Drs. Brock and Fernette Eide's presentation at the Seattle SPD Foundation International Symposium. The Eides discuss how SPD may affect reading, writing, math, and attention and certain types of
Drs. Brock and Fernette Eide's presentation at the Seattle SPD Foundation International Symposium. The Eides discuss how SPD may affect reading, writing, math, and attention and certain types of memory.
Common Learning Challenges in
Sensory Processing Disorder
Brock Eide M.D. M.A. and Fernette Eide M.D.
This presentation will be posted on Slideshare.net/drseide
Ways to Think About
Sensory Processing Disorder
Dr. Jean Ayres defined the clinical syndrome of Sensory
Integration Dysfunction functionally: as an impairment in the
ability to organize sensation for use.
Dr. Lucy Jane Miller: “Sensory Processing Disorder exists when
sensory signals don’t get organized into appropriate responses
and a child’s daily routines and activities are disrupted as a
Both descriptions emphasize information processing in the
We can also view SPD from the
Perspective of Learning.
What kinds of learning and cognitive issues
do we see in children with SPD?
What is Learning?
We can think of learning as: Information that
has been encoded in memory in a form that
can be used.
Long-Term Memory: Information
you can use later.
Working Memory: Information you
can use now. Mental Desk Space,
or keyboard memory. (Also
considered part of Attention)
What Kinds Of Memory Do We Have?
What Kinds Of Information Does
Long-Term Memory Retain?
Procedural Memory: How to do things.
Rules and Procedures, Rote Facts, Things
that become automatic through practice so
you can do them without conscious effort.
Declarative Memory: Facts about
Most Basic Academic Skills
• Most language skills are rule-based, including: discriminating
word-sounds; correctly articulating and pronouncing words;
segmenting words into sounds; phonics (decoding and spelling);
s; grammar and syntax; style and pragmatics.
• Many other academic skills are also rule-based, like: rote (or
automatic) memory (e.g., math facts, dates, titles, terms, or
place names); procedures like long division, carrying over,
borrowing, or dealing with fractions in math; sequences, like
the alphabet, days of the week, months of the year, etc.; writing
conventions like punctuation and capitalization; and motor rules
for forming letters the same way every time when writing by
hand, and spacing evenly between words.
• Classroom schedules, rules, and procedures/organization
• Development of Automatic Skills;
• Mastery of Procedures (versus simple facts);
• Rote Memory;
• Working Memory Overload and Attention Challenges;
• Understanding of time, space, quantity, sequence;
• Language Retrieval, organization, prosody, pragmatics;
• Social Fluency (versus comprehension);
The Link Between
SPD and Procedural Learning:
Same List of Cognitive and Learning Challenges
Limbic / Emotional
Neurologically, What Links
SPD and Procedural Learning?
Answer: Cerebellar Dysfunction
When the cerebellum’s working hard, you don’t have to...
Cerebellar Cognitive Affective Disorder:
“Dysmetria of Thought”
Dr. Jeremy Schmamman, Harvard
Risk Factors for
for Cerebellar Dysfunction
and SPD essentially the Same
• Preterm birth
• Birth injury
• Down Syndrome, Fetal Alcohol Syndrome
• Deprivation, Child Abuse
• ADHD: the most consistent brain abnormality
• Autism / Aspergers: the most brain consistent abnormality...
• Dyslexia: the most commonly identified brain abnormality
• Developmental Motor Coordination Disorder
• Pediatric Bipolar
The Cerebellum is Particularly Vulnerable to Hypoxia / Ischemia
and is the Most Commonly Affected Area in a Wide Variety of
Conditions Associated with Learning Challenges
• Failure to automatize functions leads to the need for conscious
compensation or oversight.
• When too many tasks require conscious attention, overloading
• of working memory is the inevitable result.
Cognitive/Learning Issues Besides Basic Skills:
1. Attention and Working Memory
Sustaining Attention Is Also Harder for
Children With Cerebellar Dysfunction and
Procedural Learning Challenges
• Children with procedural learning difficulties must focus more intently
to perform the same tasks as other children, and this is tiring.
• Think of the difference in attention required to drive the same stretch
of twisty mountain road on a clear day versus a rainy night—and the
difference in resulting stress and fatigue.
