Sensory Processing Disorder
What is sensory processing disorder?
Sensory processing disorder (SPD) is a neurodevelopmental disorder that is characterized
by difficulties with organizing and using sensory information from the body and
environment. This sensory information includes vision, hearing, taste, smell, tactile
(touch), vestibular (perception of movement) and proprioception (perception of body
position). The inability to organize and use this information may interfere with
development and activities of daily life.
Typically, children are able to receive, manage, process and integrate all kinds of sensory
information through their central nervous system helping them learn, respond, and adapt
to their environment. Every child has preferences of how much or how little sensory
information he or she can tolerate or use to calm, concentrate or wake up. Winnie Dunn,
an occupational therapist, has identified four sensory processing patterns or styles (See
Dunn’s Model of Sensory Processing Characteristics).
Children with SPD have problems with receiving, organizing, integrating and responding
to sensory information. The severity and symptoms vary by child, but generally children
over respond, under respond or have altered perception or discrimination of this sensory
information. Because children with SPD do not interpret and organize sensory
information adequately, their response to the information often results in poor self
regulation, arousal, attention and motor skills which affect their emotional, social,
physical, and learning abilities. Children with other developmental disorders such as
autism spectrum disorders (ASD), attention deficit/ hyperactivity disorder (ADHD),
learning disabilities, fetal alcohol spectrum disorders (FASD), and developmental
coordination disorders (DCD) may also have sensory processing disorders.
How many children have a Sensory Processing Disorder?
The number of children with a SPD is not well documented. Approximately 5% of
children in early school age (kindergarten) were found to have a sensory processing
disorder according to a parental perception survey (Ahn, Miller, Milberger & McIntosh,
2004). Other sources estimate the prevalence is as high as 10-13% in early school age
children without other developmental disabilities (Anzalone, 2004). The number of
children with a SPD under the age of 5 is not known. The prevalence of SPD in children
with other developmental disabilities is thought to be higher than for children without
disabilities.
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Dunn’s Model of Sensory Processing Characteristics (Dunn, 1997)
Neurologic
Threshold
High
Explanation
Low
Explanation
Low
Registration
 Appear
uninterested,
disconnected
 Dull or flat
affect
 Low energy
levels
 Self-absorbed
Inadequate neural
activation to
support
appropriate
responses to
environmental
cues
Sensory Sensitive
 Aware of
surroundings and
stimulation
 Distractible
 May be
hyperactive
 Difficulty
maintaining
attention
Overactive
neural system
Sensory
Seeking
 Active,
engaging,
disruptive
 Require
novelty
 Fidget,
explore
objects
 Constantly
increasing
sensory input
Inadequate neural
activation
Sensory Avoiding
 Limit sensory
input
 Unfamiliar input
distressing
 Disruptive
 Tend to have
rituals, routines,
rules
 Rigid
 Avoid or
withdraw from
new, unfamiliar
activities
Sensory
sensations
uncomfortable,
irritating,
frightening
Behavioral
Response
Passive
Active
Brain is not
receiving
adequate sensory
stimulation to
respond
appropriately
Driven to activate
neural system
through sensory
seeking behaviors
What are the causes of Sensory Processing Disorder?
The cause of SPD has not yet been identified but it is believed to be a distinct
neurodevelopment disorder.
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Difficulty
habituating
Overly active
neural system
that is highly
sensitive to
stimulation
What are the developmental complications of Sensory Processing
Disorder?
There are differences in the physiologic response to sensory stimuli and an altered ability
to habituate, or reduce reaction over time. A wide range of social, emotional, behavioral,
and functional difficulties can be seen in children with SPD. These difficulties disrupt
daily life and affect participation in home, educational and community environments.
Domain
Social-emotional
Behavioral
Functional
Areas of difficulty
Play skills
Social interaction
Self-esteem
Attention
Fear
Anxiety
Avoidance/Intolerance
Motor skills
Balance
Daily living activities
Self-confidence
Withdrawal
Self-regulation
Tantrums
Feeding problems
Coordination
Motor planning
What affect does SPD have on learning in young children?
Sensory processing disorders effect the way a child interacts with their environment and
their opportunities for learning. Depending on the nature of the disorder in the individual
child, they may avoid learning opportunities or be too distracted to learn from their
environment. Dunn and others have described the impact of SPD on learning according
to their sensory threshold and response.
