Sensory Saturday: What is a Sensory Processing Profile?

Sensory processing or sensory input refers to the constant flow of the information from sensory receptors in the body to the brain and spinal cord–there are seven total sensory receptors, but today we will focus on information from these five sensory systems:

  • Touch (tactile)
  • Visual
  • Auditory (hearing)
  • Proprioceptive (body position)
  • and Vestibular (balance)

Sensory processing is a complicated set of actions that enable the brain to process sensory input. Without this process, you would not understand what is going on both inside your own body and in the world around you.

Sensory Modulation is the body’s awareness and ability to filter, adjust, and respond to a variety of sensory input based on the frequency, intensity, and duration of that input. Behavior, attention, learning, play as well as peer interactions are significantly influenced by a child’s ability to process sensory stimuli. Self-regulation refers to the way we behave to manage our own needs.

When a child is evaluated by an Occupational Therapist (OT) one of the tests they will utilize is called The Sensory Profile-2. It is a set of judgment-based caregiver–usually mom or dad– questionnaire providing a standardized means to capture a child’s responses during the regular course of daily life. This information provides a unique way to determine how sensory processing may be contributing to or interfering with participation.

The Sensory Profile-2 evaluates four areas or quadrants and determine where a child falls–much less than others to much more than others.

  • Seeking/Seeker: Seekers have an active self-regulation strategy and generate new ideas.
  • Avoiding/Avoider: Avoiders are great at creating routines and order because they need “sameness” to reduce unanticipated sensory input.
  • Sensitivity/Sensor: Sensors detect sensory cues.
  • Registration/Bystander: Bystanders are easygoing.

Example:

The following is a sample of what you might see when you receive a report back from the OT who performs your Sensory Profile-2 evaluation.

Sensory Profile | Sensory Ninja

The sample Sensory Profile assessment reviled that this Ninja is a tactile seeker. This means that they need constant additional input from their surroundings. They might constantly be touching objects around them. In school, they might tap their pencil or want to chew on things. The more sensory input they could get the more alert they will be.

Under the avoiding quadrant, it reviled that this Ninja would move away from activities or work alone. By avoiding interaction they would be able to control their surroundings and the time they would spend on an activity. Whereas working in a group they would have little to no control.

This Ninja fell within “the majority of others” for sensitivity to the feel of tactile objects. What that means they probably are not picky about things like the fabric they wear or the texture of their food.

At the “more than others end” of the Registration/Bystander quadrant, this Ninja will miss sensory cues others would not. For example, they will not notice the teacher calling their name, or they might not notice they have their shirt on backward or twisted.

In summer, this Ninja can successfully use and understand some sensory information, they have difficulty processing touch (Tactile), movement and body position (Proprioceptive) stimulus. These deficiencies correlate with a need for an increased frequency of poor conduct and social/emotional responses. Some of these behaviors can be things such as extreme inattention, seeking out tactile and movement opportunities. This will contribute to making disruptive, impulsive, and/or unsafe choices at home, in school, social outings and during play.


The OT evaluation will take about an hour. For us, it included observing our Ninja’s tone/strength/range of motion, fine motor–Developmental Test of Visual Perception (DTVP-3)–, his ability to self-help, emotional/behavioral responses, and the sensory profile.

I was most fascinated by the results of our Sensory Profile test. Which is why I chose to cover this topic today. For me, it felt like FINALLY, someone understood my child and there he was in black and white. It was a huge relief that after years of struggling to figure things out, we could now put a plan in place and move forward with goals that would help support our Ninja at home and in school.

photo credit: Markus Spiske

Do’s and Don’t’s: IEP and 504 Meeting Preprations

With my first 504  and Individual Education Plan (IEP) qualification meeting approaching, I did what any overly prepared, easily intimidated person would do, scour the internet for tips – after all, knowledge is power. I also braved a seminar our school district held to help parents understand the 504/IEP laws, it, unfortunately,  turned from an informational meeting to a platform for other parents to air grievances. Super frustrating for those of us who attended with the hope of learning something.

I wanted to share a few amazing DO’s and DO NOT’s I have found from research and having attended my own 504/IEP qualification meeting.

