How to support children with SPD
The group of sensory disorders known collectively as sensory processing disorders (SPD) are varied in their symptoms, and the symptoms that each individual child with a sensory disorder displays can differ in kind and intensity even among children with the same form of SPD. This is why a blanket approach to SPD is never going to work.
Types of SPD
SPD is commonly broken down into three main sensory integration disorders. However, there is a key distinction to make at the outset: the difference between hypersensitivity and hyposensitivity. Hypersensitivity is where someone is more sensitive to sensory input than average, and hyposensitivity is where someone is less sensitive. For children, hypersensitivity typically results in distress being caused by things that other children don’t notice, and hyposensitivity involves the child seeking more stimulation, and showing other symptoms, such as an unusually high pain threshold.
Sensory discrimination disorder (SDD)
SDD commonly involves children being unable to identify specific pieces of information coming from sensory stimuli. Essentially, their brains are processing information in an unclear, unstructured way, which means they struggle to interpret sensory stimuli in the same way as other children. For example, they might not know what they’re holding without looking at it, or they may struggle to work out where a particular sound is coming from. SDD makes classroom learning very difficult, as the child will struggle to process the classroom’s sensory stimuli, let alone listen to what the teacher is saying and take full part in all of the activities.
Sensory modulation disorder (SMD)
Children with SMD struggle to know the correct response to sensory stimuli. The distinction between hypersensitivity and hyposensitivity is very important with SMD, and the symptoms that affected children display will normally fall fairly neatly into one of those categories. A child who is hypersensitive may be distressed by noises that other children can’t hear, or may find their clothing itchy or uncomfortable. In contrast, a hyposensitive child with SMD may actively seek out sensory stimulation, invading other children’s personal space, hugging people and hitting things.
Sensory-based motor disorder (SBMD)
Linked to dyspraxia, SBMD relates to a range of difficulties, including difficulty with organisation, motor-skills, and balance. One particular symptom that some children with SBMD show is problems with their core strength and posture, which means that in a school setting they may struggle to sit on a chair for an extended period of time, and could start sliding off or fidgeting.
A distinct, but debated, disorder
SPD is understood to be distinct from other disorders such as autism, OCD and ADHD, though it often appears in conjunction with some of these conditions and its symptoms do have some overlap. A helpful example is that children with autism will be very likely to display signs of SPD, but a child with SPD may have no other disorders at all.
It is important to be aware that medical mental health professionals do not yet consider SPD to be a diagnosable condition. Psychiatrists are not yet convinced that identifying SPD’s symptoms in such a way is the most helpful way to approach the disorder, and they point to a lack of evidence that suggests that current treatments are producing widespread, measurable results. Though there is a fair amount of anecdotal evidence to suggest that identifying and treating SPD is beneficial to the affected child’s development, the evidence has not been gathered on a scale suitable for any conclusions to be drawn.
The impact of occupational therapy
Occupational therapists are currently leading the way in the treatment of SPD. A combination of sensory gyms and exercises for the child to do both in therapy sessions and at home and school expose children to regulated sensory exposure that helps them to become used to stimulation and learn to respond to it in the right way. There is still debate over whether or not this therapy is actually making physical changes in children’s brains, in other words “rewiring” them, but individual case study evidence does suggest that occupational therapy is making a significant improvement in the lives of many children with SPD.
The use of sensory gyms allows children to explore and engage with sensory stimulation in a completely safe environment. They’re able to run around, crash into things and hit things in such a way that they get used to the stimulation. One interesting point is that although there is the distinction between hypersensitivity and hyposensitivity in terms of a diagnosis, there is less of a distinction when it comes to the treatment. The sensory gym approach is still helpful, although some of the other exercises may differ depending on the needs of the child.
A holistic approach
Though there isn’t much that can be said in a general sense about SPD, there is one thing that will always be true: the quality of the treatment will increase with the amount of information that the therapist has as to the precise nature of the disorder of the individual child. Both parents and school staff have a big role to play in feeding back how the child responds to different situations and anything of note about their behaviour. This information will help the therapist to tailor their treatment to providing the specific help that the child needs.
There also needs to be a consistency in the treatment of the child that goes beyond the couple of hours of therapy that they will have booked each week. Parents need to be committed to carrying on the exercises with their child in the home, and schools need to do what they can to ensure a uniform approach.
Simple changes that schools could make, if appropriate, include providing fidget toys or similar low-level stimuli, and making sure that transitions between activities are not too abrupt, as quick change is something that many children with SPD struggle with. Providing something for the child to fidget with is a really simple way of making sure that they have continual, regulated sensory input and, if the fidget toy is squeezable, it can also be an effective stress release. The key is for schools to be sensitive to the needs of the child, and to be in dialogue with the therapist and the parents to make sure that they are up to date with the child’s treatment and the best way to engage them in school activities.
Children with SPD in mainstream schools
Depending on the nature of the individual child’s SPD, it will not always be appropriate for them to be in a mainstream school, though this would essentially always mean that the SPD is in conjunction with another disorder that stops them from learning effectively in that environment. Where possible, however, it is important to make every effort to include the child in a mainstream school, as this allows them to engage with a range of role models, grow more comfortable with everyday social interactions, and be challenged by a high level of expectation.
If a child with SPD is going to succeed in a mainstream school, teachers and staff have to be aware of their needs. There needs to be a conscious effort to facilitate their learning style. In the case study evidence, occupational therapy has been shown to improve the symptoms of SPD to the extent that the child’s behaviour is no different from that of their peers, but during the process of the therapy, the school does need to work with everyone else involved to create an environment that is safe, welcoming and productive for the child.
It is encouraging to know that there are people working hard in occupational therapy and other areas to better understand SPD and how to help children who are affected by it. The evidence that we have so far suggests that real, noticeable improvements can be made with a sustained effort on behalf of the child’s therapist, parents and school. If we continue to have a positive mindset towards treating SPD, we can be in a great place to give children who suffer with it the help that they need to ensure that it doesn’t hold them back.
Patrick Tonks is Creative Director at Great Bean Bags, who specialise in handmade sensory bean bags designed to provide sensory stimulation for children with SPD: