Sensory Processing Disorder (SPD) Flashcards
Sensory processing disorder can also be known as…
- sensory integrative problems
- sensory integration dysfunction
Sensory processing disorder (SPD)
- not a specific problem
- group of patterns that emerge developmentally
- reflect differences in neural processing of sensory and motor systems (central nervous system, not peripheral)
- not currently identified as a disorder in the DSM
- all individuals process sensory information differently
- when it impacts occupations, that’s when it’s called SPD
Comorbidities of sensory processing disorder
- autism
- ADHD
- trauma
- anxiety/depression
- obsessive-compulsive disorder
- stand alone difficulty
Categories of sensory processing disorder
- sensory modulation problems
- sensory-based motor disorder
- sensory discrimination disorder
- praxis
Sensory reactive continuum
- hyper reactive to sensory input
- hyporeactive to sensory input
Sensory modulation occurs on a neurological threshold continuum
- under-responsive to input, high neurological threshold
- “just right” response to sensory stimuli
- over-responsive to sensory input, low neurological threshold
*not always consistent across the systems
Sensory modulation
- the ability to generate appropriate responses to sensory stimulation without over responding to under responding
- neurological thresholds = the amount of stimuli required for a neuron to respond
- nervous system responds quickly = low threshold for sensory input
- nervous system responds slowly = high threshold for sensory input
Sensory modulation depends on…
- habituation
- sensitization
Habituation
Recognizing familiar sensory information as unimportant
Sensitization
Heightened awareness to important sensory stimuli
Self-regulation
*an important skill
- the ability of people to manage their own needs in response to sensory input
- the ability to maintain a calm, alert state
- the awareness of and engagement in activities that keep one in a “just right” state for the activity
- may manage self-regulation by adding sensory input (ex: while studying, may be fidgeting, twirling hair, chewing fingernails, and listening to music to better attend)
- may manage self-regulation by reducing sensory input (ex: while studying, may need a quiet, distraction free environment)
Sensory over-responsiveness (SOR)
- these children over respond to typical sensory input within the environment, hyper-respond to sensory input
- overwhelmed by typical sensory input and react strongly, often with anxiety
- may not habituate to sensory input (ex: feeling of clothing)
- they may have a low threshold for sensory input
- overwhelmed by typical sensory input and react strongly, often with anxiety
- these children are the easiest to identify because the behaviors are easy to notice and report
- common for when people to think of sensory processing problems to only think of sensory over-responsiveness
Children can be over responsive in all sensory systems
- tactile over responsiveness
- vestibular over responsiveness
- auditory over responsiveness (cannot tolerate loud noises)
- over responsive to visual input
- over responsive to smell
- over sensitive to taste
- children who display over sensitivity in more than one sensory system are described as sensory defensive
Tactile over responsiveness
Tactile defensiveness:
- hyperactive to ordinary touch
- light touch is aversive (tolerate deep touch better)
- self-applied input tolerated better than touched by others
Vestibular over responsiveness
Gravitational insecurity:
- hyper reactive to vestibular input from the pull of gravity
- fear of movement
- moves slowly
- overwhelmed by changes in head position
- fear of heights
- decreased exploration
- feeling unsafe
Children with sensory overload-responsiveness…
- have higher than typical levels of anxiety
- may be more emotional than typical peers with outbursts
- avoids certain environments
Sensory under-responsiveness (SUR)
- these children are under-responsive (hyporesponsive) to typical sensory input within the environment
- high threshold for sensory input
Children can be under-responsive in all sensory systems
- tactile
- vestibular
- proprioception
- visual
- auditory
- taste
- smell
Behaviors of children with sensory under-responsiveness
- appear not to notice or respond to certain stimuli
- may appear lethargic (tactile)
- may not respond to sensations such as pain (tactile)
- may not notice when clothing is on incorrect or shoes are on wrong feet (tactile)
- may have poor fine motor skills (tactile/proprioceptive)
- may use too much or too little force to complete an activity (proprioception)
- may not actively explore environment
- may appear sensory seeking
Sensory seeking behavior occurs for a variety of reasons…
- generate additional sensory input to compensate for inadequate discrimination
- regulate general arousal levels
Sensory seeking behaviors include…
- engagement in increased movement throughout the day, described as “active” kids, running, jumping, and spinning
- engage in proprioceptive input such as hitting, banging, falling on purpose, and giving hugs
- appear to have “no fear”, risk takers
- tendency to touch items and people to the point of annoyance
- smell foods or objects
- put non-food items in mouth
Non-modulation based sensory integration problems
- having a motor problem
- having underlying motor issues that are because of difficulties processing vestibular proprioception input
Sensory discrimination
Brain’s ability to distinguish between different stimuli
Sensory perception
Brain’s process of giving meaning to sensory information
Sensory discrimination and perception
- can occur within any sensory system
- sensory integration based OT is most appropriate for children with tactile and proprioception problems
- when a visual-perceptual problem (difficulty recognizing the difference between d and b or p and g) is identified, an OT often uses a different approach, such as visual-perceptual training (a specific assessment of visual perceptual skills may be administered)
- occurs in auditory perception is often referred to as speech-language pathologist
- generally identified via clinical observations
Observations of sensory discrimination and perception difficulties
- proprioception discrimination problem
- tactile discrimination problem
Proprioception discrimination problem
- difficulty interpreting body position and the position and movement of muscles and joints
- clumsy, uses too much/too little force, seeks out proprioception, misjudges personal space
Tactile discrimination problem
- difficulty interpreting the characteristics of tactile input (difficulties with stereognosis)
- may have difficulty manipulating items so it impacts fine motor development
- depends on visual system to guide participation
Vestibular-bilateral dysfunction (sensory-based motor disorder)
- deficit is the inability to use two sides of the body together in a coordinated manner
- a function of vestibular-proprioceptive processing
- often demonstrates not other signs of sensory integration difficulties
- difficulty with team sports, incoordination, and fine motor tasks
Postural disorder (sensory-based motor disorder)
- difficulty with balance
- deficits processing vestibular input
- inefficient balance and equilibrium reactions
- decreased trunk strength
Dyspraxia
- DSM = developmental coordination disorder (DCD)
- impaired ability to plan and execute non-habitual motor tasks
- praxis
- includes ideation and motor planning
Praxis
The ability to conceptualize, plan, and execute a nonhabitual motor task
Ideation
- the ability to generate ideas of what to do in a novel situation or conceiving play possibilities with novel toys
- children may wander aimlessly, perform simple repetitive actions (such as patting or pushing items) or observe others to know what to do
Motor planning
The ability to plan and execute the movement
