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April, 2013

"Sense"ationalizing Your Office

By Monika A. Buerger, BA, DC

It is going to be another great day in the office. On the schedule is a six year-old child with chronic ear infections coming to you as a new patient. Unbeknownst to you, this child also struggles with attention issues and frequent aggressive outbursts. In the last issue of Practice Insights, we brought a glimpse of what a neurodevelopment practice might look like. We also mentioned Sensory Processing Disorder (SPD) and promised to bring you more on this unique population group.

I would first like you to partake in an "out of body experience" with me. Try and forget who you are and that you have ever been inside your office before. You are now this six year-old child coming to your office for the first time. When you open the door to your office, what do your eyes tell your brain, is it too bright and distracting? Is there a lot of movement and chaos? What about your ears, is it noisy? What does your nose smell, chemicals or other toxic elements? Are there toys that you can touch that your brain may enjoy? Is there seating that is warm and inviting that may help keep you grounded while you anxiously wait for your appointment? Was all of the initial paperwork received ahead of time or do you have to try and sit still while your mother or father fills everything out?

With the numbers drastically on the rise, it is imperative that our profession better understand this population group in order to provide them with the most optimal care. In this article, we will discuss environmental strategies as well as chiropractic strategies to help individuals struggling with sensory processing issues.

What is Sensory Processing Disorder?

Sensory Processing Disorder is the inability to take in, organize, analyze and integrate information the brain receives from the senses and then respond in a meaningful and appropriate manner. In essence, sensory input does not lead to proper motor output. The neurological disorganization resulting in SPD occurs in three different ways: 1) the brain does not receive messages due to a disconnection in the nerve cells, 2) sensory messages are received inconsistently, or 3) sensory messages are received consistently, but do not connect properly with other sensory messages. When the brain processes sensory messages poorly, inefficient motor, academic or emotional output is the result. A 2009 study in the Journal of Abnormal Child Psychology suggests that one in every six children have sensory issues that impede their daily functioning, socialization and learning. It is important to know that SPD is not restricted to children only. Adults with Sensory Defensiveness are thought to have higher rates of anxiety and depression as a result of trying to apply coping mechanisms in order to handle the abnormal sensory input to their brain.

The Eight Senses

The sensory processing system is comprised of five far senses: auditory, visual, tactile, taste and olfactory. This is information we take in from the outside world. In addition, there are three near senses: vestibular, proprioceptive and interoceptive. This information is received from our internal self. The vestibular system is thought to be the "chief regulator" of sensory processing with the ability to "ramp up or tone down" information coming into the CNS from all other sensory systems. Interoceptive sensation is that received from our internal viscera and organs and is primarily regulated via the Vagus Nerve.

Autonomic Regulation

The neurological underpinning within this population group is that of autonomic dysregulation. A person struggling with sensory issues may be hypersensitive to stimuli and deemed "Sensory Defensive." They are often in "fight or flight" with the sympathetic nervous on full throttle most of the time. These individuals experience otherwise non-noxious sensation as being harmful, painful or distracting and may not habituate to or cannot function effectively in their presence. As chiropractors, we must be mindful of potential vertebral subluxations in the parasympathetic nervous system when it comes to the sensory defensive (also known as sensory over-responders) patient. The adrenal glands will most likely be taxed with these individuals; thus, we will also see signs of adrenal fatigue and immune compromise. In such cases, support with dietary counseling and proper supplementation is imperative in conjunction with the adjustment. It is thought that approximately 56% of those with Autism Spectrum Disorder (ASD) and approximately 69% with ADHD are said to be sensory over-responders.

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