Course:KIN366/ConceptLibrary/SensoryProcessingDisorder

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Movement Experiences for Young Children
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KIN 366
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Instructor: Dr. Shannon S.D. Bredin
Email: shannon.bredin@ubc.ca
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Sensory Processing Disorder (SPD) is a condition that exists when sensory signals do not get organized into appropriate responses (Miller & Benjamin, 2014). Sensory Processing refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses (Miller & Benjamin, 2014). Each sense provides information that humans need to function.

Characteristics

SPD can be characterized by out-of-proportion reactions to touch, sounds, sights, movements, tastes, or smells (Biel & Peske, 2009). Severity of the disorder depends on how many senses are affected, which can range from only one sense to multiple senses. For instance, one individual might over-respond to stimulation while another might under-respond and show little to no reaction to the same stimulation (Miller & Benjamin, 2014). Children with SPD have difficulty processing information from the senses and responding appropriately to that information (Pope et al., 2014). This condition prevents certain parts of the brain from receiving the information needed to accurately interpret sensory information. An individual with SPD finds it difficult to process and act upon information received through the senses which leads to difficulty in performing everyday tasks (Miller & Benjamin, 2014). SPD effects how sensory input is taken in, organized, and utilized to interpret one’s environment and make the body ready to move, regulate emotions, interact, and develop properly (Miller & Benjamin, 2014).

Subtypes

SPD can be thought of as a global umbrella term that includes different forms of the disorder, including three main diagnostic groups (Miller & Benjamin, 2014):

Sensory Modulation Disorder (SMD):

Comprised of sensory over-responding, sensory under-responding, and sensory craving.

  • Individuals who over-respond to sensory stimuli respond faster, longer, or more intense than what is considered typical behavior (Ghanizadeh, 2010).
  • For example, a child with tactile hypersensitivity may be apprehensive for hair brushing because she/he cannot easily tolerate it (Ghanizadeh, 2010).
  • Individuals who under-respond to sensory stimuli are unaware that they respond slower to stimuli (Ghanizadeh, 2010)

Sensory-Based Motor Disorder (SBMD):

Comprised of dyspraxia and postural disorder.

  • Dyspraxia is considered to be impairment of, or difficulties with, the organization, planning and execution of physical movement (Gibbs et al., 2007).
  • Children with postural disorder exhibit poor core strength and decreased endurance (Collins, 2012).
  • This weakness mostly affects the tactile (touch) and proprioceptive systems (muscles and joints), which is demonstrated through inefficient movement and poor body awareness.

Sensory Discrimination Disorder (SDD):

Affects multiple senses including visual, auditory, tactile, taste/smell, position/movement, and proprioception (Miller & Benjamin, 2014).

Etiology

The exact cause of SPD is unknown but there are some factors that place an individual at an increased risk for development of the condition. Preliminary research suggests that SPD is often inherited however prenatal and birth complications have also been implicated as well as environmental factors with potential involvement (Miller & Benjamin, 2014). Genetic and familial factors have been suggested (Ghanizadeh, 2010). Children with autism, Asperger’s syndrome, and other developmental disabilities often have SPD (Pope et al., 2014). SPD can be associated with premature birth, brain injury, and learning disorders (Miller & Benjamin, 2014). Further research is needed to determine the cause of this irregular brain function (Pope et al., 2014).

Impact of Living with SPD

Proper intake and use of sensory input is absolutely critical to a child’s maturation process and the building of core foundational skills (Miller & Benjamin, 2014). Children with SPD often encounter problems with motor skills and other abilities needed for success in school and accomplishing childhood milestones (Miller & Benjamin, 2014). As a result, many of these children experience social isolation and suffer from low self-esteem (Miller & Benjamin, 2014). These difficulties put children with SPD at high risk for many emotional and social problems. Learning, physical and emotional development, as well as behavior can be severely impacted if the neurological process becomes disrupted due to SPD (Miller & Benjamin, 2014).

Signs & Symptoms

Symptoms can be split into categories based on each of the senses: tactile, vestibular, proprioception, auditory, oral, olfactory, and visual (Miller & Benjamin, 2014). It is the frequency, intensity, duration and functional impact of these symptoms which that determine the severity of dysfunction in the individual (Miller & Benjamin, 2014). Each category of dysfunction can be subdivided into hypersensitive and hyposensitive symptoms (Miller & Benjamin, 2014):

Tactile dysfunction

Hypersensitive children:

  • Refuse/resist messy play, resist cuddling and light touch, dislike kisses, rough clothes or seams in socks, resist baths, showers or going to the beach (Miller & Benjamin, 2014).

