This week we will be publishing a short series of posts addressing Sensory Processing Disorder (SPD). This can present
Sensory Processing Disorger can present in a range of ways in people. Each child and adult with SPD have their own way of coping and their own pattern of differences in how their sensory system works. You may recognise some of these challenges. It is currently thought that up to 1 in 20 children are affected by SPD. (SPD Australia http://www.spdaustralia.com.au/)
Your sensory system takes in sensory information from the environment and your own body. The well-known senses: vision, hearing, taste, touch, smell are not the only senses. Proprioception – the sense of where your body is and the and Vestibular sense – processing movement and giving you your sense of balance are vital systems allowing you to function in your everyday activities. The final sense is Interoception. This little-known sense is involved in the internal regulation responses, such as hunger, feeling full, needing to go to the toilet, respiration rate, and heart rate.
People with SPD can experience differences in processing the information from one sense or multiple senses. They can be over responsive – Hypersensitive and avoid the sensory input or under responsive – Hyposensitive and they seek the sensory input.
The sensory system provides information from your central nervous system to your brain which is then processed and prioritised.
What is tolerable one day can be unbearable the next as irritating sensory inputs can compound. Thought processes can impact on how the sensation is processed. Picture the already late, stressed parent struggling to get the kids out the door when the baby spits up over their shirt and the dog gets out, making them late for school drop off and work. A child with SPD that might have the overwhelming experience of getting up, having to eat a texture that is uncomfortable then brush teeth which could cause nausea, having hair brushed that feels painful, smelling fragrances from soaps, perfumes, shampoos or deodorants can cause discomfort including headaches, having to wear a school uniform that is itchy and being overwhelmed by these feelings forgetting their lunchbox or dropping their homework and having a meltdown.
Sensory information can be overwhelming, particularly for children who have little to no control over their environment and cannot communicate their experiences. These children may not understand that their experience of the world is different from their peers and may not realise that there is an alternative way of existing and moving through the world.
A challenging sensory experience may lead to anxiety and produce a flight, fight, fright reaction in the person. These reactions are often misinterpreted as bad behaviour, tantrums, ignoring, being overly emotional, being inattentive. A child under extreme stress may have a melt down or may actually shut down. Our bodies and minds work hard to protect us from possible threatening situations.
When there is SPD it is thought that the brain is not processing and prioritising the incoming information correctly. For example the background hum of a central air system in a school would fade into the background for most people, a person with SPD would potentially hear that hum for the duration of the class, unable to ignore it and keep their focus only on the teacher’s voice. Walking into the classroom if I mentioned the air conditioning the students would easily direct their attention to the sound and back. This ability to focus in on certain background sounds and then ignore them when they are no longer relevant is essential for attention and learning.
When you are in a crowded room, if the person standing next to you engaged in a conversation with anther person starts mentioning your name you will quickly find your attention diverted from your current conversation and turned over instead to your neighbour’s conversation. If you discover it is not you that they are talking about your mind quickly returns to your current conversation. This “tuning in” and “tuning out” happens throughout the course of the day as your body takes in the sensory inputs from the environment quickly scanning all incoming information to produce the correct response. If your child seems to ignore their name yet has been tested and found to have normal hearing and language skills they may be having difficulty prioritising that collection of sounds over the other sounds in their environment at that time. These examples are referring to sound modulation, but this skill is relevant to the other senses. Difficulty in sensory MODULATION can be exhausting and can cause significant anxiety. Difficulties with sensory modulation can affect learning and memory.
These challenges can result in additional difficulties as children may start to avoid experiences, seek other experiences and may struggle with increasingly complex demands. Emotional outbursts, meltdowns and behavioural challenges, self-esteem, and confidence can be affected.
Understanding SPD can be the first step towards helping your child.
Start to learn the signs for your child that indicates what is sensory and what is behaviour.
Provide control and choices to your sensory sensitive child where possible and safe.
Provide safe access to sensory play for your sensory seeking child.
Provide sensory play options that feel safe for your sensory sensitive child.
Heavy work / proprioceptive play such as climbing, crawling, lifting, pushing play and chores (age appropriate) can be very helpful to meet the sensory needs of our brains.
Meeting your child’s sensory needs is like giving your child a cup of water. It is essential to life. Their body relies on it to function. You can wait an hour to drink a cup of water, you can wait 2 hours, you can wait 6 hours. But sooner or later you will get to the point that you will fight for your life to get that water.
Children have sensory needs and they can often wait for an hour, some can wait for 2 hours, some children can even wait for 6 hours but at some point they will start fighting to get what their body needs. If you have ever experienced your child coming home from school exhausted and exploding now that they are in their safe place you will appreciate how their body will fight for an outlet to meet their sensory needs.
It is essential we meet our children’s sensory needs in a safe, appropriate way throughout the day. We can help our children grow to be able to self manage their sensory needs. We can support them by having communication systems that allow them to request their sensory tools, by having adults that understand and can allow them to access what they need and give them time to access their tools.
I challenge you: All children have sensory needs. Each child needs movement, touch, taste, visual, auditory and deep pressure experiences. Some children move away from experiences and seek others. Do you know which sensory tools help your child to remain calm and alert? Can your child request these tools or activities? Do they have safe access to options throughout their day in the different environments they are in? Can they access any sensory tools safely themselves?
Every child is different, if you need some support to meet your child’s sensory needs you can discuss with your occupational therapist
You have probably heard the acronym “SMART Goals”
When a parent or therapist is creating goals for a child these goals should be child centred and wherever possible the child should be enabled to set their own goals.
In a school context an Individual Education Plans (IEP) is created by a team. In some instances the child will attend the meeting and will be able to contribute to the development of their education goals. Goals should always be meaningful to the child and should make a difference in their lives.
Goals must be functional and they must be measurable. O’Neill and Harris (1982) propose goals should include the following:
Will do what
Under what conditions
Applying this to an IEP:
Who – The student’s name
Will do what – For example will sit on the carpet for 20 minutes during circle time in the classroom.
Under what conditions – Sitting on a move n’ sit cushion, with access to fiddle toy of their choice with Learning Support Assistant (LSA) seated behind the child.
How well – Student will remain seated without verbal prompting in 9/ 10 instances
By When – by the end of the first month (or give dates).
Now we’ve set the goals..
It is very important when considering goals to take into consideration “So What?” What does achieving this goal mean for the child? What will this goal actually enable the child to be able to do? Is achieving this goal actually going to produce any meaningful change anything for the student?
In the above example: Our goal is for the child to be able to use sensory supports to enable them to participate in circle time in the classroom with their peers for 20 minutes at a time. Our “So what?” for this goal: This will enable the child to have access to the curriculum being taught at this time.
This allows the child to be with their peers in class (by reducing distracting behavior, or by reducing running from class or other applicable change).
This allows the child to be more independent by reducing reliance on the LSA to be with their class in a meaningful way.
This actively encourages the LSA to reduce their prompts to the child.
Enabling the student to self select or manage a sensory tool can be included in a separate goal in their IEP if relevant.
Self-esteem and confidence are major traits in individuals that affect their success. While these are a lifelong process, the foundation of it needs to be established in early childhood. Building self-esteem will allow the child to deal with difficult situations that they will encounter during their lifetime.
Anxiety is something that exists in everyone’s life to a certain extent, and in a way it is medically known to be helpful as well. Because, anxiety helps us stay alert and be reactive to our circumstances, whether joyful or painful. However, when the anxiety reaches the stage where it overwhelms you mentally and physically, and affects your normal routine of life, you need the help of a clinical psychologist.