Sensory Processing - Is My Child on Time?

Sensory processing is a term that refers to the way the nervous system receives sensory messages and turns them into responses. These messages may include information on sight, sound, touch, taste, smell – the 5 senses we are all familiar with. In addition, we have two “hidden” senses that are not so familiar: proprioception (the ability to feel the amount of sensory input exerted from our muscles and joints) and vestibular (the ability to feel movement and balance) senses.

All children are unique, and there is a wide range of what is considered normal sensory development. It is important to remember that all of us experience sensory problems occasionally, and some of us experience them regularly. This does not mean that there is a problem. Isolated aversions and over-sensitivities can be developmentally appropriate depending on a child’s age, maturity and the context of the sensory input (time of day, location, intensity of the sensation, fatigue level of the child). It is only when these sensory difficulties are chronic and disrupts every day life that they warrant further evaluation. If sensory differences are chronically disrupting a child’s ability to play, engage in self-care skills, learn, participate with family/friends or develop appropriate social/emotional skills, then a referral to an Occupational Therapist trained in sensory processing disorders may be appropriate. Most typically developing children will present with some (or even many) of these “symptoms”. The key to determining if further assessment/intervention is needed is to establish if these sensory difficulties are chronic and disrupt the development of age appropriate motor, self-care, play or social/emotional skills.

Please review this checklist and talk to your child’s doctor about any concerns/questions you may have.  Also, feel free to contact SpeechPath Outpatient Clinic for any further information.  We look forward to working with you.

Toddler Checklist (12 months-3 years):

• Problems eating including gagging, food avoidance.
• Limited food choices/missing food groups impacting nutrition and age appropriate weight gain.
• Extreme separation anxiety.
• Resists dressing, seems uncomfortable in clothes. Has definite clothing texture  preferences. 
• Rarely plays with toys, especially those requiring dexterity.
• Difficulty shifting focus from one object/activity to another (more that age peers).
• Does not notice pain or is slow to respond when hurt.
• Resists cuddling, arches back away from the person holding him.                                    
• Has "floppy" body, bumps into things and has poor balance, often falls to the floor intentionally.
• Does little or no babbling, vocalizing.
• Is easily startled, over-reacts to being startled.
• Extremely active and is constantly moving body/limbs or runs endlessly without a  purpose.
• Delays in sitting, crawling, walking, running.
• Continues to mouth objects to explore them even after age two.                                                 
• Avoids messy play, over-reacts to face/hands/feet being dirty.
• Strong resistance to teeth brushing. May gag/cough when brush is in mouth.
• Strong aversion to hair brushing or haircuts, unable to calm even when held.                            
• Aversion to rain/wind against skin, unable to tolerate head getting wet.                                       
• Wanders aimlessly without purposeful play or exploration (over 15 months)                                     
• Needs adult guidance to play, difficulty playing independently (over 18 months)                                
• Participates in repetitive play for hours; i.e., lining up toys cars, blocks.
Pre-School Checklist (3-4 years):

• Difficulty being toilet trained (by age 4).                                                                    
• May appear terrified of falling even when there is no real risk of it.                                         
• Overly sensitive to stimulation, intense negative reactions to loud noises/crowds/concerts/parades.
• Unaware of being touched/bumped unless done with extreme force/intensity.
• Difficulty learning or avoids performing fine motor tasks such as using crayons/fasteners
• on clothing.
• Seems unsure how to move his/her body in space, is clumsy and awkward.
• Difficulty learning new motor tasks (catching, throwing, trike/bike riding).
• Get in everyone else's space and/or touches everything around him.
• Has difficulty making friends (overly aggressive or passive/ withdrawn).
• Is frequently intense, demanding or hard to calm and regularly has difficulty with
• transitions.
• Has temper tantrums that are unexpected/seem random or exaggerated (for age).                           
• May engage in self-injurious behaviors, bite/hit self, bang head.                                            
• Seems weak, slumps when sitting/standing; prefers sedentary activities. Avoids 
• playgrounds.                                               
• Fearful when feet are not touching the ground.                                                              
• Becomes fearful/panics when vision is occluded (when shirt goes over head while
• dressing).                     
• Reacts negatively to, or dislikes smells which do not usually bother, or get noticed, by
• other people.          
• Frequently engages in unusual play/repetitive non-purposeful play (spinning, waving
• toys).           
• Regularly has difficulty accepting changes in routine (to the point of tantrums).

School Age (5 years +):

• Overly sensitive to stimulation, overreacts to smells, sounds (fire
• alarms/crowds/assemblies/parades).
• Easily distracted in the classroom, often out of his/her seat, fidgety.
• Easily overwhelmed at the playground, during recess or class. Frequently cries or becomes aggressive.
• Slow to perform tasks (compared to age peers).
• Difficulty performing or avoids fine motor tasks such as coloring/handwriting/scissors/Leggos.
• Has exaggerated emotional responses to challenge/defeat. Poor self-calming skills.                              
• Appears clumsy and stumbles often, slouches in chair.
• Craves rough housing, tackling/wrestling games even at inappropriate times.
• Difficulties learning new motor tasks and prefers sedentary activities.
• Difficulty making friends (overly aggressive or passive/ withdrawn).
• “Gets stuck” on tasks and has difficulty changing to another task/does same task repeatedly .                   
• Has limited food preferences, gags/avoids food groups or food textures that impact nutrition and weight.        
• Plays with toys in odd ways, tends to focus on details other children don’t notice.

** If you have checked several of these skills, and you believe that these skills maybe disrupting your child’s ability to play, learn or acquire age appropriate skills,  it is highly recommended that you discuss your child’s development with your physician. When filling out this checklist, think about the child's behavior during the past six months.  To schedule a screening or  for further information, contact SpeechPath Outpatient Clinic.

Show me your ways, O LORD, teach me your paths.
Psalms 25:4