One of the greatest benefits to parents, teachers or others working, or interacting, with a child who has sensory issues is to arm themselves with knowledge on the brain and well-functioning sensory integration. Understanding how the brain and the sensory systems are supposed to work together for most individuals will assist in seeing how conditions such as Sensory Processing Disorder (SPD) can cause hurdles in overall sensory functioning, as well as to understand how sensory integration therapy helps to correct these issues. Today’s focus is the auditory sensory system, or the sense of hearing.
This system relies on vibrations that are triggered by sounds waves, and the sounds we hear are made up of four important areas that, together, create our overall interpretation of what we hear:
- Tone (or dynamics) – how loud or soft a sound is.
- Pitch – involves how high or low a sound is.
- Timbre – the quality of various sounds that distinguish them from each other.
- Duration – the length of time a sound continues without interruption.
In a properly functioning auditory system, the brain relies on these areas working together to be able to distinguish among different sounds as loud, soft, squeaky, gravelly or glass-shattering. The receptors in the middle ear send auditory sensations to the temporal lobe for processing. Not only does the brain give information about what is heard, it also directs how to respond to auditory stimuli.
The receptors also impact aspects of the vestibular system such as balance, equilibrium and coordination. This is because one of the main parts of the auditory system, called the cochlea, works directly with the vestibular system in sending and receiving sensory and motor information about where the body is in relation to people and objects in the environment as well as keeping the body upright and balanced.
Hearing is also closely related to language development. That’s often why children who have language or speech delays are sent for hearing tests to eliminate the possibility of hearing loss or some other underlying condition. If a child’s brain isn’t receiving sound stimuli from their environment, or the information isn’t being processed properly, that child may not develop language and speech the same way other children do, if at all. Of course, hearing problems aren’t the only possible cause of a child’s language or speech struggles, but the two are often connected.
The processing centers in the brain for visual and auditory information are located very close together and often exchange information. This could explain why children with sensory sensitivities are easily distracted and can experience sensory overload in busy, loud places.
Bearing all of this in mind, children with SPD may:
- Be frightened of loud or sudden noises, including certain pitched voices, thunder, sirens, vacuum cleaners or car horns.
- Become distressed from high-pitched sounds like whistles, screaming, baby cries, higher-pitch speaking or singing voices or squealing tires.
- Hear or notice sounds that most of us ignore, like toilets flushing, zippers or diaper tabs, Velcro or the humming sound some lights make.
- Have difficulty distinguishing among various noises presented together, such as when an orchestra plays or when there’s a lot of noise in a room.
- Be unable to distinguish difference between tones, like whether a voice sounds mad or happy.
- Be unable to focus when someone is speaking to them or when doing an activity because of other noises around them.
- Have difficulty following lessons, discussions or conversations.
- Have difficulty keeping time with music or other music/movement activities or recognizing /following rhymes.
- Have difficulty distinguishing between words that sound similar.
- Have a shorter attention span and misunderstand questions.
- Need more repetition for directions or descriptions than usual.
- Have trouble with expressive language because their auditory systems aren’t helping them learn how to speak, interact verbally or otherwise put their thoughts into words. Other signs include delay in speaking, a weak vocabulary, poor grammar, limited imaginative play and difficulty reading/following stories.
This list is not exhaustive, but these are some of the main areas that OTs assess and help create specific exercises and activities for to help integrate the auditory system in children with SPD and other sensory issues. Although each plan is specified to a child’s needs, some basic suggestions parents can try at home, in addition to those given from their OT, might be:
- Reduce background noise whenever possible. Noise-reduction headphones are a great tool to invest in that will assist in this area.
- Have your child look at you when you’re speaking. The child is more likely to take and understand direction when their concentration is fully on who’s speaking to them.
- Use simple, expressive sentences. Children with auditory issues already struggle with processing what they hear. Simplicity and clarity are key in communicating with them.
- Speak at a slightly slower rate and at a mildly increased volume. Due to the tone and pitch issues stated above, these children often can’t process what we’re saying if our voice pitch and tone, as well as the speed at which we speak, is ‘too much’. Starting slow and low, gradually increasing intensity in these areas as tolerance allows, is how the child will learn to distinguish among and tolerate different sounds.
- Ask your child to repeat directions, or the steps involved, in a given task. It also helps to make sure that directions or steps are as few as possible and easy to follow as children with SPD often get ‘lost’ when trying to complete a task. Visual cues, like pictures or a checklist, are helpful tools.
- For tasks that need to be completed later on, having a chart displaying the child’s household chores or ‘job’ list to refer to (including times they should be taken care of) will help increase organization, attention, memory and self-reliance.
- It can be frustrating for children with SPD who have high auditory issues when they’re in a noisy setting and they need to listen. Teach them to recognize when an environment is too noisy and have a quiet place for them to remove themselves to.
In a school setting, the child should be able to take what they practice at home, and are learning in therapy, and be able to apply similar strategies in the school environment. This is where strong communication between school and home is vital. Parents should advise the teachers what works at home, and see what could be done in the classroom to help with learning, concentration and attention.
Some simple changes such as having the child sit in the front for work or circle time, positioning their work area away from the window or classroom door, using special recording devices for instruction or even allowing the use of noise reduction headphones are all ideal ways for the child to focus on the task at hand.
The most important outcome for children with SPD and auditory issues is instilling a positive and strong self-esteem. It is difficult enough for these children to try to be as successful as their peers seem to be when hurdles are at play. However, these children are more than able to achieve the same success. All they need are the right coping tools, the best-fitting strategies and the loving support and understanding of those around them.