Sensory Processing – The Lesser-Known Area of Children’s Occupational Therapy Explained!Twinsplus Arabia
A Morning With Kids First Medical Centre
Sensory processing is the ability to process inputs from the environment. When everything is working fine, the brain is like a set of super-traffic lights at a busy junction: multiple inputs (vehicles and pedestrians) are seen and regulated and the traffic flows. For someone experiencing sensory processing difficulties, the traffic lights malfunction a bit. And traffic may be delayed or break down into gridlock.
In children, sensory processing difficulties can be experienced in many ways, some of which are not so obvious. Some may crave sensory stimulation, whether auditory, tactile, visual, taste and smell, and others may be averse to this. Some children may need frequent movement, others may avoid it. There are four main types of difficulties, summarised below for. Children can appear in more than one type as each sensory system may require different needs. If you are concerned that your little one(s) are showing signs of difficulty then a professional occupational therapy (OT) assessment may be needed.
I spent a morning learning all this at a Parents Talk run by Kids First Medical Centre. They host regular free seminars in sensory processing and all the various types of children’s occupational therapy at their Al Wasl road clinic (note – they are packed and early booking is essential!).
But how do you know if OT is needed? Seminar presenter and occupational therapist Lauren Van Zyl says “therapy comes in if sensory processing difficulties get in the way of a child’s job”. For babies and children that ‘job’ is the ability to play, learn and socialise with peers.
What I didn’t know is that sensory experience is the basis for all learning in infancy. And here’s the science-y bit: as well as our five senses (touch, taste, smell, hearing and sight), there are two others! The vestibular system (rooted in our sense of balance inside our inner ear), and proprioception (from sensory receptors in all our muscles and joints) enabling us to know where our limbs are and what they are doing!
Believe it or not, a mis-functioning vestibular system can mean that some or all of our other senses can’t work properly – and if this isn’t addressed it could inhibit learning or just the ability to live happily in the world, further down the line.
Lauren explains that self-regulation is the goal of occupational therapy with sensory processing difficulties. That means learning the ways to compensate for any difficulties our nervous system has with this.
“We all self-regulate,” she explains, “for me, it’s drinking cups of tea, for others it might be exercise or chats with colleagues at the water cooler… We instinctively repeat the little things which keep us feeling OK and on track.”
She says that when beginning sensory processing OT it’s not uncommon for a parent to remember that they had a similar issue when they were young – and that they just grew out of it. Which is exactly the case for most people – we humans are extremely good at diagnosing a problem and finding a way around it, even if that takes us a few years! Sensory processing can be hereditary. With increased knowledge and services nowadays, we can help to improve how our children experience their sensory world and therefore increase their opportunities in life.
Lauren points out that here in the UAE many parents choose to begin schooling several years ahead of other countries. And what parents may find is that toddlers or pre-schoolers who might have a slight sensory processing issue therefore have a couple of years less in which to find their own ways to self-regulate. So occupational therapy can help a child to speed up the natural development of self-regulation strategies.
It’s no surprise to learn that the majority of kiddies coming to the clinic for therapy have been prompted by either a school or a nursery. As parents, we may not even be aware that our little ones are having a tough time with something, precisely because we don’t require them to sit still and listen for ten minutes at ‘circle time’!
I ask about the links between premature birth and sensory processing issues. Lauren offers some more interesting information – that vestibular system inside our head is obviously being developed before birth. And, to really develop it properly, the vestibular system needs time upside down! If that sounds crazy, just think: before birth babies are designed to get into an upside-down position – ready to be born. But it’s not just ready to be born – it is final calibration of that sense of balance for that vestibular system (I feel like I am on first name terms with mine now).
Being born prematurely, or even breech, can interrupt some of that process. And obviously, being very premature can mean that our little one’s overall nervous system development has been interrupted and will probably need some help to handle all the sensory messages that the big wide world bombards us with.
Lauren says that parents of preemies may feel that they need to treat their littles as very fragile for a bit too long. In fact – once they are medically safe to be engaging in normal baby activity with parents – preemies need to be handled and moved around more that non-preemies! And we have some really fascinating guidance on how to do exactly that here: https://www.tamba.org.uk/Movement-for-Multiples
Now mummies, please don’t freak out. You may well have two or more preemies and have done nothing along these lines – and your little ones are of course perfectly fine! Most sensory based difficulties resolve themselves as the baby’s nervous system matures. If your little ones even had any issues you probably would not even notice (let’s all just high five our small people again for being totally awesome). And if your little ones were very premature, doubtless your doctor and/or medical team have been all over this since forever.
