Neurological Processing of Sensory Input
Proprioception
This is information that the body receives through muscles, tendons, ligaments, connective tissues and joints as well as through mechanoreceptors in the skin that respond to stretch. The proprioceptive system gives the unconscious awareness of body position, and body part position in relation to other body parts. It tells the body how much force is necessary for muscles to exert and allows for grading of movement.
Along with the other sensory systems, but particularly the tactile and vestibular systems, proprioceptive information is necessary to make sense of touch and movement experiences; it also helps with postural tone, grading of movement and arousal states within the nervous system. When this is an area that is hyposensitive, cues from the environment through the muscles and joints must be exaggerated in order for the body to respond. This child may then enjoy heavy work activities, bumping, crashing and climbing during play, things which provide a great deal of proprioceptive input which give a better sense of body in space, improve muscle tone and stability, and increase alertness such that motor skills and attending to task are easier.
Hyporesponsive proprioceptive systems may also result in a child who is lethargic, passive or tends to prefer quiet, lying down or sitting down activities. A child may also become somewhat hesitant and cautious of activities where their posture is being challenged, showing a postural insecurity, stemming from a lack of feedback from the proprioceptive system and adding to a lack of confidence that they will be able to deal with postural challenges without losing their balance.
Proprioceptive input can help when muscle tone is low as its receptors send information to the cerebellum to enhance tone and joint stability. Proprioceptive input also has the wonderful quality that it can be used to calm a child who is overstimulated as well as to invigorate a child who is understimulated. It is the least likely input for children to be overwhelmed or overstimulated by.
Vestibular
The vestibular system has communication and innervations to so many different parts of our nervous system and has influence over so many things that when this system is not functioning well it has an impact on virtually all aspects of our lives.
The vestibular system is connected with the cerebellum (which maintains equilibrium, maintains muscle tone, controls coordination and allows us to perform and memorize intricate motor tasks), and with our auditory and visual systems. Through the eighth cranial nerve it is connected with the reticular formation, the limbic system and the autonomic nervous system and therefore has influence over arousal, states of consciousness, the filtering of input, emotional states and the storage of memory. It has an impact on many higher order processes such as language, reading, writing and logical thought.
Influencing balance or providing information about where the body is in space relative to gravity is one of the basic functions of the vestibular system. It provides the information that is needed to know in all directions, at all times, where we are and how fast we are going there.
Our auditory system and vestibular system are inextricably interconnected. They share so much anatomy that it may be helpful to look at them together in order to begin to grasp the relationship between movement and language. Due to the anatomy of the auditory and vestibular systems wherein they share a cranial nerve and are both "housed" in the ear, there is a close relationship between the receptors that are responsible for orienting our body in space and the receptors that are responsible for orienting us to the environment through sound.
One way to look at this is that movement creates low frequency vibrations that the vestibular system perceives, sound creates faster higher frequency vibrations that the auditory system perceives. The difference between movement and sound is the velocity of vibration, there is a spectrum from movement to rhythm to tone. This is why people who are deaf can experience music through the vibrations through their vestibular system. This is why music makes us want to move our bodies. We both feel and hear sound though the vestibular and auditory systems.
There are some important things to mention when looking at the vestibular and auditory systems as a combination. The middle ear's primary function is to transfer the vibrations of the eardrum to the inner ear which is fluid filled and houses the cochlear and vestibular systems that register and carry sound and movement signals. The middle ear also has the job of dampening loud sounds to prevent sensory overload and enhance sound discrimination.
The body is constantly bombarded with sounds and has to determine which sounds are important to attend to more or less instantaneously in order to make sense of what is heard. Our middle ear filter system is closely tied to our survival needs through brain circuits that regulate emotion, arousal and attention. This is why when children have middle ear infections it not only has an impact on their auditory processing and speech articulation, it also has an impact on vestibular function and regulatory abilities.
The vestibular system is linked with the autonomic nervous system which controls, through the sympathetic portion, our fight-flight behaviors that prepare us for dealing with the external demands of our environment and, through the parasympathetic nervous system, our regulation and homeostatic behaviors that allow us to relax and restore.
The vestibular system is also linked with the reticular formation whose major function is to control states of consciousness from asleep to alert and generate our circadian rhythms; enhancing some features of sensation and dampening others. It is yet another part of our filter and screening system for modulating incoming input.
