Sensory Modulation Disorder.

Sensory processing disorder incorporates three primary subtypes: sensory modulation disorder (SMD), sensory-based motor disorder (SBMD) and sensory discrimination disorder (SDD; Schoen et al., 2009). Sensory modulation disorder is defined as “the inability for an individual to organize stimuli that is being presented to them within their environment and adapt to the demands that the stimuli are putting on their body” (Schoen et al., 2009).

Research conducted by Miller et al. (2007) distinguished three subtypes within SMD: sensory over-responsivity, sensory under-responsivity, and sensory craving. Individuals who are more sensory over responsive are more sensitive to sensory stimuli (STARR Institute, 2020). Sensory over-responsivity often presents as a “fight or flight” where the individual will either withdraw from sensory stimuli or react in defense as their body feels they are experiencing an overload of stimuli (STARR Institute, 2020).

Sensory under-responsivity is when individuals show signs of being “unphased” by stimuli such as a loud bang or door slam in their environment. Individuals with sensory under responsivity tendencies might appear withdrawn from groups or disengaged, and for therapists it is important to note individuals might not respond to deep pressure or tactile input, therefore impacting their body awareness (STARR Institute, 2020).

Sensory craving describes an individual who is constantly seeking some form of input with their body, whether that be tight hugs, jumping, and/or rocking their body, they will often want to touch everything in their environment (STARR Institute, 2020). An important note to make regarding individuals with sensory craving patterns is that providing them with input will not always regulate their body and produce positive outcomes, more often than not it provides an over stimuli sensation that the individual will struggle to control (STARR Institute, 2020).

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Tactile

The tactile system tells the brain what our body is feeling within the environment.

Examples include: what the ground feels like, the chair the child is sitting in, clothing, shoes, fabrics, and textures. Exposure to new textures and sensations within the environment is important to prevent sensory disruption.

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Vestibular

The vestibular system tells our brain where our head is in space. The vestibular system is activated anytime the head moves.

Activities to provide vestibular input include: spinning, rolling, going upside down, driving in a car, turning your head to look at a neighbor, swimming, and playing sports.

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Proprioceptive

The proprioception system is in charge of knowing where our bodies are in space in relation to the rest of our body.

If you are riding a scooter, doing yoga, pushing the lawn mover, walking on a balance beam, or giving someone a hug you are activating your proprioceptive sensory system. These are great activities to provide proprioceptive input into a child with modulation deficits.

Sensory Processing Disorder (SPD)

Sensory processing disorder (SPD) is a disruption with how our body’s nervous system receives and responds to sensory signals (Miller et al., 2014). Individuals with SPD misinterpret sensory information within their environment and throughout their day impacting their interactions with others, the environment, and themselves (STARR Institute, 2020).

There are three types of Sensory Processing Disorder

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Sensory Modulation Disorder

An individual will present with an inability to regulate their bodies when sensory stimuli is presented within their environment. Inappropriate behaviors occur when a child's sensory system is overwhelmed.

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Sensory Over-Responsivity

An individual will present with hypersensitivity to sensory stimuli within their environment. Often the individual will remove themselves when there is a significant amount of stimuli within an environment as their body is in a "fight or flight" state.

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Sensory Under-Responsivity

An individual will present very low or inattentive as they require a lot of sensory stimuli in order to gain their attention and engage them in a task.

References

Miller, L. J., Coll, J. R., & Schoen, S. A. (2007). A randomized controlled pilot study of the effectiveness of occupational therapy for children with sensory modulation disorder. American Journal of Occupational Therapy, 61, 228–238.

Miller, L.J., Fuller, D.A., & Roetenderg, J. (2014). Sensational kids: Hope and help for children with sensory processing disorder (SPD). Penguin Publishing Group.

Schoen S.A., Miller L.J., Brett-Green B.A., and Nielsen D.M. (2009). Physiological and behavioral differences in sensory processing: a comparison of children with autism spectrum disorder and sensory modulation disorder. Frontiers Integrated Neuroscience. 3, 29. https://doi.org/10.3389/neuro.07.029.2009

STARR Institute. (2020). Subtypes of SPD. https://www.spdstar.org/basic/subtypes-of-spd