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What is Sensory Processing?

This is the ability to register, discriminate, adapt and respond appropriately, both physically and emotionally to sensory input from our bodies and the environment.

We receive a great deal of information from our senses. We use this information in many ways – to help us understand our body, understand the environment, and successfully interact in the world.   

Some children are over responsive or under responsive to sensory inputs, and this can impact on their daily activities.   A child can be over responsive in one sensory area and under responsive in another. There are many contributing factors.

 

Sensory processing difficulties

Some children have sensory processing difficulties. Children with an Autism Spectrum Disorder can have sensory processing difficulties associated with their diagnosis.

 

Children with sensory processing difficulties can be very sensitive to certain sensations – noise, smell, texture or touch. They might try to avoid these sensations through certain behaviours. Other children are not very sensitive to certain sensations such as food around their mouth, movement or body position. They might actively seek sensations through behaviours such as chewing non-food items, fidgeting or being generally on the go.

 

This can really vary form one day to another, and can look very different for different children. When children have difficulty processing sensory information it can make every day activities challenging.

 

Sensory integration therapy

Bedfordshire, Luton and Milton Keynes (BLMK) Integrated Care System recently completed an evidence review for sensory processing to understand effectiveness and impact of interventions to support children with sensory processing needs.  The recommendations concluded that we will not currently offer sensory integration therapy in BLMK as it is not an approach that is recommended by the Royal College of Occupational Therapy, or by The National Institute for Health and Care Excellence (health and social care evidence-based guidance).

Our evidence based approach in BLMK is centred on changing the things around the child, such as the environment, the child’s activities and their personal factors, such as parent/carer knowledge and understanding (through parent/carer and education information and training programmes).

 

Where can I go for more information?

Bedfordshire Community Paediatric Occupational Therapy Service have created a 25 minute online presentation to give more details on Sensory Processing Difficulties (SPD) and what strategies could be used to help children with managing these difficulties. You can view the training and resources by clicking here

 

Bedford Borough and Bedfordshire Clinical Commissioning Group have commissioned training for parents and schools on Sensory Processing Difficulties. The dates and times for this training can be found in the ‘What’s On’ section of the Local Offer or through searching for the term ‘Sensory’ in the search terms.

Parents have found the following ‘top tips’ information useful. This has been produced by Sheffield Children’s Hospital NHS Trust. 

If you think your child has sensory processing difficulties you can talk to any health or education professionals working with your child. They will help you unpick your child’s behaviours, and whether or not they are sensory, or have another cause.  For example it can be that children with high levels of anxiety display higher levels of sensory sensitivity, or children who are struggling to communicate can use sensory behaviours to gain attention.

 

Ways to help with sensory difficulty

Sight

Difficulty identified

Suggested activities/strategies

Holds objects close to eyes

• Eye test to check for short-sightedness

• Help child to filter out irrelevant information and focus on what is important to them

Fascinated by tiny threads on carpet/small patterns

• Place large play mat/cloth on floor to discourage thread pulling and encourage task focus

Stares at fluorescent lighting

• Offer sensory environments as relaxing alternative

Likes to see toys spinning

• Incorporate spinning in play activities, gradually reducing spinning and increasing emphasis on toy function, eg rolling

Excited by flashing lights on toys

• Limit toys to use as motivators for short periods

Turns lights off/avoids looking at print in books

• Increase natural colours in child’s environment

• Keep artificial lights dimmed; increase natural light

• Reduce unnecessary visual information

• Create ‘den’ or designated area which is visually sympathetic for the child

Touch

Difficulty identified

Suggested activities/strategies

Avoids holding hands with adults or children

• Use a no pressure approach and allow child to watch from a distance

• See if child will tolerate adult holding onto a sleeve

• Expose child to range of tactile experiences

Craves rough and tumble play

• Build more gentle play sequences into play

• Include a wind down period in this play and gradually increase time

Holds people tightly/leaning on others

• Give firm handshakes or high fives throughout the day

• Play clapping and guess the object by feeling games

• Divert child to pressure toys eg squeezy balls, encourage to press down on a beach ball

Strips off clothing

Analyse what the issue is:

