What are the symptoms of sensory processing difficulties?
Sensory processing difficulties present with obvious symptoms such as: can’t tolerate certain clothing or socks; getting their hands messy or dirty; being splashed with water; being touched or the possibility of being touched by others. Food textures and tastes may also be difficult, causing a child to have difficulty transitioning from baby foods; having a very limited diet; unable to try new foods. They may have difficulty paying attention, talking or communicating; tolerating loud or unexpected noise. Babies may not like being held or want to be held firmly (swaddled); need to be in constant motion or can’t tolerate movement; difficulty sleeping or highly irritable. A child may have difficulty tolerating any changes in their routine, plans or expectations; new situations or new people. Difficulty with motor activities and sports, such as clumsy and bumping into things, avoidance of sports and physical activity. In a classroom setting the child may be easily distracted, seek opportunities to leave the class, be in constant motion, difficulty staying in the chair, unable to organize themselves or complete work, difficulty with writing, development of stomachaches or headaches, chewing on objects or fidgeting.
What are some of the diagnoses that often have sensory processing difficulties?
Autism, Asperger Syndrome, ADHD, Down Syndrome, Cerebral Palsy, Fragile X Syndrome, Learning Disability, Oppositional Defiant Disorder, Attachment Disorder, and other childhood developmental disabilities.
How do you evaluate children with these difficulties?
There are often clusters of symptoms that are similar in all people with sensory processing difficulties which are clues as to what is going on. We use a variety of standardized and non-standardized assessments and then compare the results as well as observe the child’s behavior in the clinic. Information from the home and school environments is also helpful in determining processing. A Sensory Profile is completed by the parents/caregiver and also teacher if available, which provides information regarding sensory regulation and modulation. The Sensory Processing Measure provides a questionnaire for the home, main classroom and for the various school settings a child may be in (art, music, phys ed, cafeteria, bus, and playground). The Sensory Integration and Praxis Test is a standardized assessment of sensory integration, evaluating various aspects of gross and fine motor performance. Other areas of motor performance which appear to not be developing properly are also evaluated such as handwriting and reflex integration.
What is treatment like?
Depending on the results of the evaluation, a plan-of-care is developed for each child, based on their specific processing weaknesses. Each difficulty has a specific treatment protocol to follow, which is then modified based on the child’s individual personality. Parents and caregivers are encouraged to be part of the treatment sessions if appropriate to learn specific activities to carry over at home. When parents are unable to participate, specific activities are provided for the family to have at home. Contact with the preschool or classroom teacher is also encouraged for a better understanding of the child and development of a more comprehensive program. Therapy sessions are typically a 50 minute session, once a week, unless otherwise specified.
How long does treatment last?
For each child it varies, depending on the severity of the processing and motor weakness. It typically takes a few months before progress is observable, however, sensory processing techniques can provide immediate (and temporary) relief of some sensory needs. The development of a “sensory diet” may be provided to assist the child and family with ongoing input and strategies to maintain more optimal sensory regulation. Therapy can typically last from several months to years. For the more severely involved child it may be ongoing. Goals and objectives are measured quarterly to determine progress.
Can Sensory processing disorders be cured?
There is no “cure” for sensory processing disorders, but rather the development of “detours” in processing of sensory information, to allow for more optimal performance. For most of us, our sensory processing is part of who we are, our temperament and skill level, and the ability to develop appropriate accommodation strategies. For children with more significant processing weaknesses, they do not understand why they don’t feel “just right”, and through their behavior get our attention to then help them develop the appropriate accommodation strategies for their success. Therapy will provide improved sensory processing through consistency of experiencing appropriate processing and development of skill, as well as developing an understanding of the individual’s strengths and weaknesses along with appropriate strategies for success.
How can I educate my doctor?
Provide articles on sensory integration found on the internet or books and encourage them to speak with a therapist. Specific books of interest may be The Out-of-Sync Child by Carol Kranowitz, Raising a Sensory Smart Child by Lindsey Beil and Nancy Peske, Sensational Kids by Lucy Jane Miller
How can my child be helped in school?
