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Sensory Processing Disorder

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By Carol Stock Kranowitz, MA

Surely, you know a child who is oversensitive, clumsy, picky, fidgety, and out of sync. That child may be your son or daughter, your student or Scout, your nephew or neighbor…or the child you were, once upon a time. That child may have Sensory Processing Disorder (SPD), a common but misunderstood problem that affects children’s behavior, influencing the way they learn, move, relate to others, and feel about themselves.

Sensory Processing Disorder is the inability to use information received through the senses in order to function smoothly in daily life.

SPD is not one specific disorder, as blindness or deafness is, but rather an umbrella term to cover a variety of neurological disabilities. SPD is also called Sensory Integration Dysfunction.

The result of SPD is that the child cannot respond to sensory information to behave in a meaningful, consistent way. He may also have difficulty using sensory information to plan and carry out actions that he needs to do. Thus, he may not learn easily.

Inefficient sensory processing leads to inefficient learning. Because the child with SPD has a disorganized brain, many aspects of his behavior are disorganized. His overall development is disorderly, and his participation in childhood experiences is spotty, reluctant or inept. For the out-of-sync child, performing ordinary tasks and responding to everyday events can be enormously challenging. The inability to function smoothly is not because the child won’t, but because he can’t.

Whether SPD is major or minor, the child who is out-of-sync needs understanding and help, for no child can overcome the obstacles alone.

1. Categories Of SPD Sensory Modulation Problems: Difficulties with touch, movement, and body position are the telltale signs of SPD.

The overresponsive ch ild seeks less stimulation—avoids touching or being touched, and moving or being unexpectedly moved. The child may be rigid and uncoordinated.

 
 

Tommy, Age 3

Tommy is a fussy 3-year-old. He is crying because his shoes are too tight, his socks are too lumpy. Everything scares him or makes him miserable. He hates the playground, the beach, and the bathtub. He refuses to wear hats or mittens, even on the coldest days. Getting him to eat is a trial. His teacher reports that he avoids painting and other messy activities. He fidgets at story time, lashes out at his classmates for no apparent reason. He is, however, the world’s best block builder.

 
     

The underresponsive child seeks more stimulation—may be unaware of a messy face, hands, or clothes or of how things feel; does not notice or object to being moved; lacks an inner drive to move for play, but becomes more alert after pushing, pulling, or lifting.

 
 

Vicki, Age 6

Vicki, a first grader, bumps into furniture and stumbles on grass. She fatigues easily. A family outing or trip to the playground quickly wears her out. Her parents find that getting her out of bed, asking her to put on her coat, or maneuvering her into the car is an ordeal. Although Vicki lacks “oomph,” she becomes livelier after getting into unusual positions – rocking forward and backward on all fours, hanging over the edge of her bed upside down, swinging on her tummy. Her teacher says, “Vicki has difficulty socializing and getting involved in classroom activities. She needs a jump start just to get going.”

 
     

The sensory-craver seeks constant stimulation—wallows in mud, rummages purposelessly through toys, rubs against walls and bumps into people. The child is a daredevil, craves fast and spinning movement, moves constantly, and gets into upside-down positions; and craves bear hugs and being squeezed and pressed. The child may also respond in atypical ways to sights, sounds, smells, and tastes.

 
 

Sebastian, Age 8

Sebastian fidgets constantly. At school, he riffles book pages, twiddles with markers, taps rulers and breaks pencils. He clicks his teeth and chews his collar. His knees bounce, his feet tap. He squirms in his seat and jumps out of his seat every chance he gets. His nonstop activity distracts his classmates and teacher. Sebastian craves sensations: He is the child who’s “gotta touch,” even when it should be clear that touching is inappropriate.

 
     

2. Sensory Discrimination Problems

Another category of SPD is Sensory Discrimination Disorder, or difficulty in distinguishing one sensation from another, or in understanding what a sensation means. Children may have difficulty with touch (poor body awareness, including sensations of pain and temperature); movement and balance; body position and muscle control; sight (confusing likenesses and differences in pictures); sounds; and tastes (such as distinguishing between the smells of lemons, vinegar, or soap).

3. Sensory-Based Motor Problems

This category of SPD includes both Postural Disorder, involving problems with movement patterns, balance and bilateral coordination (using both sides of the body together); and Dyspraxia—problems performing coordinated and voluntary actions, including both fine- and gross-motor planning.

 
 

Paul, Age 9

Paul is an extremely shy 9-year-old who moves awkwardly, has poor posture and balance, and falls frequently. He says he doesn’t want to go to school because he’s no good at anything, and everyone laughs at him. Paul’s teacher notes that he has a long attention span and an above-average reading ability. She wonders why a child with so much information to share becomes paralyzed when he has to write a paper. Paul’s parents think he is the perfect child…unlike other kids, who are loud and mischievous. He never makes trouble, although he is somewhat clumsy, often dropping dishes and breaking toys.

 
     

Look-Alike Symptoms & Associated Problems

Many symptoms of SPD look like symptoms of other common disabilities. An alternative diagnosis may be that the child has ADHD, learning disabilities, poor auditory or visual discrimination, speech/language problems, allergies, nutritional deficiencies, an emotional problem—or that he is behaving just like a typical child! Some children have SPD in addition to one or more other disabilities.

While SPD is not the same as its “look-alike” ADHD, these two disorders may simultaneously affect the out-of-sync child. Medicine may help the child with ADHD, but will not solve the problem of SPD. Therapy focusing on sensory integration and a sensory diet of purposeful activities help the child with SPD.

SPD And Special Ed

While SPD may affect the child’s auditory, visual, and motor skills and her ability to process and sequence information, it is not, at present, specifically identified as a qualifying disability, making a child eligible for special education and related services.

Treatment Options

“Will my child become an out-of-sync adult?” Not necessarily, if he or she receives understanding, support, and early intervention in the form of occupational therapy in a sensory integration framework. As children grow, their brains become less malleable and their unusual reactions to sensations become more established.

If your child is older, however, don’t give up hope. Older children and even adults benefit from therapy, too. It is never too late to get help.

Treatment helps the child to:

  • Process all the senses, so they can work together; as a result, perceptions, learning, competence, and self-confidence improve.
  • Develop skills to interact successfully in social situations.
  • Acquire the tools to become a more efficient learner.
  • Improve family relationships.
  • Build a strong foundation for the future.

Without treatment, SPD persists as a lifelong problem, interfering with the child’s friendships, ability to learn, and with the interactions and coping skills of everyone in the family.

Reprinted with permission of Penguin Group from The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder, revised edition, by Carol Stock Kranowitz. Perigee, 2005.