A Comprehensive Guide to Sensory Processing Disorder (SPD)

By Jay Getten LCPC LMFT

Introduction

Sensory Processing Disorder (SPD) is a condition characterized by the brain's difficulty in receiving, interpreting, and responding to sensory information, which can include sounds, textures, movements, or internal sensations. Despite its significant impact on quality of life, SPD is not recognized as a distinct diagnosis in reference manuals such as the DSM-5 or ICD-11. This lack of classification complicates access to therapy and insurance coverage (Goodman, 2023; Psychology Today Staff, 2024). Advocacy and education are essential to ensure that affected individuals obtain the necessary support (STAR Institute, 2024).

What is Sensory Processing Disorder?

Sensory Processing Disorder (SPD) is characterized by the brain's abnormal response to sensory stimuli, resulting in either hypersensitivity (overreacting) or hyposensitivity (underreacting and seeking intense stimuli). SPD manifests differently in children and adults (Goodman, 2023). For instance, children with hypersensitivity may find certain clothing textures intolerable, leading to emotional meltdowns, while adults might struggle with overwhelming noise in crowded environments, causing social withdrawal (Pedersen, 2024).

Children with SPD frequently encounter difficulties in sensory-rich school settings, which can lead to behavioral challenges and misdiagnoses, such as attention disorders (Fletcher, 2024). Adults may avoid occupations with sensory triggers, thereby limiting their career prospects (Rodden, 2023). SPD also affects emotional regulation, leading to outbursts in children and social avoidance in adults, ultimately impacting interpersonal relationships (Seeberger, 2021). Without appropriate support, these issues can escalate into anxiety or depression (STAR Institute, 2024).

Furthermore, SPD impedes learning and development. Sensory difficulties interfere with academic tasks, and Sensory-Based Motor Disorder (SBMD) affects motor skills, reducing participation and self-esteem (NeuroLaunch Editorial Team, 2024; Kranowitz, 2020). Symptoms vary by age: infants may have feeding difficulties, toddlers could avoid tactile play, and adolescents might struggle with social integration (Galiana-Simal et al., 2020; Pedersen, 2024).

Adults with SPD often develop coping mechanisms, though these may not always be effective. Office environments can be particularly distressing, affecting productivity. The lack of recognition and support can lead to mental health problems. Tailored interventions, including quiet workspaces and employer education, can significantly enhance the quality of life for individuals with SPD (Seeberger, 2021). Increasing awareness and providing accommodations for SPD are crucial for enabling affected individuals to thrive (Seeberger, 2021).

Symptoms and Impacts

Symptoms of Sensory Processing Disorder (SPD) vary widely. Individuals who are hypersensitive often experience discomfort in response to bright lights, loud sounds, or specific fabrics, leading to physical reactions and avoidance behaviors. Conversely, those who are hyposensitive seek strong stimuli to feel engaged, which may result in risky behaviors in children and a preference for high-intensity activities in adults.

SPD affects motor skills, leading to Sensory-Based Motor Disorder (SBMD), characterized by poor balance, coordination issues, and difficulties with fine motor tasks such as writing or tying shoelaces. These challenges can impact daily living and self-care activities, affecting comfort and self-esteem due to sensitivities to certain fabrics and textures.

Beyond motor skills, SPD significantly impacts emotional well-being. Individuals with SPD often face increased stress and anxiety due to unpredictable sensory stimuli. In adults, this can lead to social withdrawal and anxiety, potentially resulting in depression and chronic stress. For instance, Seeberger (2021) highlights that sensory overload can cause fatigue and irritability, underscoring the need for sensory-friendly environments.

In children, SPD can manifest as tantrums or emotional outbursts, often mistaken for behavioral problems. This can strain family relationships and lead to social isolation. Learning and development are also affected, as sensory issues hinder the ability to grasp academic concepts, particularly those requiring physical interaction. Children may struggle with tasks like sitting still, tolerating classroom materials, or focusing amidst noise, resulting in challenges in school activities and lower self-esteem (NeuroLaunch Editorial Team, 2024).

The impact of SPD varies across different life stages. Infants might experience feeding difficulties due to hypersensitivity to food textures or temperatures, while toddlers might avoid messy play, missing crucial developmental opportunities (Galiana-Simal et al., 2020). Adolescents may find it challenging to fit in while managing sensory overload, which can increase anxiety and social difficulties, and pose a risk of bullying or exclusion (Pedersen, 2024).

