Too sticky, too wet, too loud, too bright, too mushy! Not bouncy enough, not tight enough, not soft enough, not crunchy enough! Sound like a child you have or know? Sound like an adult you know? As humans, we all have certain sensory needs or sensitivities. Sensory processing is a way of our brains and body to understand the external stimuli through our five senses: sight, sound, taste, feel and smell. Around the toddler age, kids start to develop an awareness for what type of sensations they prefer, tolerate or dislike. For example, they might love being tucked in tightly in a blanket, or hate the feel of grass on their bare feet. They might like the smell of cookies, but reject certain foods based on their texture when it’s in their mouth. As adults, a lot of these sensory preferences or aversions stick, but over time some of them may change. We may become more open to different sensations that we formerly opposed. For instance, we might hated wearing clothes that were too tight, and now it might be any everyday staple. We might have loved getting messy and playing in the mud as a child, and now might maintain a very clean and organized lifestyle. Here are more examples and explanations about Sensory Processing with Adults.
My son is two and a half and his personality is definitely shining through. He’s a very social and energetic kid, loves meeting new people and discovering new things about the world. Like most toddlers, he also has established some strong likes and dislikes for certain sensory experiences. He’s never been a fan of being wet; as a baby he would scream during every bath or when we would swim in the pool. These days he loves the bath, but hates his face or hair getting wet. He likes being sprayed with a sprinkler, but hates going swimming. What bothers him the most is when the clothes he is wearing gets wet and sticks to his skin. It drives. him. bananas. Basically a sensation that some kids don’t even mind, he finds to be incredibly uncomfortable to the point of full-on meltdown unless the wet clothes are removed immediately. In occupational therapy world, we call this reaction “tactile defensiveness” and his system is overstimulated by this sensation. I’ll explain a little more about this in little further down.
Another thing you might notice about Chase is that he is very heavy handed, a little clumsy and somewhat of a “brute”. He’s always stomping around, pushing heavy boxes or furniture, jumping off of things and rolling on the ground. Even though he loves his little baby brother, he always is trying to squeeze his face or limbs like a lemon. He’ll give huge bear hugs, or squeeze or pinch my arm or leg when he’s excited. He doesn’t do this out of malice, but almost like he’s trying to transfer his happy energy. Well what he’s actually doing is seeking out proprioceptive input. Proprioception is a lesser known sense than the 5 majors ones, and deals with the feelings of the joints: feeling your hands grasping an object, your feet placed firmly on the ground, your entire body sliding an Amazon package across the floor.
What’s the Big Deal?
I know what you’re thinking. “Carolyn, these are typical toddler behaviors, it’s no big deal, he’ll grow out of it”. You’re right! This is very much being a toddler and it isn’t a big deal. As an occupational therapist, we have a clinical eye for understanding these behaviors. Why is this helpful to know? Think of a kid who can’t stand the sound of people clapping and covers her ears every time. Think of a kid sitting in a classroom who can’t sit for more than one minute without jumping out of his chair. Or how about a kid who can’t stand when something is out of place and needs to reorganize the toys until it looks right? Sometimes these reactions are innocuous, sometimes they can really impact their ability to function in typical settings. According to a study in an OT journal (sorry I can’t link it) reports that, “approximately 5% to 14% of typically developing children have some difficulties in sensory processing.” THIS DOES NOT MEAN THEY ALL HAVE AUTISM.
Chase’s teacher’s have mentioned to me that when he gets really excited he will hug or squeeze his classmates really tightly, and they tend to push him away when he does this. This may seem cute, but it can be really annoying to his peers if he’s constantly squeezing them. When you’re in a preschool setting, appropriate socialization and knowing boundaries with peers is an important skill. His teacher’s also mentioned that during splash day, Chase stayed away from all the water action and when he did approach and got his shirt wet, he had a meltdown and wanted it taken off right away. Again, the reactions are not worrisome, but when it’s affecting a child’s function in typical settings, it never hurts to address the issue. (I’m an OT, so of course I’m going to address it)
Also, knowing that these reactions are SENSORY based and not BEHAVIORAL based is very important. Often kids who react to stimuli in an abnormal way are assumed to be “acting out” or “defiant” or having ADD/ADHD, when really their sensory processing system is not being self-regulated very well.
So what do you do about it?
As occupational therapists, we identify a person’s abnormal reactions to stimuli or the environment as either behavioral or sensory. If it is behavioral, we address it with cognitive-behavioral training or other methods. If it is sensory-based, we help reorganize the body’s way of reacting to stimuli, known as Sensory Integration Therapy. This may include activities to desensitize their overstimulation to a stimuli, or so that they can fulfill whatever sensory need is not being adequately met.. To put it in simple terms, we help clients learn to regulate their sensory processing systems. Think of how you stand up and stretch when you’ve been sitting for awhile because your body is craving movement. Same thing applies to a lot of sensory processing. Here is a great description about sensory processing and how an OT is involved.
OT with Chase
Chase doesn’t have a sensory processing disorder, per se, but he does have some sensitivities and sensory regulation quirks that can be worked on. Chase is tactily defensive with water in his face and on his clothes, which means he reacts defensively to the feel of water on his skin. To address Chase’s aversion to being wet, I start with small interactions with water and gradually increase the intensity of the interaction. The key is to keep the intensity at a level that makes him feel safe and simultaneously providing positive feedback and praise. He started off with his feet in the water, and then his hands, and eventually stood on the first step of the stairs. When I would spray him with water, he was able to run and wipe his face and returned for more spraying, which was a positive interaction.
To address Chase’s squeezing issue, or under-stimulation to proprioceptive input, I notice cues when he is seeking out this type of input from his surroundings (like excessive crashing toys, pushing furniture around, squeezing our faces or limbs a lot) and channel that energy into a therapeutic activity. I’ll give him a pillow to squeeze, have him throw a ball against the wall, or his new favorite: the wheel-barrow. This puts weight through his hands, elbows and shoulders as he “walk” forward on his hands. To up the ante I’ve had him roll belly down onto a giant therapy ball (of course we have on in our house), and walk on his hands to retrieve a toy and walk back.
Another activity that is great for proprioceptive input is the slide: Pulling and stepping up the ladder, and feeling the feedback as the feet hit the ground to stop you. Most of the time we tell kids not to walk up the slide. Well I let my kid do it, at home or if no one else is at the park. It’s awesome for getting that input to his joints while he pulls his body weight against gravity up the slide.
A bonus activity that Chase made up himself was to pick up the ball and roll it down the slide. While there isn’t too much proprioceptive techniques involved in this, it does take hand-eye coordination, strength and cognitive strategy, which make it a super therapeutic and educational activity!
So my kid has a few sensory needs…for now. Could he totally grow out of it? Probably. Am I concerned? Not at all. Part of the stigma of seeking help from clinical professional is the fear of accepting “something is wrong with my kid”. However, identifying the problem that they are experiencing does NOT MEAN something is WRONG with them. They are beautifully and wonderfully made, just need some tweaking every now and then ;-). Do you have or know any kids with sensory processing difficulties? Let’s connect and talk about it!