The Ultimate Guide To Sensory Processing Disorder
by Lindsey Biel.
Lindsey Biel is the author of Sensory Change and an expert in Sensory Processing Disorder. She started as an occupational therapist working in the school system in New York City.
I had such a range of kids I was working with, some had hand writing issues, some had physical disabilities some were on the autism spectrum. I worked with a real range.
What really cut across all of these kids were these odd quirky sensory issues that they were having, so she wanted to get a handle on this because they effected so many children . She even recognised some of her own sensory issues so she became interested in and started pursuing this.
Lindsey wrote her first book “Raising a Sensory Smart Child” in 2005 with the mother of a child that she was seeing through early intervention .
It was revised in 2009 and a major revision with a lot of new material recently.
What is Sensory Processing Disorder?
Lindsey tends to not use the word "disorder" and prefers challenges.
It's not an official diagnosis - bit it's very very real none the less.
We all first learn about the world through our senses, even in utero a baby moves through space touches and hears and once born sees things. Sensory processing is how the child takes all these little bits of information and transforms them into meaningful messages, so he or she knows how to behave and how to respond appropriately to what's going on in the environment.
Because of differences in neurological wiring, some kids, teens and even adults don’t take in and use this sensory info in an expected way.
So they might have out of proportion responses to certain sounds or bright lights or smells or kinds of touches or movement challenges.
So they may have unusual reactions to these things.
They may some develop delays as a result because they are not getting the sensory feedback that is necessary to develop in a typical way.
They may have difficulty with motor movements, muscle tone or running. It can really effect all of those developmental skills.
Kids can be hyper sensitive to things like textures, seems in socks may be intolerable, certain sounds that are not that loud can be over noxious to a child.
Some kids can be under sensitive or Hypo sensitive they need a lot ore input to really register on their input.
Some might be a mix of both and it depends on their influences, how well they are sleeping , eating, how many demands are put on them. That determines how a child manages their sensory world.
The Five Senses
Most people learn about the 5 senses in school.
1) The Touch system
What do you feel, where do you feel it and is it a dangerous feeling?
Think about light touch, gently tap on the surface of your skin - that is light touch.
This information travels on your skin up to your brain.
Now go back to your arm and give it a nice firm squeeze- deep touch pressure. This travels on totally different pathways up to the brain. Lots of children with sensory issues have trouble with light touch.
They may have trouble with clothing, or an innocent child gently brushing past them in a classroom. It can feel like something they need to protect themselves against if they are hyper sensitive.
Vibration of things like a truck rubbing past, the temperature can be hard for kids, changes in seasons, going from nice warm in doors out in to the cold, or in summer out going from the warm outside to the cold indoors can be trouble some for our kids.
Some children can face difficulty with their pain processing, some are under sensitive to pain whilst others are howling if they get a tiny little cut.
Most of us start to hear at 0 - 15 decibels of sound.
Some kids, teens and adults hear at 0 or even as low as -15 decibels of sound.
This is called Hyperacusis - and when a person is hearing so much it becomes very difficult to filter out irrelevant noice and process what is important.
If you or I went to an incredible noisy restaurant we couldn’t have a good conversation with our friend.
And you can imagine a young child trying to deal with that in every day life, that is hyper sensitive hearing.
There are also some people who are also very sensitive to particular frequencies of sound e.g. hair dryers or hand dryers in public bathrooms can be really upsetting for kids.
High frequency sound that a lot of kids cannot tolerate.
It's not just about "how well do you see?"
There is a lot of visual processing skills that children need to develop.
They need to be able to see well up close and far away of course, but their eye muscles need to be able to move smoothly across a line of print in order to learn to read.
They need to be able to fuse the two fields of vision coming out of two eyes into one clear field of vision.
They need to be ale to pick out one item out of a busy visual field like finding their parent in a busy supermarket or finding teacher in the classroom.
They need to be able to follow moving objects like a ball.
Some children with sensory issues are very sensitive to glare fluorescent lights or blue LED lights that are more and more frequent.
Take a page of print with black type on white paper. Some people have difficulty with that and the letters start to break apart and move around. Unless you have sensory challenges these things seem wacky or impossible, but this is how it is for some of children and they can't tell us "Gee those letters are moving around on the page I’m having trouble reading them", it just seems difficult for them to read.
Smell is the one sense that travels directly to the emotional part of the brain.
It is the danger defencing system and it is a very primitive sense.
You can smell smoke before you see it.
You can smell rotten food before you taste it.
If a person is hyper sensitive to smell, the beautiful food that their mum or dad prepared can smell dangerous or nasty to a child.
For this hyper sensitive child it may overwhelm their smell system.
Some children have reactions to lotions, cleaning products, perfume etc
Smell system is more important that we realise.
Taste and smell contribute to feeding issues. Sometimes children can become super picky eaters just because the food doesn’t look right to them.
Some children might crave certain flavours eg salty or spicy
These are the common sense areas that we know about however there are 2 or 3 others.
The Vestibular System.
This is located in the inner ear and it detects changes related to gravity and speed.
This is what tells you when you jump in the water which way is up, how fast you are moving etc and it is very important to children.
If children are hyper sensitive to any kind of vestibular input any kind of movement is going to be disturbing or disorienting.
A baby with vestibular issues can get very disturbed if you put him down on a changing table because you have shifted their vestibular system. This can be very confusing to a child, they don’t know where their bodies are in space and it can be deeply upsetting
Proprioception is the sense of self-movement and body position. It is based in joints, muscles and connective tissue of the body. This helps you know where your body parts are.
It is important for fine motor skills like tying shoes laces, using scissors and colouring.
