Sensory processing issues in a child
An introduction to sensory processing disorders
By Christina Chismar, MSW, LCSW and Timothy L. Sanford, MA, LPC
A child who acts out regularly for no apparent reason may have sensory processing issues known as sensory processing disorder (SPD). SPD can be defined as an inability to use sensory information to function normally in everyday life. It has a physiological as well as a psychological basis and may be caused by early childhood trauma. Though common among kids who come from “hard places,” SPD is frequently misunderstood and misdiagnosed. As a matter of fact, it can easily be mistaken for ADHD. Parents can help by learning more about SPD and how to manage it.
Sensation – touch, taste, sight, hearing, balance – and the skillful interpretation and use of sensation are not the same thing. We are born with the one. However, the other is honed and shaped as a child moves through the natural stages of growth and development.
Babies fine-tune their perception of sensory information. This happens primarily within the context of a safe environment and nurturing experiences with a loving caregiver. A nursing child snuggles close to her mother’s breast and looks into her mother’s eyes. Then, she sees her own expression mirrored in her mother’s face. As this happens, her brain begins to form healthy neural and chemical connections. Thus, she is enabled to grasp the meaning of these sensory interactions with her environment. Early difficulties of any kind can interrupt this natural developmental flow. This may cause sensory processing issues that surface later in the form of behavioural and learning difficulties.
Types of sensory processing disorders
SPD is not a single specific disorder. Instead, it’s an umbrella term that covers a variety of neurological disabilities, including the following sub-types:
Sensory modulation disorder
- Sensory over-responsivity is when the child is subject to sensory overload. Simple sensations of sight, sound, and touch overwhelm or terrify him.
- Another possibility is sensory under-responsivity if the child is lethargic and seems unmoved by sensory stimulation.
- Or, sensory seeking may be the issue when a child craves more and more sensations of various kinds (examples are spinning, hanging upside down, jumping, etc.).
Sensory discrimination disorder
- This refers to a case in which a child has difficulty differentiating between stimuli, or misgauges the importance of sensory messages. As a result, he has problems with body awareness and the interpretation of visual-spatial relations.
Sensory-based motor disorder
- A child may have difficulty with her posture.
- A child displays an inability to plan and carry out simple tasks. This is known as dyspraxia.
Children with sensory processing issues may experience difficulties with a number of issues. They may struggle with touch, visual and auditory senses, balance and motion awareness or “position” or “muscle sense”. In turn, these difficulties can sometimes trigger “out of control” behaviour that is misinterpreted as “misbehaving,” disobedience or ADHD.
Recognizing the symptoms of SPD
SPD often goes undiagnosed for the simple reason that its symptoms mimic those of several other childhood disorders. For example, ADHD, learning disabilities, speech and language problems, poor auditory or visual discrimination may be suspected. Likewise, the symptoms of allergies, nutritional deficiencies and emotional imbalances might resemble SPD.
Therefore, parents can help by becoming skillful detectives, and learning to discern the signs of SPD through careful observation. Here are some practical strategies to keep in mind:
- Know the risk factors. Be familiar with issues that can contribute to the development of sensory processing issues. There are six major risk factors to be aware of:
- Look for tell-tale signs. When parenting any child, it’s important to realize her “misbehaviour” often conceals a subtle cry for help. It’s possible many of the aggravating things your child does can be best understood as survival tactics.
Kids with SPD – especially those who suffer from sensory overload – often manifest a fight, flight, fright, or freeze reaction to sensory input. Therefore, parents can help by spending time watching a child to see if her behaviour might fit into any of these categories. Does she avoid interaction with other children or display an aversion to transitions? Or, does she overreact to loud noises or bright lights? Be aware of the “sensory triggers” that seem to “set her off” or lead to “meltdowns.”
Responding to the signs and symptoms
Document your observations. Parents can help by keeping a journal where they record the specifics of their child’s behaviour. This should be done at different periods of the day. For example, they can write notes in the early morning, before and after meals, at school and at home. And, they should watch for patterns that have a potential connection with sensory processing issues. Carol Kranowitz’s book, The Out-of-Sync Child, provides several detailed checklists that can help parents recognize symptoms.
Consult with a specialist who deals with children with sensory processing issues. Sometimes, the data collected leads parents to believe that their child may be struggling with sensory processing issues. If so, they can seek out the assistance of a professional who is trained to diagnose problems of this nature. This consultation may take one of two forms. There is a short, informal screening, during which the examiner looks for developmental deficiencies. Also, she checks to see whether the child has acquired certain specific skills. On the other hand, a full evaluation may be conducted. This could be done by an occupational therapist, developmental optometrist or audiologist. And, a speech/language pathologist, pediatrician, psychologist, special education specialist, and/or social worker may also conduct an evaluation.
