Children receive information through their senses (sight, smell, touch, hearing, taste, movement and body position) 24 hours a day, 7 days a week. It’s the brains job to sort out all of these messages and create an appropriate response to them. This is called Sensory Integration and it is the foundation for all childhood development, yet it remains poorly understood. Sensory Integration Dysfunction (or Sensory Processing Disorder) is when the brain cannot effectively sort, understand and organise sensory messages. All the sensory information flooding the brain becomes jumbled or a bit like a traffic jam. Certain behavioural responses in children will indicate that this could be happening. One of these is called sensory defensiveness.
Sensory defensiveness is an overreaction of the protective senses. Non harmful everyday sensory information is misinterpreted as potentially dangerous and threatening. The child’s nervous system over reacts without their permission and they find it very hard to get to a state of calm. Patricia and Julia Willbarger, occupational therapists from America, use this analogy to describe sensory defensiveness:
Each of us has the ability to sense potential danger. Our senses tell us if a spider is creeping on our back, if we are at risk of falling, or when there is smoke in the air. At such times we can respond appropriately to protect ourselves from harm. Some people have a tendency to over protect or defend themselves. They respond to certain harmless sensations as if they irritating, dangerous or even painful. This is called “sensory defensiveness”. Sensory defensiveness is simply the over activation of our protective senses. It is a misperception that makes our clothes feel like spiders on the skin, and stairs seem like cliffs. Having sensory defensiveness is just like finding yourself in a dark parking structure. Alone. Late at night. As you walk through this dark, dim environment your eyes and ears constantly search for danger. Your heart races. You are tense; ready to act; to flee; to fight. You jump at every noise. In that dark garage, your senses strain to take in every little bit of information in the environment. Your senses are biased for your protection and defence. Later when you are home and safe your senses return to a typical state. Children with sensory defensiveness are stuck in the dark parking lot.
Symptoms or red flags of sensory defensiveness are many and varied. They will also vary in severity. What may be a mild irritation for one child may cause major distress for another. Some of the more common symptoms of sensory defensiveness are listed below.
- Is irritated by clothes tags, seams, stitching or waist/collar/sleeve bands
- Dislikes handling things that are messy, sticky or wet
- Reacts negatively to unexpected or light touch (e.g. someone accidentally bumping child, hand placed lightly on shoulder)
- Prefers no clothing
- Has a narrow range of clothes that can be tolerated
- Becomes distressed by putting shoes or socks on
- Is distressed by grooming procedures such as hair washing, hair brushing, hair cutting and nail cutting
- Dislikes physical affection even with close family or friends
- Fussy eating; will only eat a narrow range of foods
- Inability to tolerate certain textures and tastes
- Is hesitant to try new foods
- Is particular about the temperature of food
- Dislikes or becomes distressed with teeth brushing
- Reacts negatively to low frequency sounds (vacuum cleaner, lawn mower, hair drier, power tools, trucks, coffee grinder)
- Covers ears in response to certain sounds or removes self from noise source
- Is unable to concentrate with background noise
- Hears noises that others do not hear and may react to these
- Sensitivity to sun glare
- Sensitivity to bright lights or changes in lighting
- Requests shades or blinds to be down
- Is bothered by moving visual images or walking up and down stairs
Gravitational Insecurity & Intolerance to Movement (Vestibular sense):
- Becomes nauseous or dislikes changes in position (e.g. lying down for nappy change, lying to sitting).
- Dislikes head being displaced (e.g. tilting back for hair washing) and prefers to hold head upright
- Complains of feeling dizzy or sick after movement
- Experiences motion sickness
Proprioception (body position):
- Difficulty or fear walking on uneven surfaces, stairs or curbs
- Resistant or distressed by weight bearing on arms and legs as an infant
- Is distressed by certain smells and doesn’t become accustomed to them
- Becomes nauseous or gags in response to certain smells
- Complains about the smell of soaps, body lotions or perfumes
The presence of sensory defensiveness often leads to an overwhelmed response in the form of melt downs, tantrums, running away/hiding or aggression. Children with sensory defensiveness can be a bit like a yo yo- ok one minute, but having a complete meltdown the next over something seemingly insignificant. Parents of sensory defensive children often describe raising them like walking on egg shells, trying desperately not to do anything that might set them off or break the momentary peace. The challenges faced by parents are monumental and understanding that sensory defensiveness is a valid condition alone provides great validation and relief.
The presence of sensory defensiveness undoubtedly makes everyday life that much harder for children and their families. But it also often gives rise to many other issues such as difficulties with emotional regulation, poor sleep, delayed speech and language, delayed motor skills, decreased attention and concentration, controlling behaviour, high activity levels and poor social skills.
The good news is that there is much that can be done to help the sensory defensive child. Paediatric Occupational Therapists who specialise in sensory integrative disorders are the health professionals to see. They will carefully assess your child’s sensory system and devise interventions specific to your child that will allow them to process sensory input properly. Treatment will open a whole new world for the sensory defensive child. One in which they can be delighted and not terrified by their senses. A parent who has raised a sensory defensive child described it like this:
“It’s like being in a bird cage-being trapped inside bars. You could see so much joy on the other side but you couldn’t reach it because it was safe in that little cage. The first thing was understanding sensory defensiveness and realising there is a treatment. That was like the door opening and the process as gradually getting further and further away from the cage. Now we are enjoying everything that’s out there and it’s fantastic!”
Hannah Gamble is the founder and director of Thrive Occupational Therapy for Kids. Hannah works with children with sensory, gross motor and fine motor challenges. She has recently published a book on sensory defensiveness in childhood.