Sensory Processing

Disorder
David Smith - Poli Sci + Interdisciplinary Studies
(Public Policy, Education, Language)
Leila Zefri - HDFS + Psychology

April 25, 2019

 Definition
● Previously called Sensory Integration disorder, Sensory Processing Disorder (SPD) is a
neurological disorder
● Sensory Processing: the way the nervous system receives messages from the senses and turns
them into responses
● SPD = Sensory information abnormal responses
● Abnormal responses vary, examples include:
○ Too sensitive to stimuli - sensory avoider
○ Not sensitive enough to stimuli - sensory seeker
● Currently SPD is not included as a distinct diagnosis in the DSM-5
○ Disagreement over its inclusion
○ Sensory problems are filed under other disorders such as Autism, ADHD, and anxiety
disorders
Anna Jean Ayres, pioneer
in work for sensory
integration, described
SPD as a neurological
“traffic jam” that prevents
certain parts of the brain
from receiving the
information needed to
interpret sensory
information accurately
Symptoms
● Can affect one sense or multiple senses
○ Over or under responsive to sensory information
● Children can exhibit these symptoms from time to time but SPD refers to symptoms that are severe
and affect daily living/normal functioning
● Other symptoms include:
○ Uncoordinated
○ Bump into things
○ Unable to tell where their limbs are in space
○ Hard to engage in conversation or play
● Examples:
○ Leaf blower
○ Toilet flushing
○ Being touched
○ Textures of foods
○ Extreme heat or cold
Demographics and Statistics
Demographics and Statistics
● Risk factors
○ “Low birth weight (less than 2200 gram, Prematurity (less than 36 weeks gestation, Prenatal complications, Maternal
stress, Maternal illness, Maternal use of medications, Delivery complications, Assisted delivery methods, Ethnic minority,
Living with a single parent, Lower socioeconomic status” (STAR institute)
○ Heritability

● SPD is not always comorbid with ASD or ADHD

○ Between 58%-80% of cases of SPD are not comorbid with other disorders

● When children are not treated, SPD generally goes away between age 1
and 8
Physical Development Impact
● Senses:
○ Five traditional senses: sight, smell, hearing, taste and touch
○ Additional senses: proprioception (control body awareness), vestibular (balance and spatial
orientation)
■ Issues in these areas have huge impact for physical development
● If kids are reluctant to touch/play with objects due to issues with touch processing their fine motor
skills (grasping, turning pages, cutting, eating) often fall behind
● Exploring the environment is critical to many motor skills
○ SPD children may not explore their environment as much
● Many kids with SPD are clumsy (vestibular and proprioceptive senses)
○ May move slowly or even break bones more often
● Hardered for them to develop both gross motor and fine motor skills
○ Not know their own strength (e.g milk jug)
○ Seem out of control (e.g fidgeting)
Cognitive Development Impact
● Several studies have shown different neurological responses to physical stimuli in children with SPD
● Sensory gating delayed
○ Sensory gating is filtering out unnecessary stimulus
● Less able to regulate sensitivity to changes in tone freq + loudness
● Issues with parents stemming from behavioral issues
○ Fewer outings with families
○ Parenting stress/exhaustion
○ Loss of parent self-esteem in parenting skills
● Issues functioning in a typical classroom
 Emotional and Social Developmental
Impact
Socially:
● Hypersensitivity can result in them
viewing the world as scary and
unpredictable
○ Socially this leads isolation
○ On the lookout for painful input
● Heavily rely on their parents
○ They know their triggers and can provide
comfort to them in stressful situations
● May not follow socially normal
behaviors:
○ Eye contact, standing too close or too far,
etc.
○ Hard to make relationships with peers
Emotionally:
● Overactive limbic system leads to
intense emotional reactions
○ Hard to understand
● Emotionally drained or emotionally flat
○ Constantly aware/upset by their
environment
○ Hard time reading emotional cues from
others
● Often switch emotions quickly
○ Based on sensory information in the
environment
● Tend to be very anxious (i.e. on edge
due to sensory information)
Resources for Parents, Teachers,
Providers
● Miller, L., & Fuller, D. (2007).
Sensational Kids: Hope and
Help for Children with Sensory
Processing Disorder. Perigee
Trade.
● Roth-Fisch, M. (2009). Sensitive
Sam: Sam’s Sensory Adventure
Has a Happy Ending! Future
Horizons.
Resources for Parents, Teachers,
Providers
1. https://www.spdstar.org/
a. Network of support/information for
parents, children and educators
b. Focus information
diffusion/awareness/research
2. https://sensoryprocessingdisorderparentsupport.com/
a. Focused entirely on bringing
parents together
3. https://www.openaccessgovernment.org/sensory-proce
ssing-disorder-children/40427/
a. Rigorous, but more general source.
b. Good reading for lay people
1. Walker, K. , Redman-Bentley, D. , Remick-
Waltman, K. & Armstrong, D. C. (2019).
Differences in Oculomotor Function
between Children with Sensory
Processing Disorder and Typical
Development. Optometry and Vision
Science, 96(3), 172–179.
2. Yi-Shin, C., Owen, J. P., Desai, S. S., Hill, S.
S., Arnett, A. B., Harris, J., . . . Mukherjee,
P. (2014). Autism and sensory processing
disorders: Shared white matter
disruption in sensory pathways but
divergent connectivity in social-emotional
pathways. PLoS One, 9(7)
 Accommodations and Interventions