Profile
Low
Registration
Sensory
Sensitivity
Sensory
Seeking
Sensory
Avoiding
Characteristics
Effect on Learning
Disinterested, unengaged, underactive  Need increased external
structure and support
 Provide cues to maintain
engagement
Hyperactive, distractible
 Reduce distractions
Difficulty with sustaining attention
 Organization
 Routines
 Clear expectations
Distractible, hyperactive
 Need increased external
Fidget, disruptive
structure and support
Impulsive
 Embed needed sensory input
Disorganized
into tasks, routines
Disruptive
 Reduce unnecessary input
Ritualistic
 Introduce sensory
Routines
experiences carefully
Habitual
 Controlled environment
Narrow interests and experiences
 Provide clear expectations
 Avoid power struggles
 Acknowledge cues
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Screening and assessment tools used to help identify young children
with Sensory Processing Disorder
There are several screening and assessment tools designed to measure the response and
integration of sensory information from infants through adults.
Sensory Integration and Praxis Test (SIPT): school aged children
http://portal.wpspublish.com/portal/page?_pageid=53,123039&_dad=portal&_schema=P
ORTAL
Sensory Profile and Short Sensory Profile: versions for infants, children,
adolescents/adults.
http://pearsonassess.com/HAIWEB/Cultures/en-us/Productdetail.htm?Pid=076-1638-008
Sensory Processing Measure (SPM): school aged children
www.wpspublish.com/spm
What are the interventions used with Sensory Processing Disorder?
An early intervention or school age related service provider familiar with SPD designs a
program for children based on their severity and symptoms. Interventions include
increasing the tolerance threshold to the unwanted sensory stimuli, increasing awareness
to sensory information, improving the perception and discrimination of the information
and support for motor, balance, coordination and motor planning skill development.
Interventions are also specific to a child’s educational needs. Interventions that match a
child’s sensory profile are also incorporated into everyday activities and routines. The
following chart provides simple suggestions that correspond to each of Dunn’s four
profiles.
References
Ahn, R.R., Miller L.J., Milberger, S. & McIntosh, D.N.(2004). Prevalence of parents'
perceptions of sensory processing disorders among kindergarten children. American
Journal of Occupational Therapy. 58(3) 287-293
Anzalone, M. E. (2004). Sensory integration disorder. In Parker, S. Zuckerman, B.S. &
Augustyn, M. C.(Eds.) Developmental and Behavioral Pediatrics: a Handbook for
Primary Care Edition: 2. Lippincott Williams & Wilkins.
Dunn, W. (2007). Supporting children to participate successfully in everyday life using
sensory processing knowledge. Infants and Young Children, 20(2)84-101.
Dunn, W. (2001). The sensations of everyday life: Theoretical, conceptual, and pragmatic
considerations. American Journal of Occupational Therapy. 55(6) 608-620.
Dunn, W. (1997). The impact of sensory processing abilities on the daily lives of young
children and their families: A conceptual model. Infants & Young Children. 9(4), 23-35.
Jirkikowic, T., Olsen, H.C. & Kartin, D. (2008). Sensory processing, school
performance, and adaptive behavior of young school-aged children with fetal alcohol
spectrum disorders. Physical & Occupational Therapy in Pediatrics. 28(20, 117-136.
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Miller, L.J., Anzalone, M.E., Lane, S. J., Cermack, S.A., & Osten, E. (2007). Special
Issue: Cenceptualizing and identifying sensory processing issues. American Journal of
Occupational Therapy, 61 (2). 135-259.
Willimason, G. G. & Anzalone, M.E. (2001). Sensory Integration and Self- Regulation in
Infants and Toddlers: Helping Very Young Children Interact with Their Environment.
Washington, DC: Zero to Three: National Center for Infants, Toddlers and Families.
Resources
Dunn, W. (2008). Living Sensationally: Understanding Your Senses. London and
Philadelphia: Jessica Kingsley Publishers.
Kranowitz, C. S. (2005). The Out-of-Sync Child: Recognizing and Coping with Sensory
Processing Disorder 2nd Edition. New York: Perigee. http://www.out-of-sync-child.com/
Miller, L.J. & Fuller, D.A. (2006). Sensational Kids: Hope and Help for Children with
Sensory Processing Disorder (SPD). New York: Penguin Group Inc.
Sensory Processing Disorder Foundation (SPD) http://www.spdfoundation.net/index.html
Sensory Processing Disorder Resource Center http://www.sensory-processingdisorder.com/
Cite As: Georgetown University Center for Child and Human Development.
Contemporary Practices in Early Intervention: Sensory Processing Disorder Primer.
2011. Available online at http://www.teachingei.org.
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