For many of us, large department stores like Macy’s can lead to sensory overload. We walk in and are assaulted by bright lights, crowds, noisy customers, colors everywhere, and the smell of very strong perfume. For me, personally, I know that if I stay too long I can begin to feel trapped, frustrated, or overwhelmed. You might also feel this way when trying to find the dairy section in a newly reorganized supermarket, or during the honking of rush hour traffic.
This may happen only occasionally, and you may be able to recuperate quickly. But for some, sensory stimulation in the environment is completely disabling on a regular basis. Sensory overload can cause emotional and behavioral difficulties such as physical and verbal aggression, frustration, agitation, inattention, and moodiness. And when it comes to younger clients and patients, this effect is often overlooked.
As a therapist, I work with children who exhibit extreme forms of physical and verbal aggression. I have seen firsthand the ways that sensory overload affect behavior. Although practitioners tend to consider sensory processing challenges most when it comes to kids with autism spectrum disorders, kids with ADDH, depression, anxiety, oppositional defiant disorder, and even some psychotic disorders should also be evaluated for sensory issues.
Indeed, clinicians may not always realize that a child or teen who exhibits aggression, agitation, or moodiness is being triggered by their immediate environment. And so, Lindsay Biel, a New York–based occupational therapist, has written Sensory Processing Challenges: Effective Clinical Work with Kids & Teens. The book aims to alert professionals who work with children and teens to the importance of considering sensory processing issues when trying to diagnose and treat this population.
In the first few chapters, Biel makes it clear just how important our sensory system is: It helps us cope with and respond appropriately to our environment. A child who is overwhelmed by too much sensory stimulation could easily become frustrated during a school play, for example, or even by recess. To onlookers, the child might appear oppositional and noncompliant. But the truth is that the child’s sensory system is overstimulated.
Biel does a great job describing the experience of children who are overstimulated — as well as under-stimulated. She described what it might be like for a kid who has “mixed reactivity.” For example, a boy may react very strongly to the process of picking out what to wear to school, but then get to school and have a great day. For many parents and even professionals, it can be easy to attribute this mixed reactivity to mood changes: The child felt one way in the morning and a different way in the afternoon. But in many cases, the real culprit is sensory processing.
“A person’s sensory system is much like an orchestra,” Biel writes. “When sensory input comes in too loudly or too quietly or gets out of sync, arousal levels, emotions, and behavior get out of whack.”
For many kids, when their system gets “out of whack,” they shut down. They might have tantrums in grocery stores, doctor’s offices, or other places where such behavior is inappropriate. Rather than assume there’s been a mood swing of some sort, it is very important to think about what sensory issue might be triggering this behavior. Perhaps the child is under-stimulated and feels bored or trapped. Or perhaps the child is overstimulated and feels overwhelmed by the noise, the sights, or the smells.
This is a fantastic book for mental health professionals, physicians, and occupational therapists working with challenging kids and teens. Biel explains how our sensory system can signal that there’s a problem and describes clinical strategies for practitioners to incorporate. Although the book is part of a Norton series aimed at a professional audience, Biel also highlights how parents can become more knowledgeable about their child’s needs, as well as how they can work more effectively with those professionals. As a clinician myself, her work has already informed my practice.
Sensory Processing Challenges: Effective Clinical Work with Kids & Teens
W. W. Norton & Company, February 2014
Hardcover, 296 pages