Your child learns about the world through his senses, with all of the sounds, sights, touches, movement, tastes and smells working together to provide an accurate picture of the world. For most kids, sensory integration (SI) develops automatically.
Kids with SI problems experience the world differently. Sensory input can come in too loud or too quiet. A child may be terrified by the vacuum cleaner— and yet not seem to hear you when you call his name. A gentle touch on a child’s arm can feel like coarse sandpaper.
Sensory problems can range from mild “quirks” to intense reactions to everyday sensations. The behaviors are a problem when they are way out of proportion with the actual experience. Being afraid of a bleating goat at the petting zoo is not unusual for a toddler, but having a meltdown every time you put him in the bathtub or take him to the supermarket is a warning sign.
Sensory problems can cause distressing behaviors and developmental delays. If the noise of other children on the playground alarms a child, it’s no wonder he’ll only play in the sandbox in the corner rather than learn to climb the chain ladder. And if a school-age child is distracted by every sight and sound in the classroom, he won’t be available for learning.
Common Signs of Sensory Problems
- Over or undersensitive to touch, movement, sounds, sights, tastes or smells.
- Dislikes getting “messy” especially on hands or face— or seems oblivious to it.
- Bothered by particular clothing fabrics, tags, etc.
- Avoids or excessively craves intense movement.
- Squints, blinks or rubs eyes frequently.
- Resists grooming activities.
- Avoids foods most children enjoy.
- Gets dizzy easily or never at all.
- Seems clumsy or careless.
- Uncomfortable in group settings.
- Always on the go— or never sits still.
- Poor attention and focus.
The Seven Senses
There are tactile receptors not only on the outer skin but also lining the mouth, throat, inside the ears and so on. Light touch is often upsetting to a child with sensory problems. He may be distressed by diaper changes or clothing fabrics, by feeling lotion or sticky substances and by grooming activities such as hair washing. Firm touches such as bear hugs are often more tolerable. Vibration from a toy or appliance such as a refrigerator can be disturbing for some children. On the other hand, a child might think sitting on the washing machine or using a vibrating toothbrush is marvelous!
Pain and temperature are also tactile experiences. Some children crave freezing cold ice cream while others want to gobble up pizza while the cheese is bubbling. And some children refuse to eat any food that isn’t exactly their favorite temperature. Some children with tactile problems are howlingly sensitive to a small scrape while others are unaware of a broken bone.
Kids with a sensory problem can show a confusing mix of both hypersensitivity and undersensitivity, such as refusing to walk barefoot but not reacting when he bangs his head.
Listening involves both hearing and processing sounds. Sound has many dimensions: loudness, frequency/pitch, duration (how long it lasts) and localization (where it’s coming from). A child with sensory problems may have trouble putting all these qualities together.
A child with hypersensitive hearing picks up on things others don’t hear. With so much input, it’s hard to filter out irrelevant sounds and attend to what’s important. While most of us get uncomfortable when sound volume exceeds a certain level, an oversensitive child may become miserable at a much quieter level. Some are sensitive to higher sound frequencies (like a ringing telephone) or to lower frequencies (like a truck rumbling outside). If a child tells you that a sound hurts, believe him.
Poor visual acuity and impaired ocular-motor and other visual processing skills are common, and can make tasks like playing ball, reading and writing difficult. A child may be hypersensitive to color, patterns, lights, movement and contrast— and even see and hear the flicker of fluorescent lights.
Some children are visually distractible. With so much to see, they have problems attending to what’s important. A child might compensate by hyperfocusing. A child engrossed in rolling a toy car back and forth may be taking a break from an overwhelming world by tuning it out.
Taste and Smell
We only taste four things: sweet, salty, bitter and sour. Everything else is smell. For some children, life literally stinks— from that minty toothpaste to the smell of their own diaper, clothing detergent and so on.
Kids with sensory issues are notoriously picky eaters. Food issues can be about taste and smell, but most commonly also revolve around texture and temperature as well as neuromuscular issues inside and around the mouth.
Proprioception relies on receptors in joints, muscles and connective tissue to tell you where body parts are without looking. A child who lacks a trustworthy internal body map may be clumsy, move slowly and have trouble with fine motor tasks such as handwriting.
Some kids crave proprioceptive input; they crash into walls or bang and throw toys and roughhouse to get stronger sensory messages. Other children avoid it, preferring to slump on the couch or floor like a wet noodle.
The Vestibular Sense
Anytime a child moves his head, vestibular receptors inside the ear signal a change in relationship to gravity. He uses this information when he bends over to pick up a ball to make postural adjustments and not lose his balance.
Children with vestibular issues often have an exaggerated response to anti-gravity movements way out of proportion with the possibility of falling. Going on playground swings or down the slide may feel like bungee jumping. They may quickly get dizzy or nauseous on carousels or riding in a car. They may have low muscle tone and difficulty moving gracefully.
Where to Get Help
Fortunately, much can be done to help a child with sensory issues. The first step is to get an occupational therapy (OT) evaluation. If your child is under age 3, he is eligible for a free multidisciplinary evaluation and (usually free) services through each state’s Early Intervention (EI) program. Find a local EI agency by looking in the yellow pages or visit our Web site at www.sensorysmarts.com to find your statewide program’s contact information. Children older than age 3 can get a free evaluation through the local school district. You can also obtain an OT private evaluation, covered by most insurance.
If your child has sensory issues, the OT will work with you, your child and your child’s school to strengthen his sensory skills, and may also suggest environmental and activity modifications to make them more comfortable for your child. The OT should also provide your child with an individualized “sensory diet” of daily activities that satisfy your child’s sensory needs.