Sensory Conference: SPD Subtypes with Dr. Lucy Jane Miller

Sensory Conference: SPD Subtypes with Dr. Lucy Jane Miller -

When Future Horizons offered to send me to the Sensory Conference in Hot Springs, Arkansas, by paying for my registration, I was very excited. I made travel arrangements and arrived early that morning to sign in and get ready for the first session.

At first, I felt intimidated. There were some other parents there, but the crowd was larger than I had expected, and most of those present were professionals of some sort. It didn’t take long for me to realize that they considered me a sort of expert on Sensory Processing Disorder (SPD) because I am parenting a child with SPD. I started to relax.

The information presented by Dr. Lucy Jane Miller and Paula Aquilla, BSc, OT, was amazing. I was overwhelmed with the amount of information!

For the next few weeks, I will share my notes from each session of the Sensory Conference on Saturday. This week I share session one, which covered the six subtypes of Sensory Processing Disorder.

Sensory Conference: SPD Subtypes with Dr. Lucy Jane Miller

Dr. Lucy Jane Miller began her talk by sharing about the STAR Center and SPD Foundation. She also shared the early history of SPD Theory, including the work by Jean Ayres, whom Dr. Miller visited and recorded working with children.

Then she moved into a discussion of SPD as it relates to everyday life, explaining that SPD, like so many things, presents along a spectrum and is only considered a “disorder” when it affects a person’s ability to function effectively.

SPD is not a behavioral or parental problem. It’s a physiological problem.

Dr. Lucy Jane Miller

When she said, “SPD is not a behavioral or parental problem. It’s a physiological problem.”, I breathed a sigh of relief. It was so nice to listen to someone who understands that my daughter’s behavior when she’s overstimulated isn’t a result of poor parenting skills, which is something I’ve heard too many times. She also stated that the physiological data for children with SPD looks like the data from children with PTSD (Post-Traumatic Stress Disorder). SPD is real, and it’s something these kids need help with.

During the rest of the session, Dr. Lucy Jane Miller shared the six subtypes of Sensory Processing Disorder. It was very informative, so I’m going to share them now from her slides and my notes.

There are three types of Sensory Processing Disorder, with two subtypes of each, leading to six total subtypes of SPD. It is important to note that it isn’t unusual for these subtypes to occur in combination.

The six subtypes of SPD are:

  • Sensory Modulation Disorder: 1) over-responsitivity, 2) under-responsivity, 3) sensory craving
  • Sensory Based Motor Disorder: 1) Postural Disorder, 2) Dyspraxia
  • Sensory Discrimination Disorder

Sensory Modulation Disorder

  • Difficulty regulating responses to sensory input – responses are not adjusted to the situation
  • Difficulty achieving and maintaining an optimal level of arousal and adapting to challenges in daily life
  • Must be severe enough to disrupt ability to adapt to challenges in daily life

Children with Sensory Modulation Disorder are either over-responsive, under-responsive, or sensory craving.

Children who are over-responsive respond too much, too frequently, or for too long to sensory stimuli, can be aggressive or impulsive when overwhelmed by sensory stimulation,  are irritable, fussy, or moody, and are unsociable, anxious, withdrawn, excessively cautious, and upset by transitions and unexpected changes. These children usually respond well to calming activities like deep touch pressure and proprioceptive input (heavy work, brushing/joint compressions, etc.).

Children who are under-responsive are uninterested in exploring games, objects, or the world around him/her, passive quiet, and withdrawn, difficult to engage in conversation, easily lost in his own fantasy world, apathetic and easily exhausted, excessively slow to respond to directions or complete assignments. These children need activities for increasing arousal, activating muscle tone, challenging core stability, and practicing balance reactions.

Kids with sensory craving want much more stimuli than most people but become more disorganized when they receive it. These children are helped by having lots of activity, but make sure it is purposeful and interrupted movement.

Sensory Based Motor Disorder

The two types of SBMD are Postural Disorder and Dyspraxia.

Postural Disorder

  • Poor postural tone and/or poor stability
  • Poor endurance and tires easily
  • Slumps over when writing
  • Poor balance and falls over easily, even when seated
  • Does not consistently use his dominant hand

Children with Postural Disorder may appear lazy, unmotivated, or indifferent, weak and limp, tire easily or appear tired most of the time, give up when challenged physically (and often cognitively), and have difficulty with physical endurance especially in competitive games. These children are helped with multisensory input, especially proprioceptive and vestibular stimulation to enhance muscle activation, and they need to do activities that improve their core stability and that engage both sides of the body.


Children with Dyspraxia are clumsy, awkward, or accident prone, have difficulty keeping personal space organized, have difficulty with multi-step motor activities, may not have had age appropriate motor milestones, and have difficulty with sports and/or handwriting.

They may also:

  • Prefer fantasy games and talking to doing
  • Prefer sedentary activities, not active play
  • Have a messy or sloppy eating and a disheveled appearance
  • Be frustrated when unable to complete tasks due to poor motor skills
  • Lack self-esteem
  • Be extremely smart
  • Be able to talk, but can’t do

Activities that help children with Dyspraxia include those that experiment with many variations of activities, are games with specific directions of body parts in space, and should grow towards planning and executing a sequence of actions.

Sensory Discrimination Disorder

Children with Sensory Discrimination Disorder have difficulty interpreting stimuli. They may have trouble distinguishing exactly where something touches their bodies, judging how much force is required for a task, identifying and distinguishing similar sounds and letters, and difficulty following directions. They may get lost easily, refuse to play with puzzles or other visually detailed games, need directions repeated, and need more time than other children to perform tasks.

