Sensory processing disorder (or SPD) is a neurological condition in which someone cannot interpret external or internal stimuli the way a “neurotypical” person would. You know your five senses: sight, sound, touch, taste, and smell. A person with SPD might not like bright lights, loud sirens, or pungent smells. However, there are also the senses of yourself in space (proprioception) and movement (vestibular). People with SPD can be hypersensitive and may shy away from being overstimulated, or hyposensitive and can be called “sensory-seeking.”
“Each sensory system is a cup,” says Samantha Davis, an occupational therapist with Kidsplay Therapy Center. “Ideally our systems are a nice medium-sized cup,” but for kids who are hypersensitive, their cups are small. Stimuli, like loud sounds, “is going to make their cup overflow and may end up in emotional outbursts, behaviors, or for some kids, complete shutdown.” However, a sensory-seeker has a large cup—“but since their cup is so big, it takes a lot of input in order to fill it up.” They may love spicy foods or spinning over and over on the tire swing.
When my own daughter was 2 years old, I noticed that she was different from other toddlers we hung out with. She avoided being touched by other kids and liked jumping off of scary-high jungle gyms. She also had big tantrums and was having trouble eating solids. I knew kids who were autistic often had sensory sensitivities, but she didn’t show other signs of being autistic. I found a checklist from Sensory Smart Parent, and she met criteria in several categories for both hyper and hyposensitivity.
Her pediatrician agreed this sounded like sensory issues and referred us to a private occupational therapist for an assessment. Later she was put into an early intervention program through our neighborhood school district. I found out we could also have started there to receive a free assessment and services. If you’re wondering whether you child might have SPD, check with your insurance about private OT services—many of these types of assessments and therapies are covered.
“As of right now, there is no clear connection between why individuals on the spectrum or who present with ADHD also have SPD,” Davis says. But “sensory processing disorder, autism spectrum disorder (ASD), and ADHD are all neurological disorders. SPD is a comorbidity of the two disorders—although not every individual with ASD or ADHD will also have SPD, oftentimes they do. In fact, it is suspected that over half the individuals with ADHD also have SPD, and sensory deficits are one of the diagnostic criteria for ASD.” There is also a correlation between anxiety and SPD.
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Additionally, there has been research that students who are intellectually gifted are more likely to have sensory sensitivities and SPD. However, being sensitive or having another diagnosis such as ADHD or SPD may make it difficult for an intellectually gifted student to be identified because they do not always test well. Anecdotally, as a teacher for gifted students, I can say my gifted students were significantly more sensitive than the overall population.
Occupational therapy is a fabulous idea if your child has sensory sensitivities. They are trained to tailor a “sensory diet” for your child’s specific needs, and are able to see things through their OT lens the rest of us may not notice. For example, our OT noticed one reason my daughter had trouble with solids was she didn’t rotate food around enough in her mouth. She did some specific feeding therapy to address the issue.
“Parents can help their children by first listening to their children and determining the root cause of challenging behaviors and finding a way to solve that problem,” says Caitlin Sanschagrin, an OT and co-founder and owner of Bright SpOT Pediatric Therapy. “Modifications can be small yet very effective. Even changing sanitizers from gel to spray can make a huge difference for a child who is tactile defensive.”
Sanschagrin says kids with SPD need to work on their skills in the areas of self-advocacy, sensory exploration, and emotional regulation. Give your child opportunities to voice their own opinions and boundaries, engage in messy play or risky play, and practice mindfulness and calm-down skills.
SPD is not in the DSM-5, the official criteria for mental health conditions, so it is not always eligible for special education services. Paulette Selman, a school psychologist and special education advocate in Oregon and Washington explains, “When kids have a medical or clinical diagnosis that impacts their progress in school, they would qualify under the special ed category of ‘Other Health Impairment,’” but because of its exclusion from the DSM-5, some kids don’t qualify for services with an SPD diagnosis alone. For school aged children, Selman says your school may offer either an Individualized Education Plan (IEP) or 504 for a child with sensory issues, whether or not they qualify for SPD if they also have another diagnosis or if “there are delays with learning, behavior, or socialization.” If it “substantially limits” school progress, you should be able to get accommodations.
If your child does not need or qualify for special education, Selman stresses that home to school communication is especially important “for kids who have a lot of big behavior at school.” She suggests having a “team meeting” with teachers, the principal, or any other staff that work with your child to “go over what the clinician recommends as far as school-based supports, and get input from the teacher on whether the child has needed anything different than everyone else.”
Sanschagrin also suggests giving teachers and staff “cheat sheets” on your child that contain “a brief summary of the child’s personality, interests, and strengths, as well as informing them what strategies do and don’t work well for them,” she says. I also go over “triggers” with teachers so they know what to look for before a meltdown to help avoid it.
Remember that SPD isn’t something to “fix”—it is something to accommodate. By giving our kids tools and skills to regulate their bodies and emotions, we can help them incorporate their wonderful sensitivities and notice all the sensations around them without becoming overwhelmed.