Understanding Sensory Processing Disorders

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Understanding Sensory Processing Disorders

• Developed by
• Connie Ortman, OTR
• Presented by
• Kim Denny-Newkirk, OTR
• Outreach Services of Indiana
• http//www.in.gov/fssa/disability/services/seoutre
  ach/index.html

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Course Objectives

• Understand that all people process information
  differently and have individual preferences
• Recognize symptoms of sensory processing
  disorders
• Identify where to go to for evaluation and
  treatment
• Be informed about the types of services available
  and strategies to help individuals with sensory
  processing disorders.

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How does this apply to me?

• If you know the behavior has a sensory basis, you
  are less likely to take it personally and more
  likely to be empathetic.
• If you understand the underlying problem it may
  help to identify solutions and take action.
• Everyones nervous system is plastic, it can be
  changed throughout their lifetime, both
  positively and negatively.

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What is Sensory Processing?

• Definition Sensory processing is the method the
  nervous system uses to recognize, organize and
  make sense of incoming sensory input. It includes
  both information coming from the external
  environment and input from the body in order to
  create an adaptive response.

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Neurology 101
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External Senses

• Hearing (Auditory)
• Vision (Ocular)
• Smell (Olfactory)
• Touch (Tactile)
• Taste (Gustatory)

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Internal Sensations

• Vestibular System detects movement
• Tells us we are moving, surrounded by something
  that is moving or on something moving
• Receptors located in inner ear
• Tells up from down
• Influences concept of outside space

• Proprioceptive System body awareness
• Tells us where the body parts are without having
  to look at them
• Receptors are located in muscles, tendons, and
  ligament around joints
• Provides sense of the contents of the body

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What is Sensory Processing?

• Definition Sensory processing is the method the
  nervous system uses to recognize, organize and
  make sense of incoming sensory input. It includes
  both information coming from the external
  environment and input from the body in order to
  create an adaptive response.

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An adaptive response ..

• is an appropriate action taken from the synthesis
  of incoming sensory information received through
  the central nervous system.
• can be conscious or unconscious but it is not a
  reflex.
• is a result of adequate sensory integration and
  assists in improving sensory integration.

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Conscious vs. Unconscious Sensory Processing
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Normal sensory processing includes

• Receiving input from the sensory receptors.
• Relaying information to the brain.
• Identifying what information is important.
• Blocking information that is not important.
• Comparing information with past experience or
  other types of sensory experience to form a plan
  of action if needed.
• Developing a plan
• Sending the message to the parts of the body
  needed to execute the plan.
• Carrying out movements as planned. (adaptive
  response).

Dysfunction can occur at any stage of the
process.
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Normal Sensory Processing
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Sometimes an individuals brain does not process
the incoming information from the senses (vision,
hearing, taste, smell, touch or movement)
normally.

• These individuals are said to have a Sensory
  Processing Disorder (SPD) or in some literature
  Sensory Integrative Dysfunction (SID).

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SPD are caused by

• Problems getting the impulse to the brain
• Problem within the brain stem (filter)
• Communication between centers of the brain

• For more information go tohttp//www.sinetwork.or
  g/aboutspd/whatisspd.html

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Types of Sensory Processing Disorders
How do they respond to each type of sensory
input? Can they maintain an appropriate level of
awareness to meet environmental demands? Can they
use their body effectively?
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Do they respond normally to sensory input?

• Symptoms of hypersentivity, defensiveness
  or sensory avoiding
• Has a narrow or limited interests
• Fear of movement and heights, or get sick from
  exposure to movement or heights
• Be very cautious and unwilling to take risks or
  try new things
• Respond to being touched with aggression or
  withdrawal
• Responds negatively to certain sounds
• Be very picky eaters and/or overly sensitive to
  food smells
• Will only wear certain kinds of clothes,
  sensitive to tags.

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What are they thinking about?
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Can they maintain an appropriate level of
awareness to meet environmental demands?
(Regulation or Modulation)
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Normal Regulation/Modulation
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"Everyone has some sensory integration problems
now and then, because no one is well regulated
all the time. All kinds of stimuli can
temporarily disrupt normal functioning of the
brain, either by overloading it with, or by
depriving it of, sensory stimulation."

• Carol Stock Kranowitz "The Out-Of-Sync Child"
  (1995) from http//www.sensory-processing-disorde
  r.com/sensory-processing-disorder-checklist.html

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Normal Development of Self Regulation
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Impaired Regulation/Modulation
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Symptoms of poor modulation/ regulation

• Difficulty tolerating or adjusting to even minor
  changes in routine
• Disregard or impaired ability to interact with
  others
• Disrupted sleep and wake cycles
• Attention problems either easily distracted, or
  fixated on one activity with difficulty shifting
  focus
• Feel uncomfortable in busy environments, such as
  sports events, malls

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What are they thinking about?
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Can they use their body effectively?Good
Integration of Power Sensations (internal
sensations) is essential for later growth and
development
Body Aware-ness
Move-ment
Touch
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Hyposensitivity (under registration)

• Handles people or objects roughly
• Under-awareness of touch or pain, or touching
  others too often or too hard (which may seem like
  aggressive behavior)
• Taking part in unsafe activities, such as
  climbing too high
• Fatigues easily and appears unmotivated

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The senses are the building blocks for future
learning.

