Sensory Integration Therapy

Types of Sensory Processing Disorders

There are certain subtypes of sensory processing disorder that may alter the course of treatment and diagnosis. The subtypes of SPD include:

Sensory Modulation Disorder: Children who have sensory modulation disorder have problems regulating the intensity and nature of responses to sensory input. The responses may be emotional or behavioral, negative responses to stimuli not averse to others, and the problems are exacerbated by stress. Common symptoms include:

• Withdrawing from light and unexpected touch
• Gagging and refusal to eat textured foods
• Dislike of teeth-brushing, hair washing, or nail cutting
• Avoidance of messy textures such as dirt or lotion
• Avoidance of messy textures such as dirt or lotion
• Strong preferences to certain types of clothing, including textures and fit
• Over sensitivity to sounds or visual stimuli

Sensory Discrimination Disorder: Children who have sensory discrimination disorder have problems discerning and assigning proper meaning to qualities of particular sensory stimuli. These children may struggle with recognition and interpretation of characteristics of sensory stimuli, have poor detection of difference or similarities in the stimuli, and often occurs with dyspraxia and poor skill performance. Symptoms may include:

• Difficulty manipulating an object when out of sight
• Difficulties following directions
• Challenges distinguishing between similar sounds
• Problems finding an image in a cluttered background
• Uses too much or too little force
• Poor balance
• Poor sense of movement speed

Postural-Ocular Disorder: Children with postural-ocular disorder have problems controlling or stabilizing the body during movements or at rest. Muscles may be hypo or hypertonic and joints may be unstable. Poor usage of vision and coulomotor control. Symptoms may include:

• Poor posture control or strength
• Poor equilibrium and balance
• Difficulty isolating head-eye movements
• Poor tracking of visual stimuli
• Avoidance of upper extremity weight bearing
• Discomfort climbing or fear of heights
• Tires easily
• Challenges establishing dominant hand (right or left handedness)

Dyspraxia: Children with dyspraxia have a deficit in their abilities to plan, sequence, or execute unfamiliar actions. Motor skills and movement may be awkward; these children may have poor ability to generalize learned skills to apply to other tasks, and may have poor timing, sequencing, and action of motor skills. Symptoms may include:

• • Trouble performing activities of daily living
  • Accident-prone and clumsiness
  • Resists new activities
  • Poor playing skills
  • Poor fine motor coordination
  • Poor articulation

Co-Occurring Disorders

Sensory processing disorder may occur with other types of disorders. The most common co-occurring disorders include:

• • • Autism
    • Asperger syndrome
    • Attention-deficit hyperactivity disorder
    • Language disorders
    • Learning disabilities
    • Post-traumatic stress disorder
    • Fragile X syndrome

Causes of Sensory Processing Disorder

The precise cause for SPD is still unknown, although researchers are spending much time learning more about the condition. Some of the potential causes for SPD may include:

Genetic: Children born to adults who have autism spectrum disorders may be at higher risk for developing sensory processing disorder. Additionally, children with Asperger syndrome or autism are at a higher risk for developing SPD. Boys are more likely than girls to have SPD.

Sensory Modulation Disorder: Children who have sensory modulation disorder have problems regulating the intensity and nature of responses to sensory input. The responses may be emotional or behavioral, negative responses to stimuli not averse to others, and the problems are exacerbated by stress. Common symptoms include:

Symptoms of Sensory Processing Disorder

Children who have sensory processing disorder cannot properly process the sensory stimuli from the outside world and may have trouble interpreting information from one or more senses. As no two children with SPD have the same type of sensory dysfunction, the symptoms will vary tremendously from child to child and may include:

Behavioral Symptoms:

• • • Withdraw when touched
    • Behavioural problems
    • Difficulties calming oneself after exercise or being upset
    • Refuse to eat certain foods due to the textures of the foods
    • Be hypersensitive to certain fabrics
    • Only wear soft clothes or clothes without tags
    • Dislike dirtying his or her hands
    • Do not engage in creative play
    • Lack variety in play – may watch the same television program over and over
    • Oversensitivity to sounds, especially hair dryers, washing machines, or sirens
    • Be oversensitive to odours – strong or mild
    • Have challenges with certain movements, such as swinging, sliding, or going down stairs
    • Notice or hear background noises that others cannot
    • May harm others during play accidentally

Physical Symptoms:

• • • Have odd posture
    • Clumsiness
    • Poor balance
    • Delayed fine motor control, such as handwriting challenges
    • Delayed gross motor development
    • Impairments in sleep, eating, and elimination patterns
    • Be in constant motion
    • Jump, swing, spin excessively
    • Fatigue easily
    • Alternate between constant motion and fatigue
    • Poor coordination
    • May fall often
    • High tolerance to pain

Psycho social Symptoms:

• • • Decreased ability to interact with peers
    • May stand too closely to others
    • Social isolation
    • Depression
    • Anxiety
    • Aggression
    • Fearful of crowds
    • Avoidance of standing in large groups
    • Fearful of surprise touch

Effects of Sensory Processing Disorder

As SPD may be undiagnosed, especially in older people, and left untreated for years, the long-term effects of living with SPD can cause significant impairment in their daily lives. Many healthcare professionals are not trained to recognize the symptoms of this disorder and as a result, diagnosis may be delayed for years.

