Everything you Need to Know About Sensory Processing Disorder (SPD)
For those living with Sensory Processing Disorder (SPD, formerly called Sensory Integration Disorder), the sensations that come with moving through the world can oftentimes feel so extreme that common sensory experiences may feel overwhelming and even threatening, interfering with their daily life.
We are all sensory beings with our own set of unique preferences and sensitivities. Some people love the hustle and bustle of city life or a live music venue, whilst others find their sanctuary in the calm of a quiet library or immersed in nature.
Every event that we experience in our day to day lives has a sensory component. The eight sensory systems (visual, auditory, tactile, olfactory, gustatory, vestibular, proprioception, interoception) are critical for helping us understand our environment. For most of us, that body-brain sensory processing is barely noticeable, meaning we often overlook how uniquely each individual experiences the world around us.
For those living with Sensory Processing Disorder (SPD, formerly called Sensory Integration Disorder), the sensations that come with moving through the world can oftentimes feel so extreme that common sensory experiences may feel overwhelming and even threatening, interfering with their daily life. Wearing certain clothes might be maddening, whilst focusing on one conversation in the office might be impossible due to atypical processing.
SPD is the term that describes the collection of challenges that can occur when the brain has trouble receiving and responding to information that comes through the senses. When the sensory receptors in our nervous system fail to respond appropriately to the outside world, everyday stimuli such as lights, crowds or fabrics may trigger a sensory overload response.
Though the condition has gained recognition in recent years, it’s still widely debated and misunderstood as a stand-alone disorder, especially in adults.
We spoke to Virginia Spielmann, Executive Director at the STAR Institute for SPD, to discuss Sensory Health and the impact sensory differences like SPD can have on our day to day lives.
What is SPD?
SPD exists when sensory signals are either not detected or don’t get organised into appropriate responses (STAR Sensory Health), often referred to as a “neurological traffic jam” that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly.
We have to invest energy towards surviving or coping, or even towards creating the presentation of a false front because that is what it looks like everyone else is doing, and we are driven to belongVirginia Spielmann
Virginia explains, “SPD usually references Sensory Processing Disorder. This is a term that has been used to describe the point at which differences in sensory processing are so profound that they negatively impact health and wellness and disrupt day-to-day functioning. As humans, we possess complex systems in our brain and body that take in sensory data from the world and convert them into electrical and chemical signals that are integrated and interpreted in the brain. This information constructs our perception of the world around us, and thus the meaning we ascribe to these experiences and interactions. So, if our nervous system registers and interprets sound, or movement, or visual stimuli as too much and too intense – even when it is benign – then we will likely have an experience of the world and the people in it that is confusing, threatening and undermining. This experience will cause us to redirect attention and other cognitive resources from what we should or could be doing that would bring us fulfilment. Instead, we have to invest energy towards surviving or coping, or even towards creating the presentation of a false front (pretending we are ok) because that is what it looks like everyone else is doing, and we are driven to belong.”
How to identify SPD:
Sensory Processing Disorder is far from a one-size-fits-all disorder. It may affect one sense or multiple senses and those living with SPD can experience over-responsiveness (hypersensitivity) or under-responsiveness (hyposensitivity) to stimuli, depending on the form and intensity of SPD. Everyone has different sensory overload preferences.
“Differences in sensory processing can look like over- or under-responsivity to sensation and you can be over-responsive in one system (like touch) and under-responsive in another (maybe in proprioception, your sense of body position and force).
“It does not end there however, differences in sensory processing might not be anything to do with how your nervous system perceives intensity of sensory experience and might rather be about whether or not your brain and body are able to discern or discriminate the qualities of sensory data. You know you are being touched but by what? And where? How hard? What is the texture of the object etc. etc. Being able to discern the qualities of sensation enables you to develop functional posture and movement in space, to coordinate your eyes in your head, to coordinate the two sides of your body. All the actions you produce in response to events and people are the result of your unique ability to register, discriminate and respond to sensation,” says Virginia.
Signs & symptoms
“We all process sensation. All the time every day. You have probably noticed that when you are tired noise bothers you more, or maybe smells, or motion. Some people find taking off in a plane unbearable (the noise, the pressure, the smells etc.), other people barely notice what is going on. Some of us are oblivious to the impact sensation has on us, and we may be doing just fine without paying particular attention to this domain of health. For some of us, awareness of our personal sensory processing preferences and differences helps us to simply create a more supportive lifestyle – we might realise we never felt better than when we were horse-riding regularly and add that back into our leisure activities for example. We might purchase noise reduction headphones and suddenly find public transport immensely more comfortable. For some, our differences are a little more complex, they impact our ability to sustain attention, to be calm, alert and available, to problem solve, to function during day-to-day life.”
