Sensory Processing Disorder

Sensory processing disorder occurs when a child experiences difficulty processing information from the five senses: vision, auditory, touch, taste, and smell.  In addition, Sensory Processing Disorder can cause problems with a child's sense of movement and/or the positional sense, called proprioception. The child can sense the information normally, (for example, he or she can hear), but the information is processed differently in the brain. This can result in distress or confusion.  This condition can exist alone or it can exist with other neurological conditions, such as autism, attention deficit disorders, dyslexia, dyspraxia, Tourette's syndrome, multiple sclerosis, and others.

A child with sensory processing disorder will benefit from a “sensory diet” (coined by OT Patricia Wilbarger) which is a carefully designed, personalized activity plan that provides the sensory input a person needs to stay focused and organized throughout the day. Just as you may jiggle your knee or chew gum to stay awake or soak in a hot tub to unwind, children need to engage in stabilizing, focusing activities too. Infants, young children, teens, and adults with mild to severe sensory issues can all benefit from a personalized sensory diet. (Biel & Peske)

Each child has a unique set of sensory needs. Generally, a child whose nervous system is on “high trigger/too wired” needs more calming input, while the child who is more “sluggish/too tired” needs more arousing input. A qualified occupational therapist can use her advanced training and evaluation skills to develop a good sensory diet for your child, but it’s up to you and your child to implement it throughout the course of the day. (Biel & Peske)

It is helpful to understand the different sensory systems when designing and implementing a sensory diet.  We are all familiar with the senses that involve taste, sight, smell and sound, but our sensory system is constantly processing information that allows us to be organized and understand where our body is in space.

Tactile – the sense of touch centered in the skin allows us to detect light touch, deep pressure, texture, temperature, vibration, and pain.
 
Vestibular  - the sense of movement centered in the inner ear is essential for being able to orient one’s body in space.  It automatically coordinates the movements of the eyes, head and body.
 
Proprioception – sense of body position comes from the muscles and joints.  It allows the individual to automatically adjust body position to carry out and action.

Sensory integration therapy is fun!  You can have fun coming up with ideas for playing with your child using sensory input, or purchasing unique toys and products anyone would love!  You are only limited by your creativity.  There are thousands of ideas for sensory activities so it is impossible to list them all.  Below is a list of sensory products that can be used in the home. This list can serve as a starting point for working with your occupational therapist in developing a sensory diet that works for both you and your child.  All of these items can be purchased though a therapy magazine, in a toy store or online.  In addition I have tried to provide suggestions for household items that can be used in place of these products.

Weighted vests or pressure vests provide deep pressure providing the child with unconscious information from the muscles and the joints, the added weight or pressure may help the child calm down and better integrate sensory information. As a result, the child may become more organized, and improve in their ability to concentrate.  For alternatives to this proprioceptive input families can try a small backpack with some books inside or a tight spandex swim suit.

A weighted blanket can help a child to sleep during naps and at night by providing sustained deep pressure which has a calming effect.  Parents can also try a heavy blanket like a quilt that they already own.

Swings for indoors can be purchased though a company that produces sensory equipment.  They can be hung from a joist in the ceiling or a frame for the swing can be purchased.  However, this is not always practical due to the cost and space limitations.  An alternate for the home is to simply use a blanket as a swing.  Swings provide vestibular sensory input which is alerting when the swinging is irregular and intense.  Swinging can also provide a calming input when it is rhythmical.

An exercise ball is a versatile piece of sensory equipment. A large ball can be used for proprioceptive (heavy work) sensory play by pushing the ball against resistance.  You can also use the ball for vestibular sensory input by bouncing and  rocking the child on the ball.

A trampoline is a fun toy that all kids enjoy which provide great proprioceptive and vestibular sensory input.  However trampolines can be costly and take up space so you can also use a bed or couch cushions.

A tunnel can encourage a child to change his or her body position in space and do heavy work while crawling through the tunnel.  Having a child on the floor imitating a variety of crawls (bear crawl, wheel barrow walk, crab crawl, cargo crawl) is a fun sensory activity.  If you don't have a tunnel have the child crawl behind the couch or you can set up an obstacle coarse using couch cushions blanket tents and pillows.

A scooter board can be used to spin a child for vestibular sensory input.  You can also have the child push him/herself across the floor on the scooter combining heavy work and vestibular input.

A Sit and Spin can also be used to spin the child and if the child can spin him/herself you are also getting good proprioceptive input.

A wall ladder uses suction cups to adhere to the wall and is a life saver during the winter months for kids who love to climb.

A laundry basket can be used for a variety of sensory activities.  For example you can fill the basket with heavy items and have the child push or pull it as a heavy work activity.  Be creative when thinking of other heavy work sensory activities that you can incorporate into your daily routine, for example pushing a chair in, carrying groceries, stacking toy bins, etc.   Other ideas for activities with the laundry basket include spinning in the basket and having kids push each other across the room in the basket.

Big pillows or a bean bag chair provide the child with the opportunity to “crash” into the pillow pile which provides lots of proprioceptive input.  This activity is particularly effective for children who demonstrate aggressive or self injurious behaviors.

Vibrating Toys can be alerting or calming depending on the individual.  For many individuals a vibrating toy can awaken them and provide a more engaged response. For others, relaxing on a vibrating surface can calm and soothe them.

Tent – a tent can make a great calming place for a child when he/she gets over stimulated.  Inside can be a CD player with calming music, pillows, fidget toys, books or bubbles.  You can also just pull a piece of furniture away from the wall and create a quiet corner.

There are lots of tactile play activities you can do at home.  Here are just a few:  foam soap, finger paint, play-doh and sand.  You can make a dry rice or pasta bin and place toys inside as a tactile play activity.  For some kids with sensory defensiveness these activities can be very aversive.  My advice is to start with dry play like sand or rice and then move onto more wet or sticky play.  Let the child move at his/her own pace which may start by just watching you play.  Once a child learns to enjoy these activities they can be very calming and centering.  In my treatment I often end a session with a calming tactile play activity after a child has had lots of vestibular and proprioceptive sensory input.  Since many children will engage for a longer time in tactile play, I will often recommend that parents incorporate learning games into these activities.

Blowing activities which can include blowing whistles, blowing bubbles and blowing cotton balls across the table through a straw are also great calming activities to use after a lot of movement play.

Reference:  Lindsey Biel, OTR/L and Nancy Peske, www.sensorysmarts.com

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