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Sensory Processing Disorder

Sensory processing disorder affects up to one in six children. Despite this, many people have never heard of sensory processing disorder or SPD. Or if they have, it’s only a vague idea. But, sensory processing can have a big impact on your quality of life.

To understand SPD, it’s important to have an understanding of sensory processing and the types of sensory input you encounter daily. Working with an Occupational Therapist who specializes in SPD is recommended and can be very helpful in understanding your child’s needs and how to improve their sensory processing. 

How We Sense

You are consistently taking in and processing sensory input from your surroundings, right?  These inputs come from the things you hear, see, feel, taste, smell, and awareness of where you are in space. Additionally, your proprioceptive system provides you with a sense of body awareness in relationship to your surroundings. 

Sense of smell

When you take in and process these inputs effectively, you have an easier time staying regulated and focused during the day. If you are regulated, you are responding appropriately to your surroundings, you are calm, happy and ready to learn or engage in an activity. When someone has difficulties processing sensory input, they can easily become dysregulated and have difficulties with everyday tasks. 

Can you imagine how you’d feel if you were constantly aware of the lights in a room, or the texture of your clothing on your skin, or by the ticking of a clock? Or perhaps the smells from the cafeteria, or lacked the ability to know where your body was in space? These things that many of us don’t even notice can be very overwhelming or troublesome to someone with sensory processing difficulties. 

Breaking Down Sensory Processing

Sensory information flows this way: receptors in our connective tissue, joints, muscles, skin, inner ear, taste buds, etc. communicate the input (be it pressure, stretch, movement, touch, sound, flavor) through our nervous system to the brain.

The brain takes that information, interprets it, and then sends information back to the body on how to respond (push more or less hard, move slower or faster, find a crumb without looking, answer a question, spit out the yucky milk, etc.). It is this process that optimizes the body’s ability to interact and respond to its environment. 

Successful sensory processing occurs when the input that is received is interpreted accurately and results in the proper response, at the appropriate time.  

Types of Sensory Input

Some types of input you receive throughout the day are easier to understand than others. These types of input are:

  • Visual input, what you see. 
  • Auditory input, what you hear. 
  • Tactile input, what you feel (touch). 
  • Oral input, what you taste.
  • Olfactory input, what you smell.
Tactile sensory play

These inputs are easy to relate to and understand. 

Some other types of input may not be as familiar to you even though you rely on these sensory systems daily. 

  • Vestibular input is where you are in space. For example, you know you are sitting upright currently (not upside down) because of the information your brain is receiving from your inner ear. It is getting feedback from the position your head is in and telling your brain you are right side up. If you were to suddenly be flipped upside down your inner ear would register that and communicate to your brain.
  • Proprioceptive input is body awareness. This is the ability to know where your body is without having to use your sight. For example, if you close your eyes and try to touch your left knee, you will likely succeed because your proprioceptive system is functioning well. The proprioceptors located in your knee and in your hands/arms are providing the correct feedback to your brain so you have awareness of where you are without having to look. 

When we take in sensory input and process it successfully, we move through our day much easier. If we become overstimulated or understimulated by input it can be difficult for us to engage in our regular activities and we may become dysregulated. In children, this can often present as behavior issues. 

By understanding the sensory systems and how they relate to each other, you can help your family members, children and even yourself learn how to process sensory information more effectively.  Learning strategies to help during more stressful or unpleasant sensory experiences can be life-changing for both you and your loved ones. 

Sensory Processing Disorder

Sensory overstimulated child

Difficulties with sensory processing occur when the sensory input received from an experience is not processed or organized accurately. When the body doesn’t interpret the information correctly, a person may not respond appropriately to the sensory experience. 

Sensory input affects people in various ways; someone may be overstimulated by an input whereas the next person may be understimulated. Someone could be hyposensitive and the next person may be hypersensitive to the same input. 

Finding the balance between being overstimulated and understimulated is that “just right” state that is ideal. Being ‘awake’ enough to engage in the task at hand, but not so overly wound up that one can’t successfully focus their attention. 

Who does SPD Affect?

