"I just wanted to express our sincerest gratitude for helping us make Paulo more prepared to cope with the future ahead of him. Paulo was diagnosed with slight ADHD back in 2006 and we were very worried about what ways we could help him with this. Although we were all in agreement that he needed an Occupational Therapist, my husband and I felt that there has to be something more out there that may be an extra help for Paulo.

We first heard of the Tomatis® Method from our sister and I must admit that we were both initially skeptical. It was something that was new in the Philippines and none of the doctors or therapists had mentioned it to us. I was so afraid to put my son through something that was not familiar to us and I did not know if this could really help him and that it might be a cause of great disappointment to us in the end if we did not see any possible results. My husband and I decided to research on Dr. Tomatis and to our surprise, it seemed that his method made a big positive impact on many children with ADD and ADHD outside the Philippines. We immediately set an appointment so that we could see first hand what it was all about.

I was so pleased with how the program was presented to us and I remember specifically that when Gem interviewed Paulo, it was the first time she made us realize that his favorite foods were all crunchy. I know that to many, this may not be a big of a deal but she opened up the fact that Paulo was highly dependent on his senses as well and even simple things such as food was affected by his disability. Gem and Ria also helped us realized that Paulo's hearing imbalance was normal and that they gave us hope that there was a way that we could help him on top of the OT.

I’m so happy to report that Paulo's behavior has improved and I know that this was not only because of OT but Tomatis® as well. Paulo has not pulled a major tantrum since we've finished the program. He is more open to trying new foods and new experiences. He immediately answers now without having to be asked twice or thrice. He now sleeps on time and obeys the house rules without whining. He is more patient in waiting for his turn. He now greets elders without having to be told. He is easier to handle even when he's very hyper. His improvements are gradual but steadily increasing. Although we may still have a long way to go when it comes to teaching him more coping skills for ADHD, the improvement in him this year was extraordinary.

Thank you so much for helping us help Paulo. We look forward to seeing more and more improvements on him and other children who have done the Tomatis® method. Keep up the good work and big hug to all of you!"


- Annie, Mother of 8-year old Paulo, Diagnosed with ADHD

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is a complex problem affecting about 5% of school-aged children. These kids can't process the information they hear in the same way as others because their ears and brain don't fully coordinate. Something adversely affects the way the brain recognizes and interprets sounds, most notably the sounds composing speech.

Kids with APD often do not recognize subtle differences between sounds in words, even when the sounds are loud and clear enough to be heard. These kinds of problems usually occur in background noise, which is a natural listening environment. So kids with APD have the basic difficulty of understanding any speech signal presented under less than optimal conditions.

Detecting APD

Kids with APD are thought to hear normally because they can usually detect pure tones that are delivered one by one in a very quiet environment (such as a sound-treated room). Those who can normally detect sounds and recognize speech in ideal listening conditions are not considered to have hearing difficulties.

However, the ability to detect the presence of sounds is only one part of the processing that occurs in the auditory system. So, most kids with APD do not have a loss of hearing sensitivity, but have a hearing problem in the sense that they do not process auditory information normally.

If the auditory deficits aren't identified and managed early, many of these kids will have speech and language delays and academic problems.

Symptoms of APD can range from mild to severe and can take many different forms. If you think your child might have a problem processing sounds, consider these questions:

  • Is your child easily distracted or unusually bothered by loud or sudden noises?
  • Are noisy environments upsetting to your child?
  • Does your child's behavior and performance improve in quieter settings?
  • Does your child have difficulty following directions, whether simple or complicated?
  • Does your child have reading, spelling, writing, or other speech-language difficulties?
  • Is abstract information difficult for your child to comprehend?
  • Are verbal (word) math problems difficult for your child?
  • Is your child disorganized and forgetful?
  • Are conversations hard for your child to follow?
APD is an often misunderstood problem because many of the behaviors noted above also can appear in other conditions like learning disabilities, attention deficit hyperactivity disorder (ADHD), and even depression. Although APD is often confused with ADHD, it is possible to have both. It is also possible to have APD and specific language impairment or learning disabilities.

Causes

The causes of APD are unknown. But evidence suggests links to head trauma, lead poisoning, and chronic ear infections. Because there are many different possibilities — even combinations of causes — each child must be assessed individually.

Diagnosis

Audiologists (hearing specialists) can determine if a child has APD. Although speech-language pathologists can get an idea by interacting with the child, only audiologists can perform auditory processing testing and determine if there really is a problem.

Some of the skills a child needs to be evaluated for auditory processing disorder don't develop until age 7 or 8. Younger kids' brains just haven't matured enough to accept and process a lot of information. So, many kids diagnosed with APD can develop better skills with time.

Once diagnosed, kids with APD usually work with a speech therapist. The audiologist will also recommend that they return for yearly follow-up evaluations.