Other Attention Issues with Cerebellar
• Selective attention/distractibility (Poor automatic
• Difficulty with task switching (set-shifting), dividing
attention, and transitions.
• Difficulty following complex instructions
• Difficulty with “oversight” or executive functions due to
working memory overload
• Poor appreciation and understanding of time/time
2. Social Interactions
• Learning and using social and self-help rules.
• Most social interactive skills are rule-based.
• Real-time fluency/praxis versus comprehension.
• Auditory processing (telling word sounds apart, hearing in
background noise, sound sensitivity)
• Speech articulation
• Prosody/tone and style (“pedantic” or “mechanical”)
• Bright children often misdiagnosed with autism spectrum
disorders due to unusual style, prosody, or pragmatics, but
generally language comprehension is flexible and fluid
Take Home Points about
Procedural Learning in SPD
• “How” or “praxis” skills: Things that become automatic through
practice, like rules, procedures, rote facts
• Most Basic Academic Skills are procedural in nature
• Square root rule: take square root longer of number of repetitions to
• Affects implicit learning (observation and imitation) more than
explicit (detailed instruction)
• Poor automaticity requires conscious compensation and working
• Often show up on WISC as slow processing speed, decreased
• Alternative learning strategies based on explicit learning and
declarative (factual) memory mnemonics.
Common Academic Labels Given to
Children with Procedural Learning
• Autism Spectrum
SPD and Reading
Visual – skipped words and lines, misreading
Auditory – mispronounced words, trouble sounding out,
discrimination / phonics mistakes, poor word retrieval
Cerebellar – Impaired reading automaticity
SPD kids may have unrecognized Dyslexia
http://flickr.com/Old Shoe Woman
Visual Functions and Reading
Smooth eye movements for reading
Eye saccades or jumps to switch between lines
Focus adjustment near and far
Visual recognition of letters and whole words
Distinguishing similar sounds – „hod‟ for „hot‟, „brush‟ for „blush‟
Quick speech, Sounds within Words
Mishear, Mispronounce, Misspell, Misfiled - „Mushy Speech‟
Misfiled Words Harder to Retrieve
Auditory Processing & Reading
Interventions for Reading
See, hear, air write, say
Vision and visual memory
Teachers, parents, tutors, SLPs,
audiologists, dev optometrists
reading specialists, computers
SPD and Writing
Automaticity of letter writing
Motor planning and execution
Visual and kinesthetic memory
Word retrieval and organization
Emotional Toll of Dysgraphia
“His teacher would let him take his work home,
but even after 3 hours, there was no way he could finish…”
Impaired Motor Automaticity
“Draw several squares on top of each other”
May Avoid fingers
Handwriting and Working Memory Overload
Sentence Copy Better than Free Writing
Interventions for Writing
Dictation, Typing, Assistive Technology
Fine motor / Upper Girdle Strengthening
Kinesthetic Strategies – Air Writing / Imagery / Verbal
Automaticity Practice – over-learning
Template prompts, imitation, writing tutor
Expressive language work – SLP
Word Prediction Software
Report Writers- CoWriter 6
Speech to Text - Dragon Dictate
Text to Speech Software and Browsers
Ginger: Context-Sensitive Grammar
Kindle, iPad, iPhone, iPod, etc.
Intel Reader, Kurzweil
Training and Support for Assistive Tech
SPD and Math
Impaired Sense of Number and Quantity
Number Sense Related to Spatial Perception
Finger Agnosia Often Seen with Dyscalculia
Rote Math Facts, Procedural Memory
Counting and Quantity
Sequence and Multiple Steps
Money, Clocks, Time
Students with SPD Often Struggle with Math
Impaired Number Writing Automaticity
Working Memory Overload
Impaired Sense of Number and Sequence
You do not have to be a great calculating wiz
To be a great mathematician or scientist
Math Problem Solving May Be Quite Strong in Dyscalculics
Interventions for Math
Kinesthetic Strategies to Number, Quantity
Episodic / Personal Memory for Math Facts
Dysgraphia, Working Memory ,Vision
Math Reasoning ≠ Arithmetic