Start time- 1:39

End time - 2:58
Accommodations and Interventions
● Occupational therapy
○ Broadly, children with sensory processing disorder benefit from treatment by an occupational therapist
○ Use a sensory integration approach
○ Can be referred to OT at their school or one that is in private practice
○ Work to help children become calmer and better regulated
○ OTs work on appropriate responses to sensory information in an active, meaningful, and fun way to
increase the child’s functionality
○ Not much research on this
■ Pediatric neuropsychologist: “The thing we don’t really understand is how and if this approach
works for every kid who has sensory issues”
● Need more research based interventions
■ Personal testimonies
Stop- 2:00
 Accommodations and Interventions
● Sensory integration therapy
○ Goal: balance sensory input
○ First occupational therapist assess the child’s
needs (what over stimulates them and what under
stimulates them?)
○ Treatment usually takes place in a “sensory gym”
○ Use many tools to find the balance for children
and figure out what works best for them
■ OT introduces child to activities that
stimulate their senses
■ Gradually makes the activities harders
○ Many reports of success with this therapy
intervention
■ Debate over the implication that it “rewires”
a child’s response to sensory input
○ Essentially, a more extensive sensory diet
 *Disclaimer: Do NOT
Accommodations and Interventions force child to do an
activity they are not
reacting positively to*
● Sensory Diet
○ Based on Sensory integration
theory
○ Group of activities scheduled into
a child’s day to increase attention
and awareness while decreasing
overall stress the child
experiences
○ Specialized to the child's specific
needs
■ Helps child feel “just right”
instead of over or under
whelmed
○ Prescribed by an occupational
therapist
○ Tools the therapist might use:
■ Weighted blanket, fidget
toys, headphones, etc.
Accommodations and Interventions
● Wilbarger Protocol (also called brushing therapy)
○ Used for individuals who are extremely sensitive to touch
(often used in individuals with Autism)
○ Brushing the body with a small surgical brush throughout the
day
■ Starts at the arms and works down to the feet
■ Use firm pressure
○ Do NOT brush: face, chest, and stomach
○ Takes 2-3 minutes
○ Not much research behind this but many individuals with
Autism report decreased sensory defensiveness and anxiety
○ Benefits:
■ Help with transitions, improve attention span, decrease
fear or discomfort, improve self-regulation
 Accommodations and Interventions
● Family therapy/intervention
○ Can be extremely stressful for families
■ Think of grocery shopping, going to the movies, etc.
○ Parents need to learn the triggers and appropriate responses
○ Developmental, individual difference, relationship-based (DIR) model of
intervention
■ Multiple “floor time” sessions where child and parent play together for
about 20 minutes
■ Parent follows child’s lead (even if it isn’t typical)
■ Then the parent can challenge the child to master certain skills
● School
○ Allow children to use tools as necessary (weighted blanket, fidget tools)
○ Minimize loud, sudden noises
● Overall treatment is very individualized (e.g. listening therapy)
Note: access to treatment
Implications for Practice
● Given what we know, we recommend that educators;
○ Take careful time to understand this disorder and its unique nature
○ Familiarize themselves with potential accommodations such as chewing gum or using a
stress ball
○ Work to build understanding of those accommodations among the students peers in
order to destigmatize “special treatment”
○ Be intentional in responding to behavior
○ Be mindful of sensory stimulus in classroom
○ Understand that any classroom difficulties are not the child’s fault, and have sufficient
patience
Sources: Presenter 1
● https://www.webmd.com/children/sensory-processing-disorder#1
● https://childmind.org/article/the-debate-over-sensory-processing/
● https://blog.brainbalancecenters.com/2012/04/signs-and-symptoms-of-sensory-processing-disorder
● https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/sensory-processing-issues/understanding-sens
ory-processing-issues
● https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/sensory-processing-issues/how-sensory-proce
ssing-issues-can-affect-motor-skills
● https://www.understood.org/en/learning-attention-issues/treatments-approaches/therapies/download-sample-sensory-diet
● https://www.nationalautismresources.com/the-wilbarger-protocol-brushing-therapy-for-sensory-integration/
● https://www.spdstar.org/basic/impact-and-treatment-of-spd
Sources: Presenter 2
● https://www.spdstar.org/basic/latest-research-findings#f1

● https://www.spdstar.org/basic/understanding-sensory-processing-disorder

● https://www.sensorysmarts.com/working_with_schools.html

● https://www.webmd.com/children/sensory-processing-disorder#1

● https://www.webmd.com/children/sensory-processing-disorder#1

● https://childmind.org/article/the-debate-over-sensory-processing/