I want to start by saying I am a Psychologist, not an Occupational Therapist (OT). Having said that I am constantly working with children (and adults) who have difficulty managing their sensory processing. I have worked with OTs to help kids manage behaviour when at school and at home. As a result I have learnt the importance of having at least a basic knowledge of sensory processing and that we need to consider this if we are going to help with behavioural changes. Understanding arousal levels and sensory processing is a relatively new concept so it is understandable that it is not something that most parents understand. However when we do see that our children’s behaviour may be related to their ability to process sensory information, it is like we have been given a key to help them through what they find difficult.
When we talk about arousal, we mean how alert we are. What is it that we need in order to sustain our attention and perform at out best. We are all different in what it takes to keep our arousal at the best level. Some people can’t cope with any noise while they are trying to think, while others need to have music on constantly. Meeting our arousal needs depend on how we process our sensory information. The important thing to remember is that some people will need more of these sensory inputs to be at the optimum state of arousal and some will need less. We are then able to to “self-regulate” by getting our arousal levels right even when our environment changes. Self-regulating all of the sensory information can be very difficult for a child. When we work out what their sensory needs are we can help support them to meet their best arousal.
We process information through our senses. Most people understand that we have 5 senses (sight, smell, sound, taste and feel) but there are actually eight. We don’t usually think of balance (vestibular), body awareness (proprioception) and internal awareness (interoception). Understanding all of these senses is very important as a child could be overwhelmed by these or needing more of these sensations to maintain their balanced level of arousal.
Lets look at them individually.
Visual: obviously this has to do with what we see, but it is more than that. Visual input could be lots of objects, bright colours, strong lighting such as fluorescent lights. Some people thrive on having lots of things around them and colour, they find it inspiring. While others can't cope with clutter, they become distracted or even anxious.
When it comes to children who get bored at their desk and seem to lack motivation to stay on task, they may need more visual input. You could give them a visual timetable of their day and colour code it. Having a visual timer so they can see how long they need to do a task, or even adding some colour to their desk could help. However if your child seems to be constantly distracted and unable to focus they may need less visual input. In this case you need to de-clutter their work-space and move away from windows. Less colour and more natural light can be more calming.
Smell (Olfactory): have you ever smelt something and instantly been transported back to a memory? Smells have a huge impact on us. Some we will find calming and others will turn our stomach. I live in a rural area and I know people who love the smell of a truck full of sheep because it reminds them of fond memories, for most of us though it isn't a pleasant smell. Smells are everywhere and constantly being processed, if you can't filter them out the world would be really overwhelming. Some people seem to be really sensitive to smells, they will smell things before anyone else. Others seem to wear a lot of perfume or are always burning essential oils. Again it all comes back to what sensory input you need for optimum arousal.
Some kids will seek out smells. They may smell objects, clothes or even people. This is not always done in a socially acceptable way. These kids tend to not notice strong smells even if it is a really bad smell. These kids may benefit from scented pens, play dough or even having essential oils on a tissue in their pocket. However kids who are over responsive to smells might find classroom smells difficult. They may not want to eat near others because of the smell of their food. This can be difficult because it is hard to get rid of a lot of smells. However you could find a smell that they do like and again sent a tissue so they can use that when they need to.
Taste (gustatory input): We all have a preference for sweet, salty, sour or bitter foods, but what about texture of food and temperature of food/drinks? do you feel more alert when you crunch your food or does that make you tired and agitated?
Some kids are very picky eaters. They won't eat certain textures or strong tastes. I have seen children almost vomit because they hate the texture of mashed potatoes. They could also have trouble controlling the saliva in their mouths or hate brushing their teeth. You can encourage trying new foods but don't force them. However, other kids seem to crave strong flavours. They may also love crunchy foods, chewing or drinking through a straw. These kids benefit from chewing gum or chew-able necklaces.
