Guide to Sensory Processing

Prepared by Allison Travnik, MSOTS Level II Fieldwork Student Project Kavitha N Krishnan MS OTR/L Fieldwork Instructor

Sensory Processing In order to understand what is going on around us, we need to organize all of the incoming sensory information (Ayres, 2005). The sensory information involves what we see, smell, taste, hear, feel on our body, where our body is in relation to others, and how well we are balanced. This is a lot of information that our brains need to process in order to engage in productive behavior, learn, and form accurate perceptions.

Proprioceptive Where are body is in space Tactile Auditory What we feel The noise on our skin around us

Sensory Smell Processing The Sight difference What we see scents around us around us

Oral Sensory Processing Vestibular The sensations Jean Ayres developed the sensory Our sense of Disorder + balance that food give integration (SI) theory. SI gives us in our mouth meaning to what our senses are recognizing. When the sensations are not being organized properly may notice some of the same qualities in the brain, Ayres compared it to about yourself.It is important to a traffic jam. The traffic jam of remember that everyone has some sensory information can lead to quirks about their sensory processing learning difficulties and problem whether it be a sensitivity to loud behavior (Ayres, 2005). Children noises or dislike of light touch. with Sensory Processing Disorder However the identification of SPD is (SPD) are struggling with this reserved for individuals whose traffic jam. sensory quirks are outside of the Sensory processing is a typical range and affect their daily dynamic and complex theory. functioning (Miller-Nosology). Figure 1 Ayres was the pioneer of the provides an organization for SPD. For sensory processing field who these individuals, they are constantly created a theory in which being bombarded by different sensory research scholars, such as input which can be confusing or Winnie Dunn, and Lucy Miller, upsetting. Typically developing who expanded the sensory children can have sensory processing processing model. As you difficulties along with children with research more about what SPD other diagnoses such as ADHD, is, in regards to your child, you autism and fragile x syndrome.

2 Figure 1 Sensory Processing Disorder (SPD)

Sensory Sensory Sensory-Based Modulation Discrimination Motor Disorder Disorder (SMD) Disorder (SDD) (SBMD)

Sensory Over- Sensory Under- Sensory Postural Responsivity Responsivity Seeking/Craving Dyspraxia Disorders (SOR) (SUR) (SS)

Miller, 1997

Sensory Modulation Disorder Sensory Modulation A child who is Sensory enjoy intense refers to the ability to Under-Responsive sensory stimuli. provide an appropriate (SUR) may be late to When your child is response to sensory class because they did seeking sensory stimuli. When children not hear the school information we can have Sensory Modulation bell ring at all. In compare it to food. Disorder (SMD), they may clinical practice it has When you are respond in an been found that hungry it is difficult inappropriate way to the children with SUR to concentrate on stimuli. When a child is sometimes have anything else Sensory Over- Responsive difficulty acknowleding except for finding (SOR) they may respond to pain because their something to eat. the someone brushing up brain is not properly This scenario is against them in the registering the sensory exactly how your hallway by becoming overly information of pain in child is feeling upset and/or running their brain. SUR can regarding sensory away. This is because their also be described as information. SS is brain is not processing the low registration, as in also described in incoming tactile sensation Dunn’s Theory of Figure 2 from of someone touching them Response shown in Dunn’s Theory of properly and therefore Figure 2. Response. their response to the stimuli in not appropriate. Children who are SOR can also be described Sensory Seeking/ as sensory sensitivity or Craving (SS) may seek sensory avoiding as in out excessive touch Dunn’s Theory of Response such as a lot of hugs because they shown in Figure 2. 3 • In order to register the incoming Sensory Discrimination sensory information, the stimuli Disorder Low needs to be more intense than others need. Your child may appear to be Children with Registration uninterested or unable to attend to a task for a long period of time without Sensory Discrimination being distracted. Disorder (SDD) are able to recognize that there is a •In order to register the incoming sensory sensory stimuli however information, the stimuli needs to be stronger are unable to differntiate than others need. Your child is responding to Sensory this by seeking out strong sensations that may the stimuli or intensity seem too intense to others. Example: Your Seeking child may want you to hug them with more from others. For example, force than you prefer. They need a tighter hug someone with SDD may in order to feel your embrace. not be able to feel the difference between a dime • Your child is registering sensory information at a much higher rate than and a quarter or taste the Sensory others. Your child may have difficulty difference between sweet filtering background information such or salty food. This can be Sensitivity as a clock ticking or cars on the street. present in all sensory This makes it difficult to focus or attend to a task. systems including the auditory system. For • Your child is registering sensory example, in auditory information at a much higher rate than others. Because they are receiving filtering difficulites the Sensory such an extreme amount of sensory child may not be able to Avoiding input they may perceive the filter out excess noises sensations as aversive. Your child is avoiding the sensations that are making it difficult to hear uncomfortable. you calling their name. Figure 2 Sensory-Based Motor Disorder Children with Dyspraxia is the inability to Sensory Based Motor Disorders plan and execute a movement. (SBMD) have difficulty with This can be displayed in regards movement due to inaccurate to fine motor (difficulty forming sensory processing and motor letters), gross motor (difficulty planning. When children are unable climbing into a swing), or in oral to stabilize their body in response to motor (difficulty organizing the demands of the environment, chewing and swallowing foods). they may have a Postural Disorder Each of the areas that can be (PD). We can relate to children with affected by dyspraxia can disrupt PD, for instance when riding the daily functioning. train, we have to consciously think about maintaing our balance due to the unexpected movements.

