Imagine this scenario with me: I sit down with the parents of one of my pediatric clients and we chat about what brought them to therapy. We discuss their concerns over attention at school, their child's delayed fine motor skills, and maybe the child's refusal to wash their hands. And then they say it. "I also think he has some sensory issues."
I try to get them to expand, "Tell me more about the 'sensory issues.' What do you mean by that?"
"Well. He gets really upset when his socks are crooked."
Uh. Yeah. Me Too. I have literally pulled off my shoe while driving to fix a crooked sock. I don't recommend that. (It's not safe.)
Occupational Therapists have done a super job of validating our scope in the sensory processing realm. Rightfully so, the ability to adequately adjust to changing sensations is a necessary skill for all. When our sensory preferences don’t match our ability to regulate ourselves, we will have decreased ability to function in everyday-life.
I think we need to clarify something, though. What is the difference between a sensory issue and a sensory preference? At what point do occupational therapists need to be treating “sensory problems?"
A sensory preference is a tendency toward or away from a certain type of sensory information.
A sensory issue is a sensory preference that does not match our ability to regulate or to control our environment so that we cannot appropriately adapt to certain sensory situations.
Everybody has sensory preferences. I hate yogurt. It’s a texture thing for me. I so badly want to enjoy the health food wrapped in dessert clothing. I’ve tried the whipped, the Greek, and the sip-able. I just can’t do it. Does this mean I need to see an occupational therapist to help me overcome this texture-related sensory matter?
Absolutely not. Other than the fact that I so badly want to like yogurt, my dislike for it really doesn’t affect my life. I get the nutritional benefits elsewhere in my diet.
A sensory preference becomes a sensory issue either when the sensory preference is so strong that we can’t adapt or when we don’t have the skills necessary to adapt.
Let’s return to my yogurt scenario. If my dislike for yogurt were so severe that I vomited anytime I smelled or looked at yogurt, I would have a sensory issue, and one that would benefit from professional intervention.
Some real-world examples of sensory difficulties:
· A child who has a high sensory preference for touch. She runs her hand across any person she is near and hugs even strangers who tell her hello. This is a sensory issue that causes concern for safety and social participation. An occupational therapist may help in this scenario by helping the child to discover alternative methods to satisfy her need for touch in a safe and socially acceptable manner.
· A child who is highly sensitive to noise. He avoids auditory sensation at such a high level that he refuses to enter a public restroom because of the sound of the automatic toilets, the faucets, and the fan. This is a sensory issue, which significantly affects the basic self-care task of toileting and his parent’s convenience during family outings. An occupational therapist may help in this scenario by using progressive desensitization strategies.
· A child who is highly sensitive to touch refuses to wear socks. His mom is at her ‘wit’s end’ with the subsequent smell and the blisters her son has on the top of his feet. An occupational therapist may help in this scenario by using a variety of strategies including progressive desensitization, behavior management, and clothing modification.
So, the point? Everyone has sensory preferences. Among the many other things we learn in childhood, one is how to adapt and manage our environment to complement our sensory preferences. Our job as parents and therapists and anyone else who is a part of the village of child rearing is to support our children in this learning endeavor.
When your child starts to be picky for tastes and textures during mealtime, it’s okay. Keep offering, and do what you can to help him get the nutrition he needs.
When your child is hesitant to wear anything but sweatpants, it’ll be okay. Keep trying, and know she will most likely change her mind by the time she goes on her first date.
When your child can’t seem to sit still in school, it will be okay. Give opportunities for movement when you can, and think about how difficult it is for you to sit for more than an hour.
Sensory processing difficulties are on the rise, and more and more parents are expressing concerns that their child may have sensory issues. If you’re child’s sensory preferences significantly disrupt your everyday lives, please seek professional help of a physician and/or occupational therapist. But if your child’s sensory preferences are manageable, know that adapting to and managing our environment to complement our sensory systems is a learning process and we need to give our children the opportunity to learn those skills.
I hate yogurt, but I have learned to delightfully decline this unwanted food. We should give our children the same opportunity to manage their sensory likes and dislikes. Normalize sensory preferences.