Sensory processing disorder can affect anyone. It is common among children with a diagnosis of autism spectrum disorder. However, an autism diagnosis doesn’t always result in a sensory processing disorder and vice versa. Children who are born premature, who have prenatal or delivery complications, drug/alcohol exposure in utero, or whose mother had illness or stress during pregnancy are found to be at higher risk of SPD. 

Sensory processing disorder is often first recognized during the toddler years, though it can be diagnosed and treated at any time throughout the lifespan. 

Pediatricians usually recognize the signs of sensory processing disorder and refer the child to OT who can help further identify and work with the child’s sensory needs. 

Ways Sensory Processing Disorder Presents: Hypo vs Hyper Sensitive

Hyposensitive is being under-responsive to input and needing more stimulus to respond to it. This can show up in two ways that may seem different but have the same root cause of low sensory sensitivity. 

One is that the child may simply not notice things. They may be ‘unobservant’ or ignore things done around them, to them or being said to them. This can be seen by the child who doesn’t know they leave food on their face after most meals, needs extra cues to know you are talking to them and has no clue when you touch them on the back.

The ‘seeker’

The other way that hyposensitivity shows up is in what is commonly known as the ‘seeker’. These people may seek out certain types of input to try to meet their perceived lack of sensory input being received. Someone who is a seeker of vestibular input may love to swing, spin in circles or be upside down. Someone who seeks proprioceptive input may bump into things, play rough with friends, crash into the walls and jump off the furniture onto the floor. If someone seeks tactile input you may see them touch EVERYTHING! An oral seeker might put everything in their mouth. Seekers need more input; they often appear very extreme in their actions due to their seeking behavior and trying to fulfill their sensory needs.

Sensory seeking child

The ‘avoider’

Hypersensitive means being over-responsive to an input. People that are hypersensitive may avoid certain types of input as it is unpleasant to them or may be over-reactive to an input that others may not even notice. These people may be known as ‘avoiders’.

Someone who is hypersensitive to touch may be bothered by the seams in their socks or tags in their shirts. They may only wear a certain type of fabric that they find comfortable. You may see someone cover their ears when it is noisy, when the vacuum is turned on or when a toilet flushes if they are hypersensitive to auditory stimulus. 

Avoiders are more sensitive to input that most of us might not even notice or at least aren’t bothered by.

Can you be Hyposensitive and Hypersensitive at the Same Time?

Let’s dive in a bit deeper. Someone could be hyper and hypo sensitive to input all at the same time, seeking tactile input, for example, but avoiding vestibular. 

Throughout our lives this may change. It can also change day to day for some people depending on the situations they are in. Once you have some foundational knowledge regarding sensory input and sensory processing you can start to observe how different stimuli affects your child.  Does it wind them up or calm them down? Do they tend to seek or avoid certain types of input? 

Noticing these nuances about your child will allow you to better help meet their needs. Of course, working with an Occupational Therapist who specializes in sensory processing is best, as they can help you develop a plan and strategies that will work for your child. 

Relating to Sensory Processing Difficulties

Relating to and understanding someone who has difficulties with sensory processing can be hard if you don’t experience sensory processing difficulties or are not aware of your own sensory processing. We all experience sensory experiences constantly during the day and even though you may not know it, most of us have experienced some sort of difficulty processing the sensory information coming at us. 

Have you ever been completely overwhelmed in a busy store or at a noisy gathering? Have you felt that you were about to lose it when too many people were talking to you at once? If so, most likely you were experiencing sensory overstimulation. Too much input coming at you all at once, and difficulties processing and sorting it all out. 

These types of experiences may be constant for someone with sensory processing disorder. They may always be feeling overwhelmed by the amount of sensory input being received or they may always feel like they are not getting enough sensory input and seek more input during the day. 

People around them may notice changes in behavior, such as hiding or removing themself from the situation, becoming quickly and easily upset, or overly active ‘bouncing off the walls’. 

These behaviors for many children with sensory processing disorder may be a direct effect of the inaccurate interpretation of the sensory experience. 

Examples of Sensory Processing Difficulties

Have you ever noticed the kid who seems to always play too ‘rough’ on the playground? The kid who appears to push over the other kids when playing tag? Or tackles their friends to the ground wrestling with them even if that wasn’t the game?

