Halloween is a time for kids to dress up in fun costumes, however, this may be very uncomfortable for kids with Sensory Processing Disorder (SPD). Kids with SPD may find certain clothing uncomfortable due to tactile sensitivities. This may range from kid-to-kid; some kids may prefer to wear loose fitted clothing, some may prefer to wear clothes that are tight, and some kids may prefer to wear soft clothing. It is best to explore which type of clothing your child prefers prior to picking out a Halloween costume.
Once you know which type of clothing best suits your child, you can then begin to find what Halloween costume will be most comfortable for them to wear.
Here are some recommendations to make your search for a Halloween costume easier:
Allow your child to be a part of the process of choosing a Halloween costume and try to incorporate their favorite things.
Never force your child to wear a costume.
It may be helpful to find costumes that are seamless and do not have tags.
Wash the costume prior to your child wearing it.
Allow your child to wear their costume prior to Halloween.
Masks and face paint may be uncomfortable for a child with SPD. It will be helpful to practice wearing a mask or putting on face paint prior to Halloween to see if your child can tolerate the feeling of having it on his or her face. If your child decides to wear a mask, allow them to remove it if needed. Also, if your child decides to wear face paint, make sure to bring facial wipes in case you need to remove it from his or her face.
It is more important that your child is comfortable in his or her Halloween costume, rather than what costume they wear. It will be helpful to know what type of clothing your child finds comfortable and what clothing they find uncomfortable in order to find the best costume for his or her needs.
https://nspt4kids.com/wp-content/uploads/2017/09/Blog-Halloween-Costumes-FeaturedImage.png186183Ashlen Meyerhttps://nspt4kids.com/wp-content/uploads/2016/05/nspt_2-color-logo_noclaims.pngAshlen Meyer2019-10-04 05:30:202019-10-11 11:18:49How to Choose a Halloween Costume for a Child With Sensory Processing Disorder
When I think of Halloween, my mind races back to colorful memories of bright and lively costumes, overly sweet and delicious fun-sized bars of chocolate, and children of all ages screaming “trick or treat”! As most parents know, children who are especially oversensitive to auditory, visual, and tactile stimuli may experience a spark in meltdowns or increase in negative behaviors as a response to this incoming sensory input. Below are some helpful strategies to circumvent these challenges before the day and ensure a safe, fun, and successful Halloween for all.
How to survive Halloween with sensory issues:
Recognizing the symptoms of auditory sensitivity is the first step in preventing any tantrums or negative experiences resulting from auditory overload. If your child has auditory sensitivities, investing in some noise-canceling ear plugs or headphones may help to alleviate some of the meltdowns that arise with loud music or conversation at Halloween parties.
Trick or treating is one of the most fun and special parts about Halloween. Encouraging children to take part in this special tradition is important to allow them to be able to explore and grow their social skills and leisure opportunities. If your child is tactile or visually sensitive, or he becomes overly emotional or uncomfortable when having to meet and introduce themselves to people, it may be helpful to have an older sibling take on the responsibility of introducing selves to neighbors or family while trick-or-treating. Let your child choose if they want to partake in ringing the doorbell and asking for treats, and know that it is okay if they wish to hang back with caregiver while visiting unfamiliar houses. Role playing with your child to help them prepare for the day’s activities can also be a helpful way to improve their social emotional responses.
Practice makes perfect, especially when it comes time to wear a costume! Oftentimes, Halloween costumes can be hot, difficult to put on, or uncomfortable. To avoid this nightmare, prepare your child by having them wear their costume days before the festivities, so that they have an opportunity to break in their costume on their own time, which can highlight any potential issues beforehand. Hosting a fashion show with other siblings or friends could help to make the idea of wearing non-traditional clothing more fun and exciting in a non-threatening environment.
