Out of Sync Child- Sensory Modulation Disorder
Have you ever interacted with a client who strongly objects to certain textures, avoids being touched, or displays strong sensitivity to light or a reflection? What about a child with the opposite response? One who doesn’t acknowledge touch, sound or different stimuli? Or how about a client who craves sensory stimulation, like feeling a lot of pressure on the body, listening to loud noises, or enjoying bright lights? Responses such as these may be indicative of Sensory Modulation Disorder.
Written by Carol Stock Kranowitz, “The Out of Sync Child” explores sensory processing disorders (SPD), one of which is sensory modulation disorder. According to the book, SPD is “the inability to use information received through the senses in order to function smoothly in daily life.” Considered an umbrella term, SPD encompasses a variety of neurological disorders, including sensory modulation disorder. Sensory modulation disorder is the “problem of timing in the central nervous system” which can influence inhibitions; this can in turn impact one’s threshold for sensations which can cause overresponsivity, underresponsivity and sensory craving behavior.
Overresponsivity in a child with sensory modulation disorder is the result of hyperresponsive sensations coming from one or several systems. This can result in a child appearing irritated, annoyed, or threatened by particular sensory stimuli. A child with an overresponsive response to sensory stimuli may also be considered a sensory avoider due to the amount of sensory input the child takes in which can make the child avoid situations where sensory arousal may occur (ex: a light touch, his/her reflection, or a loud noise could make the child have a meltdown, become defiant, or even withdraw completely from the situation).
Underresponsivity in a child is a lack of ordinary arousal of sensory systems, which can result in a child responding less intensely to sensations than neurotypical children. A child with an underresponsive response to sensory stimuli may be referred to as a sensory disregarder because of difficulty achieving alertness or arousal in the presence of sensory stimuli. The child may appear withdrawn or may not even recognize sensory stimuli (ex: no response to loud noises, difficulty understanding nonverbal gestures, lack of hunger signals).
The sensory craving child needs far more stimuli than other children and may not recognize when they have had enough sensory stimulation. The child may be attracted, or even addicted to, stimuli such as bright lights, touching certain textures, listening to specific sounds, or places that are busy such as crowds. For a sensory craving child, wanting more and more sensory stimulation is normal and it may be a challenge for the child to know when enough is enough.
So, what does this mean for music therapists? It is important to recognize when, or if, we see sensory modulation disorder characteristics in our clients. It is likely that a child can be a combination of sensory modulation types. For example, a client may be underresponsive to a particular sensory stimulus, such as loud sounds, while being sensory craving for another stimulus, such as reflective surfaces. We can use this information to inform our decisions as music therapists in regards to improving a client’s sensory regulation and also allowing the child to have the most opportunities for success in achieving their goal. If a child craves tactile stimulation, perhaps allow the child to sit on a tactile spiky cushion or incorporate the cabasa while addressing a therapeutic goal. For a child who has difficulty regulating proprioceptive input, you could have client hold weights or heavy instruments during the session. For a child who has trouble regulating vestibular sense, you may consider incorporating movement through the session or allowing the child to be spun in a chair periodically to receive that sensory input. Perhaps a child is overresponsive to visual stimuli; this child may need lights to be dimmed or even turned off in the therapy space, and visual distractions may need to be hidden away as best as possible. If a child is overresponsive to loud noises, lower the dynamics of a song or instrument to encourage the child to continue participating while still providing music stimulus. It may also be necessary to sing a cappella without an accompanying instrument to further decrease the amount of auditory stimulation. (It is also important to note, though, that sometimes quiet in a music therapy session may be necessary to regulate the client if the auditory stimulation proves too overwhelming!)
If you’re interested in learning more about SPD or the neurological disorders that fall under SPD, feel free to read Out of Sync Child!
Katherine
