Emotional Regulation: Sensory Processing Disorder

Your child’s aggressive outbursts, clumsiness, inability to dress herself, or constant meltdowns may be due to a condition called Sensory Processing Disorder (SPD).  About 5-15% of school-aged children have it, and the rate it’s believed, is higher for internationally adopted children.  It can run in families, and there is also evidence that prenatal stressors can contribute.  A lack of proper stimulation in a child’s first years may also impact the brain’s ability to process sensory information.

Sensory integration is a person’s ability to automatically sort and organize the multitude of sensory messages our brain constantly receives.  In addition to the “five senses,” our proprioceptor system (the ability to distinguish where the various parts of your body are located in relation to each other) and vestibular system (movement and sense of balance) are involved.  For children with SPD, the world may not be a place that makes sense.  Their difficulties processing sensory information may even make the world a frightening place.  Children with sensory integration disorders often respond by trying to control what’s happening.  They would much prefer an environment that’s very predictable and consistent from day to day.  They may want the TV so low no one else can hear it, they may spill things at the dinner table or not be accepting of hugs.

Three primary patterns, with six total subtypes, of the disorder have been proposed (Miller et al., 2007).  These patterns include, sensory modulation disorder, sensory discrimination disorder and sensory-based motor disorder.  This article will consider children with sensory modulation challenges.  There are three subtypes:  over- responsive, under-responsive and sensory-seeking.

The over-responsive type responds too much, for too long, or to stimuli of weak intensity.  Children with over-responsive type have more difficulty filtering out repeated or irrelevant sensory information.  These children are easily overwhelmed by daily sensory experiences and display fight, flight, or freeze defensive responses.  This can result in frequent meltdowns, withdrawal from others, or severe aggression after being touched.  Something as simple as being jostled while standing in line at school can result in an aggressive outburst.  They are overwhelmed in situations where sensation from multiple modalities is present (e.g. a mall or a school cafeteria).  The affects of over-responsiveness can be profound, impacting a child and family’s quality of life, interfering with engagement in social interaction, participation in home and school routines, self-regulation, learning and self-esteem. 

Another child may be what is considered under-responsive. They respond too little or need extremely strong stimulation to become aware of the stimulus.  They tend to “tune-out” or not notice the same sensory experiences as others.  This could be related to what some people see as a high tolerance to pain.  This could be the kid that breaks a bone and doesn’t seem to feel any pain. 

The sensory-seeking subtype craves and seeks out sensory experiences.  They twirl on the tire swing long after other children have moved on to different activities.  They run and crash into other kids for the sensation. They can listen and learn while active, but are not able to attend to visual clues while on the move.  They are soothed by being held tight, accompanied by strong, rhythmic motions. 

Numerous studies have shown that interactions among the senses profoundly influence behavior, perception, emotion and cognition (Kisley et al., 2004). It can even lead to difficulties in learning. Advances in brain imaging demonstrate that individuals with SPD use a different part of their brain when processing sensory input. One thing that often happens is that a child with sensory integration problems will put 100% effort into doing something and manage to get it done. However, no one can sustain that level of effort all the time. When a parent or a teacher sees a child accomplish something once in awhile, they think, “Oh, she can do it and maybe she’s just not motivated, or she’s just not trying”. Adults will then often attribute a behavioral reason when a task is hard or left undone. Another scenario is that a kid may focus all their energy at school, where they know their performance is really important and they want to fit in with the group. They wear themselves out getting it right at school then arrive home exhausted and fall apart. Most kids don’t realize what’s bothering them. There may be times when they cannot put into words what is happening to them because they are so overwhelmed or simply do not know the right words to use. The inability to verbally communicate also contributes to emotional outbursts. Some children might be aware that they are agitated or feel out of control. Once a child is properly assessed and diagnosed it is important for the adults in their lives to help them understand what is going on in their bodies. Understanding the behaviors a child uses to try to self-regulate is vital in addressing each child’s unique needs, and to be able to teach them appropriate coping skills.

If you think your child may have a sensory processing disorder, you can have an evaluation done by a trained occupational therapist.  The therapist will then prescribe a “sensory diet” for your child to help them develop more typical reactions to sensory stimulation. For further information, please go to www.spdfoundation.net or www.SPDnetwork.org.

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