For Halloween parties, make sure to bring some familiar food for the child to enjoy. Safe food choices can be comforting in an unfamiliar setting like a family or friend gathering, especially when the parent is not there for support. If the party is at your house, take advantage of this by setting up a sensory corner away from the main area of entertainment and provide extensive individual and all age activities to try out. Some good suggestions may include coloring, painting pumpkins, or themed craft jewelry. Playing quiet music and decreasing the amount bright lighting can help alleviate some stress for children with sensory concerns.
https://nspt4kids.com/wp-content/uploads/2015/09/halloween-featured.png186183Mary Kate Mulryhttps://nspt4kids.com/wp-content/uploads/2016/05/nspt_2-color-logo_noclaims.pngMary Kate Mulry2019-09-30 12:35:472019-10-11 11:20:29Surviving Halloween With Sensory Issues
The school cafeteria hits the senses with a wide array of sensory experiences all at once. Some children, especially those with Sensory Processing Disorder (SPD), can find the lunchtime experience overwhelming because of some or all of the sensory aspects of a cafeteria. Preparing your child or student for this part of the school day can help them enjoy, not dread, lunchtime and that can positively impact their entire school experience.
Location, location, location- Where a child sits in the cafeteria can greatly affect his or her behavior and sensory input. For example, a child who is easily visually distracted should be sat so that he or she is facing away from the entire room, which will help them to they can focus on their meal. For a child with sensitivity to smells, make sure they are sat as far away from the lunch line as possible.
Help the child advocate for themselves- Children with SPD can feel when they’re starting to get overwhelmed by whatever sensory stimulus is bothering them, but they can have a hard time explaining it to others. Teach the child that when they start feeling bad, upset, or their “engine” is running too fast (or any other term you use when your child is escalating) they should tell their teacher that they need a break. This could be a movement break, or some quiet time in a hall or designated quiet space.
Give the child a fidget toy- This is a small toy the child can fidget with, ideally, without distracting other children. This would be great for the child who has a hard time not touching his friends who are sitting close to him.
Put a sensory toolkit in their lunchbox- This can vary from child to child, depending on what their sensory needs are. You could put in a fidget for the child who has a hard time sitting still, or a favorite lip balm or lotion for the child who is sensitive to smells to give them a familiar scent to help calm them down (or one to mask the smell of the cafeteria). You could put in pictures of sensory strategies as reminders of how to calm down if they’re getting overwhelmed (e.g. deep breaths, hand-pushes, chair push-ups). Sunglasses could be helpful for the child who is sensitive to the bright lights in the cafeteria.
Familiar foods- For those children with oral sensory sensitivities who are picky eaters, make sure to pack foods they will eat. This is not the time to send mustard on their sandwich for the first time or ask them to try whatever the cafeteria is serving. Have your child help you pack their lunch so that they know what to expect, or go over the menu for the week with them and choose the day(s) they will buy their lunch.
Regulating foods- crunchy foods (e.g. carrots, pretzel sticks) can be very regulating for children with SPD, particularly children with oral-seeking behaviors. Other great food ideas include sucking thick liquids (yogurt, applesauce) from a straw, hard candies, or gum.
https://nspt4kids.com/wp-content/uploads/2016/08/Blog-Sensory-Cafeteria-FeaturedImage.png186183Kimberly Reidhttps://nspt4kids.com/wp-content/uploads/2016/05/nspt_2-color-logo_noclaims.pngKimberly Reid2019-09-01 05:30:512019-09-19 12:20:056 Coping Strategies for Children with Sensory Processing Disorder in Their School Cafeteria
Throughout the year, you and your family are bound to hit the open road a time or two for one of a number of reasons. Many families may want to check out the scene in a new city. Others, will seek thrills at an amusement park or visit a family member that lives out of town. These trips can provide children with priceless learning opportunities and families with memories that will last a lifetime. For children with Sensory Processing Disorders however, these trips can be also be extremely challenging. Below are 6 tips and tricks to use in order to best support children who have difficulty processing sensory information on your next family vacation.
Discuss what to expect: Talking about the specific logistics of a trip can help to ease your child’s anxiety about the ambiguity of what’s coming next. Similarly, it’s important to talk about what will be expected of your child while traveling. Here are some questions that your child may have prior to traveling. Think through each one and discuss them as a family before your next adventure begins:
What is the mode of transportation (ie. plane, train, or automobile)?
What will you see? Will there be a lot of people?
What will you smell?
What will you hear? Will it be loud?
How much time will it take? What will you do to pass the time?
How much space will your child have? Will there be time or room to play?
What are the rules while traveling?
Decrease the amount of extraneous and unfamiliar noise: Use noise cancelling headphones or calming music. Both strategies can help your child to calm themselves and more effectively process auditory sensory information, especially with the added stressors of travel.
