To understand sensory defensiveness, we need to first look at Sensory Integration.
Sensory Integration is the process your central nervous system goes through when it takes information in from your body’s 8 senses, processes that information, and then responds accordingly.
When one’s central nervous system has difficulty processing any of this sensory information, the body’s responses are atypical and can be observed in motor, language, or behavioral skill difficulties. Occupational therapists diagnose these atypical characteristics as Sensory Processing Disorder or SPD.
When we talk about Sensory Processing Disorder (SPD), occupational therapists diagnose 3 subtypes of SPD:
- Sensory Modulation Disorder
- Sensory-Based Motor Disorder
- Sensory Discrimination Disorder.
It is likely that people with sensory processing dysfunction demonstrate a combination of symptoms from the subtypes, however, the symptoms we are focusing on in this article fall under one particular subtype: Sensory Modulation Disorder: Sensory Over-responsivity (SMD-SOR).
SENSORY OVER-RESPONSIVE TYPE AND SENSORY DEFENSIVENESS
A child who presents with SMD-SOR has a low threshold for sensory stimuli - meaning, it doesn’t take much for him or her to be overwhelmed, overstimulated, irritated, or avoidant. This child is very sensitive to sensory stimuli. This oversensitivity or over-responsivity to sensory input limits the child’s willingness to play, explore, and feel safe or comfortable in his environment.
This over-responsivity can be referred to as “sensory defensiveness” because the child often defends himself (emotional or behavioral response), avoids, or tries to minimize the exposure to these sensations. Sensory defensiveness can be seen in any or all sensory systems and the child will avoid or become irritated by sensations, eliciting a physiological response that is referred to as “fight, fright, flight.”
SIGNS OF SENSORY DEFENSIVENESS
Sensory defensiveness can affect social, emotional, and behavioral areas of a child’s life.
Some common complaints in daily sensory life can present as:
- Frequently covers ears, especially in loud environments.
- Runs away, cries, or covers ears with loud or unexpected sounds.
- Is bothered by or distracted by background environmental sounds.
- Requests quiet environment.
- Easily distracted by sounds not noticed or bothered by others.
- Refuses to go to activities where there is a lot of noise.
- Picky eater, often with extreme food preferences – soft foods, crunchy foods, hot food, cold food, etc.
- May only eat soft or pureed foods past 24 months of age.
- Has difficulty with sucking, chewing, and swallowing.
- Avoids seasoned, spicy, sweet, sour or salty foods; prefers bland foods.
- Extreme resistance to trying new foods.
- Easily gags with textured foods.
- Complains about toothpaste and mouthwash.
- Extreme resistance or fear of going to the dentist.
- As an infant, does not like to be held or cuddled; arches back, pulls away.
- Becomes distressed when diaper or clothes are changed.
- As a toddler, prefers to be naked; pulls diapers and clothes off constantly.
- Appears fearful standing in close proximity to others.
- Is fearful, anxious or aggressive with light or unexpected touch.
- Is excessively ticklish.
- Overreacts to minor cuts, bug bites.
- Becomes distressed about having hair brushed; insists on a particular brush.
- Resists friendly or affectionate touch from anyone besides parents or siblings (and sometimes them too!)
- Avoids touching certain textures of material – rough, silky, scratchy, etc.
- Becomes distressed or may refuse to walk barefoot on grass or sand.
- May walk on toes only.
- Refuses to wear clothes with rough textures such as turtlenecks, jeans, hats, or belts; distressed by seams in socks and may refuse to wear them.
- Dislikes “messy play” – sand, mud, water, glue, Playdoh, slime, etc.
- Is a picky eater, only eating certain tastes and textures; mixed textures tend to be avoided as well as hot or cold foods; resists trying new foods.
- Distressed when having face washed.
- Resists brushing teeth and is extremely fearful of the dentist.
- Tells others how bad/funny they smell.
- Refuses to eat certain foods because of their smell.
- Is bothered by, gets sick, or has behavioral issues after the use of household cleaning products.
- Notices and/or reacts negatively to smells which are not noticed by others.
- Irritated by the smell of perfumes, lotions, cologne, candles.
- Likes/dislikes an environment by the way is smells
- Avoids eye contact.
- Easily distracted by visual stimuli – toys, movement, decorations, windows, etc.
- Rubs eyes, has watery eyes, or gets headaches after reading, writing, computer use or watching TV.
- Sensitive to bright lights; squints, cover eyes, cries, gets headaches from light.
- Will have difficulty in bright colorful rooms or a dimly lit room.
- Has difficulty keeping eyes focused on a task/activity for an appropriate amount of time.
