Sensory processing concerns 

Toddlers who hate the bath, babies who refuse to let you dress them, little ones who will only eat three specific foods – these are all pretty common problems new parents face. Babies and and toddlers have sensitive skin, tendencies towards sweet flavors, and can be wary of new experiences. Some young children, though, have a harder time adjusting to new sensations, flavors, textures, and sounds, and one reason that may happen is because of sensory processing issues.

What is sensory processing? 

Sensory integration is the ability to take in, organize, and understand the information the senses are picking up – the sights, smells, tastes, sounds, and tactile sensations around a child – unconsciously, and without effort. Children with normal sensory processing abilities are thought to be able to understand all of the sensations that go with an action as part of one experience – the feeling of the water around them as well as the sound of the tap running into the bathtub, and the way the room looks from the point of view of the bathtub. Children who have sensory processing problems, on the other hand, are thought to have trouble organizing those feelings into one experience, and can be over- or under-sensitive to stimuli, or can have unusual, unpredictable responses. 

Common sensory-based problems 

The areas where children with sensory processing difficulties have trouble tend to be with touch, sound, or food textures. These can appear as an increased sensitivity, as with children who can’t stand loud noises, or will only eat very specific textures. They can also show up in an absence, like children who seem to have a much higher tolerance for pain than normal, or who may not notice walls or cars or other obstacles in the world around them.

Toddlers who may be having trouble with sensory processing may:

  • Have severe aversions to noise or light
  • Resist the feeling of clothes or shoes that are too itchy, too tight, or too confining
  • Get very preoccupied with sniffing or licking non-food objects
  • Resist being touched, or be very sensitive to touch, and a light touch may be experienced as painful, while deep pressure may feel calming
  • Withdraw from unexpected touch
  • Compulsive touching of certain things and complete aversion to others
  • Indifference to pain
  • Hypersensitivity to some sounds, and complete indifference to others
  • Only eat certain foods or certain textures
All of these signs can also be signs of other concerns or disorders as well, however, and can also be part of normal stages of development. If reactions like these start to get in the way of your child’s day-to-day life, check in with your pediatrician.

The debate over sensory processing disorder

A sensory processing disorder (SPD) is not an official diagnosis, although occupational therapists (OTs) use the label as a way of directing appropriate treatments. Since sensory processing disorder is not an official diagnosis, it’s hard to tell how many children are affected by sensory processing concerns, but one survey’s conservative estimate suggested that about 5% of children have sensory processing difficulties.

The fact that many children have trouble with sensory processing isn’t up for debate, but it’s not clear whether sensory processing problems are a separate disorder, instead of a symptom of several other disorders. When a child presents with multiple sensory-based problems, other developmental and behavioral disorders must always be considered, and a thorough evaluation should be completed. In 2012, the American Academy of Pediatrics released a policy statement that cautioned pediatricians not to use SPD as an independent diagnosis.

Sensory processing and other disorders 

Sensory processing concerns often occur in children who are also diagnosed with other disorders. Disorders that are often comorbid (two conditions that appear together) with sensory processing difficulties include:
  • Autism spectrum disorder
  • Attention deficit/hyperactivity disorder
  • Fragile-X syndrome
  • Down syndrome

How are sensory processing problems treated?

The data for the efficacy of treatments of sensory-based problems are limited, but children with sensory processing may benefit from evaluation and treatment by a developmental pediatrician or child psychiatrist. These pediatric specialists may then refer an occupational therapist. Occupational therapists often use sensory-based therapies (also called sensory integration therapy) based on play using sensory experiences like brushes, touch, pressure to help children acclimate to different sensations gradually. Nevertheless, research behind the effectiveness of sensory integration therapy is limited and inconclusive.

If you believe your child may have sensory processing issues, it’s a good idea to bring it up with their doctor at the next well-child visit.

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