SENSORY DISCRIMINATION DISORDER Lucy Jane Miller, Phd, OTR and Britt Collins, MS, OTR

SENSORY SOLUTIONS SENSORY DISCRIMINATION DISORDER Lucy Jane Miller, PhD, OTR and Britt Collins, MS, OTR

e will finish our year’s column that SDD can occur in any combination Auditory: Did she say cat, cap, or pack? on Sensory Processing Disorder of sensory domains: visual, auditory, Tactile: Is that a quarter or a nickel in (SPD) with the sixth subtype, proprioceptive, vestibular, tactile (touch), my pocket? Sensory Discrimination olfactory (smell), gustatory (taste), and/ Visual: Where is the key that looks Disorder (SDD). First, a quick or interoceptive (sensations from internal like this? Wreminder: children do not fall neatly into organs such as the stomach). Proprioceptive: How hard should I only one of the six subtypes of Sensory Discrimination is the ability to push this forward to move it, but Processing Disorder; most of the time interpret information. It allows you to not break the glass? children have multiple symptoms and fit compare various details, disregard- Vestibular: Which way am I turning? into more than one subtype of SPD. ing irrelevant information. A disorder Sensory Discrimination Disorder of discrimination means that you have This discussion highlights how is the last and most difficult category difficulty interpreting information (i.e., discrimination challenges in each to describe in 1,200 words! It is really differentiating stimuli in the affected sensory domain might affect a child. eight separate subtypes if you consider sensory systems). For example:

32 Autism Asperger’s Digest | November – December 2012 Visit SPDStar.org and SPDFoundation.org for more information about Sensory Processing Disorder and the STAR (Sensory Therapies and Research) Center.

Tactile Domain to page 103.” Symptoms may include the he is a sensory craver and runs around Children with tactile discrimination dif- following: trying to get more, more, more! But ficulties typically have difficulty deter- • talks too loudly or softly discrimination challenges are harder to mining what they touch “by feel”; they • experiences confusion when see. Often discrimination issues, which must see it (stereognosis). We use stere- given directions are frequently missed by diagnosticians, ognosis many times a day. We just don’t • appears to ignore others are the cause of school problems. think about it because it comes Children who have poor to us automatically. For example: Visual Domain discrimination need sensory-rich • buttoning a shirt or pants while Children with poor visual discrimination activities in the domain in which they holding cell phone to ear tend to have trouble in school. It may be have issues. • touching something got out of difficult for them to “read” emotions or Visual: category games (e.g., microwave to know if it’s the to recognize letters and symbols. This find everything in the room that’s a right temperature causes problems such as letter reversals, circle, while driving point to all food- problems finding pictures in a busy related signs) Proprioceptive Domain background, or difficulty reading. Other Interoceptive: Talk about how your How do we choose “just the right symptoms may include difficulty with body feels at times when you are happy amount” of tension or force required to the following: versus worried. Say things such as, “I’m interact with an object (e.g., how hard to • lining up numbers in a math problem so happy, I can feel my heart beating lift to carry box up the stairs)? It is our • scanning a page to find the keywords fast!” or “I always feel nervous when I proprioceptors that give us the informa- in a story [fill in the blank]. My stomach feels like it tion about how hard our muscles have • judging the distance between oneself is flipping over.” That way the child will to contract to accomplish the box-lifting and an object or person begin to understand the body sensations task. If a child demonstrates difficulty in related to emotional content. this area, he may show some of the fol- Olfactory/Gustatory Domain Auditory: Play the same-and-different lowing problems: Smell and taste discrimination do not game, “I’m going to say two words, • roughhousing to the point of cause as severe a social problem, so they and you tell me if they are the same or someone getting hurt are usually only treated when they occur different. Then it will be your turn to try • judging how much force to use with another sensory discrimination to trick me.” when throwing a ball issue. For example: Proprioceptive: Play Simon Says or • using gentle touch to pet an animal • difficulty telling the difference Mother May I? performing unusual, novel between things that are somewhat body movements. Vestibular Domain sweet and those that are too sweet “The vestibular system helps determine • cannot tell if bread is burning, but While we have enjoyed presenting this where our head is in space, relative to has general sense something is wrong series of six Sensory Solutions columns, gravity. If a child has difficulty with • does not know familiar smells (e.g., we are also painfully aware of all that vestibular discrimination, he may not feel grandma’s perfume, coffee shop you remains unsaid, especially in this last when he is starting to fall and will not be frequent) column on SDD. The take-home message able to catch himself before he gets hurt” is this: If you have or work with a child (Bialer and Miller 2011, 160). For example: Interoceptive Domain who you suspect has Sensory Processing • poor awareness of movement of body Many functions of daily life depend on Disorder, seek out a multidisciplinary in space (gets disoriented easily) sensory messages from our body organs. evaluation that includes occupational • knows he’s falling, but can’t tell which Some examples include the following: therapy. Don’t settle for “Don’t worry, way and can’t protect himself • soreness you feel after a good he’ll grow out of it” or “Here’s a brochure abdominal workout on parenting classes.” Follow your Auditory Domain • sensation of being hungry or too full instincts and find answers. Remember, Children with auditory discrimina- • sensation of an upset stomach there is help and hope! tion challenges may be mislabeled with • sensation of a full bladder attention deficit hyperactivity disorder (ADHD) or disciplined for “never listen- Ways to Help a Child with SDD Reference ing” because they appear to ignore what It is important to make sure that a Bialer, D. S., and L. J. Miller. 2011. No is said to them. It may be difficult for child is regulated before intervening Longer A SECRET: Unique Common them to hear the difference between with discrimination issues. You will Sense Strategies for Children with Sensory background noise and the teacher asking, know when a child’s overresponsivity or Motor Challenges. Arlington, TX: “Take out your science books and turn causes a meltdown. You will know if Sensory World.