It is estimated that between 5-13% of children entering school have Sensory Processing Disorder (SPD) and that three out of four of them are boys.
Have you ever worked with a child like Sam or Anna?
Sam is unable to be with his class during circle time without rocking in his chair, chewing on his shirt and twirling his hair. He has trouble standing in line and often complains that others are hurting him. He dislikes the sound of the school bells ringing.
Anna often breaks her pencil by pressing down too hard. She often falls out of her chair and she dislikes physical education class, though she loves to swing at recess. She has a hard time organizing her desk and homework and gets easily frustrated.
SPD can be an isolated diagnosis however is often associated with other diagnoses such as:
- Learning disabilities
- Attention Deficit Disorder
- Autism Spectrum Disorders
- Language disorders
- Anxiety disorder/depression
- Behavioral disorders
- Attachment and post-institutionalization
What does SPD look like in the classroom?
A problem regulating responses to sensory inputs resulting in withdrawal or strong negative responses to sensation that do not usually bother others. Problems are often seen in fluctuating emotions that are made worse by stress, and vary with the situation.
Common signs that you might see in the classroom include but are not limited to:
- Easily distracted by noise, oversensitivity to sounds
- Reacts defensively to being touched lightly or unexpectedly
- Overly active
- Easily distracted by visual stimuli
- Strong outburst of anger, low frustration tolerance
A problem recognizing/ interpreting differences or similarities in the quality of stimuli. It is commonly seen with problems in processing sensations from touch, muscles and joints (proprioception) and head movements (vestibular or inner ear sensations).
Common signs that you might see in the classroom include but are not limited to:
- Bumps or pushes into others
- Grasps objects too tightly or uses too much force on objects
- Frequently drops things or knocks things over
- Mouths, licks, chews, or sucks on non-food items
- Craves movement, e.g., likes to spin self around
- Afraid of heights, swings or slides
- Has poor balance
A problem with control of posture or quality of movements seen in low muscle tone or joint instability and/or poor functional use of vision. It is often seen with vestibular and proprioceptive problems.
Common signs that you might see in the classroom include but are not limited to:
- Seems weaker than other children
- Fatigues easily
- Frequently moves in and out of seat
- Slumps while sitting
- Difficulty making eye contact/tracking with the eyes, e.g., reading
- Falls and tumbles frequently
- May seek quantities of swinging or spinning
A problem with planning, sequencing and executing unfamiliar actions resulting in awkward and poorly coordinated motor skills typically seen with a sensory processing deficit. It is usually seen with difficulty doing new activities or those that are done infrequently.
Common signs that you might see in the classroom include but are not limited to:
- Difficulty following multistep directions
- Strong desire for sameness and routine
- Has an awkward pencil grasp
- Has poor handwriting
- Dislikes or reluctant to participate in sports
- Intense and easily frustrated
- Problems with daily life tasks like dressing or using utensils
Children often present with more than one subtype of SPD and often present with an inconsistent pattern of symptoms making it difficult to identify why a child is struggling to perform.
How do I know if I should refer a child to occupational therapy?
How do I know if I should refer a child to occupational therapy?
Click here to print off a teacher checklist.
If a child has overall difficulty in one category, or shows several items in three or more categories, this may indicate a need for an occupational therapy evaluation.
How do I help a child with SPD?
Individuals with SPD may present with very different challenges and needs. However there are a variety of accommodations that will help most children with SPD and will probably help all of the children in your class to remain organized and focused and support them to complete age appropriate activities. Many of the ideas and accommodations are adaptions and activities that you may already use with your class but the child with SPD may need a little more support or a little more intensity to benefit from the activity.
Many children with SPD can become easily overwhelmed by extraneous touch, visual and auditory input. By controlling the classroom environment you can maximize children’s ability to remain focused and organized.
- For the student who experiences sensitivity to touch (tactile defensiveness), allow the child to stand at the end of the line and arrange the classroom seating to minimize the risk of being jostled or bumped by classmates (i.e. have the child’s desk either near the teacher or at the back of the room).
- When planning an art activity, modifications to the activity may need to be made to accommodate the child who is sensitive to touch (i.e. be aware that materials such as glue, finger paints, clay, paper mache´, etc. may cause the child to have an aversive response). Using tools (i.e. hammer, paint brush, etc.) may help child participate more fully.
