Helpful Overview of Sensory Processing Disorder
For parents whose children have been diagnosed with sensory processing disorder, your head might be spinning. It is not uncommon to be concerned with how your child will learn to grow and function while living with this condition. Bionix Health at Home assembled this resource for you to learn about sensory processing disorder as well as provide tips and tools you can implement in your child’s life to help them live comfortably and grow into a healthy adult.
What is SPD?
Sensory processing disorder is a condition in which the nervous system does not process input gathered from the senses in a correct fashion. The nervous system receives messages from the body’s senses and translates them into appropriate motor and behavioral responses. All activities from reading to running require the correct processing of signals to be successful.
In patients with SPD, the sensory signals either
- Do not get detected or
- Do not get organized into appropriate responses.
Certain parts of the brain are prevented from receiving information they need to form an appropriate response. This lack of information can cause problems as wide-ranging as motor clumsiness to behavioral issues to depression (Source: https://www.spdstar.org/basic/about-spd)
SPD is frequently misidentified as being on the autism spectrum. It is easy to see how SPD and autism might be confused for each other or be believed to overlap. Both SPD and autism spectrum disorders have “over-responding” and “under-responding” categories. According to STAR Institute, it is true that about three quarters of autism spectrum children also show symptoms of sensory processing disorder. However, most children with SPD do not have an autism spectrum disorder. The two conditions are distinct, just as SPD is distinct from ADHD. (Source: https://www.spdstar.org/basic/co-morbidity)
To get a better idea of the symptoms and disruptions that sensory processing disorder can cause, it is essential to understand the human body’s sensory systems on a basic level. STAR Institute describes the 8 sensory systems as follows:
|Name of system
||Primary brain area
||Color, shape, orientation, motion
||Superior temporal gyrus
||Frequencies, changes in frequency or amplitude, combinations of frequencies
||Olfactory bulb (forward part of the brain on the bottom side)
||Olfactory epithelium in the nose
||Discriminating among odors, enhancing detection of odors, filtering out background odors
||Primary: insular cortex deep in the lateral fissure
||Taste buds located on the upper surface of the tongue, soft palate, upper esophagus, the cheek and epiglottis
||Tastes such as sweet, salty, bitter, sour, and umami
||Lateral postcentral gyrus
||Touch, pressure temperature, and pain
||Head movement in space
||Many parts: cerebellum, cranial nerves, reticular formation, spinal cord, thalamus
||Inner ear: semicircular canals and the otoliths
||Balance and orientation in space
||Sensations from muscles and joints
||Cerebrum and cerebellum
||Neurons in the inner ear and stretch receptors in muscles
||Position, location, orientation, and movement of the body muscles and joints
||Sensations related to internal organs and the physiological condition of the body
||Dorsal posterior insula
||Nerve endings lining the respiratory and digestive mucous membranes
||Responses that guide regulation, including hunger, heart rate, respiration and elimination
The first five are the “traditional” or basic senses. The Tactile, Vestibular, and Proprioceptive interact with each other in a way called “sensory integration” that equips people to respond appropriately to their environments. It is these three areas that are frequently the focus of Sensory Processing Disorder or sensory integration dysfunction. (Source: https://en.wikipedia.org/wiki/Sensory_processing_disorder)
Sadly, symptoms of SPD can frequently be misinterpreted as poor behavior on the part of a child. Knowing potential symptoms will help you have more patience with your child when their behavior is frustrating.
STAR Institute has assembled a helpful checklist with potential signs and symptoms grouped by ages. Notice that some of the symptoms appear to be opposites; it just depends on the expression of SPD your child has.
Here are some examples:
- My infant/toddler is extremely irritable when I dress him/her; seems to be uncomfortable in clothes.
- My infant/toddler has difficulty shifting focus from one object/activity to another.
- My infant/toddler does little or no babbling, vocalizing.
- My infant/toddler is extremely active and is constantly moving body/limbs or running endlessly.
- My child is overly sensitive to stimulation, overreacts to or does not like touch, noise, smells, etc.
- My child is unaware of being touched/bumped unless done with extreme force/intensity.
- My child has difficulty learning new motor tasks.
- My child has sudden mood changes and temper tantrums that are unexpected.
- My child is easily overwhelmed at the playground, during recess and in class.
- My child has difficulty performing or avoids fine motor tasks such as handwriting.
- My child craves rough-housing and tackling/wrestling games.
