I heard about sensory diet when, years ago, when I attended a workshop conducted by Carol Kranowitz. Carol, an expert from the U.S. in Sensory Processing Disorders (SPD) in children, gave a fascinating talk about children, who exhibit behaviours that are confusing to comprehend, both by their parents and teachers. She demystified those bewildering conditions and their causes in simple terms.
She wrote the book The Out-of-Sync Child in simple language to give hope to thousands of parents and teachers and help them understand strange behaviours and the struggle of those with SPD.
I know from my practice that children with sensory processing problems often exasperate and exhaust their parents and are barely tolerated by their siblings. This article is an attempt to raise awareness of SPD among parents and teachers.
It is also known as Sensory Integration Dysfunction. Every day our brain receives a great deal of information from our bodies and surroundings; interprets these messages and organises our responses and we successfully interact with the world. Most people can name the five senses — sight, hearing, smell, taste and touch. Yet, there are many other senses that are just as essential for survival. According to the research of occupational therapist and psychologist A. Jean Ayres, known for her work in the area of sensory integration dysfunction, these sensory systems include —
It provides us with information, primarily through the surface of our skin, from head to toe, about the texture, shapes and size of objects in the environment. It tells us whether we are actively touching something or are passively being touched. It helps us distinguish between threatening and non-threatening touch sensations. A child that is over responsive to touch stimuli hates to be hugged. He remains aloof. Look closely, and you will find him holding a “squeezy” or a stuffed toy and anxiously watching other children having fun. Caressing the toy calms him. In contrast, there are those who crave touch sensations. For instance, they would love to jump on the bed, bounce on the cushions and be sandwiched between them.
It tells us where our heads and bodies are in relation to the surface of the earth. It tells us whether we are upright, upside down or at an incline; whether we are moving or standing still; and whether objects are moving or motionless in relation to our body. It also informs us where we are going and how fast, and if we are in danger.
Children’s vestibular system does not function smoothly, making it difficult for them to integrate, modulate, discriminate, co-ordinate or organise balance and the sensation of movement.
Muscle and joint sense or proprioception, “the position sense”
It refers to the internal awareness of the position of one’s joints and muscles in space which allows one to lift a spoon to one’s mouth without spilling it. It helps integrate tactile and vestibular senses.
What happens when one or more of our senses are not being interpreted properly? A child with vague or hazy feedback about his sense of touch, body position, or movement and gravity is in a world totally foreign to ours. Imagine yourself in a world where something as basic as the pull of gravity or the touch of other children is perceived as something unreliable, inconsistent or threatening. You would not experience the security, safety, and fun that other children do.
Knowledge of SPD helps us understand why overly sensitive children feel the world is unsafe. They retreat into themselves, into a space where they do not feel threatened. These sensitivities place them on the sidelines of life. They are isolated from peers and siblings and often relegated to passive computer and video games.
The exact mechanism underlying SPD remains unknown. There is no single lesion, no single neurotransmitter system, no single gene that has been identified as a trigger of SPD. While it is important to know the origin of SPD, more important is to know what can be done about it. So that children, who sit wistfully on the sidelines, fearful of joining the fun, who are overly sensitive to noise and touch, grow and emerge from their cocoon of sensory dysfunction.
What can be done
The child needs an environment with suspended equipment specially designed to meet his needs. The occupational therapist (OT), with training in sensory integration, designs an environment to enable the child to interact more effectively. The therapist, after a comprehensive assessment and consultation with the parent, and keeping the individual’s specific needs in mind, plans a sensory diet. The diet includes activities planned through the day to deal with stress and keep the nervous system in a state of balance. The therapy helps the child with SPD to respond in a more adaptive way to the environment — to reconnect with self and the environment.
Signs of SPD
Is over- or under-responsive to touch, movement, sight or sound.
Has an unusually high or low activity level.
Is impulsive, fidgety, inattentive and easily distracted.
Has a poor awareness of the body.
Frequently misjudges distances between self, other people and objects.
Becomes easily emotional and frustrated when things aren’t just right.
Resists change. Has a hard time with transition.
The writer is a Remedial Educator