Sensory Processing Disorder
Sensory Processing/Motor Integration
What is sensory processing/sensory integration?
Sensory Processing or Sensory Integration as it is also known, is the effective registration (and accurate interpretation) of sensory input in the environment (including one’s body). It is the way the brain receives, organises and responds to sensory input in order to behave in a meaningful & consistent manner.
Sensory Processing Disorder or sensory integration dysfunction is a neurological disorder in which sensory information that an individual receives results in an abnormal response. Sensory information goes into the brain but it is not organised into appropriate responses, the sensory information gets “mixed up” and therefore their responses can be inappropriate to the situation they are in.
There are 3 possible components of Sensory Integration difficulties.
- Sensory Modulation Disorder :
This is a problem where the child is unable to turn sensory messages into controlled behaviours that relate to the nature and intensity of the sensory information.
- Sensory-Based Motor Disorder
This describes the condition where the child shows difficulties with balance, gross motor and fine motor coordination, and the ability to perform skilled, familiar and/or novel motor actions.
Along with impairments in postural control, bilateral integration, and sequencing, sensory-based motor disorders also encompass impairments in praxis. This is where the child hasproblems with stabilising, moving or planning a series of movements in response to sensory demands.
Sensory-based motor disorders manifest from deficits in either tactile, proprioceptive, and/or vestibular processing; these differ from neuro-motor disorders in which there is a specific structural/anatomical, biochemical, or electrical abnormality in the brain, spinal cord, or nerves (i.e. Cerebral Palsy, seizure disorders, gene or chromosomal abnormalities)
- Sensory Discrimination Disorder
The child has problems in recognising/interpreting differences or similarities in the qualities of stimuli.
It is commonly seen with children who have difficulties with processing sensations from touch, muscles and joints [proprioception] and head movements [vestibular or inner ear sensations]. Is a problem with sensing similarities and differences between sensations?
- Other factors
These can include: speech and language difficulties, attention difficulties (e.g. ADD/ADHD), psychological issues (e.g. anxiety, depression), fatigue, diagnosis specific behaviour and conscious choice behaviour.
- Environmental factors
Theseinclude: the sensory input around them, the degree of structure of the setting, the time of day, the impact of fatigue, and the expectations placed on them by the tasks they are doing.
Why is sensory processing/motor integration important?
A new born baby is able to see, hear and sense their body but is unable to organise these senses well; therefore meaning very little. They are unable to judge distances or feel the shape of one object versus another. As the child is exposed to various sensory inputs, they gradually learn to organise them within their brain and are able to give meaning to them. The baby becomes better able to focus in on one sensation and as a result their performance improves. Their movement changes from being jerky and clumsy, to more refined and they are able to manage multiple amounts of sensory input at one time. By organising sensations the child is able to modulate their response and as a result they seem to be more connected with the world and in control of their emotions.
When children are efficient in their processing, appropriate responses to the environment around them occurs naturally and is demonstrated by mastering skills, behaviour, attention and self-regulation. Children are able to sit and attend to the important pieces of information in a classroom and therefore will have a good chance at achieving their academic potential.
Furthermore a child will be able to understand their body’s movement in relation to their surroundings and itself. This allows for success in gross motor activities. This in turns aids the social development of a child.
What are the building blocks necessary to develop efficient sensory processing/motor integration?
All the sensory systems need to work together for effective sensory processing. It is important to recognise that there are in fact 7 senses that make up the sensory system and it are these systems that process information as a building block to many other skills.
- Visual sense:
This is the ability to understand and interpret what is seen. The visual system uses the eye to receive information about contrast of light and dark, colour and movement. It detects visual input from the environment through light waves stimulating the retina.
2. Auditory Sense:
This is the child’s ability to interpret information that he/she has heard. The auditory system uses the outer and middle ear to receive noise and sound information. They receive information about volume, pitch and rhythm. It is important for the refinement of sounds into meaningful syllables and words.
3. Gustatory Sense:
This is the ability to interpret information regarding taste in the mouth. It uses the tongue to receive taste sensations. It detects the chemical makeup of the taste through the tongue to determine if safe or harmful
4. Olfactory Sense:
This is the ability to interpret smells. It uses the nose to receive information of the chemical makeup of particles in the air.
5. Tactile sense:
This is the ability to interpret information coming into the body by the skin. It uses receptors in the skin to receive touch sensations like pressure, vibration, movement, temperature and pain. It is the first sense to develop (in the womb), thus very important for overall neural organisation
6. Proprioceptive Sense:
This is the ability to interpret where body parts are in relation to each other. It uses information from nerves and sheaths on the muscles and bones to inform of position and movement of body through muscles contracting, stretching, bending, straightening, pulling and compressed.
