The impact of sensory processing issues and how to help

Sensory processing issues are a common comorbidity of neurodevelopmental disorders such as autism and ADHD. But what does the term ‘sensory processing’ actually mean and how does it manifest? How can we help our children when they are suffering from sensory overload or sensory-craving to the point of injuring themselves?

Some children receive a diagnosis of Sensory Processing Disorder (SPD). In the UK, this is usually diagnosed after an assessment with Occupational Therapy or Peadiatrics. However, in this article, we will use the more generic term of ‘sensory processing issues’ or ‘sensory processing difficulties’ because many children are affected by sensory dysregulation but don’t have a specific diagnosis of SPD.

What do these terms mean?

Hypersensitive

being overly responsive to sensory input, can lead to sensory-avoiding behaviour (see below).

Hyposensitive

being under responsive to sensory input, can lead to sensory-seeking behaviour (see below).

Sensory craving

is described as when one is “driven to obtain sensory stimulation, but getting the stimulation results in disorganization and does not satisfy the drive for more”. It can become excessive and even dangerous; such as in cases of repeated head-banging.

Hyperarousal

involves heightened baseline levels of autonomic arousal. The child is already in a heightened state of arousal so it doesn’t take much for them to become seriously overwhelmed.

Hypervigilant

involves scanning the environment for threat-relevant stimuli, and preparation for potential threat. In the case of children with sensory processing issues, they may seem to always be on the alert and extremely anxious about the possibility of sudden loud noises.

Sensory overload

this happens when you’re getting more input from your senses than your brain can sort through and process. Multiple conversations going on in one room, flashing overhead lights, or a loud party can all produce the symptoms of sensory overload. But when there’s competing sensory information, your brain can’t interpret it all at the same time. For some people, this feels like getting “stuck”; your brain can’t prioritize what sensory information it needs to focus on. Your brain then sends your body the message that you need to get away from some of the sensory input you’re experiencing. Your brain feels trapped by all the input it’s getting, and your body starts to panic in a chain reaction.

Have a look at these videos by The National Autistic Society to see how sensory overload can feel:

‘Make It Stop’

‘Can You Make It To The End?’

This causes the ‘flight or fight’ response of the sympathetic nervous system to be triggered. Have a look below at the difference between the sympathetic nervous system and the parasympathetic nervous system & the vast array of systems they can affect.

When we experience sensory overload, our sympathetic nervous system is activated. To help calm a child down during sensory overload, we want to reduce the input they are receiving and try to activate the parasympathetic nervous system instead.

These activities stimulate the vagus nerve and encourage the body to calm down. It can be really effective to implement some of these strategies when our children are struggling. Try a few and see which work best for you.

How many senses do we have?

Most people with automatically respond with “Five”, but we actually have at least eight.

Let’s look at each sense in turn. We will see how to spot whether our children are under or overly responsive to various types of stimuli, and also what adjustments we can make to help them.

The Auditory System

A healthy functioning auditory system allows children to respond appropriately to what they hear. For example, they may turn their head when their name is called, or follow verbal directions given by a teacher. They would also be able to filter out irrelevant noises (such as another child tapping their pen, or the buzz of an electric light). Some children however, may be hyper or hyposensitive to the sounds that they hear and this can affect their behaviour.

The Visual System

A healthy visual system allows the child to filter out inconsequential things they can see, and also to pay attention to information that is important. Some children are overly sensitive to visual stimuli; this is particularly true of children on the autism spectrum.

They may benefit from a reduction in visual stimuli, as demonstrated below.

As seen here, the TEACHH workstation method is very effective for children who are hypersensitive to visual stimuli.

Some children are under sensitive to visual stimuli and may need bright colours and visual stimulation to keep them engaged.

The Tactile System

The tactile system is the sense of touch. A healthy tactile system allows us to process temperature, feel pain, differentiate pressure and texture. When the tactile system is well regulated, a child is able to filter out unnecessary tactile input; such as a breeze blowing in their face. They are also able to tolerate a variety of textures, such as different fabrics of clothing.

A child who is overly sensitive to tactile input may present with the following behaviours:

Children who are under responsive to tactile input may benefit from the following strategies:

The Gustatory (Oral) System

The sensory receptors in our mouths allow us to perceive temperature, texture (e.g. smooth like yogurt, hard like a crisp, or a mixture of textures like cereal with milk), and taste (e.g. sweet, salty, bitter, sour).

Our brains also receive lots of proprioceptive information from the joint of the jaw as we bite and chew different foods that provide different types of resistance (e.g. a crunchy carrot, chewing gum)

Children with a healthy oral system are able to eat a variety of foods, including a range of tastes and textures. They would also not need to seek out extra oral sensory input such as chewing on clothes, in order to regulate their behaviour.

A child with dysregulation in the gustatory system may demonstrate some of the symptoms below:

Alerting and calming activities can help to regulate the gustatory sensory system.

The Olfactory System

A child with a healthy olfactory system is able to tolerate smelling foods and other odors in his environment.  He can even tolerate unpleasant odors (within reason) without extreme reactions.  A functioning olfactory system helps a child know the difference between “good” smells – those that are safe, pleasant, or associated with positive emotions – and “bad” smells – those that are dangerous, displeasing, or reminders of negative experiences.

Children who are hypersensitive to smells may demonstrate the behaviours below:

Some children may crave olfactory input and would benefit from trying some of these activities:

The Proprioceptive system

What is the proprioceptive system?

When children move and play, their muscles stretch and contract.  Proprioception refers to the way joints and muscles send messages to the brain to help coordinate movement.

This sense also allows us to grade the force and direction of our movements – our bodies instinctively know to apply more effort when lifting a heavy box and less effort when lifting a piece of paper.  While the vestibular system tells the brain about balance and moving against gravity, the proprioceptive system helps us coordinate the movement of our arms and legs in an efficient manner to play and move without even having to look.

