This blog looks at how sensory processing differences can impact on two people from the same family in different ways, offers explanations for certain behaviours through a sensory lens and outlines strategies that can help with navigating everyday life.
"You’re too sensitive” a refrain I heard all too often throughout my life, leaving me feeling as if this was a fault that I should be able to do something to change. So many experiences left me feeling overwhelmed, irritated or simply scared. I was aware that I was limiting others enjoyment of an experience because of my sensitivity; a walk in the hills would end up with me on my hands and knees, clinging to the ground because of my fear of uneven surfaces and heights; a family boat ride where we were forced to return to shore because of my seasickness; a school ski trip which saw me being carried on the ski instructor’s shoulders, because I was holding everyone up due to my fear of falling.
I would avoid fairground equipment, scared by the movement. I hated flying because of the sensation of take-off, landing, and turbulence and would get motion sickness on any form of transport.
In contrast, my brother would be dashing on to the next thing, climbing so high, swinging as far as he could and appearing to take unnecessary risks. He loved flying, could read while travelling in the car and was exhilarated by a choppy boat ride.
I found clothing irritating; labels, seams, waistbands and cuffs drove me mad. I would often cut out labels and end up with a wardrobe full of clothes I never wore, like those ‘scratchy’ jumpers that looked so comfy; I have only recently realised that I can choose to wear comfortable clothes that won’t distract me. Sensitivity to clothing wasn’t an issue for my brother, but I remember when he was little my mum often having to readjust twisted and untucked clothing on him.
Certain noises would cause what felt like physical pain (unless I was in control of them) the vacuum cleaner, hand dryers and sharp sounds like cutlery and crockery clinking together. This super acute hearing (as I thought it was) would also allow me to hear nearby conversations, when those with me were oblivious to them; this was sometimes a blessing, allowing me to pick up on things before others, like an early warning system, but could make larger gatherings and classes uncomfortable, as I wouldn’t know where to direct my attention.
I became totally overwhelmed in one job, where I was moved from a small office of three people, to a large open plan office, I couldn’t understand how everyone else was still able to concentrate when I was picking up bits of everyone else’s conversations and struggling to get on with my own work.This same "superpower" got my brother into trouble act work, when he was told off for "earwigging" a conversation going on behind him, not realising it wasn't meant for him to hear.
On the other hand our dad would often take what seemed like several minutes to respond to a question. My mum convinced him to go for a hearing test, only to find that his hearing was fine.
"Clumsiness" was also a feature of my childhood, falling over and grazing my knees, knocking things over, spilling things and unintentionally breaking stuff. I filed this as another “character flaw” that I should be able to control, thinking I was careless and that “I must try harder”, an internal narrative that has stayed with me until quite recently.My brother might also have been called “clumsy” or “destructive”, at times exerting more force than required, resulting in broken toys.
My first introduction to Ayres Sensory Integration was when I chose the paediatric module of my Occupational Therapy degree, I learnt that there are senses beyond the five that we all know about, and that they all need to work together well for a person to interact appropriately with the environment and people around them.
These sensory systems previously unknown to me were;
The Proprioceptive system - relays information from receptors in our joints and muscles telling us where our body parts are in relation to each other and how they are moving. Without this we can’t grade the movement of our arm and hand, for example to pick up a tool, throw a ball and myriad other activities that we perform throughout the day.
A difference in the capacity of this sense to take in information would cause my brother to put too much force through a pencil when writing, breaking the lead. He would chew his cuffs until they had holes in them suggesting a need for more proprioceptive input, stimulated through the muscles and joints in the jaw.
The Vestibular system - relays information from receptors in our inner ears, like internal spirit levels, allowing us to know what position our head is in, whether we are upright, lying down etc. It is integral in our ability to balance and move against gravity.
My challenges with travel are likely due to a sensitivity in this system. My brother’s ability to tolerate and even enjoy this type of movement, suggests a need for more input in order to “feel” what is happening.
The Interoceptive system - a relatively new one to me, it has emerged as an important sense over the last twenty years. It is the sense of our internal body systems such as hunger, thirst, need for the toilet etc.
I am just learning to tune in to my interoception. I often miss cues that I am thirsty, but can be very aware of changes in my internal systems like heart rate and temperature.
These three senses work alongside the five we are all familiar with:
The Tactile system –sense of touch, received through receptors in our skin, some close to the surface, some deeper. It can be divided into deep pressure touch and light pressure touch.
My intolerance of certain fabrics and food textures, demonstrates a sensitivity in the light pressure touch system. I seek out massages and deep pressure, as this type of touch overrides the light pressure and has a calming impact on the nervous system.
Although my brother could tolerate different clothing textures, he did have some aversions to food textures, this shows that even within the same sensory system it is possible to be over and under reactive at the same time.
The Auditory system – our sense of hearing.My apparently super acute hearing is in fact auditory sensitivity and my dad’s “hearing loss” was likely to be a difference in processing auditory information.
The Visual system –sense of sight.I rely heavily on my visual system and sometimes crave light and colour, although at times can feel overstimulated by busy visual environments like supermarkets and classrooms.
The Gustatory system –sense of taste. Again, I crave input through this sense, I seek out strong flavours especially sour and spicy, also true for my brother.
The Olfactory system – sense of smell.I seek out the pleasant scents of citrus, lavender and coffee, but can also detect unpleasant odours that others don’t seem to smell, this was heightened during pregnancy, a common protective response.
These senses all work in symphony and enhance each other to make our interactions with our environment as smooth as possible. If one or more of these senses is working at a different capacity to the others, this can cause challenges with lots of activities.
Sensory reactivity can have a considerable impact on behaviour and at times can be misinterpreted as stubbornness, being naughty or wilful, out of control or reckless, when really the person is trying to “feed” or manage their own nervous system in the only way that is accessible to them.
