ParenTalk: Sensory Processing Disorder, Your Child, and You

We’ve all seen it. Situations where a child has been upset about being taken to a party in the dress they didn’t wish to wear, their lunch being a little lumpier than they like it, or being extremely anxious around certain sounds. We assign it to picky eating and having strong likes and dislikes. The list could go on and on #beenthere. 

Yes, it is completely normal behaviour from a child who doesn’t yet know how to regulate feelings and expressions. Experts call these temper tantrums, brief episodes of extreme, unpleasant, and sometimes aggressive outbursts in response to frustration or anger. Majority of temper tantrums in toddlers and young children are typical and part of normal toddler behavior that ebb as the child grows older. A natural meltdown which is part of the game of every caregiver-child relationship, a typical scene we could recognize yards away- the wailing, kicking, biting, crying, flailing and also pausing in between to check if anyone’s noticing or not before resuming! 😂😂

But when is a temper tantrum more than that? When it is Sensory Processing Disorder (SPD), a more complex situation that calls for attention and care from caregivers. Children with sensory processing disorder have difficulty processing information from the senses (touch, movement, smell, taste, vision, and hearing) and responding appropriately to that information. This may show up in atypical/ intense behaviours, especially in newer environments where the brain has trouble receiving and responding to information that comes in through the senses. Some children may be oversensitive or under responsive to one or more sensory stimuli.

What are the symptoms of SPD? What are the telltale signs to look out for? 

Sensory processing disorders in children could present itself in many ways that may be confusing for caregivers to differentiate the behavior as normal tantrum or a deeper issue. Watch out for these atypical responses to sensory inputs that may help in recognizing SPD in children: 

Sensitivity to Light
Shielding eyes and intolerance to sunlight or bright light is a classic SPD response in children. They may begin crying and complaining about the lights being too bright. They may find difficulty in reading anything in sharp color contrasts or fluorescent colors.

Food textures
It is common for children with SPD to have very strong preferences regarding food. They can have texture issues, like preferring a certain texture, and categorically rejecting or even have repulsion issues with certain other textures. They may prefer their food to be neatly separated from each other so that they don’t mix. They may even prefer foods that do not make a certain noise when chewed.

Textures/ surfaces
Some children with SPD may not tolerate cloth tags and labels. They may not stand the way certain clothing feels on their bodies or surfaces feel under their touch. They may not be able to wear certain fabrics like wool, linen, polyester etc and would want clothes with minimal seams. You may notice if your child tiptoes or always wants to wear socks to avoid walking barefoot on the floor surface. In some SPDs a child does not like the feel of a brush or comb in her/his hair and is upset every time you approach their hair.

Olfactory responses
Certain smells and odors in food, skincare products, mosquito repellants or people’s perfume may elicit a strong reaction like dislike and repulsion. 

Noises or loud noises
Children with SPD may be oversensitive to loud noises like loudspeakers, sirens, vacuum cleaner or other noisy children. These noises can cause discomfort and confusion in them hampering their ability to concentrate or complete a task.

Poor gross motor skills
Children with SPD may be weak at riding a bike or cycling and may have poor fine motor skills like using crayons or pens, coloring within boundaries or dressing dolls or putting together the LEGO. Such children may always need help in dressing and may not be able to put on the buttons of their clothing. 

Difficulty with change or transitions
Every child takes his/her sweet time to adapt to changes like shifting from house/room, new classrooms, school timetables, even a shuffle in their play area. But children with SPD find it very challenging to adapt to these changes or switching from one activity to another. These changes cause extreme meltdowns or bottling up in response. 

Balance and Movement
Children with SPD often bump into things or people and sometimes themselves strip easily since they have poor balance. They seem clumsy and may find difficulty in perceiving spaces. They may get overwhelmed by their surroundings causing them to “not see” things or people around them. These children may also avoid going on swings or joyrides. 

Oversensitive or Under Responsive to stimulation
This may be the most important sign to notice in SPD since it may cause them physical harm. Things that should cause discomfort like being too hot or too cold prompt little response, while other stimuli like noise, light or speed may cause extreme physical distress and anxiety. Such children may have muted sensations thus they constantly touch people or things or try to play rough games wrestling 

It is important to understand that every child is different and may or may not show the above symptoms.  Even if they show one or many of these signs it may still not be a case of SPD. Caregivers must observe and assets their child’s sensory responses and discuss it with a healthcare provider or therapist to get more clarity on their child’s behavior. 

Who do we speak to for a diagnosis? 

Occupational therapists are trained professionals that help retrain the senses through fun challenges and physical activities in a subtly structured way where the child is encouraged to complete the tasks. The purpose of working with an occupational therapist is to develop adapted and appropriate responses to sensory inputs. For example – Heavy physical activities like hurdle tracks, exercises, rolling jumping etc can help calming a child that is over-responsive to sensory input. Activities like gymnastics, dancing and yoga help in maintaining balance and increase body awareness. An OTs facility will be filled with many sensory equipments like swings, handrails, wobble seats, nets, ropes, climbing wall that help children get comfortable in a regulated sensory environment.  

How to tackle it at home and outside like school where caregivers are absent? 

At School

Beyond the confines of home a child spends considerable outdoor time at school. Where the child can only engage with his schoolmates, teachers and helpers. Parents of children with SPD must foremost apprise the teachers/instructors about the issues and behavior of the child. 

The school may adopt strategies that would give them control over the amount of sensory input to deal with, thereby decreasing stress throughout the day. The school may be requested to allow more breaks to calmer areas ( to washroom or activity/playrooms). Allowing use of earplugs may help in muffling the noises in the corridors, school buses or cafeterias that may be disconcerting for the child. Flexibility to choose co-currriciular activities and  physical/sports activities that are calming to the child help control sensory reactions over time.  Above all, an understanding, accommodating environment is what helps.

It is important that caregivers and teachers work in tandem to develop the abilities of a child who is struggling with expression. Whether the condition is SPD or something else, it is important to seek professional help to have a better assessment of the child’s behavior and neurodevelopment. 

At Home 

Home is the primary environment of every child. It is their safe space, and caregivers can help children cope with their sensory environments by providing sensory stimulation through toys, music, cuddles and hugs and recognition on completing tasks. 

Sensory-seeking vs avoiding
Once you recognize if your child’s behavior is sensory-seeking (needing extra squeezes and hugs) or sensory-avoiding (avoid touching, playing in groups or shaking hands) can help you select creative activities to engage and teach the child. 

Textures
A child who is sensitive to textures can be sensitized to different tactile inputs that make them touch a variety of textures with their bare hands. For example hand/finger painting kits, playdoughs, paper tearing/ripping/cutting activities. 

Routine
Make a timetable that has short duration activities like, jumping jacks on the trampoline, home dance party, 15 minutes daily exercises. A routine will help the child to adapt to automatic responses to a variety of sensory stimuli in and around the house. 

Trust them
With any activity, trust them to signal when it is enough for one go. You can put new food on their plate, but have no expectation from them to eat it. Do not disguise foods, they like everyone, deserve to know what they’re eating. Keep patience. If its tough for you, imagine how tough it is for them.

Patience, acceptance, love, trust and adherence to your OT's recommendations is key to help a child with SPD.