If you take your hands and join them together up above your head, how do your fingers know where the other fingertips are?
They should meet nicely above your head.
Your Proprioception system works this out for you.
They work like a GPS system for the body so you or you child know where you are located on planet earth at any given time.
This is very important for safety.
If they are a little off then it's going to be a big problem for your child.
Interoception is a lesser-known sense that helps you understand and feel what's going on inside your body. Children who struggle with the interoceptive sense may have trouble knowing when they feel hungry, full, hot, cold or thirsty.
So there are 8 Sensory systems, not 5. We talk about them as separate channels of info but really they should all work together and be integrated by the brain and body.
Sometimes they don’t integrate well.
A child may receive this information but be confused by it.
So if a child has difficulty with one sense its going to effect the whole child.
What can be done about it?
The good news is when you start to give beneficial input into 1 sensory system it benefits the whole child.
Life is multi sensory
Its very important to keep in mind everything needs to be working together
How do i know if my child has Sensory Processing Difficulties?
What is the red flag to a parent to know his child has sensory difficulties?
Look for out of proportion reactions - things like being bothered by clothing fabrics, being stressed by light or unexpected touch.
Maybe your child dislikes getting messy e.g. with finger paints or play doh.
Maybe they hate getting their hair shampoo'd and often fight grooming activities.
This is more than just toddler pickiness.
Its a real problem.
Maybe they are very sensitive to sound eg lights or patterns
Perhaps they have very high or very low pain threshold.
If they move awkwardly or clumsily that is something to look at.
If your child is a super picky eater this is something to be thinking about.
All toddlers and children develop strong likes and dislikes
When we talk about a sensory feeding problem - a child lives on very very few foods
Eg pasta with no sauce or only one sort of brand of chicken fingers and ice cream and that's it.
A child who gets really quickly over stimulated in a group setting eg in a gym class, but is fine at home may have sensory processing difficulties.
What can parents do at home?
Always base what you do on what your child is able to do.
Keep in mind, "Is this something my child is interested in or capable of doing, or is it too big a leap?"
It must be achievable.
Let's say your child hates getting messy, don’t set out finger paints or a gluing project.
Don’t start there
Take baby steps
With children who are super tactile aversive, try to do play Doh and a fun factory.
If the child doesn’t want to touch the Play Doh, then give them a tool so they don’t have to touch the play doh, they can use a stamper or a cutter. They don’t have to put their hand in it.
Protect your child from things that terrify them.
You need to push a little bit but not a lot.
Instead of finger paints, provide a paint brush or gloves and slowly work towards it using the fingers.
Give the child a sense of control
The world feels out of control and they feel at the mercy of their sensory experience
Give them a sense that they can control what happens in their life
If they don't want to use paste glue get squeeze glue.
When the child feels comfortable with these types of materials they will get messy.
Work with an Occupational Therapist on the sensitisation techniques.
Set up a sensory bin of dry uncooled rice and beans and they play in that. Let them put their hands in it.
Bury plastic animals and toys and let them find them.
This de-sensitises the hands.
I HATE WEARING THESE TIGHTS, THEY ARE ITCHY
Give in for the sensory friendly clothing.
There is no law saying they must wear socks with seams.
Turn the socks inside out and get the seams off the sensitive feet.
Or get seamless socks.
They are available online.
It is much easier to accommodate very real neurological needs for very comfortable clothing.
If a child says their ears hurt, believe them and protect them and help them to build skills.
Get sound reducing ear muffs for your super sound sensitive child who freaks out at the playground because it's too loud.
Its ok to protect their hearing with ear muffs for short periods but don’t leave them on all day long as this doesn’t help your child at all.
Work with an Occupational Therapist and build the underlying sensory skills.
Get to a developmental optometrist who can assess your Childs vision and visual processing skills.
COVD.org to find your nearest one.
Vision Care Development are Developmental Optometrists and are based in York, England. Contact firstname.lastname@example.org for a free consultation.
At least 50 % of the kids Lindsey works with have an undiagnosed visual problem that can be corrected.
In addition - avoid fluorescent lights
Avoid Blue LED lights and if you can change the bulbs.
Turn off the overhead lights, especially in the bathroom
Kids often wont brush teeth because they cant tolerate the lighting - change the lighting.
Add a different kind of light
If you can't - use a light diffuser
EG you are renting and can't change the light - get what's called a "cozy shades" which is a fire retardant fabric that you can safely put over a light fixture. It attaches with a magnet which will diffuse awful lighting that lots of kids react against
ALWAYS CONSIDER THE MEDICAL FIRST
If your child is getting a lot of ear infections you should check to see if there is any residual fluid in the ear.
Always consider the medical first.
A Paediatrician will only do a screening not an evaluation
TASTE AND SMELL
Throw away house hold garbage every night
Put essential oils in the child's room if they like them or on a cotton ball in a bag and your child can carry it around and smell it in situations when they tend to get reactive around smell.
Vestibular system - give lots of opportunities for your child to move.
If your child starts spinning in circles or jumping around whenever its time for dinner, then give them intense moving opportunities 20 mins before dinner.
EG jump on a mattress on the floor
Climb the stairs
This is all before its time for calmer behaviour at dinner.
Is an App that gives lots of ideas for activities.
Try to integrate them into daily life.
Have your child pull out the wet laundry from washing machine and put into the dryer
This has massive benefit to sensory input.
Get your child to push a supermarket trolley or baby pram.
WEBSITES FOR MORE INFORMATION:
Here you will find lots of tips and articles, podcasts and more practical information.
For professionals go to
Finally, remember, it will get better.
Many grow out of their sensory issues - with an understanding parent and professional assistance.