What is Sensory Processing?
Sensory Processing is a fairly new area of work that examines how the various senses work and how they can affect behaviour.
Imagine that you are in a lecture theatre with no windows. The lights are dim and the only noise is the lecturer’s voice. He has no visual aids, no pictures, no power point presentation. His voice is quiet and dull, with no dynamics. The lecture will go for 3 hours with no breaks and no change. How well will you be able to concentrate? If you are like me, my mind will wander within 5 minutes. You will probably start drawing on your lecture notes and be unable to concentrate. Why does this happen? In order to focus, learn and operate properly, the human brain needs a certain level of stimulation. In this example, the brain does not have enough stimulation. Your sensory thresholds have not been reached.
Now imagine you are in a small cramped room. The lights are incredibly bright. Joining you in this room are two football teams, just after a match and they have not showered. You have no space and the smell is indescribable. The heaters are turned on. It is now 40 degrees. Suddenly the room is flooded with the sound of jet engines. You now have to read ‘The Tale of Two Cities” from cover to cover and write a book report about it. What grade will this book report get? In this example, the brain has too much sensory stimulation. The light is too much for your eyes, the smell is too much, you are too close to a group of sweaty men! Too much unpleasant stimulation.
Everybody processes sensory input differently. The level of noise and light that make me feel most comfortable will be different to your level. However, most people have a fairly similar level of processing ability. This is how we manage to have a level of lighting that most of us can tolerate. But what happens when our sensory processing ability is affected? What if we cannot process certain “normal” sensations? This is called Sensory Processing Disorder.
Sensory processing disorders can be seen in children with Autism, ADD and ADHD. Typically developing children can also exhibit symptoms of sensory processing disorder. Some behaviours displayed by children with sensory processing difficulties include:
- inability to focus
- very sensitive or under-sensitive to touch or sound
- very fidgety
- very dreamy
- dull expression
The best description regarding sensory processing disorder was coined by Carol Kranowitz. She described the children as “out of sync*.”
Many early childhood workers, teachers and parents will recognise a child with some of these symptoms. As with all conditions, the symptoms of Sensory Processing Disorder can range from very mild to severe. One child may recoil from the slightest of touches, whereas another child may crave physical contact. All children are unique and all children with sensory processing disorder will have unique symptoms. What works for one child may not work with another.
*Kranowitz, C.A. (2005). The out-of-sync child. Penguin:New York
The world of sensory processing has a lot of jargon. Before moving on to how to help children with Sensory Processing Disorder, it is important to understand the terms used. Here are some definitions to help explain some commonly used terms:
- Sense-Refers to the way the brain interprets information coming from the environment.
- Tactile-The sense of touch
- Vision-The sense of sight
- Olfactory-The sense of smell
- Auditory-The sense of hearing
- Proprioception-This refers to body awareness, or knowing where your limbs and body are without seeing them. A way to test proprioception is to touch your nose with your finger with your eyes closed
- Vestibular- The vestibular sense is responsible for balance. It is also be responsible for sense of direction. The vestibular system is located in the inner ear as well as the brain. If the inner ear is damaged, the vestibular system can be affected. The brain interprets the signals from the inner ear.
- Modulation-The ability to change. In sensory processing jargon, this often refers to the ability to switch from a high impact activity (outside play, running, jumping, shouting) to a low impact activity (indoor play, academic tasks, whispering).
The diagnosis of Sensory Processing Disorder involves a visit to an Occupational Therapist. The OT will conduct a standardised assessment called “The Sensory Profile.” This assessment is a rating scale that describes behaviour. The most common sensory profile is conducted on children aged 3-10. This profile contains 125 items which report on the frequency of a certain behaviour. Questions in the profile will examine how the child responds to certain sensory stimuli, for example, “my child responds violently to physical touch.” The caregiver will then be presented with a rating scale ranging from “Never” to “Always.” The profile will take about 30 minutes to complete. When conducting a profile, I prefer to sit with the parents and go through it together. I prefer to have all primary caregivers involved in the profile to ensure the most accurate results, however therapists will operate differently.
