Sensory Processing Disorder

Sensory Processing Disorder

By Dr. Sara Murphy, Occupational Therapist

Sensory processing is how a person is able to take in information from their environment and how the nervous system will receive, organize and understand that information. This determines how a person responds to their environment as well as within their own body (Reed, 2014).

A child with sensory processing disorder (SPD) may misinterpret sensory information such as sound, touch and movement. For instance, children may feel noxious to auditory or visual sensory information, or they may not even register the sound of their name being called. Children who have this neurological disorder may be affected developmentally and may have difficulty with self-regulation.

There are three types of SPD: sensory modulation disorder (SMD), sensory-based motor disorder (SBMD) and sensory discrimination disorder (SDD) (Reed, 2014):

• A person with modulation disorder will have difficulty interpreting sensory information which may result in behaviors that do not match the intensity and the nature of the information. For example, a child may show signs of distress and avoidance when playing with messy play such as finger paint or shaving cream because the tactile information coming in is too intense for them. On the other extreme, someone with SMD may be under-responsive to sensory information: For instance, a child may not feel it when they bump into a wall or fall down, and therefore may continue risky behaviors.

• A person with a sensory-based movement disorder will have difficulty moving or planning a sequence of movements in response to sensory demands. This disorder can present as dyspraxia, which affects both fine and gross motor skills, motor planning and coordination, or as a postural disorder, which can cause long-term pain issues. Movement orders are not related to intelligence, but can sometimes affect cognitive skills.

• A person with sensory discrimination disorder cannot sense differences between sensory information. For example, they may not recognize that they are hungry or that their bladder is full. Discriminating between letters or sources of sounds also may be difficult.

Diagnosis

There is no specific reason for sensory processing disorder, but it has been linked to birth trauma, heredity, prenatal complications and sensory deprivation. SPD often occurs with other disorders, such as autism spectrum disorder, attention deficit disorder, Down syndrome, fetal alcohol syndrome and fragile x syndrome.

A variety of assessments are used by occupational therapists during evaluations to determine SPD. A diagnosis is often not recognized as an official disorder and insurance may not cover testing. The gold standard of testing is the Sensory Integration and Praxis Test which can be used to create a more targeted therapy approach. This test is administered by therapists with extensive training in sensory integration in children ages 4-9; it takes about 2 hours to administer.

An Occupational Therapist’s role in treatment

Occupational therapists work with physicians, psychologists and teachers to create treatment approaches. Intervention focuses on how a person responds with frequency, duration, intensity, rhythm, complexity of input and the novelty of tasks to find the right balance of regulating arousal when information is introduced. Methods include establishing routines that are predictable or minimizing extra stimuli of a particular sense for those who may be sensory over-responsive (Reed, 2014). For a person who is under-responsive, the goal is to enhance a task or daily routine in order to receive more intensity, duration or frequency of stimuli (Reed, 2014).

To address sensory disorders, it is necessary for a child to interact with their environment in order to learn. A person’s self-care includes being aware of their body and keeping themselves safe but engaged when interacting with their environment. It is important then for a therapist to provide cues to use cognitive strategies to understand when a person is calm or when their body is in high arousal and unable to learn. It is important for a child’s body to be regulated before using interventions.

Interventions for a person with SDD include sensory-rich environments which include factors with which they have issues. For example, for someone with visual sensory issues an activity may include locating everything in a room that is a circle (Bialer & Miller, 2011). For someone with proprioceptive issues, the sense of self-movement and body position, a therapist may have a child play along with “Simon Says” or perform novel body movements.

Concerns with your child

If you have any concerns about whether your child is experiencing sensory processing issues, please consult with your pediatrician. They can prescribe having an evaluation with an Arbor Therapy occupational therapist.

References

Bialer, D., & Miller, L. J. (2011). No longer a secret: Unique common-sense strategies for children with sensory or motor challenges. Future Horizons.

Reed, K. L. (2014). Quick reference to occupational therapy. Austin, Texas: Pro-Ed.