Sensory Processing Disorder: An Interview with an Expert

Success Through Play™ Magazine interviewed leading Sensory Processing Disorder (SPD) Expert: Carol Stock Kranowitz, M.A. As a music, movement and drama teacher for 25 years, Carol Stock Kranowitz observed many out-of-sync preschoolers. To help them become more competent in their work and play, she began to study sensory integration ("SI") theory. She learned to help identify their needs and to steer them into early intervention. In her workshops and writings, she explains to parents, educators, and other early childhood professionals how sensory processing issues play out – and provides practical and enjoyable techniques for addressing sensory issues at home and school.

In addition to The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder, revised (Perigee, 2005), Carol is the author of its sequel, The Out-of-Sync Child Has Fun: Activities for Kids with Sensory Integration Dysfunction (Perigee, 2003).

What inspired your interest in Sensory Processing Disorder?

Carol Stock Kranowitz: I wondered why some of my preschool students were not "doin' what comes naturally." They were bright and healthy, yet they responded in unusual ways to classmates, teachers, objects, and ordinary nursery school activities. Some children avoided altogether the experiences that their schoolmates enjoyed, others dove pell-mell into activities without an ounce of precaution, and still others tried to participate but did so clumsily. Were these out-of-sync kids behaving inappropriately on purpose? Of course not! No child seeks disapproval of his “significant olders.” Every child wants to learn; every child wants to play and have friends. Something else was going on that made it so difficult for them to succeed in their occupation of childhood. Until I learned about Sensory Processing Disorder, I could not find a pattern in these children. The only common thread -- and this is what troubled me the most -- was their disconnectedness. They lacked a sense of belonging. Whether their modus operandi was hostility, aggression, anger, frustration, sadness, bewilderment, tuning-out, whining, silliness, or wildly inappropriate gusto, they all seemed to sense that they weren't like the other kids. Their behavior suggested that they didn't know how to behave. There had to be an explanation, and I had to find it.

What is the prevalence of SPD?

Carol Stock Kranowitz: Estimates range from 5% to 20% of people of all ages all over the world.

What do you find to be the most common sensory problems among children?

Carol Stock Kranowitz:

Children with Sensory Processing Disorder exhibit unusual responses to touch and/or movement experiences. They also may have atypical responses to other sensations – sight, hearing, smell and taste.

A common difficulty is Sensory Modulation Disorder. This category of SPD makes it challenging to regulate sensations coming into the central nervous system from the child’s own body and the world around him. If children are over-responsive to touch sensations, these “sensory avoiders” will shy away from touching and being touched. They are on alert and ever vigilant to protect themselves from real or imagined hazards in a scary and confusing world. They will avoid messy play, physical contact with other children and adults (except for a select few, such as parents or a favored babysitter, to whom they will cling), pets, certain textures of fabric, many foods, bumpy sock seams, etc. If they are under-responsive to touch sensations, they may be “sensory disregarders” and not notice what they are touching or what touches them. They are not defensive enough and are more likely to have trouble protecting themselves. They may not feel pain or be aware of the world around them. Or, if they are “sensor cravers,” they'll excessively seek touching and being touched. They will be fingerpainting their arms, stuffing too much food into their mouths, shouting indoors, turning up the volume, and bumping and crashing into people and furniture. If children with a Sensory Modulation problem are over-responsive to movement experiences, their feet will never leave the ground. They will shun playground equipment and object to riding in the car or elevator. They may refuse to be picked up. If they are under-responsive, they may not know when they are falling or that they have been on the swing for too long. If they crave intense movement, they may seem always to be in upside-down positions, swinging on the tire swing for long periods, and on-the-go constantly -- jumping, bouncing, rocking and swaying.

Some children with SPD have Sensory Discrimination Disorder, which is difficulty discriminating among and between sensations. I call them “sensory jumblers.” Is the water hot or cold? Is the sand hard or soft? Does the button go into this buttonhole or that one? Is the bathroom is this direction or the other?

Some children have Sensory-Based Motor Disorder. One type is Postural Disorder, causing problems in getting into new positions and maintaining them. These are “sensory slumpers.” They struggle to go through obstacle courses. They slouch. They fall off the swing. They need support to hold themselves up, because defying gravity seems to be too much for them. And some children, “sensory fumblers,” have another type of Sensory-Based Motor Disorder, called Dyspraxia, which is difficulty in coming up with an idea of an action they want to take, such as getting on and riding a scooter; doing the motor planning necessary; and executing their motor plan.

It is important to note that many children are over-responsive to sensations, covering their ears when a truck rattles by, or pinching their nostrils to avoid smelling an old banana. Many children are undersensitive, perhaps liking spicy pizza and fireworks more than others do. Many children have occasional problems discriminating between and among sensations. Many children have moments of slumping in their chairs and clumsiness when they tackle a novel and complex sequence of actions. We wouldn't necessarily say that these kids with occasional sensory difficulties have Sensory Processing Disorder. It is unusual, persistent reactions to touch and movement, making life very challenging, indeed, that suggest SPD.

If parents suspect that their child may have a sensory processing disorder, what do you suggest they do?

Carol Stock Kranowitz:

• Be a detective! Keep notes on your child's atypical behavior. Does his reaction to a sensory stimulus occur with frequency, intensity and duration? For instance, does the child have a heck of a time calming down after getting a splinter in his finger or being accidentally knocked down?

• Ask yourself the "WH" questions, i.e., When did it happen? Where? Who was involved? What happened or what was said? How did your child respond? After taking notes for a while, you may be able to see the pattern and find the answer to the trickier question of "Why did it happen?"

• Share your observations about your child with his teacher. The teacher may have noticed similar challenges. Collaborating with all adults who care for your child will make life easier for everyone.

• Find an occupational therapist certified to provide Sensory Integration treatment. This is referred to as “OT/SI.” (Only about 20% of occupational therapists are.) For a list of certified therapists, contact

www.SPDnetwork.org

Have you learned more about SPD since you wrote the book that you would like to share with parents?

Carol Stock Kranowitz: Yes, I'm learning more every day about exciting research in the field of SPD. Parents and all others can read about research, get referrals to OTs practicing OT/SI, and learn about joining parent support groups at www.SPDnetwork.org. Also see the wonderful magazine, S.I. Focus at www.SIFocus.com Check out national conferences at www.SensoryResources.com

My website has information, too, at

www.out-of-sync-child.com

Based on a 1998 interview by Allison Martin at www.comeunity.com

Success Through Play™ comments: We applaud the work that Carol Stock Kranowitz, M.A. is doing by giving a voice to children with SPD.