Notes of sensory processing

2. Sensory Processing
• In order to understand sensory difficulties we must first understand how
sensory information is processed in the brain.
• We are bombarded with sensory information all the time in our daily lives.
• Countless bits of sensory information enter our brain at every moment, not
only from our ears, eyes, nose but from every part of our bodies.
• Normally this occurs without us knowing that it is happening
• The brain is programmed to organise or integrate this information and make it
meaningful to us, a bit like a traffic cop directing traffic or a telephone
exchange directing calls.
• When the sensory information is processed correctly, it allows us to respond
automatically and comfortably to sensory information and to efficiently cope in
our everyday life. All the senses work together to help us function efficiently

3. Sensory modulation
Effective sensory processing relies on the brain’s ability to correctly
process and modulate sensory information.
Sensory processing: This is the ability of the brain to organise information
from the different senses and to respond appropriately. It is an automatic
response, which helps us to cope with the demands of our daily
environment. It enables us to receive and interpret sensations in a refined
and precise way. It works alongside sensory modulation to create well
balanced sensory system.
Sensory modulation: This is the ability of the brain to balance sensory
information and to decide what information is important to attend and
respond to and to filter out unimportant information. It helps us to regulate
arousal levels and maintain an optimal level of arousal and attention to
allow us to focus on a task.

4. Sensory systems
• Most of us are familiar with the 5 senses of touch, hearing, smell, taste
and sight and how they function. These are known as the “far” senses
because they respond to external stimuli that comes from outside our
bodies.
• Working closely with these are the Proprioceptive and Vestibular
senses which are known as the “near” or “hidden” senses. We are not
as aware of these senses, which respond to stimuli inside the bodies
and are very important to our ability to function.
• These two critical systems can often get overlooked as they get no
attention if everything is running smoothly. It is only when they things
go wrong with them that become aware of the problems that can occur
when they are not working properly.

5. The proprioceptive system
• Tiny receptors from the proprioceptive sense are found in the body’s
muscles, ligaments and joints and are stimulated by movement.
• They send messages to the brain as to whether the muscles are
stretching or contracting and if the joints are bending or straightening.
• These receptors inform us of where exactly our bodies are in space
without us having to look e.g. allows us to reach behind our backs to
tie an apron etc.
• They let us know that our bottoms are on the chair, our feet are resting
on the floor etc. without us needing to look.
• An efficient proprioceptive sensory system is essential for the
performance of smooth movement.

6. The vestibular system (VS)
• The VS consists of sensory receptors that are located in semi-circular canals in the
inner ear which provide us with information on movement, gravity and vibration.
• These canals have little hairs with tiny carbonate crystals (like raindrops or pebbles)
resting on them, which are covered with a fluid called endolymph
• When your head is tilted, moved from side to side, is held upside down etc, the hairs
and the crystals shift from their normal position alerting the brain to a change in the
heads’ relation to gravity e.g. are we moving, standing still, direction and speed of
movement etc.
• Allows us to make the necessary postural adjustments to prevent us from losing
balance and falling over.
• Different types of movement provides different stimulation, jumping up and down
causes the crystals to jiggle up and down, running and using swings make them
sway back and forth and make the fluid swish around.
• Spinning and quick start stop movements provide intense vestibular feedback e.g.
swinging, rocking, spinning. Vibration is carried by the bones to the inner ear.

7. Tactile system.
• First sense to develop in the embryo and the largest sensory system in
the body.
• This sensory system receives information from the receptor cells in the
skin, which are located all over your bodies.
• It provides information on different types of touch sensations i.e. light
touch, deep pressure, vibration, pain, temperature etc.
• It has both protective and discriminative abilities and the successful
function of the tactile system depends on the correct balance between
these abilities.
• Feedback from this system contributes to our body awareness and motor
planning and all functional tasks depend on a well integrated tactile
system.

