Sensory processing disorder (SPD; also known as sensory integration dysfunction) is a condition alleged to exist when multisensory integration is not adequately processed in order to provide appropriate responses to the demands of the environment.
The senses provide information from various modalities—,vision, audition, tactile, olfactory, taste, proprioception and vestibular system—that humans need to function. Sensory processing disorder is characterized by significant problems to organize sensation coming from the body and the environment and manifested by difficulties in the performance in one or more of the main areas of life: productivity, leisure and play or activities of daily living. Different people experience a wide range of difficulties when processing input coming from a variety of senses, particularly tactile (e.g., finding fabrics itchy and hard to wear while others do not), vestibular (e.g., experiencing motion sickness while riding a car) and proprioceptive (having difficulty grading the force to hold a pen in order to write).
Sensory integration was defined by occupational therapist Anna Jean Ayres in 1972 as “the neurological process that organizes sensation from one’s own body and from the environment and makes it possible to use the body effectively within the environment”
Classification
Sensory processing disorders are classified into three broad categories: sensory modulation disorder, sensory-based motor disorders and sensory discrimination disorders.
Sensory modulation disorder (SMD)
Sensory modulation refers to a complex central nervous system process by which neural messages that convey information about the intensity, frequency, duration, complexity, and novelty of sensory stimuli are adjusted. Those with SMD present difficulties processing the degree of intensity, duration, frequency, etc., of information and may exhibit behaviors with a fearful and/or anxious pattern, negative and/or stubborn behaviors, self-absorbed behaviors that are difficult to engage, or creative or actively seeking sensation.
SMD consists of three subtypes:
- Sensory over-responsivity
- Sensory under-responsivity
- Sensory craving/seeking
Sensory-based motor disorder (SBMD)
Sensory-based motor disorder shows motor output that is disorganized as a result of incorrect processing of sensory information affecting postural control challenges, resulting in postural disorder, and/or developmental coordination disorder.
The SBMD subtypes are:
- Dyspraxia
- Postural disorder
Sensory discrimination disorder (SDD)
Sensory discrimination disorder involves the incorrect processing of sensory information. Incorrect processing of visual or auditory input, for example, may be seen in inattentiveness, disorganization, and poor school performance.
The SDD subtypes are:
- Visual
- Auditory
- Tactile
- Taste
- Smell
- Position/movement
Symptoms of Sensory Processing Disorder
Sensory issues are usually defined as either hypersensitivity (over-responsiveness) or hyposensitivity (under-responsiveness) to sensory stimuli. Below, find some common signs of Sensory Processing Disorder.
Hypersensitivities to sensory input may include:
- Extreme response to or fear of sudden, high-pitched, loud, or metallic noises like flushing toilets, clanking silverware, or other noises that seem unoffensive to others
- May notice and/or be distracted by background noises that others don’t seem to hear
- Fearful of surprise touch, avoids hugs and cuddling even with familiar adults
- Seems fearful of crowds or avoids standing in close proximity to others
- Doesn’t enjoy a game of tag and/or is overly fearful of swings and playground equipment
- Extremely fearful of climbing or falling, even when there is no real danger i.e. doesn’t like his or her feet to be off the ground
- Has poor balance, may fall often
Hyposensitivities to sensory input may include:
- A constant need to touch people or textures, even when it’s inappropriate to do so
- Doesn’t understand personal space even when same-age peers are old enough to understand it
- Clumsy and uncoordinated movements
- An extremely high tolerance for or indifference to pain
- Often harms other children and/or pets when playing, i.e. doesn’t understand his or her own strength
- May be very fidgety and unable to sit still, enjoys movement-based play like spinning, jumping, etc.
- Seems to be a “thrill seeker†and can be dangerous at times
Sensory Processing Disorder Checklist
Many of the symptoms listed in the following categories are common to that particular age group. Where more than a few symptoms are found in a child, we recommend you talk to your doctor or check the SPD Foundation’s Treatment Directory for a professional experienced with treating Sensory Processing Disorder.*
Infant/ Toddler Checklist:
- My infant/toddler has problems eating.
- My infant/toddler refused to go to anyone but me.
- My infant/toddler has trouble falling asleep or staying asleep
- My infant/toddler is extremely irritable when I dress him/her; seems to be uncomfortable in clothes.
- My infant/toddler rarely plays with toys, especially those requiring dexterity.
