Having established an understanding of the highly sensitive child in the first part of this article, I now look at some aspects of caring for the functional sensitive child and the dysfunctional sensitive child (the latter includes children with sensory integration disorders), who probably represent a single spectrum with wide variation.

The functional sensitive child
Functional sensitive children are a normal variation of typically developing children. Such children lead relatively normal lives and manifest evidence of sensitivity without significant disruption to their everyday life. They are therefore supposed to be “normal’, yet they often stand out as “different’ children and thus create huge challenges for their caregivers.

Signs
These children tend to be empathetic, highly intuitive, intelligent, creative, talented, cautious, conscientious and fussy. They have rich inner lives, and strong feeling responses: intense love, awe and joy, but also fear, anger, and sadness that can easily lead to depression. They are emotionally intense, deeply reflective, easily hurt, harshly self critical, and have low self-esteem and more reactive immune systems with higher incidence of allergies.1 They have a tendency to perceive more, to respond more intensely to a range of sensory stimuli usually consistent from birth, and are often aware of subtleties that others miss. They are more easily overwhelmed by high sensory input, which they try to avoid. If this can’t be avoided they are easily upset, which can lead to variable responses depending on the temperament: over-complaining, fussing, tantrums, rages, over-activity, and overcompensation through over-achievement and perfectionism; or withdrawal, introversion, shyness, avoidance, submission, perfect obedience and resignation: resulting in continual physical reactivity such as tummy aches, etc.

The sensory dysfunctional child
The term sensory dysfunctional child describes one who has moderate or severe sensory dysfunction resulting in physical, emotional, behavioural or social dysfunction that requires some form of remedial action.

Signs
These children may exhibit a wide range of disturbances: they may be oversensitive or undersensitive to specific sensations. One of the 12 senses (described in the first part of this article) may be overstimulated, e.g. the child avoids unnecessary movements, climbing, running or swinging, or understimulated, e.g. the child likes to spin, swing or rock. He may exhibit disturbances in muscle tone and co-ordination: his muscles are tense or floppy, he is awkward, clumsy and accident prone, and he has difficulty planning and executing certain movements, e.g. riding a bike, writing, clapping, etc. He may show unusually high or low energy levels and activity, tend to be impulsive, lack self-control, and be easily distracted, disorganised and forgetful. He may show many of the features of attention deficit disorder with or without hyperactivity (ADD/ADDH).2 He underachieves at school, often has learning disabilities, lacks hand preference by age 4 or 5 years, and has poor eye-hand co-ordination leading to poor handwriting. He frequently has high levels of frustration, difficulty in adapting to new situations, and struggles emotionally as described above.
A number of other conditions that exist in their own right often overlap, but share the intrinsic constitutional factor of high sensitivity. These include ADD/ADDH, learning disabilities, auditory, speech and visual disturbances, Asberger’s syndrome, digestive disturbances, sleep dysregulation, immune dysfunctions leading to allergies, sensitivities, frequent infections, and psycho-emotional disturbances.

Steps to caring
1. The first and obvious step in caring for a sensitive child is to acknowledge that she is different from a typically developing child and to recognise her heightened sensitivity. It will make a huge difference to such a child and her relationships if the following principal guidelines are followed:
• Respect sensitivity. This is the cardinal principle: acknowledging the reality of the child’s pain and understanding her sensitivity makes it easier for her to live with the intensity of her emotions.
• Enhance self-esteem by enhancing her self worth: consistent loving care, showing interest and spending time with her, respecting and supporting her sensitivity and actively working through her difficulties with her will give her a stronger sense of her self worth.
• Discuss sensitivity openly. Openness and acceptance of the sensitivity, not overplaying or underplaying it, is helpful. Being different can be cool.
• Encourage effective ways of dealing with sensitivity. Help the child to take responsibility for her sensitivity. Explore areas of competency where there is a minimum of pressure or competition, pre-empt newness, changes and situations that may affect the child negatively, avoid overstimulation, and provide safe places for the child to withdraw or disappear.
• Reduce shame that frequently coexists with sensitivity and undermines self-esteem.
• Wise firm discipline maintains healthy boundaries and normal standards of behaviour.
2. All efforts should then be made to remove potential environmental trigger factors such as food sensitivities, allergic irritants, dietary excesses, environmental pollutants, and excessive TV, video and computer viewing.
3. Counselling family members and the sensitive child in particular can significantly reduce stress, create awareness of the dysfunctions and empower all family members in discovering their potential resources.
4. The child can in addition be supported with an individually prescribed natural dynamic medication (anthroposophical and/or homeopathic) to help integrate his sensory dysfunctions.
5. Further specialist advice should be obtained to determine whether educational, remedial and specific therapeutic interventions such as therapeutic eurhythmy, occupational therapy, body alignment, brain gym or other modalities should be instituted. Parents of functionally sensitive children are usually reassured that there is nothing wrong with their children. Dysfunctional children are those who need referral to appropriate therapy as early as possible because of the enormous improvements that can be obtained if instituted early enough. Unfortunately, the scope of this article does not permit a more detailed description of the therapeutic opportunities available.
Highly sensitive children have a vital role to play in our Westernised materially based culture that tends to ignore the reality of soul and spirit. These children remind us of the ever-present reality of soul and spirit, for by manifesting these differences and dysfunctions “they stand nearer to the Spiritual than the things that are done by the human being in his healthy functioning’.3
In the third and last part of this article, I will examine childhood autism.

References
1. Goldberg R. Understanding the allergic child. South African Journal of Natural Medicine 2003; 7: 28 – 31, 92.
2. Goldberg R. Awakening to attention deficit disorder. South African Journal of Natural Medicine 2004; 15: 54 – 59.
3. Steiner R. Curative Education. London: Rudolf Steiner Press, 1972.