Wednesday, August 18, 2010

SPD: Sensory Processing Disorder? YEP! We Got it!

Sensory Processing Disorder (SPD)is a complex disorder of the brain that affects children and adults.

People with SPD misinterpret everyday sensory information, such as touch, sound, and movement. They may feel bombarded by information, they may seek intense sensory experiences, or they may be unaware of sensations that others fell. They may also have sensory-motor symptoms such as a weak body, clumsiness or awkwardness or delayed motor skills.

The term "sensory processing" refers to:
1. our ability to take in information through our seven senses: the basics five plus the "hidden two": proprioception (sensations of body parts in relation to each other) and vestibular (sense of where body is in space relative to the earth's gravity)

2. our ability to organize and interpret the sensory information we perceive

3. our ability to make a meaningful response to the sensory information coming into our brains.

For most people, this process is automatic. Children and adults who have a Sensory Processing Disorder (SPD), however, don't experience this process in the same way. SPD affects the way their brains interpret the sensory information they perceive. SPD also affects how people react to the sensory information. If a person has SPD often symptoms seem like emotional, attentional, or motoric problems. There are six subtypes of SPD and many people have a combination of more than one. They are:

Sensory Seeking - Individuals with the pattern actively seek or crave sensory stimulation and seem to have an almost insatiable desire for sensory input. They tend to be constantly moving, crashing, bumping, and/or jumping. They may "need" to touch everything and be overly "affectionate" not understanding what is "their space" vs. "other's space".

Sensory Over-Responsivity - Individuals with sensory over-responsitivy are more sensitive to sensory stimulation than most people. Their bodies feel sensation too easily or too intensely. They might feel as if they are being constantly bombarded with information. Consequently, these people often have a "fight or flight" response to sensation e.g. being touched unexpectedly or loud noise, a condition sometimes called "sensory defensiveness." They may try to avoid or minimize sensations, e.g., withdraw from being touched, or cover their ears to avoid loud sounds.

Sensory Under-Responsivity - Individuals who are under-responsive to sensory stimuli are often quiet and passive, disregarding or not responding to stimuli of the usual intensity available in their sensory environment. They may appear withdrawn, difficult to engage and or self absorbed because they did not detect the sensory input in their environment. Their under-responsivity to tactile and deep pressure input may lead to poor body awareness, clumsiness or movements that are not graded appropriately. These children may not perceive objects that are too hot or cold or they may not notice pain in response to bumps, falls, cuts, or scrapes.

Postural Control Disorder - An individual with postural control disorder has difficulty stabilizing his/her body during movement or at rest in order to meet the demands of the environment or of a motor task. When postural control is good, the person can reach, push, pull, etc. and has good resistance against force. Individuals with poor postural control often do not have the body control to maintain a good standing or sitting position.

Dyspraxia/Motor Planning Problems - Individuals with Dyspraxia have trouble processing sensory information properly, resulting in problems planning and carrying out new motor actions. They may have difficulty in one or more of the following: 1) forming a goal or idea, 2) planning a sequence of actions or 3) performing new motor tasks. These individuals are clumsy, awkward, and accident prone. They may break toys, have poor skill in ball activities or other sports, or have trouble with fine motor activities. They may prefer sedentary activities or try to hide their motor planning problem with verbalization or with fantasy play.

Sensory Discrimination Disorder - Sensory discrimination refers to the process whereby specific qualities of sensory stimuli are perceived and meaning attributed to them. It is understanding accurately what is seen, heard, felt, tasted, or smelled. Individuals with SDD difficulties have problems determining the characteristics of sensory stimuli. The result is a poor ability to interpret or give meaning to the specific qualities of stimuli (Do I see a "p" or a "q"? Do I hear "cat" or "cap"? Do I Feel a quarter or a dime in my pocket? Am I falling to the side or backwards?). It is hard to detect similarities and differences among stimuli. Individuals with poor sensory discrimination may appear awkward in both gross and fine motor abilities and/or inattentive to people and objects in their environment. They may take extra time to process the important aspects of sensory stimuli.

