Sensory Processing Disorders may present itself as:

• over sensitivity to certain sensory input and under sensitivity to others
  
• vestibular system weakness affecting listening, eye functions, balance, muscle tone and proprioception.

Children who have trouble paying attention may actually be blocking certain types of sensory stimulation and seeking others, making it difficult for them to adjust their attention flexibly to meet varying demands from the environment. With this in mind, let’s take another look at our two students, Farah and Amaar.

Farah is over reactive to touch. Sitting in such close proximity to other children is stressful for her because she is constantly focused on avoiding being touched. If another child inadvertently brushes against her, she reacts aggressively, either because it actually hurts her more than a typical child, or because of her built-up anxiety. Because her attention is diverted to fending off unpleasant tactile stimulation, her ability to concentrate on the lesson is compromised. At the same time, Farah finds it calming when she touches other people and things. Fidgeting and picking at her socks actually helps her cope with her need to defend herself from unwanted touch, allowing her to be more attentive and less anxious.

Amaar, on the other hand is under responsive to touch and movement. He also has a poorly developed proprioceptive system resulting in his tripping and bumping into things and not registering pain. Because his brain does not efficiently process sensory information from his muscles and joints, he receives insufficient feedback and applies more pressure than necessary. Underlying Amaar’s hyperactivity is his need to seek out movement, tactile, and proprioceptive stimulation, which interferes with his ability to be attentive in class and to concentrate on homework.

Both children have difficulties with writing. Because of her over-reactivity to touch, Farah avoids the very movement activities, like painting, gluing, and modelling play-dough, that would develop her fine-motor skills and eye-hand coordination.

Problems with proprioception and spatial awareness often coexist with tactile sensitivities, making it difficult for a child like Farah to make sense of visually complex material like busy worksheets and puzzles.

Amaar’s under sensitivity to touch coexists with proprioceptive immaturities. He does not have a sufficiently developed sense of body in space and spatial awareness to help him distinguish between “b” and “d”, “M” and “W”, and “3” and “E”. Planning and sequencing the motor actions needed to write and draw do not come automatically for him, so he has to think before writing every letter and shape, which slows him down. He also has low muscle tone, resulting in a loose pencil grip, which affects the quality of his writing.

Some children compensate for low muscle tone by applying extra force, even using the muscles of the forearm, upper arm, shoulder and back to increase pressure on the pencil. These children soon develop stiffness and pain when writing more than a few lines.

Speech therapy, physiotherapy, and occupational therapy have traditionally been used to treat SPD, as well as other learning disorders. By gathering information from evaluations and assessments, it is possible to determine sensory sensitivities. The disorder can then be treated at its origin producing permanent changes in the nervous system, so that the child can learn and function more effectively both in school and daily life. Sensory integration assessments and therapy are generally done by an occupational therapist.

There are many theories regarding the cause of SPD and associated learning problems. There appears to be a genetic component or predisposition involved. However there is evidence of environmental factors. SPD is prevalent in adopted children, particularly those who have been institutionalized for the first year of life, and in premature babies having fairly long incubation after birth, resulting in a lack of normal movement and tactile stimulation. Since the vestibular system is located in the inner ear, problems can occur after repeated or severe ear infections. Limiting children’s natural movement by excessive use of infant seat, jumper and/or playpens can result in learning difficulties later in life.

Physical movement is crucial The neural pathways in the brain that later come into use for learning are formed through the simple physical movements that developing children normally carry out (i.e. rolling, crawling, climbing). It is vital that children have many and varied physical play opportunities. The best toys are the simplest ones. In this day and age children spend hours sitting in school, commuting by car instead of walking and then relaxing in front of the television or playing computer games, instead of engaging in active and imaginative play with other children in their neighborhood.

At the same time the rates of ADHD and Autism Spectrum Disorders are rising at an alarming rate. Physical movement and traditional play activities are the modalities by which children develop an integrated brain. These same activities, professionally administered, offer the “cure” for learning difficulties resulting from Sensory Processing Disorders.

About the Writer:
Andrea Khan, a graduate of Teachers College New Brunswick, Canada has been residing in Karachi for 19 years. Andrea taught at the Karachi American School for ten years. She coordinated the Learning Differences Project at Zubaida Medical Centre before launching her own organization, STRATEGIES FOR LEARNING, offering neurodevelopmental and sensory integrative therapies for children with attentional and learning disorders.