Too Much/Too Little/Too Fast/Too Slow:

Understanding How Sensory Issues Impact Behavior

OverviewWhat is Sensory Processing Disorder?Neurological Disorganization:

Difficulty: Taking in sensory information Interpreting sensory information Integrating sensory information

Response (outcome) Inappropriate response

Imagine If:“Imagine driving a car that isn’t working well.

When you step on the gas the car sometimes lurches forward and sometimes doesn’t respond. When you blow the horn it sounds blaring. The brakes sometimes slow the car, but not always. The blinkers work occasionally, the steering is erratic, and the speedometer is inaccurate. You are engaged in a constant struggle to keep the car on the road; it is difficult to concentrate on anything else.

Stanley Greenspan, “The Challenging Child” (1995)

What if:You could see obstacles in your way but you could not make

your body move in the direction you wanted to avoid them.Your clothes feel like they were made of fiberglass.Every time you tried to write with your pencil, it broke

because you pushed too hard.The humming of the lights sounded louder than my voice.Every time someone touched you it felt like they were

rubbing sandpaper on you.You wanted to write something down but it took you at least

5 seconds to form each letter. You can see the letter in your head but your hand will not go in the right direction to write it.

You had to pull over the car 3 times on the ride here because the motion made you sick.

Eight Sensory SystemsSensory systems receive information from

stimuliOutside our bodiesInside our bodies

It is then sent to the brain for interpretation

Then: Brain generates a response

Motor Behavioral

This response is unique to the individual; based on personal experiences and associations.

Sensory information can support or challenge a child

Sensory Systems1. Sound

2. Sight

3. Smell

4. Taste

5. Touch• Protective• Discriminative

6. Vestibular

7. Proprioception

8. Interoception

Almost all children with SPD have more than one sense that is impacted

Sound/Auditory SystemGives ambient and focal informationDiscerns background noise from relevant noiseRight/left spatial discriminationAssociated closely with vestibular systemHelps us understand movementDetects pitch, tone, frequencyFoundation for language development

Movement/rhythm are paired with speechTemporal and spatial orientationEarliest form of communication - relief from

discomfort, attain desired needs, establish proximity

Behaviors Associated With Dysfunction of Auditory SystemsAfraid of moving toys

Cannot locate where they are coming fromDifficulty discerning mom’s voice from background noiseMissing specific pitches can sound like a person talking with

marbles in the mouthSensitivity to noise children cover ears/cryOverwhelmed=overactivity and/or aggressionDifficulty regulating own volumeDifficulty discriminating certain sounds: “Come with me.”

“See that tree.” Rule outs: hearing loss/impairment, frequent ear infections Can look like: trauma, ADHD, reactive attachment, ODD,

autism

SightFoundation for bonding, spatial orientation,

movement through space, social communication

Shows us exactly where we are in spaceWorks closely with vestibular, proprioceptive,

and tactile systemsWith these systems together we move in

response to the events around us Kicking/catching a ball Understand body language (a majority of

communication)

Reading, writing, calculation, spelling

Behaviors Associated With Dysfunction of Visual SystemsOverwhelmed in cluttered area (can’t find

something <right> in front of them)Wearing hats or sunglasses to avoid glare (lamps

instead of overhead lights)Do not know how to create their own visual

boundariesOval/circle are the same“b”, “d”, “p” are the sameRule outs: visual impairment, strabismus,

amblyopiaCan look like: ADHD, autism

Smell/OlfactoryProcessed through our Limbic System

• Related directly to emotion1st to developFoundation for bondingProtection for noxious itemsImportant for attending/deciphering to enjoyable

foods and dangerous surroundings (i.e. fire)

TasteQuality of foods/liquids

• Texture – crunchy, chewy• Color – white, colorful (vibrant)• Property – sweet, salty, sour

Behaviors Associated With Dysfunction of Olfactory/Gustatory SystemsFight/flight response to certain restaurants, cafeteria food

preparationsDinner problems/food aversionsSniff all foods before they will tasteOnly eat white foods (bland)Only eat spicy foodsRule outs: food allergies, illness, traumaCan look like: “picky eating”, eating disorder, ODD,

reactive attachment, OCDFoods That Change Arousal:Crunchy – calming Sucking – calming Chewy –

calmingSalty – alerting Sour - alerting

Touch/TactileVery important in behavior

Skin largest sensory systemEarliest sensations infant feelsBonding/attachment/feeding/emotional responses

Information about:Touch – light/deepPressureTextureHeatColdPain

Tactile/proprioception work together

Two Systems:• Protective – respond quickly as we are protecting

ourselves against something potentially harmful• Discriminative – gives us details about things. Is

our little detective. Tells us internally what’s going in externally (hard, soft, round, square, hot, cold)

(I.e., “If it’s square, cannot be a penny.”)