However if some of this rings a bell with you or makes you wonder if one of your kiddies could use some help, then look up your nearest clinic and give them a call. Or you might be interested in a new online self-paced training package in Ayres Sensory Integration for parents that Kids First are offering which is 30 hours of study when and where it suits you (contact the clinic for full information). Below you’ll find the fascinating details of the four types of sensory processing difficulties, along with a variety of ideas for either calming or stimulating a little one who suffers from a processing glitch.
Now, what I have found fabulous is that so much of this I can apply to my own two pre-schoolers – who don’t have sensory processing difficulties that require therapy. But they do have different preferences for how they experience the world through their senses. One is very movement focussed and adores auditory stimulation (the best thing we ever did was buy a second-hand drum kit!) and one really prefers specific touch and quieter less stimulating environment to recharge tired batteries!
So I am using some of these ideas on my two and so far, we are all loving it! And the other thing I love is feeling much more knowledgeable and able to understand some of the needs of other kids around us. I think we’d all agree that the UAE’s efforts at inclusion and integration in our schools is fantastic: and I have a bit more of a clue about it all now, which I can pass on to my kids.
Huge thanks to Lauren and Kids First Medical Centre. Get on down there.
Further Information: The Four Types of Sensory Processing and the Sensory Diet:
1. Sensory Seeker
2. Low Registration
3. Sensory Sensitivity
4. Sensory Avoider
These children need a constant stream of sensory input in order to remain alert. They have a high threshold for receiving sensory input from the world along with an active response to that input. Characterised by:
· needing “more more more!”
· often touchers and feelers and also bumpers and crashers!
· present as risk takers having a higher lack of safety judgement and impulse control
· often distracted and unable to ‘pay attention’
These children have a “ho, hum” response. They have a high threshold for receiving sensory input from the world along with a passive response. Characterised by:
· disregards sensations – does not seem to notice them and may seem lethargic or just not bothered by much
· appearing to lack initiative, is unable or slow to get going and get organised, forgets things easily
· appears clumsy – bumps into things or people
· presents as lacking safety judgement and a low registration of pain or extreme temperatures
These children have a low threshold for receiving sensory input from the world, along with a passive response to that input. Their sensitivity can often be unnoticed. Characterised by:
· copes fairly well during the day – often with no obvious signs that teachers or others may pick up on
· appears withdrawn, shy or distracted in certain situations
· tendency to ‘snap’ later in the day when they may finally become overwhelmed or overstimulated beyond their passive response ability to cope
These children will flee from a sensations they dislike, which may cause them anxiety or present physical symptoms such as sweating or raised heartbeat. The have a low threshold for sensory inputs from the world, along with an active response to them. Characterised by:
· demonstrating a ‘fight or flight’ response to sensory inputs, becoming actively defensive
· observing rigid routines to minimise sensory stimulation
· tantrums and flamboyant episodes with unwillingness to compromise on some things
Well, when I first read through this list I could spot at least a few things in several of the ‘types’ that fitted both my children! And it’s why sensory processing difficulties are so often only observed once a child reaches nursery or school stage: because the majority of those characteristics described above are pretty normal behaviour for many kids who haven’t reached full emotional and developmental maturity yet (which experts say happens at around age seven!).
So, it is easy to see why both the entire ‘sensory processing’ area is quite a new one as it is only relatively recently that medical and psychological experts began to realise that not all ‘problem kids’ were deliberately being problematic!
As the Kids First team explained, milder sensory processing difficulties are not going to have any severe consequences for our children as children usually develop their own methods of self-regulation and just get by. But, it may be that entire avenues of experience and life opportunity have been missed out on because kids in the past have just avoided, or ‘got by’ – and that is doing a disservice to our little ones.
Occupational Therapy is the method of helping children to be able to play, learn and be attentive when experiencing sensory difficulties (or other difficulties such as speech or other communication). But it is not the full answer; parents need to be involved and informed about what is referred to as the ‘Sensory Diet’ their child needs. That is nothing to do with food – it’s an individualised programme of activity which maps out the best ways of increasing and decreasing sensory input throughout the day as necessary.
Below is a list of the common activities that an expert will use to compose a sensory diet.
These activities are great for all little ones – from babies to school-age – so try a few and see if you can see the sensory preferences that your growing people naturally have. Enjoy!