Sensory processing disorder
What is sensory integration?
Parents often raise concerns about different aspects of their child’s behaviour. Sensory integration often helps to explain children’s behaviours and offers practical ideas to help if needed.
Sensory integration is the brain’s organisation of both the input from the senses and output such as for movement and speech. It allows all the sensory systems to work together, so a child can function well in their environment.
Sensory information is taken in from the sensory systems including the senses of:
Sensory integration is the brain’s organisation of both the input from the senses and output such as for movement and speech. It allows all the sensory systems to work together, so a child can function well in their environment.
Sensory information is taken in from the sensory systems including the senses of:
- Touch (tactile system)
- Sight (visual system)
- Hearing (auditory system)
- Taste and smell
- Proprioceptive system (the position sense)
- Vestibular system (balance, gravity and movement)
What is a sensory processing disorder?
In normal development, children gradually learn to integrate sensation as they understand the world. However some children have difficulty with the processing of sensory information and it can interfere with their development and learning.
The sensory systems usually work together in a co-ordinated way. However a sensory processing disorder can occur in any or several of these systems. Sensory integration disorder often occurs with other developmental disorders such as an autistic spectrum disorder, or ADHD. It may exist independently of other conditions. Sensory processing disorders can affect modulation or praxis or a combination. These terms are explained in more detail below.
The sensory systems usually work together in a co-ordinated way. However a sensory processing disorder can occur in any or several of these systems. Sensory integration disorder often occurs with other developmental disorders such as an autistic spectrum disorder, or ADHD. It may exist independently of other conditions. Sensory processing disorders can affect modulation or praxis or a combination. These terms are explained in more detail below.
Sensory modulation disorder
The brain regulates the input of sensation to maintain ideal levels of attention and activity. Some children have difficulty filtering sensory information and are either over responsive or under responsive to changes in the environment which prevents them attending to what is important and filtering out the other sensations. Some children are sensory seeking, or there may be a combination of responses to sensory input. A modulation disorder may impact on a child’s ability to listen, develop language and play.
Over responsive
Children who are over responsive are usually very active and often impulsive. They may easily become over excitable and have difficulty calming down. Over responsive children often avoid certain sensations such as light touch or hugs. Hair washing, nail cutting, showers, textures of clothing or labels and messy play such as with sand play-doh or paint can produce strong adverse reactions due to tactile over responsiveness. A child who puts their hands over their ears for music or certain sounds, or reacts to the tiniest noise in the environment, such as distant traffic, may have an over responsive reaction within the sense of hearing. He or she may be excessively fearful of household sounds such as a hoover, or hairdryer. An unusually strong nervousness about small changes in height such as on a stairs or escalator may indicate an over responsive vestibular system. Children may be sensitive to certain tastes, smells and textures of food and in some cases will only eat a limited range of foods.
Under responsive
Some children lack responsiveness to sensory input. They may be withdrawn and hard to get going. They may not react as strongly as would be expected to pain or temperature. They often have low motor tone, so may appear to “slouch” and can be rather clumsy.
Sensory seeking disorder
Some children seek out sensation because of poor perception of sensation or to increase their alertness. They may frequently put toys and other objects in their mouth beyond the typical age for this. They may chew on clothes toys, pencils or their finger nails. These children are often extremely active and sometimes lean on, bump into, push, hit or bite others in order to seek out tactile or proprioceptive sensations. They may seek movement by running and climbing, or seek vestibular sensation by spinning. They may lack an awareness of danger.
Some sensory seeking behaviour has a calming effect on the child and may help them to focus their attention. It is important to provide safe and socially acceptable sensory input for a child who is sensory seeking.
Over responsive
Children who are over responsive are usually very active and often impulsive. They may easily become over excitable and have difficulty calming down. Over responsive children often avoid certain sensations such as light touch or hugs. Hair washing, nail cutting, showers, textures of clothing or labels and messy play such as with sand play-doh or paint can produce strong adverse reactions due to tactile over responsiveness. A child who puts their hands over their ears for music or certain sounds, or reacts to the tiniest noise in the environment, such as distant traffic, may have an over responsive reaction within the sense of hearing. He or she may be excessively fearful of household sounds such as a hoover, or hairdryer. An unusually strong nervousness about small changes in height such as on a stairs or escalator may indicate an over responsive vestibular system. Children may be sensitive to certain tastes, smells and textures of food and in some cases will only eat a limited range of foods.
Under responsive
Some children lack responsiveness to sensory input. They may be withdrawn and hard to get going. They may not react as strongly as would be expected to pain or temperature. They often have low motor tone, so may appear to “slouch” and can be rather clumsy.
Sensory seeking disorder
Some children seek out sensation because of poor perception of sensation or to increase their alertness. They may frequently put toys and other objects in their mouth beyond the typical age for this. They may chew on clothes toys, pencils or their finger nails. These children are often extremely active and sometimes lean on, bump into, push, hit or bite others in order to seek out tactile or proprioceptive sensations. They may seek movement by running and climbing, or seek vestibular sensation by spinning. They may lack an awareness of danger.
Some sensory seeking behaviour has a calming effect on the child and may help them to focus their attention. It is important to provide safe and socially acceptable sensory input for a child who is sensory seeking.
Dyspraxia and postural disorders
Praxis is the ability to plan and carry out sequences of movement. Signs that a child may have difficulty with praxis are clumsiness, tripping over, or bumping into things. This is known as dyspraxia. A child may have difficulty learning new motor skills such as riding a bike or tying their shoe laces. Skills such as dressing, cutting, using a knife and fork, writing and ball skills can be challenging for children with dyspraxia. They sometimes have difficulty with thinking of new ideas in play and may rely on familiar activities leading to rather repetitive play.
Children with postural disorder may have difficulty maintaining an upright position. They quickly tire when seated and start to loll, lean, or appear lethargic.
Children with postural disorder may have difficulty maintaining an upright position. They quickly tire when seated and start to loll, lean, or appear lethargic.
Sensory processing disorder and speech and language development
Sensory integration disorder may impact on a child’s communication in some of the following ways:
- Paying attention to speech.
- Coping with background noise and selecting relevant sounds and language such as when the teacher speaks in a classroom.
- Looking and listening to non-verbal and verbal communication
- Taking longer to process what is said to them.
- Difficulties understanding words and sentences.
- Difficulties formulating responses.
- Using language to express themselves.
- Sequencing sounds into words and words into sentences.
What should I do if I suspect my child has sensory integration difficulties?
- Ask for an assessment by an occupational therapist trained in sensory integration.
- Contact the Sensory Integration Network for more information.
- Discuss your concerns with your speech and language therapist or another professional.
- Useful introductory books about sensory integration.