NOW: With all that...why did I write a post on SPD? Well, our little Turbo has been evaluated and has been found to have a combination of the subtypes of SPD. The conclusions from the Evaluation are:

Impact of sensory over-responsivity on emotional regulation: Turbo's ability to relate to his environment is altered by his arousal level. When he is over-stimulated by tactile, auditory or multi-sensory input he has a difficult time self-regulating. He also is less tolerant of these sensations when he is experiencing other stressors. If he is emotionally challenged (i.e. transition) when he has a heightened arousal level, the is is more likely to have an outburst, run away or use an inappropriate coping strategy. This may explain why he has a varied response to inputs at different times, depending on what is "in his cup" at any given time.

Impact of sensory over-responsivity on self-care: Self-care's inherently imposed sensory experiences on young children can be a significant stressor for children and their families when they become a daily struggle. If Turbo has, in the past, had a "fight or flight" sensation around traditional self-care experiences, that emotional memory becomes ingrained and will make the next time he does the task emotionally over-arousing. If he begins a challenging sensory task, while emotionally over-aroused, it is more than likely going to end in a tearful power-struggle and another state of panic further ingraining his determination to avoid these activities. Clothing tends to be constant focus for many children like Turbo. When children feel out of control of their body and their environment they focus on the things that they can control like clothing. It is an adaptive way to make his body feel better. Family intervention that treats both the sensory and the emotional over-arousal is recommended.

Because eating is a sensory, motor and emotional challenge, it is not surprising that it is very difficult for him. Many times when children have sensory and motor aversions to food, the visual input is enough to evoke the physiologic memory of the food or a similar food and cause avoidance behaviors. In his mind, he is protecting himself from something that he feels honestly threatened by. When routine behaviors are not met adaptively, it can be very challenging for parents and children to feel successful. This can affect all of the relationships in the household.

Impact of sensory seeking on regulation and attention: Turbo is a very inquisitive and energetic guy whose body and brain is telling him to seek input. When his brain sees a pillow, it tells him to jump on it. When he hands see a vibrating toy, his brain tells him to pick it up. This drive to seek this sensation is VERY strong and frequently over-rides his better judgement making him appear hyperactive and inattentive. The input that he seeks and the way that he seeks it do not serve to regulate him and he frequently gets dysregulated in multi-sensory environments. When he is dysregulated, his voice gets higher, his force of movement gets stronger and his more impulsive. When he is in this state, his social interactions are affected because he is less likely to attend to the needs of others and to adhere to social norms for space and movement.

WOW! To say the least. I'm glad that someone else saw what I was seeing EVERYDAY! We will begin on September 20th for a marathon run of Occupational Therapy sessions ranging from 2 times a week to 4 times a week for 30 sessions. Right now, our schedule is taking us to the last part of January 2011. After that, we will see where his progress is, and determine our next steps.

So for school: Hmmm...Still thinking about that. I had originally planned to do a couple of hours in the morning while Tank slept 3-4 times a week with a couple of "FREE" days built in, and then some arts/science stuff in the afternoon before dinner. As of now, our schedule is so jumbled, we might have to take to squeezing in school time whenever we can when Turbo's "CUP" isn't too full of sensory input on a particular day. As of now, our main focus this fall semester is getting Turbo some help, and consequently, us some help so that we can begin to function again as a family rather than walking on eggshells around him so as to avoid a meltdown.

I am thankful for the help, words of encouragement and the phrase, "yes, we can help!", but am anxious about the massive amount of time, effort and understanding from family and friends these next few months will demand from our family. I covet your prayers during this time! WHEW! Totally covet them!

2 comments:

  1. Hi,

    I stumbled onto your blog, and thoguht I would say hi.

    The SPD path can be daunting, but therapy is amazing for kiddos like ours!

    Thanks for sharing -- keep going!

    Hartley
    Author of This is Gabriel Making Sense of Scool
    www.hartleysboys.com
    SPD Blogger Network

    ReplyDelete