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Some kids love loud noises, bright lights, and chaotic environments, like fireworks and busy amusement parks. Other kids may go into meltdown mode if they so much as hear some wooden building blocks tumble down. If your child is either oversensitive or under-sensitive to noise, lights, touch, and other stimuli, you may be looking at a case of sensory processing disorder (SPD).
What is sensory processing disorder (SPD)?
Sensory processing disorder (SPD), previously called sensory integration dysfunction, is a condition in which a person has difficulty responding appropriately to information through the senses (stimuli). The stimuli can be sights, smells, sounds, touch, body position, or movement. Someone with SPD may be sensitive to just one of those stimuli or to a combination of them (Critiz, 2015).
SPD is most common in children, but adults can have it as well. Kids with SPD may have problems regulating their emotions, paying attention, and changing activities (Khan, 2021). Currently, SPD isn’t considered a distinct medical diagnosis in the DSM-5, the latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual.
Types of sensory processing disorder
People with SPD can have two sensory processing issues: oversensitivity (hypersensitivity) and under-sensitivity (hyposensitivity).
A child can display each type at different times of the day or change from day to day. SPD exists on a spectrum. Some kids have SPD so severely that an ordinary sound like a fire engine siren down the street can send them into a full-blown meltdown. Others are more mildly affected.
With hypersensitivity, certain triggers, such as bright lights, loud noises, irritating clothing, some types of food, and many others, can create sensory overload. This can overwhelm kids and cause them to retreat or to have meltdowns. These meltdowns are different from standard tantrums because the kids really can’t control themselves.
In contrast, with hyposensitivity, there’s less sensitivity to stimuli than normal. This can cause the child to seek out sensory stimuli by running, jumping, touching people or objects, making noise, or “playing rough.”
Sensory overload: what is it, symptoms, treatment
How common is SPD?
An estimated 5–15% of children have SPD. Some 80–90% of people with autism spectrum disorder (ASD) also have SPD. But that doesn’t mean someone with SPD necessarily has ASD—the features of the two conditions are different. For instance, people with ASD are typically uninterested in socializing with others. However, a child with SPD may want to socialize with other kids but be unable to tolerate the sensory stimulation that comes with play (Galiana-Simal, 2020).
What are the symptoms of SPD?
Symptoms of SPD can include:
- Hypersensitivity to things in their surroundings, especially light, sound, or touch
- Hyperactivity or distraction (this is common)
- Trouble with fine motor skills (like handwriting)
- Problems with physical coordination and poor muscle tone
- Having difficulty transitioning from one activity to another; not handling change well
- Being easily overwhelmed by people and places
- Having frequent tantrums or meltdowns
- Bumping into things
- Having difficulties with schoolwork
- Often finding clothing uncomfortable
- Having problems with speech
- Having difficulty planning for tasks
- Avoiding touching people
- Being a picky eater
Most kids have these problems at one time or another. When this type of behavior starts interfering with everyday life, or if your child seems to experience these problems more often than other children, SPD may be the culprit.
What other conditions can occur with SPD?
Several other conditions often happen in combination with SPD (Critz, 2015; Al-Heizan, 2015):
- Attention deficit hyperactivity disorder (ADHD)
- Cognitive disorder
Do I have ADHD? Can you be diagnosed as an adult?
But SPD can also occur on its own, without another disorder.
Someone with SPD is four times more likely to be later diagnosed with emotional problems (such as anxiety). They’re also three times more likely to be diagnosed with externalizing behavioral problems (such as rule-breaking and aggressive conduct) (Critz, 2015).
What causes sensory processing disorder?
It’s not clear what causes SPD, although some preliminary studies on twins found that SPD may have a genetic component (Goldsmith, 2006). A 2013 study used MRI to look at the brains of children with SPD and found abnormal tracts in the brain’s white matter, a part of the brain that connects the auditory, visual, and tactile systems involved in sensory processing. These brain changes suggest that SPD may be biologically based (Owen, 2013).
Other factors related to SPD include prenatal or birth complications, low birth weight (less than 4.9 lbs/2.2 kg), and premature birth. 46% of children born with less than 32 weeks of gestation have SPD symptoms at four years of age (Crozier, 2016).
How is sensory processing disorder diagnosed?
SPD can be identified by a number of different health and childcare professionals, including occupational therapists, pediatricians, psychologists, and school evaluators.