- My child has difficulty making friends (overly aggressive or passive/ withdrawn).
- I am over-sensitive to environmental stimulation: I do not like being touched.
- I often begin new tasks simultaneously and leave many of them uncompleted.
- I use an inappropriate amount of force when handling objects.
- My speech lacks fluency, I stumble over words.
- I must read material several times to absorb the content.
You can read the full symptom checklist on the STAR Institute website.
Caring for a child with SPD
Now that you know your child’s diagnosis, the next challenge is learning what special needs they have and how you can adjust their environments to help grow up healthy and happy. Of course, every case of sensory processing disorder is different. Some of the activities listed below are for “over-responders” and some are for “under-responders.”
Do not be too hard on yourself if you can’t find the perfect activities right away. There may be a test-and-learn period at the beginning, which is completely normal. Soon you and your child will get into a rhythm.
You will have to pay close attention to your child’s reactions to activities. If they are expressing fear or distress, they should not be forced to participate. The child’s fear and discomfort is based on a nervous system reaction and is not under his or her control.
Tips for Home
- Bath time: Scrub with a washcloth or bath brush and use a variety of soaps or lotions. Let the child play with shaving cream and draw on the wall. You can rub body lotion (deep massage) into him or her after the bath is done.
- Baking or meal preparation: Let your child pound the dough flat! Mixing ingredients, especially thick ones, will work their muscles and give more intense sensory input. You could even let your child carry heavy pots of water or food with supervision.
- Mealtimes: Encourage your children to eat chewy or textured foods. Drinking out of a straw can become a focused sensory activity. Letting your child site on an air cushion can allow some movement. If your child needs intense sensory input, a weighted blanket could help.
- It is common for children with SPD to only eat a small variety of food. According to Denver-based pediatric dietitian Jessica Crandall, RDN, “Eating fewer than 10 foods and really struggling to try new foods is beyond being picky and a red flag for a problem eater.” This should be a pretty clear sign to differentiate between a picky eater and a problem eater. (Source: http://www.foodandnutrition.org/September-October-2014/Picky-Eater-Sensory-Processing-Disorder/)
- Using other therapeutic aids between meals may help make their mouths more receptive to new foods and textures. Some parents find success with oral massagers or letting their children chew on “chewy tubes” throughout the day to get used to oral stimulation. When brushing their teeth, first brushing the tongue and cheeks with water, then following up with toothpaste may help. Vibrating toothbrushes are the best for this activity if your child will tolerate them. (Source: http://www.sensory-processing-disorder.com/picky-eaters.html)
- Playtime: There are lots of opportunities here.
- When reading books, sit in a beanbag chair or a rocking chair.
- Play the “sandwich game” during which your child lays between two pillows and you provide pressure to the top pillow to the child’s desired amount. Ask them, “harder or softer”? Some children prefer much deeper pressure than you would expect.
- Take a walk around the neighborhood with a heavy wagon or baby doll stroller.
- Swimming in a pool can be a wonderful sensory activity, as can horseback riding or bowling.
Regarding more general rules for home, consistency is key! People with SPD value routines, schedules, and organization of possessions. If you know of an anticipated change in routine, give your child plenty of warning. As time passes, you’ll become familiar with how early your child “needs to know.” (Source: https://www.spdstar.org/basic/home-activities)
Tips for School
- Heavy backpack: While you want to make sure the backpack is not too heavy for your child to handle, the additional weight can help meet the child’s sensory needs. Make sure the straps are padded. It might be worth discussing with your child’s teacher if he or she can wear the backpack all day to help rein in behavior.
- Alternative discipline: It is a common tactic to take away recess or free time as a punishment for acting up in school. However, for children with sensory processing disorder these movement times are valuable opportunities to meet their sensory needs. Taking away playground time might make classroom behavioral issues worse. Instead of punishment, try teaching the child self-regulation skills instead. Just like you cannot reason with a toddler who is having a temper tantrum, you cannot reason with a child with SPD who is overcome with anxiety at the sensory overload he or she is experiencing. Teach your child to use techniques such as deep breathing or affirmations (“I’m feeling calmer. I am okay.”) Calming visualizations can help tame the fight-or-flight response. After your child is calm, acknowledge and praise your child for having calmed down. Then discuss why the behavior was not appropriate and what you expect of him/her. Read more at Sensory Smart Parent.