The vestibular system is also linked to the limbic system which is our "emotional brain"; functioning to organize our basic drives and survival behaviors as well as our perception and expression of emotion. The limbic system works to help balance emotions and alertness and reactivity and has the important job of attaching meaning to memories. It is important to understand that our memories do not just deal with the past, they are what we use to make predictions about what is going to happen or what will work "this time". So our memory helps us understand the past and the present, as well as to plan for the future even if that is the immediate future.
The vestibular system is very complex and important, not just for balance, posture and central muscle tone, but for listening, for our emotions, our arousal and our memory. In this way it is important to remember that movement is powerful and likewise not moving is powerful.
Children may have differing processing challenges, it may be that they are oversensitive and over responsive to movement where a little goes a long way; they may not register the input, be hyposensitive and under responsive; or they may be slow to process the input initially but then become overwhelmed as the input is assimilated. So a child may have a very hypersensitive system and may show fear with movement or gravitational insecurity, which has a significant influence on activities that that child will engage in, and of course on all the things we discussed above, balance, arousal levels, communication, visual skills et cetera.
A child may also have a hyposensitive system and this child may be able to engage in intense movement experiences without getting much information at all which again will have a significant influence on activities of choice, balance, arousal, et cetera. A child may have inadequate modulation of vestibular input where they may have no hesitation or fear of movement but may never the less quickly escalate and subsequently become disorganized, impulsive or overwhelmed.
Depending upon the child and situation, vestibular stimulation can either calm or stimulate, it can facilitate a more organized activity level or be over stimulating and disorganizing. Rhythmic and gentle linear input is most frequently calming; rotational, vigorous, inconsistent input tends to be arousing. It depends on the child, their vestibular processing abilities and their present level of arousal what type of input will have what effect.
Tactile
The tactile system has the largest sensory organ, our skin. Thousands of receptors detect the quality of touch, and details of the shape and pressure and temperature of an object. The mouth and fingers have the greatest density of receptors. When this system functions optimally a child is able to bond and attach, wear clothing, get haircuts, play with messy stuff, stand calmly in line, sit quietly next to a friend, and register pain and act accordingly.
Reception and utilization of tactile information can have significant influence on development of higher level developmental and cognitive skills, such as, spatial awareness and spatial relations needed for math and manual writing, social skills and developing personal boundaries or close physical relationships, and independence in self care and grooming.
Light touch tends to be alerting for the body while deep pressure tends to be inhibiting or calming input in general, however, children may have varying responses to different types of touch and textures, different amounts of touch, self initiated or other initiated touch, unanticipated touch or predictable touch. In any of these areas children may have difficulties which also may vary from one day to the next. It is important to be aware of the importance of touch and the constant input that the human body receives through the tactile system in all activities throughout the day.
Children who are over sensitive to tactile input may interpret touch as a threat and avoid any variety of textures, they may become irritated or exhausted by input that they can not desensitize to like tags in clothing or seams in socks, or become stressed by the wind or rain. Children may become easily overwhelmed and may emotionally over-react to being bumped or touched unexpectedly. For the person who is hyper-sensitive to tactile input it is important to recognize how much constant information the body is receiving through all the receptors of the skin, every moment of every day and how that can be overwhelming.
Children who have an under-reactive tactile system may have no problems with a variety of textures but they also may not react to pain, to falls, or to changes in temperature which can lead to safety issues. Poor tactile registration interferes particularly with fine motor skills and precision hand skills as lacking a keen sense of the quality of objects in the hand make it difficult for the hand to develop skill at all.
Visual
Visual acuity is the sharpness of sight and can be impacted by such things as astigmatism or cataracts; a ratio such as 20/20 refers to acuity. Mechanical skills include accommodation or the ability to change focus; binocularity or the teaming of the two eyes together so that they can converge and point to the same place; ocular motor fixation (tracking) or the ability to direct and coordinate eye movement to follow a moving object or move across a line on a page; and eye hand coordination. These are all neuro-muscular abilities controlled by the muscles inside and outside the eye networking with the brain. Visual processing is the brain's ability to organize and interpret information that is "seen," and give it meaning.
Visual acuity, mechanical skills and processing have an impact on skills such as language, visual perception, motor, cognitive, as well as social and interpersonal development. The visual system provides information that allows abilities such as depth perception, object permanence and constancy, perception of background and foreground, differentiation between similar objects, recognition of familiar faces, objects, numbers and letters.
