Each of us has the ability to sense potential danger. We are able to respond to these events with an appropriate amount of defense. Some people have a tendency to respond to certain harmless sensations as if they were dangerous or painful. This is called "sensory defensiveness".

Sensory defensiveness is simply an over-activation of our protective senses. It is a tendency to react negatively or with alarm to sensation that is generally considered harmless or non-irritating. Take, for example, children with sensory defensiveness. Their clothes may feel like spiders on the skin and a flight of stairs may seem like a cliff to them. Common symptoms may include over-sensitivity or over-reaction to light or unexpected touch, sudden movement, high-pitched noises and certain smells.

Sensory defensiveness results in varying degrees of stress and anxiety with each child. The child with sensory defensiveness may perceive the world as dangerous, alarming or at the very least irritating. Children with sensory defensiveness can be described as sometimes over-active, emotional or sensory-seeking. Learned patterns and habits are often developed around avoiding disrupting sensory events or seeking out sensation that might restore comfort. When sensory defensiveness dominates a child's behaviour, parents or caregivers may find it increasingly difficult to manage the child. For example, the child may frequently hit or bite other children at school, throw temper tantrums during outings or destroy toys and books.

Each child with sensory defensiveness develops his own set of behaviour. These are usually a combination of sensory avoidance and sensory seeking behaviours. There may be defensiveness to one or many types of sensations. Although it is not possible to list all the symptoms of sensory defensiveness, the following is a list of common symptoms that can be attributed to each of the sensory systems.

Tactile Defensiveness:

Children with tactile defensiveness avoid letting people touch them and would rather touch others instead. They frequently fuss or resist hair washing or cutting. They may scream or throw a tantrum during baths/showers or when having their clothes changed. They often do not like to get their hands or feet dirty. Some may bump or crash into things on purpose as a way of seeking sensation or seem under-responsive to certain sensations or pain.

Oral Defensiveness

Some children dislike or avoid certain textures or types of food. They may be over or under-sensitive to spicy or hot foods, avoid putting objects in their mouths and intensely dislike brushing their teeth or washing their faces.

Gravitational Insecurity

This appears to be an irrational fear of change in position or movement. These children are often fearful of having their feet leave the ground, or head tipped backwards e.g. when sitting on swings at the playground.

Postural Insecurity

This is a fear and avoidance of certain movement activities like jumping, hopping and climbing stairs.

Visual Defensiveness

This may involve over-sensitivity to light and visual distractibility. They may startle more easily or avert their eyes and avoid eye contact with others.

Auditory Defensiveness

This reflects an over-sensitivity to certain sounds and fearful responses to noises like vacuum cleaners, motors, fire-alarms etc. Children sometimes make excessive amounts of noise to block out sound.

Others

Other symptoms can include unusual sensitivities to taste or smell.

Occupational therapists have successfully identified and treated sensory defensiveness for many years. It is important that the diagnosis be made by a knowledgeable therapist through a careful sensory history review.

If your child displays some or all of the symptoms, and your daily routines are severely affected by the child's behaviour, you may wish to bring your child to see the occupational therapist for an assessment.

To consult an occupational therapist at KK Hospital's Rehabilitation department, you will need a referral letter from your doctor.