These professionals can choose from a variety of different diagnostic tools to determine if someone has SPD. The most commonly used tools for assessing children’s sensory processing are the Sensory Integration and Praxis Test (SIPT), the Sensory Processing Measure (SPM), and the Sensory Profile (SP). A more recent diagnostic tool for SPD is the Evaluation in Ayres Sensory Integration (EASI) test (Mailloux, 2017; Galiana-Simal, 2020).
Treatment for sensory processing disorder
Occupational therapy is the most common treatment for SPD, using an approach called sensory integration therapy. This type of treatment uses certain sensory activities to help a child respond appropriately to various stimuli, such as light, sound, touch, smells, and others.
What is occupational therapy? Who is it for?
Sensory integration therapy may include a “sensory diet,” a series of physical activities tailored to the individual’s needs. For instance, for kids who are overly sensitive to sensory inputs, the sensory diet may include calming activities, like holding a yoga pose. For kids with under-sensitivity, the diet may include activities to help them feel more alert, like jumping up and down. If it helps them, kids may be given fidget toys or crunchy foods to chew.
All of these activities are intended to be fun for the child. Play is an important part of SPD therapy because kids learn by playing (Hunt, 2017). SPD treatment is often combined with speech therapy for kids who have problems communicating.
Sometimes, SPD is the result of an immature sensory system, and the child outgrows it. Other times, the person doesn’t outgrow the condition but finds ways to deal with it—for instance, by taking up a profession that protects them from uncomfortable stimuli. Either way, if you believe that you or your child have sensory processing disorder, there is help available. Qualified professionals can guide you toward managing the symptoms and leading a full and satisfying life.
- Al-Heizan, M. O., AlAbdulwahab, S. S., Kachanathu, S. J., & Natho, M. (2015). Sensory processing dysfunction among Saudi children with and without autism. The Journal of Physical Therapy Science, 27(5), 1313–1316. doi: 10.1589/jpts.27.1313. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26157208/
Critz, C., Blake, K., & Nogueira, E. (2015). Sensory processing challenges in children. The Journal for Nurse Practitioners, 11(7), 710–716. doi: 10.1016/j.nurpra.2015.04.016. Retrieved from https://www.npjournal.org/article/S1555-4155(15)00448-1/abstract
Crozier, S. C., Goodson, J. Z., Mackay, M. L., Synnes, A. R., Grunau, R. E., Miller, S. P., & Zwicker, J. G. (2016). Sensory processing patterns in children born very preterm. The American Journal of Occupational Therapy, 70(1), p1–p7. doi: 10.5014/ajot.2016.018747. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26709425/
Galiana-Simal, A., Vela-Romero, M., Romero-Vela, V. M., Oliver-Tercero, N., García-Olmo, V., Benito-Castellanos, P. J., et al. (2020). Sensory processing disorder: key points of a frequent alteration in neurodevelopmental disorders. Cogent Medicine, 7(1). doi: 10.1080/2331205x.2020.1736829. Retrieved from https://www.tandfonline.com/doi/full/10.1080/2331205X.2020.1736829
Goldsmith, H. H., Van Hulle, C. A., Arneson, C. L., Schreiber, J. E., & Gernsbacher, M. A. (2006). A population-based twin study of parentally reported tactile and auditory defensiveness in young children. Journal of Abnormal Child Psychology, 34(3), 393–407. doi: 10.1007/s10802-006-9024-0. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301432/
Hunt, J., van Hooydonk, E., Faller, P., Mailloux, Z., & Schaaf, R. (2017). Manualization of occupational therapy using Ayres Sensory Integration® for autism. OTJR: Occupation, Participation and Health, 37(3), 141–148. doi: 10.1177/1539449217697044. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28621219/
Khan I, Khan MAB. (2021). Sensory and perceptual alterations. [Updated 2021 Jan 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK563136/
Mailloux, Z., Parham, L. D., Roley, S. S., Ruzzano, L., & Schaaf, R. C. (2017). Introduction to the Evaluation in Ayres Sensory Integration® (EASI). American Journal of Occupational Therapy, 72(1). doi: 10.5014/ajot.2018.028241. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29280717/
Owen, J. P., Marco, E. J., Desai, S., Fourie, E., Harris, J., Hill, S. S., et al. (2013). Abnormal white matter microstructure in children with sensory processing disorders. NeuroImage: Clinical, 2, 844–853. doi: 10.1016/j.nicl.2013.06.009. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24179836/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.