Pro Educational Toys: Sensory Processing Disorder Part Two by Trisha Roberts

Sensory Processing Disorder (SPD)

Part Two: How is a Sensory Processing Disorder Diagnosed?

A Checklist for Parents

by Trisha Roberts

It is important to seek professional help if a Sensory Processing Disorder is suspected. Occupational Therapists, Speech Therapists and some Physical Therapists are trained in the area of Sensory Integration and will be able to evaluate your child and design a treatment plan. The following information is a guideline for helping parents decide whether they should seek additional help. Professionals can diagnose and determine in which category your child is struggling, how it is impacting their life and levels of performance.

A Sensory Processing Checklist for Parents

Symptoms of a Sensory Processing Disorder (SPD) may vary according to the disorder's type and SPD can affect one or more areas of function. A true sensory processing disorder has a significant functional impact on the person's life. Each child is unique; they may not exhibit every characteristic and they may be inconsistent in displaying symptoms. This checklist is meant to help define and target a specific area to be investigated more thoroughly. You might want to request a detailed evaluation if your child has a large number of the symptoms on the following checklist that are impacting or interfering with their day-to-day performance.

I. Sensory Modulation Disorder refers to individuals who seek sensory stimulation due to an under or over response to sensory stimuli.

Signs of Over-Responsivity:

Distressed by textures of fabrics, foods, hair products, etc. to the point of interfering with normal function
Upset by the smell of perfume or cologne
Dislikes hair combing or brushing
Disturbed by clothes rubbing on skin; may want to wear shorts and short sleeves year-round, or only loose clothing
Pulls off diapers and clothes, prefers to be naked
Dislikes brushing teeth
Is aversive to face being washed
Overly distraught during diaper change
Eats only soft or pureed foods past 2 years of age
Gags with textured foods
Avoids eye contact
Experiences difficulty with sucking, chewing, and swallowing; may choke or have a fear of choking
Resists wearing new clothes or clothes with rough textures
Irritated by seams in socks and may refuse to wear them
Avoids crowds and noisy places (movie theater, athletic stadium, shopping mall, parades, concerts, etc.)
Experiences motion sickness that is unrelated to other medical causes
Irritated by household or cooking smells

Irritated by Food Smells
Sensitive to movement; avoids swings, merry-go-rounds and slides. Gets dizzy or nauseated easily
Fearful or anxious of standing in close proximity to other people; may resist standing in lines
Dislikes kissing, cuddling or hugging; may “wipe off” kisses
Runs away, cries, or covers ears with loud or unexpected sounds
As an infant, did not like to be held or cuddled--arching away from parent and/or crying
Overreacts to minor cuts, scrapes, or bug bites
Walks on toes the majority of the time
May get fearful, anxious or aggressive with light or unexpected touch
Feels seriously discomforted, sick or threatened by normal sounds, lights, movements, smells, or tastes
Distracted by sounds not normally noticed by others, often to the point of being unable to concentrate on any other activity; hum of refrigerators, heaters, fans, or clocks ticking
Prefers the dark; may cover or shade eyes with hand when in the light
Asks people to be quiet; stop making noise, humming, talking, or singing
May be a picky eater; avoids certain foods and may have a very limited diet

Aversion to Certain Foods and Textures

Does not like foods to be mixed
Sensitive to bright lights; will squint, cover eyes, cry and/or get headaches from the light
May avoid hot or cold foods
May refuse to play at someone's house because of the way it smells; decides whether they like someone or some place by the way it smells
Resists trying new foods
Avoids “messy” play (dislikes paint, sand, glitter, play dough, glue, etc.)
Resists fingernail or toenail cutting
Bothered by background environmental sounds like outside construction, traffic noises, lawn mowing
Hates getting hair cut

