Sensory processing is the term we use to describe how our central nervous system manages sensory information.

We receive sensory information constantly from our bodies and from our environment. Our brains must be able to organise this information effectively to allow us to function successfully in our day-to-day lives. This makes sensory integration a vital part of our nervous system functioning.

Sensory integration, sensory discrimination, and sensory modulation are all a part of sensory processing. Sometimes the central nervous system is unable to manage sensory information effectively to the point of delaying foundational skills and interfering with an individual’s daily life.

When we talk about ‘sensory integration’ we are referring to the information we receive from our five ‘main’ senses – touch, sight, hearing, taste, and smell as well as three other ‘internal senses’ known as proprioception, our sense of body awareness, vestibular, our sense of movement and balance, and interoception, our sense of knowing what’s happening inside.

Everyday, our senses help us to:

• Monitor the environment
• Process information to enable us to plan actions
• Direct our movements
• Receive and process feedback about our actions/movements 

What do sensory processing difficulties look like?

Though there are common clusters of symptoms, there is no universal “sensory processing difficulty experience.” Symptoms exist on a sort of spectrum, varying greatly in type and severity across people of all genders, ages, and races.

Sensory processing can be broken down into three different components: discrimination problems, modulation problems, and praxis problems. Each of our seven sensory systems has both a modulation and a discrimination component, which in turn impact our praxis skills in different ways. Sensory Processing Disorder may affect only one sense, but just as often will affect two or more, or even all seven, possibly in different ways.

• Sensory modulation is our ability to take in sensory information, decide what is relevant, and to make an appropriate behavioural response.
• Sensory discrimination allows us to understand the specific qualities of sensory information. For example, the texture of an object or the direction of a sound.
• Praxis, in the context of sensory integration, is the ability to conceptualise, plan, organise and sequence the steps of a motor task to adaptively meet environmental demands.

One person, for example, may only have visual discrimination problems, while another person may have the same problem in addition to auditory modulation difficulties. Yet another person may have praxis difficulties because of visual processing problems but may not otherwise have significant visual discrimination or modulation problems. Sensory processing difficulties often, but not always, exists with other diagnoses that present with sensory related problems, such as attention deficit/attention deficit hyperactivity disorder, autism, and various learning disabilities.

Our Sensory Systems:

Touch (tactile)

Our sense of touch, called the tactile system, gives us information such as the shape, size, and texture of objects, which helps us better understand our environment and enable our recognition of how to manipulate objects. It is also vital to the development of body schema and emotional regulation.

Visual

Our sense of sight, the visual system, is critical to identifying and interpreting shapes, colours, symbols, body language, and more. In turn, our interpretations of these visual cues guide our movements and social interactions.

Hear (auditory)

Our hearing, or auditory system, allows us identify the quality and direction of sounds. It allows us, for example, to recognise without looking that a person is talking, who that person is, who they are talking to, and how far away they are.

Taste & smell (gustatory & olfactory)

Taste and smell, the gustatory and olfactory systems, work together to allow us to enjoy good and safe food while making us react negatively to unpleasant or dangerous sensations.

Joint position, movement & action (proprioceptive) 

The proprioceptive system is our sense of body awareness. It takes the information we receive from our muscles and joints to help us identify our body’s position in relation to itself and other objects.

Balance & coordination (vestibular)

Located in our inner ear is the vestibular system, our sense of movement and balance. This system tells us about the position of our head in relation to gravity, and the speed and direction of movement.

Internal signals of physical & emotional states (interoception)

Interoception, the eighth sense, allows our body to perceive its internal state and helps to control the way that we feel. Through this sense, we identify our emotions and bodily sensations, including hunger and feeling cold, and be motivated to seek out comfort in a timely manner.

Sensory sensitivities

A high percentage of people with a diagnosis of Autism experience differences in their sensory processing. 

This can result in challenges (e.g. difficulties coping in busy environments) and also, advantages, (e.g. heightened focus on senses useful for musicians, surgeons, sound engineers etc.) and/or pleasure (e.g. greater enjoyment from fairground rides/lights/music). 

These differences may include being over (hyper) sensitive, or under (hypo) sensitive in any, or all of their senses.

Sensory hypersensitivity means a person may receive or pick up more sensory information, compared to most people. This may result in a person responding to sensory information differently (e.g. covering ears when others may not).

Sensory hyposensitivity means a person may not receive or pick up less sensory information, compared to most people. This may mean a person responds to sensory information differently, or may not respond at all (e.g. not noticing a smell others comment on).

A traffic warden directs the traffic, like our brain detects sensory information.

If the pieces of information (vehicles) flow in an organised way, the brain uses them for smooth actions and helpful behaviours. 

