Sensory Input Guide
Sensation seeking, sensory sensitivity, sensation avoiding, fluctuating modulation- these are terms that occupational therapists like myself are guilty of peppering conversations with under the assumption that everybody knows what we’re talking about. Firstly, I would like to say that this is our problem, not yours. Parents seeking a diagnosis, or who have a newly diagnosed child, are generally jumping from appointment to appointment, from discipline to discipline, all the while having different sets of vocabularies thrown at speed at them- nobody could reasonably expect you to be au-fait with every piece of terminology you hear. There is absolutely no shame in stopping a professional and asking them to explain what they mean by a particular term- even if they have explained it to you before, even if they explained it five minutes previous, even if it’s a word you feel you should definitely know the meaning of. You are at the early stages of your child’s diagnosis, and you are likely tired, overwhelmed, and not processing information as well as you usually would- we get that. With that being said, sometimes everyone forgets to ask questions in the moment- and that is why I am putting this article together for the frazzled caregiver frantically googling words and phrases that their OT might have used in a session. Let’s start from the start:
Sensory processing- this is a broad phrase that generally refers to how a person makes sense of information that they get through their sensory receptors. So for example, if I am in the supermarket and my tactile receptors register light touch in the form of a tap on my shoulder, my brain processes this, and integrates it with my knowledge of social cues, and without me even consciously registering what I am doing I turn around and pay attention to the person who tapped me.
My top tip would be to have a think about your sensory profile and any little quirks that you may have- then normalise them to your child by highlighting your sensory patterns and talking about them in whatever language your child finds easiest to understand.
Sensory modulation- this is where things get interesting. Sensory modulation basically means how sensitive your receptors are to certain cues. Some individuals are sensory sensitive to particular types of input. This means that their sensory processing system may inappropriately perceive safe input as a threat and initiate a flight or fight response. For example, if I was tactile sensitive and somebody tipped me on the shoulder in the supermarket, my sensory system might interpret this light touch as pain, and I might either run away or turn around and hit the person touching me before my conscious mind realises what I’m doing. On the other hand, some individuals can have low registration when it comes to certain types of input- meaning the message that sensory receptors pass on about tactile input may be inappropriately filtered out as irrelevant before the brain can decide on an appropriate reaction. So if I had low tactile registration and somebody tapped me on the shoulder in the supermarket, I might not even feel the tap and would continue with my shopping without turning- leaving the person thinking I was ignoring them. So you can see how reactions arising from differences in modulation can easily be misinterpreted as behavioural issues.
Fluctuating modulation- this is a phenomenon whereby somebody’s sensory system may process stimulation in a typical way one day, and a non-typical way the next. From a neuroscientific perspective, we aren’t sure yet how or why this happens exactly- but anecdotally, sensory modulation does appear to be affected by factors such as mood, energy, and general health.
Sensation avoiding- this is generally an active response to sensory sensitivity, that children develop as a coping strategy. Going back to our example of tactile sensitivity, a child with this modulation issue might avoid games, like tag, that involve the likelihood that others will touch them. They might insist on wearing gloves during messy play, or just opt out of the activity altogether. While the temptation can certainly be there to push your child to ‘just do it anyway’- imagine for a second that being touched felt like being cut, or pinched. You too would go out of your way to avoid that feeling!
Sensation seeking- this tends to be an active response to low registration, that children can develop to satisfy needs for increased amounts of particular inputs. Again using the sense of touch as an example, if a child has low tactile registration they might love activities that involve novel textures- such as baking or play with shaving foam. They might actively seek out this kind of input during day to day tasks by doing things like squeezing out all the toothpaste when you turn your back during tooth-brushing time. This can obviously be very frustrating- but pre-emptively putting in opportunities to experience the craved input during the day can help to minimise incidents like this.
Sensory profile- this can actually mean two things. There is a formal assessment called the Sensory Profile, copyrighted by Winnie Dunn, which involves a self-report about reactions to different forms of sensory stimulation, and produces a score that tells us more about how the person in question processes sensory information. An OT may tell you that they are going to run a Sensory Profile, and in this case it is this assessment that they are likely referring to. The term is also used interchangeably to describe an individual’s overall sensory processing patterns. We all have a sensory profile- it is not something particular to children with a diagnosis. Let me give you an example from my own personal life. I do not have any diagnosis and would consider myself largely neurotypical, but for as long as I can remember, I have not been able to handle the feeling of chalk dust on my fingers. The sensation is so intense to me that it makes me physically shiver and brings on a distinct feeling of nausea. I can recall particular incidents in my school days whereby I would pretend that I did not have my homework done or did not know the answer to a question when the teacher called for me to write my work on the chalkboard, as the sensation was so unpleasant that I preferred to get in trouble than be put in a situation where I had to experience it. Back then, I thought I was just ‘weird’. Now that I have language to put on that feeling, I realise that my tactile processing system inappropriately identifies the sensation of chalk dust as a threat, and invokes a flight or fight response that has led me to developing sensory avoidant tactics. Nowadays when I work with chalk I wear gloves, and am glad of the opportunity to explain and educate people on sensory processing when they ask me why. On the other hand, I have also experienced low registration in my taste receptors for my whole life- I would regularly sneak into the pantry to drink straight vinegar as a child. Now as an adult, I satisfy this sensation seeking pattern by adding lots of flavour to my cooking- and am very happy about the health and wellness trend of taking shots of apple cider vinegar in the morning! My top tip would be to have a think about your sensory profile and any little quirks that you may have- then normalise them to your child by highlighting your sensory patterns and talking about them in whatever language your child finds easiest to understand. The more mainstream this discussion becomes, the less isolated people with pronounced sensory processing issues will feel and the more understanding the general public will be.
Sensory integration- this is a term that is misused a great deal. Sensory integration (SI) refers to a specific theory developed by Dr A Jean Ayres, which uses Ayres’ research to explain and categorise different types of sensory processing dysfunction. Sensory integration therapy, the intervention that arises from this theory, can only be carried out with standardised training. Not every OT is an SI practitioner; and not every SI practitioner is an OT. Your OT may be using sensory-based interventions that are not necessarily linked to SI. If you are not sure whether your OT is using SI, it is best to specifically ask- they will be able to explain their training and the theory that underpins the treatment plans that they are proposing.
Sensory processing disorder (SPD) - this is a standalone condition whereby a person has generalised issues in processing sensory information to an extent that their daily life is significantly affected. Having sensory issues does not necessarily mean that you have sensory processing disorder- atypical sensory processing is associated with a number of other disorders, such as autism and ADD.