Aversion to Haircuts

Dislikes toothpaste and mouthwash

Brushing Teeth is a Battle

Wipes or washes hands frequently or gets distraught when hands get dirty
Excessively ticklish
Reacts negatively to smells which do not usually bother, or get noticed, by others
Avoids elevators and escalators
Fearful of the sound of a toilet flushing, dog barking, vacuum, hairdryer, squeaky shoes, door bell
Appears restless and fidgety
Has difficulty getting to sleep or waking up because of a slight sound
May dislike certain people because of the sound of their voice

Dislikes Going Barefoot in the Grass

May refuse to walk barefoot on grass, shag carpet, or sand
Refuses to eat certain foods because of the way they smell
Finds it difficult to self-calm

Signs of Under-Responsivity:

Excessive Drooling

Shows extreme difficulties waking up
Unaware of being touched or bumped unless done with extreme force or intensity
Seems to ignore certain sounds
Unaware that face or hands are dirty; may not feel that nose is running
May not be able to identify which part of their body was touched if they were not looking
Appears unreactive and slow
Excessive drooling past the teething stage
May have experienced little or no babbling as an infant
Appears to make noise just to make noise
Unaware of pain; not bothered by injuries, like cuts and bruises
Shows little or no distress with vaccinations
Fails to notice or ignores unpleasant odors
Might appear deaf even when hearing is normal; may not respond when name is called
Difficulty with toilet training, unaware of being wet or soiled
May need directions repeated often, or will say, "What?" frequently

Signs of Sensory Craving:

Fidgets excessively
Seeks or makes loud, disturbing noises
May crave touch, needing to touch everything and everyone
Seeks out and enjoys messy play
Looks for surfaces and textures that provide strong tactile feedback; may constantly rub against the object
Loves being tossed in the air
Could spin for hours and never appears to get dizzy

Could Spin for Hours
Loves jumping on furniture, trampolines, jumping off objects, spinning in a swivel chair, or getting into upside down positions
Enjoys swinging as high as possible and for long periods of time
Prefers food with strong flavors--excessively spicy, sweet, sour, or salty
Climbs, jumps and crashes constantly
Searches for "extreme" sensations
Kicks feet on chair or floor while sitting at desk
Loves to drag, push or pull heavy objects
Seeks out fast or spinning activities
Loves fast, intense rides at amusement parks

Sensory Processing Disorder Hyposensitive

Craves Fast, Intense Activities

Wants to be tightly wrapped in many blankets at bedtime
Prefers clothes to be as tight as possible
Sucks on or bites clothing, fingers, pencils, etc.
Chews on straws, pencils, shirt sleeves, hair

Chewing on Hair or Other Non-Food Objects
Mouths objects excessively beyond infancy
Frequently crack knuckles
Enjoys excessively loud music; turns TV, radio or headphones to high volume
May be self-abusive; pinching, biting, or banging head
Enjoys “roughhousing” and wrestling types of play
Bangs toys and objects excessively
Craves deep pressure and hugs
Grinds teeth during the day
Appear impulsive
Demonstrates high level of risk-taking behavior; seems unaware of danger; may be reckless

II. Sensory-Based Motor Disorder refers to individuals who incorrectly process motor information, leading to poor motor skill performance.

Signs of Sensory Motor Based Problems:

Appears slow, clumsy and uncoordinated
Demonstrates poor motor skills
Poor handwriting

Poor Handwriting
Slumped posture; difficulty sitting or standing erect
Delayed development of crawling, standing, walking or running
Difficulty attending to, understanding, and remembering what is said or read; often asks for directions to be repeated and may only be able to understand or follow two sequential directions at a time
Slow to develop hand preference, not clearly right or left-handed by age 5

Sensory Motor Based Problems Poor Posture

Slumped Posture

Unable to throw or catch a ball
Displays an awkward grip on pencils or other writing tools
Grips items too tightly or too loosely; frequently spills liquid out of drinking glass
Displays poor coordination in fine motor tasks, such as cutting, holding a marker or pencil, manipulating fasteners (zippers, snaps, buttons), opening and closing containers, stringing beads, putting on clothing (shoes, socks, jacket, pants), etc.
Unable to eat well using fork, spoon, and knife
Frequently drops or spills thing
Written work is messy, often rips the paper when erasing
Unable to drink from an open cup or straw
Appears overly messy when eating compared to other children their age
Exhibit difficulties in imitating age-appropriate shapes and letters
Has trouble coloring within the lines
Excessively short attention span for age

III. Sensory Discrimination Disorder refers to individuals who typically have poor postural control, have difficulty attending to tasks and lack body organization.

