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Physical Therapy Guide to Sensory Processing Disorder

Sensory processing disorder, or SPD, describes when difficulties with noticing, making sense of, and/or reacting to information perceived from touch, taste, sight, smell, sound, movements, muscles and joints, and even the organs in our body interfere with daily tasks. SPD is often noticed in childhood but can affect people of all ages. SPD makes tasks, such as self-care, learning, playing, or working, hard to do. A person who has SPD may avoid some sensations altogether or may seek greater amounts of sensory information. This disorder affects up to 16% of the general population, but it is much more common in people with autism, ADHD (attention-deficit/hyperactivity disorder), and anxiety. Although many people with sensory processing disorder do not have autism, about 95% of people with autism experience difficulty processing sensory information. A person’s ability to move and act in the environment can also be affected by a sensory processing disorder. Physical therapists are qualified to analyze how a person processes and uses sensory information for movement. Physical therapists, working together with other experts, can help make it easier for a person to use sensory information successfully in daily life.

Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.

What Is Sensory Processing Disorder?

Sensory processing is a three-step process. It involves:

  1. Noticing sensory experiences (such as touch, movement, and sound).
  2. Making sense of them in the brain.
  3. Responding to them in a useful way.

Sensory processing disorder occurs when a person has a hard time with one or more of these steps. Some health professionals may refer to it as sensory integration disorder or, more simply, sensory challenges.

Sometimes a person with SPD notices a sensation, and their response is “just right.” Other times, they are bothered by a sensation, want more of it, or don’t notice it at all. Their responses may be different from one minute to the next and may vary depending on which senses are affected. SPD can cause a person to react in unusual or unexpected ways. This may make it hard for them to talk to or play with others, take care of themselves, pay attention, or move like others. People with SPD may have a hard time staying calm and relaxed. They may become frustrated easily or may demonstrate behaviors that make it hard to be around others. They may have difficulty learning. For some, SPD can make it very hard to go through each day.

SPD can affect anyone, including people who have:

How Does It Feel?

The body has many senses. There are also many ways a person can be affected by — and respond to — each sensation. It is very hard to describe exactly how a person with a sensory processing disorder feels. However, people with SPD may respond to various types of sensory information in similar ways. It is important to note that each person is unique and may experience one, many, or none of the following examples.

People with sensory processing disorder may be:

  • Bothered by sensations and their environment, such as:
    • Touching messy or sticky things.
    • Taking a bath, brushing their teeth, washing their hands, or getting hugs.
    • Experiencing lights, movement, or loud noises, which make it hard for them to concentrate.
    • Moving among others in areas of high activity, such as playing on a playground.
  • Picky about the foods they like or strongly dislike (“picky eaters”), like the smells, textures, or consistent presentation of certain foods.
  • Constantly seeking more sensation by:
    • Putting everything in their mouth (even things that are not food).
    • Touching everything.
    • Staring at things that spin, flap, flash, or move.
    • Moving constantly or being on the go. The more they move, the more out of control their body becomes.
  • Hanging on to, pushing up against, or hugging people or things often.
  • Missing important details around them, such as:
    • What people say to them, making it hard to follow directions.
    • The location of things in their room or in a bag, making it hard to find things.
    • Where things are in relation to themselves, which may cause them to break things or seem clumsy.
    • Pain or injury, not noticing when they get hurt.
  • Avoiding movement that is hard for them. They may:
    • Have a hard time following movements or imitating movements of others.
    • Find it difficult to hold their body upright and may lean or lay on things.
    • Become tired quickly.
    • Trip often and seem clumsy and lack coordination.

People who have sensory processing challenges also may experience:

  • Hyperactivity
  • Loose or stiff muscles
  • Difficulty with speaking or understanding language
  • Difficulty learning
  • Poor organization
  • Poor self-esteem
  • Poor emotional regulation

How Is It Diagnosed?

At present, SPD is not an official medical diagnosis. However, the term is used by therapists, physicians, and other health care providers to describe people with sensory differences that affect daily life. Some experts use the term “sensory processing challenges” rather than labeling the group of symptoms as a disorder.

While SPD can affect adults, it is often noticed and treated in childhood. Parents often seek the help of a physical therapist to address their child’s needs. A physical therapist treating a child for another condition (such as an injury, muscle tightness, or toe walking) may notice signs of the disorder.

Your physical therapist will perform a complete evaluation to assess you or your child. They will start by gathering information about you or your child’s health history. They may ask questions such as:

  • How long have you been noticing sensory differences or challenges?
  • How do these symptoms affect daily life for you, your child, or your family?
  • How do you or how does your child tolerate taste, touch, sight, sound, and movement? Do any of these bother you or your child? Do they constantly seek more sensation in any of these areas?
  • Does a busy sensory environment affect you or your child? Do they become overwhelmed, anxious, hyperactive, shut down, or feel the need to escape?
  • Do you or others describe yourself or your child as clumsy?
  • How do you or how does your child like the playground or amusement park? Do they like swings, slides, spinning toys, etc.?

Your physical therapist may ask you to complete a survey to help identify any sensory patterns you have noticed, including how much they affect your or your child’s daily activities and function. They also will conduct a physical exam. As part of their exam, they may ask you or your child to do activities that involve the senses. This may occur as part of a formal sensory or movement test, or a simple screening of sensory skills.

