Sensory Processing Disorder

Sensory Processing Disorder (previously known as sensory integration dysfunction), describes difficulties in managing information that comes into the brain via the senses. This includes not only smell, sight, touch, taste and sound, but also information that is gathered and processed by the ‘vestibular system’ and the ‘proprioceptive system’, which are responsible for telling our brain about the position in which our limbs are, in relation to the rest of our body and the environment around us.

Children with SPD are not able to organise sensory messages from their bodies into appropriate, organised responses or behaviours, although physically they seem to have no impairments. This problem may first become apparent with very young children, who begin to react inappropriately to certain smells and specific noises, or respond abnormally to touch. They may also struggle with co-ordination of movement, or have developmental delays with their speech and language skills.

Children with SPD may present with tactile dysfunction, vestibular dysfunction, and / or proprioceptive dysfunction, and experience difficulties in the way in which they interpret sound, smells, and visual information. They may have difficulties with some or all of these sensory systems, and each child’s presentation will be different from the next, regarding the extent and nature of their problems. It may be difficult for parents to comprehend why a sensory processing problem manifests itself as a movement difficulty or a behavioural characteristic in a child. This can lead to such characteristics being overlooked or ignored as simply “bad behaviour”.

The following examples may give you an idea as to how this condition may present, although it is not an absolute diagnostic checklist and is to be used as guidance only.

• Unable to hold an upright position in sitting
• Specific sounds and smells may be found to be overwhelming
• Withdraws from touch and avoids being touched by people or objects
• Conversely may crave touch
• Indifference to pain with reduced awareness of painful stimuli
• Complains about having their hair brushed
• Dislikes having their hair or nails cut
• Avoids group situations for fear of being touched, brushed against etc.
• Dislikes standing in queues or in line at school in case they are knocked or touched
• Avoids using their hands during play
• Hypersensitive to rough seams or labels on their clothes
• May pinch or bite themselves
• Seeks out surfaces that provide different textures and sensations to touch
• May appear frightened of falling even though there is no risk of this
• Fearful of walking on uneven surfaces
• Finds balancing difficult
• Dislikes moving on swings, bicycles and roundabouts
• Prefers to move slowly and cautiously and dislikes being rushed
• Finds it difficult to plan and carry out motor tasks
• Always jumps and runs instead of walking
• Twirls and spins around regularly through the day
• Rocks body, wriggles legs whilst sitting
• Loves fast rides at amusement parks, swinging high on swings and bumpy car rides
• May toe-walk
• Difficulty throwing, catching and kicking a ball
• May appear floppy
• Tires easily
• Difficulty co-ordinating opening jars, turning door knobs etc.
• May never have crawled
• May find dressing, tying shoe laces and fastening buttons difficult
• Appears clumsy and bumps into things
• Messy written work
• May not have an understanding of what is light or heavy
• Frequently breaks toys and objects
• Regularly falls on the floor intentionally
• Difficulty judging how to put arms in sleeves and legs in trousers etc.
• May press on too heavily or too lightly when drawing
• Loves tight hugs and tightly wrapped blankets around them in bed
• Aversion to certain tastes and smells
• May gag with certain textured food
• Difficulty with jigsaw puzzles, finding differences between pictures/object
• Loses their place easily when copying work at school from the board
• Hypersensitivity to brighter lights
• Unable to regulate thirst or hunger

It is not clear why some children have problems with the processing of sensory messages, but it is often wrongly or undiagnosed. Difficulties with sensory processing may not be picked up at first and indeed, some health professionals have little knowledge of this disorder. SPD may co-exist in association with other disorders such as Cerebral Palsy, Autistic Spectrum Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Developmental Co-ordination Disorder and some learning difficulties.

Physiotherapy intervention for Sensory Processing Disorders can be extremely successful in maximising a child’s potential function, and can be vital to their maturation process and their future as an adult. Early intervention influences the immature brain and its sensory pathways which are still susceptible to change whilst a child is growing and developing. In this way, by deliberately retraining the way in which a child perceives information about a certain smell, touch, sound and / or their surroundings, their response can be adapted and their movement and behaviour regulated more effectively.

At Yorkshire Children’s Physiotherapy, our Specialist Paediatric Team can carry out a thorough assessment of your child, in order to identify their individual problems and their rehabilitation needs. We would then discuss our findings with you and offer advice regarding what intervention may be appropriate. Should your child require physiotherapy input, we can explain what this process will involve and what the aims of physiotherapy would be for your child.

It is very important to us that children perceive their physiotherapy treatment sessions to be fun, and that their therapy incorporates as much play as possible. Rather than asking them to carry out a specific task, our approach focuses on encouraging children to process information about a particular activity in a manner that stimulates their sensory system correctly, and therefore evokes an appropriate response. By working in this way, we find that children are generally happy to have their physiotherapy sessions, and are more compliant with rehabilitation activities, whilst they are in fact working hard to build and develop essential skills and improve their functional ability.

For example, activities involving playing with play-doh, sand, jars of dried beans and water provide a variety of different textures for children in order to develop normal tactile processing skills. Children who shy away from handling certain textures and objects need to be able to learn how to regulate their sensory information about these items, so that they can respond normally to them and carry out any associated skills correctly.

If you are concerned that your child has difficulties with sensory processing, or simply that your child doesn’t seem to be successfully reaching some of their developmental milestones, please do get in touch to discuss your concerns with us. It can be very worrying as a parent if you feel that something is not quite right, but you are unable to find a solution and you don’t know what to do or who to consult. Being concerned about your child’s development is natural. Commonly, a child may just be a little slower to reach a specific milestone, but often catches up later. Your child’s likes and dislikes are very much part of their individual character and do not necessarily mean that they have difficulties with sensory processing.

Our Specialist Paediatric Team would be happy to chat to you over the telephone, about your child and any concerns you have. Alternatively, we can arrange a Consultation appointment with you and your child in order to assess them more formally. We may only need to offer some reassurance and advice. However, if any specific difficulties are identified, we can work together with you to resolve these.