Welcome to SENSE-ABLEBABY.COM!  Where you can find thorough information about sensory processing in babies & its impact on development.

This page includes the following sections and links:

• The Development of Sensory Processing in Infants
• Who Has Difficulties With Sensory Processing
• "Red Flags" for Poor Sensory Processing : Touch, Vision, Hearing, Taste/Smell, Proprioception, Vestibular
• How Poor Sensory Processing Impacts Development : Physical/Motor, Communication, Cognition, Social-Emotional,    Adaptive
• Disclaimer                                                                                             

                                                                      
 

For one reason or another, some children have difficulties processing the sensations that they receive externally from the world or internally from their bodies. Often, children with the following may experience poor sensory processing:

• Prematurity, especially prior to 32 weeks gestation
• Neurological diagnoses including cerebral palsy or under-developed/missing areas of the brain
• Developmental delays and disabilities including Down Syndrome, failure to thrive, and autism
• Exposure to certain drugs in utero (legal or illegal)
• Being diagnosed with a feeding disorder
• Babies who are medically fragile or recently had major surgery (e.g. heart), and have limited time to explore toys and various positions on the floor (e.g. tummy time). Often, once the medical problems resolve, the baby can "catch up" with help
• Multiples- twins, triplets, or more
• Genetic predisposition in which a sibling or parent had difficulties with sensory processing or learning disabilities
• Environmental: babies in orphanages or in a situation that is not very stimulating to the baby's development, or one in which the baby does not bond or attach to at least one caregiver which may be the case with severe neglect
• Poor fit between caregivers and infant, such as a baby who is quieter with a cautious personality who lives within an overwhelmingly loud, chaotic environment with caregivers who have an outgoing personality and do not understand how to "read" the baby's signals of being over-stimulated (listed on "alertness & crying" page)
• Unknown origin

FYI: Some sources use the term sensory processing & others may use the term sensory integration            

             "RED FLAGS" FOR POOR SENSORY PROCESSING

In order to figure out if the baby's sensory processing abilities are typical or not, look at the reaction the infant has to various sensations. Although most infants do not enjoy their noses being wiped or clothing being changed, they should recover quickly from their fussiness. Babies who respond to sensations with more intensity and take a long time to recover may have a sensory processing problem known as over-responsiveness. In comparison, some babies who are described as being overly good may also have poor sensory processing as noted by being under-responsive to sensations. These babies are described as "laid-back" and may not cry much or be interested in interacting with toys and/or people. This can result in delays in development especially in the areas of language and motor skills. See "alertness & crying" page for ideas on how to provide input to the baby to calm or "perk" him up. Listed below are possible symptoms of poor sensory processing from each of the sensory systems:

• TOUCH:
  
  
• Dislikes hugs and may arch when not held "just right"
• Feeding problems 
• Difficulties with self-soothing and calming down
• Dislikes "tummy time"
• Doesn't explore toys with his mouth as expected for a baby
• Sleep problems: takes longer to fall asleep and doesn't stay asleep for long
• Irritable during diaper changes, getting dressed, and/or bathing

  VISION:
  

• Does not give eye-contact when spoken to even when there aren't many distractions
• Does not want to look at toys
• Eyes are not aligned or able to track a moving object 
• Sensitive to the sun and certain types of lighting 

  HEARING:

   

   

• Fussy in loud environments
• Does not turn to person talking to him or act as if he hears the speaker, yet passed hearing tests and doesn't have an ear infection   
• Doesn't babble or make baby noises or does so on a limited basis

  TASTE/SMELL:

• Picky eater- picky about formula or baby food and dislikes textures such as stage 3 baby food or certain finger snacks
• May "pocket" food and not feel it in the roof of the mouth or inside of cheek, especially with blander tasting foods
• Gags or vomits easily with foods and/or smells, in which the behavior is not related to infant reflux

  PROPRIOCEPTION:

• Skips motor milestones such as crawling or is late with motor milestones such as rolling, crawling, and walking
• May dislike maintaining a crawling or standing posture due to putting weight through extremities
• Dislikes playing with push or pull toys for assisted walking
• Falls over when turning his head to the side to look away
• Gets stuck in postures and unsure of how to move, such as when rolling one way, then can't roll back the other way
• Has low muscle tone and tires easily
• Decreased exploration of body parts such as sucking on fingers or playing with his toes
• "Locks" out extremities when in a crawling or standing position and has poor balance reactions
• Delayed with reaching and play skills

  VESTIBULAR:

• Delayed with motor skills such as rolling, sitting, crawling, or cruising along furniture and poor balance reactions
• Dislikes head tilted backwards such as for a diaper change or when being held by an adult who bends over  
• Low muscle tone and seems to have low endurance for motor skills, may feel floppy
• Dislikes unexpected movements such as being tossed in air or bounced
• Overly active with excessive climbing, rolling, crawling, and/or walking
• Responds slowly when listening, moving, or looking at people or objects     

   

   

                HOW POOR SENSORY PROCESSING IMPACTS DEVELOPMENT 

It is typically expected that an infant will progress with his development throughout the first year of life. But sometimes when a child has difficulties with sensory processing then one or more areas of development may be hindered. The five main areas of development include physical, communication, cognition, social-emotional, and adaptive. Three patterns of sensory processing problems that may be seen are:

1. Over-responsiveness- may be sensitive to or avoid that particular sensation (s)
2. Under-responsiveness- may not detect the sensation (s) unless it is intense, therefore appears to not register it; may be lethargic
3. Sensory-seeking- overly desires a particular sensation (s)

There are other patterns of poor sensory processing, but this discussion will be limited to these three, which are also known as sensory modulation problems as they are the most common problems. Listed below are how a child with poor sensory processing may be impacted in the five main areas of development throughout the first year of life.  However, there are numerous other possibilities of how a child's development may be effected by his sensory processing difficulties.

