Understanding It
What Sensory Processing Means
Every one of us takes in a constant stream of sensory information and, mostly without noticing, decides what matters and what to ignore. That filtering is what lets you hold a conversation in a noisy café.
For some people the filtering works differently. Ordinary sensory input arrives too loudly, too faintly, or unpredictably: and the response looks, from the outside, like behaviour.
Most people know the five obvious senses. Three others matter just as much here:
- Vestibular: movement and balance, sensed through the inner ear. Affects how someone responds to swinging, spinning, heights and being upside down.
- Proprioception: where your body is in space, sensed through muscles and joints. Affects coordination, force control, and how hard someone hugs, writes or closes a door.
- Interoception: signals from inside the body, hunger, thirst, needing the toilet, temperature, and the physical sensations tied to emotion. This one is frequently missed, and it explains a great deal about toileting difficulty and about children who cannot tell you they are upset until they are overwhelmed.
An important note on terminology. Sensory processing difficulty is a description of how someone functions, not a formal diagnosis in Australia. It is very commonly seen alongside autism, ADHD, developmental delay, prematurity and cerebral palsy, and it also occurs in people with none of those. You do not need a diagnosis to get support for it.
How does it usually present?
Three broad patterns, and many people show a mix depending on the sense involved.
Over-responsive: the input is too much
- Distress at everyday noise: hand dryers, vacuum cleaners, assemblies, shopping centres, fireworks
- Clothing battles: tags, seams, socks, waistbands, anything scratchy
- Haircuts, nail cutting, teeth brushing and hair washing as major events
- Avoiding messy play, food textures, glue, sand, grass
- Dislike of unexpected touch, or of being in a crowd or a queue
- Strong reactions to smells, or to bright and fluorescent light
- Motion sickness, or fear of playground equipment and escalators
Under-responsive: the input does not register
- Not responding to their name, or seeming not to hear
- High pain tolerance, or not noticing injuries, heat or cold
- Not noticing a messy face, wet clothes, or a full nappy
- Appearing tired, slow to start, or disengaged
- Missing the signals for hunger or needing the toilet
Sensory seeking: actively chasing more input
- Constant movement, spinning, jumping, climbing
- Crashing into furniture, people and floors
- Chewing on clothing, pencils, hair or hands
- Touching everything and everyone
- Loud voice, heavy footsteps, doors closed hard
- Preference for strong flavours, or for very hot or very cold food
Across all patterns, you may also see difficulty with transitions, meltdowns in busy environments, exhaustion after school, trouble settling to sleep, restricted food range, and toileting delays.
Adults have sensory differences too. They usually look like avoided environments, an intolerable open-plan office, exhaustion after socialising, or a wardrobe of the same three fabrics.
When to Act
When to Seek Help
Consider an occupational therapy assessment when sensory responses are limiting daily life: when a family cannot go to the shops, when school is unmanageable, when mealtimes have narrowed, or when a child is exhausted by the effort of coping.
Speak to your GP or paediatrician promptly if a child:
- Loses skills they previously had — regression at any age needs medical review, not monitoring
- Does not respond to sound or their name — arrange a hearing assessment. Reduced hearing and vision problems mimic sensory processing difficulty and should be excluded first
- Does not react normally to pain, heat or injury — reduced pain awareness can mask a fracture, burn or illness, and needs to be known about
- Is injuring themselves — through head banging, biting or hitting
- Has a restricted food range affecting growth, weight or energy
- Shows a sudden change in sensory tolerance — a child who abruptly cannot bear touch or sound may be unwell, in pain, or have an ear infection, and this deserves a medical look before it is treated as sensory
- Has episodes of staring, unresponsiveness or unusual repetitive movements that could be seizures
How We Help
How Our Team Can Help
Occupational therapy is the main discipline for sensory processing. Assessment builds a picture of how a person responds across each sensory system, and (more usefully) where and when that causes a problem. The plan that follows is generally built from four things: modifying the environment, sensory strategies through the day, building the underlying skills, and coaching the adults.
Occupational Therapy
Sensory assessment across each system, environmental modification, sensory strategies matched to the person and situation, building underlying skills (dressing, mealtimes, toileting, handwriting, play, sleep), and coaching parents, teachers and support workers.
Speech Pathology
Where communication or feeding is also affected.
Dietetics
Where food restriction is affecting nutrition.
A word on evidence, because there is a lot of confident marketing in this area. The strongest support is for adapting environments, teaching strategies and building participation in real activities. Passive sensory treatments (devices, brushing protocols, listening programs and similar) have a much weaker and more contested evidence base. We will tell you what the evidence supports and what it does not, rather than sell you a program.
Starting Out
What to Expect at Your First Appointment
Assessment usually happens where the difficulty happens: at home, at school, or in clinic if that suits better.
Your occupational therapist will talk with you about what a typical day looks like, which situations go wrong and which go well, and what you most want to change. They will use a sensory profile questionnaire, observe the person in activity, and look at the environments involved.
You will leave with an explanation of the pattern, a small number of strategies to start with, and (where relevant) written recommendations for school. We would rather you left with three things you will actually do than twenty you will not.
Ready to book?
Ready to get started?
Contact inOne Healthcare on 1300 765 456 or submit a referral online. Sensory processing is assessed and supported by our Occupational Therapy team, with Speech Therapy and Dietetics where communication or eating are affected.
info@inonehealthcare.com.au
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Related: Autism Support · Fussy Eating · Handwriting Difficulties