Our vision and ability to process or make sense of the visual information we get is an integral part of learning on a motor level, in communication and social interactions, and on a cognitive level. When a child has difficulty using vision for any reason, in order to compensate there must be successful integration of information from other intact sensory systems, such as auditory, tactile, vestibular or proprioceptive.
Often children with difficulties processing sensory information in other systems rely on their vision heavily to compensate; these children may become very distracted by visual input because they are attending more vigilantly. For many children their vision is a strength as well as a distraction; that is they are visual learners or do well with visual cues, but may have difficulty with concentration or focus because of their attentiveness to visual information.
Auditory
Auditory function includes the reception of sound itself and the "acuity" of hearing, as well as the processing of the information after sound has been "heard". Hearing is not the same as listening. Hearing is the passive process of receiving sound while listening is the ability to process and focus on select sounds in order to interpret their meaning while also blocking out irrelevant sounds.
The physical act of focusing the ear is performed by middle ear muscles which work like a telescope lens, constantly adjusting to fine tune low, middle and high frequency sounds. In some cases the middle ear muscles can become weakened or can be influenced by low muscle tone; both of these things will interfere with auditory perception. In other cases the muscles become overly sensitive and shut out different frequencies altogether which will also interfere with auditory perception and processing.
A child's auditory system may be unable to differentiate and inhibit at appropriate times making auditory input very distracting and disorganizing. Difficulty processing auditory input is most often a separate issue to hearing and in fact children may have adequate or even excellent reception and acuity when auditory processing is challenging. Auditory processing and integration includes the reception and perception/making sense of sound, along with the ability to attend to that sound, remember it, retain it in both the long- and short-term memory, and the ability to localize and listen to sound selectively.
Difficulty processing auditory information may show up in many ways. Children may have strong responses to loud or unexpected sounds crying or holding hands over their ears for protection, and may become distracted in environments with either typical background or more varied noises. Occasionally children may appear to hear what has been said but not respond to what was heard or respond with somewhat off topic answers.
Children may have difficulty tuning out sounds that are "unimportant" to the situation at hand, may make their own noises and sound effects to help tune out other sounds in the environment or may be overstimulated by noises due to difficulty with recognizing foreground and background sounds. Each and every moment of the day the body is bombarded with sound, and has to be able to tune in to what is important and tune out that which is not necessary. When this is difficult a child may easily become overwhelmed or confused.
Modulation of arousal level
Arousal regulation and modulation refers to a person's level of alertness in terms of the state of their nervous system. To attend, concentrate and perform tasks in a manner suitable to any situation, the nervous system must be at an optimum level of arousal for that situation.
Arousal is based on response and registration to input from the environment with over-orientation on one end of the continuum and failure to orient on the other. When a child does not respond or register to a stimulus they tend to be under-aroused, when an individual is highly sensitive to a stimulus they tend to be over-aroused. An underaroused child may be very busy seeking out input to raise their alertness, or an over aroused child may try to be still in order to limit the input they are receiving; it is important to note that the "activity" level of the child is not necessarily the same as the "arousal" level of the nervous system.
Self-regulation is the ability to attain, maintain or change arousal appropriately in order to be successful in a task or environment; this is very challenging for those with sensory processing difficulties or sensory integration difficulties. Arousal levels undergo variations in the course of a day for all individuals and need to in order to be appropriate to the task at hand, so when a child cannot find or maintain adequate arousal it becomes a problem. Rapidly shifting from one extreme to another or spending excessive time at one end or the other of the arousal level spectrum is common for children with sensory processing or sensory integrative difficulties regardless of the diagnosis or primary issue.
Impaired sensory regulation or modulation of the amount of sensory information that enters conscious awareness is where many children have difficulty. Sensory input must be classified by the nervous system in very short order as either important enough to attend to or unimportant enough to ignore. Children with sensory integration or sensory processing challenges admit either too much or too little information into their conscious awareness.
Letting in too much information creates a situation where there is a "competition for the child's attention" from various stimuli which is confusing, distracting or overwhelming; in addition there may be the experience or sense of threat and danger as the sympathetic nervous system is engaged such that fright/flight/fight responses are evoked. Letting in too little information on the other hand creates a situation where the child must seek more input or become lethargic for lack of input.
Children who receive too much information are flooded by more information than they can reliably process. This can be so overwhelming that they may start to tune out important details and fail to respond appropriately to the environment. On the other hand they may not be able to tune out all the unimportant sensory stimuli such that they are unable to ignore any detail. Children who are overstimulated may appear distractible or agitated but they may also become sensory avoidant, turning off or withdrawing in order to limit the information they have to process. Either of these pictures can look something like the lethargic child who is understimulated.