Problem Areas for Kids With CAPD

The five main problem areas that can affect both home and school activities in kids with APD are:
  • Auditory Figure-Ground Problems: when a child can't pay attention if there's noise in the background. Noisy, low-structured classrooms could be very frustrating.
  • Auditory Memory Problems: when a child has difficulty remembering information such as directions, lists, or study materials. It can be immediate ("I can't remember it now") and/or delayed ("I can't remember it when I need it for later").
  • Auditory Discrimination Problems: when a child has difficulty hearing the difference between words or sounds that are similar (COAT/BOAT or CH/SH). This can affect following directions, and reading, spelling, and writing skills, among others.
  • Auditory Attention Problems: when a child can't stay focused on listening long enough to complete a task or requirement (such as listening to a lecture in school). Kids with CAPD often have trouble maintaining attention, although health, motivation, and attitude also can play a role.
  • Auditory Cohesion Problems: when higher-level listening tasks are difficult. Auditory cohesion skills — drawing inferences from conversations, understanding riddles, or comprehending verbal math problems — require heightened auditory processing and language levels. They develop best when all the other skills (levels 1 through 4 above) are intact.
How Can I Help My Child?

Strategies applied at home and school can ease some of the problem behaviors associated with APD. Because it's common for kids with CAPD to have difficulty following directions, for example, these tactics might help:
  • Since most kids with APD have difficulty hearing amid noise, it's very important to reduce the background noise at home and at school.
  • Have your child look at you when you're speaking.
  • Use simple, expressive sentences.
  • Speak at a slightly slower rate and at a mildly increased volume.
  • Ask your child to repeat the directions back to you and to keep repeating them aloud (to you or to himself or herself) until the directions are completed.
  • For directions that are to be completed at a later time, writing notes, wearing a watch, and maintaining a household routine also help. General organization and scheduling also can be beneficial.
It's especially important to teach your child to notice noisy environments, for example, and move to quieter places when listening is necessary.

Other strategies that might help:
  • Provide your child with a quiet study place (not the kitchen table).
  • Maintain a peaceful, organized lifestyle.
  • Encourage good eating and sleeping habits.
  • Assign regular and realistic chores, including keeping a neat room and desk.
  • Build your child's self-esteem.
Be sure to keep in regular contact with school officials about your child's progress. Kids with APD aren't typically put in special education programs. Instead, teachers can make it easier by:
  • altering seating plans so the child can sit in the front of the room or with his or her back to the window
  • providing additional aids for study, like an assignment pad or a tape recorder
One of the most important things that both parents and teachers can do is to acknowledge that CAPD is real. Symptoms and behaviors are not within the child's control. What is within the child's control is recognizing the problems associated with APD and applying the strategies recommended both at home and school.

A positive, realistic attitude and healthy self-esteem in a child with APD can work wonders. And kids with APD can go on to be just as successful as other classmates. Although some children do grow up to be adults with APD, by using coping strategies as well as techniques learned in speech therapy, they can be very successful adults.

Source: kidshealth.org

Autism is a complex developmental disability that causes problems with social interaction and communication. Symptoms usually start before age three and can cause delays or problems in many different skills that develop from infancy to adulthood.

Different people with autism can have very different symptoms. Health care providers think of autism as a “spectrum” disorder, a group of disorders with similar features. One person may have mild symptoms, while another may have serious symptoms. But they both have an autism spectrum disorder.

Currently, the autism spectrum disorder category includes:

  • Autistic Disorder (also called “classic” autism)
  • Asperger’s Syndrome
  • Pervasive Developmental Disorder Not Otherwise Specified (or atypical autism)
Source: mayoclinic.com

Autistic Disorder

Autism is one of a group of serious developmental problems called autism spectrum disorders (ASD) that appear in early childhood—usually before age 3. Though symptoms and severity vary, all autism disorders affect a child's ability to communicate and interact with others.

It's estimated that three to six out of every 1,000 children in the United States have autism—and the number of diagnosed cases is rising. It's not clear whether this is due to better detection and reporting of autism, a real increase in the number of cases, or both.

Symptoms

Children with autism generally have problems in three crucial areas of development—social interaction, language and behavior. But because the symptoms of autism vary greatly, two children with the same diagnosis may act quite differently and have strikingly different skills. In most cases, though, the most severe autism is marked by a complete inability to communicate or interact with other people.

Many children show signs of autism in early infancy. Other children may develop normally for the first few months or years of life but then suddenly become withdrawn, aggressive or lose language skills they've already acquired. Though each child with autism is likely to have a unique pattern of behavior, these characteristics are common signs of the disorder:
  1. Social Skills
    • Fails to respond to his or her name
    • Has poor eye contact
    • Appears not to hear you at times
    • Resists cuddling and holding
    • Appears unaware of others' feelings
    • Seems to prefer playing alone-retreats into his or her "own world"
  2. Language
    • Starts talking later than other children
    • Loses previously acquired ability to say words or sentences
    • Does not make eye contact when making requests
    • Speaks with an abnormal tone or rhythm—may use a singsong voice or robot-like speech
    • Can't start a conversation or keep one going
    • May repeat words or phrases verbatim, but doesn't understand how to use them
  3. Behavior
    • Performs repetitive movements, such as rocking, spinning or hand-flapping
    • Develops specific routines or rituals
    • Becomes disturbed at the slightest change in routines or rituals
    • Moves constantly
    • May be fascinated by parts of an object, such as the spinning wheels of a toy car
    • May be unusually sensitive to light, sound and touch and yet oblivious to pain
Young children with autism also have a hard time sharing experiences with others. When read to, for example, they're unlikely to point at pictures in the book. This early-developing social skill is crucial to later language and social development.