The long-term effects of SPD may include:

• • Trouble maintaining a mainstream job
  • Challenges with interpersonal relationships
  • Inability to find pleasure in recreational activities that over stimulate the senses
  • Depression
  • Underachievement
  • Social isolation
  • Poor self-confidence
  • Decreased friendships
  • Low self-esteem

What is dyslexia?

In a person with dyslexia, the brain processes written material differently. This makes it hard to recognize, spell, and decode words.
People with dyslexia have problems understanding what they read. Dyslexia is a neurological and often genetic condition, and not the result of poor teaching, instruction, or upbringing. Between 5 and 15 percent of people in the United States have dyslexia.

Symptoms

• Dyslexia commonly causes difficulties in word recognition, spelling, and decoding.
• Dyslexia is different from delayed reading development, which may reflect mental disability or cultural deprivation.
• The most common signs and symptoms associated with dyslexia can be displayed at any age, but they normally present in childhood.

Childhood symptoms of dyslexia include:

Difficulty in learning to read
Many children with dyslexia have normal intelligence and receive proper teaching and parental support, but they have difficulty learning to read.

Milestones reached later
Children with dyslexia may learn to crawl, walk, talk, and ride a bicycle later than the majority of others.

Delayed speech development
A child with dyslexia may take longer to learn to speak, and they may mispronounce words, find rhyming challenging, and appear not to distinguish between different word sounds.

Slow at learning sets of data
At school, children with dyslexia may take longer to learn the letters of the alphabet and how they are pronounced. There may be problems remembering the days of the week, months of the year, colors, and some arithmetic tables.

Coordination
The child may seem clumsier than their peers. Catching a ball may be difficult. Poorer eye-hand coordination may be a symptom of other similar neurological conditions, including dyspraxia

Left and right
The child may confuse “left” and “right.”

Reversal
They may reverse numbers and letters without realizing.

Spelling
Some children with dyslexia might not follow a pattern of progression seen in other children. They may learn how to spell a word and completely forget the next day.

Speech problems
If a word has more than two syllables, phonological processing becomes much more challenging. For example, with the word “unfortunately” a person with dyslexia may be able to process the sounds “un” and “ly,” but not the ones in between.

Concentration span
Children with dyslexia commonly find it hard to concentrate. Many adults with dyslexia say this is because, after a few minutes of non-stop struggling, the child is mentally exhausted. A higher number of children with dyslexia also have attention deficit hyperactivity disorder (ADHD), compared with the rest of the population.

Sequencing ideas
When a person with dyslexia expresses a sequence of ideas, they may seem illogical or unconnected.

Types

Dyslexia can be broken down into different subtypes, but there is no official list of dyslexia types because they can be classified in different ways.
However, the following categories are sometimes used:

Phonological dyslexia:
The person has difficulty breaking down words into smaller units, making it hard to match sounds with their written form. This is also known as dysphonetic dyslexia or auditory dyslexia.

Surface dyslexia:
The person cannot recognize a word by sight, making words hard to remember and learn. This is sometimes called dyseidectic dyslexia or visual dyslexia.

Rapid naming deficit:
The person cannot quickly name a letter or number when they see it.

Double deficit dyslexia:
The person finds it hard to isolate sounds also to name letters and numbers.

Visual dyslexia:
The person has an unusual visual experience when looking at words, although this can overlap with surface dyslexia. Sometimes people refer to “directional dyslexia,” meaning it is difficult to tell left from right. This is a common feature of dyslexia, but it is not a type.
If a person has difficulty with math learning, the correct term for this is dyscalculia. It is not dyslexia.

Phonological Deficit:
Difficulty decoding or assembling words based on their sounds. Note that phonemic awareness is not a reading deficit per se since it involves only sounds and not letters.

Speed Naming Deficit:
Slow reading: poor use of sight. A sight word is a word that is instantly recognized by the reader: is not sounded out, and requires almost no effort to understand.

Comprehension Deficit
Poor understanding of what was just read.

