#42 - Sensory Processing Disorder Teenage Symptoms

Hello hello,

Welcome back to episode #42 of the Food Explorers Podcast. I just want to start by saying - I’m so happy you’re here. This podcast has grown week by week and I am just so grateful to every single one of you who tunes in to join me. If you’ve been loving this podcast, I would be so grateful if you would consider leaving a review, or share it with a friend, as it helps others just like you find this podcast, and get the information they’ve been searching for. 

Today we are talking all about sensory processing challenges with teenagers. Raising a teenager is tough, and that’s when they don’t have sensory or feeding challenges. When we add those in, it’s a whole new kind of tough. 

But that doesn’t mean hope is lost. Many people think that by the time we reach teenage years it’s too late. It’s not. As humans we grow, change, and learn every single day. Literally from the time we’re born until the time we die. It is never too late to learn new skills, or make changes.

Think about this - you’re here learning with me today. You’re older than a teenager. So why would we think a teen couldn’t learn too? They can, if we give them the chance and the right supports. 

Before we dive in, I do want to say that most of this episode is based on my own personal experience. I tried to look up research in this area and it was pretty limited when trying to specifically target teenagers. Doesn’t mean it’s not out there, but I just didn’t have success yet.

First, let’s talk about the term sensory processing disorder.

When you hear me talk, you’ll usually see that I say sensory processing difficulties. This is for one major reason. As an occupational therapist, it is not within my scope to diagnose disorders. 

Now, it’s really interesting. Because the majority of the time, a doctor will make a sensory processing disorder diagnosis off of an occupational therapist’s evaluation and findings. But in our evaluation we point out areas of sensory processing where a child or adult may be having difficulties. So that’s why you’ll hear me say difficulty instead of disorder.

What is sensory processing disorder?

According to Dr. Lucy Jane Miller, sensory processing disorder, also known as SPD, “exists when sensory signals are not organized into appropriate response; as a result, a child’s daily routines and activities are disrupted. Atypical responses to sensory messages can be behavioral, emotional, or attention related or they can manifest as problems with motor abilities or organization”

The reason I chose to quote Dr. Lucy Jane Miller, is because as an OT she is who you think about when you think about sensory processing disorder. She herself studied under Dr. Jean Ayres, the founder of the sensory integration theory. She is also the founder of the STAR Institute, where much of the research and education on sensory processing originates. 

In her book, Sensational Kids: Hope and Help for Children With Sensory Processing Disorder, she also shares 10 research supported statements she recommends sharing about sensory processing disorder, so I wanted to share those with you:

1. Sensory Processing Disorder is a complex disorder of the brain that affects developing children and adults.
2. Parent surveys, clinical assessments, and laboratory protocols exist to identify children with SPD.
3. At least one in twenty people in the general population may be affected by SPD.
4. In children who are gifted and those with ADHD, Autism, and fragile X syndrome, the prevalence of SPD is much higher than in the general population.
5. Studies have found a significant difference between the physiology of children with SPD and children who are typically developing.
6. Studies have found a significant difference between the physiology of children with SPD and children with ADHD.
7. Sensory Processing Disorder has unique sensory symptoms that are not explained by other known disorders.
8. Heredity may be one cause of the disorder.
9. Laboratory studies suggest that the sympathetic and parasympathetic nervous systems are not functioning typically in children with SPD.
10. Preliminary research data support decades of anecdotal evidence that occupational therapy is an effective intervention for treating the symptoms of SPD.

I know that next questions coming up for many of you is - how do I know if my child has sensory processing disorder?

Or how do I find out? Currently, sensory processing disorder is not recognized as a formal standalone diagnosis in the DSM. Rather, it is included within other larger diagnoses like autism or ADHD.

Occupational therapists do have standardized ways to assess sensory difficulties, so that could be a great place to start - but they cannot offer a full diagnosis - that must come from a physician.

Since you’re here today I’m guessing you might have already noticed some symptoms or signs that your teen might be struggling with sensory processing challenges. 