Typically occupational therapy is a supportive service to academics and not a stand-alone service. This means that a child has to have a handicapping condition, such as speech and language, learning disability, other health impairment, etc., to qualify for special services, and if OT is warranted to help the child be successful in school, it will be recommended. An evaluation is then done by the school therapist and recommendations are made regarding therapy and accommodations strategies for the classroom. It has generally been my experience that teachers are grateful for any assistance they receive regarding strategies for a child’s success in the classroom, however, they are limited with the amount of individual time they have for a child. A private therapist can often do a classroom observation to provide further suggestions and strategies which may be helpful.
Does insurance cover this therapy?
Some insurance companies pay for services such as evaluation and therapy. This can be determined by parental inquiry with their carrier as well as PDC clerical staff. Early intervention treatment may be paid for by CDS if the child qualifies for services. Some schools may pay for outside service if the child’s processing weaknesses are severely impacting their ability to learn. Please contact us to find out more information regarding your specific insurance questions.
What payment sources do you accept?
Anthem Blue Cross Blue Shield, Aetna, Harvard Pilgrim (treatment only), Cigna, MaineCare, and many other private insurance carriers. Child Development Services pays for children who meet eligibility criteria.
What other services do you provide?
- Evaluation and treatment for developmental delays and sensory processing
- Handwriting assessment and intervention
- Oral motor assessment and treatment regarding difficulty with movement of the food in the mouth, food choices and textures.
- Sequential Oral Sensory Feeding Program
- Therapeutic Listening
- Intervention for infants regarding feeding, regulation, muscle tone and motor delays
- Consultation with parents and families regarding behavior and organization
- Observation and consultation to preschools and schools
- “How Does Your Engine Run” programs for self regulation
- Bike Riding Clinics
What special programs are available?
In addition to individual therapy, we offer group therapy for children not eligible for CDS, insurance or third party reimbursement, and looking for ongoing therapy. The group focuses on improving the foundation skills of body awareness, attention span, self-regulation, motor planning, handwriting and sensory processing.
- Therapeutic Listening – The Pediatric Development Center now implements the use of Therapeutic Listening! This program uses specifically modulated music input to target the vestibular and auditory systems for improved internal organization. We offer skilled information, assistance and a lending library to help you and your child get the most out of this exciting therapeutic tool. Click Here for more information.
- Handwriting, including printing and cursive are also available as needed. Several writing programs are offered, such as “Handwriting Without Tears” and “Loops and Other Groups”.
- How Does Your Engine Run? is a program to enhance self regulation, developed by Mary Sue Williams and Sherry Shellenberger. We have adapted their program to work with individuals and groups of children to help them develop an awareness of their body as an “engine”, in that sometimes it runs “too high” and sometimes “too low”. We explore what situations tend to cause their engine to change speeds and what helps them to regain a sense of organization for a more calm-alert state. Parents are given homework to do with the children to encourage use of strategies within the home.
- Bike Riding Clinic is offered on two Saturday mornings in early June to provide children an opportunity to learn to ride a bike. Typically there are weaknesses in balance, bilateral coordination and security with movement which will prevent the child from successfully learning to ride their bike. Our strategy is to help them first learn to feel safe before taking the next step of balance and coordination. Our success rate has been about 75%.
- Tummy Time: At various times, depending on the need, we offer Tummy Time groups of 4-5 parents and babies to better understand the importance of babies being on their stomachs. Methods to have babies on their stomachs as well as how to build their tolerance are worked on. Babies on their tummies provides the foundation skills of higher level reflex integration, muscle tone, trunk stability, hand control and coordination.
What are some good resources?
“The Out-of-Sync Child” by Carol Kranowitz
“The Out-of-Sync Child Has Fun” by Carol Kranowitz
“101 Activities for Kids in Tight Spaces” by Carol Kranowitz
“The Goodenoughs Get In Sync” by Carol Kranowitz
“Raising a Sensory Smart Child” by Lindsey Biel and Nancy Peske
“Sensational Kids” by Lucy Miller
“Smart Moves – Why Learning Is Not All In Your Head” by Carol Hannaford Ph.D
“Why Motor Skills Matter” by Tara Losquadro Liddle, MPT
“Positive Discipline” by Jane Nelson
“Toolbox for Parents” by Diana Henry
“Toolbox for Teens” by Diana Henry
“Take Five, Staying Alert at Home and School” by Mary Sue Williams and Sherry Shellenburger
“How Does Your Engine Run?” by Mary Sue Williams and Sherry Shellenburger
“Teaching Your Children Values” by Linda and Richard Eyre
Websites are provided in the sensory integration section