If the volume or the flow of the information is not organised, chaos prevails and life feels like a traffic jam during rush hour.

We all have unique sensory experiences 

Just because someone is hypersensitive to one sense, does not mean they will be hypersensitive to everything, although this is possible.

Some people may experience some hyper and some hyposensitivity's and some senses may not be different at all.

When these sensitivities are experienced, it can impact physical and emotional state.

For example – if hypersensitive to sound and a loud noise (e.g. siren) is heard this may trigger symptoms of anxiety, and for some people cause physical pain.

Sensory hypersensitivity examples:

• Appear to be in own world
• Talkative – make noises (e.g. hum, whistle)
• Enjoy loud music & repetitive sounds
• High pain threshold / under responsive to pain
• Judging personal space
• Enjoy tight hugs
• Enjoy strong flavours (may limit diet)
• Seek out things to chew
• Like to brush teeth
• Focus on details and patterns
• Distracted by bright colours / lights
• Tire easily when reading
• Enjoy strong smells / Use lots of perfume
• Lick things to get a better sense of what they are
• Not notice body odour

How our sensory experiences affect our behaviour:

Hyper sensory sensitivities can lead to sensory overload (when one or more of the body's senses experiences over-stimulation from the environment) resulting in distress/meltdown. 

Under sensitivity can lead to sensory seeking, this is someone who can’t get enough of sensation, for example seeking out strong flavours.

A mixture of the two can result in avoiding and seeking sensations and difficulties managing emotions, including levels of anxiety.

Signs of difficulties with interoception:

• Feeling sick all the time or never reporting or presenting with signs of illness
• Overeating or only eating when prompted to do so
• Drinking all the time or only when prompted to do so
• Episodes of incontinence
• Not noticing when feeling hot or cold
• Difficulties noticing different emotions and/or becoming overwhelmed by them

If someone does not recognise the signals for an emotion, they are not able to respond to it. This can result in anger becoming rage, sadness becoming distress and so on.

When experiencing mental health difficulties and/or overwhelm with life, interoceptive accuracy can decreases significantly. 

This may affect the ability to self-regulate and self-manage. Self-regulating is the ability to manage emotions and feelings. Self-management is the ability to respond helpfully to biological needs such as hunger and thirst.

Sleep and interoception

• Difficulty getting to sleep – having irregular sleep patterns
• High levels of stress and anxiety can underlie sleep difficulties. 
• Increasing awareness of your internal body signals can lead to better sleep
• Being more aware of internal signals helps to calm body and mind

Mindfulness and interoception

Mindfulness meditation can be helpful to develop interoceptive awareness 

Mindfulness is a type of meditation in which you focus on being aware of what you're sensing and feeling in the moment

Practicing mindfulness can be done using a variety of methods, such as breathing exercises and simple yoga stretches.

Some Mindfulness techniques can be added into daily activities you enjoy such as connecting with nature on a walk, whilst eating or having a shower

There are lots of Mindful walking podcasts online here is a link to some examples: https://www.bupa.co.uk/newsroom/ourviews/mindful-walking-meditation

Mindfulness is a type of meditation in which you focus on being aware of what you're sensing and feeling in the moment.

It gives the person time to focus on their body and emotional state and can help to develop awareness

Practicing mindfulness may involve breathing methods, such as breathing exercises or simple yoga stretches.

With yoga you can focus you can not only focus on your body, but you are also providing good proprioceptive and vestibular input. This practice encourages you to look internally and focus on how the body and mind if feeling. 

Breathing exercises are calming and also help a persons to pay attention to what is going on inside their bodies.

Some Mindfulness techniques can be added into daily activities – this is where you focus on the sensory experience of the activity, rather than paying attention to your thoughts. 

Activities could include anything, such as connecting with nature on a walk, eating or having a shower. Taking a shower as an example, here you might focus on the sound, feel and temperature of the water, the smell of your soap/shampoo etc.

• Brain studies reveal the interoceptive centre in the brain, is strongly activated during meditation. 
• Those who participate in regular meditation have been found to have better functioning in this region. 
• Interoceptive awareness difficulties have been linked with autism, ADHD, depression, and anxiety.
• This practice can also help with improving sleep
• Regular practice can help you to relax and re- energise.

A high percentage of people with a diagnosis of Autism experience differences in their sensory processing. 

This can result in challenges (e.g. difficulties coping in busy environments) and also, advantages, (e.g. heightened focus on senses useful for musicians, surgeons, sound engineers etc.) and/or pleasure (e.g. greater enjoyment from fairground rides/lights/music). 

These differences may include being over (hyper) sensitive, or under (hypo) sensitive in any, or all of their senses.