Hyposensitive children:

  • Fail to realize hands or face are dirty, touch everything constantly, be self-abusive, play rough with peers, don’t seem to feel pain or may even enjoy it (Miller & Benjamin, 2014).

Vestibular dysfunction

Hypersensitive children:

  • Avoid playgrounds and moving equipment, fear heights, dislike being tipped upside down, fear falling, walking on uneven surfaces, and avoid rapid, sudden or rotating movements (Miller & Benjamin, 2014).

Hyposensitive children:

  • Crave any possible movement experience, especially fast or spinning, never seem to sit still, seek thrills, shake legs while sitting, love being tossed in the air, never seem to get dizzy, are full of excessive energy (Miller & Benjamin, 2014).

Proprioceptive dysfunction

Under-responsive children:

  • Constantly jump, crash, stomp, love being squished and hugged, prefer tight clothing, love roughhousing, may be aggressive with other children (Miller & Benjamin, 2014).

Over-responsive children:

  • Experience difficulty understanding where body is in relation to other objects, appear clumsy, bump into things often, move in a stiff and/or uncoordinated way (Miller & Benjamin, 2014).

Children with difficulty regulating input:

  • Don’t know how hard to push an object, misjudge the weight of an object, break objects often and rip paper when erasing pencil marks (Miller & Benjamin, 2014).

Auditory dysfunction

Hypersensitive children:

  • Cover ears and get startled by loud sounds, become distracted by sounds not noticed by others, fear toilets flushing, hairdryers and/or vacuums, resist going to loud public places (Miller & Benjamin, 2014).

Hyposensitive children:

  • May not respond to verbal cues, love loud music and making noise, appear confused about where a sound is coming from, may say “what?” frequently (Miller & Benjamin, 2014).

Oral Dysfunction

Hypersensitive children:

  • Picky eaters with extreme food preferences and limited repertoire, gag on textured food, find difficulty sucking, chewing, and swallowing, extremely fearful of the dentist, dislike toothpaste and brushing teeth (Miller & Benjamin, 2014).

Hyposensitive children:

  • May lick, taste, or chew on inedible objects, love intensely flavored foods, may drool excessively, frequently chew on pens, pencils, or shirt (Miller & Benjamin, 2014).

Olfactory Dysfunction

Hypersensitive children:

  • Bothered or nauseated by cooking, bathroom and/or perfume smells, may refuse to go places because of the way it smells, choose foods based on smell, notice smells not normally noticed by others (Miller & Benjamin, 2014).

Hyposensitive children:

  • May not notice unpleasant or noxious odors, smells everything when first introduced to it, may not be able to identify smells (Miller & Benjamin, 2014).

Visual Dysfunction

Hypersensitive children:

  • Irritated by sunlight or bright lights, easily distracted by visual stimuli, avoid eye contact, may become over aroused in brightly colored rooms (Miller & Benjamin, 2014).

Hyposensitive children:

  • Difficulty controlling eye movements and tracking objects, mix up similar letters, focus on little details in a picture and miss the whole, loose their place frequently when reading or copying from the blackboard (Miller & Benjamin, 2014).

Diagnosis

When SPD symptoms appear, they must be taken seriously so proper treatment can begin as early as possible from a professional (Miller & Benjamin, 2014). If your child is exhibiting SPD symptoms, make an appointment with your child’s doctor and ask for a referral to an occupational therapist for an evaluation (Miller & Benjamin, 2014). A developmental specialist can also rule out or pick up on other developmental disorders. A health professional will evaluate the child by observing their responses to sensory stimulation, posture, balance, coordination, and eye movements (Pope et al., 2014). They will look for a certain pattern of behavior when diagnosing SPD.

Misdiagnosis

Children are most commonly diagnosed with SPD however it is often misdiagnosed for attention deficit hyperactivity disorder (ADHD) and in turn get inappropriately medicated (Miller & Benjamin, 2014). Misdiagnosis is common since many health professionals are not trained to recognize sensory issues that are seen with SPD. SPD and ADHD may occur together and even interact (Ghanizadeh, 2010). Sensory processing problems in children with ADHD are more common than in typically developing children and the patterns of sensory modulation in ADHD children are significantly different from typical children (Ghanizadeh, 2010). SPD is not considered to be on the autism spectrum and a child can receive a diagnosis of SPD without any comorbid conditions.