What are some examples of how these differences can make daily life challenging?
“Someone who is over-responsive to sound might find that they are often triggered by noises in their environment, people’s phones, chewing and eating noises, typing noises, scraping chairs are all common examples. Continuous background noise is another common one—the air conditioner that everyone else is ignoring is JUST SO IRRITATING and you simply cannot get your work done. You can also be under-responsive to sensation. In this case you might miss a lot of what is going on around you. You might seem oblivious to people touching you lightly, calling your name, or to smells for example. You can be over-responsive in one system and under-responsive in another, which makes it more complicated.
You might know that you are being touched but not exactly where you were touched, how hard, or by what.Virginia Spielmann
“Sometimes it is not about the responsivity at all, it’s more about how your brain makes sense of sensation. So, you might know that you are being touched but not exactly where you were touched, how hard, or by what. You might know that you are moving but be unsure about speed or direction. Remember, if this is the case you’ve probably lived like this for years, if not your entire life, so it’s your baseline. When you are unable to make sense of movement sensations like this it usually impacts our ability to coordinate our body movements, make plans for movement and action, be emotionally regulated, and to develop and maintain functional posture. We might even have difficulty coordinating the movements of our eyes, have low muscle tone, or have difficulty breathing from the diaphragm.”
What about social/emotional challenges?
“Can I just say “it’s complicated”? There are so many ways that differences in sensory
integration can interfere with building social confidence and competence. A primary challenge faced by adults in the western world is how unaccommodating our culture is to sensory differences. Wearing sunglasses inside, or noise reduction headphones is just not normal. We’ve forgotten that normal is just a setting on a washing machine, not a template for how to be a human. Our general resistance to anything different can make living with disordered sensory processing 100 times harder than it needs to be.”
Why do you think SPD is still so overlooked, misinterpreted, and often sadly dismissed?
As the symptoms of SPD can be quite diverse, it isn’t recognised as an official neurological condition included in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5). Consequently, there is no formal criteria for a diagnosis meaning many people living with disordered sensory processing don’t receive the support they require.
Virginia says, “Honestly, part of the challenge is communication around the issue. We are working really hard on communicating what sensory health really is in a way that is relatable. It is not easy! That is why I did a TEDx talk on sensory health this year, and why we regularly produce sensory stories—beautifully illustrated stories based on real life that describe different facets of the impact sensory differences can have.
“Another battle has been around recognition of SPD as a stand-alone diagnosis. This has not happened and that means sometimes that people do not get funded support when they should. We are hopeful though that if this domain of health gains the recognition it deserves then the support will begin to be offered appropriately, earlier, more comprehensively, and with best practice (and evidence-based practice) in mind).”
From your experience working with both children and adults with sensory processing differences, what does SPD feel like for them?
“Again, it’s super complicated and incredibly important to remember how disparate it is from person to person. Some people have such huge body-based responses to visual stimuli and to smell that it makes eating really challenging. Others with more profound differences are constantly having their fight-or-flight response triggered by events around them – events that their peers likely perceive as non-threatening and even trivial. These individuals are constantly bombarded by the sensory world, it’s like a state of permanent threat.
“For many people, differences in sensory processing also have a plus side. Going outside means being immersed in the natural world and experiencing exuberance and joy within nature that other people have “grown out of” for example.”
Is SPD something experienced all the time or can someone with SPD have periods when it’s more acute?
“When you are more tired, sick, stressed, your sensory differences will be exacerbated.
You can also have seasons where sensory differences change for the worse or better and it’s not clear what the cause is – it might be hormones, growth spurts (during adolescence for example), changes in the season or other somewhat nebulous influences. In short, yes absolutely, you can have periods of acutely disordered sensory processing, and other times in life where your differences are mostly manageable.”
Whilst many of us might be affected by sensory challenges in our day-to-day lives, at what point should somebody seek support?
“When our differences in sensory integration and processing interfere with our long-term well-being, that is when we need help. Occupational Therapists with advanced certification in sensory integration are the best resource in this case. You might get an evaluation and discover that there are simple strategies you can employ to improve your enjoyment and productivity in all your activities of daily living. Sometimes changing up your environment and finding activities that nourish your nervous system is enough. Other people will find that they need to stick with the Occupational Therapist for longer so that they can figure out more about what works for their brain and body and try to change how their nervous system reacts to sensation through therapy.
If in doubt, get more information. Your sensory experiences of day-to-day life should support your well-being. If you are working against the environment, struggling with everyday sounds, smells, and other sensations, then you are probably working harder than you need to.
