Sensory Processing Disorder

Sensory Processing Disorder is a condition in which the brain has trouble receiving and responding to information that comes in through the senses. 

Formerly referred to as sensory integration dysfunction, it is not currently recognised as a distinct medical diagnosis.

Some people with sensory processing disorder are oversensitive to things in their environment. Common sounds may be painful or overwhelming. The light touch of a shirt may chafe the skin.

Others with sensory processing disorder may:

• Be uncoordinated
• Bump into things
• Be unable to tell where their limbs are in space
• Be hard to engage in conversation or play

Sensory processing problems are usually identified in children. But they can also affect adults. Sensory processing problems are commonly seen in developmental conditions like ASD.

Sensory processing disorder is not recognised as a stand-alone disorder. But many experts think that should change.

Symptoms of Sensory Processing Disorder

Sensory processing disorder may affect one sense, like hearing, touch, or taste. Or it may affect multiple senses. And people can be over- or under-responsive to the things they have difficulties with.

Like many illnesses, the symptoms of sensory processing disorder exist on a spectrum.

In some children, for example, the sound of a leaf blower outside the window may cause them to vomit or dive under the table. They may scream when touched. They may recoil from the textures of certain foods.  But others seem unresponsive to anything around them. They may fail to respond to extreme heat or cold or even pain.

Many children with sensory processing disorder start out as fussy babies who become anxious as they grow older. These kids often don't handle change well. They may frequently throw tantrums or have meltdowns.

Many children have symptoms like these from time to time. But therapists consider a diagnosis of sensory processing disorder when the symptoms become severe enough to affect normal functioning and disrupt everyday life.

Causes of Sensory Processing Disorder

The exact cause of sensory processing problems has not been identified. But a 2006 study of twins found that hypersensitivity to light and sound may have a strong genetic component.

Other experiments have shown that children with sensory processing problems have abnormal brain activity when they are simultaneously exposed to light and sound.

Still other experiments have shown that children with sensory processing problems will continue to respond strongly to a stroke on the hand or a loud sound, while other children quickly get used to the sensations.

Treatment for Sensory Processing Disorder

Many families with an affected child find that it is hard to get help. That's because sensory processing disorder isn't a recognized medical diagnosis at this time.

Despite the lack of widely accepted diagnostic criteria, occupational therapists commonly see and treat children and adults with sensory processing problems.

Treatment depends on a child's individual needs. But in general, it involves helping children do better at activities they're normally not good at and helping them get used to things they can't tolerate.

Treatment for sensory processing problems is called sensory integration. The goal of sensory integration is to challenge a child in a fun, playful way so he or she can learn to respond appropriately and function more normally.

 

Further sources of information:

Sensory Integration Education

 

Aims of sensory work include:

• To provide an environment to develop the child’s awareness of their senses.

• To provide a safe environment where the child can relax and have fun.

• To provide an environment that reduces sensory input and reduces the child’s anxiety.

• To teach strategies that enables the child to increase their tolerance of a specific sensory stimuli.

• To provide activities that encourages the child to explore their environment.

• To help the child develop concepts.

• To develop attention and concentration.

• To encourage interaction.

• To give opportunities for the child to express preferences and make choices.

• To develop turn taking.

 

Tactile

Some examples of observed behaviours that suggest the child has difficulty with tactile input and would benefit from the tactile activities suggested and from similar tactile exploratory work:

• Does not like wearing certain textures of clothes, avoids wearing shoes, irritated by labels in clothes.

• Does not like touching a range of different textures.

• Seems overly sensitive to light touch.

• Hits, bites self.

• Frequently puts objects in mouth.

• Avoids putting hands in messy substances.

• Plays with a limited range of toys.

 

Possible aims for the tactile exploratory work:

• To touch a range of different textures.

• To expand the range of textures the child has experienced.

• To tolerate touch from other people.

• To indicate appropriately their preference for textures.

• To have appropriate strategies when there is a texture they do not like.

Many children find tactile sensory activities much more motivating than traditional rewards such as stickers. Some possible observed behaviours that could indicate the tactile activities suggested in the table below would be motivating for the child and could be used as rewards or for calming the child:

• Is fascinated by certain textures.

• Enjoys messy activities.

 

Auditory

Some examples of observed behaviours that suggest the child has difficulty with auditory input and would benefit from the auditory activities suggested in the table below and from similar auditory exploratory work:

•    Screams or becomes upset at loud noises.

•    Puts fingers in ears or covers ears, hits ears when distressed.

•    Makes repetitive noises to block out sounds.

•    Does not always respond to sound or speech.

•    Has a delayed response to sound or an instruction.

