What do sensory needs have to do with sleep? Why do we devote an entire module to the sensory needs of babies and children on the Holistic Sleep Coaching Program? How do sensory needs manifest themselves in infancy? And what can we do to support babies, children and parents with these needs in order to improve quality of life, behavior and sleep?
What are sensory needs
During everyday life, one of the many jobs the brain has is to integrate and organize sensory input from many different sources, and interpret them correctly. Our sensory systems are constantly providing information about the world around us – sights, smells, light, pressure and touch, temperature and taste. The brain has to receive this information via many different neural pathways and different parts of the body – for example our tongue, mouth, fingers, feet, skin receptors, eyes, ears and many other sources.
How do sensory needs affect us?
To some extent, modern life is making our sensory processing harder. We are often overwhelmed with sensation, such as light, noise and crowded spaces. Increasingly, we have more sedentary lives – urban life makes this even more likely, as opportunities to explore and exercise in nature are limited, and this changes the types of sensory input we receive. In addition, we are exposed to numerous artificial adaptations, such as chemical processes, foods, and synthetic substances, as well as artificially manipulating our very environment. We make it colder when it’s too hot, we make it wetter when it’s too dry, and we make it lighter when it’s dark outside. In short, some of the demands of modern life is forcing our bodies to adapt in ways that are not always biologically rhythmical.
When we think about babies and children, some of the activities that may be making childhood harder are the very devices that parents seek to make life easier. We choose activity centres, baby gyms, jumping toys and screens. We ferry the kids to school in cars, and we take them to structured activities after school as well.
From a young age, babies develop to a large extent in response to the care, interactions and opportunities presented to them. If they are responded to promptly, kept calm, and held a lot then they receive appropriate levels of touch, co-regulation and communication exposure. When children can walk, they should be encouraged to have as much exercise as possible to build strong bones, develop lean muscle mass and core strength, and expend their energy. Sadly, sedentary lives, lack of physical exertion and an over-reliance on mental stimulation rather than physical play can lead to obesity, over-stimulation and in some children already pre-disposed – sensory difficulties.
For most people, the nervous system responds appropriately to ordinary sensation and stress. For example, if you walk into the street and a car unexpectedly drives past, it is normal and appropriate for your fight-flight mechanism to kick in. This comes from your sympathetic nervous system, and an instant stress response is mounted that enables you to quickly deal with the dangerous or stressful event that has presented itself. This is our primitive survival instinct. Once you have acted on the fight-flight response by moving out of harm’s way, your parasympathetic nervous system helps you to breathe normally, get your heart-rate don, and stop your palms from sweating!
However, for a person with faulty wiring, this normal process is exaggerated and often inappropriate. For example, it is not normal to mount a stress response when we receive a hug, or put on socks, or take a shower. These are normal activities, that should not alert our parasympathetic nervous system to the possibility of threat or danger.
For a person with sensory processing problems or oversensitivity, a vast array of different events, experiences, sensations and environments can provoke a profound stress response, so that a person can feel like they are lurching from one physiological crisis to another, never safe, never calm, and frequently on ‘high alert’.
The overall result is that a sensitive person will remain in fight-flight mode all the time, living in a state of vigilance and arousal, physiologically ready for the next ‘threat’. When an actual stressor comes along, this can tip them over the edge.
How does this present in babies?
Everyone has different sensory needs, so it is often more appropriate to give an explanation of what to look for, rather than suggest what might be causing babies or children to become dysregulated and distressed. However, there is sometimes value in giving some examples.
Perhaps you have met a baby who seemed to be on high alert all the time, never calm, found sleep impossible, and seemed to become distressed at seemingly random events or experiences?
Have you met a child who breastfed continuously all night. They rejected any other forms of comfort, even a pacifier or bottle as a substitute. Only the breast would do.
What about the baby who screams as if in pain during changing, dressing, nail clipping or bathing?
It would be unwise to ‘diagnose’ any baby or child with any of the above symptoms, until more possibilities have been ruled out, but equally, there are some simple suggestions that you can make to parents to calm and regulate their child.
How do sensory needs affect sleep?
Normally, people cycle through different states of sleep quite easily. People who are stuck in ‘fight-flight’ mode can find it harder to get into and stay in deep sleep. These may be the infants who wake at the slightest noise, or are sensitive to minor fluctuations in temperature, pressure or movement.
In addition to this sensitivity to changes, it is also much harder to calm infants or children who are in high alert, as their cortisol and adrenaline levels are high, making it hard to calm them and get them settled for sleep.
While harsh sleep training may teach a child to expect a ‘non-response’ – i.e. no matter how long they cry, nobody will come and stay/hold their hand/nurse/rock or whatever it is that the child usually expects, this approach is wholly inappropriate as it fails to address the child’s underlying dysregulation. Not only this, but allowing a child to remain in constant fight-flight mode can permanently change their behavioural response to stressors, and tech them to exist in a state of high arousal even in non-threatening situations. They become the children and teens who never seem to relax, and the adults who are quick to lose control, panic, or over-react.
How do we support parents of sensitive children?
As sleep coaches, we may encounter children who are constantly alert, stressed or dysregulated. We are also going to meet their parents, who are frequently confused, frustrated, exhausted and stressed. Finding ways to support them is crucial to the sleep plan success.
- Recognise the challenge: Parents who are caring for a sensitive child often have to deploy far more tactics than other parents, and yet get less positive feedback for all their effort. They may have resigned themselves to the need to rock, bounce, or dramatically alter their child’s daily routines or environment in order to keep the peace. This is exhausting, draining, often misunderstood and socially isolating. I have often found that these parents go ‘underground’, having encountered one too many incredulous looks at the levels they have to go to keep their child calm. Perhaps they have been accused of ‘pandering’ to their child, or making a ‘rod for their own back’. Faced with this lack of comprehension from others these parents sometimes retreat within their own carefully controlled evironments to avoid the stares, meltdowns and embarrassment. This can lead to social isolation and subsequent mental health problems that this can cause. The truth is, these parents aren’t ‘pandering’ or doing something that was ill-advised: They were just attempting to meet their child’s needs, and this is an area that is not widely understood or recognized. Far from chastisement, these parents deserve our unswerving admiration and support for the challenges they face.