Treatment

Therapy is usually conducted by an occupational therapist (OT) that focuses on activities that challenge the child with sensory input (Pope et al., 2014). The therapist helps the child respond appropriately to sensory stimulus. For example if a child is hypersensitive to tactile stimulation, therapy might include applying deep touch pressure to a child’s skin with the goal of allowing him/her to become more used to and process being touched (Pope et al., 2014). Occupational therapists also work on fine and gross motor skills since many children have difficulty with these (Biel & Peske, 2009). SPD treatment activities are fun, creative, and unique. Often children just think they are playing when really they are actually working at building essential skills with their bodies and neurological systems (Miller & Benjamin, 2014). Treatment has not been widely studied but many therapists have found that sensory integration therapy improves problem behaviors (Pope et al., 2014). Treatment of SPD is tailored to the individual’s symptoms so they can maximize daily functioning, social and emotional development, as well as achieve normal developmental milestones (Miller & Benjamin, 2014).

Examples of therapy and treatment activities include (Miller & Benjamin, 2014):

Play doh

  • Children need to touch different textures to develop normal tactile processing

Heavy work activities

  • Imperative for children who have difficulty regulating their arousal levels
  • These activities are designed to help their bodies appropriately receive desired input into their muscles and joints so they can settle their bodies down
  • Tools include weights, weighted products, jumping, bouncing, pushing, pulling, and being “squished”

Sleep programs

  • Children with SPD often experience difficulty settling down for sleep and regulating sleep cycles
  • You can try nature sound machines, aromatherapy machines, lava lamps, relaxation CDs, weighted blankets, heavy work activities prior to bedtime

Vestibular movement

  • Children need to move
  • Indoor trampolines, swings, rocking toys, ride on toys, gliders, seesaws

Aromatherapy

  • Therapeutic way to address children who seek out certain smells or are hypersensitive to smells
  • Can help the child tolerate smells or use them to relax and calm depending how and when they are used

Vibrating toys and products

  • Vibration is an essential tool when doing sensory integration activities
  • Vibration can take some individuals months to tolerate

Recommendations for Parents

It is important for parents of children with SPD to understand that the disorder is not a reflection on their parenting. Parenting typical children is very different from parenting a child with SPD. Parents need to take a more conscious and prepared approach to daily activities to parent a sensory child. Keeping that in mind, parents need to be able to adjust and adapt plans to the daily situations that sometimes might be a challenge (Dalgliesh, 2013). No single solution will work forever for your child. Frequent changes will need to be implemented to support the ever-changing sensory child (Dalgliesh, 2013). One of the best tools you can give sensory children is to teach them strategies to cope with their symptoms. If you start practicing this at an early age, your sensory child will have years of practice and examples of success (Dalgliesh, 2013). If parents can remain patient and understanding throughout the everyday routine with their child, both will have a rewarding and positive relationship.


References

Biel, L., & Peske, N. (2009). Raising a sensory smart child: The definitive handbook for helping your child with sensory processing issues (Updated & rev. ed.). New York, N.Y.: Penguin Books.

Collins, B. (2012). Sensory-Based Motor Disorders: Postural Disorder. Autism Asperger's Digest, 46-47.

Dalgliesh, C. (2013). The sensory child gets organized: Proven systems for rigid, anxious, or distracted kids. New York, N.Y.: Touchstone.

Ghanizadeh, A. (2010, November 20). Sensory Processing Problems in Children with ADHD, a Systematic Review. Retrieved February 25, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3

Gibbs, J., Appleton, J., & Appleton, R. (2007, June 1). Dyspraxia or Developmental Coordination Disorder? Unraveling the Enigma. Retrieved February 25, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC20

Miller, L., & Benjamin, S. (2014, January 1). Sensory Processing Disorder Foundation | Research, Education and Advocacy. Retrieved February 25, 2015, from http://spdfoundation.net/index.html

Pope, J., Bailey, T., & Volkmar, F. (2014, May 23). Sensory Processing Disorder. Retrieved February 25, 2015, from https://myhealth.alberta.ca/health/pages/conditions.aspx?hwid=te7831&