- Gets motion sickness often or easily –cars, elevators, head movement.
- May have disliked being placed on stomach as an infant.
- Disliked baby swings/jumpers.
- Dislikes or is fearful of walking on uneven surfaces or going up/down stairs.
- Dislikes playground equipment.
- Does not like activities where feet leave/don’t touch the ground.
- Prefers sedentary tasks.
- Dislikes spinning or fast movements.
- Moves slowly and cautiously, avoids taking risks, and may appear “wimpy.”
- Dislikes head movement, especially in extension, i.e. washing hair.
- Dislikes elevators and escalators.
- Afraid of heights, even the height of a curb or step.
- Is fearful of activities that require balance; loses balance easily.
- Difficulty riding a bike, jumping, hopping, skipping or balancing on one foot (especially if eyes are closed).
- Has low muscle tone, limp/floppy body.
- Fatigues easily.
- Has difficulty turning doorknobs, handles, opening and closing items.
- May have never crawled as a baby.
- Has poor body positional awareness –bumps into things, knocks things over, trips, appears clumsy.
- Poor gross motor skills – jumping, catching a ball, jumping jacks, climbing a ladder, etc.
- Poor fine motor skills – difficulty using tools such as pencils, silverware, combs, scissors, etc.
- Does not establish hand dominance by 4-5 year old; may appear ambidextrous, frequently switching hands for throwing, coloring, cutting, writing etc.
- Has difficulty learning exercise or dance steps.
While these sensory stimuli may not affect the typical child or adult, sensory sensitive or defensive kids are bothered by the presence of (what they perceive or interpret as) noxious smells, tastes, sounds, touch, or movement.
Depending on the severity of your child’s sensory defensiveness, and which sensory system he over-responds to, the emotional and behavioral reactions could range from mild (i.e. fabric preferences, avoiding denim) to severe (i.e. throwing up with food textures, aggression when touched accidentally).
WHAT CAN YOU DO TO HELP SENSORY DEFENSIVENESS?
The best way to address sensory defensiveness is with a comprehensive, well-designed sensory diet that proactively supports your child’s sensory systems. It is best to consult your occupational therapist (OT) for a sensory diet plan that is tailored to your child’s individual needs, especially surrounding sensory defensiveness.
A well-trained OT will structure sensory diet activities in a certain sequence or “recipe” to foster organization, calm, and relaxation by targeting the release of neurotransmitters. For example, proprioceptive sensory input triggers the release of Serotonin, a neurotransmitter that helps with regulation. Proprioception also contributes to increased levels of dopamine which keeps us emotionally balanced.
Because of their calming, organizing, and regulating effects, deep touch pressure or proprioceptive activities are often used therapeutically to help modulate the over-responsive sensory child.
“BRUSHING” FOR SENSORY DEFENSIVENESS
Within a sensory diet for sensory defensiveness, many occupational therapists will provide a recipe for deep touch pressure or proprioceptive activities that can include the Wilbarger Therapressure Protocol.
This therapeutic brushing program applies deep pressure touch input (not light touch) using a specialized plastic bristle brush to the arms, legs, back, hands, and feet. While a staple within many sensory diet recommendations for sensory defensiveness, it is critical that the recommending therapist, as well as the parents, be properly trained in the protocol so that the positioning of the Therapressure Device, an appropriate amount of pressure, direction and sequence of the ‘brushing’ be carried out correctly.
DEEP TOUCH PRESSURE FOR SENSORY DEFENSIVENESS
Weighted objects such as a weighted blanket or lap pad (check out our products if you are in need of a lap pad) can support sensory regulation, as can compression garments and vests. Additional examples of deep touch pressure activities can include:
- Rolling/wrapping a child firmly in a blanket to make a “burrito”
- Squishing a child between two soft pillows (“sandwich”)
- Firmly rolling a therapy ball or Pressure Foam Roller on top of a student’s trunk, legs, and arms
- Deep vibration to the whole body
- Wearing of weighted vests or compression garments
- Weighted blanket use
- Bear Hugs
- Deep massage
- Joint Compressions
- Climbing under sofa cushions
- Deep Pressure seating options
Sensory defensiveness is a term used to describe people who are over-responsive to sensory input and avoid or minimize their exposure to the sensations that are bothersome.
The physiological responses that occur when a child is sensory defensive can be minimized by deep touch pressure activities that provide proprioceptive input. Ideally, a sensory diet should be developed in consultation with your child’s occupational therapist to support his regulation skills proactively, but know that additional deep touch activities and strategies should be part of your sensory toolbox on-the-go.