Virginia Spielmann
“The same goes for the sensory-based motor piece. Coordinating your body for movement, even organising food for cooking dinner, or doing other common household tasks should not be overwhelming and disorganising. Sensory based differences are a common contributor to everyday stressors that we think we must live with but really do not have to. Instead, getting the help you need and building a lifestyle that works for you can free up precious energy and resources that allow you to flourish at school, work, and in relationships.”
Is it possible to become overly sensitive to stimuli or is this something that would have existed since childhood and as adults we just find ways to deal with SPD?
“You can suddenly get sensitive to stimuli but there is usually a cause, perhaps stress, medication, an illness (for example we are hearing this about a lot of covid long haulers), brain injury, chemotherapy, all sorts of things can cause a change in your sensory processing capacity. This is why it’s so important that more people know about it.”
Treatment:
There are strategies adults living with SPD can adopt to assist them with everyday life and reduce anxiety around their triggers. From noise cancelling headphones to calming screensavers, targeted exercise and lifestyle practices that best suit your sensory processing needs.
Virginia says, “Figure out 1) what activities you can do to make your body feel grounded and organised. Is it long hikes, resistance training, knitting with a weighted blanket on your lap, reading while rocking on a swing or in a rocking chair? Figure it out and then plan it in and do it, a lot. 2) change your environment and lifestyle. Should you take the bus instead of driving? Should you go to the supermarket when it’s quiet? When there are less people there or when they are not playing music (many supermarkets have sensory hours now). Wear sunglasses and headphones on the underground if you need to. You do you. Allow yourself the accommodation, practice self-compassion, you will be amazed at the difference it makes.”
In terms of treatment, occupational therapy with a sensory integration approach can help people learn new reactions to stimuli and sensory techniques for home. Strategies can be identified during treatment for avoiding or decreasing the intensity of those relationships and situations that cause failure and lead to anxiety and depression.
This is usually based on Ayres Sensory Integration and is “provided by an Occupational Therapist with advanced certification (this should be about one year of post professional training, not a weekend course),” says Virginia.
Can SPD become more manageable over time?
You can absolutely develop more sensory processing capacity through therapy – this is based on principles of neuroplasticity.Virginia Spielmann
“Children with differences in sensory processing grow into adults with differences in sensory processing. Sometimes, very rarely, an individual might have the right life experiences to diminish these differences so much that they are no longer a major factor. You can absolutely develop more sensory processing capacity through therapy – this is based on principles of neuroplasticity. The right activities, the just-right success, and the right number of repetitions will change the brain and nervous system for the better. This should always be done on the person’s terms and be fun and purposeful. It is not the same as protocols or exercise and the only evidence-based practice for this work is called Ayres Sensory Integration Therapy.
“It’s important to know though that even with all that work we are not talking about a ‘cure’. Most individuals with disordered sensory processing will need to return to therapy at some stage or another, or will need to build a sensory lifestyle that replaces therapy and continuously nourishes their nervous system with the necessary inputs.”
What is the association with SPD and ADHD, anxiety disorders and OCD? Is it a stand-alone disorder or is SPD related to other developmental disorders?
“Disordered sensory processing is known to co-occur in autism, adhd, OCD, anxiety, schizophrenia, and other learning differences and genetic differences (like Fragile X syndrome). It is also known to be present in people with no other diagnosis, although it has not yet been recognised as a standalone diagnosis.”
Is sensory overload considered the same as SPD, how are the two related?
“Sensory overload can happen to anyone thanks to the world we live in. The parade at the theme park, the opening ceremony at a huge event, there are lots of opportunities for sensory overwhelm. Those with sensory sensitivities or who have trouble making sense of sensation, are simply more likely to experience overwhelm more often.”
How does STAR Institute For Sensory Processing work with children and adults with SPD – what’s your mission?
“We want to see a world where sensory heath is widely understood, talked about over coffee, dinner, at the doctor’s office, during teacher training. Our vision is Sensory Health and Wellness for the State, the Nation, and the World. At STAR we do this in three ways – through our therapy centre where we are continuously refining and pioneering best practice, through research investigating the effectiveness of therapeutic supports for different populations and also the neurology behind sensory processing, and through education where we share what we have learned with parents and professionals. These three departments work in unity and make STAR Institute a global centre of excellence for sensory health.”
What can be done to drive awareness and ensure those living with SPD get the support they need?
“Learn about your own sensory preferences and strengths. Follow social media accounts like STAR Institute and the UK based Sensory Integration Network. Read and share the sensory stories and the TEDx talk.”
Something you’d like everyone to know about SPD…
“If we think about sensory health as a domain of wellness, everyone will benefit. Everyone in the workplace, the family, the community. Perhaps this will also help us cultivate greater compassion for one another and accept and celebrate differences and the value of diversity.”