Sensory hypersensitivity means a person may receive or pick up more sensory information, compared to most people. This may result in a person responding to sensory information differently (e.g. covering ears when others may not).

Sensory hyposensitivity means a person may not receive or pick up less sensory information, compared to most people. This may mean a person responds to sensory information differently, or may not respond at all (e.g. not noticing a smell others comment on).

A traffic warden directs the traffic, like our brain detects sensory information.

If the pieces of information (vehicles) flow in an organised way, the brain uses them for smooth actions and helpful behaviours. 

If the volume or the flow of the information is not organised, chaos prevails and life feels like a traffic jam during rush hour.

We all have unique sensory experiences 

Just because someone is hypersensitive to one sense, does not mean they will be hypersensitive to everything, although this is possible.

Some people may experience some hyper and some hyposensitivity's and some senses may not be different at all.

When these sensitivities are experienced, it can impact physical and emotional state.

For example – if hypersensitive to sound and a loud noise (e.g. siren) is heard this may trigger symptoms of anxiety, and for some people cause physical pain.

Sensory hypersensitivity examples:

• Appear to be in own world
• Talkative – make noises (e.g. hum, whistle)
• Enjoy loud music & repetitive sounds
• High pain threshold / under responsive to pain
• Judging personal space
• Enjoy tight hugs
• Enjoy strong flavours (may limit diet)
• Seek out things to chew
• Like to brush teeth
• Focus on details and patterns
• Distracted by bright colours / lights
• Tire easily when reading
• Enjoy strong smells / Use lots of perfume
• Lick things to get a better sense of what they are
• Not notice body odour

How our sensory experiences affect our behaviour:

Hyper sensory sensitivities can lead to sensory overload (when one or more of the body's senses experiences over-stimulation from the environment) resulting in distress/meltdown. 

Under sensitivity can lead to sensory seeking, this is someone who can’t get enough of sensation, for example seeking out strong flavours.

A mixture of the two can result in avoiding and seeking sensations and difficulties managing emotions, including levels of anxiety.

The Sensory Ladder is a visual tool that can help a person to better understand and increase self-awareness of how their senses can affect their mood and behaviour.

It can help a person to understand their mood and behaviour in a different way. The ladder can help to improve self-awareness so that strategies can be put in place to better manage (regulate) emotions and to change unwanted behaviours.

For example Someone who finds the (sensory) environment of a bus too noisy and too bright might become overwhelmed in this situation and that leads them to feel anxious (mood), this may result in avoidance of this situation (behaviour).

Once the person understands this, then sensory strategies can be developed to enable the person to better manage the unpleasant sensory input, thereby reducing their anxiety so they can travel on the bus.

It can be difficult to be able to place yourself on the ladder but the more you practice, the more in tune you’ll become with your state of arousal, and the more easily you’ll be able to respond to what your body needs. 

It’s a continuum, so you can fall anywhere along the ladder. For example, you might be in the green, just-right arousal state, but are you in the middle, or closer to the edge of the yellow or the blue.

You can make a sensory ladder your own and they can be helpful for anyone of any age and any ability. They can help a person to understand themselves better as well as developing a shared understanding with other people.

You can add your own language, think about how you feel and/or behaviour at the different stages of the ladder.

They preferred to add numbers to ‘measure’ their alertness levels & Pokémon characters to represent how they feel. You can be as creative as you like this with. We have seen all kinds of creative sensory ladders!

The use of the ladder can be a part of developing awareness of how you are feeling, which in turn can help a person to be able to apply sensory strategies to manage their emotions. 

Practical examples to help you move through the levels:

The good news is that we can use our senses to boost our arousal if its low, or lower our arousal if its high, and bring ourselves closer to that just-right state

Here are some examples:

Vestibular movement, such as swinging or rocking, has a positive effect on an overactive brain. For instance, if you swing back and forth, your sensory nervous system perceives and integrates motion, which has a normalizing and calming effect on the brain.

After a long, exhausting day, having a calm place to, hang out, and relax is important. 

Have some soft cushions or a large beanbag chair you can sit in. 

Add a lava lamp or some fibre-optic lights for soft, soothing lighting. 

A heavy/weighted blanket on your chest may also have a calming effect.

Games which include hand/eye co-ordination can help you focus and enhance organisational skills. Switching hands is important too, ping-pong is a great game to enhance focus especially!

Create a “sensory box” – include items which you can use to help organise your neural pathways so you can improve your ability to focus such as rubber ball, lightweight lap-pad anything that you can manipulate, touch, fidget with etc. 

Entertain the mouth! The mouth works as an amazing organiser for dealing with sensory input. 

If you are feeling under alert have a crunchy snack that exercises the jaw muscles. 

Celery sticks, apple slices, or an ice pop work well. Sipping drink through a straw etc.

