The Journey: Sensory Discomfort to Sensory Comfort

We usually don't pay so much attention to our senses because we don't know how it feels when one of our senses does not work properly.

Just imagine, you are listening to one particular sound constantly, how does it feel to you? It's unbearable! Right? Actually people with auditory processing issues have to face this problem everyday.

Just imagine, you lose your balance every time you climb down the stairs, you will be frustrated. People with vestibular challenges face these issues. People with proprioception problems cannot feel their own body in the environment.

It is not easy for parents or caregivers to identify if a child's senses are not working properly. Sometimes we think a child is not responding to their name, because he does not want to but this is not the case. If a child is unable to process what you are saying, how can he respond to you? Or you can also see that many children get upset with light because they cannot bear that light. Sometimes children will scream suddenly because they cannot bear the sound though it sounds normal to us.

If we understand how our senses function, we can understand these problems. We commonly know about the 5 senses i.e. Auditory, Visual, Touch, Smell and taste. However there are three more senses that we normally do not speak about that much. These are Vestibular (Which is our sense of balance), Proprioceptive (which is our sense of body in space) and finally Interoception (Which is our sense of the performance of our internal organs that is shared with our brain).

Sensory function includes:

• Awareness

• Discrimination

• Recognition of sensory stimuli from the environment and Central nervous system(CNS) and use this sensory information for directing our motor behavior.

Sensory processing refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses. People with sensory processing issues can be overly sensitive to sounds, lights, textures, smells, flavors and other sensory input. Sensory processing disorder(SPD) is a neurological condition in which the brain has a difficulty in receiving and responding to information that comes in through the senses. Sensory processing disorder may affect one sense, like hearing, touch, or taste or it may affect multiple senses which is called multiple sensory disorder.

People can be over- or under-responsive to the things they have difficulties with. Children with sensory overresponsitivity are too excited or over aroused to participate and engage in a productive manner. Children with sensory underresponsitivity are too lethargic or unaware of internal and/or external sensory stimuli to participate in a meaningful manner.

Types of Sensory Processing Disorder(SPD):

• Sensory Modulation Disorder:

Sensory modulation is the organization of sensory information. Sensory modulation disorder is an inability in regulating responses to sensory inputs resulting in withdrawal or strong negative response to the sensations. Children with sensory modulation disorder

• Gets overwhelmed by loud noises

• Gets irritated by bright lights

Example: There was a child who had vestibular issues and he was scared of falling during sports and dancing in school. We started his sensory integration therapy. We used balance board activity, swiss ball exercises, trampoline, obstacles and hurdles activities with a therapeutic listening programme (TLP). After a few months, he started to participate in dance, sports and other activities in school.

• Sensory Discrimination Disorder:

Sensory Discrimination is a problem in interpreting differences or similarities in qualities of stimuli. For example, Children with SDD - Frequently drops things

- cannot differentiate between edible and non-edible things

- have poor balance or seem clumsy

- react poorly to sudden movements, loud noises or touches.

• Postural- Ocular Disorder:

Postural-ocular disorder is a problem with control of posture or quality of movements seen in low muscle tone or joint instability or poor functional use of vision. It always occurs with vestibular and proprioceptive problems. For example, Children with Post- Ocular disorder

• Difficulty in tracking objects with eyes

• Depth Perception issues

• Visual peripheral challenges

• Dyspraxia:

Dyspraxia is a problem with planning, sequencing and executing unfamiliar actions.

• Difficulty in playing with toys

• Difficulty in putting puzzles together

• Difficulty in academics can seem like learning disorders

Sensory distortions come from what might be described as a bottleneck in the information processing system. Incoming signals from the world outside are not in sync with the rate at which they can be processed. This can be due to hypersensitivity to external signals in any of the senses – vision, sound, touch, taste, smell and balance. With hyposensitivity the problem

is when the brain is not receiving enough of a signal. There also seems to be a more generalized confusion overloading the system.

Hypersensitivity and Hyposensitivity:

Hypersensitivities can occur in any of the senses. This includes both senses that receive inputs from the outside world – such as vision, sound, touch, smell, taste and balance – and internal sensations such as desire and embarrassment and other visceral feelings. Also included are proprioceptive signals which come from the sensors on our muscles and internal organs.

Example, there was a child who had lots of auditory issues. He used to get disturbed with any sound. We started his sensory integration therapy with a therapeutic listening program and transauricular vagus nerve stimulation therapy. Earlier he was not happy with any music. He used to squeal during activities. After therapy, he stopped squealing and started communicating.

Hyposensitivity is when the person is not getting enough of the signal to make sense of its message. This happens most often in relation to the internal muscular feelings or proprioception. Apart from hyper- and hypo-sensitivities, we may also be looking at more generalized sensory distortions, for example, such as lack of consistency and size shifting.

Example, We had one child who was hyperactive. He did not get enough information through his senses. He was not aware of danger. We started his sensory integration and reflex integration therapy with a therapeutic listening programme. Changes have been seen within months.

CONCLUSION

Treatment for SPD depends on a child's individual needs. But in general, it involves helping children do better at activities they're normally not able to perform and helping them get used to things they can't tolerate. Sensory integration means how we experience, interpret and respond to information coming from our senses. It is a neurological process that organizes sensory information of one’s own body and the environment in the brain to make adaptive responses and makes it possible to use our body effectively within our environment. It is important in all the things that we need to do on a daily basis, such as getting dressed, eating, moving around, socializing, learning and working.

So in Sensory Integration therapy, we help children learn to use all their senses together - that is audio,visual, tactile, proprioception, vestibular and olfactory. We used a therapeutic listening program, quick shift, braingym, and sensory motor programme, etc. The programme is individually designed according to the needs of the child which is done only after comprehensive assessment.

References:

• Amanda Pickett, DAPE Teacher, Sartell-St. Stephen Schools amanda.pickett@sartell.k12.mn.us and Michelle Schluender, PT, DPT Benton Stearns Education District mschluender@bentonstearns.k12.mn.us ‘THE AFFECTS OF REFLEXES AND SENSORY SYSTEMS ON GROSS MOTOR SKILLS.’

• Phoebe Caldwell with Jane Horwood (2008) “Using Intensive Interaction and Sensory Integration’

• Ayres, A.J. (1979) Sensory Integration and the Child. Los Angeles, CA: Western Psychological Services.