Navigating Adult Sensory Processing Disorder as OTs

Sensory processing disorder seems to be a buzz phrase or diagnosis at the moment. You may know it as sensory integration disorder. Many adult-based occupational therapists have heard about it, but may not be familiar with treating it. It is often a condition more associated with the pediatric community, and OTs working with the adult community may feel at a loss for what to do. You can, however, see this condition in adults too, so this article will go into greater detail on adult sensory processing disorder and what you can do to address it.

What is Adult Sensory Processing Disorder?

Medical explanation:

• Sensory processing disorder disrupts the brain’s ability to process sensory information. 
• Sensory information includes information we receive from: hearing, seeing, feeling, tasting, and even proprioceptive and vestibular information (1).
• Sensory processing disorder can therefore interfere with how we integrate, modulate, analyze, and interpret these senses. This can result in hypersensitivity to your environment, which can impact day-to-day functioning (1).

Simpler explanation:

• Our brain receives information from our senses every second of the day!
• In neurotypical people, this information is filtered appropriately, and only the most important information makes its way to our conscious awareness. 
• In people with sensory processing disorder, the brain has difficulty filtering the information, and it is therefore bombarded with information throughout the day. You can imagine how this can feel overwhelming and draining. Some people can even be under-responsive to the stimuli. 

How Does Adult Sensory Processing Disorder Present?

Every adult will experience sensory processing disorder differently, but examples may include:

• Being particular with what clothes they wear: how it fits, if tags or seams are bothering them, and they don’t enjoy the feel of certain textures/materials.
• Sensitivity to certain tastes or smells. Ex: being hyper aware of people wearing perfumes, or not enjoying the texture of certain foods. 
• Feeling uncomfortable in busy, loud areas and wanting the TV or music to be lower. 
• Discomfort with being in close contact with other people and being touched (like with hugging or cuddling)
• Difficulty with balance, coordination, and fear of escalators or elevators (2).

Many people with sensory processing disorder feel as if they are being attacked by their everyday experiences. Several adults never received diagnoses during their childhood and therefore never learned to develop coping strategies or developed an awareness of their sensory needs.

It is unlikely that their symptoms started only in adulthood. Occupational therapists can assist with sensory integration and modulation at any point in a person’s life. 

What Does the Medical Community Say?

Unfortunately, there is ongoing debate as to whether sensory processing disorder can be a standalone diagnosis or whether it is linked to ADHD or autism (3). Currently, it is not considered a standalone diagnosis. It is also not currently recognized in the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders). Irrespective of this, occupational therapists can still assist with intervention. 

There are several studies that have been done that are researching the link between sensory processing difficulties and anxiety. A study found that sensory processing impairments in childhood may increase the risk of anxiety disorders in adulthood (4).

Adult Sensory Processing Disorder Assessment

One needs to assess the sensory profile of an adult in order to ascertain in which areas the adult is over or under sensitive. Doing a thorough assessment is integral to be able to structure your intervention accordingly.

• Pearson has a well-rounded assessment to form a sensory profile, but unfortunately, it does have to be purchased. You can find the Adolescent/Adult Sensory Profile here.
• There are also many free sensory checklists available online. Just note that they are not standardized assessments, but rather are helpful in yielding further information about where the adult is over or under sensitive in different areas. Here is an example of one (SPD Symptoms), and here is another one (Sensory Assessment List).
• Here is a lovely, free screening questionnaire for Sensory Defensiveness in Adults.
• Lastly, here is a free Sensory Motor Preference Checklist for Adults 

Adult Sensory Processing Disorder Intervention

Education

As always, we want to help our patients gain greater insight into what they are experiencing and why they are feeling that way. You can teach them about their individual sensory profiles, and what activities seem to be enjoyable or calming for them, versus what activities result in sensory overload for them. Raise their awareness on how their SPD might be affecting them daily in their different occupations.

Incorporating a Sensory Diet

You can use this checklist of sensory diet activities to help your patients learn more about what activities are helpful to them when feeling distressed.

Helping your patient develop a sensory diet is very helpful in supporting the sensory needs of that individual. This can help them to self-regulate, and avoid feeling overwhelmed. The OT Toolbox has a lovely article on this here that provides ideas and activities in categories according to the different senses. 

Keeping a Sensory Journal 

Writing down different activities during the day and tracking how overwhelmed/sensory overloaded you feel is very helpful in identifying triggers, as well as what activities are calming or non-threatening. This will help your patient gain greater insight into their own sensory profile, and help them with planning activities in the future. For example, if you’ve noticed from your sensory journal that you always have difficulty concentrating, and feel irritable or overwhelmed after going to a loud, busy bar, you can choose alternatives that you know are quieter. 

Sensory Integration

This will include using activities to expose the adult to different sensory elements. This is done by a trained OT in a structured and repeated manner, to allow the brain to adapt and the adult to process and cope with challenging sensory experiences. Activities will be upgraded and made more complex so that over time the adult can cope with a variety of scenarios (4).

Environmental Adaptations

As OTs we are well-tailored to be able to assist with appropriate adaptations of the home, school and work environment according to the patient’s sensory needs.

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As you can see, sensory processing disorder is a complex condition that is so different in each adult. For this reason, it is very helpful to have an occupational therapist assess their patient’s sensory profile, and use this information to provide individualized intervention. 

References

1. Rodden. J, ‘Signs of Sensory Processing Disorder in Adults’, Additude, 2023, https://www.additudemag.com/sensory-processing-disorder-in-adults/#:~:text=If%20you%20are%20hypersensitive%20to,don’t%20hear%20or%20feel, Accessed on: 3/31/23. 
2. Patterson. E, ‘Sensory Processing Disorder: Signs, Symptoms, & Treatments’, Choosing Therapy, 2022, https://www.choosingtherapy.com/sensory-processing-disorder/, Accessed on: 3/31/23. 
3. Sullivan. D, ‘Introduction to Sensory Processing Disorders in Adults, Neurodiverging, https://www.neurodiverging.com/introduction-to-sensory-processing-disorder/#How_Does_Sensory_Overwhelm_Occur, Accessed on: 3/31/23.
4. McMahon. K, Anand. D , Morris-Jones, M , Rosenthal. M, ‘A Path from Childhood Sensory Processing Disorder to Anxiety Disorders’, Frontiers in Integrative Neuroscience, Volume 13, 2019.