How many times, in your classes, have you had a child who constantly melted down for “no apparent reason”? We’ve all had those students who had behavior problems nearly every day in the lunchroom, or in art, or PE.
According to A NeuroImage: Clinical study published in 2014, up to sixteen percent of school-age children have one form or other of sensory processing difficulties. While Sensory Processing Disorder is not yet considered a diagnosis under the standards of the Diagnostic and Statistical Manual of mental disorders, it is real, and it affects students in your classroom every day. Given the high percentage noted above, you are likely to have 4-5 students with a sensory processing disorder.
What are Sensory Processing Disorders?
Below, you will find a list of types and semi-clinical descriptions of what these various disorders look like. In looking at this list, do you see any of your students?
Sensory Modulation Disorder – Difficulty regulating responses to sensory stimuli
- Sensory Over-Responsive – Predisposition to respond too much, too soon, or for too long to sensory stimuli most people find quite tolerable
- Sensory Under-Responsive- Predisposition to be unaware of sensory stimuli, to have a delay before responding, responses are muted or responds with less intensity compared to the average person
- Sensory Craving- Driven to obtain sensory stimulation, but getting the stimulation results in disorganization and does not satisfy the drive for more
Sensory-Based Motor Disorder – Difficulty with balance, motor coordination, and the performance of skilled, non-habitual and/or habitual motor tasks
- Postural Disorder- Impaired perception of position of body position; poorly developed movement patterns that depend on core stability. Thus, appears weak and/or has poor endurance
- Dyspraxia- Difficulty thinking of, planning and/or executing skilled movements especially novel movement patterns
Sensory Discrimination Disorder– Difficulty interpreting subtle qualities of objects, places, people or other environments
- Auditory DD- Difficulty interpreting characteristics of sensory stimuli that is heard; (may be called Auditory Discrimination Disorder
- Visual DD – Difficulty determining/interpreting characteristics of sensory stimuli that is seen
- Tactile DD- Difficulty determining/interpreting characteristics of sensory stimuli that is felt on the skin or interpreting higher level visual/spatial characteristics of touch (includes stereognosis and graphesthesia disorders
- Vestibular DD- Difficulty interpreting characteristics of sensory stimuli, experienced through movement of the body through space or against gravity
- Proprioceptive DD- Difficulty determining/interpreting characteristics of sensory stimuli experienced through use of the muscles and joints
- Gustatory DD- Difficulty determining/interpreting characteristics of sensory stimuli that is tasted
- Olfactory DD- Difficulty determining/interpreting characteristics of sensory stimuli that is smelled
- Interoception- Difficulty interpreting stimulation from internal organs (may not feel need to use the toilet or may have frequent somatic complaints such as stomach aches)
Pattern 1: Sensory Modulation Disorder
- Sensory Over-Responsivity
- Individuals with sensory over-responsivity are more sensitive to sensory stimulation than most people. Their bodies feel sensation too easily or too intensely. They might feel as if they are being constantly bombarded with information. Consequently, these people often have a “fight or flight” response to sensation, e.g. being touched unexpectedly or loud noise, a condition sometimes called “sensory defensiveness.” They may try to avoid or minimize sensations, e.g. withdraw from being touched or cover their ears to avoid loud sounds.
- Sensory Under-Responsivity
- Individuals who are under-responsive to sensory stimuli are often quiet and passive, disregarding or not responding to stimuli of the usual intensity available in their sensory environment. They may appear withdrawn, difficult to engage and or self-absorbed because they do not detect the sensory input in their environment. Their under-responsivity to tactile and deep pressure input may lead to poor body awareness, clumsiness or movements that are not graded appropriately. These children may not perceive objects that are too hot or cold or they may not notice pain in response to bumps, falls, cuts, or scrapes.?
- Sensory Craving
- Individuals with this pattern actively seek or crave sensory stimulation and seem to have an almost insatiable desire for sensory input. They tend to be constantly moving, crashing, bumping, and/or jumping. They may “need” to touch everything and be overly affectionate, not understanding what is “their space” vs. “other’s space.” Sensory seekers are often thought to have Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD). ?A key factor with Sensory Craving is that when the individual receives more input it does not regulate him/her; in fact, those with true craving disorders become disorganized with additional stimulation.
Pattern 2: Sensory-Based Motor Disorder
- Postural Disorder
- An individual with postural disorder has difficulty stabilizing his/her body during movement or at rest in order to meet the demands of the environment or of a motor task. When postural control is good, the person can reach, push, pull, etc. and has good resistance against force. Individuals with poor postural control often do not have the body control to maintain a good standing or sitting position.?
- Dyspraxia/Motor Planning Problems
- Individuals with Dyspraxia have trouble processing sensory information properly, resulting in problems planning and carrying out new motor actions. They may have difficulty in forming a goal or idea, planning a sequence of actions or performing new motor tasks. These individuals are clumsy, awkward, and accident-prone. They may break toys, have poor skill in ball activities or other sports, or have trouble with fine motor activities. They may prefer sedentary activities or try to hide their motor planning problem with verbalization or with fantasy play.?
Pattern 3: Sensory Discrimination Disorder
- Sensory discrimination refers to the process whereby specific qualities of sensory stimuli are perceived and meaning attributed to them. Discriminate means understanding accurately what is seen, heard, felt, tasted, or smelled. Individuals with SDD difficulties have problems determining the characteristics of sensory stimuli. The result is a poor ability to interpret or give meaning to the specific qualities of stimuli or difficulty detecting similarities and differences among stimuli. (Do I see a “P” or a “Q”? Do I hear “cat” or “cap”? Do I feel a quarter or a dime in my pocket? Am I falling to the side or backwards?). Individuals with poor sensory discrimination may appear awkward in both gross and fine motor abilities and/or inattentive to people and objects in their environment. They may take extra time to process the important aspects of sensory stimuli.
Let’s take a look at a day in the life of a student with Sensory Processing Disorder (Please note, the student in this vignette appears to have all of the processing disorders- most students will have 1 or 2 at most)
Some ways you can help
- Talk to the parents about stress-free clothing (clothing without tags, heavy seams, etc) or clothing such as “hug shirts” and laceless shoes
- Offer hearing protection in loud environments
- Ensure the lights in your room are not flickering or buzzing
- Provide a sensory kit- chewy pencil toppers, stress ball, a nail brush to provide additional input…
- Provide students with a signal they can give you if they are feeling over- or under-whelmed and need a sensory break
- Give things a test-drive. With the exception of chewies, all sensory objects can be changed out for something different (throw that chewy away, though, if it’s not of use- I’ll get more!)
- Provide consistent routines, and warn students of changes, when possible
- Ask special education about possible accommodations or additional tools, or for a functional behavior assessment if you are unsure what is setting the student off (for example a student who consistently refuses to write, but will scribble on a white board may have oversensitivity to the sound or feel of pencil on paper!)