Unfortunately, when it comes to teens, there really is limited support out there. There’s a ton of education & support for children, but not so much for teens. Personally, in the practices I’ve worked in, it’s actually been pretty rare for me to receive a referral for a teenager. Often, they’ve received therapies in the past and had graduated out either because they were not improving as much as the therapist hoped, or they mastered the skills they needed at the time.

But here’s the thing - needs change as children age, and teens need just as much support as younger children do.

So today I wanted to talk about some areas of sensory processing where teenagers may be struggling, and some ideas of how we can start to support them.

• Changing bodies: I put this as number one, because I think this is the most obvious area we think about when it comes to teenagers. I mean a couple different things here. 
• There’s a lot of physical growth during this time. We often see that teens are clumsy, and that’s often because the proportions of their body are changing, and their proprioceptive sense needs to adjust to support them. 
• During puberty we can’t ignore sexual health. For teenage boys it may be education and strategies to support new urges. For teenage girls we also may additionally want to talk about bras and periods. Bras, tampons, and pads all bring a new sensory challenge to the party. They’re not very comfortable. And people with sensory processing challenges often feel sensory input more, so some teenagers may really struggle with needing to wear these. Education is key here, but it is going to differ based on your child’s level of understanding. I really like using social stories and visual aids for teaching all about sexual urges, periods, and bras. There’s some great options out there on Teachers Pay Teachers. And I’ve heard of many families having success with those new period panties, as they can offer a bit more comfort. There’s a lot of trial and error when it comes to bras and these types of things, as everybody is comfortable with different types of sensory input.
  
  
• Socialization: autistic teenagers and teens with sensory processing challenges can struggle with interacting with their peers appropriately. 
• The visual input from looking people in the eyes may be too much. 
• They may not pick up social cues. Again social stories and education can be your friend here. 
• They may have a hard time wearing the type of clothing their friends wear. So searching for sensory friendly options can help them feel like they are better fitting in. 
• Or, they may shy away from sports and physical activities because of motor planning and postural challenges. A really interesting study identified that kids with sensory seeking tendencies were more likely to participate in activities, while teens with low registration or sensory avoidance were less likely to. If these terms are unfamiliar to you, I highly recommend you take my Understanding Sensory Challenges mini-course, coming out anyday. I truly believe that if you have a child with sensory challenges, you need to know their sensory type and profile, and this mini-course helps teach you that. If your teen struggles with physical activities or has a hard time keeping up with their peers, this is where occupational and physical therapy can really help. I feel like it’s rare to see a referral for this, but SO many teens with sensory processing challenges demonstrate muscle weakness and endurance challenges that therapy can vastly improve. 

I think a really great strategy is to pinpoint your teen’s interests and strengths and what they enjoy and encourage them to find friends who have those same interests. For example, this is where I believe that screen time might be helpful. They can play virtually with their friends and still have a social connection without the added challenge of social situations and sports. Now, I’m not saying avoid those activities, because that is super important too, but it can be a way to help them connect with friends. We know that socialization is one of the biggest parts of being a teenager, and so finding ways for them to connect and relate to friends can be a vital part of promoting their mental, emotional, and social health.

•  School: of course, we can’t ignore that learning may be more challenging for teens with sensory challenges. 

• They may have a hard time sitting still in class
• Looking back and forth from the board
• Handwriting
• Processing what the teacher is saying
• Focusing, and more. 

From my experience, school struggles can trigger low self-esteem. If your teen struggles in school, it’s really important to sit down with the teacher and your teen (remember your teen will give you awesome information we can’t get from younger children) and figure out what exactly is breaking down in the learning process, and where they need a bit more support. If you haven’t listened to it already, I highly recommend checking out my back-to-school series on the podcast. Those are episodes 35-40.

• Regulation: Overall, we all know of the teenage years as being a time of moodiness and hormones. But, when a teenager also has sensory processing issues, this can be exacerbated. As you know, I like to talk about our sensory system as a thermometer. When we feel just right, we’re at that perfect temperature. But other times our body can be too irritable or excited and be too hot. Or it can be sleepy and sluggish and be too cold. As a teen, hormones are often already making you lean a bit more toward one way or the other, so they may be more prone to pop or breakdown when sensory information pushes their sensory thermometer even farther. Teaching them about this sensory thermometer, and identifying how they feel in the moment can help them take control of their body and mind.
  
