By Lesley Chow, MS, OTR/L, Occupational Therapist, and Stephen A. Dantzig, Psy. D., Education and Outreach Program Manager, United Cerebral Palsy Association of Hawai’i
We introduced the topic of sensory processing disorders in our last blog. In summary, our brains receive a huge amount of data from eight sensory systems every second, but we respond consciously to a tiny amount of that information. Adequate sensory processing, sensory modulation, or sensory integration (depending on the term used) results in the ability to filter important stimuli from that which can be stored for future use or ignored. The result in the classroom is a student who is able and ready to recognize and react to information that is needed to promote learning.
However, in very simplistic terms, someone with a Sensory Processing Disorder (SPD) may under-register or over-register incoming information. Several questions become critical when thinking about sensory processing, including: who does it affect, how is it assessed, and what can we do to help?
Who Experiences Sensory Processing Difficulties?
Sensory processing difficulties are often thought to be one of the hallmarks of autism, but it is now being thought of as a separate disorder, even though they are frequently seen in people with autism. Recent studies suggest that between 90% and 95% of people on the autism spectrum have sensory processing differences,” says Ainsley Hawthorn, Ph.D. “The reverse, however, doesn’t hold true: Most people with SPD aren’t on the autism spectrum.”
Other Conditions Linked to SPD
According to the Cleveland Clinic, SPD commonly coexists with the following conditions:
- Autism spectrum disorder (ASD)
- Attention Deficit Hyperactivity Disorder (ADHD)
- Bipolar disorder
- Developmental delays
- Disruptive mood dysregulation disorder (DMDD)
- Obsessive-compulsive disorder (OCD)
- Schizophrenia
- Other learning disorders
Sensory processing disorders are also prevalent in many people with cerebral palsy.
Additionally, many individuals with and without disabilities do not have a formal label or diagnosis of SPD but still experience sensory challenges that impact their active engagement in daily occupations. It’s important to understand that we all have sensory preferences, but they may not be so dominant as to interfere with our daily activities.
How Are Sensory Processing Difficulties Assessed?
Sensory processing challenges are often assessed in several ways. Standardized assessments are important; however, clinical observations in a child’s natural environment are equally, if not more, important as they capture specific information about a person’s individualized sensory processing needs. This often includes informal, detailed observations or specifically designed sensory activities that allow a therapist to observe the child’s sensory responses in real time.
Standardized sensory assessments that are commonly used include two norm-referenced questionnaires completed by parents, other caregivers, and teachers: The Sensory Profile, 2nd edition, and the Sensory Processing Measure, 2nd edition (SPM-2).
About the Sensory Profile 2 (SP-2)
The Sensory Profile 2 (SP-2) is a widely used assessment that evaluates how sensory processing affects daily functioning and can help identify sensory-related behaviors that may be interfering with performance in various areas of life. This assessment is based on a sensory processing framework that examines how individuals detect sensory information and respond behaviorally to sensory processing.
Sensory processing patterns (quadrants) are determined to help explain how someone detects sensory information and assist in identifying strengths and challenges:
- seeking/seeker: one who finds interest and pleasure in sensations
- avoiding/avoider: one who is bothered by sensory information and needs to control or avoid sensation
- sensitivity/sensor: one who can acutely notice sensations
- registration/bystander: one who misses sensory information.
The Sensory Profile 2 also looks at sensory sections that address each sensory system and behavioral sections that look at general behaviors associated with sensory processing.
About the Sensory Processing Measure (SPM)
The Sensory Processing Measure (SPM) is another comprehensive assessment that supports the identification and treatment of children and adults with sensory integration and processing difficulties. It assesses each of the sensory systems as well as how these sensory systems may impact praxis (motor planning) and social participation.
It also assists in identifying sensory integration vulnerabilities — under-reactivity or over-reactivity, sensory seeking behavior, and perception difficulties — and it assesses across multiple environments, like at school and in the home, and various raters such as parents, other caregivers, and teachers.
This assessment is often easier for parents and teachers to complete and understand, as well as easier for therapists to score and interpret.
What Can We Do to Help Children With Sensory Processing Difficulties?
