The highly sensitive child, behavioural inhibition and learning movement skills
Reblogged from The highly sensitive child, behavioural inhibition and learning movement skills | skillsforaction.com.
About 15 – 20 percent of children are born with a temperament style that is very cautious and often quite fearful. Elaine Aron coined the phase “highly sensitive child” for these children describing them as being very aware and quick to react to everything. Jerome Kagan, who did the early research on infants and young children who appeared sensitive and fearful, called this temperament trait behavioural inhibition (BI).
Children who are very cautious and fearful have a very active behavioural inhibition system (BIS). The regions of the brain that assess signals from within the body (such as body sensations) and information from the environment for the presence of potential threat or danger are unusually alert and reactive. Things that are new, novel, different or difficult are interpreted as being threatening. This creates a fear response and activates the body’s fear response systems to fight, flee or freeze.
Infants with an active behavioural inhibition system (BIS) may be fussy, react strongly to any changes such as being undressed, are difficult to calm, react strongly to strangers or new situations. They also are very sensitive to being wet, or hungry, or in discomfort. These babies become easily over-aroused and distressed when there is a lot going on around them.
As the child with BI gets al little older he or she may avoid activities that seem difficult , physically challenging or complex. Intense physical activity such as running or jumping creates strong sensations of effort within the body – and the child may interpret these as being threatening and so avoid physical activity.
Cautious babies and toddlers
Movement based activities for training self-regulation and attention
The BIS and the autonomic system
The BIS is closely linked to the autonomic nervous system, which primes the body for action by affecting breathing, heart rate and blood supply to the muscles.
Stephen Poges describes three components of the autonomic system, each with a different set of body responses:
· The social engagement system – mediated by the polyvagal system (a part of the parasympathetic system) orients the organism towards a situation and promotes engagement.
· The sympathetic system primes the body for action and provides the impetus for muscle work. In situations of danger, it is the sympathetic system that promotes flight or fight responses – whichever is more appropriate.
· The primitive parasympathetic system primes the body for freezing in situations where not responding and being very still has survival value.
If the child finds the situation interesting and challenging she will orient her attention towards what she encounters, her attention will become focussed and the physiological systems needed for action will be mobilised with just enough energy for the task, and in social situations she will act with positive facial expressions and focussed attention to the human voice. The child experiences the event in a positive manner and feels good about herself.
However if the child perceives the situation to be threatening, the brain’s fear / avoidance systems prime the sympathetic system towards the flight or fight responses. The heart starts to beat faster, breathing rate increases, there is a sensation of butterflies in the stomach. These responses create the feeling of either excitement or of fear.
Children who are overly cautious tend to have strong emotional responses to situations perceived as threatening which in turn provokes very strong physiological reactions and thus strong sensations from the body. The child with behavioural inhibition, being particularly sensitive to sensations coming from the body, interprets them are threatening and to be avoided.
The other way in which the child may react to a threatening situation is to “freeze” – the body is primed for disengagement, for being very still, not responding and not being noticed. This is the most basic and primitive way for an organism to respond to threat. The child simply refuses to engage with a situation, and no amount of persuasion will get her to change her mind.
When a child has once experienced a fear response related to a particular situation, the next time he is confronted with the same, or similar situation, the memory of the previous experience evokes the same body responses as before and this influences the child’s behaviour and decision to approach and engage or freeze at a very basic level. The situation has been labelled by the emotional brain as being unpleasant and to be avoided.
Joint hypermobility and the highly sensitive child
Movement skills and the child with BI
Learning to perform a new movement based task requires engagement and sustained mental effort to support the emotional and cognitive work needed to approach a new and unfamiliar situation, control and sustain attention, explore ways of achieving the goal and keep going until the goal is achieved, often in the face of frustration and failure.
In the face of the challenge of tackling an unfamiliar task, a child needs to regulate his emotional responses, and direct his attention appropriately (effortful control) and call into play a range of thinking skills (executive functions) needed for planning and organising his actions.
(Self-regulation refers to the child’s capacity to control the inherent tendency to react to situations in a particular way, such as approach or avoidance, holding back or rushing in. It refers to a child’s ability to adapt and control his or her innate responses to stimuli from within the body and from the environment, and the ability to direct and use attention in an appropriate way.)
Does your highly sensitive child have adequate strength and endurance for everyday tasks?