As they mature, some children with autism become more engaged with others and show less marked disturbances in behavior. Some, usually those with the least severe problems, eventually may lead normal or near-normal lives. Others, however, continue to have great difficulty with language or social skills, and the adolescent years can mean a worsening of behavior problems.

The majority of children with autism are slow to acquire new knowledge or skills and some have signs of lower than normal intelligence. Other children with autism have normal to high intelligence. These children learn quickly yet have trouble communicating, applying what they know in everyday life and adjusting in social situations. An extremely small number of children with autism are "autistic savants" and have exceptional skills in a specific area, such as art, math or music.

Source: mayoclinic.com

Asperger’s Syndrome

Asperger's Syndrome is a developmental disorder that affects a child's ability to socialize and communicate effectively with others. Children with Asperger's syndrome typically exhibit social awkwardness and an all-absorbing interest in specific topics.

Doctors group Asperger's Syndrome with other conditions that are called autistic spectrum disorders or pervasive developmental disorders. These disorders all involve problems with social skills and communication. Asperger's Syndrome is generally thought to be at the milder end of this spectrum.

Symptoms

Signs and symptoms of Asperger's Syndrome include:

  • Engaging in one-sided, long-winded conversations, without noticing if the listener is listening or trying to change the subject
  • Displaying unusual nonverbal communication, such as lack of eye contact, few facial expressions, or awkward body postures and gestures
  • Showing an intense obsession with one or two specific, narrow subjects, such as baseball statistics, train schedules, weather or snakes
  • Appearing not to understand, empathize with or be sensitive to others' feelings
  • Having a hard time "reading" other people or understanding humor
  • Speaking in a voice that is monotonous, rigid or unusually fast
  • Moving clumsily, with poor coordination
  • Having an odd posture or a rigid gait
Source: mayoclinic.com

Pervasive Developmental Disorder—Not Otherwise Specified (PDD-NOS)

Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS) is a 'subthreshold' condition in which some—but not all—features of autism are identified. PDD-NOS is often incorrectly referred to as simply "PDD." The term PDD refers to the class of conditions to which autism belongs. PDD is not itself a diagnosis, while PDD-NOS is a diagnosis. The term Pervasive Developmental Disorder—Not Otherwise Specified (also referred to as "atypical personality development," "atypical PDD," or "atypical autism") encompass cases where there is marked impairment of social interaction, communication, and/or stereotyped behavior patterns or interest, but when full features for autism or another explicitly defined PDD are not met.

Source: yale.edu

ADHD is a chronic condition that affects millions of children and often persists into adulthood. Problems associated with ADHD include inattention and hyperactive, impulsive behavior. Children with ADHD may struggle with low self-esteem, troubled relationships and poor performance in school.

Symptoms

ADHD has been called attention-deficit disorder (ADD) and hyperactivity. But ADHD is the preferred term because it describes both primary aspects of the condition: inattention and hyperactive-impulsive behavior.

While many children who have ADHD tend more toward one category than the other, most children have some combination of inattention and hyperactive-impulsive behavior. Signs and symptoms of ADHD become more apparent during activities that require focused mental effort.

In most children diagnosed with ADHD, signs and symptoms appear before the age of 7. In some children, signs of ADHD are noticeable as early as infancy.

Signs and symptoms of inattention may include:

  • Often fails to pay close attention to details or makes careless mistakes in schoolwork or other activities
  • Often has trouble sustaining attention during tasks or play
  • Seems not to listen even when spoken to directly
  • Has difficulty following through on instructions and often fails to finish schoolwork, chores or other tasks
  • Often has problems organizing tasks or activities
  • Avoids or dislikes tasks that require sustained mental effort, such as schoolwork or homework
  • Frequently loses needed items, such as books, pencils, toys or tools
  • Can be easily distracted
  • Often forgetful
Signs and symptoms of hyperactive and impulsive behavior may include:
  • Fidgets or squirms frequently
  • Often leaves his or her seat in the classroom or in other situations when remaining seated is expected
  • Often runs or climbs excessively when it's not appropriate or, if an adolescent, might constantly feel restless
  • Frequently has difficulty playing quietly
  • Always seems on the go
  • Talks excessively
  • Blurts out the answers before questions have been completely asked
  • Frequently has difficulty waiting for his or her turn
  • Often interrupts or intrudes on others' conversations or games
ADHD behaviors can be different in boys and girls.
  • Boys are more likely to be hyperactive, whereas girls tend to be inattentive.
  • Girls who have trouble paying attention often daydream, but inattentive boys are more likely to play or fiddle aimlessly.
  • Boys tend to be less compliant with teachers and other adults, so their behavior is often more conspicuous.
You may suspect your child's behavior is caused by ADHD if you notice consistently inattentive or hyperactive, impulsive behavior that:
  • Lasts more than six months
  • Occurs in more than just one setting (typically at home and at school)
  • Regularly disrupts school, play and other daily activities
  • Causes problems in relationships with adults and other children
Source: mayoclinic.com

A learning disability is a neurological disorder. In simple terms, a learning disability results from a difference in the way a person's brain is "wired." Children with learning disabilities are as smart or smarter than their peers. But they may have difficulty reading, writing, spelling, reasoning, recalling and/or organizing information if left to figure things out by themselves or if taught in conventional ways.

