more than others. His first one tended to get a very wise and know-it-all look on her face when he reacted strongly, which he did increasingly early in her sessions. As a parent, it was hard not to respond to her bullshit analysis with pointing out the obvious: "No, the problem is, he just doesn't like you." And he didn't. I didn't like her either.

I loved this question from both that original OT (the one we have now, I should say, is fabulous and John looks forward to their sessions) and the school evaluator: "Does he only hug on his own terms?" To which my response is, "What the fuck?" Do these people not consider the logic of what they're asking? To follow these expectations to their logical conclusions, children should be able to tolerate being touched or even hit by anyone. Of course nobody thinks about it that way, but where do you draw the line?

To insist that a child hug and kiss on anyone else's terms but their own is extremely dangerous. How far do you expect them to take that? Do you hone your therapy to override their own instincts and self-preservation, much less any safety protocols built in by parents? I don't want my child to accept hugs, kisses, or touch of any kind from anyone if he's not comfortable, much less insist he give the same when he doesn't feel like it.

The nice OT, when I asked her how this could possibly be good for children, explained that the question should really be "Does he like hugging," as in hugging from parents and close relatives, anyone they'd be comfortable around. Unfortunately, the way it's asked is open to gross misinterpretation and makes me question the safety of the therapy itself, at least when unmonitored by a parent (which the school therapy services are -- unmonitored, that is).

So maybe that's a big of an overreaction. But I, personally, have never liked being touched when it's uninvited. And I certainly know when it feels wrong (try being a young female journalist in Australia and you'll get intimately acquainted with people trying to touch you inappropriately, and constantly). How much of this therapy would it take before a child starts to lose that sense, starts to mistrust their own intuition telling them this touch is simply not right?

I don't know the answer. But I do know one thing. There is no way I'm going to risk my son finding out.

(Apologies if this post sounds a bit bitchy. But you try watching someone poke and shove your kid, and tap their joints and fiddle with them when they're trying to eat, as your child gets increasingly annoyed, irritated, and frustrated at his inability to make them stop, and see how well you react to it.)


laulette said...

This is from Niamother: Would it be fair if john got a chace to poke, push & pull x therapist when she(he) did/didn't wanT? As a young child on my grandfather Tom Hansen's homestead, where I grew up, I had an Uncle -- no, NOT a "molester," just a nice, standard man, ex-soldier, who allowed kids in his lap, sometimes, while he was eating dinner. I was fascinated by the way that THING in his throat bobbed up and down, so I pressed my tiny finger there, repeatedly, when he was trying to swallow. To see if it could stop bobbing. I howled when I found myself unceremoniously dumped on the floor. Maybe the therapist needs to understand that a child, if prodded repeatedly, wilkl take the lesson that he/she gets to poke/prod others without asking, or when asked to stop. My Uncle (and father, and grandfather-) taught me vividly the error of such assumptions. I never doubted that I was still loved, but I did not poke people in their throats no matter how the adam's apple wiggled enticingly. (I have seen kittens learn similar lessons.) It seems this would be a useful lesson to take out into the world. I'm sorry jh's therapists never had a chance to learn it. Hugs & smiles, dear John-child! Yr Grandma

Antonia Malchik said...

What a great story, Mama! John responds that he is grateful to have such an intelligent and insightful Grandma :) Actually, I wonder if the therapists have ever thought about it that way? How would they like uninvited touch, if no one explained to them what was going on and they hadn't agreed to it? Maybe I should ask the evaluator that, if she tries to talk about it at our meeting!

Karrie said...

Hello! This is @karriehiggins, your fellow CNF tweeter. Wow, your post has me very worried about the kind of therapy one of my nephews is receiving for "sensory" issues. I have to look into it and find out what is going on. :/

I remember arguing with my parents about my adamant dislike of hugs. They used to tell me to "go hug grandma" (or whoever), and I would be punished if I did not comply.

Egads, I never realized that therapists were using such invasive touch as a conditioning tool. Very upsetting! I agree with the above comment, too. Wow. Just wow.

Antonia Malchik said...

Karrie, it's so good to 'see' you here! I've missed your microessays, hope we'll see more soon :-) I sent my mom (the commenter above) a copy of the CNF journal our #cnftweets were in, and she really liked yours.

I'm sure there's solid scientific basis for some of the treatment. Well, I'm not sure, but I've got to believe *some* kids benefit. I just don't have any faith that the therapists, by and large, have a good understanding of who truly benefits and who just gets more annoyed. There seems to be a vague and finely drawn line between kids who are normally sensitive and those who have "sensory integration issues." How many people are perceptive enough about other human beings to know the difference?

This is based only on my own experience, not any research. For 2 months John had an occupational therapist who insisted on joint tapping, joint compression, lots of imposed touch, and a great deal of it while he was trying to eat. I didn't have to be a researcher or therapist myself to see that his increased annoyance and frustration was not, as she claimed, a problem, but was in fact just a toddler's response to really annoying behavior he had no control over.

As my mom said above, maybe I should have let John poke the therapist back and see how she liked it.

I find the hugging thing very odd, too. My husband went through a little thing where he'd tell John to give him a hug when the boy didn't feel like it, and even that really bothered me. Luckily, my husband agreed, even if the therapist didn't. He likes hugging plenty, just ... on his own terms :) Like most of us! Like you with your grandma, I never wanted to give hugs unless, well, unless I really wanted to. Which I rarely did.

I hope your nephew is doing well. I think the one therapist we had was a bit extreme. The current one sees no sensory issues at all, so they do tend to vary.

And I hope you're well too!