Sensory processing disorder (SPD) impacts a person's abilities to interpret sensory information such as touch, movement or whether or not two shapes look the same. Individuals with SPD may demonstrate motor or perceptual deficits, sensitivities to stimuli or behavioral problems that interfere with learning, self-esteem and social skills. Therapy involves promoting a person's successful interaction with objects and people in his environment.
Learning to Self-Regulate
Children with SPD often have difficulties with self-regulation. They may have a temper tantrum because another child bumped into them, or they might zone out during classes. Occupational therapists Mary Sue Williams and Sherry Shellenberger, creators of the "Alert Program" and authors of "How Does Your Engine Run?" describe the brain as an "engine" that might be running too low or too high. They recommend finding specific activities that help children to bring their brains to an optimal alertness level. Children or their caretakers learn to recognize the children's "engine levels" throughout the day and to find sensory activities that will help them to remain calm but alert enough to learn. Possible activities include relaxing in a darkened corner on a bean bag chair while squeezing toys, or taking a break from desk work to perform jumping jacks.
Developing Motor Skills
Children with SPD are often clumsy and struggle to learn motor skills such as riding a bicycle and handwriting. Because the right and left hemisphere do not communicate well, these children may not develop a consistent hand preference or they might avoid crossing midline during activities. "Crossing midline" means reaching with one hand across an imaginary line that runs down the middle of the body (dividing the body into right and left sides). Developing a consistent hand preference is important in order to learn complex tasks such as using scissors or writing. These children also have difficulty using both hands together in order to stabilize materials or perform complex manipulation tasks, such as folding paper. Occupational therapy objectives might include developing a hand preference, crossing midline during activities, stabilizing paper during writing tasks or manipulating clothing fasteners. Objectives may also include developing coordination to perform age-appropriate gross motor skills, such as jumping jacks or riding a bicycle.
Decreasing Sensory Defensiveness
Individuals with SPD often find sensory experiences---such as walking across a park bench or barefoot over grass---aversive because their brains interpret the stimuli as threatening. Their impaired vestibular sense interferes with balance, so that they feel like they are going to fall whenever their feet are off the ground. The grass might feel like needles piercing their skin. These individuals are often picky eaters, hate many mild odors and are overwhelmed by the bombardment of sensations that make it difficult to focus on any one activity. Occupational therapy typically involves providing movement and heavy pressure touch experiences, such as being squished between two mats, to stimulate the vestibular sense organs (in the inner ears), muscles, joints and skin. Objectives may include performing specific tasks such as playing catch while sitting on a swing; tolerating foods with a mushy texture; or wheelbarrow walking, which is done with hands on the ground and ankles supported, while traveling over a variety of textures such as grass or sand.
Developing Discrimination Skills
The right and left hemispheres of the brain must communicate in order to interpret and use sensory information in a successful way. Sensory integration therapy always focuses on first building a foundation of rich sensory experiences that promote brain organization. The next step is to help the individual interpret sensory information--to make discriminations such as which line is longer, to identify an object by touch and to choose puzzle pieces to fit into a board. Occupational therapists often start sessions with sensory stimulation, such as jumping on a trampoline, and they then incorporate discrimination tasks either during this movement or afterward. An example of such a task would be to walk across a balance beam while tossing red bean bags into a red box and blue bean bags into a blue box. Possible therapeutic objectives include finding matching objects in a bag using only touch, identifying right and left on your body or forming letters with correct size and orientation to writing lines.
References
- "Sensory Integration and the Child"; A. Jean Ayres; 2005
- "How Does Your Engine Run?"; Mary Sue Williams and Sherry Shellenberger; 1994
- "The Out-Of-Sync child"; Carol Stock Kranowitz; 2006.
- "Building Bridges through Sensory Integration"; Ellen Yack, Paula Aquilla and Shirley Sutton; 2004
