As a school-based OT, you play a crucial role in supporting students with various challenges, including sensory processing differences. But addressing these challenges is a complex and evolving aspect of school-based OT practice. Sensory processing refers to how our nervous system receives, interprets, and responds to sensory information from our environment. While sensory processing difficulties are commonly observed in children, there is ongoing disagreement about this area of practice. This lack of consensus has left school-based OTs uncertain about the most effective approaches to address sensory processing challenges in students.
Sensory Processing as a Diagnosis
Sensory processing difficulties can affect children and students across a wide range of ages and abilities. While it’s not limited to any specific population, sensory processing challenges are often observed in autistic students or those with ADHD. However, it’s important to note that sensory processing difficulties can also occur in children without any diagnosed conditions. These individuals may exhibit a range of sensory responses, including over-responsivity (being highly sensitive to certain stimuli), under-responsivity (not being responsive enough to certain stimuli), or sensory-seeking behaviors (actively seeking sensory input). Understanding the unique sensory profiles of children and students is crucial for school-based OTs in effectively addressing their specific needs and providing appropriate support.
However, it’s also important to acknowledge that there is ongoing disagreement within the medical community regarding sensory processing. The term “Sensory Processing Disorder” is not currently recognized in the DSM (Diagnostic and Statistical Manual of Mental Disorders) or recommended as a diagnosis by the American Academy of Pediatrics.
Despite the differing viewpoints, your focus should remain on understanding and addressing the individual sensory needs of your students, regardless of diagnosis. By adopting a comprehensive perspective and considering the advantages alongside the challenges, you can better support their educational journey.
Recognizing Sensory Processing Strengths
When viewing sensory processing through a deficits-based lens, you may unintentionally overlook the strengths and advantages that students possess. It’s essential to recognize that sensory preferences vary among individuals, and these preferences can have an impact on regulation, attention, self-help skills, and more. But this isn’t always a negative thing. For instance, a child who appears oblivious to stimuli in their surroundings may actually excel at focusing on a chosen task. By identifying and harnessing these strengths, you provide opportunities for students to thrive in their learning environments.
School-Based OT Sensory Processing Assessment
To start seeing your students through a strengths-based lens, a full evaluation of sensory processing is key. You’ll also want to do this before implementing sensory-based interventions, which also goes along with AOTA’s best practice recommendations. Typically, you’ll want to do an assessment like the Sensory Processing Measure or Sensory Profile. Keep in mind that these assessments are checklist-based and have limitations. You’ll definitely want the student’s teacher to complete a checklist, and you should consider having the parent and student fill one out as well.
Beyond the checklist, it’s critical to complete clinical observations of the student in the natural environment so that you can actually see how their sensory processing abilities may or may not be impacting them in the classroom. You may also want to consider completing a performance-based assessment of sensory processing like the SOSI-M, though standardized options for this type of assessment are very limited at this time, and may not always be a great fit for school-based practice.
Once you’ve completed all of your assessments and observations, it’s key to synthesize them into your evaluation report so that you can develop the full picture of how the student’s sensory processing abilities impact them in the school environment. If you need evaluation report templates, feel free to snag mine here!
Sensory Processing’s Impact on Behavior
One of the most common reasons school-based OTs get sensory referrals is due to behavior. And let’s be clear – sensory processing difficulties can absolutely impact a student’s behavior. But it’s also essential to consider all possible factors contributing to their actions. While sensory factors may play a role, other aspects such as emotional regulation, communication difficulties, or academic challenges could also contribute to certain behaviors. Taking a holistic approach and considering the interplay of various factors will help you develop a comprehensive understanding of your student’s needs and provide appropriate support.
Sensory Processing Treatment in the Schools
In the school setting, our interventions typically focus on accommodations and modifications to the environment. By creating an optimal learning environment, you can empower students to navigate their sensory experiences more effectively. For instance, noise-reduction headphones can be provided to students who become overwhelmed or distracted by auditory stimuli, allowing them to maintain focus. Alternatively, offering students the option to work or take tests in a quiet space can help minimize sensory distractions and promote their success.
This isn’t to say that students never need direct OT services for sensory processing in the schools. And in fact, I’d advise you to be very cautious about ever using a blanket statement like “We only offer consultation for sensory processing needs,” as this is not legally sound and could put your district at risk for a lawsuit. Remember that IEPs need to be individualized and that services should not be predetermined. That includes restricting services for certain deficits by way of “district policy.”
But regardless, it’s also important to remember that our goal in the school system is to uphold the Least Restrive Environment (LRE). This typically means that we want to try to keep students in class receiving instruction as much as possible. Any time we pull a student out for treatment, we’re making their environment more restrictive. And in most cases, I’ve found that accommodations, modifications, and education to the student/team are enough to ensure that a student has access to their educational environment despite sensory differences.
This is also supported by feedback from many adults with sensory processing differences who don’t necessarily want or need to change what they consider to be a core part of their being. Instead, they would like to have easier access to accommodations, in the same way that we offer glasses to people with vision impairments or ramps to people who use wheelchairs. And remember, everyone has a unique profile of sensory processing strengths and weaknesses. That’s not necessarily something we need to change or encourage conformity with. Differences are what make us special. Diverse perspectives, talents, and abilities contribute to innovation, problem-solving, and the richness of human experience.
Evidence-Based Approaches for Sensory Processing
The field of sensory processing intervention is characterized by diverse approaches, and there is ongoing debate about the most effective treatment methods. It’s crucial to critically evaluate the interventions you employ, ensuring they are supported by evidence and aligned with best practices.
One of my favorite ways to stay updated with current evidence is using Google Scholar. With this tool, you can look up specific interventions to review research studies. Alternatively, you can set keyword alerts. I have one set up for “sensory processing,” so anytime new studies are published, I get an email right in my inbox.
While certain interventions, such as therapeutic brushing or integrated listening, may not have sufficient scientific backing, it’s important to remember that every student is different. If you’ve already tried more evidence-based interventions and have been unsuccessful, it’s okay to try strategies that don’t have as much support in the literature as long as they are not harmful. In these cases, it’s very important to collect and analyze data specific to each student. This way, you can determine the effectiveness of interventions for your individual student even if they don’t have extensive research support.
Sensory processing difficulties are a complex area of concern that requires careful consideration and individualized support. Despite the ongoing disagreements and uncertainties in the medical community, your focus as a school-based OT is to understand and address the unique sensory needs of your students. By recognizing sensory strengths, completing thorough assessments, employing evidence-based interventions, and implementing appropriate accommodations, you can provide a supportive environment that fosters student success. Remember, each student is a unique individual, and our goal is to empower them on their educational journey while honoring their autonomy and individual experiences.
Want to learn more about OT assessment and intervention in the school system? My course, The Dynamic School OT, is the perfect resource for any therapist looking to become a more effective school-based OT. We’ll take an even more in-depth look at sensory processing, as well as other appropriate interventions, assessment, and time management. Click here to learn more!