By Sensory System

Auditory Dyslexia
Auditory Dyslexia involves difficulty processing sounds of letters or groups of letters. Multiple sounds may be fused as a singular sound. For Examples the word ‘back’ will be heard as a single sound rather than something made up of the sounds /b/ – /aa/ – /ck/. Single syllable words are especially prone to this problem.

Visual Dyslexia
Visual dyslexia is defined as reading difficulty resulting from vision related problems. Though the term is a misnomer, visual problems can definitely lead to reading and learning problems.

Attentional Dyslexia
Attentional Dyslexia in which children identify letters correctly, but the letters jump between words on the page. “kind wing” would be read as “wind king”. The substitutions are not caused by an inability letters or convert them to sounds, but instead result from the migration of letters between words-the first letters of one word switches place with the first letter of another word.

By Deficit

Phonological Dyslexia
Phonological dyslexia is extreme difficulty reading that is a result of phonological impairment, meaning the ability to manipulate the basic sounds of language. The individual sounds of language become ‘sticky’, unable to be broken apart and manipulated easily.

Surface Dyslexia
A type of dyslexia characterized by difficulty with whole word recognition and spelling, especially when the words have irregular spelling sound correspondences”.

Deep Dyslexia
Deep dyslexia is an acquired form of dyslexia, meaning it does not typically result from genetic, hereditary (developmental) cause. It represents a loss of existing capacity to read, often because of head trauma or stroke that affects the left side of the brain. It is distinguished by two things: semantic errors and difficulty reading non-words.

By Time of Onset:

Developmental Dyslexia
Developmental dyslexia is not so much a type of dyslexia, it is dyslexia. In fact our definition of it would be the same as our definition of dyslexia generally: Extreme difficulty reading caused by a hereditary, brain based, Phonologic disability. So why do people use the term instead of just saying dyslexia? The simple answer is they are trying to be more specific, distinguishing ‘regular’ dyslexia from the other types of dyslexia. In particular, distinguishing it from acquired forms of dyslexia that result from stroke or head trauma for example, which often present very differently. For more on developmental dyslexia.

Acquired Dyslexia
This type results from trauma or injury to that part of the brain that controls reading and writing. Late in life this can be the result of a tumor or stroke.

Other Dyslexia Types:

Directional Dyslexia
Directional dyslexia is distinguished by left-right confusion and tendency to become disoriented or lost. The term is also occasionally used to mean confusion with letters such as P and b or d and b, where there is confusion over the ‘direction’ of the letter. Generally, problems with direction are a symptom of dyslexia more than a sub type. Not all dyslexics have this problem.

Math Dyslexia (Dyscalculia)
Math dyslexia or dyscalculia is not, in fact, a type of dyslexia, but we included it here because the term is frequently used. According to the U.S National Center for Learning Disabilities, math dyslexia, or dyscalculia, refers to wide range of lifelong learning disabilities involving math, varies from person to person and affects people differently at different stages of life

As with reading, when basic math skills are not mastered early, more advanced math becomes extremely difficult. Approximately half of people with dyslexia also have dyscalculia, though far less research has been conducted regarding testing, assessment and remediation.

Language Disorder group, Articulary and Dyscoordination Group and a Visual spatial Perceptual Disorder group

They divided the children into three groups: (I) those with brain damage who could read, (II) those with brain damage who were dyslexic and (III) those without brain damage who were dyslexic. Interestingly enough they found a similarity between those with developmental dyslexia and those with brain-damage dyslexia. On the basis of these results and a battery of neuropsychological examinations, they divided dyslexia into three syndromes.

• Syndrome I Language Disorder- This syndrome is characterized with anomia, comprehension deficits, confused imitative speech and speech- sound discrimination. Vision and motor coordination is normal.
• Syndrome II Articulatory and Graphomotor Dyscoordination- Children with this syndrome have gross and fine motor coordination disorders. They have poor speech and graphomotor coordination.
• Syndrome III: Visuospatial Perceptual Disorder- These children score 10 points more on verbal IQ than performance IQ. Their visuospatial perception is very poor, as is their ability to store and retrieve visual stimuli.

What is dyspraxia?

Dyspraxia is a neurological disorder that impacts an individual’s ability to plan and process motor tasks.

Individuals with dyspraxia often have language problems, and sometimes a degree of difficulty with thought and perception. Dyspraxia, however, does not affect the person’s intelligence, although it can cause learning problems in children.

Developmental dyspraxia is an immaturity of the organization of movement. The brain does not process information in a way that allows for a full transmission of neural messages.<br.
A person with dyspraxia finds it difficult to plan what to do, and how to do it.

The National Institute of Neurological Disorders and Stroke (NINDS) describes people with dyspraxia as being “out of sync” with their environment.

