Picture this: You're standing in a grocery store when the child in the cart 10 feet away from you lets out a blood-curdling scream and covers his ears, seemingly unprovoked. The store is quiet aside from the sound of a distant ambulance whizzing past outside. Without knowing much about the situation, you might chalk the outburst up to the child's mother refusing to buy a sugary cereal. But what might otherwise be interpreted as bratty behavior could stem from something not entirely within the kid's control — such as a sensory processing disorder.
Though the name sounds clinical, Dr. Dilip Karnik, a pediatric neuroscientist with Child Neurology Consultants of Austin, says SPDs are an undiagnosable condition having to do with the way people receive and respond to sensory information. He explains that people with sensory processing conditions typically have "exaggerated, unusual responses" to things like tastes, textures or, as in the hypothetical scenario above, sounds. While many of us are able to hear an ambulance whiz by and experience at most a mild annoyance, someone with an auditory sensory processing condition may process the noise in an entirely different manner and could feel distressed or potentially threatened by it.
Not all SPDs cause an overreaction to stimuli, however. According to Dr. Mayra Mendez, a licensed psychotherapist at Providence Saint John's Child and Family Development Center, some people have abnormally subdued reactions to things such as heat or volume. For instance, most children will feel the pain associated with a blistering sunburn; a child with a hypo-reaction to temperature may not even realize they've been injured.
Being able to recognize the signs and symptoms of sensory processing conditions can significantly improve a child's life. We've gathered some tips on how to differentiate a temper tantrum from an SPD and ways you can help a child with the condition cope.
“Most of the time, this is seen in pediatric patients," Karnik says. "Generally, when a child is around 1-1/2 to 2 years of age, they start developing the symptoms, and they get worse [as they get older].”
Children in this age group may exhibit other behaviors, such as kicking, screaming, crying, head banging and finger chewing when confronted with uncomfortable visual or auditory stimuli. Others, who struggle with taste or touch, might avoid certain foods or clothing altogether, which we sometimes misinterpret as picky eating or general stubbornness.
"Sometimes, the symptoms are so subtle, they'll just fall into normal development," Karnik says. "But most of these children will have a significant problem. For example, the common problem I see in my clinical neurology practice is that they have problems with food, and they will have a very limited diet."
Watch how your child interacts with others and handles everyday situations. Do routine sounds like a blender or the flushing a toilet send them into a panic? Do they insist on only eating a handful of foods? If so, do those foods have similar textures? These clues could be indicative of an SPD.
But the condition can also appear in infants, which might make it harder to catch.
"Let's say [a baby is] very sensitive to sound," Mendez posits. "Of course, the baby doesn't tell you, 'I didn't like that sound,' and the baby also doesn't put his fingers in his ears to cover a sound that would be a good red flag for us... but, they'll cry, they won't sleep. We might not know it's the sound, and we might call the baby 'fussy' or 'finicky,' and they might be all of those things, but they might also be reacting to some environmental sensory stimulation that is noxious to them."
Sensory processing conditions could be indicative of other issues, such as anxiety, autism, ADHD or a developmental delay, Karnik says. Some children might exhibit clumsy behaviors or have difficulty writing or speaking. But SPD isn't necessarily related to another condition.
First and foremost, Mendez says parents need to acknowledge there is an issue.
"The parent would want to be able to recognize and put into words, 'I think my kid is overreacting to things and doesn't know how to manage his sensorial experience, and if he can't process it, he's having all of these other problems,'" she explains. "[Parents] can go into behavioral problems, emotional problems, educational problems, interactional problems, which would be relational, and then a pediatrician or primary care physician could give a referral so that there could be an occupational therapy evaluation, and they can assess for sensory processing."
The sooner your child receives an evaluation, the quicker a medical professional can treat symptoms. Thankfully, Karnik says the condition doesn't always stick around for the long haul.
"Most of the children I've seen will improve by 6 or 10 years of age as their sensory systems improve, as the brain matures or the symptoms improve," he said, adding that over time, kids may start showing more "tolerant reactions."
One way to help a child with SPD become more tolerant of different sensory experiences is to enlist the help of an occupational therapist who can initiate a desensitization process.
"[The occupational therapist] can start to introduce certain sounds, certain textures, certain tactile experiences," Mendez explains. "It's very experiential, active and hands-on but still uses the gradual approach to get the person to tolerate levels of sensory stimulation. The more comfortable the person becomes with tolerating sensory information, the less likely they are to overreact to it. On the opposite end, if they're not reacting appropriately, we want to increase the body's awareness to a reaction."
For example, if a child has an overreaction to the sound of a flushing toilet, an occupational therapist might play a similar noise on a low volume for an extended period. Over time, they might increase the volume as the child becomes more familiar with and tolerant of the sound.
Still feeling lost and need help identifying symptoms? Try downloading this symptom checklist from the STAR Institute of Sensory Processing Disorder — and, of course, speak with your doctor.
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