Sensory Processing
Sensory integration or sensory processing refers to the way in which a child registers and perceives
information through a variety of sensory channels. Organization of multiple sensations is needed to
adequately adapt to environmental demands. Frequently difficulties in sensory processing underlie
difficulties in behavior, coordination, attention, and completion of routine tasks. Sensory modulation
is the ability of the nervous system to regulate, organize, and prioritize incoming sensory information.
It occurs when the sensation is received and is interpreted by the brain as relevant or irrelevant.
When the brain is constantly responding to irrelevant information, resultant behavior appears to be
inappropriate and the nervous system becomes overworked or stressed. Sensory modulation problems
are related to overall arousal states of the nervous system and can affect behavior and emotions, as
well as motor responses. When a child experiences difficulty modulating the information around them
and becomes over-aroused, this over-stimulation can be observed in behaviors such as acting very
active or silly, becoming inattentive and distractible, demonstrating fear, striking out, and becoming
non-compliant or withdrawn. Children experiencing low arousal may appear unmotivated, slow, or lazy.
They may also exhibit fidgeting and overactive behaviors in an attempt to increase their arousal state.
Fluctuation between over-arousal and under-arousal of the nervous system occurs naturally in
all people to some degree. A well-modulated nervous system adapts to changes in the environment, has
a level of attention appropriate for the task, blocks out irrelevant information, and attends to the
relevant stimulation, making an appropriate response. Fluctuation of arousal level becomes
problematic when the extreme fluctuation occurs (either under/over aroused) on a routine basis or
when the ability to achieve or return to a moderate state of arousal takes a long period of time and
interferes with performance.
The following information is taken off of the Sensory Profile Questionnaire.
This test is designed to evaluate the possible contributions of sensory processing to the child’s daily
performance patterns and to provide information about both the child’s tendencies to respond to
stimuli and which sensory systems are likely to be contributing to or creating barriers to functional
performance. The profile consists of questions that are divided into three main sections:
Sensory processing: indicates the child’s basic response to sensory systems. It is further divided into
6 subcategories: auditory, visual, vestibular, touch, multisensory and oral sensory.
Modulation: reflects the child’s regulation of neural messages through facilitation or inhibition of
various types of responses. It consists of sensory processing related to endurance and tone.
Modulation related to body position and movement, modulation of movement affecting activity level,
modulation of sensory input affecting emotional responses, modulation of visual input affecting
emotional responses and activity level.
Behavioral and Emotional Responses: reflects the child’s behavioral outcomes of sensory processing
which is broken down into emotional/social responses, behavioral outcomes of sensory processing, and
items indicating thresholds of responses.
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Sensory Processing: The Sensory processing profile identifies responses to the basic sensory
processing systems and their functional cognitive expression.
Tactile Processing: The tactile system serves two functions. One function is to protect
us from stimuli that are interpreted as harmful by the brain. Individuals with an overly
sensitive or under responsive tactile system interpret touch differently. When tactile inputs
are misinterpreted as being harmful, stimulation from certain types of clothing, food,
texture, or unexpected touch may elicit emotional reactions such as pulling away, striking out,
or increased or agitated activity. This routine misinterpretation or unusual reaction to touch
is referred to as tactile defensiveness. The second function of the tactile system involves
the discrimination of touch that enables us to learn about and identify size, shape and
texture of objects in the environment. Tactile discrimination allows one the ability to
distinguish the difference between a coin and key in one’s pocket or to realize a piece of food
in still on your lips. Tactile processing difficulties also impair awareness of tongue and mouth
is seen with selectivity of food textures and speech delay. Hypersensitivity to touch will
result in a flight or fight response to unexpected or light touch. The touch section measure
the child's responses to touch to the skin, i.e.: becomes irritated by shoes or socks, itchy
material, doesn't like wind blowing on their skin, and doesn’t feel anything.
Proprioception: The proprioception system is comprised of a variety of receptors within
our muscles, joints, ligaments, and tendons. These receptors provide feedback regarding the
amount of force a muscle is exerting, the position of a body part in space, and assist with
providing feedback to perform gross and fine motor activities. The receptors in the muscles
also constantly provide feedback to the brain creating postural tone and balance . Challenges
in this area can result in poor body awareness, poor static balance, difficulties in motor
sequencing, or difficulties self-regulating during movement.
