SENSORY AND PERCEPTUAL DEVELOPMENT IS A CRUCIAL ASPECT OF DEVELOPMENT FOR INFANTS AND TODDLERS

SENSORY AND PERCEPTUAL DEVELOPMENT

IS A CRUCIAL ASPECT OF DEVELOPMENT FOR

INFANTS AND TODDLERS

1.Introduction to Sensory and Perceptual Development

Sensory and perceptual development is a crucial aspect of development that often gets

overlooked. Our sensory system begins to form in utero and continues to develop through

adulthood. It is important to note that genetic, environmental, and stress factors can affect the

sensory system. We have the eyes (sight), ears (sound), nose (smell), tongue (taste), touch

(skin), and two other less well-known but equally important ones, vestibular (inner ear) and

proprioceptive (large muscle groups).

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7.1.1 : What is Perception?

Perception

Perception refers to the process of taking in, organizing, and interpreting sensory information.

Perception is multimodal, with multiple sensory inputs contributing to motor responses

(Bertenthal, 1996). An infant's turning his head in response to the visual and auditory cues of

the sight of a face and the sound of a voice exemplifies this type of perception, "the fact that the

senses provide overlapping information . . . is a cornerstone of perceptual development"

(Bahrick, Lickliter, & Flom 2004).[1]

As infants develop increasing motor competence, they use perceptual information to decide

which motor actions to take (Adolph & Joh, 2007). For example, they may adjust their crawling

or walking in response to the rigidity, slipperiness, or slant of surfaces (Adolph, 1997). Motor

movements, including movements of the eyes, arms, legs, and hands, provide most of the

perceptual information infants receive (Adolph and Berger 2006). Young children's bodies

undergo remarkable changes in the early childhood years. In describing this development,

Adolph and Avolio (2000, p.1148) state, "Newborns are extremely top-heavy with large heads

and torsos and short, weak legs. As infants grow, their body fat and muscle mass redistribute.[1]

In contrast to newborns, toddlers' bodies have a more cylindrical shape, and they have a larger

ratio of muscle mass to body fat, especially in the legs." These changes in weight, size,

percentage of body fat, and muscle strength provide perceptual/motor challenges to infants as

they practice a variety of actions (Adolph & Berger, 2006). This dramatic physical development

occurs within the broad context of overall growth. As infants master each challenge, their

perceptual and motor behavior reflects their social environment.[1]

The extent and variety of infant perceptual and motor behavior are remarkable. Infants and

toddlers spend a significant part of their days engaged in motor behavior of one type or another.

By three and a half months of age, infants have made between three and six million eye

movements during their waking hours (Haith, Hazen, & Goodman, 1988). Infants who crawl and

walk have spent roughly half of their waking hours involved in motor behavior, approximately

five to six hours per day (Adolph & Joh, 2007, p.11). Daily infants who are walking ". . . take

more than 9,000 steps and travel the distance of more than 29 football fields. They travel over

nearly a dozen different indoor and outdoor surfaces varying in friction, rigidity, and texture.

They visit nearly every room in their homes, and they engage in balance and locomotion in the

context of varied activities" (Adolph & Berger, 2006, p. 181).

Early research in motor development involved detailed observational studies that documented

the progression of infant motor skills and presented an understanding of infant motor behavior

as a sequence of universal, biologically programmed steps (Adolph & Berger, 2006; Bertenthal

& Boker, 1997; Bushnell & Boudreau, 1993; Pick, 1989). In comparison, current research in

motor development often emphasizes action in the context of behavior and development in the

perceptual, cognitive, and social domains (Pick, 1989). In particular, contemporary accounts of

infant motor development address (1) the strong relationship between perception and action

(Bertenthal 1996; Gibson 1988; Thelen 1995), (2) the relationship between actions and the

environment (Gibson 1988; Thelen 1995), and (3) the importance of motives in motor behavior,

notably social and explorative motives (von Hofsten 2007). How these developing behaviors

and abilities play a role in the social/emotional aspects of the child's life and functioning, such as

forming early relationships and building an understanding of others, is noteworthy.[1]

The current view suggests that thinking about perceptual/motor development includes infants

and toddlers with disabilities or other special needs. Children whose disabilities affect their

perceptual or motor development still want to explore and interact with the people and

environment around them. Although the perceptual and motor development of children with

disabilities or other special needs may follow a pathway that differs from typical developmental

trajectories, sensitive and responsive caregivers can provide alternative ways in which to

engage children's drive to explore, building on their interests and strengths and supporting their

overall physical and psychological health.[1]

For years, researchers, educators, and early childhood professionals have emphasized the

interrelatedness of the developmental domains. Current research supports an even greater

understanding of the relatedness and dependence of factors, domains, and processes in

development (Diamond 2007). The developmental domains are linked with factors such as

culture, social relationships, experience, physical health, mental health, and brain functioning

(Diamond 2007). In the case of perceptual and motor behavior, Diamond (2007) has observed

that perception, motor behavior, and cognition occur in the context of culture, emotion, social

relationships, and experience, which influences physical and mental health and overall health

brain functioning. Bertenthal (1996) has proposed that perception and motor action are

interrelated rather than autonomous processes. They may be best viewed as different

components of a system. Common behaviors such as reaching and turning the head for visual

tracking illustrate the interrelatedness of infant development's motor, perceptual, cognitive, and

social-emotional domains. Even as very

7.2.1 A142774 young infants, children are highly motivated to explore, gain information,

attend, and engage in their physical and social environments (Gibson 1987). As Gibson (1988,

pg. 5) explains, We don't simply see, we look. "Research by Berthier (1996, 811) indicates that

"infant reaching is not simply a neural program that is triggered by the presence of a goal object,

but that infants match the kinematics of their reaches to the task and their goals."

