Top 10 red flags for Sensory Processing Disorder- Term life

I wanted to put this list out there because one of the most common questions I get from parents and other professionals is “What should I look for if I think it’s a “sensory” issue?”.  This list is by no means inclusive of all of the difficulties a child can have as a result of processing delays but does hit on some of the most common symptoms we see with SPD.

1.      Difficulty with grooming tasks, specifically having teeth brushed, hair and nails cut, and washing hair and body. We are talking about SIGNIFICANT dislike…so much so that it might take multiple adults to hold the child down to cut nails, the family has stopped even attempting to give the child hair cuts, or the child is unsafe in the bath tub because they have such huge fits when getting washed/handled in the water.

2.      Picky eater. Refusing certain food textures (smooth, crunchy, lumpy) or resisting certain flavors / temperatures.  Unfortunately, this can be hard because lost of toddlers are picky eaters.  But, again, we are looking for  pretty significant difficulties with feeding, so much that the family routine and/or child’s nutrition are being disrupted.  We might see a child only wanting crunch foods (pretzels, chips, crackers) or not eating foods with multiple textures (peanut butter and jelly sandwhich). Sometimes children show a tendency to want only beige starch foods (french fries, bread, crackers).  Other children might resist certain temperatures (only want food at room temperature, NOTHING cold).

3.      Extreme difficulty with having face and hands get messy during feeding and play activities. I hear parents say “He will shake his hand and whine until I wipe his hand clean if he gets any food on it when we are eating”.  These children might also resist eating messy/puree foods altogether.

4.      Disliking playing in the sand, having lotion on skin, or wearing certain fabrics. Often times, children with tactile sensitivities or tactile defensiveness will shy away from play activities where the substance stays on their hands. These activities (finger painting, sand play, shaving cream) are all “light touch” activities and light touch is the kind of tactile input children most frequently have difficulty interpreting correctly.

5.      Showing fear when having head tilted backward (when changing diapers or playing at the park). Thse behaviors could be indicators that children are not understanding their relationship with gravity as a result of poor vestibular processing. Frequently, these children have a history of struggling with diaper changes or with having their hair rinsed in the bath tub.

6.      Showing fear with having feet off of the ground (swinging, rough house play, stepping off curbs). Again, these are behaviors that could indicate a child is not processing movement (vestibular) input correctly and struggles with having a good understanding of what it feels like to be on a curb 4 inches off of the ground versus a balance beam 4 feet off of the ground.

7.      Constant climbing / jumping/ crash such that the child has difficulty sitting still to complete a simple, sort, age appropriate play activity. This can be a very difficult area to assess as toddlers are expected to still be learning how to sit and engage in simple play activities. So what we look for is a child who craves movement so much that he/she struggles significantly with seated work that lasts for more than 1-2 minutes. We also look to see if the child struggles remaining at the dinner table, darts from family consistently when in public settings, and is observed to climb and jump on household objects excessively.

8.      Seeking spinning, swinging or other movement activities excessively. These types of behaviors could indicate that a child is not processing vestibular input efficiently and as a result needs extra movement to help their level of arousal get to a “just right” state. We might seek children spin in circles, run around a rug in the family room, or drive a ride-on-toy around the kitchen island for hours.

9.      Muscles that seem loose or floppy, such that the child slouches or struggles with sitting upright for long periods of time. Children with vestibular processing delays are frequently noted to have low muscle tone. We describe children with low muscle tone as looking loose or floppy and seem to have extra movement around their joints.

10.  Difficulty with transitions and sleep can be related to processing delays at times. Sometimes, children can struggle with filtering all the sensory information they get from the environment as well as from their own bodies. We call this ability to regulate our own level of arousal “modulation”. Children with modulation difficulties are frequently reported to have difficult self calming, have extreme tantrums, have difficult getting and staying asleep, and have difficult with transitioning between tasks and activities.

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