OT-550 Ch. 7: Sensory Processing Disorder

Sensory processing

The ability to take information in from the environment through the senses, organize and interpret it, and create a meaningful adaptive response.

Adaptive response

Action or reaction of an organism to the environment that is organized and goal-directed.

Vestibular system

Inner-ear mechanism detecting linear and angular head movements and gravity; contributes to arousal, regulation, balance, postural control, spatial perception, and stable visual field.

Proprioception

Ability to detect the position of body parts in space, force, and velocity of movement via mechanosensory neurons.

Interoception

Awareness of the body’s internal physiological state and processing of signals from internal organs (e.g., heart rate, satiety) linked to emotion regulation.

Sensory Processing Disorder (SPD)

Neuropsychological condition where sensory input is poorly processed or interpreted, resulting in atypical responses.

Etiology of SPD

No single specified cause; theories include hereditary factors, prenatal conditions, perinatal complications, environmental factors, and postnatal stress exposure; possible posterior white matter abnormalities.

Sensory Modulation Disorder (SMD)

SPD subtype with abnormal modulation of sensory input; includes overresponsivity, underresponsivity, or craving.

Sensory Overresponsivity (SOR)

Heightened or prolonged response to sensory stimuli.

Sensory Underresponsivity (SUR)

Diminished or delayed response to sensory input, possibly due to CNS prediction/processing deficits.

Sensory Craving (SC)

Insatiable seeking of sensory input or heightened arousal seeking.

Sensory Based Motor Disorder (SBMD)

SPD subtype involving motor coordination problems, including postural disorders and dyspraxia.

Postural disorders

Difficulty maintaining postural tone due to inefficient processing of kinesthetic input.

Dyspraxia

Difficulty with motor planning and executing unfamiliar or novel movements; a clear sensorimotor problem.

Sensory Discrimination Disorder (SDD)

Difficulty with qualitative processing and discrimination of sensory stimuli across modalities.

Incidence and prevalence of SPD

About 1 in 20 in the general population; 8–16.5% of school-aged children; higher prevalence in gifted individuals and those with ADHD, Fragile X, or autism spectrum conditions.

Signs/Symptoms of SPD

Maladaptive responses to stimuli; difficulties with gross/fine motor tasks; challenges with education/self-care; tactile sensitivity issues.

Diagnosis of SPD

Not currently in DSM-5; diagnosed via behavioral measures, clinical observation, caregiver/teacher sensory profiles, and self-report; supported by standardized assessments showing impact on occupational performance.

Prognosis and course of SPD

SPD is not typically outgrown; influenced by home life, nutrition, early identification, interventions, genetics, and temperament; adaptations often occur with age but challenges may persist.

Medical management of SPD

Limited or virtually non-existent evidence; few medical/surgical approaches; primary management involves occupational therapy and environmental/modification strategies.

Impact on Play (occupational performance)

SPD can reduce play quality and social cue awareness; may lower engagement and ability to resolve conflicts during play.

Impact on ADLs

Multi-sensory processing challenges can impair bathing, dressing, eating, grooming, and personal hygiene.

Impact on IADLs

Independent activities of daily living (e.g., driving, managing meals) can be difficult, especially in noisy environments.

Impact on Health Management

Problems processing health information, managing medications, and keeping medical appointments.

Impact on Sleep

Sleep difficulties can be present; sensory factors like auditory issues (SOR) or settling problems (SC) may contribute.

Impact on Education

Inattention, emotional/physical distress, anxiety, and reduced participation due to sensory challenges.

Impact on Work

SPD can affect job performance and may require environmental adjustments or task modifications.

Impact on Social Participation

Accurate sensory processing underpins emotion, attachment, and social engagement; SPD can limit participation in social activities.