Hearing (auditory input): I love quiet, my husband on the other hand has music or the radio on constantly. Our auditory sensory needs are very different. Some children find filtering out sounds difficult. They can't distinguish between hearing the teacher and hearing background noises like the air-conditioner. They can be very sensitive to particular sounds such as vacuum cleaners or traffic noise. These are the kids that might be really excited to go to a concert but cry the whole time or cover their ears. This is difficult at school because it is hard to keep so many children quiet. If a child finds noise really difficult they could try noise cancelling headphones. Giving the child warning that there may be noise like a vacuum can help them manage the anxiety around this.
Other kids will have the TV turned up so loud the whole neighborhood can hear. Or if it is quiet, they will make their own noises tapping, humming, singing, anything to break the silence. Having background music can be helpful. Chances are they will also enjoy learning a musical instrument.
Feel (tactile): This is how we feel about all touch sensations including light touch, deep pressure, vibrations, texture, temperature and even pain. Kids that are oversensitive to tactile input might hate their hair brushed, they can't cope with seams on socks or tags on clothes, they may hate playing the sand or getting dirty. At school these kids might need a quiet corner they can go to when they are overwhelmed. Deep pressure before they get dressed can help them tolerate their clothes.
Kids who seek touch may doodle or click a pen while listening. They may seem to be constantly touching things or playing rough. They don't seem to react when they are touched lightly or even if they have food on their face. These kids often don't seem to notice temperature, they will wear shorts and t-shirts in the middle of winter. Have these kids experience lots of textures with sand, dough or fidget toys. Be careful to make sure that that the fidget toy helps and doesn't distract, it has to be meeting a sensory need.
Balance/motion (vestibular): If a child has difficulty with vestibular input, they won't want to go on swings, or rides that move fast. They may even avoid elevators and escalators. They need options for play that are less active such a board games. Then there are the kids that are always upside-down on the monkey bars, doing rolls on the lounge or they seem to spin without getting dizzy. Movement breaks are really important for these kids. At school have them go and give messages between classes, or have the class do a few exercises. Wobble chairs and elastic bands on the chair that they can kick may also be helpful.
Body awareness (proprioception): This can be a little hard to explain but essentially it is knowing where you are in space. So, if you close your eyes, stretch out your hands and try to touch your two index fingers, you are using your proprioception system. The receptors to do this are in your muscles and joints. Kids that need less proprioception input are often seen as lazy and lethargic. They may have poor pencil grip and just seem clumsy. Deep pressure massage may be helpful. It is a matter of finding a movement exercise that they child finds calming.
Kids who seek this input are often seen as hyperactive. They constantly moving, are rough, love jumping and swinging. They may chew their clothes and they may like to be under a lot of blankets in bed. These kids often feel calmer after heavy impact work that involves pushing, pulling or lifting. Most movement activities and stretching will be beneficial. Weighted blankets and compression vests can also be calming.
Internal Awareness (interoception): This is the ability to recognise signals in the body like hunger, thirst, itching, the need to go to the toilet and even emotions. If you think about this, how are you behaving if you are hungry or need to go to the toilet? Chances are your are emotionally a bit volatile. But some kids aren't recognising their needs before it is too late. In the same way they may miss the subtle changes that their bodies make in terms of emotions until they are at the point of exploding. Kids that need more interception input may have a huge pain tolerance. They may not know when they are hungry or full and they may accidentally wet themselves because they didn't realise that they had to go. To help these kids you may need to make scheduled food/drink/toilet breaks. You can also teach the changes in their bodies. Have them draw a picture of their body and go through the body cues.
Of all the eight senses we can be either sensory seeking or sensory avoiding in order to feel that we are at our optimum state of arousal. This can seem quite overwhelming, but if we are able to look at our kids's behaviour we may see that what they are doing is trying to get the input right so that they can do their best. The kids who is making annoying noises probably isn't doing it just to get on your nerves, they may be trying to give themselves the auditory input they need. If we are aware of this we can try and meet this need in a way that doesn't drive everyone crazy. Having an understanding of these sensory needs will help us as parents to understand our kids and support them to function to the best of their ability.