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    SEPTEMBER 23, 2004
 
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Impact of, treatment for sensory defensiveness examined in study


Kinnealey


Koenig

Most of us use our senses to understand and respond to our surroundings. The sense of touch alerts us when something is too hot. Our sense of sight adjusts to variations in light. And our sense of smell signals nearby nourishment.

But for those with sensory modulation disorders, the senses are out of sync — they are over-sensitive to everyday stimuli. For example, the sun is painfully bright, the feeling of their clothing is continually distracting or sounds that others don’t notice hurt their ears.

Until recently, many experts believed children with such disorders would eventually just “grow out of it.” Lack of physiological evidence of such disorders further propagated this belief.

Temple researchers, finding the opposite to be true, are examining the lifelong impact of such disorders and are now completing a study of intervention in adults with sensory defensiveness, a type of sensory modulation disorder. Additionally, ongoing research by the group focuses on the neurophysiological differences between normal groups and those with sensory defensiveness.

“We found that patients with sensory defensiveness are literally wired differently,” said Moya Kinnealey, professor and chairman of occupational therapy at the College of Health Professions. “They perceive and react to sensory stimuli differently than other people at a physiological level (an elevated sympathetic response) and don’t get used to repetitive stimuli like a skirt brushing against their legs when they walk. 

“We also found that people don’t grow out of sensory defensiveness. Rather, the affliction leads to more problems as sufferers get older, often impacting all of their lives’ choices, such as career, residence, friends and hobbies.”

Looking back, one study participant, Craig, age 46, can clearly see that he’s suffered from sensory defensiveness his entire life. But it wasn’t until he read an article about the disorder in The Washington Post that he aggressively sought help.

His most debilitating symptoms relate to sound. “A ringing telephone can put me into another zone, as can many people talking simultaneously at a meeting,” he explained.

Still, the symptoms didn’t keep him from achieving a great deal career-wise. He continually rose to positions of greater prestige and responsibility, but in almost every case he’d take on too much and would eventually “crash.”

Craig now works for himself with a small roster of clients. During the day, he often goes out to garden or to take a walk as part of his sensory diet. He also goes to the gym every day. His therapy has brought great relief and he is now enjoying a new relationship.

Since the problem is sensory-based, the Temple researchers used sensory-based solutions, most of which can be self-administered.

“The goal of treatment is to ease the exaggerated and emotional response of the nervous system to sensory stimuli such as noise, light and touch,” said Kristi Koenig, another member of the Temple research team.

Traditional treatments like “talk” therapy, pharmacology, behavior or cognitive therapy might help but do not address the precise problem or lead to long-lasting relief.

There are three parts to the Temple treatment. First, the therapists explain to the patients why they respond the way they do to touch, movement, vision, smell, hearing and taste. With this information, patients begin to gain some control over the amounts and types of sensory stimuli they encounter and can advocate for themselves.

Second, patients engage in sensory and physical activities that make them feel better, such as applying pressure to the skin, experiencing heavy vibration, jumping on a trampoline, rocking in a rocking chair or more extreme activities several times per day.

Third, patients are advised to add strenuous activity to their lifestyles, such as jogging, swimming, aerobics or weight lifting.

Patients often start to feel better right away. “Just being diagnosed is very liberating for people who thought that they were odd or mentally ill their whole lives,” Kinnealey said.

“It’s amazing how much being diagnosed helps,” said Craig, who participated in the research study at Temple. “Now I know I’m not crazy. I can self-advocate and stop and say, ‘I’m having a moment here.’”

For Abe (not his real name), 34, another participant in the Temple study, strenuous physical activity has relieved many of his symptoms. But it wasn’t until his 2-year-old daughter, Julie, began to show signs of sensory defensiveness that he took his therapy seriously.

“Once I saw how much Julie improved with therapy, I returned to my own therapy,” he said. “She and I both enjoy using the exercise ball to apply pressure to our skin and bones.”

“When I was growing up, I was very hyper and had difficulty concentrating on schoolwork, but I was also extremely active and burned off a lot of the tension riding my bike, hiking and rafting,” Abe said. “As I got older, though, I stopped most of the physical activity because of work, school and family responsibilities, and my symptoms increased. I finally sought treatment after my wife did some research and found out about Temple.”

Another crucial aspect of the Temple research takes place in the Neuromuscular Function Lab, directed by Sinclair Smith, assistant professor of physiology in the occupational therapy department. Smith uses noninvasive physiological assessment techniques to study nervous system responses to sensory stimuli in patients with sensory defensiveness in hopes of developing better understanding and insight into possible treatment.

Smith’s preliminary studies suggest that sensory-defensive adults have atypical physiologic responses to sensory stimulation. In an ongoing study of adults with sensory defensiveness, supported by the Wallace Research Foundation, he is investigating the response of the autonomic nervous system to sensory stimuli, somatosensory processing using electroencephalography techniques and brain metabolism using magnetic resonance imaging.

Sensory defensiveness goes beyond abnormal sensory processing. There is also a relationship between sensory defensiveness and anxiety, depression and social emotional issues. Fortunately, as preliminary results of the Temple study have shown, self-treatment with some guidance is effective, resulting in improved mood, increased flexibility, improved interpersonal relationships, better focus and generally better quality of life.

In addition to this study on adults and ongoing research on the neurophysiological aspects of sensory defensiveness, the group is completing a study on the effectiveness of intervention in children with the disorder.

For more information and a questionnaire on sensory defensiveness in adults, go to http://www.temple.edu/chp/departments/ot/OT_NeuromuscularFunctionLab.htm.

- By Eryn Jelesiewicz

 

 


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