Understanding Sensory Processing
As a parent or caregiver, you may have heard the terms sensory processing, sensory integration, sensory modulation, sensory regulation, and sensory sensitivity. You may know these terms indicate a relationship to your senses but are unsure of what these specific terms mean and how they relate to your child.
What Is Sensory Processing?
The term sensory processing is interchangeable with the term sensory integration. Sensory processing is the brain's ability to receive, interpret, and organize sensory information as it is felt by the body. The brain then makes changes in order to keep a desirable balance and form a response to the information it receives. When someone has difficulty processing sensory information they may be diagnosed with a sensory processing disorder (SPD).
The Sensory Systems
Auditory: receives and processes sound through the outer and middle ear
Visual: processes visual information through the eyes
Gustatory: the ability to detect taste
Olfactory: the ability to sense smells
Tactile: interprets tactile sensations received through the skin
Vestibular (balance and motion): located in the inner ear, the vestibular sense processes information relating to movements and balance. By incorporating information from your visual and auditory systems this sense helps the body stay upright in space and control neck, head, and eye movements.
Proprioception (sense of body in space): allows the body to understand movement, location, and action without using vision
Sensory Modulation
Sensory modulation refers to the body’s ability to respond to sensory stimuli with an appropriate level of response. For example, if someone greets you in a normal tone of voice you wouldn’t shout at them in response, shouting back would be over-responding. This is also referred to as a graded response. Sensory modulation problems occur when the body over or under-responds to sensory stimuli. Sensory over-responsiveness may appear to be an overreaction to stimuli.
For example, a child may show excessive fear toward linear movement (gravitational insecurity) or not be able to stand the feel of certain textures against their skin (tactile defensiveness). Someone who shows signs of underresponsiveness may appear to be unaware of sensory stimuli, such as a child not responding to hearing their name.
Sensory Registration
Low Registration
There are four patterns of sensory processing. The first two fall into the category of low registration. Someone with low registration is under-responsive to sensory stimuli. These two patterns include low registration and sensory seeking. Someone with low registration may seem to not register stimuli at all or underreact to the level of stimuli presented, such as hearing a loud bang and not flinching or walking into a wall and not reacting. A sensory seeker also has a low register of sensory stimuli but instead of not reacting, they are purposefully seeking out extra sensory input to register the feeling of it. Examples of this include individuals who seek movement through rocking or enjoys loud music.
High Registration
The second two patterns of sensory processing are individuals who fall into the category of high-registration. Someone with high registration feels sensory stimuli more intensely and reacts more intensely as a result. These two patterns include being sensory avoidant and sensory sensitive. Someone avoidant feels overwhelmed by sensory information and may react by avoiding sensory stimuli.
For example, a child hears a loud noise and reacts by covering their ears. An individual who is sensory-sensitive feels sensory stimuli more intensely but does not go out of their way to avoid it. They may startle easily or have difficulty paying attention when there is background noise. (See Figure 1)
Sensory Regulation
You may have heard the term sensory regulation, but aren’t sure what it means. Sensory regulation is the body’s ability to adjust its level of arousal (alertness) to the level required for the activity at hand. For example, a high amount of energy is required to run a mile, and a low amount of energy is required to take a nap. What happens when our level of energy doesn't match the energy required for the task at hand? This is referred to as dysregulation, our body and mind are not appropriately adjusting to the task.
Think about regulation as each of us has a glass of water. Having our glass full to the brim is the perfect amount of regulation needed to complete a task. If our glass is spilling over then our level of regulation is over responding to the task. If the glass is only half full then our level of regulation is under-responding to what is needed.
The goal is for all of us to have that perfect amount of regulation needed to have a full glass. This is also called our optimal state of regulation. So what do we do when our state of regulation is not optimal? Many adults and children struggle with this on a daily basis. However, most adults have learned to self-regulate. For example, if you have too much energy and can’t focus on a task you might go for a short walk, take a stretch break, or have a cup of calming tea. If you don’t have enough energy to complete a task you might go for a run to wake your body up or have a cup of coffee. These are all forms of self-regulation.
Humans are not born with the ability to self-regulate. We start learning how to regulate as infants through co-regulation (regulating with assistance) from our caregivers. Children with sensory processing difficulties struggle to self-regulate. Let’s use the sensory-sensitive child example from earlier. This child is being asked to perform a structured task in the classroom, but the lights are hurting their eyes, there is background chatter, and the tag inside their shirt is feeling itchy. This child is going to have difficulty completing the task because the over-responsiveness of their sensory system is preventing them from regulating. This is where sensory-based OT can help!
Creating A Sensory Plan
The goal of sensory-based OT is to help children (and sometimes adults) learn to recognize the signs of dysregulation and self-regulation. For children, this often requires assistance from the adults i.e. parents, caregivers, and teachers. OTs work to help families understand and recognize the signs of dysregulation in a child and create a sensory plan to promote regulation. This begins with getting to know a child through structured OT sessions and having an open dialog with parents and caregivers to understand the child’s sensory challenges. An OT can then devise a list of regulating techniques and activities to help that child reach a regulated state.
Self-regulation looks different for everyone. However, there are some sample activities known to promote regulation.
Activities for Arousal (Alertness)
● Movement-based activities
● Listening to upbeat music
● Crunchy snacks (carrots, apples)
● Cold foods (ice pops, frozen fruit)
Activities to Decrease Arousal
● Calming music
● Breathing exercises
● Liner movements (swinging)
● Rhythmic movements (rocking and percussive movements)
● Heavy work (activities with physical weight and resistance like carrying books or moving large cushions)
References
Case-Smith, J., & O’Brien, J. C. (2015). Occupational therapy for children and adolescents. Elsevier Mosby.