- My infant/toddler has difficulty shifting focus from one object/activity to another.
- My infant/toddler does not notice pain or is slow to respond when hurt.
- My infant/toddler resists cuddling, arches back away from the person holding him.
- My infant/toddler cannot calm self by sucking on a pacifier, looking at toys, or listening to my voice.
- My infant/toddler has a “floppy” body, bumps into things and has poor balance.
- My infant/toddler does little or no babbling, vocalizing.
- My infant/toddler is easily startled.
- My infant/toddler is extremely active and is constantly moving body/limbs or runs endlessly.
- My infant/toddler seems to be delayed in crawling, standing, walking or running.
Pre-School Checklist:
- My child has difficulty being toilet trained.
- My child is overly sensitive to stimulation, overreacts to or does not like touch, noise, smells, etc.
- My child is unaware of being touched/bumped unless done with extreme force/intensity.
- My child has difficulty learning and/or avoids performing fine motor tasks such as using crayons and fasteners on clothing.
- My child seems unsure how to move his/her body in space, is clumsy and awkward.
- My child has difficulty learning new motor tasks.
- My child is in constant motion.
- My child gets in everyone else’s space and/or touches everything around him.
- My child has difficulty making friends (overly aggressive or passive/ withdrawn).
- My child is intense, demanding or hard to calm and has difficulty with transitions.
- My child has sudden mood changes and temper tantrums that are unexpected.
- My child seems weak, slumps when sitting/standing; prefers sedentary activities.
- It is hard to understand my child’s speech.
- My child does not seem to understand verbal instructions.
School Age:
- My child is overly sensitive to stimulation, overreacts to or does not like touch, noise, smells, etc.
- My child is easily distracted in the classroom, often out of his/her seat, fidgety.
- My child is easily overwhelmed at the playground, during recess and in class.
- My child is slow to perform tasks.
- My child has difficulty performing or avoids fine motor tasks such as handwriting.
- My child appears clumsy and stumbles often, slouches in chair.
- My child craves rough housing, tackling/wrestling games.
- My child is slow to learn new activities.
- My child is in constant motion.
- My child has difficulty learning new motor tasks and prefers sedentary activities.
- My child has difficulty making friends (overly aggressive or passive/ withdrawn).
- My child ‘gets stuck’ on tasks and has difficulty changing to another task.
- My child confuses similar sounding words, misinterprets questions or requests.
- My child has difficulty reading, especially aloud.
- My child stumbles over words; speech lacks fluency, and rhythm is hesitant.
Adolescent/Adult:
- I am over-sensitive to environmental stimulation: I do not like being touched.
- I avoid visually stimulating environments and/or I am sensitive to sounds.
- I often feel lethargic and slow in starting my day.
- I often begin new tasks simultaneously and leave many of them uncompleted.
- I use an inappropriate amount of force when handling objects.
- I often bump into things or develop bruises that I cannot recall.
- I have difficulty learning new motor tasks, or sequencing steps of a task.
- I need physical activities to help me maintain my focus throughout the day.
- I have difficulty staying focused at work and in meetings.
- I misinterpret questions and requests, requiring more clarification than usual.
- I have difficulty reading, especially aloud.
- My speech lacks fluency, I stumble over words.
- I must read material several times to absorb the content.
- I have trouble forming thoughts and ideas in oral presentations.
*While this checklist can’t diagnose a child with SPD, it can be a helpful guide to see if additional testing should be done. When filling out this checklist, think about the child’s behavior during the past six months.
References:
- “Sensory Processing Disorder Explained”. SPD Foundation.
- Ayres AJ (1972). “Types of sensory integrative dysfunction among disabled learners”. Am J Occup Ther 26 (1): 13–8. PMID5008164.
- “Breakthrough Study Reveals Biological Basis for Sensory processing disorders in Kids”. UC San Francisco. Retrieved 2015-10-18.
- “Course information and booking”. Sensory Integration Network. Retrieved 23 July 2013.
- Lane AE, Young RL, Baker AE, Angley MT (January 2010). “Sensory processing subtypes in autism: association with adaptive behavior”. J Autism Dev Disord 40 (1): 112–22. doi:1007/s10803-009-0840-2. PMID19644746
- “American Psychiatric Association Board of Trustees Approves DSM-5”. Retrieved 15 July 2013