In adulthood, SPD affects various aspects of daily life. Adults with SPD often develop coping strategies, such as avoiding certain environments, but these may not always be effective in unavoidable situations like commuting or mandatory work events (Rodden, 2023). Office settings with harsh lighting, frequent interruptions, and background noise can cause distress and impact concentration and task completion (Pedersen, 2024). Personal relationships may also suffer, as individuals might withdraw from social activities to avoid sensory overload, leading to isolation.

Misunderstandings in the workplace are common, where the requests for quieter or more controlled environments are sometimes dismissed as overreactions or anxiety. This lack of recognition can contribute to secondary mental health issues such as anxiety and depression. Tailored interventions, including quiet workspaces, flexible schedules, and employer education, can enhance the quality of life and productivity for adults with SPD (Seeberger, 2021).

Raising awareness about SPD is crucial for providing support across all ages. Healthcare providers and employers must recognize that SPD persists into adulthood and requires accommodations for affected individuals to thrive. By promoting inclusivity, adults with SPD can better manage sensory challenges and lead fulfilling lives.

Finally, SPD also impacts motor skills, with SBMD being characterized by poor balance and coordination, affecting daily tasks (NeuroLaunch Editorial Team, 2024). Challenges in self-care tasks due to sensory sensitivities are common (Kranowitz, 2020). Emotional well-being is also influenced, with adults facing social withdrawal, anxiety, and emotional dysregulation when their sensory needs are misunderstood. Creating sensory-friendly environments is essential to mitigate these effects (Seeberger, 2021).

Potential Causes

The etiology of Sensory Processing Disorder (SPD) remains incompletely understood, though current research indicates a potential genetic component, particularly in cases of hypersensitivity to light and sound (Goodman, 2023). Genetic predispositions may influence sensory processing differences, especially within families affected by neurodevelopmental disorders such as ADHD or autism. The frequent co-occurrence of SPD with these conditions suggests shared heritable factors (Galiana-Simal et al., 2020).

Neuroimaging studies have identified atypical brain connectivity in individuals diagnosed with SPD. Functional MRI scans demonstrate unusual patterns of connectivity between sensory regions and areas responsible for emotional regulation and attention, potentially explaining the difficulty in filtering sensory information (Goodman, 2023). Children with SPD often show hyperactivity in certain sensory regions and hypoactivity in others, resulting in varied responsiveness to stimuli.

The prevalence of SPD among children with autism and ADHD can be attributed to disruptions in sensory integration pathways. These pathways are critical in processing sensory information, contributing to sensory imbalances characteristic of SPD. Neurodevelopmental disorders frequently include sensory processing challenges, suggesting common biological mechanisms, such as variations in neural plasticity and synaptic function.

Environmental factors, including prenatal stress, premature birth, or insufficient sensory exposure during critical developmental periods, may also contribute to the development of SPD (Galiana-Simal et al., 2020). Exposure to prenatal toxins and maternal stress can impact the developing nervous system, while early sensory deprivation or inconsistent sensory input can impede typical sensory processing development.

Camarata, Miller, and Wallace (2020) advocate for more rigorous clinical trials to evaluate the efficacy of Sensory Integration/Sensory Processing Treatment (SI/SP-T) for SPD. Understanding the neurological differences between children with and without SPD could enhance treatment methodologies. Comprehensive neuroimaging studies should be employed to assess the impact of SI/SP-T on neurodevelopmental changes.

In summary, SPD likely arises from an interplay of genetic, neurological, and environmental factors. Continuous research is crucial for elucidating these contributors and for the development of targeted interventions and preventive measures for individuals at risk of SPD.

SPD vs. Autism Spectrum Disorder (ASD)

Sensory processing disorder (SPD) is frequently misidentified as autism spectrum disorder (ASD), due to overlapping sensory sensitivities. However, whereas ASD encompasses difficulties in social interaction, restricted behaviors, and sensory challenges, SPD exclusively addresses sensory processing issues without inherently affecting cognitive abilities or social communication (NeuroLaunch Editorial Team, 2024). ASD may include challenges with interpreting social cues, maintaining eye contact, and engaging in conversation, which are not typically present in SPD unless co-occurring with another condition. SPD can exist independently or alongside other conditions such as ADHD and ASD, complicating both diagnosis and treatment (Psychology Today Staff, 2024).

Differentiating SPD from ASD is particularly challenging in young children, given their shared symptoms like intense responses to sensory stimuli. In ASD, these symptoms are part of a broader behavioral spectrum, whereas in SPD, sensory difficulties are the primary concern without associated cognitive or social impairments (Fletcher, 2024). Additionally, ASD may involve sensory-seeking behaviors connected to repetitive actions, unlike SPD where sensory responses vary based on individual profiles.