PHYSICAL/ MOTOR:
This area has to do with how the baby uses his large muscle groups for gross motor skills and his small muscle groups (hands) for fine motor skills.

Over-responsiveness to vestibular and proprioceptive input such as avoiding getting in and out of seated and standing postures can result in delayed gross motor skills. Over-responsivity to touch input, also known as tactile sensitvity, can result in delayed fine motor skills since the child may only manipulate toys on a limited basis. It can also result in delayed gross motor skills since the child may not want to put his hands on the floor for crawling or his bare feet on the floor for standing and walking. Babies with over-responsiveness also seem to use their peripheral vision more than their central vision, because they are often "on guard" looking for sensations and events they might perceive to be dangerous.

Babies with under-responsiveness tend to fatigue easily due to low muscle tone and arousal and may not want to explore their surroundings much which can result in delayed gross motor skills. Since they take longer to respond to sensations, they often have poor balance reactions. These babies may also develop asymmetries in which one side of their body is significantly stronger than the other; to rule out any neurological problems (stroke, cerebral palsy, etc.) discuss this symptom with your child's physician. It is also common for babies with under-responsiveness to have delayed functional vision such as tracking their eyes on a moving object/person and giving eye contact. This does not mean they need to wear eyeglasses because often the health of their eyes and near/far sight are fine, but until they develop good trunk and body strength, they may possibly have difficulties with eye movements.

Sensory seeking: this child is often advanced with his gross motor skills, such as being an early walker, but due to his "busyness" might be delayed with fine motor skills.

COMMUNICATION: 
This area has to do with listening, gesturing, body language, and vocalizing sounds or words.

Babies who are over-responsive to touch input may not like to suck on their fingers or put teething toys in their mouth.  This decreased amount of oral input may negatively impact pre-speech skills. Babies who are over-responsive to auditory input may learn to avoid people who are talking or may tune out the noise.

Babies who are under-responsive to auditory input may take a while to respond which makes them appear to not hear or be listening. They may also have low muscle tone which impacts breathing and articulation patterns. If they also have delayed motor coordination, then gesturing and body language may be delayed as well.

Babies who are sensory seeking to motion may be so driven to move that they are not focused on speaking which could result in a language delay. However, babies who are sensory seeking to auditory input may like to make noises with their mouth and therefore could be on target or advanced with communication.

COGNITION:
This area has to do with how the baby is thinking and problem-solving.

Often during the first year of life, cognitive skills are similar to communication skills. When a baby responds to verbal directions or vocalizes, it allows us to know what he is thinking. The older the child gets, these two areas begin to differ more. In addition to the issues listed in the "communication" section above, some other issues may arise from poor sensory processing. Babies who are under-responsive to vestibular and proprioceptive input may not be motivated to roll or crawl to toys which can decrease their opportunities to explore toys. They may initially have the desire to move, but then fatigue quickly or are unable to problem-solve the task. In addition, babies who over-respond to tactile input may have lower cognitive skills because they do not want to touch and explore toys at the same rate as other babies the same age would. 

SOCIAL-EMOTIONAL:
This area has to do with how the baby interacts with other people, bonds and attaches, and handles his emotions.

Often, babies who are over-responsive to noises, touch, and visual input begin to fear being in crowded places and learn to avoid people, especially other children who move around fast in unpredictable ways. Their avoidant behavior may even compromise the attachment and bonding process with their own parents and caregivers. Babies who are over-responsive also tend to be anxious whether it be to movement as noted by how an adult is holding them while walking or to taste as noted by feeding problems.

Babies who are over-responsive or sensory seeking may have sleep problems such as difficulties falling asleep, staying asleep, and self-soothing. When this is the case, they may not be sleeping through the night by an age-expected time and are using the parent to soothe them back into a deep sleep. This may result in a greater separation anxiety from one or both parents than is typical during the waking hours.

Under-responsive babies may not show facial gestures and react as quickly as a typical baby. This negatively impacts bonding and attachment.

Often babies (and children) who are sensory seeking are more intense with their emotions. Although all babies cry, these children may cry for a longer duration and/or with more intensity. On the flip side, they may be more intense with laughter.

ADAPTIVE:
This area has to do with feeding, sleeping, bathing, and dressing abilities.

Babies with over-responsiveness to taste and smell tend to have feeding problems such as excessive gagging and picky eating, whereas babies with under-responsiveness to taste, smell, and touch may have chewing and swallowing problems in addition to poor latch-on to the bottle or breast. 

Over-responsiveness and sensory seeking of touch, movement, noise, and visual inputs may contribute to poor sleeping.

Over-responsiveness to touch and movement impairs bathing, dressing, and diapering routines, as the child is touched during these routines and his head will move in various positions (tilted back or to the side when seated or lying on back or belly). Also, certain clothing or bedding fabrics may be perceived as aversive.