1. Introduction to Sensory Processing Disorder By: Theresa Sabens, OTR/L

3. What is Occupational Therapy? Occupational therapy “is a health profession concerned with improving a person’s occupational performance. In a pediatric setting, the occupational therapists deal with children whose occupations are usually players, preschoolers, or students…[Therapy is] based on knowledge of neurology, kinesiology, development, medical diagnosis, and current research.” (SII, 1986)

4. What is Physical Therapy? As pediatric physical therapists (PTs), we work with children and their families to assist each child in reaching his/her fullest potential. We use our expertise in gross motor development, movement analysis, and physical rehabilitation to promote independence as well as to promote active participation in home, school, and community environments.

5. History of Sensory Theory Jean Ayres Ph.D, OTR Began work on the theory in the late 1950’s. Research included children with learning disabilities, other forms of neurobehavioral development i.e. autism, pervasive developmental disorder, behavioral disorders, mental retardation, etc. (Kramer & Hinojosa, 1999)

6. Typical Sensory Processing “Sensory processing refers to our ability to take in information through our senses (touch, movement, smell, taste, vision, and hearing), organize and interpret that information, and make meaningful response. For most people, this process is automatic. We hear someone talking to us, our brains receive that input and recognize it as a voice talking in a normal tone, and we respond appropriately.” (SPD Foundation)

7. Atypical Sensory Processing Children who have a Sensory Processing Disorder (SPD), don’t experience sensory information in the same way. SPD affects the way brains interpret and respond to information from the environment. Everyday experiences can be overwhelming or fail to register at all manifesting as emotional outbursts, inability to attend, difficulty planning movement, or other responses. (SPD Foundation)

8. Fundamental Facts of SPD Sensory Processing Disorder is a complex disorder of the brain that affects developing children and adults At least one in twenty people in the general population may be affected by SPD In children who are gifted and those with ADHD, Autism, and fragile X syndrome, the prevalence of SPD is much higher than in the general population Studies have found a significant difference between the physiology of children with SPD and children who are typically developing

9. Fundamental Facts Cont. Laboratory studies suggest that the sympathetic and parasympathetic nervous systems are not functioning typically in children with SPD  This shows that SPD has a neurological basis and that it is not just behavior – from Sensational Kids: Hope and Help for Children With Sensory Processing Disorder (SPD ) p. 249-250 by Lucy Jane Miller, PhD, OTR

10. Protective Responses “Sensory defensiveness is simply the over activation of our protective senses.” (Wilbarger & Wilbarger, 1991) Fight Fright Flight Freeze

11. What sensory systems are affected? Tactile (touch) –Provides information about the world and about the shape, size and texture of objects. It helps us to understand our surroundings, to feel safe and to bond with loved ones.  Things to consider: texture of clothes, tags in clothes, intensity of touch, adverse reaction to touching various textures, etc.

12. Sensory Systems Cont. Vestibular (Sense of position and movement) -The vestibular sense is located in the inner ear. It provides information about balance, movement and our body’s relationship to gravity. -It also tells us basic survival skills i.e. whether we are upside up or upside down, how fast we are moving and in what direction we are moving.  Things to consider: How does my child tolerate swinging? Spinning? Bending over (changing head position)? Is my child always moving? Does he/she get car sick/motion sickness? Is my child afraid of heights?

13. Sensory Systems Cont. Proprioceptive ( Joint and muscle sensations) -The proprioceptive system provides information that contributes to awareness of our body position. This system makes it possible for a person to move his arm or leg without having to observe every action. -Proprioception also allows him/her to automatically adjust his/her body position. It also tells how much force is needed for tasks, such as picking up a heavy object, throwing a ball or how much pressure is needed when writing.  Things to consider: Does my child purposely crash into the floor or fall down on purpose, does he like to wrestle or rough house excessively, frequently want very tight hugs, etc

14. Sensory Systems Cont. Auditory (hearing) -The hearing sense tells us the quality and directionality of sound. This system helps us to understand speech and turn our head and look when we hear a noise or someone talking to them.  Things to consider: Do loud noises seem to bother him/her? Does your child cover his/her ears because the environment is too loud? Are the lights making noise?

15. Sensory Systems Cont. Visual (sight) sense -The visual system interprets what we see and can be very sensitive. It lets us recognize colors, letters, words and numbers. -Vision guides our movement which helps our balance and allows us to continually monitor our actions. -It is also important with verbal and non-verbal communication.  Things to consider: How bright is it in the room? Is it visually over stimulating? Does the clutter or busyness of a room make your child unfocused?

16. Sensory Systems Cont. Gustatory (taste) -This sense provides us with information about how food tastes such as is it salty, sweet, bitter or spicy.  Things to consider: Is my child a picky eater? Does he/she only eat certain textures or tastes?

17. Sensory Systems Cont Olfactory (smell) -This sense allows us to enjoy foods and causes us to react negatively if there are unpleasant or dangerous smells.  Things to consider: How does going to a restaurant impact my child? Does he/she appear to be affected by perfumes, lotions or candles? (SPD Foundation)

18. Conclusion “SPD is a complex disorder of the brain that affects the way sensations are experienced and organized. Research indicates that at least 1 in 6 children experiences sensory challenges sufficient to disrupt their academic, social, and/or emotional development. That’s about 16% of the childhood population – 4 or 5 children in every classroom. In children with autism spectrum disorders, the incidence of SPD is estimated to be even higher-at least 80%” (SPD Foundation)

19. Conclusion Pediatric Occupational and Physical Therapists are integral members of a team of professional who can help children with SPD. OT and PT can help by using specialized evaluations, treatment planning and therapeutic interventions to improve the child’s ability to integrate all of the systems more effectively. We work closely with each child and family to find strategies that will carry through into all aspects of their life.

20. Resources The Out of Sync Child By Carol Stock-Kranowitz Sensational Kids: Hope and Help for Children With Sensory Processing Disorder (SPD ) by Lucy Jane Miller, PhD, OTR I Believe in You: A Mother and Daughter’s Special Journey By Michelle Gianetti I like birthdays…It’s the parties I’m not sure about By Laurie Renke Meghan’s World: The Story of One Girl’s Triumph over Sensory Processing Disorder By Diane Renna