Common Learning Disabilities:

  • Dyslexia: A language-based disability in which a person has trouble understanding written words. It may also be referred to as reading disability or reading disorder.
  • Dyscalculia: A mathematical disability in which a person has a difficult time solving arithmetic problems and grasping math concepts.
  • Dysgraphia: A writing disability in which a person finds it hard to form letters or write within a defined space.
  • Auditory and Visual Processing Disorders: Sensory disabilities in which a person has difficulty understanding language despite normal hearing and vision.
  • Nonverbal Learning Disabilities: A neurological disorder which originates in the right hemisphere of the brain, causing problems with visual-spatial, intuitive, organizational, evaluative and holistic processing functions.
Source: ldonline.org

Dyslexia

Dyslexia is a language-based learning disability. Dyslexia refers to a cluster of symptoms, which result in people having difficulties with specific language skills, particularly reading. Students with dyslexia usually experience difficulties with other language skills such as spelling, writing, and pronouncing words. Dyslexia affects individuals throughout their lives; however, its impact can change at different stages in a person's life. It is referred to as a learning disability because dyslexia can make it very difficult for a student to succeed academically in the typical instructional environment, and in its more severe forms, will qualify a student for special education, special accommodations, or extra support services.

Symptoms

The problems displayed by individuals with dyslexia involve difficulties in acquiring and using written language. It is a myth that dyslexic individuals "read backwards," although spelling can look quite jumbled at times because students have trouble remembering letter symbols for sounds and forming memories for words.

Other problems experienced by dyslexics include the following:

  • Learning to speak
  • Learning letters and their sounds
  • Organizing written and spoken language
  • Memorizing number facts
  • Reading quickly enough to comprehend
  • Persisting with and comprehending longer reading assignments
  • Spelling
  • Learning a foreign language
  • Correctly doing math operations
Source: ldonline.org

Dyspraxia

Dyspraxia is a term that refers to a specific disorder in the area of motor skill development. People with dyspraxia have difficulty planning and completing intended fine motor tasks.

Dyspraxia can affect different areas of functioning, varying from simple motor tasks such as waving goodbye to more complex tasks like brushing teeth.

Symptoms

Dyspraxia is a lifelong disorder that affects a person's development in the area of motor development. Though many challenges can persist throughout a person's life, the types of difficulties experienced can change.

  1. Young Children
  2. Babies with dyspraxia may avoid crawling and rolling over, and may resist tasks involving motor skills. As they get older these children are prone to:
    • Difficulty with eye movements—they may move the whole head instead of just the eyes
    • Difficulty using eating utensils and holding a cup while drinking
    • Difficulty walking, hopping, skipping, throwing and catching a ball, riding a bike
    • Delay in using spoken language and speech that is difficult to understand
    • Bumping into objects
    • Late establishment of laterality (right- or left-handedness)
    • Difficulty doing fine-motor activities such as tying shoelaces or buttoning clothing
    • Difficulty with handwriting
    • Sensitivity to touch—may find clothing uncomfortable; and may find hair-brushing and cutting, teeth-brushing and nail-cutting unpleasant
    • Poor sense of direction
  3. School-aged Children
  4. Dyspraxia can make it difficult for children to develop social skills, and they may have trouble getting along with peers. Though they are intelligent, these children may seem immature and some may develop phobias and obsessive behavior.

    All young people must deal with their rapidly changing bodies. However many young people with dyspraxia may also have the added stress of dealing with coordination problems, as well as speech and academic difficulties.
    • Coordination difficulties can be particularly problematic in physical education classes and other sports activities.
    • Speech difficulties can interfere with casual conversation, which can result in social awkwardness and an unwillingness to risk engaging in conversation.
    • Writing difficulties such as poor letter formation, pencil grip and slow writing can make school work frustrating.
  5. Teenagers & Adults
  6. The challenges presented to adults with dyspraxia can be seen in all aspects of everyday life. Difficulties can have an impact on:
    • Driving
    • Completing household chores
    • Cooking
    • Personal grooming and self-help activities
    • Manual dexterity needed for writing and typing
    • Speech control—volume, pitch and articulation
    • Perception inconsistencies—over- or under-sensitivity to light, touch, space, taste, smell.
Source: ldonline.org

Auditory Processing Disorder

An auditory processing disorder interferes with an individual's ability to analyze or make sense of information taken in through the ears. This is different from problems involving hearing per se, such as deafness or being hard of hearing. Difficulties with auditory processing do not affect what is heard by the ear, but do affect how this information is interpreted, or processed by the brain.

An auditory processing deficit can interfere directly with speech and language, but can affect all areas of learning, especially reading and spelling. When instruction in school relies primarily on spoken language, the individual with an auditory processing disorder may have serious difficulty understanding the lesson or the directions.