The diagnostic challenges of SPD are exacerbated by its absence from the DSM-5, leading to inconsistent recognition and coverage for treatment compared to ASD (Fletcher, 2024). As a result, insurance companies may not cover sensory integration therapies for SPD unless it is linked to a recognized condition such as ASD.

SPD must also be differentiated from Sensory Processing Sensitivity (SPS), a temperament trait observed in highly sensitive individuals. SPS involves heightened awareness and deeper processing of sensory information without the neurological misfirings typical of SPD (Rodden, 2023). While SPS can lead to strong reactions to sensory stimuli, it does not result in the same level of dysfunction as SPD, which significantly impairs daily life through sensory integration challenges.

SPD is not associated with social and communicative delays, unlike ASD. For instance, a child with ASD might exhibit difficulty with social games or conversations, whereas a child with SPD might avoid social situations due to overwhelming sensory input rather than a lack of social understanding. Sensory issues in ASD often contribute to restrictive behaviors such as hand-flapping or rocking, which are less common in SPD unless related to specific sensory needs (NeuroLaunch Editorial Team, 2024).

Misdiagnosis or delayed diagnosis of SPD and ASD, especially in children, can occur. Differentiating between the two necessitates specialized expertise, involving multidisciplinary evaluations for accurate assessment (STAR Institute, 2024). Early differentiation is crucial since intervention strategies differ. Specifically, ASD interventions focus on speech, social skills, and behavior, while SPD interventions target sensory integration and occupational therapy.

Finally, although SPD and ASD share certain features, particularly in sensory processing, they fundamentally differ in core symptoms and impacts on daily life. Clear differentiation is essential to ensure appropriate support and effective interventions tailored to each condition.

Treatment Approaches

Addressing Sensory Processing Disorder (SPD) poses significant challenges due to its lack of recognition as an official medical condition. Occupational therapy, particularly Sensory Integration Therapy (SIT), is frequently employed to provide structured sensory experiences aimed at enhancing sensory processing (Camarata et al., 2020). The DIR model, developed by Dr. Stanley Greenspan and Dr. Serena Wieder, incorporates "floor-time" activities designed to improve engagement and sensory tolerance (Goodman, 2023).

For adult individuals, Cognitive Behavioral Therapy (CBT) offers strategies for coping with sensory triggers, such as anxiety or frustration (Pedersen, 2024). Additionally, lifestyle modifications, including the use of noise-canceling headphones, sensory-friendly clothing, and yoga, can help alleviate sensory overload (Seeberger, 2021). Early intervention with sensory integration therapy is paramount for minimizing developmental delays and enhancing overall quality of life (Galiana-Simal et al., 2020).

Developing a personalized sensory toolkit, which may include items such as fidget toys and weighted blankets, as recommended by Christel Seeberger (2021), allows individuals to exert control over their environments and manage sensory demands more effectively. Implementing a "sensory lifestyle" with structured activities further supports self-regulation (Kranowitz, 2020).

Living with SPD: Strategies and Support

Supportive environments are essential for individuals with Sensory Processing Disorder (SPD). Families, friends, and caregivers play a crucial role in managing this condition. Understanding SPD, respecting sensory boundaries, and creating sensory-friendly spaces can significantly enhance the quality of life (Pedersen, 2024). Factors such as bright lights, sudden noises, or strong smells can trigger hypersensitivity, while individuals with hyposensitivity may require increased sensory input. Adapting environments to meet these needs helps reduce sensory overload or under-stimulation.

Adults with SPD benefit from predictable routines, sensory-safe spaces, and tools such as sensory kits (Seeberger, 2021). Predictable routines offer control and stability, thus reducing anxiety. Sensory-safe spaces, including quiet rooms or areas equipped with calming tools, provide controlled environments during sensory challenges. Tools like noise-canceling headphones, fidget toys, and sunglasses help manage sensory changes and prevent overload. A “sensory lifestyle” involves structured activities designed to promote self-regulation, tailored to individual sensory profiles (Kranowitz, 2020).

Occupational therapists can develop sensory diets, which consist of activities aimed at regulating sensory input, like meal plans but focused on sensory needs (Fletcher, 2024). These activities might include utilizing textured balls or weighted vests for tactile-sensitive individuals or engaging in exercises that provide deep pressure for those with hyposensitivity.

Support from family and social networks is imperative. Establishing sensory-safe spaces at home, minimizing sensory triggers, and educating friends and peers about SPD fosters understanding and reduces stigma (Seeberger, 2021). Community involvement enhances support, with educational institutions, workplaces, and public facilities adopting sensory-friendly practices. Mental health professionals play a vital role by offering therapies such as Cognitive Behavioral Therapy (CBT) to address emotional impacts and facilitate the development of coping strategies. Occupational therapists assist families in incorporating sensory activities into daily routines, thereby promoting balanced lifestyles.