Thinking
Hearing
Vision
Body Awareness
Move-ment
Touch
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Poor Integration or discrimination

• Has difficulty with fine motor tasks such as
  handwriting, cutting, tooth brushing, clothing
  fasteners, or assembly tasks
• Trouble maintaining balance or coordinating
  movements for activities such as kicking,
  throwing, dressing, in/out of showers or tubs,
  negotiating stairs

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For more detailed symptom checklists go to

• http//www.kidfoundation.org/spdchecklist/
• or
• http//www.sensory-processing-disorder.com/sensory
  -processing-disorder-checklist.html

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Checklists can be helpful, but ....

• Ask yourself
• How much does this interfere with the quality of
  life or ability to function?

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Sensory processing dysfunction can be classified
as MILD

• Individual can generally hold it all together
  while at work or school but tend to loose it when
  they get home or when under stress
• They are generally unhappy, feel different but
  are unable to pin point why.
• May tend to be compulsive and maintain strict
  routines
• May appear to be tightly wound
• Have a narrow range of interests/activities

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Sensory processing dysfunction can be classified
as MODERATE

• Usually affects all settings of life home,
  school, work, and leisure.
• The person may avoid situations or sensory input
  that is aversive.
• Not only is the individuals life affected but it
  also negatively affects those around them.

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Sensory processing dysfunction can be classified
as SEVERE

• This person needs the help of others to
  participate or complete basic self-care needs
• They are obviously uncomfortable for a
  significant portion of the day
• They may engage in stereotypic, aggressive or
  self injurious behavior.

for more examples of what it feels like to have
a SPD go to http//www.sensory-processing-disorde
r.com/sensory-processing-disorders.html
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What can you do?

• Report your concerns and the symptoms you observe
  to your personal care physician or case manager.
• Obtain a referral for an occupational therapy
  evaluation from a practitioner who has experience
  evaluating sensory processing disorders.

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Diagnostic Manual for the Interdisciplinary
Council on Developmental and Learning Disorders
(ICDL) "Regulatory Sensory Processing Disorder"
(code 200)

• www.icdl.com

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Sensory Processing Evaluation should include

• Interview of individual if possible, parents
  and/or caregivers.
• Observation of individual, if possible in natural
  setting.
• Informal or standardized testing of the
  individuals response to a variety of sensory
  input.

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Be informed

• Review evaluation results and ask questions of
  therapist if you do not understand information
  presented.
• If sensory processing problems are identified and
  treatment is recommendedask what things will
  they be doing, will you be able to observe
  therapy.
• Request suggestions that can be done at home to
  support therapy such as a sensory diet.
• Share information with other care providers and
  across settings ie. home, school, or workshop

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What is Sensory Integration Therapy?

• Active Participation
• Just Right Challenge
• Adaptive Response
• Self Directed

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Goals and Outcomes of Sensory Integration Therapy

• Improve attention to task, participation and
  learning
• Increase independence in self care tasks
• Decrease fear and anxiety
• Improve communication
• Improve ability to adapt to change/flexibility
• Increase socialization
• Increase self confidence
• Improve ability to explore choices in their
  environment, community integration

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Consultation Services

• Strategies
• Sensory Diet
• Home Program

Discuss methods to review or monitor results
of sensory diets or home program
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Sensory Diet vs. Sensory Stimulation

• For more information or examples of a sensory
  diet you can go to
• http//www.sensorysmarts.com/diet.html
• http//www.sensorysmarts.com/diet.htmlSample

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Resource for Sensory Equipment

• http//www.southpawenterprises.com
• http//www.flaghouse.com
• www.abilitations.com
• www.sensorycomfort.com

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Ideas for modifying environment

• If easily overwhelmed by change, reduce stress by
  setting up structured daily routines.
• Involve speech therapy to help improve
  communication strategies.
• Provide a calming space when over stimulated.
• Establish realistic expectations and adhere to
  consistent guidelines for intervention.
  (Behavioral clinician, case manager, social
  worker or psychologist are good recourses).

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How to modify environment for Hypersensitivity

• Increasing your awareness of environmental
  stimuli which may cause distress i.e. toilet
  flushing, vacuum cleaner, dishwasher, fans,
  bright sunlight, fluorescent lighting.
• Reduce the frequency or intensity of problematic
  stimuli.
• Work to develop trust by only providing
  interaction/input as tolerated.

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Where can I go to learn more?

• American Occupational Therapy Association
• Sensory Integration International
• Websites, associations or support groups for
  Autism or Pervasive Development Disorders
• Fact sheet for this presentation

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Alternate Views

• SPD often coexist with other conditions. It is
  possible for SPD to be misdiagnosed. Precautions
  should be taken so that any other conditions will
  not be overlooked.
• Remember you can not separate mind and body. The
  effects of stress on the body of a normal nervous
  system can present similar symptoms of SPD.
• Sensory Integrative Therapy often works better in
  combination with other supports such as speech
  and behavioral approaches.
• Although sensory integration research has been
  published in peer-reviewed (mostly occupational
  therapy) journals, most are case studies or have
  a small sample size. Other professionals have
  questioned the research design and
  conclusions/results of these studies. Clearly
  more research is needed.