DO

  • Put together binders with all current information you have to date on your child. (Should your meeting be regarding possibly seeking evaluations I recommend having medical information such as birth weight, length, and term of pregnancy as well as the notes your Pediatrician has on their monthly, bi-monthly, and yearly growth milestones. You can request a copy of this information from your doctor’s office)

Make a MASTER copy for you, one for the teacher, principal, nurse, special education director, and school counselor.  Include a picture of your child doing an everyday task – it helps to put a face to the name plus it “humanizes” your child.

Every binder should have the same sections and information, i.e.,  Psych Evaluation; Occupational Therapy Evaluation; Physical Therapy Evaluation; Doctor Reports; Teacher Progress Report; Teacher Correspondence; Multidisciplinary Evaluation Team (MET) – for the official signed meeting notes); and Notes.

  • Have a firm understanding of the rights and resources that are available for your child.
  • Know the difference between a 504 vs. IEP and which you feel would best support your child.
  • Arrive at your meetings with well thought out ideas or strategies to help support your child and teachers.
  • Prepare to compromise and have realistic expectations of what can be accomplished during school hours vs. at home.
  • Dress appropriately for the meeting. (i.e., slacks and semi-casual top vs. workout clothes) You would think this is obvious, but many parents show up like they are going to the gym or have just rolled out of bed. Your 504 or IEP is an important meeting dress accordingly.

All of these things will help you to be prepared and ready to advocate with confidence!

DO NOT

  • Expect the others at your meeting to have all the answers.
  • Argue about unimportant details. As much as we want the 504/IEP to be the magic wand remember that nothing will be 100% perfect.
  • Expect the school to put in all the effort. It is a two-way street, and a lot of work and time will need to be given by you the parent.
  • Be argumentative. It is easy enough to do, trust me, I wanted to bang a few heads together a couple of times. Keep calm and remember everyone in the room is vying for a spot on “TEAM NINJA,” and working to find the best way to help your little Ninja to be successful.

I know that this time can be super stressful when all you want to do is help your child be as happy and successful as they can be. I promise that is everyone’s goal.

Keep in mind that the qualification meeting for a 504 or IEP is the first step in the process of continued meetings and goal setting. You will want to have lines of communication open between everyone.

I remember the first 504/IEP meeting I felt like I was sitting in front of a firing squad pleading our case. The hoops you have to jump through to obtain a 504 or IEP are intense. Once the meeting concluded, I felt utterly drained. It is tedious, emotional, and demanding. The best news is, you will be one step closer to creating a successful school career for your Ninja. Now that is worth celebrating. Eat some chocolate; you’ve earned it!  

Can you see that: A Closer Look at Vision Processing (part 2)

Vision has a very complex sensory job to do. It helps our brain to remember, identify, and judge where our physical body is within our surroundings. If our visual processing is flawed or taken away entirely life will become challenging very quickly.

If you missed the first half, I recommend you read part one and then come back. Because Vision Processing Disorder (VPD) is an involved topic I broke it down into two parts and today am finishing the review of the remaining four issues:

What are visual processing issues?

  • Long or Short-Term Visual Memory Issues: Children with either long-term or short-term memory issues can struggle to remember what they’ve seen. Reading and spelling will be challenging as well as using keyboards, calculators or even recalling what they have read.

What would you say is the one word that would cause you nightmares? Mine is, SPELLING! Why? Because studying spelling words each week is a living nightmare. The one thing that has helped most is a free app called “Spelling Bee.” He is far from perfect, but 8/20 is an incredible achievement! Also, one of the games he plays on the app has sliding letters across the screen from the left and right. After working with this app for a little over a year, my Ninja can successfully track and pick out the letters he needs to spell a word. HUGE deal!

  • Visual-Spatial Issues: Children with visual-spatial difficulty will struggle with judging where objects are in space, i.e., how far things are from them or each other, and where characters or objects are located in a descriptive narrative. Some children may also find telling time or reading maps difficult.

After our full evaluation came back, it was SHOCKING to see in black and white my child described as “floating in space.” Visual-Spatial Processing is a huge roadblock for our Ninja. It was also relieving to finally understand why he had to touch everything around him all the time, or why when we would be out for a walk, he would stop in the middle of the road and not at the corner as instructed.