• Are tags rubbing? Remove if possible

• Stick to familiar acceptable clothes and gradually introduce new garments for short periods

A fitted vest/body stocking can sometimes help to comfort against irritating fabrics

Finds nappy change distressing

• Ensure mat is not cool – place towel underneath child when changing

• Determine if child needs firm or light touch and use single quick movements

• Team activity with familiar song or toy

Avoids messy play

• Incorporate familiar toys into messy play, eg car in paint tray

• Let child manipulate materials with long, then short handle tools

• Use Ziploc bags filled with messy materials for close exploration

Doesn’t show distress when hurt

• Expose to variations of touch eg light and firm to help child to learn to identify different sensations

Smell and taste

Difficulty identified

Suggested activities/strategies

Smells toys before playing

• Show alternative ways of identifying toys, eg by texture

• Use scratch and sniff books during play

Puts objects up nose

• Show child appropriate distance to hold objects when smelling them

• Allow to sniff different fragrances on large pieces of fabric

Eats non-food items

• Intervene and replace with small food item; use small box with seal to encourage child to eat edible items

• Direct to special box of chewable toys (teethers, rings) each time an inedible item is put in mouth

Chews/mouths everything

• Possibly at stage of development where mouth exploration is dominant

• Provide with range of textured toys/objects to explore with hands

Bites people for no apparent reason

• Could be experiencing overload. Approach child slowly from front, not touching child

• Child could wear a small rubber ring to divert to when he feels urge to bite

Eats specific foods only – dry, sloppy, etc.

• Gentle taste tests; child is offered very small pieces of new food in between favourites

• Reward for any positive approach to new food such as smelling, touching or holding in mouth

• Exploratory play with various food materials, eg wet spaghetti, porridge oats

Refuses to sit at table to eat

• Adult to model sitting at table with child

• Decrease amount of time child is expected to sit at table. After short period of appropriate sitting, allow to move away to do favourite activity

Licks people/objects

• Divert child to different ways of identifying people through sight and touch

Movement and body sense

Difficulty identified

Suggested activities/strategies

Climbs to excess

• Give lots of opportunity to play on large play equipment

• Play running /catch games

Seeks rocking motion

• Engage in paired play eg row the boat, roly poly song

• Use of a large child sized gym ball to simulate rocking motion

Spins excessively

• Play games where spinning appropriate, eg ring a roses

• Read books that involve swirling actions, eg

Bear Hunt

Constantly on the move

• Provide child with regular, frequent bursts of gross motor play

• Reduce time spent on sit down activities

Difficulty negotiating around obstacles

• Raise sight awareness of obstacles with regular reminders

• Put visual markers on fixed obstacles

• Play games involving moving around obstacles

No sense of danger when climbing

• Ensure safety by diverting climbing to appropriate play equipment and reinforcing ‘no climbing here’

Difficulty with fine motor skills

• Provide fine motor play opportunities

• Encourage play with tactile manipulative toys, eg squishy balls

Sound

Difficulty identified

Suggested activities/strategies

Distressed by loud, sudden noises eg balloon popping, child screaming

• Identifying noise through visual and verbal labelling can reassure, eg ‘wow it’s the balloon, look!’

• Encourage child to play with object or watch others play with it

• Create fun games, eg blowing up balloon and letting it go, releasing small squeaky bursts of air, etc.

Becomes over excited from repetitive sounds

• Use sand timer to show that activity is going to finish

• Limit access to sound before it over-stimulates the child

Distressed by everyday noises eg hand dryer

• Encourage child to stay at distance but in same room, so they can see it but feel protected

• Visually identify sound source to ease anxiety.

Eventually encourage child to move near it…

touch it…turn it on

Places hand over others mouth when they sing/talk

• Prepare the child by providing explanation if group are going to sing

• Try to ensure that one adult talks to child at once

• Use soft, calm voice. Speak in short, simple sentences

Doesn’t respond when spoken to

• Eliminate hearing difficulty

• Provide structured teaching in distraction free area for short periods

• Use child’s name at start of any interaction

• Use animation in voice to help child pay attention

• Basic work on identity/name recognition using photographs and labelling tray, chair, etc to support with recognition