Prepare a backpack of travel essentials: Many adults pack a small carry-on bag with a few items that will help them pass the time. Items often include shoulder pillows, eye masks, ear phones and iPods; as well as a favorite book or magazine. For children with various sensory processing disorders, include some of the items listed below:
Snacks, water, gum, or hard candies.
Pack a heavy object to help your child regulate. A book or weighted blanket are great options.
Bring a comfort object such as a blanket or favorite stuffed animal.
Include fun activities such as mini board games, coloring pages, books, or playing cards
Call the airline or tourist destination ahead of time: Explain your child’s sensory needs. Certain airlines, parks, and museums have special accommodations for children with sensory processing disorders.
Preparatory Heavy Work: Before taking off for your trip, or during breaks in travel, engage your kiddos in Heavy Work activities. Tasks include animal walks, pushing or pulling luggage, push ups, or big hugs from mom and dad. All of these activities provide your child’s big muscle and joint groups with proprioceptive input. This input is extremely regulating for children, like exercise could be for an adult, and will help to calm your child for the next leg of travel.
Expect some ornery fellow passengers: While it is unfortunate, you may come across someone throughout your travels who will have a low tolerance for kids being kids. Depending on your comfort level in doing so (or your ability to turn the other cheek), write out small note cards explaining that your child has a Sensory Processing Disorder and that as a family, you are doing the best you can to travel with minimal interruptions to the routines of those around you. You could even offer nearby passengers earplugs to help block out any extraneous noises.
The bottom line is that while traveling can be challenging, it can also be an extremely rewarding experience for everyone involved. With a fair amount of foresight and appropriate preparation, you can help to shape your trip into an experience of a lifetime for your whole family. Happy travels!
https://nspt4kids.com/wp-content/uploads/2016/02/BlogSPDTravel-FeaturedImage.png186183Lindsey Moyerhttps://nspt4kids.com/wp-content/uploads/2016/05/nspt_2-color-logo_noclaims.pngLindsey Moyer2019-03-04 05:30:012019-09-06 19:48:11Happy Travels with a Child with Sensory Processing Disorder
While it is called a “diet,” it’s not a FOOD diet, but it should be considered nutritional intake that your child’s body/brain need daily.
Consistency is key and it is important to find a schedule that works for you. Work with your occupational therapist and teacher to develop a timeframe that works best. Do not overdo it if it does not seem sustainable.
As much as possible, sensory diet activities should be completed around the same time each day.
Many sensory diet activities can be adapted to be used across many environments in order to promote consistency i.e. at home, in school, while traveling.
When appropriate, get other siblings and family members involved!
Watch your child’s responses before, during, and after sensory diet activities and be sure to address any abnormal changes you see with your occupational therapist.
The best sensory diet combines tactile, proprioceptive, and vestibular based activities.
Just as no two children with sensory processing difficulties will present the same, no two sensory diets will be identical.
As your child’s brain continues to develop, the sensory diet will likely eventually need to be updated in either types of activities or frequency.
Examples of sensory diet activities for each sensory system:
Proprioceptive: jumping and crashing on pillows, heavy work activities such as pushing a heavy laundry basket or helping carry grocery bags to put away, wheelbarrow walk or animal walks (bear crawl, crab walk), joint compressions.
Vestibular: log rolls, cartwheels, swinging, head inversions over the edge of a couch, yoga poses, rocking chair.
Tactile: messy play (shaving cream, water, finger painting), sensory bins (uncooked rice or pasta noodles, kinetic sand), exposure to novel materials (i.e. corduroy, velvet, sandpaper, sand, silk).
Auditory: participation in Therapeutic Listening program under the guidance of your occupational therapist, listening to calming music, listening to white noise, play exploration with various instruments or toys/books that make sounds.
Oral: blowing bubbles, use of straws, use of chewy tubes or “jewelry”, food texture exploration (i.e. creamy, dry, wet, lumpy), having a chewy or crunchy snack to provide “heavy work” to the mouth”.