7. Vestibular sense:
This is the ability to interpret information relating to movement and balance. The vestibular system uses the semi-circular canals in the inner ear to received information about movement, change of direction, change of head position and gravitational pull. It receives information about how fast or slow we are moving, balance, movement from the neck, eyes and body, body position, and orientation in space.
Some signs of difficulties with sensory processing/motor integration include:
- The child shows heightened reactivity to sound, touch or movement.
- The child appears under-reactive to certain sensations (e.g. not noticing name being called, being touched, and high pain threshold).
- The child seems lethargic/disinterested; and can be described as appearing to mostly be in their ‘own world’.
- The child has difficulty regulating their own behavioural and emotional responses;
Increased tantrums, emotional reactive, need for control, impulsive behaviours, easily frustrated or overly compliant.
- The child is easily distracted, has a poor attention span and has difficulties with concentrating.
- The child has poor motor skills; appears clumsy, has immature coordination, balance and motor planning skills are delayed, and/or poor handwriting skills.
- The child has poor sleep patterns.
- The child has a restricted diet and is a very picky eater.
- The child becomes distressed during self-care tasks (e.g. hair-brushing, hair-washing, nail cutting, dressing, tying shoe laces, self-feeding).
- The child loves movement and seeks out intense input (e.g. constant spinning, running around, jumping, and crashing in objects/people).
- The child will avoid movement based equipment (e.g. swings, slides).
- The child appears floppy or has ‘low muscle tone’, tires easily and is often slumped in postures.
- The child tries hard but often performs tasks with too much force, has big movements, moves too fast, writes too light or too hard.
- The child has delayed communication and social skills, is hard to engage in social interactions.
- The child prefers to play in isolation or has difficulty knowing how to play with other children.
- The child has difficulty accepting changes in routine or transitioning between tasks.
- The child has difficulty engaging with peers and sustaining friendships.
When there are difficulties with sensory processing/motor integration, there may also be some difficulties with:
- Attention and concentration: The child has difficulties in sustaining effort, completing activities without distraction and being able to engage in the activity long enough to get it done.
- Behaviour: The child’s behaviour may appear to be inappropriate and they can be seen as “lashing out” for no obvious reason. They may appear “flighty” and on edge and seem stuck in a “fight or flight” state.
- Body awareness: Knowing body parts and understanding the body’s movement in space in relation to other limbs and objects. They may struggle to work out where their limbs are in space and how to move them in relation to the body and environment.
- Coordination: The child may not have the ability to integrate multiple movements into efficient movement.
- Expressive language (using language): They may struggle to use language through speech, sign or alternative forms of communication to communicate wants, needs, thoughts and ideas.
- Play skills: The child may not be able to voluntary engage and be self-motivated in activities that are normally associated with pleasure and enjoyment where the activities may be, but are not necessarily, goal oriented.
- Receptive language (understanding): They may struggle with Comprehension of language.
- Self-regulation: They may not have the ability to obtain, maintain and change their emotions, behaviours, or attention and activity at a level appropriate for a task or situation in a socially acceptable manner.
- Articulation: They may struggle to speak with clarity of speech sounds and spoken language.
What can be done to improve sensory processing/motor integration?
- Education around varying management strategies.
- Enhancing the child’s efficient and appropriate response to sensory stimulation.
- Recognise triggers: Educate the child’s adult carers (parents, teachers) of the triggers that spark inappropriate sensory reactions.
- Environmental factors: Improve the parents and carers knowledge of how to reduce the environmental factors that contribute to sensory issues.
- Sensory dietto provide sensory feedback to the body to enable it to sensory regulate. These activities might be activities such as:
- Obstacle course
- Wheelbarrow walking
- Animal walks
- Swings (forward and back, side to side, rotary)
- Rough and tumble play / squishing or sandwiching with pillows or balls
- Wearing a heavy backpack
- Weighted items (wheat bag on lap while sitting or heavy blanket for sleep)
- Chewy toys
- Visual schedules enable a child to see and understand what is going to happen next. Schedules also help people to organise themselves and to plan ahead.
- Timers help with transitions as they tell the child how long and when they are going to have to do an activity. Timers allow us to pre-warn the child.
- Talking/question counters: For small periods of time where the child is engaged in other activities, implement the idea that a child has a limited amount of questions that they can ask. Each time they ask a question take a counter from them. When they child has no more counters, adults do not respond and a child learns to hold onto questions and improves the ability to know when to ask.