 

Some possible aims for the auditory exploration work:

•    To listen to a range of different sounds.

•    To  expand the range of sounds the child has experienced.

•    To indicate appropriately their preference for particular sounds.

•    To have appropriate strategies when there is a sound they do not like.

 

Many children find auditory sensory activities much more motivating than traditional rewards such as stickers. Some possible observed behaviours that could indicate the auditory activities suggested in the table below would be motivating for the child and could be used as rewards or for calming the child:

•    Is fascinated with certain sounds.

•    Enjoys sounds to be repeated – for example turns radio on and off

•    Puts ear close to sound to listen.

 

Visual

Some examples of observed behaviours that suggest the child has difficulty with visual input and would benefit from the visual activities suggested in the table below and from similar visual exploratory work:

•    Hits or rubs eyes when distressed.

•    Seems sensitive to changes in lighting.

•    Avoids direct eye contact.

•    Does not like bright light, squints, closes eyes.

•    Does not like particular colours.

 

Some possible aims for the visual exploration work:

•    To look at a range of different colours or patterns.

•    To  tolerate a change in lighting.

•    To  expand the child’s experience of looking.

•    To indicate appropriately their preference for looking at objects or people.

•    To have appropriate strategies when there is a light source they do not like.

Many children find auditory sensory activities much more motivating than traditional rewards such as stickers. Some possible observed behaviours that could indicate the visual activities suggested in the table below would be motivating for the child and could be used as rewards or for calming the child:

•    Enjoys watching moving colours or patterns.

•    Enjoys watching a repeated action.

•    Likes turning lights off and on.

•    Moves head very close to objects to look at them.

•    Moves fingers or objects in front of eyes.

 

Taste

Some examples of observed behaviours that suggest the child has difficulty with taste input and would benefit from the taste activities suggested in the table below and from similar taste exploratory work:

•    Only eats small selection of food.

•    Prefers food of particular type – for example crunchy foods.

•    Does not like trying new food.

•    Eats inappropriate substances.

Some possible aims for the taste exploration work:

•    To taste a range of different foods.

•    To  expand the range of food the child has experienced.

•    To indicate appropriately their preference for foods.

•    To have appropriate strategies when there is a food they do not like.

Many children find taste sensory activities much more motivating than traditional rewards such as stickers. Some possible observed behaviours that could indicate the taste activities suggested in the table below would be motivating for the child and could be used as rewards or for calming the child:

•    Likes chewing on things for a long time, chews clothes, objects.

•    Licks objects or people.

 

Smell

Some examples of observed behaviours that suggest the child has difficulty with tactile input and would benefit from the smell activities suggested in the table below and from similar tactile exploratory work:

 

Some possible aims for the smell exploration work:

•    To experience a range of different smells.

•    To  expand the range of smells the child has experienced.

•    To indicate appropriately their preference for smells.

•    To have appropriate strategies when there is a smell they do not like.

Many children find smell sensory activities much more motivating than traditional rewards such as stickers. Some possible observed behaviours that could indicate the smell activities suggested in the table below would be motivating for the child and could be used as rewards or for calming the child:

•    Is fascinated by certain smells.

•    Likes sniffing objects, people, food.

 

Movement

Some examples of observed behaviours that suggest the child has difficulty with proprioceptive or vestibular input and would benefit from the movement activities suggested in the table below and from similar movement exploratory work:

•    Stumbles frequently, bumps into objects, people.

•    Gets frightened if feet leave the ground.

•    Unaware of own body sensations – for example doesn’t feel hunger.

•    Rocks back and forth.

•    Avoids balancing activities.

•    Has difficulty walking or crawling on uneven surfaces.

 

Some possible aims for the proprioceptive and vestibular exploratory work:

•    To  expand the range of movement the child has experienced.

•    To tolerate different movements.

•    To indicate appropriately their preference for movements.

•    To have appropriate strategies when there is a movement they do not like.

 

Many children find proprioceptive and vestibular sensory activities much more motivating than traditional rewards such as stickers. Some possible observed behaviours that could indicate the movement activities suggested in the table below would be motivating for the child and could be used as rewards or for calming the child:

•    Seeks fast moving activity.

•    Enjoys rough and tumble play

Hanieh Abraheh (Paediatric Occupational Therapist) shares information on supporting pupils with proprioceptive and vestibular sensory needs:

Activities to promote proprioceptive discrimination

The proprioceptive system’s receptors are located in our muscles and joints and are mainly stimulated by resistive activities (pushing and pulling against something) or by stretching. Proprioceptive input helps develop body scheme, and has an organising effect, helps obtain and maintain optimum levels of arousal. Try and spend 10-15 mins a day at least doing any of these activities.