Supportive environments for individuals with SPD require a comprehensive approach involving family education, community adaptations, personalized sensory diets, and professional intervention. With effective strategies and robust support systems, individuals with SPD can lead fulfilling lives, mitigating the disruptions caused by sensory challenges.

SPD in the Context of Co-Existing Conditions

Sensory Processing Disorder (SPD) frequently co-occurs with attention deficit hyperactivity disorder (ADHD) and Autism Spectrum Disorder (ASD), which complicates diagnosis and treatment since each condition requires distinct approaches. Approximately 75-90% of individuals with ASD experience sensory challenges, although many with SPD do not meet the criteria for ASD (NeuroLaunch Editorial Team, 2024). Accurate diagnosis by occupational therapists or multidisciplinary teams is essential for developing personalized treatment plans (STAR Institute, 2024).

The STAR Institute (2024) emphasizes the importance of evaluating SPD alongside other disorders to tailor interventions appropriately. For example, children with both ADHD and SPD may exhibit overlapping behaviors such as impulsivity stemming from sensory needs. Differentiating these symptoms is crucial for effective treatment.

For ADHD, common treatments include behavioral interventions, medication, and structured environments, whereas SPD treatments often involve sensory integration therapy. Identifying the root causes of behaviors is critical in creating comprehensive interventions. Co-occurring conditions such as anxiety or obsessive-compulsive disorder (OCD) add complexity and require nuanced understanding for proper treatment planning (STAR Institute, 2024).

Multidisciplinary evaluations involving various specialists provide a comprehensive perspective, thus avoiding the mislabeling of behaviors. SPD can obscure or exacerbate symptoms of other conditions, making precise diagnosis vital. Effective interventions consider both sensory challenges and broader neurodevelopmental issues.

Individualized treatment plans are indispensable for managing co-existing conditions. Integrating sensory integration strategies with behavioral interventions benefits individuals with both ADHD and SPD. Educational accommodations and sensory tools can aid children in managing sensory and attentional difficulties. Adults may benefit from sensory regulation strategies, cognitive-behavioral therapy for co-occurring SPD and anxiety, or organizational tools for SPD and ADHD (Seeberger, 2021). A holistic approach that addresses all aspects of an individual's condition leads to improved outcomes. Understanding how SPD interacts with other conditions ensures effective care tailored to complex needs.

Conclusion

Sensory Processing Disorder (SPD) is a multifaceted condition that often faces misunderstanding and mischaracterization. Despite its absence as a formally recognized diagnosis, the manifestations of SPD are tangible for those impacted. Intervention strategies such as occupational therapy, sensory integration techniques, cognitive-behavioral therapy (CBT), and modifications to the environment can enable individuals to manage their symptoms effectively and enhance their daily functioning. Through heightened awareness, ongoing research, and individualized interventions, individuals with SPD can attain an improved quality of life and greater functional engagement.

References

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Fletcher, J. (2024, March 8). Sensory Processing Disorder vs. Autism: Differences Explained. Medical News Today. Retrieved from https://www.medicalnewstoday.com

Galiana-Simal, A., Vela-Romero, M., Romero-Vela, V. M., Oliver-Tercero, N., García-Olmo, V., Benito-Castellanos, P. J., Mu?oz-Martinez, V., & Beato-Fernandez, L. (2020). Sensory Processing Disorder: Key Points of a Frequent Alteration in Neurodevelopmental Disorders. Cogent Medicine, 7(1), 1736829. https://doi.org/10.1080/2331205X.2020.1736829

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NeuroLaunch Editorial Team. (2024, August 11). SPD vs Autism: Key Differences Explained. NeuroLaunch. Retrieved from https://neurolaunch.com

Pedersen, T. (2024, July 9). Sensory Processing Disorder in Adults: Symptoms, Treatment, More. Healthline. Retrieved from https://www.healthline.com

Psychology Today Staff. (2024). Sensory Processing Disorder. Psychology Today. Retrieved from https://www.psychologytoday.com

Rodden, J. (2023, August 25). Sensory Processing Disorder in Adults: SPD Symptoms & Causes. ADDitude. Retrieved from https://www.additudemag.com

Seeberger, C. (2021, August 15). How to Manage Sensory Overload in Adults. Sensory Friendly Solutions. Retrieved from https://www.sensoryfriendly.net

STAR Institute. (2024). Co-Morbidity: SPD and Other Disorders. STAR Institute for Sensory Processing. Retrieved from https://sensoryhealth.org