Children who receive too little information and are under-responsive to sensory stimuli may be distractible, on the go, in constant motion in their sensory seeking behaviors as a coping strategy for raising their level of arousal. On the other hand, as a result of being insufficiently alert and not having the motivation to seek input to raise their arousal, they may be more passive or lethargic and need encouragement to get up and play.
For children who are "on the go" or those with frequent "melt downs" behavior does not necessarily improve with stimulation or distractions removed. It is important for all children to get an adequate amount of input; for children with sensory processing challenges it is important to help develop more effective and efficient ways of getting the input necessary to remain organized while maintaining an effective level of arousal. It can be challenging for caregivers to determine whether a child's distractibility is an attempt to seek input to raise their arousal or whether it is an inability to tune out input from an over-responsive system. Good observation skills for the quality of the child's responses and trial and error while getting to know what works for a child can be a challenging process.
Balance
The body maintains, sustains and regains its balance mainly through three systems, the vestibular system housed in the inner ear which tells the body where it is in space relative to gravity, the proprioceptive system which uses information from receptors in the joints and muscles to provide postural awareness of where the body is in space relative to itself, and the visual system which provides necessary information about the body's position in space relative to the environment. Proper balance requires intimate coordination of these systems or senses. In addition balance is influenced by tactile and auditory processing, and by muscle tone all of which provide additional information that helps in the complex task of regaining or sustaining balance. For accurate balance one must have at least two systems working properly, relying heavily on one system or having inaccurate information will affect the efficiency and effectiveness of a child's balance.
Motor Planning
Motor planning is the process of deciding what your body has to do and then doing it; the process includes conceiving, planning, sequencing and executing actions. Good motor planning ability requires accurate sensory processing. Motor planning results from the integrative processes of organizing and executing responses to sensory input; it relies on sensory feedback from the body and environment as well as on language, memory and cognitive or thinking skills. When children are having difficulty processing any sensory information it has an impact on their ability to motor plan.
Many children are quite adaptive at compensating for one system with another, but it takes effort to do this. In addition to simply making acquisition and mastery of motor skills more challenging, difficulty with motor planning (dyspraxia) may have an impact on behavior, ability to make transitions during the day, endurance, tolerance and flexibility, social skills and ability to interact with others (social interactions are unpredictable and require constant changing and adapting). Motor planning is impacted by improving sensory processing in general; therapeutic intervention that is effective works to bring relative sensory hyper and hyposensitivities to the middle and to provide input (vestibular, proprioceptive, tactile or auditory) that supports each system.
EXECUTIVE FUNCTION
Executive function helps people read social cues, adapt their behavior, and stay connected in healthy, balanced relationships. When executive function is weak, a person might appear socially immature, impulsive, insensitive, or withdrawn, even if they care deeply about friendships; they struggle with the self-management skills that smooth social life.
Executive function skills include the following:
1. Inhibition (Impulse Control)
Helps a person pause before speaking or acting, preventing hurtful or inappropriate comments.
Supports taking turns in conversation and resisting the urge to dominate discussions or interrupt.
2. Cognitive Flexibility (Flexible Thinking)
Allows someone to see situations from another person's perspective, a key part of empathy.
Helps with resolving disagreements, adapting when plans change, and understanding that friends may think or feel differently.
3. Working Memory
Enables remembering details about friends' lives (like birthdays or shared experiences).
Helps one keep track of ongoing conversations, so responses stay relevant and connected.
4. Planning and Organization
Supports managing social commitments - remembering to call, text back, or show up on time.
Helps organize shared activities and manage group dynamics.
5. Initiation
Makes it easier to start conversations or reach out to others to make plans.
Encourages taking social risks, like introducing oneself or joining group activities.
6. Self-Monitoring
Involves being aware of how one's words or actions affect others.
Supports adjusting tone, body language, or behavior to fit the social context.
7. Emotional Regulation
Allows someone to handle frustration, rejection, or conflict without overreacting.
Helps maintain stable and supportive friendships, even when problems arise.
