Sensory Processing Disorder (SPD) is a complicated diagnosis and requires more education than therapists receive in their formal training in order to treat effectively. In this article, we provide a brief overview of the disorder, its subtypes, and a general approach to intervention. We conclude with continuing education recommendations and information on using BrainWorks to create effective sensory diets.
What Is Sensory Processing?
Sensory processing is the brain’s ability to receive sensory information from the environment or the body and respond appropriately. A simple example of sensory processing would be a person removing her hand from a hot stove. The sensory input would be a hot burning sensation while the response would be removing her hand. But many instances of sensory processing are far more subtle and involve complex neurological processes. For example, while writing this article, my brain is inhibiting sensory input competing for my attention. Examples might include the sound of my dog in the other room, and the feel of my clothing on my skin. Also consider the response to input from my muscles allowing me to remain upright in my chair and position my fingers to type accurately.
The Eight Sensory Systems
Humans have eight sensory systems but many of us are only aware of the first five:
- Visual (sight)
- Auditory (sound)
- Olfactory (smell)
- Gustatory (taste)
- Tactile (touch)
The remaining three are often called hidden senses because they play a vital role in how we respond to our environment:
- Proprioception: This is our sense of muscle and joint movements and gives us information about where our body parts are in relation to each other. A common test of sobriety involves touching your nose with closed eyes. This test relies heavily on a fully-functional proprioceptive system.
- Vestibular: This is our sense of where our bodies (especially our heads) are in relationship to gravity. It tells me if I’m moving and in which direction. It also contributes to eye movements and the ability to stay upright even when our eyes are closed.
- Interoception: This sensory system provides vital information about physiological variables. Examples include indicators of hunger, thirst, illness, heart rate, and the need to go to the bathroom. Interoceptive awareness plays a vital role in identifying emotions as well.
Sensory Processing Disorder
SPD occurs in two ways. First, there may be an issue with detection of sensory input. Second, input may not be integrated in a way that results in an appropriate response. This can impact everything from motor coordination to emotional regulation. There are three subtypes of SPD:
- Sensory Modulation Disorder: People with this subtype have difficulty regulating responses to sensory input. They may struggle to determine which forms of sensory input are most important at the moment. Because of this, they struggle with attention to task or become overstimulated easily. There are also three subtypes of Sensory Modulation Disorder, which are described later. This article titled What Is Sensory Modulation Disorder provides more information.
- Sensory-Based Motor Disorder: This subtype primarily impacts motor planning and postural control. Our webinars on primitive reflexes by Kim Wiggins and dyspraxia by Lori Benson Adams address interventions applicable to children with sensory-based motor disorder.
- Sensory Discrimination Disorder: With this subtype, people have difficulty differentiating subtle differences in sensory stimuli.
One study indicates that as many as 1 in 6 children experience sensory symptoms significant enough to impact their daily lives (Ben-Sasson, Carter, Briggs-Gowen, 2009). In general, research shows 1 in 20 children are affected by SPD (Ahn, Miller, Milberger, McIntosh, 2004).
Common Signs and Symptoms
Symptoms will vary from one child to the next depending on the subtype of SPD as well as which sensory systems are involved:
- Becomes agitated in busy environments
- Resists activities of daily living such as tooth brushing, nail trimming, hair washing
- Frequent meltdowns
- Often described as picky or finicky
- Either high energy (hyper, constant movement) or low energy (sedentary, lethargic)
- Difficulty concentrating
- Delayed motor skills
- Delayed speech and language
For more in-depth information, please see my six-hour course sensory diet course.
Treatment for SPD typically involves occupational therapy and frequently necessitates physical and speech therapy as well. Outpatient therapy often uses specialized equipment to provide the just-right challenge. This allows sensory systems to interpret and respond to sensory input in a more adaptive manner. Occupational therapy frequently uses an approach known as Ayres Sensory Integration (ASI). This form of intervention is based on the work of Dr. Jean Ayres. She utilizes the principles of neuroplasticity as well as a developmental frame of reference to facilitate neurological change related to sensory processing. In addition to clinic-based intervention, most therapists recommend a sensory diet for use in the home and school. For an in-depth look at using ASI for intervention and assessment, check out my ASI webinar.
