The way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses is referred to as sensory processing.1 Sensory input is received and understood through sights, sounds, touch, tastes, smells, movement, balance, body position, and muscle control.2 The successful integration of this sensory information aids in developing motor skills, social skills, and focus and attention essential for learning.3
Sensory Processing Disorder (SPD), which was originally referred to as sensory integration dysfunction, is a condition that exists when sensory signals don’t get organized into appropriate responses. While most people experience some sensory difficulty occasionally, for children with SPD, the difficulties are chronic and disrupt their everyday lives.
Because children with SPD react differently to sensory input, they often become socially isolated with difficulty in making friends or participating in a group setting. They can appear clumsy, disruptive, uncooperative, aggressive, and out of control. This can result in anxiety, depression, poor self-esteem, and academic failure.4
One or more senses can be affected, and children may over-respond to sensation finding it unbearable or they might under-respond showing little or no reaction to stimulation. Each sense has multiple responses that can indicate signs of dysfunction:
- The tactile sense receives input from the skin receptors about touch, pressure, temperature, pain, and movement of the hairs on the skin. Hypersensitivity to touch can be seen in children who avoid being touched or held by others. They may resist messy play and dislike rough clothes. Hyposensitivity to touch is indicated by under-responsive reactions to pain and the craving for strong sensory input. They seek out messy play and may not realize their hands or faces are dirty.
- The vestibular sense receives input from the inner ear about equilibrium, gravitational changes, movement experiences, and position in space. Hypersensitivity to movement can be seen in children who dislike the motion of playground equipment such as swings, slides, and merry-go-rounds as well as other settings where movement occurs. Hyposensitivity to movement results in the opposite reaction with children loving to spin and swing as high as possible. They are in constant motion running and jumping rather than walking.
- The proprioceptive sense receives input from the muscles and joints about body position, weight, pressure, stretch, movement, and changes in position in space. Sensory seeking behaviors include enjoying bear hugs, rough and tumble play, and stomping, jumping, and other forceful activities. Those displaying difficulty with “grading of movement” may misjudge the amount of pressure needed to perform tasks and may play too forcefully breaking objects and toys. They may bump into things often and appear clumsy and uncoordinated.
- The auditory sense receives input relating to sounds and the ability to correctly perceive, discriminate, process, and respond to sounds. Hypersensitivity to sound causes children to be startled by loud sounds and to avoid being around vacuums, hairdryers, and loud public places. They can also be distracted by sounds not normally noticed by others. Hyposensitivity to sound is seen in children who love excessively loud music and making noise, but who may not respond to verbal cues.
- The senses of taste, smell, and sight can also have dysfunctional responses that are displayed in hypersensitive and hyposensitive symptoms. Children may become picky eaters, find strong odors to be offensive, and be easily distracted by visual stimuli. On the other hand, they may love intensely flavored foods, not be able to distinguish smells, and have difficulty controlling eye movements and tracking objects.
While many people have difficulty processing certain sensory stimuli, it has been identified as a sensory processing disorder when it becomes disruptive and significantly impacts everyday functioning.5
The concept of sensory integration dysfunction was pioneered in the 1960s by A. Jean Ayres, an occupational therapist and psychologist. Interest in exploring the issues of sensory integration dysfunction has spread, however, because it has not been deemed a formal medical diagnosis, little funding has been available to research scientists.
A decade-long campaign to include SPD in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (known as DSM-5) published by the American Psychiatric Association failed in 2013, and the American Academy of Pediatrics advised against using SPD as a diagnosis claiming that it is unclear whether children with sensory problems have a distinct disorder or whether their challenges are linked with other disorders, such as autism, ADHD, and anxiety.6 For SPD to receive recognition as a distinct medical diagnosis, peer-reviewed studies must be done that define the symptoms apart from other disorders, a typical clinical course, and treatment data.7
As with other disorders, such as ADHD and autism, the causes of sensory integration dysfunction are not clearly understood. There appear to be neurological problems with children with SPD, and brain activity seems to be affected giving otherwise normal children difficulty in combining sights, sounds, and touch as a whole experience. Genetics and environmental issues may also be involved.8
The treatment of children with SPD is primarily done by occupational therapists with a sensory integration approach typically done in a sensory-rich environment. Children are guided through fun activities that are subtly designed to constantly challenge the child to foster appropriate responses to sensation, successfully enabling the child to behave in a more functional manner. When parents, caregivers, teachers, and others who interact with the child are included in understanding the child’s challenges and methods of helping him in therapeutic activities, the child can be aided in taking part in normal activities of childhood.9
Most experts endorse occupational therapy as a good course of action; however, with little scientific evidence to prove its effectiveness, others caution that families may be taken advantage of by false promises of cures. Without a medical diagnosis, insurance companies often do not pay for treatment for SPD, and long-term therapy can become expensive.10
For a child with SPD, the typical playground is a chaotic and noisy place. Children who are prone to over-stimulation are often misunderstood or considered disruptive. Playground equipment manufacturers are designing more inclusive environments that offer a diverse range of activities for physical, sensory, and social play. Sensory activities that provide tactile, visual, and auditory stimulation as well as cozy, quiet spaces can create an environment that meets the diverse needs of children with SPD. A successful inclusive playground will encourage engagement between children of different abilities and will be welcoming to all.11
- 1. “About SPD.” Sensory Processing Disorder Foundation.<spdfoundation.net/index.php/about-sensory- processing-disorder/ > 31 May 2016.
- 2. “Welcome To The Sensory Processing Disorder (SPD) Resource Center.” Sensory Processing Disorder. <www.sensory-processing- disorder.com> 31 May 2016.
- 3. “Sensory Integration Dysfunction Symptoms: What You Must Know!” Sensory Processing Disorder. < www.sensory-processing- disorder.com/sensory-integration- dysfunction-symptoms.html > 31 May 2016.
- 4. Op. cit., “About SPD.”
- 5. Op. cit., “Sensory Integration Dysfunction Symptoms: What You Must Know!”
- 6. Jarvie, Jenny. “Is ‘Sensory Processing Disorder’ a Real Medical Condition?” New Republic. 24 June 2014. < https://newrepublic.com/article/118319/sensory-processing- disorders-myriad- symptoms-create- controversy> 31 May 2016.
- 7. Wallis, Claudia. “The Next Attention Deficit Disorder?” Time. 29 Nov. 2007. < http://www.time.com/time/magazine/article/0,9171,1689216,00.html > 31 May 2016.
- 8. Op. cit., Jarvie.
- 9. Op. cit., “About SPD.”
- 10. Levingston, Suzanne Allard. “The debate over sensory processing disorder: Are some kids really ‘out of sync’?” The Washington Post. 12 May, 2014. < https://www.washingtonpost.com/national/health- science/the-debate- over-sensory- processing-disorder- are-some- kids-really- out-of- sync/2014/05/12/fca2d338-d521- 11e3-8a78- 8fe50322a72c_story.html > 31 May 2016.
- 11. “Inclusion: Our Philosophy.” Playworld. < http://playworld.com/why_playworld/inclusive_play > 31 May 2016.