Intellectual Ability Untouched : Clumsy Youngsters May Have Sensory Dysfunction

Children who regularly spill their milk at the table may be reprimanded or even ridiculed for their behavior. But for some, the problem may be an infrequently recognized brain disorder.

In addition to throwing off coordination, the disorder can affect the sense of touch and movement, making the child either fearful or too aggressive in activities involving motor skills or contact with other children.

“It’s a difficulty interpreting information that comes in through sensory organs in the ear and touch mechanisms,” said Dr. Anita Bundy, a researcher and occupational therapist at the University of Illinois at Chicago.

“The children are frequently clumsy or may dislike being touched,” Bundy said.

The condition does not affect intellectual capacity, although it can overlap with learning disabilities, she said.

Called sensory integrative dysfunction, it has been gaining wider recognition in recent years. Although it was first identified several decades ago, some physicians still dismiss it as no more than a phase that children outgrow.

“It’s not a medical diagnosis. It’s a diagnosis usually given by occupational therapists trained to do that and involves a rather lengthy process,” Bundy said.

Cannot Be Outgrown

Bundy believes SI dysfunction is not outgrown, though it may become less apparent as people age. She has found some treatment methods often are quite helpful, even in adults.

But severely affected children can face great frustrations, finding that sitting still, writing and playing require almost exhaustive effort, but win them little understanding.

Writing and drawing are difficult, for example, because they require fine motor skills, coordination and the ability to copy visual cues with physical motions, Bundy explained.

Symptoms also can include difficulty with physically navigating around objects.

“Some children don’t get good feedback from their own bodies so they don’t know how much force to use on a toy or to move something. These kids are perpetually spilling milk at the table because they can’t gauge how far away the milk is or how much force to use in moving it,” she said.

“I’ve had mothers come in and tell me their kids aren’t allowed in any of the neighbors’ homes because they are always breaking things,” she said.

It is not known why the condition occurs, although it appears to be inborn rather than acquired.

Many children, Bundy said, are bright enough to figure out ways to adapt to the handicap. They may play the class clown, for example, to make a joke of their clumsiness.

‘Could Do Better’

“Typically, a teacher will say, ‘This kid is real bright and if he or she just tried harder, could do better,’ when the kid is trying three times as hard (as other children) already,” Bundy said.

One especially disturbing symptom impairs interpretation of sensations, making unexpected or even light contact with others disturbing.

“A lot of children have difficulty accepting touch and only want to be touched on their own terms. They don’t like light touch,” she said, because it is “neurologically more bothersome and often translated as noxious touch.”

Preliminary results from a five-year national survey for a new diagnostic test found that as many as 15% of more than 2,000 children aged 4 to 8 showed some form of the central nervous system dysfunction, said Stephen Laneau, executive director of SI International, a nonprofit agency in Torrance.

The agency maintains a list of trained occupational therapists across the country and offers training in SI dysfunction therapy.