Does my child have a Sensory Processing Disorder?

Following the series of articles dedicated to the Family Behavior Tips We come to the first trigger. Many children with communication disorders also present Sensory Integration Disorders (SPD). What does this mean? That They don't respond to the world the way most people do. Some may register few stimuli or require many to activate. Others will present hypersensitivity to the slightest variation in these stimuli. This may occur in one or more modalities. sensory touch, smell, hearing and everything related to the body Proprioceptive kinesthetic and vestibular. We'll discuss each of these modalities separately later due to their importance. We'll provide a general overview for now, before going into more detail later. 

That is also why we are surprised that families are surprised by completely unexpected reactions toto music, to a caress, to dressing them, to some foods, to grooming them… Some moments end up being pitched battles, with screams, tantrums and crying, with the respective anguish of the child and the frustration of his parents And this is where the cause lies in everything related to these processes of sensory integration.

Sensory Processing Disorder (SPD) in autism impacts individuals in a variety of ways. Knowing how to identify the signs of SPD will help us prepare better interventions, reduce stereotyping and problematic behaviors, and improve the quality of life for the individual and everyone around them.

Very often, this SPD is the cause of learning, behavioral, and motor coordination problems in children. It can affect social relationships, the development of play patterns, caring skills, personal autonomy, and communication.

What is Sensory Processing Disorder?

The Dr. Jean Ayres, American occupational therapist, was the first to describe a set of atypical behaviors related to poor sensory processing. In 1972, she defined sensory integration as “the organization of sensory information for use”. It is a neurological process that allows us to make sense of our world by receiving, recording, modulating, organizing, and interpreting the information that reaches our brain from our senses. Ayres based his work on the hypothesis that some children have a deficit in sensory integration that manifests itself in the difficulties observed in intentional behavior. This dysfunction in sensory integration may explain why some children have problems to learn new skills, to self-organize, regulate their attention, participate in activities and games at school or in positive social experiencesAyres, and many who have followed his theory, have worked to establish the validity of this theory through research in clinical and basic sciences.

SPD is a complex brain disorder that affects the way sensations are experienced (sight, sound, touch, smell, taste, and movement) and their organization within a behavior. SPD can affect one or more senses (sight, taste, touch, smell, hearing, proprioception, and/or vestibular/balance). Some children with this disorder feel bombarded by sensory information and avoid it.. Others, on the contrary, seem to They are unaware of the stimuli around them and appear indifferent.Sensory processing is a term used primarily by occupational therapists to describe children who have trouble integrating different types of sensory information, such as images, sounds, tastes and smells.

In simple words, it is a lack of synchronization and/or regulation of the different senses, either individually or jointly. Sensory information is therefore not processed properly, and interactions between the different senses are altered. This causes information to be received either excessively or insufficiently. It is not processed properly and the response is therefore incorrect. According to some studies (1,2) it is estimated that between 60 and 95% of people with autism have SPD, which is also present in a multitude of developmental, communication and socialization difficulties.

We can divide sensory problems into the following groups:

1. Hearing: Hypersensitivity to sounds for example.
2. Visuals: 80% of the stimuli we receive are visual in origin. Today we know that the asynchrony between vision and hearing (for example) in autism is common. Also common are aspects related to spatial location or focal vision.
3. Touch: They do not allow themselves to be touched or hugged or they have exaggerated reactions to certain textures.
4. Olfactory: Certain everyday smells cause a strong repulsion in them.
5. Gustatory: Problems reacting appropriately to everyday flavors, or seeking out strong or spicy flavors.
6. Vestibular: For example, performing a swing to improve balance.
7. Proprioceptives: Problems with spatial location, motor skills or even synesthesia.

We can find hypersensitivity or hyposensitivity, and even a mixed response. For example, hypersensitivity to sounds is very common, but there are cases where there is hypersensitivity to certain sounds and hyposensitivity to other frequencies. This mixed response is sometimes more difficult to detect, but careful observation of responses to stimuli can provide more than enough indicators.

How does sensory disorder impact?

The assumption that autism and other associated disorders have a highly impactful sensory disturbance is gaining ground. The most affected areas are strongly related to aspects linked to sensory processing. A greater impact on sensory disturbance is often associated with the severity of the disorders. Today we know that this is not always the case, although the impact will obviously influence many of the child's responses. We can see that the greater the number and intensity of the affected senses, the greater the difficulties for the child, but that does not mean that these aspects cannot be addressed and, with appropriate intervention, eliminated or mitigated.

Communication and language are one of the most quickly detectable aspects, along with behaviors and low social interaction. Curiously, language is sensory and motor, and in autism the reception and processing of Visual and auditory language stimuli are not processed properlyChildren who cover their ears when faced with a certain sound, or those who experience anxiety when faced with changes in clothing or surroundings, to name just a couple of examples. These types of situations generate anxiety states in children, which, combined with communication problems, lead to a very complex and generally problematic behavioral situation. A significant percentage of behavioral problems originate in these sensory aspects, and in many cases, they can be a trigger.