Symptoms

  • Phonological Awareness
  • Phonological awareness is the understanding that language is made up of individual sounds (phonemes), which are put together to form the words we write and speak. This is a fundamental precursor to reading. Children who have difficulty with phonological awareness will often be unable to recognize or isolate the individual sounds in a word, recognize similarities between words (as in rhyming words), or be able to identify the number of sounds in a word. These deficits can affect all areas of language including reading, writing, and understanding of spoken language.
  • Auditory Discrimination
  • Auditory discrimination is the ability to recognize differences in phonemes (sounds). This includes the ability to identify words and sounds that are similar and those which are different.
  • Auditory Memory
  • Auditory memory is the ability to store and recall information which was given verbally. An individual with difficulties in this area may not be able to follow instructions given verbally or may have trouble recalling information from a story read aloud.
  • Auditory Sequencing
  • Auditory sequencing is the ability to remember or reconstruct the order of items in a list or the order of sounds in a word or syllable. One example is saying or writing "ephelant" for "elephant."
  • Auditory Blending
  • Auditory blending is the process of putting together phonemes to form words. For example, the individual phonemes "c", "a", and "t" are blended to from the word, "cat".
Source: ldonline.org

The term Sensory Processing Disorder is used synonymously with Sensory Integration Disorder or Sensory Integration Dysfunction. Based on the original work of A. Jean Ayres, it is used to define and describe the disorder/dysfunction symptoms.

Difficulty taking in or interpreting the varied sensory input can lead to devastating consequences in:

  • daily functioning
  • social and family relationships
  • behavioral challenges
  • regulating emotions
  • self-esteem
  • learning
Symptoms

It is important to be aware of the "Five Caveats" that Carol Stock Kranowitz points out in her book, The Out-Of-Sync Child (1995), about using the following Sensory Processing Disorder checklist. She writes:
  1. "The child with sensory dysfunction does not necessarily exhibit every characteristic. Thus, the child with vestibular dysfunction may have poor balance but good muscle tone."
  2. "Sometimes the child will show characteristics of a dysfunction one day but not the next. For instance, the child with proprioceptive problems may trip over every bump in the pavement on Friday yet score every soccer goal on Saturday. Inconsistency is a hallmark of every neurological dysfunction."
  3. "The child may exhibit characteristics of a particular dysfunction yet not have that dysfunction. For example, the child who typically withdraws from being touched may seem to be hypersensitive to tactile stimulation but may, instead, have an emotional problem."
  4. "The child may be both hypersensitive and hyposensitive. For instance, the child may be extremely sensitive to light touch, jerking away from a soft pat on the shoulder, while being rather indifferent to the deep pain of an inoculation."
  5. "Everyone has some sensory integration problems now and then, because no one is well regulated all the time. All kinds of stimuli can temporarily disrupt normal functioning of the brain, either by overloading it with, or by depriving it of, sensory stimulation."
Tactile Dysfunction

Tactile Sense: input from the skin receptors about touch, pressure, temperature, pain, and movement of the hairs on the skin.
  1. Hypersensitivity To Touch (Tactile Defensiveness)
    • becomes fearful, anxious or aggressive with light or unexpected touch
    • as an infant, did/does not like to be held or cuddled; may arch back, cry, and pull away
    • distressed when diaper is being, or needs to be, changed
    • appears fearful of, or avoids standing in close proximity to other people or peers (especially in lines)
    • becomes frightened when touched from behind or by someone/something they can not see (such as under a blanket)
    • complains about having hair brushed; may be very picky about using a particular brush
    • bothered by rough bed sheets (i.e., if old and "bumpy")
    • avoids group situations for fear of the unexpected touch
    • resists friendly or affectionate touch from anyone besides parents or siblings (and sometimes them too!)
    • dislikes kisses, will "wipe off" place where kissed
    • prefers hugs
    • a raindrop, water from the shower, or wind blowing on the skin may feel like torture and produce adverse and avoidance reactions
    • may overreact to minor cuts, scrapes, and or bug bites
    • avoids touching certain textures of material (blankets, rugs, stuffed animals)
    • refuses to wear new or stiff clothes, clothes with rough textures, turtlenecks, jeans, hats, or belts, etc.
    • avoids using hands for play
    • avoids/dislikes/aversive to "messy play", i.e., sand, mud, water, glue, glitter, play-doh, slime, shaving cream/funny foam etc.
    • will be distressed by dirty hands and want to wipe or wash them frequently
    • excessively ticklish
    • distressed by seams in socks and may refuse to wear them
    • distressed by clothes rubbing on skin; may want to wear shorts and short sleeves year round, toddlers may prefer to be naked and pull diapers and clothes off constantly,?or may want to wear long sleeve shirts and long pants year round to avoid having skin exposed
    • distressed about having face washed
    • distressed about having hair, toenails, or fingernails cut
    • resists brushing teeth and is extremely fearful of the dentist
    • is a picky eater, only eating certain tastes and textures; mixed textures tend to be avoided as well as hot or cold foods; resists trying new foods
    • may refuse to walk barefoot on grass or sand
    • may walk on toes only
  2. Hyposensitivity To Touch (Under-Responsive)
    • may crave touch, needs to touch everything and everyone
    • is not aware of being touched/bumped unless done with extreme force or intensity
    • is not bothered by injuries, like cuts and bruises, and shows no distress with shots (may even say they love getting shots!)
    • may not be aware that hands or face are dirty or feel his/her nose running
    • may be self-abusive; pinching, biting, or banging his own head
    • mouths objects excessively
    • frequently hurts other children or pets while playing
    • repeatedly touches surfaces or objects that are soothing (i.e., blanket)
    • seeks out surfaces and textures that provide strong tactile feedback
    • thoroughly enjoys and seeks out messy play
    • craves vibrating or strong sensory input
    • has a preference and craving for excessively spicy, sweet, sour, or salty foods
  3. Poor Tactile Perception and Discrimination
    • has difficulty with fine motor tasks such as buttoning, zipping, and fastening clothes
    • may not be able to identify which part of their body was touched if they were not looking
    • may be afraid of the dark
    • may be a messy dresser; looks disheveled, does not notice pants are twisted, shirt is half un tucked, shoes are untied, one pant leg is up and one is down, etc.
    • has difficulty using scissors, crayons, or silverware
    • continues to mouth objects to explore them even after age two
    • has difficulty figuring out physical characteristics of objects; shape, size, texture, temperature, weight, etc.
    • may not be able to identify objects by feel, uses vision to help; such as, reaching into backpack or desk to retrieve an item
Vestibular Dysfunction