Some examples of test activities include:

  • Running, walking, jumping, climbing, and balancing
  • Playing games like “Simon Says”
  • Asking your child to move their hands, fingers, and mouth
  • Testing your child’s strength
  • Copying pictures, looking for hidden pictures
  • Playing with different textures
 

How Can a Physical Therapist Help?

Treatment for sensory processing disorder aims to improve a person’s ability to use sensory information effectively so they can live, work, and play with satisfaction and enjoyment. Physical therapists can help people with sensory processing disorder better understand their sensory differences and how to modify the environment or the task to reduce overload or interact more effectively. They also help people use their senses to move more efficiently, with better control and coordination.

Your physical therapist will partner with you, your caregivers, and the other professionals on your child’s school and health care team to understand their daily challenges and related concerns. Occupational therapists, for example, are often part of the treatment team. The physical therapist will offer many different sensory experiences and will guide you or your child through activities that are designed to build sensory processing skills to address specific needs, challenges, and goals. They will work with you or your child to help them:

  • Use their senses in ways that can help them feel calm and comfortable.
  • Move with better control and coordination.
  • Identify specific ways to make it easier to use their senses to learn, play, and work, like modifying their environment (or surroundings).
  • Improve function and behaviors by addressing sensory issues and working directly with the senses.
  • Improve the brain’s ability to process and organize sensory information.

Physical therapy strategies to improve sensory-based movement and function may be provided in home, school, or clinic settings.

There are a variety of treatment methods used for SPD with varying degrees of effectiveness. It’s a good idea to ask your therapist about their level of training and treatment approach for SPD so you can understand your options and get the best care for your child’s needs.

For young children, physical therapy looks and feels like play. The physical therapist will first build trust with your child. Then, they will offer activities designed to gradually increase your child’s skills in affected sensory areas. You and your child will take part in planning and doing these activities. This will include various sensory experiences guided by the physical therapist to help build sensory awareness and processing skills.

For older children and adults, the physical therapist may use teaching strategies to help them understand how the brain processes sensory information. They will then build on that knowledge to help practice tasks that challenge them or make them feel uncomfortable or unfocused, to help improve sensory processing. Helping to choose and doing these activities may help improve how individuals with SPD take in, process, and react to sensory experiences.

Your physical therapy program may include:

Patient and family education. Your physical therapist will help you and your child understand their areas of sensory strength (what works) and sensory challenges (what makes life harder). With this information, you can use the areas of strength to help improve and support the areas of challenge.

Direct interventions. Your physical therapist will work with your child to explore different sensory experiences. They will use age-appropriate games and activities, including daily functional tasks. Equipment and activities may include:

  • Swings, slides, zip lines
  • Climbing activities
  • Therapy balls
  • Weighted or heavy work (pushing, pulling, lifting, carrying, hanging)
  • Toys with different shapes, sizes, and textures

For teens and young adults, physical therapy involves fewer play-based activities and more activities around school, work, hobbies, leisure/fitness, or self-care.

Motor planning and movement. Your physical therapist can help your child generate ideas about ways they can move and practice different sensory experiences. They may use fun activities, such as obstacle courses or games, to help your child improve their ability to control and time their movements. They also will work with your child to improve their coordination (moving more than one part of their body at a time). The body uses movement to create sensory information, and it uses sensory information to create movement. Movement can both calm or excite our body and activity when used effectively.

Balance and strengthening. Your child’s physical therapist can use movement activities to help your child build strength and improve their balance. This helps them use their senses in a way that makes it easier to hold their body upright and move in a coordinated way.

Can This Injury or Condition Be Prevented?

The exact cause of sensory processing disorder is unknown, and there is currently no way to prevent it. However, identifying the cluster of symptoms and behaviors associated with SPD early can help children and families learn how to manage it and prepare them for other challenges that may come with various life stages and new experiences.

Treatment aims to improve a person’s ability to use sensory information effectively so they can live, work, and play with satisfaction and enjoyment. As the demands and stages of life change, SPD may “look” different. Increased sensory challenges often happen during times of change or stress. For example, a child who is treated for sensory processing disorder may show new or returning symptoms during their teen years, after the birth of a sibling, or when moving to a new home or school.

With the help of a physical therapist, people with SPD may learn how to:

  • Recognize the early signs of impaired sensory processing.
  • Use the specific strategies they’ve practiced to respond more appropriately.

Physical therapists can teach children and their caregivers how to anticipate challenging situations ahead of time so they can prepare their body and senses, leading to a better ability to handle their environment.

What Kind of Physical Therapist Do I Need?

All physical therapists are trained through education and experience to evaluate, manage, and treat various symptoms and conditions. You may want to consider seeing a physical therapist who is:

  • Experienced in treating children with sensory processing challenges or people with autism.
  • A board-certified clinical specialist in pediatric physical therapy or a physical therapist who has completed a residency or fellowship in pediatrics. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.
  • Working in a facility that focuses on pediatrics and sensory-based interventions.

You can find physical therapists in your area with these credentials and clinical expertise through Find a PT, a tool built by the American Physical Therapy Association.

General tips when you’re looking for a physical therapist (or any other health care provider):

  • Get recommendations from family, friends, or other health care providers.
  • Ask about the PT’s experience treating people with sensory processing disorder before you make an appointment.
  • Be prepared to describe your child’s symptoms in as much detail as possible. Make a note of what makes your child’s symptoms worse or better.

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