Honest moment here: I truly thought he was just a boundary-pushing punk. Yes. I called my child a punk because that’s the best way I can describe his behavior before I understood. Obstinant and defiant. It turns out that he couldn’t judge where he was in his space. I felt about 1″ tall for a month, but now I have perspective, understanding, and knowledge, which has empowered me to advocate for my “seeking” child!

  • Visual Closure Issues: is when a child is unable to identify an object that is missing part or parts of it. i.e., a bike without wheels, or a drawing with missing details such as a bird without its beak.

When given an evaluation for Occupational Therapy (OT) my Ninja was asked to complete the look of a shape. He sat very studiously (well for him that is) which means he was bouncing here there and everywhere while attempting to complete the other side of a triangle with a square in its center. It was a mess. I am happy to report with a lot of hard work on his part and a fantastic occupational therapist that he can now complete the other half. Not neatly, but with better accuracy than on his first trial.

  • Letter and Symbol Reversal Issues: Children that switch and substitute letters or numbers when writing is age-appropriate until age 7. If they continue to struggle with correct letter formation, it will begin to affect reading, writing and math skills.

Children with VPD may not know that they see the world around them differently. In fact, many VPD issues get misdiagnosed as Dyslexia and ADHD. Because a child will exhibits classic ADHD or Dyslexia symptoms such as the struggle to maintain attention, reading, tracking and sustained focus.

To avoid being misdiagnosed, I would encourage you to research and understand VPD. I would also urge you to find a Developmental Othomologist to evaluate your child. (Check out www.covd.org to find one in your area) Be sure to express any concerns you have when making an appointment.

Should your child have Sensory Processing Disorders (SPD) it may present some challenges during your exam. However, with time, a patient and kind Othomolgist, they will be able to obtain the visual information they will need to make a proper diagnosis.

Never forget to advocate for your child’s healthcare needs. I took our Ninja to a well respected and noted Othomolgist in his community. After our first follow-up appointment to discuss results from testing (that he did not even perform), I didn’t agree with his assessment and course of suggested treatment. So, I took my Ninja to get a second opinion. I’m very thankful I listened to that “mom voice”! I found another well-respected Othomolgist, waited on her new patient list for a month, and had an entirely different experience. She was hands-on and worked with us at each appointment. We were able to put in place a treatment that has helped my Ninja.

Don’t be afraid of that shine plaquet on their walls. Speak up (respectfully), and ask questions. Doctors are human too and capable of error. Being a voice for your child never wrong!

photo credit: Dmitry Ratushny

Did you see that: A Closer Look at Vision Processing (part 1)

Vision is a sensory that goes far beyond the concepts of how well one can see. The information from the world around us is utilized and processed by our brain, not eyes. We all knew that, right? Of course! It was a well-taught fact when we learned about the five senses in grammar school.

Logic would lead us to the next question: how does our brain use the information it is receiving every second, of every waking moment, of every single day? Well, we use vision in everyday life for things such as visual motor skills and visual planning, visual memory, fine motor skills and hand-eye coordination.

WOW! Our eyes and brain do this all on their own, without us having to do a thing (other than look at the world around us). Sounds like another thing we “just do”, like breathing. We don’t think about how we see; our body just does it.

What are visual processing issues?

Understood.org breaks it down beautifully for us. I’ve summarized it here…with tidbits from my Ninja’s experiences with Sensory Processing Disorder (SPD) and visual processing issues.

There are a total of eight possible visual processing issues. No one is limited to just one, in fact, my Ninja has a few. Because this is a huge chunk of valuable information I’ve decided to cover the first four now and the remainder in a follow-up post. They are as follows:

  • Visual Discrimination Issues: This means that a child will mix up letters or shapes, and the orientation of objects, i.e., “d” for “b”, left from right, and top from bottom. So a child might write a letter “d” in place of the letter “p”.

While Visual Discrimination appears to be dyslexia it is in fact not. Dyslexia is a language-based learning disability, that cannot be reversed. While Visual Discrimination can be greatly improved with vision therapy based exercises to help strengthen eye control and movement as well as visual processing.