Hypersensitive baby pulling feet away from grass

This kid is hyposensitive in the area of proprioception, remember that’s the sense of body awareness. His strong push to ‘tag’ really just feels like he is tapping his friend. He needs more deep pressure for this sensory bucket to be fulfilled. So instead of playing soft, he crashes, falls, and wrestles to try to fulfill his seeking need. 

How about the baby that pulls their hands away when you set them down in the grass or gets upset when their hands and face are messy? They are displaying tactile defensiveness. The touch sensation they are receiving is unpleasant to them, and so in reaction, they withdraw from the input. 

They may also become very upset crying or yelling as a way to show their displeasure with the sensory input they are receiving. 

Why Play Matters

We are not born with our sensory systems working optimally. Sensory integration develops with time and at different speeds in the various categories. This is why play matters.

Kids need to experience various types of input regularly to help them learn to take in, process the information in the brain, and send back a useful response to the body. 

Every time a message is sent to the brain and back it strengthens the system’s ability to handle that type of input, it’s called neuroplasticity. It’s very exciting! This means that you can directly impact a child’s sensory integration by providing meaningful play opportunities. 

This is especially important while the child is young and the brain is developing so rapidly.

Sensory play in ball pit

Who Can Help?– Occupational Therapy!

As mentioned above, working with an Occupational Therapist (OT) who specializes in sensory processing disorder can be very valuable when trying to figure out how best to help your child. 

The OT will do a comprehensive evaluation with you and your child. During this they will identify areas of need and set goals to work towards. Usually they will engage your child in a sensory diet made up of sensory activities in the clinic, and provide you with education to better help you understand your child’s needs. 

The first job of a pediatric OT is to help families understand what sensory processing is, and how it relates to their specific situation. 

Without this foundational knowledge, families can’t understand what is going on with their child and progress will be stalled. However, if there’s a clear understanding of SPD, then the effects of therapy will be accelerated. 

In conjunction with OT, it is important for families to carry over sensory activities at home. Performing a sensory diet on a regular basis will help to achieve the best results. 

Working with an Occupational Therapist who can help you better understand your child’s needs can be very valuable. But having a basic idea of these concepts and observing how your child responds to sensory stimuli is a great place to start. 

Sensory Diet

Therapists use a sensory diet to help feed the sensory system information. This isn’t a food diet but rather a prescribed ‘diet’ of certain activities. Regularly feeding sensory opportunities to a child will help their system take in, process, and respond to information in their environment.

A sensory diet will help your child play in ways that will target the major sensory categories. It will be important, however, that you help find the ‘just right challenge’. This means being able to make small changes to an activity to make it easier or harder based on the child’s ability and tolerance. The desired outcome of a sensory activity is one that challenges their system to grow a little but doesn’t overwhelm them.

If a child is continually presented with sensations that are too much for them it will strengthen a negative response to that input. So, if a child pulls away, tells you it hurts, or asks to stop, please try to modify it to a tolerable level or stop and try again later. Starting at a lower level or presenting that activity when the child is in a good space or even ‘sneaking’ it in while the child is busy playing with a favorite activity is another way to work on non-favored input.

Sensory Success 

The wonderful thing about our nervous systems is that they can change and our ability to process sensory information more successfully can be improved. Families who work with an OT and implement a sensory diet often report their child is sleeping better, not having meltdowns as frequently, tolerating clothing with greater ease, or eating a more varied diet. 

Successful sensory processing

Improving sensory integration is not a short term goal. Of course, some tools presented will show an immediate response (deep pressure to the wound up child for example can usually elicit a calming effect), and we want to use those tools, but we are looking for longer term gains, which will only happen with consistency and time. 

Engaging your child regularly in sensory activities can help their nervous systems learn to better process sensory information. In the long run, becoming more tolerant of that annoying tag, or the flushing toilet, not needing to crash into the wall, or chew on the toy. 

By working with the sensory system we can help children better organize their sensory worlds, in turn becoming more successful in daily tasks that otherwise were hard to participate in. 

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