Vestibular Sense: input from the inner ear about equilibrium, gravitational changes, movement experiences, and position in space.
  1. Hypersensitivity To Movement (Over-Responsive)
    • avoids/dislikes playground equipment; i.e., swings, ladders, slides, or merry-go-rounds
    • prefers sedentary tasks, moves slowly and cautiously, avoids taking risks, and may appear "wimpy"
    • avoids/dislikes elevators and escalators; may prefer sitting while they are on them or, actually get motion sickness from them
    • may physically cling to an adult they trust
    • may appear terrified of falling even when there is no real risk of it
    • afraid of heights, even the height of a curb or step
    • fearful of feet leaving the ground
    • fearful of going up or down stairs or walking on uneven surfaces
    • afraid of being tipped upside down, sideways or backwards; will strongly resist getting hair washed over the sink
    • startles if someone else moves them; i.e., pushing his/her chair closer to the table
    • as an infant, may never have liked baby swings or jumpers
    • may be fearful of, and have difficulty riding a bike, jumping, hopping, or balancing on one foot (especially if eyes are closed)
    • may have disliked being placed on stomach as an infant
    • loses balance easily and may appear clumsy
    • fearful of activities which require good balance
    • avoids rapid or rotating movements
  2. Hyposensitivity To Movement (Under-Responsive)
    • in constant motion, can't seem to sit still
    • craves fast, spinning, and/or intense movement experiences
    • loves being tossed in the air
    • could spin for hours and never appear to be dizzy
    • loves the fast, intense, and/or scary rides at amusement parks
    • always jumping on furniture, trampolines, spinning in a swivel chair, or getting into upside down positions
    • loves to swing as high as possible and for long periods of time
    • is a "thrill-seeker"; dangerous at times
    • always running, jumping, hopping etc. instead of walking
    • rocks body, shakes leg, or head while sitting
    • likes sudden or quick movements, such as, going over a big bump in the car or on a bike
  3. Poor Muscle Tone and/or Coordination
    • has a limp, "floppy" body
    • frequently slumps, lies down, and/or leans head on hand or arm while working at his/her desk
    • difficulty simultaneously lifting head, arms, and legs off the floor while lying on stomach ("superman" position)
    • often sits in a "W sit" position on the floor to stabilize body
    • fatigues easily
    • compensates for "looseness" by grasping objects tightly
    • difficulty turning doorknobs, handles, opening and closing items
    • difficulty catching him/her self if falling
    • difficulty getting dressed and doing fasteners, zippers, and buttons
    • may have never crawled as an baby
    • has poor body awareness; bumps into things, knocks things over, trips, and/or appears clumsy
    • poor gross motor skills; jumping, catching a ball, jumping jacks, climbing a ladder etc.
    • poor fine motor skills; difficulty using "tools", such as pencils, silverware, combs, scissors etc.
    • may appear ambidextrous, frequently switching hands for coloring, cutting, writing etc.; does not have an established hand preference/dominance by 4 or 5 years old
    • has difficulty licking an ice cream cone
    • seems to be unsure about how to move body during movement, for example, stepping over something
    • difficulty learning exercise or dance steps
Proprioceptive Dysfunction

