One of my three kids has a much harder time than her siblings getting ready in the morning. Every transitional step from bed to breakfast to teeth brushing feels weighted. It's a struggle to keep my 6-year-old daughter focused. And when it's time to get dressed, it’s difficult to find the right angle that will help my daughter put clothes on her body.
What I didn't know initially is my daughter is one of the 5 to 16 percent of school-aged children with sensory processing disorders (SPD), and she’s overstimulated by the clothing on her body. It’s worse in the wintertime—she often refuses to put on weather appropriate clothing when the temperature drops. Just recently, she left the house in shorts and a T-shirt.
Aside from sight, sound, touch, taste, and smell, there are also two other senses—proprioception and vestibular—that give us a sense of body or spatial awareness and coordination or balance. People with SPD experience too much (hyper) or too little (hypo) stimulation through one or more of these senses. This means a touch may feel like a punch or a whisper may sound like a scream.
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Occupational therapists have been treating sensory processing for years, but it’s often overlooked because it doesn't appear in American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which medical professionals use to diagnose disorders. This is in part because some doctors don’t believe SPD is a disorder but rather a symptom of other disorders like autism, ADHD, or anxiety. But a breakthrough study linked SPD to differences in brain structure and set it apart from other conditions. The study found kids with SPD had abnormal white matter in the back of their brain which is involved in sensory processing. These findings help to distinguish SPD from coinciding clinical diagnoses, such as autism and ADHD.
Without the help of learned coping skills or the assistance of an adult or parent, a child who is flooded with these mixed signals is prone to outbursts, crying, hitting, and a loss of control as they try to gain it back. But there are ways to help your kid through their struggles with SPD.
How to help your kid with SPD
I wasn’t always the best source of comfort when my daughter refused to put on a coat or mittens. I didn't immediately recognize that her tantrums had less to do with stubborn defiance and more to do with her inability to regulate her senses. The clothes were too hot, too tight, or just not right. The socks didn't feel good. The jacket was too heavy. I yelled at her to put on her boots. One time, I put them on for her while she lay on the ground screaming.
Her whole system was in overdrive, and I wasn't helping. “It can be very tricky to figure out when a child is overwhelmed by sensory input or if they are simply asserting their will,” says Juliana Bloom, Ph.D., a pediatric neuropsychologist based in Orlando, Florida who serves on the board of the Levin Center, a nonprofit educational consulting and advocacy organization. “Parents have to try a lot of approaches and try to collect information on which one is the problem, and then design solutions."
Dr. Bloom, who also has a child with sensory issues, says kids generally like to have choices, and are typically able to choose between a few shirts when given the option. But if a kid can't handle wearing any type of shirt then that could signal something more is going on. Other complaints about clothing not feeling right, sounds being too loud, or touch being too much are also signs to look out for. Also, while some kids may over-respond to sights and sounds, other kids may not respond at all. That can be a signal too.
Ethan Fechter-Leggett, a father whose son has sensory processing disorder, has learned not to care about what his kid wears to school. "If it gets us out the door without us screaming at each other, it's good enough for me,” he says.
I’ve learned not to focus on what my child wears either. Instead of forcing her into weather appropriate attire, I now pack extra clothes in her backpack in case she needs them later in the day. Removing tags, finding shirts with wide collars, buying socks without seams, and letting my daughter pick out the clothes she likes helps too. And I’ve been more understanding when I introduce new clothing. “It is a lot easier when a child is full of nourishing food, rested, and moderately worn out from exercise. Don't choose to try the new jacket during the morning rush for a child with SPD; wait until they are at their mental and physical best,” advises Dr. Bloom.
As an example of how to deal with a sensory trigger for her child, Dr. Bloom describes how she and her son deal with new shoes—something that is hard for him. Dr. Bloom associates the new footwear with something enjoyable. She sets a timer for her son and after the first minute of wearing the shoes, he gets a reward. She slowly increases the time and when her son gets to 30 minutes of wearing a pair of new shoes it’s not much of an issue anymore.
Parents can find a plan that works for them to help their child get through their morning routine. Then plan on making adjustments to that plan because winter is the worst for kids who can't stand to have extra layers on their bodies. And don’t be afraid to seek out professional help either. "Working with an occupational therapist can be very helpful,” says Dr. Bloom. “If prescribed for your child, techniques, such as skin brushing and joint compression, may reduce sensory symptoms."