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Sensory Processing

Sensory processing refers to the way a person sorts, interprets and responds to sensation from their body, environment and the world around them. The sensations or sensory information comes from the seven senses of touch, taste, sight, sound, smell, movement and body position.

Processing occurs in the brain and nervous system (Central Nervous System). When the brain is processing sensations accurately, the person gets a clear perception of the world and is able to make an appropriate response; for example, the goose bumps on my skin tell me it’s cold outside so I better wear a jumper or someone is talking to me, I will concentrate on what they are saying, on their facial expression and body language. The brain automatically tunes out other unimportant sensations to make concentrating possible.

“How do you know anything about your world? … the answer is: through your senses. In fact, without your senses of vision, hearing, touch, taste and smell, your brain, the organ that is responsible for your conscience experience, would be an internal prisoner in the solitary confinement of your skull.

Your world is what your senses tell you it is.

The limitations of your senses set the boundaries of your conscious existence.” Coren, S., Porac, C., & Ward.l. (1984) Sensation and Perception. Academic Press, Inc. Orlando, Florida.

Sensory processing has a huge impact on a person’s life. Life can be very difficult for the person with sensory processing difficulties.

A general overview of sensory processing

Sensory processing can be viewed as the foundation to a person’s development.

In order for a child to learn about their body and their world, they must first process sensory information accurately.

The brain processes and integrates sensation which helps them form a strong foundation on which to build other higher level skills; for example, reading/writing.

Some children experience difficulty with their sensory processing.

One type of sensory processing difficulty or dysfunction a child can have is a sensory modulation difficulty. Modulation is a process involving ‘tuning in’ to what is relevant in a situation (e.g. mum talking) and tuning out what is irrelevant (e.g. the noise of the air conditioner in the background).

When a child has a modulation difficulty they find it challenging to ‘strike a balance’ with this tuning in/out process so they tend to over or under respond to their world. In other words, their responses are too big or too small and don’t seem to quite ‘fit’ the situation.

An example of a response that is too big would be a child screaming and being very distressed whenever dad mows the lawn. An example of a response that is too small would be preschooler not noticing lots of their toys on the ground and walking over rather than around them.

In general, modulation difficulties impact a child’s ability to have a ‘just right’ level of alertness so they may appear overly ‘busy’, hyper or overly lethargic. Some children fluctuate greatly between being really ‘up’ and really ‘down’ with their activity level. This can all impact on how distractible a child is. Children with modulation difficulties can have very emotional reactions to situations; for example, crying in response to being overwhelmed by sights, sounds and smells at the shopping centre.

Modulation difficulties can impact a child’s behaviour; for example, excessive tantrums or aggression in seemingly ‘unprovoked’ situations. Modulation difficulties can have a significant impact on a child’s ability to interact with others, play and participate in self care activities; for example, distress during hair washing.

One of the ways an Occupational Therapist can assess and measure how well the brain is processing sensory information is through the Sensory Profile by Winnie Dunn.

The Sensory Profile is a questionnaire that assists in gathering information about how a child processes the seven senses of touch, taste, sight, sound, smell, body position and movement. It helps to identify a child’s individual sensory personality (sensory profile) which is related to their pattern of responding.

Each person has a specific sensory personality or pattern for each of their seven senses. They also have a general/overall sensory personality.

The patterns of responding (sensory personalities) can be divided into four basic types.

Low registration

A child with this type of sensory personality often under responds to their environment and can appear not to notice things. Words that people may use to describe children with this sensory personality might include disinterested, dull/flat effect, withdrawn, ‘overly tired’, apathetic, self absorbed or ‘away with the fairies’ – a bit like Eeyore from Winnie the Pooh stories.

Sensory seeker (craves and seeks out more and more sensory experiences)

A child with this type of sensory personality tries to notice and does notice most things in their environment. They really like to ‘get into things’. They try to ‘add on extra value’ to life. Words that people may use to describe children with this sensory personality might include hyperactive, fidgety, excitable and continuously engaging. This person is a bit like Tigger from Winnie the Pooh!

Sensory Sensitive

A child with this type of sensory personality tends to notice ‘too much’ and is often disturbed by sensations. Words that people may use to describe children with this sensory personality might include over sensitive, distractible, hyperactive, ‘complainer/whinger’, vigilant, rule bound, reliant on rituals, controlling, highly emotional and distressed. Some children may avoid people and situations which really bother them all together. The Rabbit character from Winnie the Pooh is a lot like this.
The Winne the Pooh character is what we all strive to be like for most of the day. Calm, attentive, a little excited when appropriate but not overly excited, able to calm down, regulate and control his own behaviour. This is a good state for playing, interacting, learning and doing the ‘every day’ things that need to be done.

