How Sensitive is Too Sensitive?

By Maureen Karwowski, OT

I am sure that I am not the only person to buy a wool sweater that I thought looked great.  I bought this sweater despite the fact that it might be a bit itchy.  The first cold morning of the year I decide it is time to wear this sweater, and it feels okay, but not great.  As the day progresses, I am more and more aware of the feeling of my new sweater.  After a long day of working, and a brutal commute home, my skin is crawling.  This sweater is intolerable.  For many of the children that I work with as an occupational therapist who have sensory processing difficulties, this experience may be familiar to them.   

Sensory processing challenges occur when a child has difficulty interpreting  and responding to the sensory experiences in daily life.   It is estimated that 1 of 20 children are impacted by a sensory processing deficit (Ahn, Miller, Milberger, McIntosh, 2004).   When I assess a child who has a suspected sensory processing difficulty, I look at 3 areas:

• sensory regulation
• sensory modulation
• sensory discrimination

In my last blog, I discussed sensory regulation.  It is generally understood that sensory regulation is the ability to keep ourselves at the optimal activity and alertness level for the situation.  For instance, being able to sit through a meal or story time at the library all requires a child to be regulated.   We all have tricks to keep us “regulated”.  Drinking coffee, chewing gum, or working out are just a few examples of how adults naturally regulate themselves.

Sensory modulation impacts a child’s ability to function at home, in the community and at school.  Sensory modulation refers to how sensitive a person is to different touches, sounds, sights, smells or movement. 

As I described my sweater experience, this may be similar to how some children respond to a variety of clothing.  The seams of jeans, or the texture of socks may be very hard for some children to tolerate.  We encounter textures every day, all day and for most of us, we are hardly aware of them.  For others textures such as soap suds, food textures, glue, hand sanitizer, t-shirts with writing on them, and band aids are just a few textures that can be troublesome.

Many children with sensory processing disorders can have extreme challenges in busy environments such as a family party, the school cafeteria, or even McDonald Land.  The sensory input in these situations is immense.  Noise levels are higher and unpredictable.  Large spaces, or crowded spaces can be very hard for children who are sensitive to visual experiences.  Novel foods have new smells, tastes and textures.  All of these experiences can cause an over-reaction.  Some children react by getting so revved up that they can lose control.  Other children cling to their parents or cover their ears.  Some children avoid these situations entirely.    For most children, climbing ladders, and spinning on a merry-go round at the park are delightful.  Others prefer to keep their feet on the ground as movement can be very scary and uncomfortable for them.

On the other side of the coin are the children who are under-reactive to sensory input.  These children often seek intense input in order to register it, and to feel calm.  For instance, a child may be bouncing up and down in their seat at the dinner table without even realizing that they are moving at all.  Another child may seek intense “rough and tumble” play at inappropriate times, climb or jump on furniture despite being asked to stop repeatedly.  These children may have difficulty judging how hard to touch someone or something which can impact them socially.

We can all identify some sensory “quirks” that we have.  I know that the sound of Styrofoam makes me cringe.  My co-worker cannot stand the smell of my peppermint tea (crazy right?).  We all have things that are “triggers” for us, certain noises, textures or smells.  When a child has enough of these “triggers” that it is interfering with their ability to learn at school, socialize with other children, and function at home, an evaluation by an Occupational Therapist may be appropriate.

The good news is that a skilled OT can work with you and your child to help them with these sensory issues.  The key is a comprehensive evaluation, using parent interview, observations of your child, and a standardized assessment.  Once that is complete, treatment sessions are typically enjoyable for your child while they are working towards their goals.  You can work with your child’s OT to problem solve the sensory situations that are challenging at home, and when in the community.

For more information about Easter Seals DuPage & Fox Valley and Occupational Therapy please visit EasterSealsDFVR.org.