The child with BI learning a new skill
For the child with BI approaching and engaging with an unfamiliar task is difficult and often overwhelming. The immediate response, before even considering the task may be a fear reaction with over-arousal and feelings of anxiety. The child’s emotional system may go into panic mode with a tendency to an emotional outburst, but more often the physiological response is to freeze – and simply refuse to even try.
· The child may approach the task, but become discouraged at the first hurdle, and not be able to work out what to do next. Or he may narrowly focus his attention on one aspect of the task – get stuck on that and refuse to proceed.
· The child with BI is often over focuses on physical sensations from within the body and may react strongly to the feelings of effort that accompany activities that require muscular effort or get the heart beating fast.
· The fearful child often experiences the heart beating rapidly when he gets anxious and scared. Running will also get the heart beating rapidly – and the child finds this unpleasant because he associated this sensation with fear and anxiety.
· Jumping high or far elicits a powerful contraction in the quadriceps muscles, and a feeling of pressure in the knees – and the child finds this unpleasant and dangerous.
· Hanging from the monkey bars is scary because you are a long way from the ground, but it also quite hard on the hands and creates strong activity in the shoulder muscles. It is no wonder that the child with BI avoids the monkey bars and climbing frame
By the age of five a young a child with movement difficulties notices his peers doing a range of balance, climbing, agility and ball skills. He expects to be able to do them as well and gets disheartened when he cannot compete and keep up. What he does not understand is that his peers have invested a great deal of time and effort over a number of years into learning and perfecting these skills. And as a result they are also more agile, stronger and fitter.
The same logic applies to construction activities and learning to draw – it requires effort and practice.
School for bravery – helping children with BI to overcome their fears
In my work with fearful children who have movement difficulties I am always amazed at how quickly and easily a child can be shifted from fearfulness to courage in the face of physical challenges. As one 6-year-old put it – “I have leant to face my fears”.
The same child had also learnt to enjoy working his muscles hard and to interpret sensations of tiredness in his muscles as a good thing – because “it means that my muscles are working hard enough to make them stronger”.
He had learnt to put in the extra effort needed to complete a task when his muscles were starting to tire, and the pleasure of pushing himself hard to reach a goal or meet a challenge.
Michael was nearly five when he first came to see me. He tolerated the assessment tasks for about 20 minutes – then started to whine and wanted to leave. So we switched to games. We played being chased by a lion and did shuttle runs across the room, with me shouting loud warnings about the lion catching me and encouragement to run faster. When we stopped I encouraged him to feel his heart beating. Yes, it was beating very, very fast because that is what hearts do when one runs. He wanted his mom to feel his heart, and then wanted to feel my heart beating fast. After a little rest he wanted to run again – so that he could feel his heart again.
His perception of his heart beating fast had shifted from being a signal of an anxiety-provoking situation to the sensation of effort, exercise and excitement. (You do have to realise that I make a great deal of fuss about escaping from that lion that is chasing us.)
We also did some jumping from one big cushion to another – big jumps across a river. He did a few, then refused to do any more. So we had a conversation about what his knees felt like when he jumped. And my response was “That is what knees feel like when you jump”. His mom reported that in the car on the way home Michael was very excited about feeling his knees. “Mom” he said “I can feel my knees”. He also did a lot of jumping at home in the week that followed.
Intervention for children with behavioural inhibition – basic working rules
Getting stronger and fitter and improving coordination requires effort and hard work. Physiotherapy geared to achieving improvement in physical conditioning needs to keep in mind the basic rules for strengthening and increasing endurance. The child’s physical limits need to be pushed and difficult tasks need to be engaged with and practised repeatedly. The trick is to provide a physical and social environment that gets passed the barriers to activity created by the child’s fearful temperament style. Here are some tips:
If a child refuses to do a task – respect that refusal. There is probably a deep-seated emotional reason associated with previous experience and no amount of persuading or bribery is going to change the child’s mind.
Do whatever it takes to make the physiotherapy room a fun and exciting place to be, so that the child starts to associate physical activity, hard work and engaging in challenging tasks as a positive experience.
To start with adapt the task so that it appears to be less difficult or challenging. Once the child is engaged and enjoying the activity, make it more difficult.
Help the child to interpret the sensations coming from his body – muscles working hard cause strong sensations – and that is a good thing because that is the way to make muscles stronger