Proprioceptive Sense: input from the muscles and joints about body position, weight, pressure, stretch, movement, and changes in position in space
  1. Sensory Seeking Behaviors
    • seeks out jumping, bumping, and crashing activities
    • stomps feet when walking
    • kicks his/her feet on floor or chair while sitting at desk/table
    • bites or sucks on fingers and/or frequently cracks his/her knuckles
    • loves to be tightly wrapped in many or weighted blankets, especially at bedtime
    • prefers clothes (and belts, hoods, shoelaces) to be as tight as possible
    • loves/seeks out "squishing" activities
    • enjoys bear hugs
    • excessive banging on/with toys and objects
    • loves "roughhousing" and tackling/wrestling games
    • frequently falls on floor intentionally
    • would jump on a trampoline for hours on end
    • grinds his/her teeth throughout the day
    • loves pushing/pulling/dragging objects
    • loves jumping off furniture or from high places
    • frequently hits, bumps or pushes other children
    • chews on pens, straws, shirt sleeves etc.
  2. Difficulty With "Grading Of Movement"
    • misjudges how much to flex and extend muscles during tasks/activities (i.e., putting arms into sleeves or climbing)
    • difficulty regulating pressure when writing/drawing; may be too light to see or so hard the tip of writing utensil breaks
    • written work is messy and he/she often rips the paper when erasing
    • always seems to be breaking objects and toys
    • misjudges the weight of an object, such as a glass of juice, picking it up with too much force sending it flying or spilling, or with too little force and complaining about objects being too heavy
    • may not understand the idea of "heavy" or "light"; would not be able to hold two objects and tell you which weighs more
    • seems to do everything with too much force; i.e., walking, slamming doors, pressing things too hard, slamming objects down
    • plays with animals with too much force, often hurting them
Auditory Dysfunction (no diagnosed hearing problem)
  1. Hypersensitivity To Sounds (Auditory Defensiveness)
    • distracted by sounds not normally noticed by others; i.e., humming of lights or refrigerators, fans, heaters, or clocks ticking
    • fearful of the sound of a flushing toilet (especially in public bathrooms), vacuum, hairdryer, squeaky shoes, or a dog barking
    • started with or distracted by loud or unexpected sounds
    • bothered/distracted by background environmental sounds; i.e., lawn mowing or outside construction
    • frequently asks people to be quiet; i.e., stop making noise, talking, or singing
    • runs away, cries, and/or covers ears with loud or unexpected sounds
    • may refuse to go to movie theaters, parades, skating rinks, musical concerts etc.
    • may decide whether they like certain people by the sound of their voice
  2. Hyposensitivity To Sounds (Under-Registers)
    • often does not respond to verbal cues or to name being called
    • appears to "make noise for noise's sake"
    • loves excessively loud music or TV
    • seems to have difficulty understanding or remembering what was said
    • appears oblivious to certain sounds
    • appears confused about where a sound is coming from
    • talks self through a task, often out loud
    • had little or no vocalizing or babbling as an infant
    • needs directions repeated often, or will say, "What?" frequently
Oral Input Dysfunction
  1. Hypersensitivity To Oral Input (Oral Defensiveness)
    • picky eater, often with extreme food preferences; i.e., limited repertoire of foods, picky about brands, resistive to trying new foods or restaurants, and may not eat at other people's houses
    • may only eat "soft" or pureed foods past 24 months of age
    • may gag with textured foods
    • has difficulty with sucking, chewing, and swallowing; may choke or have a fear of choking
    • resists/refuses/extremely fearful of going to the dentist or having dental work done
    • may only eat hot or cold foods
    • refuses to lick envelopes, stamps, or stickers because of their taste
    • dislikes or complains about toothpaste and mouthwash
    • avoids seasoned, spicy, sweet, sour or salty foods; prefers bland foods
  2. Hyposensitivity To Oral Input (Under-Registers)
    • may lick, taste, or chew on inedible objects
    • prefers foods with intense flavor; i.e., excessively spicy, sweet, sour, or salty
    • excessive drooling past the teething stage
    • frequently chews on hair, shirt, or fingers
    • constantly putting objects in mouth past the toddler years
    • acts as if all foods taste the same
    • can never get enough condiments or seasonings on his/her food
    • loves vibrating toothbrushes and even trips to the dentist
Olfactory Dysfunction (Smells)
  1. Hypersensitivity To Smells (Over-Responsive)
    • reacts negatively to, or dislikes smells which do not usually bother, or get noticed, by other people
    • tells other people (or talks about) how bad or funny they smell
    • refuses to eat certain foods because of their smell
    • offended and/or nauseated by bathroom odors or personal hygiene smells
    • bothered/irritated by smell of perfume or cologne
    • bothered by household or cooking smells
    • may refuse to play at someone's house because of the way it smells
    • decides whether he/she likes someone or some place by the way it smells
  2. Hyposensitivity To Smells (Under-Responsive)
    • has difficulty discriminating unpleasant odors
    • may drink or eat things that are poisonous because they do not notice the noxious smell
    • unable to identify smells from scratch 'n sniff stickers
    • does not notice odors that others usually complain about
    • fails to notice or ignores unpleasant odors
    • makes excessive use of smelling when introduced to objects, people, or places
    • uses smell to interact with objects
Visual Input Dysfunction (no diagnosed visual deficit)
  1. Hypersensitivity To Visual Input (Over-Responsiveness)
    • sensitive to bright lights; will squint, cover eyes, cry and/or get headaches from the light
    • has difficulty keeping eyes focused on task/activity he/she is working on for an appropriate amount of time
