Sensory Processing Disorder (SPD)

What Are Sensory Processing Difficulties?

Young people with sensory processing difficulties have trouble in dealing with their sensory input and can find everyday life difficult. Most humans seamlessly deal with information related to touch, sight, hearing, smell, taste, body movements, etc. But those suffering from this sensory processing difficulties can be either hypersensitive or hyposensitive to one or different senses. Some can suffer a combination of both hyper and hypo sensitivity to different senses.

Children and adolescents with sensory processing difficulties can be fussy, fidgety, overactive, struggle to concentrate in classes, get anxious,and react aggressively when faced with uncomfortable stimuli and refuse to engage in normal daily activities. Even innocuous activities like taking bath, brushing teeth, and getting dressed can become a battle when the child is having sensory processing difficulties. They can be easily misunderstood and their behaviour can be wrongly interpreted as intentionally difficult.

Sensory processing difficulties can run in families and is said to have a genetic component. It may happen due to differences in the way senses are processed by the brain, but the exact cause and biological underpinnings are still being studied.

Hypersensitivity:

Young people suffering from hypersensitivity can be highly disturbed by seemingly normal sensory input. Usual sensory stimuli can be perceived as uncomfortable or painful and can negatively affect the person’s emotions and behaviour.

• Some find it difficult to tolerate loud sounds. Even sounds which are part of daily life like vacuum cleaner, hair dryer, chatting in groups, etc., can be too much and sufferers tend to cover their ears with their hands. They need to move away from noisy environments.

• Hypersensitivity to taste will make people avoid strong spicy food.

• Hypersensitivity to light will make people avoid bright rooms, avoid going out during sunny weather and dislike highly coloured places.

• Those with hypersensitivity to smell will avoid food items with strong aroma and avoid perfumes. They gag when they dislike the sensory stimuli.

• Some people can dislike touch, particularly certain textures and feel that can make them uncomfortable. Common examples include avoiding certain types of clothes, dislike of cloth labels and cutting them off new clothes, wearing only loosely fitting garments, etc.

• Even a routine chore like visiting a barber for hair cutting can be extremely challenging if a child has hypersensitivity to touch and noise. They can be very particular to the temperature of the water they drink or take a bath.

• Some young people are not able to tolerate excessive vestibular input. They may dislike playing in swings, jumping on the trampoline, travelling up a hilly terrain, etc.

Hyposensitivity:

• Young people with hyposensitivity tend to seek a higher level of sensory input compared to others.

• Those with hyposensitivity to sound tend to keep the volume loud. They can seem oblivious to the loud noise. Sometimes they may not notice some noise and may fail to respond to being called.

• Hyposensitivity to taste will make them prefer spicy food with strong tastes.

• Likewise, hyposensitivity to smell will make them prefer strong perfumes. They may seem less bothered by some strong odours.

• Those with hyposensitivity to light may seek out bright contrasting colours, prefer bright lights.

• When the person is hyposensitive to touch, they can be fidgety and seek more stimulation. They may have a higher threshold to pain.

How to Manage Sensory Processing Difficulties?

Many young people learn to compensate and some have spontaneous improvement in their sensory symptoms as they grow older. Improving awareness about this condition, especially among parents and teachers will help to manage young people with sensory processing difficulties. Recognize that sensory overload can upset young people with this condition and can adversely affect their behaviour. Health professionals can advise about making simple modifications and help people to manage uncomfortable sensory input, which will have a calming effect. For example,

1. Wearing ear plugs can help to manage noisy areas and going out during non-peak quieter hours can help.
2. Wearing sunglasses can help to manage a bright environment.
3. Choosing comfortable fabrics and cutting off labels can help to tolerate new clothes easily.
4. Chewy and crunchy food can help with improving eating.
5. In some people, using weighted blankets can help to calm them when getting anxious and agitated. In some children, using a small fidget toy can help them to distract from other disliked stimuli.

Consult a doctor experienced in this field or occupational therapist who can help to formulate an individual plan to manage people based on their sensory profile.

Case Example:

Some months ago, I had a parent consulting me for advice about his son who was in primary school. He is reported to have behavioural difficulties and parents found it hard dealing with his fussy behaviour on a daily basis. For example, parents were frustrated to get him dressed. The child always wanted to wear the same pants daily. He threw a major tantrum when his parents made him wear other clothes. He was very comfortable wearing blue coloured jeans from a lesser known brand. He preferred the same colour, he was comfortable with the feel and stitch of that particular jeans brand. He was reluctant to wear other clothes, he did not even try jeans from other costlier brands. Whenever he was made to wear other pants, he became restless, distractible, anxious, and eventually had behavioural meltdowns. He also was eating a limited repertoire of food items. He disliked food items with strong taste, smell, and gagged when made to eat oily food. He also disliked the noise when parents were using a mixer grinder and vacuum cleaner at home.

This young boy was clearly hypersensitive to touch, texture, smell, taste and noise. Before his difficulties were recognised as related to sensory processing difficulties, his parents, family and teachers wrongly assumed that he was deliberately difficult. All disciplinary measures did not work and life was difficult for the young boy and everyone involved. Thankfully, a practical approach involving calming strategies, sensory strategies with occupational therapy input helped in managing the child’s various hypersensitivities. There was a remarkable improvement in his behaviour both at home and school in a matter of a few weeks.

If any parents or teachers are concerned about possible sensory processing difficulties in their children, consult your doctor for further advice. Health professionals like paediatrician, child psychiatrist, psychologist or occupational therapist can help with further assessment and management.

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