Signs of Sensory Discrimination Problems:

Drops things constantly
Frequently breaks toys and objects, exerting too much force
Poor handwriting
Difficulty dressing and eating
Struggles to use scissors
Uses inappropriate force to handle objects
Participates in repetitive play for hours; lining up blocks or toy cars, watching one movie over and over
Frequently bumps into things, trips, knocks things over, or appears clumsy
Poor balance and righting reflexes
Seems weaker than other children
Frequently trips or falls for no apparent reason
May be a messy dresser; looks untidy, does not notice shirt is not tucked, shoes are untied, pants are twisted, collar of shirt is up, etc.

Appears stiff and rigid, or loose and floppy
May have difficulty articulating and speaking clearly
Low muscle tone
Frequently “W-sits” on the floor to stabilize body

W-Sitting to Stabilize Body

Poor core (trunk) control
Avoids playground equipment like swings, ladders, slides, or merry-go-rounds
May appear terrified of falling even when there is no real risk of it
Prefers playing alone with objects or toys rather than with people
Terrified of heights, even the height of a curb or small step
Excessive difficulty accepting changes in routine
Fearful of feet leaving the ground
Nervous walking up or down stairs or walking on uneven surfaces
Afraid of being tipped upside down, sideways or backwards
Difficulty learning an exercise or dance steps
Stomps feet when walking
Difficulty climbing stairs

Clumsy with Poor Body Control and Frequent Stumbling
Unsure about how to move body during movement, for example, negotiating an obstacle course, retrieving a ball from under a table, stepping over an object in their path
Unable to assume a "superman" or “V-up” position (lifting arms and legs together when lying on tummy)
Often interrupts, talks out of turn, or "off topic"
Unable to stand on one foot with eyes open
Difficulty jumping, hopping, galloping, skipping or performing a “Jumping Jack”
Unable to kick a moving or stationary ball
Struggles to turn doorknobs, handles, or to open and close items
Unable to catch or throw a ball overhand
Difficulty getting along with peers

Frequently Breaks Pencils and Crayons by Using Too Much Force

Unable to regulate pressure when coloring or writing; frequently breaks crayons or ends of pencils; coloring or handwriting may be too faint to see
Difficulty getting on or off playground equipment; need assistance to use properly
Fearful of riding a bike or difficulty riding a tricycle or bike
Unable to locate the source of a sound
Moves slowly and cautiously, avoids taking risks, prefers sedentary activities
Low endurance; tires quickly with minimal work
Difficulty sitting upright in a chair; frequently slumped over desk or table
May not be able to identify objects by feel; needs to use vision to help find an item in desk or backpack

Do not panic if your child has several of the indicators above! No one is perfectly regulated all of the time; we all have some sensory integration problems now and again due to an overload or deprivation of sensory stimulation. But if a large number of the indicators above describe your child on a regular basis and are interfering with daily life, I encourage you to seek help. Start with your Primary Care Physician (PCP), your local Early Intervention Program (available in each state for children birth to 3 years old), or your child’s teacher. They should be able to put you in touch with someone who can start the evaluation process.

We will continue this topic with our next blog:

Part Three: Strategies for Treating a Sensory Processing Disorder

We carry many great Sensory and Tactile Toys for children. Visit our Retail Website Here.

Author: Trisha Roberts

proeducationaltoys@gmail.com

www.proeducationaltoys.com

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