LANGUAGE/AUDITORY PROCESSING CHALLENGES
Language Processing Disorder (LPD) (also called Auditory Processing Disorder) is characterized by difficulty understanding and making sense of what is heard. It is different from hearing loss or deafness. Children with LPD may have normal hearing; however, their brains do not process or interpret auditory information correctly. LPD sometimes occurs with speech and language difficulties, learning disabilities, attention deficits, sensory processing disorder, ASD and developmental disabilities. Children with LPD may have difficulty hearing the differences between sounds in words, even when the sounds are clear and loud enough to be heard. These problems may become more apparent when the child is in a noisy environment with multiple sources of sound, in unfamiliar environments, during novel or unfamiliar tasks, during challenging tasks, or when disorganized or dysregulated. Children with language processing difficulties benefit from time, structure, and visual supports.
At School
Common Challenges:
* Trouble following multi-step directions
* Hesitant participation in class
* Misunderstanding peer discussions
Supports:
* Use visuals and written directions
* Give one-step instructions at a time
* Provide extra time for responses
* Check for understanding
* Allow peer or teacher support
* Summarize key points verbally with visual supports
At Home
Common Challenges:
* Appears to 'ignore' when actually processing slowly
* Needs repetition and rephrasing
* Struggles explaining events or feelings
* Frustration during homework or conversations
Supports:
* Get attention before giving directions
* Use clear, short sentences
* Pause between steps
* Reinforce routines and visuals
* Model language and emotion labeling
* Celebrate effort and communication
Social and Emotional Development
Common Challenges:
* Misinterprets jokes or social cues
* Appears shy, anxious, or withdrawn (more-so with peers, greater ease with adults who show more patience and are more predictable)
* Difficulty joining peer conversations
Supports:
* Encourage small group play
* Praise communication attempts
* Coordinate with SLP, OT or counselor
Cognitive and Executive Function Impact
Common Challenges:
* Difficulty recalling or sequencing information
* Appears disorganized or overwhelmed
Supports:
* Provide checklists and visuals
* Practice sequencing routines
Therapeutic and Educational Support
* Speech-Language Therapy for receptive, expressive, and pragmatic skills
* Occupational Therapy for sensory and attention regulation
* IEP or 504 accommodations for classroom success
* Collaboration among teachers, OTs, SLPs, and families ensures consistency
NONVERBAL LEARNING DISORDER
Nonverbal Learning Disorder (NVLD) is a neurodevelopmental condition that affects a person's ability to understand and interpret nonverbal information; body language, facial expressions, tone of voice, spatial awareness, and visual organization. Individuals with NVLD often have strong verbal skills, good memory for facts, and a large vocabulary. On the other hand, challenges they may face are that they may struggle with visual-spatial tasks (like reading maps, puzzles, or handwriting), social communication (understanding social cues), and organization or problem-solving when visual or nonverbal information is involved. NVLD can make math reasoning, reading comprehension of complex material, and abstract thinking more difficult. Because they miss subtle nonverbal cues, individuals may appear awkward, overly literal, or have trouble making or keeping friends. It's important to note that NVLD is not formally recognized as a specific diagnosis, but it is widely recognized and studied in neuropsychology and education.
Additional Resources:
Angie Voss www.asensorylife.com
The Understood website offers a variety of information regarding learning and thinking differences:
https://www.understood.org/en/articles/understanding-sensory-processing-challenges
ASD online social groups: www.aane.org/resources/fa,o;u-and-friends/teens-support-groups/
OCD exposure and response exposure therapy: www.treatmyocd.com
Benefits of physical activity: www.additudemag.com/exercise-and-the-adhd-brain/
The Baffling Behavior Show Podcasts Robyn Gobbel (you can subscribe to her podcasts as well at www.subscribepage.com/startherepodcast)
Vision: Peter Charron, OD Phone: (360) 393-4479 or Amy Bearden, OD Phone: (360) 676-4030
Neuropsychologist: Jody Veltkamp Phone: (360) 676-7445
Sacarin Center: Audiology/Therapeutic Listening Program: Liliana Sacarin, PSI address: 1914 N 34th St Suite 406, Seattle, WA 98103 phone: (206) 522-8873 website: https://sacarin.com/
Animals as Natural Therapy/ANT: Phone: (360) 671-3509 website: https://www.animalsasnaturaltherapy.org/
Northwest Therapeutic Riding Center/NWTRC: Address: 1884 Kelly Rd, Bellingham, WA
98226 Phone: (360) 966-2124 website: https://www.nwtrc.org/
Lang's Horse & Pony Farm 21463 Little Mountain RD, Mount Vernon, WA 98274
(360) 424-7630 www.comeride.com