    • easily distracted by other visual stimuli in the room; i.e., movement, decorations, toys, windows, doorways etc.
    • has difficulty in bright colorful rooms or a dimly lit room
    • rubs his/her eyes, has watery eyes or gets headaches after reading or watching TV
    • avoids eye contact
    • enjoys playing in the dark
  2. Hyposensitivity To Visual Input (Under-Responsive or Difficulty With Tracking, Discrimination, or Perception)
    • has difficulty telling the difference between similar printed letters or figures; i.e., p & q, b & d, + and x, or square and rectangle
    • has a hard time seeing the "big picture"; i.e., focuses on the details or patterns within the picture
    • has difficulty locating items among other items; i.e., papers on a desk, clothes in a drawer, items on a grocery shelf, or toys in a bin/toy box
    • often loses place when copying from a book or the chalkboard
    • difficulty controlling eye movement to track and follow moving objects
    • has difficulty telling the difference between different colors, shapes, and sizes
    • often loses his/her place while reading or doing math problems
    • makes reversals in words or letters when copying, or reads words backwards; i.e., "was" for "saw" and "no" for "on" after first grade
    • complains about "seeing double"
    • difficulty finding differences in pictures, words, symbols, or objects
    • difficulty with consistent spacing and size of letters during writing and/or lining up numbers in math problems
    • difficulty with jigsaw puzzles, copying shapes, and/or cutting/tracing along a line
    • tends to write at a slant (up or down hill) on a page
    • confuses left and right
    • fatigues easily with schoolwork
    • difficulty judging spatial relationships in the environment; i.e., bumps into objects/people or missteps on curbs and stairs
Auditory-Language Processing Dysfunction
  • unable to locate the source of a sound
  • difficulty identifying people's voices
  • difficulty discriminating between sounds/words; i.e., "dare" and "dear"
  • difficulty filtering out other sounds while trying to pay attention to one person talking
  • bothered by loud, sudden, metallic, or high-pitched sounds
  • difficulty attending to, understanding, and remembering what is said or read; often asks for directions to be repeated and may only be able to understand or follow two sequential directions at a time
  • looks at others to/for reassurance before answering
  • difficulty putting ideas into words (written or verbal)
  • often talks out of turn or "off topic"
  • if not understood, has difficulty re-phrasing; may get frustrated, angry, and give up
  • difficulty reading, especially out loud (may also be dyslexic)
  • difficulty articulating and speaking clearly
  • ability to speak often improves after intense movement
Social, Emotional, Play, And Self-Regulation Dysfunction
  1. Social
    • difficulty getting along with peers
    • prefers playing by self with objects or toys rather than with people
    • does not interact reciprocally with peers or adults; hard to have a "meaningful" two-way conversation
    • self-abusive or abusive to others
    • others have a hard time interpreting child's cues, needs, or emotions
    • does not seek out connections with familiar people
  2. Emotional
    • difficulty accepting changes in routine (to the point of tantrums)
    • gets easily frustrated
    • often impulsive
    • functions best in small group or individually
    • variable and quickly changing moods; prone to outbursts and tantrums
    • prefers to play on the outside, away from groups, or just be an observer
    • avoids eye contact
    • difficulty appropriately making needs known
  3. Play
    • difficulty with imitative play (over 10 months)
    • wanders aimlessly without purposeful play or exploration (over 15 months)
    • needs adult guidance to play, difficulty playing independently (over 18 months)
    • participates in repetitive play for hours; i.e., lining up toys cars, blocks, watching one movie over and over etc.
  4. Self-Regulation
    • excessive irritability, fussiness or colic as an infant
    • can't calm or soothe self through pacifier, comfort object, or caregiver
    • can't go from sleeping to awake without distress
    • requires excessive help from caregiver to fall asleep; i.e., rubbing back or head, rocking, long walks, or car rides
  5. Internal Regulation (The Interoceptive Sense)
    • becoming too hot or too cold sooner than others in the same environments; may not appear to ever get cold/hot, may not be able to maintain body temperature effectively
    • difficulty in extreme temperatures or going from one extreme to another; i.e., winter, summer, going from air conditioning to outside heat, a heated house to the cold outside
    • respiration that is too fast, too slow, or cannot switch from one to the other easily as the body demands an appropriate respiratory response
    • heart rate that speeds up or slows down too fast or too slow based on the demands imposed on it
    • respiration and heart rate that takes longer than what is expected to slow down during or after exertion or fear
    • severe/several mood swings throughout the day (angry to happy in short periods of time, perhaps without visible cause)
    • unpredictable state of arousal or inability to control arousal level (hyper to lethargic, quickly, vacillating between the two; over stimulated to under stimulated, within hours or days, depending on activity and setting, etc.)
    • frequent constipation or diarrhea, or mixed during the same day or over a few days
    • difficulty with potty training; does not seem to know when he/she has to go; i.e., cannot feel the necessary sensation that bowel or bladder are full
    • unable to regulate thirst; always thirsty, never thirsty, or oscillates back and forth
    • unable to regulate hunger; eats all the time, won't eat at all, unable to feel full/hungry
    • unable to regulate appetite; has little to no appetite and/or will be "starving" one minute then full two bites later, then back to hungry again (prone to eating disorders and/or failure to thrive)
Source: sensory-processing-disorder.com