Regarding motor skills, both fine and gross, the topic of clumsy boy or girl in motor skills. The kind of child who trips over a pencil line drawn on the floor. To that we can also add muscle hypotonia. And we have a child who is generally poor in motor skills and coordination. And here again, we have sensory aspects. Vision is one of the major problems in sensory disorders, and certainly little known and little treated.

In turn, Many stereotypes have a strong sensory component, are used as a stabilizer or regulator, in some cases to control hyperstimuli, in others, such as swings, to enhance spatial or bodily sensation. The walk on tiptoes It is another stereotype that has a lot of sensory aspects, from visual to vestibular. And in the vestibular area we can also see how children who are hypersensitive to vestibular stimuli will present fear behaviors towards playgrounds, will have problems to go down stairs or they will always do so holding onto the handrails or holding someone's hand. And on the opposite side will be those with vestibular hyposensitivity, and they will seek by all means a high level of arousal, such as spinning on themselves, some of them with typical behaviors kamikaze.

Carry out a proper assessment It is important to know what and how to intervene, as well as to adequately measure the impact of this problem on proprioception. 

We have seen how sensory aspects encompass a large number of interactions, and therefore, when these are altered, the problems that arise can lead to the development of other problems. It is important to note that mixed reactivity, where the child may have a hypo response to some things and a hyper response to others, may also present fluctuations; that is, on certain occasions, the child responds to a stimulus differently depending on the situation. Sometimes he may not be able to integrate the whole of a situation, and may only be able to identify parts, which will also create confusion. In situations where the child has a sensory overload, you can perceive your environment and sensations in a distorted way, nothing better than achieving a “time out” so that it can regulate itself. 

As usual, The advice of professionals with accredited training is always importantSensory disorders may require specific, individualized interventions; what works for one person may not work for another.

Movement is medicine, 
to create physical, emotional, and mental change. (C. Welch)

What activities can we work on from home?

• Bouncing on the Pilates ball, both sitting and standing. Sing a song; this always helps keep track of time, and if they want to keep bouncing, they just have to ask appropriately. With the ball, you can work on core control and postural adjustments while sitting; you can also add an object, such as small colored balls, and while bouncing, pick them up and put them in a box (this works on attention, stimulus inhibition, and hand-eye coordination).
• Pull the sheetA seated child has to adapt their body to the different postural changes. You can walk down the hall or through the dining room to get them to the sofa or mat.
• Mattress or mattress. Take advantage of that soft surface to squish every little part of their body with the ball or pillows. Let them struggle to get out of there, using force (don't press too hard).
• Let objects go up and down (chair, sofa, bed, etc.); also, let them crawl underneath them. All of this will help develop proprioception and body awareness.
• In the Hammock In addition to linear movement and relaxation, you can work on attention and eye-hand control. The airplane position is also very useful for working on vestibular stimulation inside the hammock: with your arms facing outward, pass a rope over your head and have them pull forward, also working on your scapular muscles, grip strength, and bilateral coordination.
• With the scooter Position yourself on your stomach and move both hands forward to work on bilateral mobility, upper limb strength, and coordination. You can also attach a rope and have the child pull it forward from the scooter.
• The roll This is an object that can also be added to the circuit. The child can be placed on their tummy and moved forward and backward, pushing off with their feet and hands in a prone position. Likewise, different textures can be placed on the sides of their hands, and in that position, they can search for different objects. This will also help tone the shoulder muscles. The roll can also be used while sitting like a horse, moving both feet to the right and left. This will help work on bilateral coordination and balance.
• The lights You can use them as a way of relaxing in the calm corner, as a game: “I hide them and once you finish the circuit you have to find them” or as a way to initiate communication and joint attention.
• The vibration It's a rather calming object. You can rub the stimulus all over your body, saying the name of each part. It's also a great way to relax while bouncing the ball.
• The weight bags They can also be used for relaxation. While the child is in the hammock or lying on the mat, they can be placed on their body to apply deep pressure. They can also be used to play fetch or to throw them in a bucket, exerting finger-palmar strength.

They are always games that motivate the child; never force, since that is where neuronal work is most effective. Let the child choose what you want to play with and how. Help him develop not only the initiative for functional play and problem solving, but also the independent ideation, planning and execution of an activity. This will then be reflected in the environment around him. It is necessary that they are adapted to their capabilitiesNeither easier nor more difficult, with small challenges that they have to achieve. It always helps to create stories that motivate children to play games and achieve sensory regulation.

Don't miss the next article where we will talk specifically about Communication and language problems are the second leading cause of behavioral problems in children with developmental difficulties! 

Text adapted by Cristina Oroz Bajo

Sources: Recenit and Autism Daily