By the time they’re toddlers, most kids have developed clear likes and dislikes—some of which can seem pretty quirky. (Ketchup on waffles, anyone?) But when a child’s reactions to touch, sounds or food textures are so strong that they interfere with everyday functioning, it could be a sign of sensory processing disorder (SPD).
Children with SPD usually fall into one of two main categories: hypersensitive (over-responsive) or hyposensitive (under-responsive). These manifest in opposite ways, but the underlying issue is an inability to accurately process information relating to touch, sound, smell, movement or taste.
Hypersensitive SPD: Sensory Avoiders
Children with hypersensitive SPD are “sensory avoiders,” who perceive certain sensations very intensely. These children may have issues with the following:
- The feel of their clothes. Tags and seams in clothing can cause a lot of discomfort for hypersensitive children. They might be bothered by the length of sleeves or pants and the feeling of socks or underwear. They may also want to wear clothes that don’t match the season, such as short sleeves and shorts in winter.
- Certain sounds. Hypersensitive kids may experience everyday noises as physically painful. For instance, they may cringe when mail is dropped through the mail slot or cover their ears and run away when you vacuum the house. Regular lights in a classroom might even distract them and cause them to be misdiagnosed with Attention Deficit Hyperactivity Disorder (ADHD).
- Certain smells. Children with hypersensitive sensory issues may have a strong aversion to smells that don’t bother other people. When you prepare food for them, they might react by gagging. Sometimes these kids are misdiagnosed with reflux and put on unnecessary medications or simply labeled as picky eaters.
- Skin sensitivity or surface sensations. Grooming activities such as clipping nails, brushing teeth and brushing or cutting hair can be extremely unpleasant for a hypersensitive child.
- Group play. Hypersensitive children often prefer to play alone because they’re afraid of being too close to others or want to avoid being touched or hugged. Sometimes, these kids are labeled as loners, socially inappropriate or having a pervasive developmental disorder (PDD).
- Too much activity. Many hypersensitive kids favor sedentary activities such as coloring, playing with cars or completing puzzles instead of running and climbing like their peers. They’re often labeled uncoordinated or dyspraxic.
- Walking flat-footed. Some hypersensitive children avoid using their full foot when walking. The tendency to walk on tiptoes is a symptom of tactile sensitivity that’s noticeable early on in a child’s life.
Hyposensitive SPD: Thrill Seekers
Children with hyposensitive SPD are often mistaken as “fearless” or “thrill seekers.” They tend to have a high pain tolerance, resulting in injuries when they fail to react to whatever is causing harm. Where hypersensitive children withdraw from sensory input, hyposensitive children crave it.
Your child might have hyposensitive sensory processing disorder if he displays:
- Biting tendencies. Hyposensitive children often bite or chew on themselves, objects or other people for self-gratification and sensory input.
- A lack of body awareness. Children who are hyposensitive are constantly jumping, crashing, wrestling and falling. They might bump into people, push or pull door handles with too much force, touch animals or friends with too much pressure and be generally unable to grade their own force and movements. They’re often labeled as fidgety, not knowing their personal space and having difficulty sitting during circle time.
- Swallowing problems. Many hyposensitive kids eat very quickly. They have trouble swallowing effectively and may have choking issues.
- Difficulty staying still. Hyposensitive children crave movement and activity and find it hard to wind down.
- Difficulty transitioning between activities. It can be extremely difficult for hyposensitive children to stop what they’re doing and move on to something else.
Is It Really SPD?
All young children may exhibit some of these behaviors from time to time, and it’s not uncommon for a toddler to dislike having her nails cut or to throw a tantrum when it’s time to clean up the toys. But your child’s behavior may signal a more serious problem if:
- The behavior impacts your child’s ability to function in society.
- Transitions between activities lead to intense tantrums that aren’t easily overcome.
- The behaviors are consistent rather than an occasional “quirk.”
Strategies for Parents and Caregivers
If you suspect that your child has SPD, consult your pediatrician, who can refer you to a neurologist and an occupational therapist specializing in sensory issues.
Once an SPD diagnosis is made, here are some tips that can help:
- Acknowledge the indicators. Identify the stimuli affecting your child, and go through the motions with him by jumping along with him, replacing inedible chewing with edible chewing or having him brush your hair before brushing his own.
- Get everyone on the same page. Make sure all parents, siblings, caregivers and educators are aware of your child’s needs so they can make accommodations for him in social situations.
- Develop a bag of tricks. Learn what works to ease your child’s sensitivities, and make those tools available to all caregivers. Headphones for blocking out noise, a hat to shield a child who’s sensitive to light, chewy toys or crunchy snacks for oral seekers, and weighted blankets to calm a child during naptime are all good tools for helping the child self-regulate.
- Get involved in your child’s treatment. Sit in on therapy sessions to learn strategies for working with your child. Extending the therapist’s work into your home will help you see results much more quickly.
- Stay calm. To help your child cope with his extreme sensory responses, you must keep your own emotions under control. Get down to your child’s eye level, and let him ride out the tantrum. Jumping in too quickly can make things worse, so wait for a good opportunity to hold the child, make a strong connection, and try to calm him down.
- Use your words. For hypersensitive children, it’s helpful to redirect them to something else, using a soothing and calming voice. For hyposensitive children, get down to their level, and engage in their jumping or running, then gradually slow them down to switch activities. Using your child’s name and child-appropriate words can be effective, such as “James, your body is moving too fast/too slow/at just the right speed.”
A diagnosis of SPD can be overwhelming for the whole family, but helping your child is within your control. When you supplement your child’s therapy at home, develop some creative solutions and stay calm, you’ll see your child grow and thrive.
Rebecca Dean is the president of Tiny Tots Therapy Inc. and owner of Therapy Nook, Kids Blvd, and Fun Factory Sensory Gym. She earned her degree in occupational therapy from Kean University, and she’s praxis-certified and trained in sensory integration. Rebecca believes in a holistic therapeutic approach and realizes that alternative methods combined with traditional therapy allow children to acquire functional and developmental skills and retain them.