  • Visual Figure-Ground Discrimination Issues: Kids with this specific issue will have difficulty finding shapes or items on a page of information or maybe a specific toy from a large pile, as well as being able to pull a shape or character from its background.  The “Where’s Waldo” books might cause more frustration than joy, and Waldo will probably remain lost.

Thankfully, this is not a big stumbling block for my Ninja. He will at times struggle, but that happens more often when he is tired. It’s also one of his sensory triggers that we have learned to avoid or work through.

  • Visual Sequencing Issues: Children with this type of issue will have a difficult time seeing the order of symbols, words or images. They may skip lines when reading or writing and struggle to copy information from one source to another. They may also reverse or misread letters, numbers, and words.
  • Visual-Motor Processing Issues: Children with this issue will struggle with writing, and their ability to coordinate the movement of other parts of their body. They may be clumsy and have difficulty copying text.

Before my Ninja received physical and occupational therapy he was very clumsy. As an infant, he crawled or walked right into walls and furniture. Sometimes, he would bump his head or hand on the object again before moving to the side to avoid his stationary roadblock. Can you even begin to imagine what a crowded room would do to him visually? It caused frequent toddler meltdowns.

Conclusion

Even though I’ve only covered four visual processing topics, we already get a clearer picture of how essential it is for our eyes and brain to work in tandem. The struggle for children with SPD and or any Visual Processing Disorder (VPD) is a compounded daily struggle.

I would like to encourage you,  the next time you notice a parent struggling with a child, not to jump to conclusions. Please, keep in mind they might be facing challenges such as SPD or VPD.  No matter how good a parent might be, children can express themselves in ways which present as “acting out”. It could be a coping mechanism; with parent and child doing the best they can.

I don’t have perfect children—all kids have bad moments. Either way, having perspective, and knowledge is a powerful set of glasses to help us all be a little more patient and kind to those around us.

photo credit: frank mckenna

What is Sensory Processing?

The human body is amazing! From the moment we are born it automatically kicks into a full functioning multifaceted working machine. It’s astounding how everything comes together and just works! Well for some of us anyway. 

Sensory Processing:

Sensory processing refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses.

Now that we have a textbook definition of what sensory processing is let’s play a game. Question: How many senses make up our sensory processing?

Did you think 5?

I’m sorry but the answer is 7! 7! and if just one isn’t working correctly…well if you’re exploring what Sensory Processing Disorder (SPD) means, then you’ll start to have an idea of the impact.

Internal and external environment is processed through the following

  1. Vision (ocular)*
  2. Hearing (auditory)*
  3. Taste (gustatory)
  4. Smell (olfactory)
  5. Touch (tactile)*
  6. Movement (Vestibular)*
  7. Joint and Muscle Awareness (Proprioceptive)*

The stars next to each of the senses are areas in which my child struggles; some areas more than others, but they all interrelate.

SPD can affect people in only one area or-like my child-in multiple. While no child will experience SPD the same as another, they are put into two groups, and in some cases, they can overlap. There are the Sensory Seekers and Sensory Avoiders. For example, my child does not like loud, noisy environments-avoider, where on the other hand he seeks deep pressure-like hugs or tightly fitted clothing-seeker.

What causes SPD?

The STAR Institue for Sensory Processing Disorder and their collaborators have been studying this very question. And so far their research suggests that it is inherited. So all you parents out there asking “was it something I did?” the answer is no. It is a DNA thing. Other factors are complications with a pregnancy or birth, as well as some environmental factors. (for more information check out spdstar.org it’s fantastic!)

Bottom line

It is unfortunate that children-like my own, suffering from SPD, are often times misdiagnosed – and therefore often inappropriately medicated- for ADHD. SPD can look like Autism Spectrum Disorders or even ADHD. I was told by two teachers that my child could have ASD or ADHD (good thing they aren’t doctors.) Remember, YOU- the parent! not Grandma, or Auntie or even the teacher knows your child better. If you feel like your child could have any kind of sensory delay speak with your child’s doctor. Be prepared to hear that it is “normal.” My pediatrician is an expert when it comes to diagnosing ear infections, not so much when it came to SPD-he totally missed it. We actually avoided our doctor altogether and took our child to get full evaluations from a psychologist. Whatever you decide to do, know that you are the only one that can/will advocate for you child.

photo credit: Johannes Plenio