Dysfunction:Hypersensitive (sensory-defensive)Hyposensitive (sensory-seeking)Combinations are common

Behaviors Associated With Dysfunction of Tactile SystemsInability to distinguish similar objects without lookingCannot button coat without lookingDo not like baths, haircuts, cuddling, diaper changes/toiletingTwisted clothes or socksDislike certain kinds of clothes or texturesEmotionally detachedEither overreact to messy hands/face or do not noticeFeeding problems (suck, chew, swallow, stuffing mouth,

choking)Decrease level of comfort and security; easily upsetControlling behaviors (and avoiding activities that are

unpleasant to them)Overreacts to touch or is too rough with touch (headbutting,

rough play) Can look like: OCD, reactive attachment, autism, ADHD,

bipolar

VestibularMost primitive systemInvolved in neck control – coordinates with vision

Gives information about your headGravity relationshipHead acceleration

Organizing/soothing – linear rocking; auditory connection with ear structures

Alerting – rotational movementFoundation for postural reactionsAllows one to focusGives sense of security/predictabilityTrust comes from grounding to the earth

Behaviors Associated With Dysfunction of Vestibular SystemUncomfortable with changesDoesn’t like car rides or grocery carts (backward

space)Dizzy feelingCannot navigate space around oneselfDirectionally – cannot tell which way they are

movingSocial difficulties/playRisky behaviorsCan look like: ADHD, autism, anxiety,

depression/withdrawal, OCD, bipolar

ProprioceptionBending, straightening, pulling, compressing

joints and muscles – feel changesUnconscious (most of the time)Body scheme/body mapsFoundational SystemsTactile, visual, vestibular, united to this

system

Behaviors Associated With Dysfunction of Proprioceptive SenseErase through paperPush too hard/shove othersDifficulty with sportsClumsyToe walkingKnocks over drinksCan look like: ADHD, autism, conduct

disorder

InteroceptionSensations from sensors near organsGreat modulatorSuggest we are hungry, thirsty, sleepy, need

to use the bathroom

Behaviors Associated With Dysfunction of IntroceptionAt school nurse for aches/painsToilet trainingCommunication – cannot tell you what wrongLow energyEmotionally fragileCan look like: OCD, depression, anxiety, IBS,

malingering

Emotional RegulationMost important foundation for functioning with all

types of SPDModify your behavior/circumstancesAdapt to changes remain organize calmDevelopment Evolution

Infancy – dependent on adult for regulation stateBy age 4 – need less external forms of regulationOlder children – talk/negotiate difficulties

Understand your own strategies for emotional regulation

Use pretend play

Behaviors Associated With Poor Emotional Regulation

FearDoom/gloomUnproductiveLow self-esteemPoor attendingDistractive

Mood swingsDecreased social

interactionsPeer conflictsDifficulty tolerating

unpredictibilityInflexibleWithdrawl

Activities for Emotional Regulation

Chew gumDeep breathingMassage handsCalming scents

(lavender, vanilla)Visual cues

Drinking cold waterQuiet space (“tent” or

library corner)Quiet music or white

noiseDimming lightsReward

Subtypes of Sensory Processing Disorder(Permission granted from SPD Foundation)

www.spdfoundation.net

SENSORY PROCESSING DISORDER (SPD)

Sensory Modulation

Disorder (SMD)

Sensory-Based Motor Disorder

(SBMD)

Sensory Discrimination Disorder (SDD)

SOR SUR SS DyspraxiaPostural

Disorders

SOR= Sensory Over-ResponsivitySUR= Sensory Under-ResponsivitySS= Sensory Seeking/Craving

“Miller, L.J., Anzalone, M.E., Lane, S,J., Cermak, S.A., Osten, E.T. (2007). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61(2), 135-140. Sensational Kids Hope and Help For Children With sensory Processing Disorder (SPD), Copyright (2006) by Lucy Jane Miller