Sometimes children need ‘extra’ help to get into and stay in this state.
An Occupational Therapist who specialises in sensory integration can investigate how to support a child to be calm yet alert throughout the day.

These sensory personalities help to describe outward behaviours that reflect internal brain processing, imbalances in stress and happy hormones and arousal/alertness states. So when children display the sorts of ‘behaviours’ listed above it could be because they have sensory processing (modulation) difficulties.

When observing our children’s behaviour it is always important to ask ‘Could it be sensory?’

Sensory processing and sensory modulation are complex processes. The information provided here is really just the ‘tip of the iceberg’. We encourage people to learn more if they feel it is relevant for their child. Learning Links runs workshops on sensory processing and our staff would be happy to help, particularly our occupational therapists.

A general tip to help the brain with sensory processing is to fill your day with physical exercise, heavy body work that involves deep pressure, pushing, pulling, lifting, moving, singing, dancing, chewing, crunching and other feel good sensations!

Bibliography

Parent Resources

Sensational Kids: Hope and Help for Children with Sensory Processing Disorder by Lucy Jane Miller and Doris A. Fuller. Publisher: Perigee Trade.
The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder, Revised Edition by Carol Stock Kranowitz. Publisher: Perigee Trade.
The Out-of-Sync Child Has Fun, Revised Edition: Activities for Kids with Sensory Processing Disorder by Carol Stock Kranowitz. Publisher: Perigee Trade.
Is It Sensory or Is It Behaviour? Behaviour Problem Identification, Assessment, and Intervention by Carolyn Murray-Slutsky. Publisher: Psychological Corp.
Starting Sensory Integration Therapy: Fun Activities That Won’t Destroy Your Home or Classroom by Bonnie Arnwine. Publisher: Future Horizons.
Learning Through the Senses Resource Manual Northern Territory Department of Health and Community Services, 2006.
Building Bridges through Sensory Integration, Second Edition (Spiral-bound) by Ellen Yack, Shirley Sutton, Paula Aquilla. Publisher: Sensory Resources.

Professional Resources

Sensory Integration: Theory and Practice (Hardcover) by Anita C. Bundy, Shelly J. Lane, Anne G. Fisher, Elizabeth A. Murray. Publisher: F. A. Davis Company.
Exploring the Spectrum of Autism and Pervasive Developmental Disorders: Intervention Strategies by Carolyn Murray-Slutsky, Betty A. Paris (Author). Publisher.

Therapy Skill Builders

Understanding the Nature of Sensory Integration with Diverse Populations: Susanne Smith Roley, Erna I. Blanche, and Roseann C. Schaaf. Publisher: Pro-Ed.
Pathways to play! Combining sensory integration and Integrated Play Groups. G. Fuge , & R. Berry, Publisher: Autism Asperger Publishing Company.

TREATMENT FOR SENSORY DEFENSIVENESS
(SENSORY MODULATION DIFFICULTIES)

The Wilbarger Protocol was designed by Patricia Wilbarger, an Occupational Therapist who specialises in sensory defensiveness (sensory modulation difficulties). It is an intensive treatment program designed to reduce sensory defensiveness and over sensitivity. The specific elements of this program have been researched and put into practice. Many therapists and families have found this to be a very effective treatment for sensory defensiveness.

The program involves two parts which are carried out together: the therapressure component and a sensory diet.

Therapressure Program

This consists of:

brushing with deep, heavy pressure over the body immediately with a special brush followed by
compressions to the joints of the body (joint compressions).

Brushing and joint compressions are carried out every 1 ½-2 hours for 2-3 weeks (only when the child is awake).

Sensory diet

This involves a ‘diet’ of sensation (sensory activities which are carried out several times a day) which specifically suits the child’s sensory personality.

Examples of sensory activities which may be included in a sensory diet might be jumping on the trampoline and heavy lifting because these can be calming and grounding for some children. A sensory diet is more of a life-style thing (like a diet) and children benefit from being on a sensory diet long-term.