Challenges with sensory discrimination, being able to make sense of incoming sensory input to organise an appropriate motor output, is known as dyspraxia, leading to difficulties with activities requiring complex coordination.
One that can impact on a lot of adult’s lives is driving. If there is a discrepancy in the capacity of your nervous system to take in and make sense of sensory information, this impacts your spatial awareness, ability to judge force and speed and to coordinate both sides of the body to do different things at the same time (bilateral integration) i.e. changing gear and steering.
Armed with this new knowledge things suddenly made perfect sense (pun intended), and I had a much better understanding of myself. This led me to choosing which direction my OT career would take, and I spent the next 15 years working in paediatrics with children with Sensory Integration difficulties, using sensory integration therapy and strategies.
Sensory integration therapy involves using a graded approach through fun activities, incorporating different sensory inputs to elicit useful movement. The "just right challenge", pitches the activity at a level that is just challenging enough, but doesn't cause frustration. Over time this has an impact on the persons neural pathways, achieving permanent change (Neuroplasticity).
I could empathise, and explain to these children why they found certain activities challenging and give them strategies to help improve their quality of and participation in life.
Unfortunately after having children, this work became overwhelming and the constraints of services meant that I was unable to offer the support people needed, I burnt out and left the profession for good, or so I thought...
Fast forward 13 years and I am now a fully registered OT again, refreshing my training in Ayres Sensory integration and reigniting my passion for it.
In the last few years, I have discovered that I am neurodivergent. I now have an explanation for all my differences, as well as my sensory processing. I realise this is not a flaw that I should just be able to ‘get over’ but a neurological difference requiring specialist knowledge, understanding and intervention to help make the world an easier place to navigate.
I have developed many strategies over the years to help myself and although there is no “one size fits all” strategy, these are some of the things I have found helpful:
Tight underclothes activate the deep pressure receptors, overriding light pressure touch receptors that detect irritation from itchy clothes etc.
I sit in the front of the car and look out of the front window. I have also tried sitting on a pile of newspapers, the theory being it provides a more sensory information, reducing the mismatch between what the visual and vestibular senses are telling us.
I apply deep pressure to myself when flying, by doing the following exercises (I also apply deep pressure to my husband’s hand by squeezing it hard on take-off and landing! I’m not sure he finds this particularly helpful) These have an overall calming effect on the nervous system.
weighted blankets and shoulder wraps are another way of applying deep pressure
a heavy duvet, soft bed linen and earplugs help me sleep. I’ve also discovered that leggings are the most comfortable bedwear for me, applying all over deep pressure.
I opt out of activities I know are going to cause me distress and limit other people’s enjoyment. This reduces stress for everyone and I no longer feel like I am “wimping out” I know the reasons I don’t participate are not things that I can just overcome through exposure. However, I intend to practice some sensory integration therapy on myself to see if this has an impact on my ability to participate in certain activities.
My sensitivity to food textures has improved over the years, but reappeared when I was pregnant highlighting to me that it can be a necessary, protective response to something which could cause us harm.
My auditory sensitivity fluctuates according to my general stress levels, wellness and how tired I am. If I am anticipating some loud noises, I use the deep pressure/joint compression exercises above, I’ve also invested in a pair of loop earplugs, which take the edge off sharper noises.
My poor coordination doesn’t impact me too much, I know I’ll never be a professional dancer, and I’m fine with that. I try to take more care and engage my visual system more if there are obstacles in my way.
I still get a feeling of sensory overwhelm in environments like supermarkets, arcades, airports, certain restaurants; basically anywhere where there is bright light, lots of people, noise, smells and visual "clutter". I generally try to avoid these places and have built strategies such as only doing online or click and collect shopping, choosing places to eat that I know take a lower sensory "toll". If it can't be avoided I will use the deep pressure exercises above, breathwork and allow myself time to recover.
I have also started to look at the strengths these differences give me. We are generally much more attuned to our challenges and perceived flaws, and it can be hard for us to reframe and look at our areas of strength. Many of these sensitivities are necessary protective responses that served us well throughout most of human evolution, just not always in the context of our modern world.
Having super acute hearing is a strength allowing us to hear potential danger in time to protect ourselves.
detecting light tickly touch on our skin allows us to brush off that insect before it can bite us.
Travel sickness is our nervous system warning us that there is a mismatch between what the eyes are telling us and what our vestibular system is feeling i.e. we are still but moving! This is thought to be a response to potential poisoning –the theory being that the brain mistakes this for a hallucination caused by poisoning, and we vomit as a defensive measure (What happens in my body when I’m seasick? (2023) )
Feeling ‘bits’ in food means we can spit out foreign bodies that may do us harm.
It’s important to remember that although most people’s “sensory profile” doesn’t change dramatically, it can be variable, the same person can be hyper (over) reactive to some sensations and hypo(under) reactive to others. This can also vary depending on factors such as tiredness, illness, hunger and thirst, other internal body processes like hormonal fluctuations as well as environmental stressors.
There are many ways in which differences in sensory integration show up in people. If this is having a detrimental impact on someone's quality of life, an occupational therapy assessment may be worth considering. There is always a bit of detective work to be done to pin down what is happening, an OT will complete standardised assessments and questionnaires as well as making general observations, building a comprehensive picture to allow them to work with the person and choose the best interventions to apply in the context of their life.
As with all these things, awareness is key, once you know what your challenges are and why, it allows you to start putting strategies in place to make your interactions with the environment and people around you more comfortable.
Onitha Jarrold is an Occupational Therapist, offering sensory assessments and intervention to adults, as well as coaching in executive function and heath and wellness.
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