Sensory issues or behavioural reactions?
Sometimes it’s hard for parents to tell if a child is being naughty or dealing with sensory processing issues. So, here’s a way for parents to determine which is the case.
It’s likely a behavioural issue if:
An audience of some sort is required
The behaviour will stop once the “need” has been met
The child has a specific need or want
The child is likely to use their eyes to convey emotion
It’s likely a sensory processing issue if:
There’s no regard to whether there’s an audience or not
The behaviour may continue even after the “need” has been met
The child may not be able to verbalize what she wants – or the want may change
The child likely will avoid eye contact
Reasons to be encouraged
Before saying anything else, we want to offer parents of children with sensory processing issues a word of encouragement. There is hope for every child who struggles with sensory processing disorder. Here, as in almost every area of parenting children, the bad news and the good news are the same. The human brain is plastic, and as a result can always reorganize itself. And, it may do so to deal with danger and trauma. Or it may need to adapt to a new environment of safety and trust.
Parents can help by beginning to build a new foundation and counteracting the effects of early sensory deprivation. This may be accomplished by working with an occupational therapist who specializes in sensory integration (OT/SI). Choose a therapist who makes a point of working with parent and child together.
Also, remember that therapy sessions are only a jumping-off point for work you’ll do with your child at home. In between visits with the OT, help your child interpret and verbalize his sensory experiences in meaningful words. And, build his self-esteem by telling him, “You are an extremely sensitive person. You experience the world in a way that most people can’t.” Become his advocate at school, church, or in the neighbourhood. Stand up for him wherever there are people who don’t understand sensory processing issues.
Good treatment takes time
The treatment needs to be holistic in nature – it must take the whole child into account. Furthermore, it must proceed by way of a complete restructuring of his environment.
We can make up for the sensory deprivation a child suffered during his early years. We start over at the beginning and “re-do” the entire developmental process. But this takes time. Even under ideal circumstances, the human brain requires three years of mentoring to develop normal sensory processing. Parents can help kids with SPD by investing a significant amount of time in bringing their child back “online.” Healing comes from deep, intuitive insight into the child’s early experiences and a patient reversal of the negative effects.
How to help your child
There’s no “quick fix” for SPD. However, parents can help by building a sensory-rich environment and engaging in playful interaction. Also, providing sensory activities for a child with sensory processing issues can be helpful. Parents can actually begin to change a child’s brain chemistry. Consider the activities listed below.
- Try alerting activities for an under-responsive child. These include crunching food, taking a shower, bouncing a ball, crashing and bumping, or jumping on a trampoline.
- Use calming activities for an over-stimulated child. Encourage sucking, rocking, swaying, back-rubs, pushing against walls, or taking a bath.
- Teach organizing activities for children who have trouble regulating their responses to stimuli. Work on chewing, hanging by their hands, pushing or pulling, or assuming an upside-down position.
- Introduce activities to develop the tactile sense. Engage in water play, finger painting, sand play or handling pets.
- Work on activities to develop the vestibular system. Help your child with rolling, swinging, sliding, jogging, or balancing on a teeter-totter.
- Include activities to develop the proprioceptive system. Encourage lifting and carrying heavy loads, pushing, pulling, and making a “people sandwich”. Position your child between two pillows or mattresses and apply pressure to the top of the “sandwich.”
- Offer activities to develop the visual sense. Guide your child in making shapes, jigsaw puzzles, building blocks, cutting activities, mazes, and dot-to-dot activities.
- Provide activities to develop motor skills. Have fun with flour-sifting, stringing beads, and collecting and organizing shells, buttons, or bottle caps.
- Engage in activities to develop motor planning. Make games out of jumping from a table, walking like animals, or playground games like Simon Says.
- Encourage activities that promote bilateral coordination. Work with your child on catching a ball, body rhythms, ribbon dancing, jumping, swimming, and riding a bike.
For more information
Check out information about a therapeutic parenting model developed by the late Dr. Karyn Purvis. It is called TBRI (Trust Based Relational Intervention). We recommend you visit the webpage of TCU’s Karyn Purvis Institute of Child Development, which has a free one-hour “Introduction to TBRI” online video. You can find other resources through their online store.