Visual: activities such as “i-spy”, spot the difference picture games, and word searches, de-clutter the home environment, oculomotor exercises, dim lights and avoid fluorescent bulbs.
https://nspt4kids.com/wp-content/uploads/2017/05/Blog-Sensory-Diet-FeaturedImage.png186183Corinne Kreutzhttps://nspt4kids.com/wp-content/uploads/2016/05/nspt_2-color-logo_noclaims.pngCorinne Kreutz2017-06-02 09:20:062019-09-20 09:58:08What You Need to Know About Sensory Diets
A fidget tool is one sensory strategy used to help children achieve self-regulation. Self-regulation is the ability to maintain an optimum level of arousal in order to participate in daily activities. Self-regulation is a critical component of learning, as it can impact a student’s attention, emotional regulation and impulse control; a child’s performance in the classroom is directly related to his regulatory state.
A child’s nervous system, specifically the sensory system, needs input to help achieve a regulated state to successfully complete tasks. The theory behind fidget tools is that it provides a sensory experience to increase self-regulation, attention, participation and performance.
During the school day, a child’s body works tirelessly to perform the functions necessary to participate in the classroom. Children need:
Muscle control and endurance to sustain a seated, upright position to sit at a desk or on the rug during circle time.
Auditory attention to attend to instructions and lessons, while also blocking out surrounding sounds of peers chattering, shuffling papers or chairs scooting across the floor.
Visual attention to read work instructions, look at the teacher during lessons and complete written work, while also blocking out other visual distractions around the classroom.
Impulse and body control to keep hands, legs and other body parts from touching objects or peers nearby.
Emotional control to regulate emotions when happy, sad, confident, frustrated or embarrassed throughout the day.
For some kids, the demands of the classroom environment exceed what their bodies can handle. This isn’t due to a lack of intelligence or willingness to learn; it stems from difficulty coping with a neurologic system that isn’t organizing and responding appropriately to a variety of sensory stimulation from the external world.
The result of a child’s inability to organize his nervous system during the school day is an increase in behaviors that are often deemed inappropriate or distracting in the classroom. Such behaviors may include inability to sit still, wandering around the room, constant touching of objects or peers, laying on the floor, emotional outbursts, not following directions or not understanding how to complete a task.
These behaviors are actually how the child attempts to regulate his body to participate in the classroom. To minimize these behaviors and increase positive participation, it is important that the child is set up for success by providing individualized strategies for him to sustain a regulated state throughout the day.
One of these strategies is the fidget tool. I frequently recommend that my clients use a fidget tool in the classroom to help sustain attention and increase performance. Fidgets come in a variety of forms including Koosh balls, stress balls, small weighted balls, small figurines or fidget spinners.
Fidget tool recommendations are always given with the stipulation that the student must understand that the fidget needs to be used appropriately. I suggest that the parent and teacher review appropriate uses for the fidget with the child (i.e keeping the fidget in the hands, under the desk in the child’s lap), inappropriate uses for the fidget (i.e. throwing the fidget, rolling the fidget, giving the fidget to a friend) and the consequences for inappropriate use of the fidget (i.e. having the fidget taken away). Laying out clear guidelines for the use of the fidget helps students know the expectations and follow the rules.
While several schools have banned the use of fidget spinners in the classroom due to the craze they have caused, as an occupational therapist I support fidget tools as a sensory, regulatory strategy, as long as clear expectations are set and rules are followed. I have seen great success in my clients’ performance and attention when they use fidgets appropriately and not as a toy.
Does that mean my child needs a fidget spinner?
Fidget spinners or tools may not be suitable for everyone. Each person’s sensory system will respond differently to various strategies and may be needed at different times during the day. Some children benefit from fidget tools during writing activities, some may benefit from the tool during lecture periods and others may require use of the fidget more frequently. There may also be children who have difficulty with self-regulation where fidget spinners or fidget tools cause increased distraction or dysregulation. Check out our other blogs for ideas on other strategies that may be incorporated in the classroom to promote optimal performance.
https://nspt4kids.com/wp-content/uploads/2017/05/Blog-Fidget-Spinners-FeaturedImage-01.png388382Dana Paishttps://nspt4kids.com/wp-content/uploads/2016/05/nspt_2-color-logo_noclaims.pngDana Pais2017-05-05 10:35:072017-07-26 11:31:00Fidget Spinners: The Bottom Line
I have worked for North Shore Pediatric Therapy for more than two years in the marketing department. I thought I was familiar with the many challenges families go through with their children, however, the idea of going through “the IEP process” never crossed my mind, until I had to.