8. Auditory System
• Located in the inner ear and stimulated by air and sounds
• Allows us to process and interpret sounds from our environment.
• Has the ability to detect the source and location of sound and to
distinguish selected sounds from background noises
• Helps to distinguish between similar sounds
• Helps us to recognise sounds in different locations.
• Allows us to identify tone, pitch, rhythm and sequences of sounds
• Can activate memory

9. Gustatory (taste)
• Chemical receptors in the tongue.
• Closely linked with smell
• Provides information on different types of taste and textures i.e.
sour, sweet, bitter, salty, crunchy, soggy etc.
• Lets us know when our mouths are full, if there are large lumps in
our food that we need to chew before we swallow
• Lets us know when we have saliva in our mouths and activates
our swallowing mechanism

10. Visual system
• Located in the retina of the eye
• Stimulated by light
• Provides information about objects or persons in the environment
• Helps us to be aware of hazards, boundaries etc. as we move through
space

11. Olfactory system (smell)
• Chemical receptors located in the nasal structure
• Closely linked to taste
• Provides information on different smells
• Helps us to identify danger by smell i.e. smoke means fire etc.
• Can help recreate memories

12. Sensory difficulties
 People who have sensory difficulties have difficulty organising and
modulating information from their sensory systems.
 They display inappropriate and inconsistent responses to sensory
stimulation.
 Difficulty to use sensory information to plan and execute movement
 Difficulty in regulating and maintaining an optimum level of arousal.
 can be hyper (over) or hypo (under) responsive to information from the
sensory systems but can also display a fluctuating response to this
information often due to changes in anxiety, excitement, or tiredness.

13. Hyper-responsive
• The person responds too intensely to sensory information. They
become over aroused by normal levels of sensation and can be
distractible as they constantly pay attention to the stimuli even if it is
not relevant to them or their situation.
• Hyper-responsive children have difficulty with adapting to change and
tend to respond with the fight or flight reaction.
• The hyper-responsive child tends to avoid or escape sensory input in
an attempt to calm/organise themselves.
• They will have difficulties with transitions and changes of plans due to
anxiety regarding the unknown.

14. Hyper-responsive tactile
• Avoids touching objects or being touched.
• Reacts with a fight or flight response to certain tactile experiences
• Inability to tolerate having their hands, face etc dirty and avoids
messy play
• Struggles and reacts negatively to having their hair washed, nails
cut etc
• Dislike of certain fabrics and difficulty tolerating new clothes.
• Finds it difficult to tolerate labels on clothes, seams on socks

15. Hyper-responsive
proprioceptive
• The person will be rigid and tense and fearful of movement.
• Avoid activities that require motor skills i.e. ball games, PE, etc
• Avoid activities that require co-ordination and motor skill and
therefore reduce their opportunities to develop their skills
• Have difficulty grading their movement, unable to do anything gently
or in a controlled manner
• Appear clumsy

16. Hyper-responsive vestibular
• Avoids movement especially unexpected or unpredictable movement,
• Difficulty with balancing
• Become dizzy or nauseated quickly
• Experience anxiety if their feet are off the ground
• Watching another person spin can make them sick.
• Dislike having their head upside down etc.
• If they are tipped off balance they find it difficult to recover
• Avoid activities that involve running, jumping, climbing, swinging etc
• Feel sick in cars or on boats.
• Feel uncomfortable with fast or spinning movement.

17. Hyper-responsive oral
• Strongly object to certain textures and temperatures of food i.e. Dislikes
soggy, wet, dry food. May also have difficulty with strong tastes and flavours
• Only eat food if it is separate on the plate so textures cannot blend i.e. will
not eat beans and chips together as beans make chips soggy.
• May gag if forced to eat certain food textures
• May identify textures of food by colour and for example refuse to eat
anything red if perceive it as soggy.
• May touch food before eating it to determine the texture.
• Reluctant to feed as babies, attach to nipple

18. Hyper-responsive visual
• May become over excited if there is too much visual stimuli in the
environment.
• May cover their eyes to block out stimuli
• Overreact to bright lights e.g. florescent lighting, sun streaming
through a window, going outdoors into bright sunlight etc. and may
try to escape the area
• They find well lit areas like supermarkets difficult to cope with
• Will attempt to escape to a dark space i.e. under the table, behind a
curtain etc

19. Hyper-responsive olfactory
• Will object to certain smells that others do not appear to notice.
These may not necessarily be strong smells.
• They can react negatively to people wearing strong perfume etc
• They can be upset by somebody changing their perfume, soap etc
or by having their clothes washed by a different detergent
• They can recognise people by smell alone and become distressed if
that person changes their smell.
• May avoid using areas they associate with strong smells i.e. dining
halls, bathrooms, science labs etc,

20. Hypo-responsive
 Person registers sensations less intensely than normal and do not
always receive adequate sensory information to cope with situations.
 They require a great deal of stimulation to just to achieve normal
levels of arousal and alertness.
 A hypo-responsive nervous system causes the person to be non-
responsive, rarely seem awake and keen to do something, show little
emotion and prefer passive and sedentary activities.
 Person can appear compliant but may not be following the lesson. Has
difficulty engaging in tasks that are not stimulating i.e. handwriting
 Difficult to gain their attention and motivation. They do not appear to
notice changes in their environment.