- As much as possible limit the amount of extraneous visual material you have hanging from the ceiling and on the walls.
- Store fine motor and math manipulative inside plastic containers or cubbies.
- All materials should have an organized and labeled place where they belong.
- Help desk organization with a picture template of where each item inside the desk belongs.
- By closing your classroom door you can limit extraneous auditory input from the hallway, rugs and carpet also help to reduce noise.
- Seat the child who has sensory sensitivities and distractibility away from open windows and doors.
- As much as possible prepare the child who is sensitive to noise for clean up bells, fire drills and morning announcements.
- For a child who has difficulty with his body position in space, try allowing him to sit in a bean bag chair or on a small rug remnant on the floor during circle or group activities to let him know where “his” space is. Create a quiet corner in the room (e.g. refrigerator box, reading corner, and “listening center” with headphones and music or books on tape).
- During times of independent work try playing classical music in the background. Mozart and Vivaldi are thought to be conducive to learning.
- Adjust the chair and table to a height suitable for the student to best perform table top work. (Feet touching the floor and the table height so the child’s elbows can rest comfortably on topwithout hunched shoulders).
Many children with SPD demonstrate poor motor planning skills and benefit from structure and a predictable schedule and additional support with new and unfamiliar tasks.
- Each morning outline the schedule for the day with the class. Highlight any changes from the typical routine that will occur that day.
- Discuss or create a “story” about unexpected events before they occur, (e.g. fire drills or assemblies) to help children prepare for these potentially overwhelming situations.
- Help younger children make transitions between activities by creating a “clean up” song or “new game” song.
- Older children will benefit from a homework organizer to keep their schedule and homework assignments in. The teacher may have to check this after each class to make sure the homework assignments are correct and the child understands what the homework entails
- For the student with difficulty in motor planning, give simple step-by-step directions.
- Help the child identify the steps needed to accomplish the task. Demonstrate or ask another student to model the motor activity and then ask the child to try.
- Help the student plan out a task by asking questions such as “What materials do you need?” “What do you do first?” etc. A child with motor planning difficulties may need assistance to recognize and improve on performance/work that is not accurate.
Many children with SPD will benefit from sensory diet activities incorporated throughout their day to support organization and focus. When establishing a sensory diet it is important to consider the duration, intensity and frequency of the input. Pressure, rhythm, oral-motor input, and exercise are types of sensory input that help a child organize himself/herself.
- To provide “heavy work” input, have the child push the chairs under the table or carry heavy objects when it is clean up time. This kind of input will help the child maintain a better state of organization.
- Have the child become a teacher’s assistant and bring back books to library for increased heavy work input, or be office messenger to allow more movement opportunities.
- Providing opportunities for a student to jump on a mini-trampoline or bounce on a therapy ball throughout the day may help increase organization and postural control.
- Placing your hands on the child’s shoulders or head with safe, firm pressure can help them slow down.
- Teach kids to take several deep breaths before making a transition to a busy environment, or working on a difficult project.
- Have younger children “march” from one activity to another. The rhythmical body motion and input to the feet can be organizing.
- Input to the mouth through drinking or eating chewy or crunchy foods helps with focus and organization. Allow children to have water bottles or crunchy snacks at their desks as needed.
- Have younger children try to “hold the walls up” or “push the walls down” while waiting in line at the bathroom, etc. Teach older children to do push-ups with their hands in their seats.
- People often “fiddle” with small objects such as erasers or paper clips as a way to maintain attention. If it is not interfering with classroom learning allow “fiddle” objects during listening activities.
- Take “movement breaks” to stand up and stretch
- To decrease fidgeting at the desk and to promote improved postural adjustments, allow the student to stand at the desk or to work on the floor in a prone-on-elbows position (on stomach). Bungee cord or Theraband wrapped around chair legs provide sensory input to assist a child in remaining seated longer.
- Using a partially inflated air pillow (stadium seat) may help increase postural control by increasing sensory feedback in sitting.
How do I talk about SPD with a parent?
Some children perform well within the home environment and challenges become more evident when they enter a classroom situation. Other children have demonstrated challenges throughout infancy and childhood. It is important that children who are exhibiting difficulties receive the help they need. Sometimes initiating a discussion with parents that a child is struggling can be challenging and difficult for parents to hear, however parents often want information to help them to understand why their child may be struggling.
Click here for a Parent Fact Sheet describing the signs and symptoms of SPD.