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Sense & Sensibility

And how it relates to speech and language!


Sight, taste, touch, smell, and hearing. They’re the five senses we learned about in grade school, right? But did you know there are three more?  


Proprioception, Vestibular, and Interoception.  


We promise we didn’t make these up! These are lesser known, but equally important, senses. 


Ballerina

Let’s start with proprioception. Our proprioceptive sense is our awareness of our own body parts and their movements. It’s kind of like the dancer of the senses – the one that helps us move our body in a coordinated way. Nailed that tricky pose in your weekly yoga class? That’s your proprioceptive sense at work. 


Thrill Seeker

The vestibular sense is the thrill seeker of the group (kind of). It provides input about our feeling of balance and how we perceive our body in space. Love riding the scariest rollercoasters at theme parks? You’re stimulating your vestibular sense! On the flipside, if you feel a bit dizzy when you’re at the top of a tall building, that’s your vestibular sense telling your brain and body you’d rather be on lower ground! 


Whiny toddler

Finally, our interoceptive sense is a bit like a whiny two-year-old. “Mooooom, I’m hungry! Daaaaad, I’m tired!” Or, in more clinical terms: interoception is our awareness of our internal states. Ready for your morning coffee? That’s your interoception kicking in telling you that you need a boost! Feeling bloated after a big family dinner? Thank you intere


But what does this have to do with speech and language?


Hang on, Talk Time is a speech and language clinic. Why are we talking about senses?


Glad you asked! 


I’ll start with a caveat: SLPs are NOT occupational therapists (although we love to collaborate with our OT colleagues). According to the American Occupational Therapy Association, OT intervention “uses everyday life activities to promote health, well-being, and your ability to participate in the important activities in your life”. This includes finding ways of helping children regulate any sensory sensitivities and needs. OTs are the truly experts in this area. If your child has specific sensory needs, we will always recommend you consult with a professional, licensed OT.


Occupational therapy speech therapy

However, at Talk Time Boston, we work with many families who have a child with Autism Spectrum Disorder (ASD). As many as 74% Autistic individuals also have documented sensory differences (Kirby et al., 2022). 


These differences are often one of the first features that parents and professionals spot in early autism screenings (Wiggins et al., 2021). In fact, sensory differences are a key part of an ASD diagnosis. 


We also work with a variety of other disorders – like ADHD – that often co-occur with sensory differences. That means it’s really important we know about them and incorporate them into our treatment sessions where possible. 


Let’s take a step back… what exactly are sensory differences? 


Okay, so another caveat:

There’s no hard and fast rule for what sensory differences look like. ALL individuals – whether neurodivergent or neurotypical – have sensory preferences and aversions. 

Let’s imagine that it’s 3am, and you’re fast asleep in your warm bed. Suddenly, the fire alarm goes off, bright lights turn on, and you realize that heat has turned off during the night. How does that make you feel? 


Children who experience sensory differences might feel like this at many points throughout the day. It may make them want to cover their eyes or ears, or even run and hide. It may also make them want MORE of certain sensory environments. For example, feeling new textures all along their arms, or on their faces (rather than just with their hands). 


The key thing is that sensory differences look different for everyone. For neurodivergent individuals, their sensory systems can be over- or under-reactive enough that it affects simple, daily activities (Schenker, 2022). It’s important for that we help kids with sensory differences to be regulated (however that looks for them) so that they are ready to learn. This is why we want to know about sensory needs for speech therapy.


Hypersensitivity vs. Hyposensitivity 


Let’s first talk about the difference between hypersensitivity and hyposensitivity


Important reminder: hypo- and hyper-sensitivity are NOT mutually exclusive. Most Autistic people will experience a combination of the two. 


  • Hypersensitivity can also be called sensory avoiding, or sensory defensive. It’s a heightened response to situations that some people may be able to easily tune out (like bright lights or loud noises – or even certain tastes, smells, or textures). 

  • Hyposensitivity – also known as sensory seeking – is the opposite end of the sensory spectrum. While hypersensitivity might result in aversion or avoidance of sensory input, hyposensitivity might result in pursuing more intense levels of sensory experiences. This might look like exploring things with various parts of the body – such as putting non-edible objects in and around the lips and mouth. It also might look like spinning round in circles, or banging body parts into different surfaces.  


Reframing Autism, an Autistic-led charity, offer some sensory tips for creating a neurodiversity affirming environment for Autistic children: 


  1. Attend to the sensory environment. Autistic students are likely to have heightened sensory needs, and will feel sensory overwhelm much more easily than their peers. That means if it is too loud, too visually busy, too smelly (even with “nice” smells), or too tactile (think, brushing against other students), they’re much less likely to be able to attend to learning.