21. Hypo-responsive to tactile
• The person may be unaware of pain or extremes in temperature.
• They struggle to identify objects from touch alone and may rely on
smell, vision, taste etc.
• They may not realise that their face or hands are dirty or sticky
• They may rub against walls or furniture or bump into people
• They may chew their skin or scratch cuts to extreme
• The person will not be aware of when their clothes are rucked up,
socks fallen into shoes, shoes on the wrong feet etc
• Not able to identify what area of the body is hurting them i.e. do they
have stomach ache or headache

22. Hypo-responsive
proprioception
• The person will have difficulty maintaining body position and tone
• They will require constant feedback regarding their body position in
space and so will keep moving
• They will crave deep pressure activities i.e. bouncing, crawling, rough
and tumble play, being wrapped in a blanket, having a hug etc
• They can appear clumsy as they have difficulty grading movement
(only using a small amount of force)
• They can bump into objects, doors etc
• They will constantly fidget and engage in activities such as hand
clapping, foot tapping etc.

23. Hypo-responsive Vestibular
• Crave fast and spinning movement such as swinging, rocking, twirling
etc.
• Enjoy playground equipment particularly swings, merry go rounds etc.
• Really enjoy fast rides at the fair
• Move a lot but not always in an organised manner
• Difficulty moving against gravity, i.e. getting up to stand from the floor
• Rarely become dizzy
• Constantly move and cannot sit still
• Can present as daredevils and show little awareness of danger

24. Hypo-responsive auditory
system
• Can ignore commands or appear not to have heard instructions.
• They may be unaware of their tone or pitch and speak in too loud or
too soft voices
• They have the volume of their stereo, TV etc turned up really high
• They crave background noise and sometime need the sound of the
vacuum cleaner, fan, music etc to help them sleep
• They need to be spoken to directly (say their name) to know what is
being said to them
• Can require visual information to understand something they are
told.

25. Hypo-responsive Oral sense
(taste)
• May constantly lick or taste items or people
• They will eat inedible objects such as crayons, soil, etc
• They will not be able to discriminate between hot and cold food
• They constantly mouth items and chew on clothes, pens, notebooks
etc and on extreme cases on their own skin, back of their hands etc
• They cannot discriminate taste and often crave really spicy food to
allow them to taste it
• The child is not aware of when their mouths are full, and may overstuff
their mouths or not be aware of where food is and choke.
• May take food out of their mouth to explore it further.

26. Hypo-responsive visual sense
• The child may often miss facial expressions or gestures
• They may use touch, smell or taste to establish what an object is or to
identify a person
• They may not react to changes in lighting i.e. light being switched on
in a dark room
• Can overfocus on novel visual stimuli i.e. mobiles, flicking lights,
movement in the environment etc
• Find it difficult to locate items when together with other items i.e.
socks in a drawer etc

27. Hypo-responsive olfactory (smell)
• They may smell a person when they meet them
• They may smell food before they eat it
• They will not notice a strong or unpleasant odour
• They will not be aware of body smells relating to personal hygiene,
particularly as they grow and are more in control of managing this.
• Would not be alerted to danger by smell of smoke etc.
• May sniff objects i.e. toys, books etc.

28. Sensory seekers/avoiders
Some children who are hypo-responsive to information from the
sensory systems can present as sensory seekers (constantly
seeking out stimulation) to raise their alertness. They are often
impulsive and cannot sit still. They engage in crashing, bouncing,
jumping and need to be physically active in order to increase their
arousal levels to allow them to attend to tasks.
Other children who are hypo-responsive will choose to remain so
and will not actively seek out additional stimulation to raise their
arousal levels. Their arousal levels are so low that they often miss
things. They require a great deal of stimulation to engage in activity.
These children are sensory avoiders and are often overlooked in
busy classroom environemnts

29. Sensory overload
 If the sensory difficulties experienced by the person are not resolved
then they will stack up and cause them to become more and more
stressed and anxious
 Sensory overload occurs when arousal levels get higher and the
person cannot cope and therefore shuts down and is unable to
process information
 This can present as withdrawn or avoidant and they can be overlooked
as they can present with no problem behaviours.
 Can present as under stimulated, but any stimulation given can make
them become more and more withdrawn instead of becoming aroused.
 Difficult to know the difference. Best way of knowing is that if you
stimulate a child who is under aroused they can wake up and become
interested, but if they are overaroused they can shut down further.