When my son started kindergarten, we had some concerns about certain behaviors, but honestly really thought they were only phases. A few weeks into the school year as they began practicing drills, he had a severe panic attack requiring help from the school social worker. At that time, his teacher recommended he begin seeing the social worker more frequently and that led to our process of seeking a full evaluation to really understand him.
He was evaluated by Dr. Greg Stasi at NSPT and given a diagnosis of Anxiety Disorder and Sensory Processing Disorder. It was then that we were faced with the dreadful IEP meetings. I had heard so many stories of hardship parents faced when fighting for their child’s needs. As a result, I went into the process expecting a fight, and boy would they get one if necessary because in my mind, nothing was going to come between my child getting the help he needed.
Because of my job, I am fortunate enough to have access to excellent professionals and resources, who understand the IEP process, and who helped me prepare for the initial IEP meeting. I was ready for that day. And you know what happened? I didn’t have to fight. I was so fortunate to have a wonderful team wanting and willing to give my son everything he needed to succeed. Everything I was prepared to fight for was already part of their plan, too.
I know this isn’t typical, and so many families struggle to get their child’s needs met.
Here are some tips, from a mom’s perspective on how to approach IEP meetings to get what you, and your child, need:
Be prepared. Those same resources I have access to because of my job…guess what? YOU have access to those same things! NSPT has so many blogs and infographics to help you begin your journey. Having a full neuropsych evaluation is a real plus as it lends a direction for goal development and is appreciated by the district staff.
Be understanding. Understand that those on the other side of the table really do want to help. Often they are restricted by legal mandates. So you may find that there are questions you ask where they can’t fully answer.
Ask questions. Don’t be afraid to ask any and all questions you have in order to understand each element being addressed. It goes fast. And they use a lot of terms you don’t recognize. Stop them and ask.
Bring help. Don’t be afraid to bring outside support, such as a school advocate, to help speak on your behalf. They know the rules and can help you “fight.”
Don’t sign the plan if you are not happy. You will be asked to sign the plan at the end. If you are not comfortable, don’t do it, unless it’s on the condition that you are requesting another meeting to go over the details again to re-write the goals.
Hold Accountability. As the school year continues, don’t be afraid to check in on the team, the therapists, and the teacher to ensure all accommodations are being met.
Be the voice. Remember, you are your child’s voice. Don’t be afraid to speak up.
https://nspt4kids.com/wp-content/uploads/2017/04/Blog-IEP-Meetings-FeaturedImage.png186183Julie Hrdlickahttps://nspt4kids.com/wp-content/uploads/2016/05/nspt_2-color-logo_noclaims.pngJulie Hrdlicka2017-04-17 14:36:332019-04-10 12:34:04IEP Meetings From a Mom's Perspective
Gravitational insecurity is a term that means an excessive fear of ordinary movement. It can also be characterized by a child being uncomfortable in any position other than upright, or fear of having one’s feet off the ground. Gravitational insecurity is a form of over-responsiveness to vestibular input. This input is detected by the Otolith organs, located in the inner ear. These organs detect movement through space as well as the pull of gravity.
Recess is a common time you may notice children having difficulties with gravitational insecurities.
Here are some common red flags that may indicate your kiddo is having difficulty with gravitational insecurity:
Avoidance of playground equipment that kids of similar age enjoy
Avoidance of swings
Fear of heights or uneven surfaces
Overwhelmed by changes in head position
Fear of having their feet off the ground
Overly hesitant on slides
Has difficulty tilting their head back to look up at monkey bars
If you notice your child exhibiting some of the red flags listed above, they would likely benefit from an occupational therapy evaluation and treatment focusing on sensory integration. Throughout therapy your child will receive graded vestibular information through a multisensory approach. Slowly, they will learn to integrate and process sensory information more effectively.
The way children take in and respond to sensory input from the environment may vary from child-to-child and day-to-day. It’s important to take into consideration that how children’s senses pick up information from the environment may influence their reactions and behaviors. Children might have a harder time taking in and processing sensory input to respond appropriately within the environment.
Below are several ways you can explain these sensory input reactions and behaviors to family, friends, and community members:
Auditory Input: Some children are sensitive to sounds (e.g. hand dryers; toilet flush; alarms). You might see these children cover their ears to certain sounds. Other children may not be as aware to sounds. You might see these children not respond to their name being called.
