This guest blog was graciously provided by my colleague Lori Howell. Lori has been working as an Occupational Therapist in paediatrics for 21 years. She has treated children in various settings such as schools, homes, daycares and a paediatric treatment centre. She has been working in full-time private paediatric practice for the past five years. Lori earned her sensory integration certification through the University of Southern California and WPS in 2015. She treats children and babies with developmental delays, feeding issues, fine motor delays and sensory processing issues.
I am often asked whether there is a link between sensory processing difficulties and anxiety. The answer is a resounding YES!
From a clinical perspective, I very often see children who experience problems in these two areas at the same time. The biggest question is why do these issues often occur together? Anxiety and sensory processing difficulties are very closely related as they both create physical changes in the body and both are mediated by the nervous system.
What is Sensory Processing Anyways?
Our primary sensors such as the eyes, ears, mouth, nose, hands, muscle, joints and tendons pick up sensory information. This is all of the stuff we take in from our environment that tells us about the world around us. This information is directed primarily to a part of the brain called the thalamus, a brain structure that routes information along different pathways depending on where it needs to go. The thalamus takes the incoming raw information and sends it to areas of the brain that make sense of it. For example, the raw images our eyes produce don’t in fact look anything like what we actually see. The images on the retina (the part of the eye that is like a movie screen) are in fact upside-down, have a big black hole in the middle, and of course there are two of them since we have two eyes. Yet what we see is right-side up, seamless, and integrated. This is because the raw information is all put together and processed into one nice image. This is sensory processing.
Once the incoming information has been correctly processed, the brain can organize and create a physical response based on that information. This includes big movements like riding a bike or running around the block, or very small movements like directing the muscles of our eyes to track the words when reading or maintaining our head in the correct orientation while running.
Sensory issues can take several forms and can often be misinterpreted as misbehaviour or laziness. If there are issues with the actual processing, then what for most of us is harmless (e.g. the sound of a pencil on paper) can become a really disturbing experience for some. Visual stimuli like bright lights can also become very overwhelming if the processing of the raw images is exaggerated or disturbed in some way.
Another issue is filtering. Picture for a moment, a busy shopping mall on a Saturday afternoon. Simultaneously, our nervous system must process loud noises, bright lights, and various movement experiences (e.g. dodging other people) as we navigate our way to a particular store, all while focusing on fulfilling our shopping list before the mall closes. Typically, the nervous system becomes very good at filtering the sensory experiences that are unimportant to reaching our goal. Loud noises are filtered out so that we can carry on a conversation with our friend and the commotion of others moving in and out of stores is filtered so that we can target open areas in the process of getting from point A to point B. However, many children and adults have disorganized nervous systems that cannot smoothly filter the incoming information from their senses. Because of this disorganization, the brain can quickly become overwhelmed with sensory information.
Connection to Anxiety
It might be starting to become clear why a child could feel anxious if sensory processing issues, which make regular experiences very harsh, are present and/or the child is unable to filter unimportant sensory input that is experienced on a daily basis while attending school. These children often feel overwhelmed by touch input that comes from their clothing, unpredictable loud noises such as the school bell or announcements over the intercom, movement experiences such as climbing playground equipment with peers, and strong odours during lunch time that interfere with their ability to eat familiar foods.
When this happens, the most primitive part of the brain becomes active and can create a fight, flight or freeze response to certain types of sensory input. This puts the child in a defensive mode and takes them out of a state of mind conducive to learning. Some children become more active and need to move around to dissipate this flight response whereas other children shut down and become very sleepy in response to an overstimulating environment.
It is important to identify your child’s anxiety-inducing sensory systems (e.g. sounds vs. odours, bright lights vs. big movements) and determine the most common times that anxious responses are most likely to occur. Some children can start to develop anxiety just thinking about school or dance class. This is called anticipatory anxiety. Some detective work is needed to determine exactly which elements of these environments are creating the anxiety if your child isn’t old enough to identify this him/herself.
What can we do about this?
Children typically show a mixed pattern of over-sensitivity (hypersensitivity) and under-sensitivity (hyposensitivity) to sensory input. Senses that are hypersensitive will become overloaded very quickly. Senses that are hyposensitive take a significant amount of stimulation before the nervous system even tunes in.
Helping a child develop emotional regulation strategies is key to dealing with sensory-related anxiety. With the help of an Occupational Therapist, a thorough sensory-motor examination is the first step. Identifying developmental strengths and areas of weakness provides insight into how the brain and body (senses) are communicating.
A weak sensory system can impact a child’s ability to learn new motor skills as well as impact their overall level of alertness. We can determine which senses can be used to help calm the nervous system in times of stress and which sensory inputs can be used when the child’s arousal level is too low for optimal learning. When addressing sensory processing difficulties, we are looking closely at the child’s strategies for emotional regulation. What helps a child feel calm in one situation of stress may not be as effective in another.
My goal as an Occupational Therapist is to ensure that learning experiences are paired with a calm nervous system. The greater number of sensory tools a child has in their toolbox, the greater likelihood that they can experience learning enjoyably!
If you would like to contact Lori for more information she can be reached at:
P: 613-260-2847
intake@loriot.ca