30. Is it sensory or is it behaviour??
• Sensory difficulties do not explain all behaviours of children. Behaviours that
may appear sensory based may be due to several other issues.
• An awareness of sensory difficulties can help you to look at the child in a
different light and to understand the reasons for certain behaviours
• Behaviours that start out as sensory seeking/avoiding may become learned
behaviours as the child learns that they will get a response to the behaviour.
They then need treating as a behavioural issue.
• It requires careful observation and knowledge of the child to identify when it is
appropriate to give more stimulation and when to reduce the demands and
change the situation or environment.

31. Sensory diets
 A sensory diet is a plan of specific activities that support the person’s ability to
remain in a functional state of alertness.
 It aims to provide the just right combination of sensory input to achieve and
maintain the right level of alertness and performance of the child.
 A properly introduced sensory diet can assist in the reduction of hyper- and
hypo-responses to sensory input and assist the individual to cope with the
demands of daily life.
 Every person has unique sensory needs and their sensory diet must be
customised to meet their individual needs and sensory responses.
 A sensory diet is not just a matter of providing the person with a fidget box,
weighted blanket etc. The activities chosen should be timed carefully and
spread throughout the day to promote optimum levels of alertness.

32. Sensory Strategies
• Sensory strategies are lists of exercises, activities,
modifications and environmental changes that can
assist the person to cope with their sensory
difficulties on a day to day basis.
• They can be provided for home and school and
inform the parent, teacher, carer etc. on strategies
that they can implement to assist the person to cope
with sensory demands of different environments.
• Examples of the types of situations that the child
may find difficult include the supermarket, swimming
pool, going to the dentist, wearing school uniform,
having their hair washed/cut/brushed etc.

33. Strategies to develop proprioception
.
 Adventure playgrounds, climbing frames, slides, monkey bars etc.
 Trampoling, bouncing on a therapy ball, bouncy castles etc.
 Hobbies i.e. horse riding, swimming, running, jumping, dancing,
climbing etc.
 Exercise sessions at the Gym push ups, weights etc.
 Practical activities; pushing a shopping trolley, carrying or putting
away shopping wiping the board in class etc.
 Provide a seated surface that allows movement and feedback i.e.
move’n’sit or disk’n’sit cushions, bean bags etc.
 Wrapping tightly in blankets, duvets or towels
 Using weighted blankets
 Regular movement breaks throughout the day, encourage marching,
stretching, dance, movement to music etc.
 Provide access to “fiddle toys” or a piece of blue-tac or stress ball

34. Strategies to develop vestibular
 Swinging: Encourage the child to use swings whenever
possible if he is willing to do so. Be aware that the child with
vestibular processing difficulties may be anxious if their feet
are off the ground.
 Linear swinging is calming, whenever possible avoid circular
swinging as this can cause over excitedness.
 Using playground equipment; roundabouts, seesaws, slides
etc.
 Bouncing on a trampoline, therapy ball, bouncy castle, space
hopper etc.
 Encourage any activities that involve rolling i.e. rolling on their
sides on a mat, rolling down a hill, using a plastic barrel with
hands and feet sticking out.
 Riding bikes and scooters.
 Playing games such as Twister and hopscotch.
 Using soft play areas.

35. Strategies for auditory hyper-sensitivity
 Identify the sounds that the person finds distressing i.e. crying, fans
etc
 Gradual introduction to noisy environments or sounds
 Ear muffs, headphones, or a tight hat to dampen down noise.
 Playing favoured music through headphones
 Allowing some control or understanding over the noise i.e. on off
button on the hover, how a fan works etc.
 Awareness of your tone and pitch of your voice when speaking, use a
calm soothing voice particularly in high anxiety situations.
 Provide visual backup to assist language
 Allowing opportunities to escape from noisy or distressing
environments
 Reduce background noise and provide a quite calm environment, play
calm music can help.
 Use social stories, schedules, visual cues etc. to prepare the person
for transition to new potentially noisy environments

36. Strategies for auditory hypo-sensitivity
 Gaining the person’s attention before speaking to them
 Break down instructions into stages and give one at a time
 Use short clear concise phrases and repeat instructions if necessary
allowing time to process
 Ensure that the person has correctly heard and understood the
instructions
 Whenever possible remove other auditory distractions.
 Give visual prompts to back up verbal instructions.
 Some people with an under-responsive auditory sensory system may
crave “white noise” or background noise i.e. fans, Hoovers, hairdryers
and may need this noise to help them settle. There are “white noise”
CD’s available on line, which may assist with this and avoid the child
turning on Hoovers, hairdryers etc.