Daily sensory input

Daily life is also filled with sensory opportunities, and sometime these can be helpful to be added into daily routines. Getting the right amount of input can be tricky. Small adjustments can make a big difference to a persons day, like having the right toothbrush, the towel that doesn’t feel scratchy, or the right lighting in the bedroom.

Sensory experiences are integral to what makes good and bad days.

Sensory lifestyle

Developing what we call a ‘sensory lifestyle’ in order to try to get the right amount of sensory input can make a huge difference to how you feel and what you are able to get done.

This means using strategies throughout the day to help your

• Brain to stay organised
• Regulate your emotions                          
• Motivate yourself into action
• To stay focused

Sound familiar? This is the calm and alert section of the sensory ladder, where we all need to be to be able to do the things we want or need to do.

A sensory lifestyle can also help to address hyper/hypo sensitivities

Explore your sensory preferences 

By identifying your sensory preferences, it can help you to identify some strategies to help you to manage how you feel  (to move up and down the sensory ladder).

Visual

Do you like things that lights up, like computer games, watching YouTube videos or fibre optic lights; looking at photographs, artwork or rain showers? If so, how do they affect how you feel and behave?

Do you prefer dim lighting, wearing sunglasses, or having the curtains closed to block light out? How do these impact of how you feel and what you are able to do?

Audio

What sounds do you like listening to? Are they sounds that you can make or ones that you can hear via technology or other?

Touch/texture

Making some adjustments to your environment to suit your sensory needs, can help you to feel calmer and/or more motivated, depending on your needs at the time. , for tactile input having lots of fluffy cushions, soft blankets and/or heavy blankets might be helpful.

Smell

The addition of smells can calm and/or alert, using something like a diffuser with different essential oils is an option.

Sensory input and mental health

You can also use sensory strategies as crisis management tools. 

• If you feel irritable, angry or anxious – try using a calming strategy, such as slow deep breathing whilst holding a preferred texture and/or listening to calming sounds (practice regularly). 
• Develop a sensory box
• Include calming and alerting items, such as weighted lap-pad anything that you can manipulate, touch, fidget with, or look at (e.g. lights, snow globes, ooze tubes), smell or taste or chew etc.

Going out - have a ‘travel kit’

Always have items in your coat/bag for when you leave the house. If you are going away you can have a miniature, more travel-friendly version already made up.

If you travel by car, then you could have things in the glove box. Think about what music you may want to listen to, or not and whether an air freshener might be beneficial, or not. 

Who is travelling with you? Do they understand your sensory needs? If not then it can important to help them to understand how small adjustments can make a big difference to you.

Being prepared can also help to reduce anxiety.

Ways to manage supermarkets and streets

• Writing a shopping list which means greater efficiency, less time taken in the shop and less opportunity for anxiety to take hold.                                                                                            If you know the shop well, write it in order of the aisles.
• Noise cancelling earplugs/headphones to negotiate the noise 
• Listen to music or a podcast may help some to maintain focus 
• Go at quieter/less busy times [early, late, weekdays]
• Keep an eye out for sensory friendly times in supermarkets
• The sunflower lanyard can be helpful for some people: https://hiddendisabilitiesstore.com/shop/sunflower-lanyards.html

Ear Plugs

https://www.flareaudio.com/

https://www.flareaudio.com/products/calmer

Shared spaces

•       Separate bedrooms so both people can sleep/relax at night. This means the person with sensory differences can tailor the environment to their needs, such as using a weighted blanket, painting the walls to their liking, listen to particular sounds/music, or be in silence etc.

•       It may be helpful to replace the intimacy of sharing a bed with other activities, such as walking, art classes, wash or shower together etc. It does not need to be the end of your sex life.

•       Some people may divide some of the house, so some is partly shared and other sections are for one partner only.

•       Creation of visual timetables developed by both partners can also help to reduce anxiety and friction, especially if routine is helpful for the person.

Shared spaces with others

• Some of the previous suggestions can also be applied to any form of living together, whether romantic, family or otherwise.
• Division of the home may still apply.
• Creation of visual timetables can also be greatly beneficial. It is also very important to discuss and advise of changes as soon as you are aware of them.
• It can be helpful to have open conversations to understand the needs of everyone within the home, so adjustments are beneficial.

 

What can help?

You can be consulted by your Occupational Therapist to find what sensory activities work for you.

The overall goals of sensory informed practice are to meet the sensory needs of an individual by preventing sensory overload, supporting self-regulation and helping to have an organized response to sensory stimuli.

Choosing which sensory activities are right will require consideration of your lifestyle. The steps include analysis and identification, strategising, applying strategies and monitoring effectiveness to ensure individual needs are being met