Sensory Processing Disorder: It’s Not… Something You Outgrow

by Mim Ochsenbein, MSW, OTR/L

The “Terrible-Twos”. Separation anxiety. Night terrors. These conditions are closely associated with childhood. They can cause misery to child, caregiver and family alike. They bring distress, angst, loss of sleep, and unfortunately, sometimes the need for professional intervention. What these childhood conditions generally share as a group is the tendency for people to “outgrow” them as they age. In general, we view “childhood conditions” as just that – issues we need only worry about with children. Sensory Processing Disorder (SPD) is also a condition most commonly associated with children. But is that accurate? Do children grow out of SPD, like the childhood conditions listed above?

SPD is not an “acquired” condition – meaning that a person does not suddenly develop SPD as the result of illness or injury. SPD is there from very early in life (potentially in-utero), and if it goes unchecked, can create a whole host of issues. For example, children with SPD often present with significant feeding issues that can impact their growth, physical health, bowel and bladder functions, and even brain development. We also know that sensory problems in childhood are correlated with an array of childhood psychiatric symptoms (e.g. anxiety, ADHD, ASD) and difficulties with social-emotional and behavioral functioning (Miller, Neilsen, Schoen, & Brett-Green, 2009). But what every parent wants to know is, “Will my child just outgrow this?” Unfortunately, the answer – like the condition itself – is complex. We simply do not have evidence that children can “outgrow” SPD if it is left untreated. In fact, there is evidence to the contrary. Research has shown a strong correlation between SPD symptoms in childhood and adulthood (Rosenthal, M.Z., 2013). But what does that mean, exactly? If SPD is left unchecked, without intervention, what can that look like in an adult?

One of the areas hit hardest by SPD is emotional functioning. It is often the driving force behind a family seeking help. Chronic emotional dysregulation in a child can impact daily functioning, social-emotional development, school performance, and family quality-of-life. The impact of SPD on emotional functioning has long been understood (Amthauer, Miller, Brett-Green, Coll, Schoen, 2004). Social and emotional responses rely heavily on the brain’s ability to make sense of sensory information. Inaccurate information from processing deficits results in aversive emotional reactions from which maladaptive behaviors grow. A person’s behaviors, and other people’s reactions to those behaviors, influence an individual’s sense of self (Rosenthal, M.Z., presentation, 2013). For a child, this may mean feeling out of control, “different”, or unable to trust themselves. These feelings may further develop into signs of anxiety or depression. For adults, the picture does not improve. There is evidence that links some mental health disorders with sensory over-responsivity (SOR), a subtype of SPD. Reports of significant SOR in childhood has been associated with adulthood depressive symptoms, anxiety symptoms, negative emotions, poor self-concept, neuroticism, and inattention. Adulthood SOR has been linked to higher incidences of depressive symptoms, anxiety disorders, introversion, negative emotions and poor self-concept (Rosenthal, M.Z., 2013; Kinnealey & Fuiek, 1999).

So, is that it, then? A diagnosis of SPD translates to an adulthood of social-emotional strife? No, of course not. Many factors go into both a child’s and an adult’s ability to improve and manage their SPD and the impact it has on their life. Some factors are obvious: a safe and supportive home life, proper nutrition, adequate sleep, early identification, and appropriate intervention. Others are harder to pin down: temperament (the hard-wired part of personality), genetic disposition, intrinsic motivation, and relationships with others are just a few of the “it” factors that impact how SPD presents itself and the effect it has on life as a person ages. And even though research in the field continues to grow and uncover some of the many mysteries of SPD, researchers have not yet discovered “secret sauce” – how to predict what exact constellation of interventions are needed at key moments in development. What we do know is that not addressing SPD and the problems associated with it can have significant negative outcomes.

As it stands today, many more resources are available to young children with SPD and their families than to adolescents and adults with SPD. The vast majority of sensory-trained clinicians are pediatric-based (usually that means 0-12 years). Services are most accessible through sensory trained Occupational Therapists (OTs) providing early intervention and school-based therapies. The field narrows considerably once a child ages out of these options, but narrow does not mean non-existent.

There is a growing number of sensory-trained therapists specializing in the adolescent and adult populations, and their unique set of needs. Exploration and use of sensory equipment is still common with these older populations. But instead of the focus being on play themes, imagination and games as it is with children, OTs put more focus on the adolescent and adult client actively engaging at a more cognitive level, with attention to understanding what SPD is, and bringing a client’s attention to what and how different sensory experiences affect them emotionally and physiologically. Biological markers such as heart rate, breathing patterns, and muscle tension are used to help a client become aware of how their system processes certain sensory-based experiences. Older clients work on recognizing their own sensory constellation, what is comforting, and what is dysregulating. Then, with an OTs guidance, they apply this knowledge to their own real-world occupations by developing plans and strategies for support implementation, compensations, and regulating sensory experiences. Treatment may occur weekly or on a consultative basis depending on the needs of the client. Although the current number of adolescent and adult sensory specialists is far lower than those of their pediatric-focused colleagues, the number is steadily increasing as awareness of the unique needs and presentations of adolescent and adult populations grows. And OTs are not alone. More and more mental health providers are recognizing the connection between SPD and emotional well-being and are seeking out training and consultation from sensory-based OTs.

Laughter. Contentment. Hope. Joy. These conditions are not closely associated with a particular age or developmental stage, but instead with an individual empowered through understanding and addressing their SPD.

If you are looking for SPD treatment for yourself or your child fill out a child or adult intake form now to be treated at STAR Institute Treatment Center or search our Treatment Directory to find services in your area.

MimMim Ochsenbein, MSW, OTR/L has been a practicing pediatric occupational therapist for over 20 years. She has received advanced training in sensory processing (STAR Institute Intensive Mentorships, SIPT certification), listening therapy (Therapeutic Listening), feeding therapy (SOS) and infant massage (CIMI). Mim received her MSW in 2012. Her work with children and youth has occurred in a variety of settings including early intervention, school based, clinic based, mental health and private practice. In her role as STAR Insitute’s Director of Education, Mim creates and teaches STAR Institute trainings, oversees SPD University, and provides educational programming and resources for clients and families.