37. Strategies for oral hyper-sensitivity
 Be aware of the person’s sensitivity to different textures when
preparing or offering food.
 Be aware that while the person may enjoy different food items but
may not like them placed together on a plate
 Provide food on different plates or plates with separate sections
 Whenever possible encourage the person to try out different foods,
this should be done gradually, used alongside familiar safe foods
and taken away if they become upset.
 Provide opportunities to explore different foods in safe situations i.e.
role play, tasting games etc.
 Chewing on hard and crunchy food i.e. carrots, breadsticks etc can
assist in reducing oral sensitivity
 Drinking from water bottles, using straws blowing bubbles etc.

38. Strategies for oral hypo-sensitivity
 Provide opportunities to chew on hard crunchy food e.g. apples, carrot sticks,
fruit bars, dried fruit etc
 Sucking from sports bottles or a drinking straws, use thicker liquids e.g.
milkshakes etc.
 Massage the face gently around the mouth area particularly prior to eating.
 Blowing bubbles, whistles, blow football, blow pens etc. can help to wake up
the receptors in the mouth. The child should be supplied with a selection of
these for use. These should be used with supervision
 Use of towelling wrist bands can stop the child from chewing on the sleeves of
their clothes or on their skin. These can also be useful for the child who
dribbles as they can be encouraged to wipe their own chins.
 There are a number of specialist items available that are specially designed for
chewing. These include “Chewy Tubes”, “Chewellery (chewable jewellery)”,
“Chew Ease” pencil toppers and other products. These should be used with
guidelines from Occupational Therapist.

39. Strategies for tactile hyper-sensitivity
 Use textured soaps and textured bath mitts.
 Provide opportunities to explore a wide range of graded tactile objects.
Remove at once if they become distressed
 Activities used must be motivating for the person, develop games to increase
tolerance to different textured surfaces
 Motivating activities e.g. cooking, icing biscuits, mixing bread dough etc
 Remove labels from clothes, turn socks inside out or use seamless socks etc.
 New clothing can appear scratchy, wash them several times prior to wearing in
familiar washing powder or softener
 Choose softer textures clothes.
 Gradually introducing new clothes and limiting wearing times.
 Compromise i.e. wearing familiar item with new item etc.
 Wearing a soft familiar vest can help to tolerate new or unfamiliar clothes
 Discussing clothes issues regarding uniform to school staff
 Avoid light or unexpected touch as this can provoke a negative reaction

40. Strategies for tactile hypo-sensitivity
 Wash using textured soaps and to use different textured bath
scrubbers.
 Provide opportunities to engage in deep pressure activities, running,
bouncing, climbing, trampoling, crawling, using playground
equipment, horse riding, swimming etc. This will also assist in the
development of sensory (Proprioceptive and Vestibular) processing.
 Encouraging the exploration of different textures i.e. playdough,
sandpaper, tissue, putty, sand, water, cardboard, etc.
 Identify different items without seeing them, i.e. hiding objects in a
feely box or bag and have the child identify them by touch alone.
 Hiding items in lentils, sand, packing foam, rice etc can also be very
effective.
 Massaging the hands can help to wake up tactile system.

41. Strategies for visual hyper-sensitivity
 Be aware of visual overload when introducing the person with visual
processing difficulties to brighter environments.
 Gradual introduction to bright environment.
 Wearing sunglasses, a sun visor or peaked cap
 Allowing opportunities to escape from areas that are too bright and
causing distress
 Whenever possible provide a safe dark space to escape to get away
from bright lights i.e. using a large box with a blanket over the
entrance, a quite space/room with subdued lighting,
 Allow the person opportunities to develop/design their own safe
spaces or strategies to help them to cope with visual sensitivity.

42. Strategies for olfactory sensitivity
 Awareness of difficulty in coping with environments that have strong
smells i.e. supermarkets/pet shops/swimming pools/dining halls etc
 Awareness that the person can react negatively to sitting next to
people who are eating strong smelling foods e.g. crisps etc.
 Sitting the person next to the door/at the end of the table/ behind a
partition/ etc. can help to manage this.
 In extreme cases the person may be best to eat alone in a different
room.
 Avoid wearing strong scent or washing clothes in strong smelling
fabric conditioner
 Avoid sudden changes of scent, washing powder/conditioner etc
 Be aware of cooking strong smelling food in the home environment
e.g. fish, sprouts etc.