A functioning proprioceptive system allows a child to write with a pencil without pushing so hard that he breaks the tip or take a drink from a paper cup without crushing it in his hand. A functioning proprioceptive system allows children to move, play, and explore in a smoothly coordinated and efficient way – not too gently, not too rough.

To help regulate the proprioceptive system, sensory circuits; a sensory diet and heavy work can be very beneficial.

The Vestibular system

The vestibular system has to do with balance and movement and is centered in the inner ear.  Each of us has vestibular organs located deep inside our ears. When we move our heads, the fluid in these organs moves and shifts, constantly providing us with information about the position of our heads and bodies in space (spatial awareness).

When our vestibular sense is fully functioning, we are secure and organized enough in our bodies to be able to attend and respond to all of the other senses we encounter daily.  A child with a well-developed vestibular sense feels confident and safe during movement activities, even if his feet are off the ground.  He is able to start and stop movement activities calmly and with control.  He is comfortable with climbing, swinging, somersaulting, and jumping – knowing that his body will adapt and that he will be able to maintain his balance and keep himself from falling or getting hurt.

The Interoceptive system

So how can we help our children with sensory processing issues?

Apart from using the sense-specific strategies above, children with sensory processing disorders can be really helped by the use of sensory circuits and a specifically-tailored sensory diet.

Both programs take time to organize and implement so we will have a blog post dedicated to each one individually. Subscribe to have them delivered straight to your inbox!

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Helpful links:

Subtypes of SPD

Hypervigilence: symptoms, causes and strategies

Anxiety disorders & sensory over-responsivity in children

OT & self-regulation

Heavy work activities & sensory processing disorder

Introduction to Sensory Processing

Many children with autism struggle with sensory processing. As shown in a previous article, sensory issues are now part of the diagnostic criteria.

Our senses affect how we respond to the world around us. Many children are either over-sensitive (hyper) or under-sensitive (hypo) and it can be tricky for them to cope with their reactions to what is going on around them.

Below are some examples of different issues that our children may have and just a few tips on how to help them. This is an extensive subject with many research projects underway, so there will be more in depth articles to follow.

  • Taste

Some children may need to sniff their food before tasting it, or they may have a preference for very bland flavours. Similarly, they may prefer textures that are only crunchy, dry, or liquid or they might love spicy food. Trying new foods can be really challenging. My son declared that he hates kiwi fruit and it’s the worst thing in the world; he’s never tried it but he wanted to make sure he didn’t have to. When he did try it later, he decided that he loved it. I still can’t persuade him to try anything that looks too wet or ‘slimy’ (as he puts it).

How To Help: Offer the child a small amount, but don’t force it. If your child has a preference for certain textures or flavours, try to introduce similar items to their diet so it is balanced and healthy.

  • Sound

I’ve found that for most children and adults that I’ve worked with noise is a big trigger for negative behaviour. Many autistic people are sensitive to certain noises or pitches. Sudden noises, such as a police car or fire alarm, can be really distressing. In addition, areas with a lot of background noise- such as a busy cafe or supermarket can cause a build up in anxiety.

How To Help: Ear defenders are a good option and available in many colours and sizes. Alternatively, having an iPod or MP3 player handy when out and about can give the child something auditory to focus on and block out the rest of the noise.

  • Touch

This can be pressure on the body, the feel of clothes, physical contact with other people like hugging or holding hands, brushing teeth, getting their face wet, or experiencing pain. Some of our children may be hypo (under) sensitive to pain or temperature, whilst others may really struggle with something as (apparently) simple as a hug.

How To Help: For a child that is over-sensitive to touch, a verbal or visual warning may be needed. Don’t force the child to hug/cuddle/touch something if they find it too distressing as this could only exacerbate the issues.

For a child that is under-sensitive, then they may like a weighted jacket or blanket, or deep pressure massage.

  • Vision

Children with autism are predominantly visual learners. This means that they take in a lot of information through what they can see. Some colours or sights may be distressing or overstimulating. They may struggle with bright sunshine or the flickering of a strobe light.

How To Help: Sunglasses and window shades in the car- these have been a lifesaver for me and avoided many a meltdown due to the sun being “too shiny”. Try to keep bedroom walls clear of clutter and posters, this will help the child to be settled at bedtime rather than visually over-stimulated.

  • Smell

Smell can be a particularly emotive sense for many people and children with autism are no different. Some scents may be preferred and a source of comfort,  whereas a change in washing powder or air freshener can be very upsetting.

How To Help: Introduce new scents slowly. If a change in behaviour is noticed as a response to a certain smell, it may be best to avoid it.

  • Proprioception

This is basically our sense of position and movement. It’s something that many children with autism and ADHD struggle with as their sense of spatial awareness and connection with their own body can be a bit disjointed. This may manifest as clumsiness and issues with personal space.

  • Vestibular

This ties in very closely with proprioception in that it affects spatial awareness but also incorporates balance. Again, it can manifest as clumsiness or a child who spins or swings quite vigorously in order to get some sensory feedback from that sensation.

How To Help: Sensory circuits and physiotherapy exercises can really make a difference with these issues. There will be a guide to sensory circuits on the website in a few weeks, as it is such an effective way to help with behaviour due to sensory imbalances.

Occupational therapy and physiotherapy can help the child to master their fine motor control and strengthen their core. An occupational therapy assessment would be the first port of call to assess which difficulties the child has and how to help them individually. 

As I said before, this is just a brief introduction to sensory issues and there are more in depth articles on the way. In the meantime, please feel free to e-mail me for advice or further information.

© Peta Slaney, 2020, All Rights Reserved.