After the profile is complete, the Occupational Therapist will then calculate the score from the answers given. Following the scoring process, the occupational therapist will work out a plan of treatment that is referred to as a “sensory diet”
A sensory profile through a private occupational therapist can be expensive. Receiving therapy through the public sector is free, however many centres have a limited session framework, where each child is only able to receive a set number of sessions before going back on the waiting list. Not all area health services operate on this framework, and those that do are often able to extend the number of sessions depending on the need.
A sensory diet is like a food diet. It must be adhered to for a long time. Like a regular diet, it may take time to have any benefits.
The diet will consist of times and activities. The times may be a set period, e.g. 7:00am to 7:20am, or a transition time, e.g. 10 minutes before bed time. At the given time, a specific activity must take place. This may be time on the trampoline, 5 minutes of the “Wilbarger brushing protocol,” or wearing a weighted vest.
It is vitally important that the sensory diet is followed every day. Like a food diet, if you cheat on the diet, there will be no improvement. While implementing the diet, you must be in constant contact with the occupational therapist for adjustments. Improving a child’s sensory processing abilities takes a long time. It may take years. Some children will recover in most areas but then regress in others. After a set period of time, the therapist may require another sensory profile to ensure the child is improving.
Before beginning any sensory activities, it is important that you consult an occupational therapist. Sensory processing is not an area where an unqualified person can assist. It is possible to make a child’s sensory processing dysfunction worse by engaging in activities that are not appropriate for the child. The activities listed here are examples of what you can expect from a sensory diet.
Scooter Board: One of the best activities to develop proprioception and vestibular skills. The scooterboard has many applications that makes it appropriate for sensory processing. To find out more follow this link.
Lycra: An excellent material. Buy a 3 meter length that is taller than your child. One thing you can do with your child is wrap him/her up in the lycra like a mummy. Your child can then push against it and try to wriggle out of the wrap. Great for excess energy.
Weighted blankets/vests: These items assist the child’s proprioception. Many children with sensory processing issues do not recognise their own body and will seem hyperactive. By giving them a weighted vest to wear, they will feel the extra weight on their body. This will give the child’s brain extra sensory input, increasing the child’s proprioceptive ability
Crash Mat: The crash mat is great fun. There are many purpose made crash mats available but it is cheaper to make your own. Buy foam offcuts from places like Clarke Rubber and sew a large bean bag type shape out of tough material. Ideally the crash mat should be bigger than a bean bag, have enough foam inside to catch the child but still be resistant enough not to allow the child to hit the ground through the foam. Allow your child to jump into the mat from high places (safely). It is fun just to jump into the crash mat and rumble on it. The odd shapes of the foam make the crash mat an uneven surface that is fun to rumble on.
Wrestling/Rough play: Very important for all children, not just those with sensory processing difficulties. Too many children today are not allowed to engage in rough play as parents worry about injury. To avoid injuries, ensure you supervise the activity. Make sure the children only use open hands and not fists. Do not allow kicking, punching or biting. Older children enjoy sock wrestling. The physical feedback during rough play stimulates the proprioceptive and vestibular sections of the brain. This is a high energy activity so ensure the children do not get too hyped up which can lead to angry outbursts. Supervision is the key to this activity
Swings/Trampolines: Again, these activities stimulate the proprioceptive and vestibular sections of the brain. These pieces of equipment are usually easy to access in the local park if you do not have room for them yourself.
These are only a few activities. There are thousands of different activities to assist sensory processing. Two books that I recommended are
Building Bridges Through Sensory Processing by E. Yack, P. Aquilla, and S Sutton
The Out-of-sync Child Has Fun by C. A. Kranowitz
both of these books are very well researched and contain many different ideas to try.