- Provide reassurance and education: Often parents first need to have their concerns validated and understood. It is often enlightening and empowering to have someone recognize that their struggle is real, they are not alone and that solutions exist to reduce the struggle.
- Teach them skills to support their children to become calm: Parents are often surprised at how much of an impact their own emotional state can have on their child. An experienced, calm, responsive and well-adjusted parent is able to accurately interpret infant dysregulation and moderate their response to support the infant to become calm. This may include noticing subtle changes in the child’s physiological state and behavior that give clues as to whether the current intervention – whether that is rocking, shushing or swaying are helping or hindering the calming process. A parent who is stressed, exhausted, depressed or frustrated will themselves become dysregulated and stressed by their stressed child. This negative cycle of parent and child dysregulating each other can be difficult to break. In my experience, this is often when parents reach breaking point and ask for help with sleep. But sleep is just one small aspect of this situation. The bigger picture is to be able to educate parents about sensitivities and support them to be the calming influence their child needs.
- How to calm a stressed parent: This sounds all very well, but what about the highly stressed, anxious and exhausted parent who is at the end of their rope? First of all, parents may need more support than a sleep coach is able to provide. Importantly, sleep coaches must always refer to more appropriately trained professionals. Secondly, we must be able to talk about stress in a way that doesn’t make parents feel stressed about being stressed. Normalising stress, and providing practical solutions is a good way to achieve this balance. Try suggesting thought journaling, guided mediation, mindfulness, or alternate nostril breathing. Cover one nostril and breathe in through the other. Hold the breath, then uncover the first nostril and cover the other side. Repeat. This is deeply relaxing and a good alternative for parents who do not find it natural to practice yoga breathing!
- Help them to develop strategies to prevent hyper-arousal, and intervene when necessary: Teaching parents how to spot the signs of dysregulation is a very empowering and transformative skill. Even experienced and responsive parents sometimes need help with learning about infant cues. Keeping a diary of behaviours can be an effective way to spot any potential patterns. Suggest noting down how the child reacts at certain times of the day, to particular environments, activities and routines. Do they have meltdowns over the same things every day? Do they always find bath-time stressful? Then also have parents note down what activities help, and at what time. Does rocking help, or make it worse? Does calm music help, or does the crying escalate? Can they only tolerate the bath when they are neither hungry nor overtired?
How do we help children who are sensitive?
As well as supporting parents, we will also need to be able to suggest strategies to calm children. With the best will in the world, we cannot always prevent all problems, nor can we always predict them and stop them in their tracks. But we should be able to equip parents with tools and solutions for their children.
- Zones of regulation: An emerging area of practical help is learning to recognize when a child is calm, and when they are becoming dysregulated, and when this escalates into a full-blown meltdown. ‘Scaling’ the level of distress in this way helps parents to moderate their response to meet the child’s needs. For example, rocking may only be needed during certain times. During a meltdown, deep pressure may be more helpful than rocking or bouncing or shushing. Only by keeping a diary can you work this out. The goals are to spot patterns of behavior, enable the parent to be more attuned to the needs of their child in particular states, and reduce the number of meltdowns to keep a child calmer and spend less time in fight-flight mode. This will help with settling and sleep, as well as general behavior, attachment and bonding, and parental confidence.
- Sensory activities: Most parents have already tried a variety of tactics to try to calm their hyped-up child. Others have found one method that seems to work at certain times – such as sleep, and that method has become unsustainable. If the child was calmer throughout the day, it is likely that the child would naturally need a lower level of support in order to be calm enough to go to sleep. Helping parents to stay on top of their child’s stress levels throughout the day is therefore intrinsic to the success of the sleep plan. In addition, they may need some alternative strategies up their sleeve to soothe their child. Children’s sensory needs tend to evolve over time, so what works in early infancy may not work in later infancy. They therefore need a large bank of solutions ready to experiment with to find the right combination and balance of strategies.
- Modify the environment: Often, parents do this instinctively, but again, once a child is calmer in general, they may find that their world, which may have started to close in on them due to self-imposed restrictions and limits they place on where they can go and whom they can meet, may open up again. The child may begin to tolerate going to the supermarket, or crowded spaces, or toddler groups. This may only be possible by making adaptations at other times – for example providing background noise for sleep, or giving a toddler heavy work to do during the day to keep them feeling grounded.
- Provide gentle, evidence-based and holistic sleep solutions: The Holistic Sleep Coaching Program is committed to gentle and respectful care of children of all ages. Children with sensory needs re no different, but they sometimes need a more creative approach. It is certainly not appropriate to leave these children to cry for any length of time, as this will just serve to further dysregulate them.
Understanding sensory needs is more than just a broad awareness of sensory strategies such as white noise and deep pressure! It is about a holistic awareness of the multiple factors that take place for a child who is sensitive. The Holistic Sleep Coaching Program is passionate about empowering parents and professionals with accurate and evidence-based information about the myriad aspects of sleep, parenting and family life. This is very true when it comes to sensory needs, as the needs of the whole family, environment and other variables such as diet and exercise all have a part to play. Sleep coaches can be surprisingly transformational with these families who have been battling with a dysregulated child for months or even years. While other professionals may be required to support families, a well-informed holistic sleep coach can provide an empathic and compassionate ear, as well as a variety of targeted solutions to support families.