Experts say that about 10 percent of people have some degree of dyspraxia, while approximately 2 percent have it severely. Four out of every 5 children with evident dyspraxia are boys, although there is some debate as to whether dyspraxia might be under-diagnosed in girls.

According to the National Health Service, United Kingdom, many children with dyspraxia also have attention deficit hyperactivity disorder (ADHD).

Symptoms of dyspraxia

Symptoms tend to vary depending on the age of the individual. Later, we will look at each age group in more detail. Some of the general symptoms of dyspraxia include:

• poor balance
• poor posture
• fatigue
• clumsiness
• differences in speech
• perception problems
• poor hand-eye coordination

Diagnosis of dyspraxia

A diagnosis of dyspraxia can be made by a clinical psychologist, an educational psychologist, a pediatrician, or an occupational therapist. Any parent who suspects their child may have dyspraxia should see their doctor.

When carrying out an assessment, details will be required regarding the child’s developmental history, intellectual ability, and gross and fine motor skills:

• Gross motor skills – how well the child uses large muscles that coordinate body movement, including jumping, throwing, walking, running, and maintaining balance.
• Fine motor skills – how well the child can use smaller muscles, including tying shoelaces, doing up buttons, cutting out shapes with a pair of scissors, and writing.
  The evaluator will need to know when and how developmental milestones, such as walking, crawling, and speaking were reached. The child will be evaluated for balance, touch sensitivity, and variations on walking activities.

Dyspraxia in children
Dyspraxia symptoms may vary depending on age. With that in mind, we will look at each age individually. Not every individual will have all of the symptoms outlined below:

Very early childhood
The child may take longer than other children to:

• Sit.
• Crawl –the Dyspraxia Foundation says that many never go through the crawling stage.
• Walk.
• Speak –according to the Children’s Hospital at West mead, Australia, the child may be slower in answering questions, find it hard to make sounds, or repeat sequences of sounds or words; they may also have difficulty in sustaining normal intonation patterns, have a very limited automatic vocabulary, speak more slowly than other children, and use fewer words with more pauses
• Stand.
• Become potty trained (get out of diapers).
• Build up vocabulary.
• Early childhood

Tying shoelaces can be a difficult task for children suffering with dyspraxia.

Later on, the following difficulties may become apparent:

• Problems performing subtle movements, such as tying shoelaces, doing up buttons and zips, using cutlery, and handwriting.
• Many will have difficulties getting dressed.
• Problems carrying out playground movements, such as jumping, playing hopscotch, catching a ball, kicking a ball, hopping, and skipping.
• Problems with classroom movements, such as using scissors, coloring, drawing, playing jigsaw games.
• Problems processing thoughts.
• Difficulties with concentration. Children with dyspraxia commonly find it hard to focus on one thing for long.
• The child finds it harder than other kids to join in playground games.
• The child will fidget more than other children.
• Some find it hard to go up and down stairs.
• A higher tendency to bump into things, to fall over, and to drop things.
• Difficulty in learning new skills – while other children may do this automatically, a child with dyspraxia takes longer. Encouragement and practice help enormously.
• Writing stories can be much more challenging for a child with dyspraxia, as can copying from a blackboard.

The following are also common at pre-school age:

• Finds it hard to keep friends
• Behaviour when in the company of others may seem unusual.
• Hesitates in most actions, seems slow.
• Does not hold a pencil with a good grip.
• Such concepts as ‘in’, ‘out’, ‘in front of’ are hard to handle automatically.

Later on in childhood

• Many of the challenges listed above do not improve or only improve slightly.
• Tries to avoid sports.
• Learns well on a one-on-one basis, but nowhere near as well in class with other children around.
• Reacts to all stimuli equally (not filtering out irrelevant stimuli automatically)
• Mathematics and writing are difficult.
• Spends a long time getting writing done.
• Does not follow instructions.
• Does not remember instructions.
• Is badly organized.

Dyspraxia in adults , symptoms include:

• Poor posture and fatigue.
• Trouble completing normal chores.
• Less close control – writing and drawing are difficult.
• Difficulty coordinating both sides of the body.
• Unclear speech, often word order can be jumbled.
• Clumsy movement and tendency to trip over.
• Grooming and dressing more challenging – shaving, applying makeup, fastening clothes, tying shoelaces.
• Poor hand-eye coordination.
• Difficulty planning and organizing thoughts and tasks.
• Easily frustrated.
• Less sensitive to non-verbal signals.
• Low self-esteem.
• Difficulty sleeping.
• Difficulty distinguishing sounds from background noise.
• Notable lack of rhythm when dancing or exercising.

Social and sensory – individuals with dyspraxia may be extremely sensitive to taste, light, touch, and/or noise. There may also be a lack of awareness of potential dangers. Many experience moods swings and display erratic behavior.