Does my child have Sensory Processing Disorder?

Written by Koh Kah Yong and Jewel Yi

We use our sensory processing skills everyday and every moment!

Sensory integration and processing takes place in our brain; we seek sensations and use these inputs to perform our daily tasks. Adults seek sensory input to maintain attention and regulation all the time; coffee breaks are super helpful on a workday afternoon and a rocking chair might help you focus on reading. We need an integrated sensory processing system to function everyday!

Lets try to understand how all this works:

Sensory Systems

Sensory information is sent to our brain from our senses. It is widely accepted that there are five main senses: Sight (visual), Smell (olfactory), Taste (gustatory), Hearing (auditory) and Touch (tactile). These senses let us feel the outside world through sensory neurons. This helps us form a feedback loop where we gather all sensation inputs and respond with our own actions.

Visual

Olfactory

Gustatory

Auditory

However, the five main senses are often not enough to describe the array of sensations that we feel every day. We have very important systems like the Proprioception, Vestibular and Interoceptive sensory systems that we use all the time without us being aware of them. In order to perform childhood occupations and activities well, the integration of these different sensory systems are required (Figure 1)

Tactile

Sensations felt all over our bodies. These sensations include touch, temperature, pain, pressure, vibrations etc. Accurate tactile sensations help us calibrate our movements and strength, and lets us function in daily tasks without being over or under sensitive to touch.

Proprioception

Felt in joints, bones, and muscles; it lets us know where the body is and what it is doing (Tuthill & Azim, 2018) e.g. when walking, proprioception allows us to coordinate our legs without having to consciously look at them, so we know when the next leg should move, and do not end up tripping over ourselves.

Vestibular

Felt when there are changes in our inner ear fluid, which happens with head position changes; it gives us the sensation of movement, body rotation, and change in gravity. Vestibular sensations help us keep calm, maintain our sense of balance and contribute to a stable body posture.

Interoception

Sensations felt inside our body. This includes hunger, needing to go to the toilet and these sensation changes according to emotions e.g. heartbeat, flushes, and rate of respiration.

Figure 1

The Pyramid of Learning by Maryann Trott and Kathleen Taylor

Note: This model highlights how the sensory systems are the foundation for many other skills. It is first created by Maryann Trott and Kathleen Taylor, and this diagram is taken from “The Pyramid of Learning” by otplan.com, 2019, https://otplan.com/pyramid-of-learning/

Normal Sensory Processing

Typically, our brain:

Receives information from the senses
Processes/Integrates the sensory information,
Decides how the body should respond
And then sends the command for the body to respond appropriately/adaptively

Everyone Processes Sensory Input Differently

While sensory processing occurs in all our brains naturally, we don’t all experience the world in the same way because our brain receives the sensory stimuli, processes and interprets them for function differently. This explains why some people love roller coasters while others hate them or why some people would choose soft porridge while others prefer crunchy rice crisps. We are all unique and have our preferences. Sensory Processing only becomes an issue when we are not able to process and integrate our sensations well and when it starts to interfere with our natural development, social skills, and task performance. We call this sensory processing disorder (‌Kranowitz, 2005).

What does Sensory Processing Disorder Look Like?

Let's look at some examples of children who struggle with sensory processing!

Sally, The "Energizer Bunny"

... a nickname coined by those around her. Sally doesn’t walk; she jumps, skips and flies! At school, Sally loves to wiggle all the time even when it is not time for dance lessons. She struggles to sit still during story time and friends wish that she could play safely. You see, Sally is good fun but she loves to zoom around at top speed, and climbs up high on playground structures before jumping off (her friend almost turned into a pancake). Children who appear "hyperactive" like Sally can be under-responsive to vestibular sensations.

Effects of Sensory Processing Disorders

When children do not understand their sensory system, they may feel disheartened by occasional failures or comments from others. This can result in the formation of a negative self-image, where one believes that they are just “bad at sports in sports”, and creates a vicious cycle where this self-image causes kids to avoid opportunities to practice needed skills. reinforces avoidant of practising opportunities.

Diagnosing Sensory Processing Disorder

Sensory Processing Disorders are usually diagnosed by the Occupational Therapist (OT) and Occupational Therapy is recommended to help children and families cope with their occupations (school work, play activities of daily living). OTs use sensory integration techniques to help your child's brain respond adaptively to challenging situations through providing graded sensory input in the Sensory Integration Gym. OTs also conduct routine-based interviews to understand how your environment contributes to maladaptive responses and provide suggestions on sensory diets and strategies to families.

It is important to take note that Sensory Processing Disorders cannot be cured by medicine. It is an underlying neurological processing deficit that can only be treated through Sensory Integration intervention.

If you think your child may have Sensory Integration Disorder, you may reach out to one of our occupational therapists for a consultation. Assessments and Treatments are usually conducted in the Sensory Integration Therapy Gym.

If you have any questions or would like an appointment, feel free to contact us. In-person therapy services are based in sunny Singapore but we are happy to consult you wherever you are.

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References

Develop Learn Grow. (2020, November 5). The Pyramid of Learning. https://developlearngrow.com/the-pyramid-of-learning/

Khan, S., & Chang, R. (2013). Anatomy of the vestibular system: a review. NeuroRehabilitation, 32(3), 437–443. https://doi.org/10.3233/NRE-130866

‌Kranowitz, C. S. (2005). The out-of-sync child: Recognizing and coping with sensory processing disorder. Penguin.

OTPlan. (2019, June 23). Pyramid of Learning. https://otplan.com/pyramid-of-learning/

Smith, M. C. (2019). Sensory integration: Theory and practice. FA Davis.

Tuthill, J. C., & Azim, E. (2018). Proprioception. Current Biology, 28(5), R194–R203. https://doi.org/10.1016/j.cub.2018.01.064

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