• Climbing on rope nets and rescuing animals on the top
• Crawl through the tunnel whilst pushing a weighted ball or a heavy object
• Tug of war games: Pull a rope or a bicycle inner tube
• Wheelbarrows: Student walks on hands while someone supports their hips or legs
• Steam Roller: Student to lie on stomach over large ball (therapy ball) with hands on floor and gradually walk forward. When they collapse, roll the ball over them with firm pressure, as appropriate. Please monitor their reactions to the pressure at all times; do not apply excessive pressure over their chest.
• Make a big pile of cushion using sofa cushions, small cushions or foam blocks and get student to jump on the spot and then crash into the soft pile of cushions.
• Encourage student to lie down on their back and pretend to ride a bicycle with their legs.
• Heavy loads: Encourage student to help move furniture around, carry books, boxes of toys, heavy balls etc. When appropriate ask them to help with lifting equipment (integrate this in your daily routine as much as possible)
• Encourage student to lay on tummy while propping with forearms flat on the ground to write, play games, or puzzles etc.

Vestibular activities include any movements that involve the head moving through space. To stimulate the vestibular system use activities that are stop and go and that occur in a variety of planes. Vestibular input supports the development of body scheme, motor co-ordination and praxis. Encourage movement with varying speed, fast, alternating, unpredictable movements, start and stop unexpectedly, encourage angular head movements, bending and fast spinning.

• Walking on the rope net without holding on. Avoid falling. For an extra challenge ask student to carry a weighted ball or a tray with a beanbag/small size ball on it
• Bouncing on a therapy ball whilst playing catch
• Long rolling along mats/carpeted area to knock over skittles/plastic blocks/tower with foam block • Rolling or bouncing on big ball or peanut ball, see ball activities listed below
• Encourage feeling movement with eyes closed, e.g. bouncing on the ball with their eye closed
• Balancing on steppingstones whilst carrying a tray with a small size ball on it. Avoid losing balance or dropping the ball. For an extra challenge you can place steppingstones with a large gap or in a zig-zag way.
• Encourage identifying body position with eyes closed
• Encourage going through an obstacle course with eyes closed, e.g. going through the rope net with eye closed, crawling through the tunnel with eye closed. General activity ideas using the following equipment:

Small Trampoline:

• Encourage student to bounce up and down on the trampoline. Do 10 jumps at a time and then have a break, repeat this process 3 or 4 times.
• Play catch with a heavy ball whilst bouncing.

Use the trampoline as part of an obstacle course Balance Board:

• Encourage students to jump on the steps and hold their position when they land on the first spot (with your help at first). When they are confident enough let them balance by themselves. See how long they can balance for. Hopefully they will be able to hold his balance for longer.
• If student is at the stage where he is balancing well, throw a ball to them to make it more challenging. You could also ask them to throw beanbags/ balls/or any other toy into a target whilst they are balancing.
• Walking heel-to-toe along a straight line. Weighted balls:
• Carrying weighted balls using both hand and jumping through hula-hoops (placed flat on the floor) with both feet at the same time.
• Playing catch (encourage them to start from short distances and progress to longer distances).
• Bounce on the trampoline whilst holding the weighted balls.
• Playing catch whilst bouncing on the trampoline using heavy balls.

Therapy Ball & Peanut Ball:

• Students to lie on their tummy over the ball. They need to roll over the ball to touch the floor with their hands, walk forward with their hands and then roll back. For an extra challenge you can ask them to reach for a bean bag and aim at a target with one hand whilst balancing on the ball.
• Lying on tummy roll over ball and ‘walk’ with hands to crash onto soft pillows or mats.
• Lying on their tummy roll over the ball to play various games. Use games such as building blocks, constructions games and puzzles. Obstacle courses: Obstacle courses help a lot with motor planning, regulation and organisation.
• Set up obstacles (using foam blocks, tunnels, ropes, blocks, rings on the floor etc.) and create a simple course for students to go through in a great, linear circle; crawl under or over, go through, and throw at a target. Progressively make the obstacles more difficult and challenging. As you design the course, mutter prepositions to yourself: up, down, in, out, over, under, across, through, between, beside, into upon, around, etc. Alternate the obstacles so that students vary the body position and kinaesthesia, as proceeds from one challenge to the next. Do not tell them how to approach the obstacle; let them figure it out by themselves. Ask students to go through the obstacle course 2-3 times.
• For extra challenge guide them through the games with less instructions/help. Try to incorporate the trampoline, therapy ball, crushing into pillows, crawling, balancing beam, and steppingstones. Adjust the level of difficulty each time so that students always find it challenging.