  2. Similarly, some Autistic students will seek movement and will “stim” (engage in self-stimulatory behaviors) to help them to process information, to self-regulate, and to manage elements of overwhelm. Encouraging stimming and modelling it (e.g., using a fidget toy while you’re concentrating) will likely not only help your Autistic students to learn, but equally all of your students regardless of neurotype.


How do we integrate sensory information into speech sessions?


This takes us back to those eight senses we talked about at the beginning. 


OT Sensory Ball

Let’s say we’re working with a child who has vestibular hyposensitivity. Remember that our vestibular sense is all about balance and how we perceive our body in space; and hyposensitivity can mean needing extra sensory input in order to engage with the environment. To get more of that, a child might want to wiggle, bounce, or spin. Are they going to learn best while sitting on a chair at a desk? Probably not! So how do we help? Maybe we get them practicing their speech sounds on a bouncy ball, role play social communication on a wiggle cushion, or even get them engaged by doing some controlled spins in an office chair. 


Slime

What about a child with tactile hypersensitivity? Tactile is all about touch, and hypersensitive individuals are likely to do better with preferred textures. Maybe we include putty or slime into our sessions (or maybe those are ones to avoid); or maybe a child feels more comfortable using a weighted blanket and a favorite stuffy during a book-based activity.


Let’s look at a fictional scenario to see how an speech language pathologist might tailor a session based on a child’s sensory needs. 


Aaron

Aaron is 6 years old. He was diagnosed with Autism at age 3, and more recently received a diagnosis of ADHD. His caregivers have shared Aaron’s OT recent assessment report with his new SLP, and emphasized that he experiences tactile and proprioceptive hypersensitivity. He loves being in an outdoor environment, and especially loves the texture of sand. He does not enjoy sitting at a desk to work. 


Thanks to this input from Aaron’s caregivers and shared professional information from an OT colleague, Aaron’s SLP can plan his session environment to help him thrive. She arranges for his session to take place in an outdoor playground close to his home and brings a sensory bin with kinetic sand in it to his first session. Together, they work on Aaron’s communication goals in an environment where he feels safe and calm. 


Essential note: When we’re trying to work out what’s best for our kiddos, it’s important that we collaborate with family members and caregivers. Our team at Talk Time are the speech and language experts, but YOU are the expert on your child. You know them best; and you likely know the environment where they’ll thrive. 


Children bouncing

Setting kids up for success


Let’s go back to that 3am fire alarm. How well do you think you’ll sleep afterwards? And how productive do you think you’ll be the next day? You’re probably not going to be your best self, right?


And THAT’s why SLPs care about sensory differences. We care about our kids making the most of every single session, and that means considering ALL aspects of their treatment to best set them up for success. If a child is having sensory disruptions or dysregulation, they are not going to learn or participate well (Schenker, 2022). 


So, if you see us bouncing on balls, using heavy blankets, or even playing tag during speech sessions, know that there’s method to the madness and it’s all in our kids’ best interests (oh, and we love our job – so we’re having fun too!). 


If you want to reach out to us at Talk Time, please email us at info@talktimeboston.com, or check us out on social media at the links below.  


References:


Centers for Disease Control and Prevention. (2022, November 2). Diagnostic Criteria for 299.00 Autism Spectrum Disorder. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/hcp-dsm.html  


Kirby, A. V., Bilder, D.  A., Wiggins, L. D., Hughes, M. M., Davis, J., Hall-Lande, J. A., Lee, L-C., McMahon, W. M., & Bakian, A. V. (2022). Sensory features in autism: Findings from a large population-based surveillance system. Autism Research. https://doi.org/10.1002/aur.2670 


Reframing Autism. (2023). I am an educator. Reframing Autism.  https://reframingautism.org.au/ 


Schenker, M. (2022, April 12). Making Sense of Sensory. The Informed SLP. https://www.theinformedslp.com/review/making-sense-of-sensory  


Wiggins, L. D., Tian, L. H., Rubenstein, E., Schieve, L., Daniels, J., Pazol, K., DiGuiseppi, C., Barger, B., Moody, E., Rosenberg, S., Bradley, C., Hsu, M., Rosenberg, C. R., Christensen, D., Crume, T., Pandey, J., & Levy, S. E. (2021). Features that best define the heterogeneity and homogeneity of autism in preschool-age children: A multisite case-control analysis replicated across two independent samples. Autism Research. https://doi.org/10.1002/aur.2663 



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