  
• Eating: Children with feeding challenges turn into teenagers with feeding challenges. But at this age, it can become more anxiety provoking and embarrassing for them in front of friends. In fact, we just had a family friend who didn’t go on a trip with their family and friends because they were scared they wouldn’t be able to eat anything in a different country. I’ve also worked with teenagers who are embarrassed because when they go to a restaurant the food doesn’t look like they expected, and they don’t want to ask for it to be fixed in front of their friends. Teenagers are one of my favorite ages to work with when it comes to eating, because they are really ready to make changes, and we can talk about it and problem solve together. In fact, in the Food Explorers Membership I have an entire training devoted to older children, and next month I’m releasing a new short training on how to specifically explore new foods with older kids & teens. 
  
  
• Life skills: As a teenager, learning independent life skills is an important way to prepare for college, or moving out on your own. For example, being able to prepare simple meals, do laundry, open packages, make the bed and more. Teens with sensory processing challenges may struggle with fine motor skills, sequencing, coordination, and more, making these activities really challenging. And when it’s too challenging, they don’t want to keep trying. For this, I love breaking it down into really simple steps and start by practicing just one step at a time. We want them to feel successful, because this is motivating to keep going and learning more.
  
  

So these are just a couple areas. Of course, teens can experience a lot of the same sensory processing challenges younger kids do too.  For example - difficulty with sounds, lights, or movement. It’s really about sitting down and figuring out exactly where your teen is feeling limited, and then figuring out what sensory components might be contributing to this. Of course, an occupational therapy evaluation can really help you with that. Unfortunately, as I mentioned at the beginning of this episode, I don’t know of a lot of specific places that specialize in teenagers. But I recommend calling therapy clinics in your area and seeing if the therapists are comfortable working with teens. They may also be able to receive occupational therapy in the school system if they qualify, or there are also certain centers and businesses that focus on independent life skills. 

In general, when it comes to teenagers, there’s are a couple strategies I do like to use:

1. Collaboration: With younger children we spend a lot of time demonstrating techniques, and having them play along or follow. But with older children and teenagers I like to work more in a collaborative way. I want to know what THEY want to work on, where they struggle, where they feel stuck. We are more motivated to do things that feel important to us, so working with them as a team tends to be a much more useful approach for me.
   
   
2. Education: It can feel really frustrating and confusing for teens when their body and brain are acting differently than their peers. I’m a big fan of providing education that helps them feel connected with their body. Teaching them about their sensory system, and how to identify strategies that help their body and mind return to that just right spot, can help them feel more confident and empowered.
   
   
3. Age-appropriate activities: For a teenager, I’m a lot less likely to be introducing messy play with shaving cream. Instead, I’m focusing more on age appropriate activities. For example, if shaving cream is an issue, maybe we’re introducing it by practicing shaving their face or legs with-out a razor. Or we’re working on getting dirty by cooking in the kitchen. Or working on strengthening through yoga. I like to tune into exactly what kind of activities a teen is interested in, and go from there. The best way to do this? Ask! I like to talk about a whole bunch of different ideas, and see where we go from there.

I’d love to know what you thought of this episode, or if there’s an area I missed for teens, head on over to @DrSamGoldman on Instagram and send me a DM.

And keep an eye out because my newest mini-course - Understanding Sensory Processing challenges will be dropping as soon as possible, and you are not going to want to miss this one. We go deep into the different types of sensory processing challenges, the subtypes, and the different profiles. A really important consideration to helping your teen is understanding what exactly is going on inside their mind and body. I can’t wait to see you there.

References:

1. https://sensoryhealth.org/basic/founder-dr-lucy-jane-miller
2. https://sensoryhealth.org/basic/understanding-sensory-processing-disorder
3. https://www.mdpi.com/2227-9067/8/11/1005 

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