4 + Examples of SPD The Occupational Therapist’s Role Behaviors Occupational Therapist’s are trained to Tactile analyze the sensory systems from a neurological, psychosocial, behavioral, and  SOR: When someone brushes up cognitive perspective as it applies to the against child in passing, they perceive child’s daily functional living skills. Sensory it as someone pushing them and may integration is a specialization in OT practice, cause an inappropriate response in which practioners focus specifically on (hitting). how sensory processing challenges are  SUR: Child may hug tighter than your interfering in the child’s daily living. The other children because otherwise they cannot feel it. therapist chooses specific activities that provide an apporpriate challenge for the Oral child’s individual needs. Treatments are designed to improve sensory processing  SOR: Refuses toothbrush or silverware abilities such as dyspraxia (motor planning  SUR: Chews on toothbrush; Bites self difficulties), discrimination, or sensory or others modulation that may result in challenging Vestibular behaviors (such as tantrums involving hitting, biting, or banging head).  SOR: Cries or avoids swings and slides Choosing dynamic activities for your  SUR: Jumps excessively; Hangs child to engage in will promote the “just upside down right” challenge and will facilitate adaptative behavior. For example, kneeling on the Auditory platform swing and throwing beanies into  SOR: Covers ears in crowds or when the basket. This activates the vestibular, school bell rings proprioceptive, and visual system all at one  SUR: Does not hear/respond to name time. Similarly our daily routines require us being called to use multiple systems at one time. Such as climbing stairs or playing basketball. OT’s Proprioceptive trained in this specific area incorporate a  SUR: Slams doors or stomps feet not multi-sensory model approach in their caused by tantrum; Runs into walls; treatment. Crashes onto floor The University of Illinois Hospital Sight provides this specialized multi-sensory approach and other complimentary  SOR: Sensitive to light/colors; treatments such as Therapeutic Listening, Becomes upset when visually too Wilbarger Brushing Protocol, Sensory many things going on Diet, and the M.O.R.E. Technique. Not  SUR: Seeks bright colors only are we providing direct treatment but Smell also home programs (sensory diet) that are tailored to the child’s individual sensory  SOR: Often upset by smell needs that caregivers will carry out in the  SUR: Loves strong smells such as home. UIH is also willing to coordinate perfumes and lotions with your child’s school to to increase success in the classroom. 5 For more information please visit: www.aota.org ; www.spdfoundation.org