Visual Input: There are children who may demonstrate sensitivity to light by covering their eyes from bright sunlight or they may express discomfort by florescent lights. Other children might seek visual input by being visually attracted to TV/computer screens with fast-paced and/or flashy visual effects.
Tactile Input: Children may demonstrate sensitivity to certain textured clothing and resist/avoid wearing them (e.g. jeans; cotton materials; tags on clothing; tight socks). There are children who have a difficult time being in close proximity to other people. These children may feel overwhelmed and demonstrate over reactive behaviors when touched/bumped into (e.g. in crowded places; in line).
Oral Input: Some children might present sensitivity to specific textures or taste of food and avoid eating them (e.g. mushy/crunchy/chewy foods; sweet/sour foods; foods mixed together). Others might seek oral input to the mouth and put everything in their mouth (e.g. toys; finger; clothing).
Vestibular/Proprioceptive Input: Children might be hesitant and present distress when their feet are not on the ground or when they are spun in a circle. These children might avoid swings, climbing on the playground, riding a bike, or car rides. There are children who seek out a lot of movement and take climbing/jumping risks. You might also see children spin in circles to obtain additional vestibular input.
https://nspt4kids.com/wp-content/uploads/2017/03/Blog-Sensory-Input-FeaturedImage.png186183Sima Rashidianfarhttps://nspt4kids.com/wp-content/uploads/2016/05/nspt_2-color-logo_noclaims.pngSima Rashidianfar2017-03-28 05:30:492019-09-06 19:38:32Explaining Your Child's Behaviors in Response to Sensory Input
A class full of students in an open gymnasium can make for a very overwhelming experience for a child with sensory processing disorder. Echoing voices, shoes squeaking on the floor, whistles blowing, the smell of sweat and cleaning agents, bright colors and moving objects are enough to increase anyone’s stress level.
Throw in the demand to attend to instructions, learn new motor skills, and keep up with your more advanced peers. For a child with sensory processing disorder, this could potentially become a recipe for disaster.
Or, with the right structure and supports put in place, this time can be a regular opportunity for fun, growth, and learning!
Below are 9 suggestions to help children with sensory processing disorder feel successful in gym class and participate to the fullest extent possible:
Provide the child with an out. Let him know that if the experience becomes too overwhelming he can let the teacher know he needs a break. The student could sit outside the room for a moment, take a trip to the restroom, or get a drink of water. Sometimes a brief break is all that’s needed.
Be aware of the student’s particular needs and allow accommodations. If a student is over responsive to noise, allow the student to wear noise-reducing headphones. If a student has tactile defensiveness, avoid putting them on teams with jerseys.
Break down new activities as much as possible. Teach one skill at a time and provide multiple modes of instruction.
When providing instruction, ask students to repeat the rules or act out a scenario. It may be helpful to repeat important points and explain why the rule exists in order to be sure they are understood.
Modify games or exercises as necessary. Students will be at different levels and physical activity can present unique challenges for those with sensory processing disorder. Provide simpler options when possible.
Establish space boundaries. Using visual cues for personal space and working in small groups can relieve anxiety for those with tactile defensiveness. Visual cues may also be helpful in showing students where they should position themselves for games and exercises.
Take extra care to maintain a positive environment. Emphasize the importance of sportsmanship and supportive language.
Avoid bringing attention to a skill the child is having difficulty with in front of his peers. When playing games in large groups, it may be best to avoid placing the responsibility of a key position on students who are already experiencing increased stress.
Provide feedback to parents. Let the student’s parents know what skills you are or will be working on so that the child can get in extra practice at home. This can be a big confidence booster for children and allow them to fully master skills with their peers.
Remember to keep it fun! Gym class is not only important for educating students on specific skill sets, it also lays the foundation for their attitudes towards physical activity in the future.
Recognize that not all students with sensory processing disorder will have the same strengths and difficulties. Meeting a student where they’re at and finding their particular strengths to build on is the best way to set them up for success!
https://nspt4kids.com/wp-content/uploads/2017/02/Blog-Sensory-Processing-Disorder-Gym-FeaturedImage.png186183Shannon Phelanhttps://nspt4kids.com/wp-content/uploads/2016/05/nspt_2-color-logo_noclaims.pngShannon Phelan2017-02-22 05:30:122019-09-06 19:20:389 Ways to Make Gym Class Successful for a Child with Sensory Processing Disorder