Assessing and Treating Sensory Processing Disorder and other Related Diagnoses

Differentiating between sensory processing disorder, ADHD, learning disorders, autism, anxiety, and early trauma exposure requires diagnostic skill and accuracy. Once clear about your child’s diagnosis, this knowledge is essential in developing the right treatment plan for your child. Read on to learn interventions drawn from child-centered play therapy and occupational therapy that can help your child with the tantrums, challenging transitions, and anxieties associated with early childhood developmental disorders.

Sensory Processing and the Brain

Historically, sensory processing symptoms were not considered to comprise a standalone diagnosis. Rather sensory challenges were thought of as symptom indicating another diagnose in the same way a fever was a symptom but a virus or an infection was the cause. However, a 2013 study out of UC San Francisco, revealed that sensory processing disorder is linked to quantifiable differences in brain structures and has a biological basis differentiated from other childhood disorders.

Underlying all our sensory systems is the vestibular system which functions within the inner ear which takes in information about our relationship to movement and gravity and provides ongoing feedback between mind and body about where we are in space. The vestibular system gets information from the body through proprioceptors, sensory neurons located within the joints of the body. This sensory feedback helps to organize the the information we receive from the world and how we respond. If we cannot orient to where we begin and end in space we tend to feel anxious. When in fight/flight activation it is difficult to pay attention, learn new information, and communicate effectively about our experience. The brain hijacks higher functioning learning systems and engages lower brain resources as if we are experiencing immediate threat. For a child, this can become a repeated habit repeatedly wiring the brain for survival.

Differential Diagnosis

Sensory Processing Disorder has its own biological and neurological underpinnings; however, our sensory system is complexly intertwined with the neurological mechanisms responsible for spatial awareness, attention, language processing, emotional regulation, and learning. Therefore, sensory processing disorder often accompanies other disorders such as:

• Speech and language delays
• Dyslexia (reading learning disorder)
• Dyspraxia (movement and coordination difficulties)
• Dysgraphia (handwriting difficulties)
• ADHD and difficulties with focus, attention, hyperactivity, and self-regulation
• Autism and difficulties with social emotional communications
• Anxiety and heightened fight/flight nervous system activation
• Children with early trauma, neglect or attachment disruption often develop sensory integration challenges

Knowing the right combination of symptoms and diagnoses allows you to target the right kind of treatment and to avoid unnecessary ones. For example, SPD can contribute to inattention and hyperactivity but medications that treat ADHD may worsen symptoms, create further agitation, or simply be unnecessary. Recognizing and addressing the underlying nervous system activation often helps children with SPD learn how to focus their minds for learning. If you have a child with multiple diagnoses it is important that all professionals understand the role that sensory processing is playing for the child. A teacher, speech pathologist, or psychologist who can integrate tools for sensory integration can make greater progress towards their learning treatment goals. For example, the speech pathologist working with my son had him wear a weighted vest that helped him feel his body. As a result he could have greater control of his mouth when learning new speech sounds.

Treating Sensory Processing Disorder and Related Early Childhood Diagnoses

Once clear about your child’s diagnosis this knowledge is essential in coordinating efforts among your child’s treatment team. You know your child best and can help teachers and other professionals working with your child understand your child’s sensory world. Here are some interventions drawn from play therapy and occupational therapy that I have found helpful:

• Create a “sensory diet” for your child. A sensory diet provides your child with regular exercises tailored to meet his or her sensory needs. Examples include skin brushing, jumping on a mini-tramp, listening therapies, and eye exercises. Integrate sensory tools into your child’s school environment by having the teacher provide noise cancelling headphones in your child’s classroom or limit unnecessary sensory stimuli when possible.
• Understand your child’s triggers. Recognize when they are in fight/flight and emphasize emotion regulation strategies that help them express emotions in healthy and safe ways. Help your child’s teachers and treatment providers recognize these triggers also so they can be aware of the early signs of dysregulation and hopefully avoid the big meltdown.
• Develop routines. Routines are a way to create more safety and predictability around tricky transitions such as leaving the house or going to bed. Talk your child through these routines and transitions so that they can develop an internal dialogue for themselves.
• Create a “safe” learning environment. In order to learn, children need to feel safe. When it comes to sensory sensitivity, it is important to reduce distractions such as background noises, visual stimuli, or social interactions that create anxiety. Integrate a body-centered practice such as brain gym before homework sessions, use weighted blankets over your child’s lap when reading together.
• Integrate play therapy interventions into your home.  Create regular child-centered play times that let your child be in charge while you offer your reflective and attuned presence. Turn off the phone and the computer. Show how you feel when your child behaves in an out of control fashion and model self-regulation techniques.

About Dr. Arielle Schwartz

As a play therapist and mother of two, my passion is to teach parents how to integrate the tools of play therapy into your home and through clinical supervision, teach other clinicians how to support families with highly sensitive children. I understand the unique challenges parents can face in raising sensitive children and specialize in working with children with sensory processing disorders, speech/language delays, anxiety, challenging behaviors, trauma exposure, and emotional problems.

Further Reading:

• Raising the Highly Sensitive Child
• My Story of Raising a Child with Sensory Processing Disorder
• Play Therapy Principles