Wednesday, 20 July 2016

Sensory Processing Disorder and Why you Need to Know About It

When my three year old started complaining about his clothes being too uncomfortable and routinely took his shirt off in public, I thought maybe I was using an abrasive detergent.

Covering ears and wearing a tag-less shirt. 
When he covered his ears in pain at sounds that were not too loud, I thought he had superior selective hearing. 

When he walked around touching all the clothes hanging in the stores, running his fingers along the walls as we walked, and occasionally throwing himself on the floor or intentionally crashing into surfaces, I could no longer make excuses for it. 

He had sensory processing disorder and I didn't know it yet. Like me, you may have not heard much about SPD. I will explain why it is not a common diagnosis shortly. According to the STAR institute, Sensory processing disorder, or sensory integration disorder, is defined as a neurological disorder in which incoming sensory information results in an abnormal response. Children are either under-responsive or over-responsive to certain sensory information. If they under-respond to stimuli, they may compensate by seeking out sensory input-in other words, they are the sensory seekers. If they over-respond to sensory information, they are sensory aversive and will not tolerate sensory information that others find tolerable. What is interesting about sensory processing disorder is how unique it is to every child. One child could both under-respond to certain sensory stimuli and over-respond to other stimuli. For example, my son's sensitivity to his clothes indicates he is over-responding to tactile input, and his sensitivity to sounds is over responsive to auditory input. However, he is under-responsive to vestibular and proprioceptive input, which makes him seek out certain movements like spinning, jumping, crashing, and falling. All of his responses to sensory information are abnormal, making his daily routine both at home and at school a more challenging one. So why is this so important to know? Because it determines whether your child is having a sensory meltdown due to overstimulation, or a tantrum. Each one should be treated differently.

When I first read about sensory processing disorder I was overwhelmed by all the new terminology. Below I list the main terms that are routinely used in books, articles, and tips regarding sensory processing disorder:
  1. Hyposensitivity is when a child is under responsive to stimuli. 
  2. Hypersensitivity is when a child is over responsive. 
  3. Most of us have heard about five sense--sight, hearing, touch, smell and taste- when in fact there are eight. Proprioceptive input refers to the sensations from joint, muscles and connective tissue that contribute to body awareness. Vestibular input refers to the sense of movement and is centered in the inner ear. 
  4. A sensory diet is not an actual food diet like I initially thought. It is a list of movements and activities designed for each type of sensory issue your child has. Each sensory category has a list of activities to do with your child to help regulate their senses. I created a sensory diet for my child using the book, Raising a Sensory Smart Child. 

I was skeptical about starting my child on a sensory diet. It seemed like an arbitrary list. But I needed a solution to his sensory integration issues that were affecting his life, so I was willing to try it all. Below is the sensory diet I used based on his hyposensitivity to oral, preprioceptive/vestibular senses, and tactile and auditory hypersensitivity:

Chewy Tube from Amazon
My son would chew holes through his shirt collars and sleeves, and bit his nails raw. He is hyposensitive to oral stimuli.

  • Chewy tube around his neck 
  • Vibrating tooth brush
  • Crunchy, chewy food
  • duration: once an hour or on going. 

My child is hypersensitive to tactile sensory experiences. He is able to tolerate firm touch but not unexpected touch, tickling, or certain clothing and tags.

  • Human sandwich or burrito. This is a great exercise to give the child deep pressure he/she craves. Wrap the child tight in a blanket or sandwich them between cushions. This technique calms my child when he is overstimulated and helps him regulate his senses. 
  • Cover in a weighted blanket
  • Use a weighted lap band or snake

  • Jumping on the trampoline once an hour or as needed (we bought a mini trampoline that stays in his room)
  • Wall or floor push-ups, crab walk, or wheelbarrow walking at least four times a day. 
  • Throwing: balls or beans in baskets. Throwing gives the joints traction input. 

  • Twist board 
  • wobble board
  • hammock in his room
  • swinging at playground. 
  • Duration: Any combination of activities three times a day.
twist board from the fitness section at Canadian Tire
Wobble board from Amazon

The sensory diet is a lot to remember. It should be printed out and shared with his teachers who tried to implement what they can at school, as per the request of the occupational therapist consultation through the school. For it to be effective, you will need to implement your child's individualized sensory diet regularly, and for it to be written and supervised by an occupational therapist. Since implementing the diet, I have seen a difference. But to maintain the diet this rigid was somewhat difficult. On lazy days, a great way to implement proprioceptive, vestiublar and tactile input is to take him to an indoor playground where he can run, jump, climb, swing, fall, and crash in a safe place. Many indoor playgrounds are designed to be sensory friendly.

I suspect my child has SPD. What are the next steps?

The first step is to see your family physician for a referral to a developmental pediatrician. You will need to rule out other conditions like ADHD and ASD, both of which my son is also officially diagnosed with. SPD is a condition that is largely misdiagnosed as ADHD and ASD, and has a high co-morbidity rate with the two diagnoses. The next step is to consult with an occupational therapist. They will assess and determine if your child has sensory processing disorder and the severity of it. Developmental pediatricians do not typically diagnose SPD because it is not viewed as a medical condition, yet. Proponents of SPD believe it should be part of the DSM-V (Diagnostic and Statistical Manual or Mental Disorders, fifth edition), but not enough research has shown SPD as a separate medical condition. Currently it is listed as a symptom of Autism Spectrum Disorder. Once your child is diagnosed, the occupational therapist will suggest OT sessions and give you a plan to work with at home. With routine OT sessions and practice at home, your child will be able to self-regulate.

I highly recommend picking up a copy of Raising a Sensory Smart Child. The authors do a thorough job explaining SPD and providing a ton of information on SPD management, other associated conditions, stories, and sensory diet ideas. After reading the book you will feel more confident about dealing with sensory processing disorder. It's a great resource to have on your shelf, and you'll find yourself going back to read it several times.

Do you have a question or comment? Email us or comment below! 

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