School-based OT often focuses on creating sensory diets to help students manage their sensory needs effectively, so they can benefit from their education. The goal of sensory diets is to help children stay at the just-right level of arousal allowing them to focus and perform their best academically, behaviorally, and socially.
What Is a Sensory Diet?
Sensory diet is a term used to refer to the sensory input received by your nervous system each day. All of us use sensory strategies continually to keep our brains at that just-right level of arousal for the situation (alert and focused, relaxed and ready to sleep, etc.). But most of us do this without putting any conscious effort into the process. Here are just a few activities adults might use to meet the needs of our nervous systems:
- drinking coffee to help you wake up,
- twirling your hair while you listen,
- going on a walk to de-stress, or
- taking a hot shower to settle down before bed.
However, for some children, this process of staying at that just-right level of arousal doesn’t happen naturally. For various reasons, they need assistance to learn to identify the needs of their nervous systems and to select sensory activities to meet those needs effectively. This is where a good sensory diet with a teaching component comes in.
Most children who benefit from the use of a sensory diet have one of the three subtypes of Sensory Modulation Disorder:
- Over-Responsiveness: An exaggerated response of the nervous system to sensory input. For example, people who easily get motion sick are over-responding to vestibular input (the sensation of movement). The nervous system goes into fight-or-flight mode even when no real danger exists. Over-responders need calming forms of sensory input. Slow, rhythmic movements, deep pressure to the muscles and joints, heavy-work activities, peaceful music, dim or natural lighting, and quiet activities are all helpful.
- (Passive) Under-Responsiveness: A lack of or insufficient response to the sensory environment. Sometimes these children appear to be daydreaming or unfocused on the world around them. They may also be uncoordinated and have difficulty with motor skills development. Passive under-responders need alerting forms of sensory input. Some examples include jumping, bouncing, racing the clock, fast or multidirectional movement, spinning, blow toys, cold items, light tickly touch, and dance music.
- Sensory Cravers: The nervous system of the sensory-craver needs intense input for the sensation to be registered properly in the brain. Therefore, the sensory-craver seeks intense sensations constantly. This is caused by under-responsivity. However, children who are sensory cravers are attempting to get to the higher level of input they need. Passive under-responders are not. Sensory-cravers also need the intense alerting forms of sensory input.
This seems confusing at first, but it makes sense once we realize that what they really need is help getting to that higher level of input they are seeking. When a child reaches that level, helpful neurochemicals will be released. At that point, the student will seem calmer or more focused. Many of the same activities that are helpful for passive under-responders are also helpful for cravers. The more thrill and excitement involved the better! Try to incorporate multiple sensory systems simultaneously such as listening to fast music while going through an obstacle course that involves crawling, rolling, and jumping.
Sensational Brain Resources
Because of the complexity of the brain, it is possible to be over-responsive to some forms of sensory input while being under-responsive to other forms of sensory input. Therefore, addressing the needs of people with sensory processing disorders requires in-depth knowledge! To that end, we have created a variety of resources designed to make it easier to determine the sensory needs of children. It can also help them become more independent in meeting their needs:
- BrainWorks: This is our sensory diet tool that helps children learn to identify their current sensory state and then choose appropriate sensory activities to help them get to that just-right level–able to focus, pay attention, follow instructions, and interact well with others.
- Continuing Education Webinars: Sensational Brain has a variety of live and view-on-demand webinars to empower occupational therapists and other professionals to effectively meet the sensory needs of their clients. See especially our FREE course An Introduction to the BrainWorks Approach to Effective Sensory Diets and Effective Sensory Diets: An Evidence-Based Approach.
For the latest research findings see the STAR Institute for Sensory Processing Disorder.
Ahn, R., Miller, L., Milberger, S., & McIntosh, D. (2004). Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy, 58(3), 28–-293.
Ben-Sasson, A., Carter, A. S., & Briggs-Gowan, M. J. (2010). The development of sensory over-responsivity from infancy to elementary school. Journal of Abnormal Child Psychology, 38, 1193–1202.