One of the first things we can do is to build our awareness of the different senses and how we process each of them individually. Having this sensory awareness can significantly impact a child’s development and daily functioning. It enables parents to provide sensory-rich experiences and a sensory-friendly home for their children, while also helping them recognize signs of dysregulation and ways to calm/regulate them.
Sensory awareness involves recognizing and understanding a child’s unique sensory needs, which stimuli may be overwhelming or calming, and whether they are quick to register sensory input or do not notice sensory input. It also helps to understand the sensory properties of other things used in daily life activities, foods, or movements.
Understanding calming input (slow linear movement, deep or firm pressure, for example) and alerting input (cold drinks, crunchy foods, fast movement with changes in direction, to name a few) can help parents provide this input as needed throughout the day.
For those where sensory processing challenges have been identified, a sensory diet can be beneficial in keeping a child more regulated. A sensory diet is a specific set of daily sensory activities designed to meet the particular needs of the individual.
Practical Sensory Tools and Environmental Modifications
For a sensory-seeking child, this could include making sure they have a lot of movement scheduled throughout their day, such as jumping on a small trampoline or swinging first thing in the morning to help keep them regulated before having to stay seated at mealtime or story time.
For an under-responsive child, this may include offering them more alerting activities or foods in the morning to wake up their bodies, such as jumping, drinking a cold drink, or eating a crunchy food.
For an over-responsive child, this may include offering more calming input (deep pressure/proprioceptive input) in the morning before school, such as giving huge bear hugs, eating breakfast with a weighted blanket on their lap, or carrying a heavier backpack to school.
Use of sensory tools can also help manage a child’s specific sensory processing difficulties, such as providing noise-cancelling headphones for those with auditory sensitivities or weighted blankets or lap pads during activities like reading. Additionally, modifying the home environment to be sensory-friendly and tailored to the child’s needs can also be beneficial. Examples include keeping only a few toys out and dimmer lighting for those over-responsive to visual input, or creating a calming space or cozy corner in the home for children to go to during times of sensory overload or dysregulation.
Supporting Growth Through Sensory Understanding
Sensory processing disorder is not limited to one diagnosis or group; it affects people across a wide range of conditions and abilities. With early identification and individualized strategies, children can build stronger self-regulation, learning, and participation skills.
Assessment tools like the SP-2 and SPM provide valuable insights, but perhaps even more powerful are the everyday observations made by parents, teachers, and therapists. When we combine professional knowledge with practical home strategies like sensory diets, calming input, and environmental modifications, we create supportive spaces where children can thrive.
Ultimately, awareness is the first step. By learning how sensory systems work and adapting accordingly, we can help children meet challenges with confidence, safety, and joy.
About the Authors
Lesley Chow, OTR/L, has been in the field of occupational therapy for over 30 years, working in a variety of settings in Southern California, including adult inpatient rehabilitation and acute care, pediatric inpatient rehab and acute care, adolescent mental health, working with at-risk teenagers, as well as several preschool, elementary, and middle schools as a school-based occupational therapist. She works as an early intervention occupational therapist at United Cerebral Palsy Association of Hawaii. She spends most of her free time with her family, going to the beach, hosting cookouts, and traveling.
Dr. Stephen Dantzig earned his Doctor of Psychology degree from the Rutgers University Graduate School of Applied and Professional Psychology in 1991. His dissertation studied the development of higher cognitive functioning of children with cerebral palsy and spina bifida. He was a school psychologist for 38 years, serving New York, New Jersey, California, and Hawai’i, and is now the Education and Outreach Program Manager at the United Cerebral Palsy Association of Hawai’i. His autobiography was Get Up, Your Bus Is Here: Living MY Life with Cerebral Palsy: Trials, Tribulations and Triumphs. Read more about Stephen here.
Your Voice Matters
Beyond this blog, United Cerebral Palsy Association of Hawai’i is working on a research study about aging with cerebral palsy. If you are an adult with cerebral palsy — or care for one — we invite you to share your experiences in their survey. Your input will help shape more compassionate care, policies, and support systems for adults with cerebral palsy.
Take the survey here.