- Seat cushion: For children who need to move a bit more, an inflated seat cushion or pillow allows them to wiggle in their seat without getting up and disrupting the class.
- Seating arrangements: Since noises can be even more distracting for kids with SPD than with other children, teachers should try to be particularly sensitive to noise distractions. Try to eliminate any buzzing and flickering fluorescent lights. Seat the child way from fans, AC units or other appliances that make noise. While some students behave best sitting near the teacher, oversensitivity to noise might tempt the child to turn around frequently to locate the source.
- Easy escapes from overwhelming environments: Being in large gatherings of students can easily trigger a meltdown. For school assemblies, consider letting the child skip them. If that is not possible, seat the child near a door so he or she can take a break in the hallway with a teacher or other supervision, if needed. Instead of eating in a loud and crowded cafeteria, explore the option of letting the student eat in a quieter room with one or two lunch buddies with a teacher or aide.
- On the playground: Playgrounds can present an increased physical risk to a kid with SPD than it does to an average child. A child might realize when he is perched on top of a metal ladder that he does not like the feeling of the cold metal rungs against his hands. He might be overly worried about bumping into other children or getting hurt. If this is the symptom, he may need encouragement that there is less need to worry than he perceived. For children that are overly aggressive on the playground, rules may need to be set to avoid injury and help the child make and keep friends.
- Occupational therapy: Occupational therapists (OTs) are the specialists who work with kids who have sensory issues. Your school may be able to accommodate your child seeing an OT once or twice a week. If not, private OT sessions are also available. Ask the OT to work on both gross and fine motor skills so he or she is more confident in any situation, whether taking notes or in gym class.
Here is a demonstration video of an occupational therapy session: https://www.youtube.com/watch?v=YUdsgQGHSR8
Tips for Being in Public
Many children with SPD need predictability, so give your child plenty of warning before unscheduled trips or errands so they can mentally prepare.
- Hair Cut: before the appointment, it may be helpful to deep massage the head or scalp if tolerated. Otherwise try letting your child wear a weighted hat.
- Dentist Appointment: Chewy foods and vibration to the mouth via electric toothbrush can help give sufficient stimulation beforehand so that the hygienist and dentist can perform needed work.
- Eating at Restaurants: There are several potential triggers in this situation. Noisy restaurants can seem like an acoustic assault to children with SPD. Earplugs or earmuffs might be a good option. Food characteristics such as texture and temperature can also be triggers. Get to know what your child likes and work with wait staff to serve a meal that the child can enjoy.
- Shopping: Crowds are not a favorite for people with SPD. For kids that do not like being touched, repeatedly brushing elbows with a stranger may lead to an outburst. If you must take your child to the store, try to go at off times. It might even be worth choosing smaller groceries stores that large superstores.
Calming Cushion Can Help
When sufferers of sensory processing disorder have a meltdown, they experience a variety of negative emotions that can include anxiety, fear, and anger. The root of the outburst is the triggering of the “fight-or-flight” response, although it is improperly triggered by normal sensory stimuli. The emotional reaction must be addressed before consistent behavioral changes can occur.
One type of therapeutic intervention that can help children with sensory processing disorder is an aid that applies pressure to the skin. It helps the child receive sufficient sensory input to feel calm and in control. Bionix makes Calming Cushion, a large cushion that squeezes around the subject and provides a deep, gentle pressure that feels like a hug.
The individual lies on their back or side in center of the 40” x 60” cushion. The small custom-made, hospital grade Calming Cushion Vacu-Pump is attached to the Cushion via a short hose. The Vacu-Pump removes the air in the cushion to provide the safe, secure pressure while forming to the contour of the individual’s body.
The Calming Cushion provides some major benefits, such as the fact it simulates a secure hold without employing physical restriction or constraint. It preserves dignity, as the subject is free to get up at any time that he or she wants to and is not strapped in. Since the Cushion operates by adding or removing air, it can be hung or folded in a closet for storage.
Sensory processing disorder can be tricky to identify and complex to handle once it is diagnosed. The most important principle to hold in hand is compassion. The reactions that adults see as annoying or even purposeful misbehaving are reactions that stem from anxiety, fear, and even physical pain at sensory overload. With sufficient occupational therapy and practice of self-regulations, sufferers of sensory processing disorder can learn to better handle and modulate sensory input to the point that they can function appropriately. Until then, Bionix Health at Home hopes that the above information will help you love your child well.