This treatment delivers a calming, regulating force to the brain that stimulates the brain to release endorphins and positive, natural chemicals (present in the typically developing brain) in a way that is not invasive or harmful. This is then thought to reduce the child’s sensitivities, supporting them to feel more comfortable and at ease in their bodies and with their world.

(Adapted from: Wilbarger P.& J. (2001) Sensory Defensiveness: a comprehensive treatment approach.)

Occupational Therapists trained in administering the Wilbarger Protocol report significant changes in children, adolescents and adults with sensory defensiveness.

For example, some children are sensitive to touch because their brain is not modulating sensation correctly and is taking in too much sensory information which is overwhelming for the child. The child may avoid hair washing, brushing and cutting, teeth brushing, finger and toe nail cutting, physical affection or even wearing certain clothes.

Following treatment with the Wilbarger Protocol of deep pressure brushing, joint compressions and a sensory diet routine, these children experience improvements, to varying degrees in the processing of touch.

One three year old boy who is a client of Learning Links was able to ‘enjoy’ a haircut at a hairdresser for the first time in his life following the treatment.
Several children were able to tolerate teeth brushing and nail cutting and begin to enjoy a more varied diet of different textures and tastes due to reduction in sensitivities.

Many children begin to enjoy physical affection and don’t shy away from touch or being in crowded places.

Following the treatment, many children are able to regulate their levels of arousal in order to control their own behavioural responses. They are better able to sit still and concentrate and therefore in a more ready state to learn.

The same impact can be made on the brain’s ability to process other sensations of sight, smell, sound, taste, movement and body position with this treatment.

Deep pressure input is a powerful healing force. You only need to experience the joy of a big hug to know how powerful deep pressure can be!

ADULT FEEDBACK

We wanted to include some feedback from an adult (Lauren) who participated in the Wilbarger program. We felt she could ‘put into words’ what we often see happens for the children who participate in the program.

Lauren* is a 25 year old woman who works as a receptionist. After much discussion and history taking with Lauren, we identified she displayed many symptoms of sensory defensiveness as a child and as an adult. Here is some feedback from Lauren about her experiences with the program.

“Why I started…

I have always had a problem with light touch, such as fingertips brushing lightly over my skin or handshakes that aren’t firm enough. My husband had to get used to the fact that he could only “bear hug” me because light touch would make me jumpy and uncomfortable.

When talking with the OT, I realised that the idea of tactile sensitivity completely fit. I have a high pain tolerance, don’t feel the cold, and now believe that my fear of cockroaches is based in the fear of light touch e.g. a cockroach crawling on my skin.

I’m also a rather anxious person, so I didn’t think the program could hurt at all and hopefully it would help!

The results…

Even before I fully got into routine, I started to feel the benefits. The brushing is like a quick massage break. It made me feel calm and fresh, almost a euphoric feeling at times. The immediate benefits would last about 15mins and then I would be looking forward to the next brush!

I’m what I’d call a food addict. I constantly think about my next meal. The brushing seemed to cool my appetite and I found I would forget about meals until hours later. Not good for everyone, but harmless (even beneficial) for me.

I started to feel a lot more grounded. I discovered that this resistive work was really good for my focus, concentration and enthusiasm for tedious jobs. I found I could concentrate on things like data entry for hours. Not typical of my generally distracted mind.

My sleep improved. I was more relaxed and my thoughts didn’t race as much when I tried to fall asleep. This may be a contributor to why I soon found I was handling stress and anxiety better, such as an in-law’s dinner party. A notorious finger and lip biter (probably due to anxiety), I also saw huge improvements in this.

My favourite part of the improvements involves the cockroach fear. I have always had an irrational fear of the little creatures and could never quite put my finger on why. As the brushing started desensitising me to light touch, I couldn’t believe how much this fear improved. I am still afraid of cockroaches. But I have gone from a screaming mess that clambers over people and furniture to get away from one, to increasing my squish count from around zero to three; amazing to me (and anyone who has witnessed my phobia).

I would recommend a program of brushing to anyone who has even an inkling they may be tactile sensitive and would encourage an open mind to Occupational Therapy. I have now weened off my program and only brush for fun and stress relief and I am still enjoying the improvements. With a history of problematic mental health, I have also found the program more beneficial than any other anxiety-related treatment I’ve participated in so far. Thanks a million!”

We wanted to note that the therabrushing may not work for every child or adult but it may work for some.

by Natasha Sansoni and Emma Mason, Occupational Therapists, Early Childhood Services, Learning Links

*Name changed for confidentiality.