Vestibular processing: The vestibular system receives information from receptors
inside the inner ear regarding the position of the head, the detection of movement, and
direction of movement. The sensations of input gathered by the vestibular system have a
direct bearing on one’s sense of balance, head control, eye gaze, and postural muscle tone. It
is responsible for balance and bilateral coordination (coordinating movements of the arms and
legs and the right and left sides of the body). The vestibular system is neurologically
connected to the visual and proprioceptive systems. Together these three systems develop
“maps” which are used to navigate the body successfully through space and perform a wide
variety of motor activities. If these systems are impaired the child cannot develop a motor
map and he/she has a hard time coordinating movements to skip, pedal a bicycle, cut with
scissors, or draw a circle on a piece of paper. Delayed motor planning affects the child’s
future preschool and academic success, since performing activities such as writing, cutting,
and reading all involve complex motor sequences. This section measures the child's responses
to balance and movement, i.e.: becomes anxious or distressed when feet leave the ground, has
trouble walking on uneven surfaces, car sickness, headaches.
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Taste: Taste discrimination helps the child discriminate food flavors. This in turn sets the
child up for attending and focusing. Challenges in this area can result in poor perception of
taste or a need for high intensity of sour or spice. Hypersensitivity may result in picky eating
or gagging.
Olfactory: The ability allows the child to activate a strong memory system and emotions. It
has the ability to calm or excite a child. Challenges in this area can result in hyper response or
hypo response to which a child may be overly sensitive to smells or unable to notice smells in
his/her environment. The oral sensory section measures the responses to touch and taste
stimuli to the mouth, delimits food preference based on texture or temperature, aversion to
things in or around mouth, or puts everything in mouth, difficulty with articulation.
Vision: The vision system is connected to all the other sensory system. Vision is paired with
movement to give an understanding of position in space. It is paired with touch to give the
understanding of form perception. This is not the same as eyesight. Visual processing is the
ability to understand visual information, not perceive the stimulus at a specific distance from
the eye. Hypersensitivity can result in sensitivity to light or visual distractions. This section
includes items that measure responses to things seen. i.e.: bothered by bright light, doesn't
look directly at objects, doesn't notice light, ignores objects, and misses details.
Auditory: Auditory information gives up the ability to perceive sounds and localize sound
within the development. It is the foundation for language development. It connects with the
brain area that is responsible for attending and focus. Hypersensitivity results in a flight or
fight response to sudden or loud noises. Children can have difficulties with discriminating
sounds, filtering sounds within the environment, or understanding the meaning of sound. The
items included in the auditory section measure responses to things heard. i.e.: distracted by
noise, noises seem too loud, trouble functioning with certain noises, doesn't hear or tunes out.
Multisensory Processing: Items in this section measure the child's response to
activities that contain a combined sensory experience, i.e.: seems overwhelmed in an active
environment, melts down, hyperactive, or catatonic.
Modulation: The Modulation section attempts to measure regulation of neural messages through
facilitation or inhibition of various types of responses. Modulation is broken down into six areas of
sensory modulation:
Sensory Processing Related to Endurance/Tone:
This section measures a child's ability to sustain performance, i.e.: tires easily, poor
endurance, breath control.
Modulation Related to Body Position and Movement: Items in this section
measure a child's ability to move effectively, i.e.: takes movement or climbing risks play that
compromise personal safety, or refuses to climb due to fear of place in space.
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Modulation of Movement Affecting Activity Level: This section measures a
child's demonstration of activeness, i.e.: spends most of the day in sedentary play.
Modulation of Sensory Input Affecting Emotional Responses: These items
measure the child's ability to use body senses to generate emotional responses, i.e.: rigid,
rituals, overly emotional
Modulation of Auditory Input Affecting Emotional Responses and Activity
Level: Items in this section measure the child's ability to integrate auditory stimuli and how
it effect their emotional responses, i.e.: anxiety over loud noises, inattention due to
background noise.
Modulation of Visual Input Affecting Emotional Responses and Activity
Levels. Items in this section measure a child's ability to use visual cues to establish contact
with others, i.e.: stares intensely at objects or people.
Behavioral and Emotional Responses: The Behavioral and Emotional Responses section
reflects the child's behavioral outcomes of sensory processing.
Emotional/Social Responses.
Indicates a child's psychosocial coping strategies, i.e.: have fears that interfere with daily
routine.
Behavioral Outcomes of Sensory Processing.
Indicates the child's ability to meet performance demands, i.e.: has difficulty tolerating
changes in plans and expectations, difficulties in transitions.
Items Indicating Thresholds for Responses.
This section includes items that indicate the child's level of modulation, i.e.: jumps from one
activity to another so that it interferes with play, can't engage with play.
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