I definitely see a combination of issues in my daughter. Having this information has helped me to better understand her behavior and to be more dedicated to helping her with sensory regulation.

What are your thoughts on the six subtypes of SPD?

More posts in this series:

Please join me for more informational posts, product reviews, and giveaways for Autism Awareness Month. You can find all the links as they go live on the landing page.

Disclosure: I received free registration from Future Horizons to the Sensory Conference in Hot Springs, Arkansas. I paid my own travel expenses and was not required to write positively about my experiences. All opinions are my own. I received no further compensation for this series of posts.

This entry was posted in Autism, Sensory Processing Disorder, Special Needs. Bookmark the permalink.

14 Responses to Sensory Conference: SPD Subtypes with Dr. Lucy Jane Miller

  1. Laurke says:

    What exactly is purposeful and interrupted mean in regards to sensory activities? I’m taking two boys for an OT evaluation next week and I do see a lot of what you described in both of them.

    • For purposeful and interrupted activities, Dr. Miller mentioned things like allowing them to run, jump, and hop, but always with the goal of getting something and bringing it back to you. She said to assign them lots of heavy work activities around the house (lifting, pushing, pulling, etc.) and to make the jobs functional when possible. She said to give them jobs like erasing the board, stacking chairs, sweeping the floor, and carrying books. Younger children can also push laundry baskets full of clothes from the hamper to the laundry room or back to the folding area. She said to give them hand fidgets in quieter situations and to give them oral motor opportunities—sucking through a straw, crunchy snacks, etc.

      Does that help?

      • Laurke says:

        Yes, thank you. I get the purposeful. Are they called “interrupted” because you are telling them to do it while they are doing something else? I just haven’t heard that particular terminology, I suppose :) I maybe give too much unstructured activity – I send them out to jump on the trampoline, ride bikes, etc., a lot. Perhaps I need to go out with them and find “jobs” for them more often. I remember that they loved raking the leaves in the fall!

        • I think the “interrupted” comes in because you have them stop to do other things—bring you the item you sent them over for, stop to fold some clothes after pushing the laundry basket, etc. If you let a sensory craver have unlimited activity, they just get more disorganized. You have to stop the activity periodically to help them regulate better.

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  3. Nina Daniels says:

    Hmm, I get it more now- why-when my son was younger, that he moved furniture several times a day, and pushed the quad around starting at 3 years old, going on for several years. we would be so amazed that he would do such, and it really caught me off guard often when he moved the furniture. now at 13 there is still need for the heavy/ pressure. as parents we have learned his ‘sweet spots’ that we can add pressure to help him. then there is always between the mattresses now and then, when life is just too much. I say he is heavy handed when he gives us his ‘love pats’. ouch! when he gets stressed I quickly try things that will interrupt his current-re-direct as best as I can. I did not know that SPD was such a variety. thanks

  4. Daya Solomon says:

    My son was diagnosed with SPD when he was 11. He had it all his life, we just didn’t know. We thought he was a wild, unusual, and quirky kid and that he would grow out of things. He was happy and exuberant much of the time until he was about 9, and that was when we began to be concerned and sought out help. He seems to have troubles in almost all of the areas described. Adolescence made it all worse. He had 3 rounds of professional OT over the years and never really liked the exercises and home activities that much, or going for the therapy. But he learned a lot. Still, being on a swim team seemed to help him the most. The days he swam were the best days for him. When he was 14, he began ballet lessons. He immediately loved how he felt when he danced. It didn’t take long before he found that he felt the best when he could dance more then 5 hours a day. He was able to do things on stage while performing that were uncomfortable and difficult in real life, like socializing and interacting in all kinds of ways while dancing a role. Much of what he did on stage he was then able to incorporate into his real life interactions with people. In fact, he turned out to have a lot of ability in character dancing and partnering. Almost everything else in his life then improved – eye contact, sleep, ADHD issues, socialization, melt downs decreased and then stopped altogether – he was a different person. After a year of dance he was awarded a scholarship at a residential ballet conservatory for full time year round training to become a professional dancer – 500 miles away from home. He moved away at 15 and it is hard to believe that 2 years before I wondered if he would ever be able to be on his own in life when he became an adult. Ballet is his first love (and obsession) but he also is really good in contemporary and modern dance. He dances 6 to 8 hours a day, 6 days a week, and fits in his academics as a long distance homeschooler. The area of his life that he still has the most problems is with eating – he is a very picky and restrictive eater, liking the same foods over and over and going on food jags. He was found to be gluten and casein intolerant and now is GFCF. We were told he is orally tactile defensive – tastes, textures, and smells can bother him. He feels each grape all over before putting it in his mouth and the grapes (or apples) must be the exact right firmness before he can or will eat them. His neuro developmental pediatrician thinks that it will take years before the effects of eating gluten and casein are gone from his body (basically when enough new cells form that have never been exposed to gluten and casein) and that then his eating might improve more. I hope the conference covered picky eaters!

    • What an inspirational story, Daya! Thank you for sharing that. It gives those of us with younger children hope that things can turn and turn quickly when our children find what works for them.

      There was some discussion of picky eating during the conference, but it wasn’t the primary focus in any of the sessions. I know that it’s a huge problem for a lot of families. My daughter is on a wheat-, egg-, and milk-free diet after spending years trying to figure out her GI issues. We are fortunate that she eats a fairly good variety of foods, but she is also very particular about smells and textures.

      I’m glad your son is doing so well, overall. I look forward to hearing of great things about him in his professional career!

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