Perception and motor action play a key role in children's experiences and psychological

processes (Thelen 1995). They also contribute to human psychological development since,

ultimately, "behavior is movement" (Adolph and Berger 2005,p 223), and psychology can be

defined as the study of human behavior. It has been proposed that infants' use of social

information to guide their motor behavior in physically challenging or unfamiliar situations

provides an excellent means to study infant social cognition (Tamis-LeMonda and Adolph

2005).[1]

[1] California Department of Education (CDE Press). Perceptual and Motor Development .

Is used with permission.

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7.2.2 A142774 7.3: Sensory Development

Overview of Sensory Development

As infants and children grow, their senses play a vital role in encouraging and stimulating the

mind and in helping them observe their surroundings. Two terms are essential to understand

when learning about the senses. The first is sensation, or the interaction of information with the

sensory receptors. The second is perception or the process of interpreting what is sensed.

Someone can sense something without perceiving it. Gradually, infants become more adept at

perceiving with their senses, making them more aware of their environment and presenting

more affordances or opportunities to interact with objects.[1]

Vision

What can young infants see, hear, and smell? Newborn infants' sensory abilities are significant,

but their senses are not yet fully developed. Many of a newborn's innate preferences facilitate

interaction with caregivers and other humans. The womb is a dark environment void of visual

stimulation. Consequently, vision is the most poorly developed sense at birth. Newborns

typically cannot see further than 8 to 16 inches away from their faces, have difficulty keeping a

moving object within their gaze, and can detect contrast more than color differences. If you have

ever seen a newborn struggle to see, you can appreciate the cognitive efforts being made to

take in visual stimulation and build those neural pathways between the eye and the brain.

Although vision is their least developed sense, newborns already prefer faces. When you glance

at a person, where do you look? Chances are you look into their eyes. If so, why? It is probably

because there is more information there than in other parts of the face. Newborns do not scan

objects this way; rather, they tend to look at the chin or another less detailed part of the face.

However, by 2 or 3 months, they will seek more detail when visually exploring an object and

begin showing preferences for unusual images over familiar ones, for patterns over solids, faces

over patterns, and three-dimensional objects over flat images. Newborns have difficulty

distinguishing between colors, but within a few months, are able to distinguish between colors

as well as adults. Infants can also sense depth as binocular vision develops at about 2 months.

By 6 months, the infant can perceive depth in pictures (Sen, Yonas, & Knill, 2001). Infants who

have experience crawling and exploring will pay greater attention to visual cues of depth and

modify their actions accordingly (Berk, 2007).[1]

Hearing

The infant's sense of hearing is very keen at birth. The ability to hear is evidenced as soon as

the 5th month of prenatal development. An infant can distinguish between very similar sounds

as early as one month after birth and can differentiate between a familiar and non-familiar voice

even earlier. Babies who are just a few days old prefer human voices, they will listen to voices

longer than sounds that do not involve speech (Vouloumanos & Werker, 2004), and they seem

to prefer their mother's voice over a stranger's voice (Mills & Melhuish, 1974). In an interesting

experiment, 3-week-old babies were given pacifiers that played a recording of the infant's

mother's voice and of a stranger's voice. When the infants heard their mother's voice, they

sucked more strongly at the pacifier (Mills & Melhuish, 1974). Some of this ability will be lost by

7 or 8 months as a child becomes familiar with the sounds of a particular language and less

sensitive to sounds that are part of an unfamiliar language.[1]

Pain and Touch

Immediately after birth, a newborn is sensitive to touch and temperature and is also sensitive to

pain, responding with crying and cardiovascular responses. Newborns who are circumcised (the

surgical removal of the foreskin of the penis) without anesthesia experience pain, as

demonstrated by increased blood pressure, increased heart rate, decreased oxygen in the

blood, and a surge of stress hormones (United States National Library of Medicine, 2016).

According to the American Academy of Pediatrics (AAP), there are medical benefits and risks to

circumcision. They do not recommend routine circumcision; however, they stated that because

of the possible benefits (including prevention of urinary tract infections, penile cancer, and some

STDs), parents should have the option to circumcise their sons if they want to (AAP, 2012)[1]

The sense of touch is acute in infants and is essential to a baby's growth of physical abilities,

language and cognitive skills, and socio-emotional competency. Touch impacts not only short-

term development during infancy and early childhood but also has long-term effects, suggesting

the power of positive, gentle touch from birth. Through touch, infants learn about their world,

bond with their caregivers, and communicate their needs and wants. Research emphasizes the

great benefits of touch for premature babies, but the presence of such contact has been shown

to benefit all children (Stack, D. M. (2010). In an extreme example, some children in Romania

were reared in orphanages in which a single care worker may have had as many as 10 infants

to care for at one

7.3.1 A142749 time. These infants were not often helped or given toys with which to play. As

a result, many of them were developmentally delayed (Nelson, Fox, & Zeanah, 2014). [1]

Taste and Smell

Not only are infants sensitive to touch, but newborns can also distinguish between sour, bitter,

sweet, and salty flavors and show a preference for sweet flavors. They can distinguish between

their mother's scent and that of others and prefer the smell of their mothers. A newborn placed

on the mother's chest will inch up to the mother's breast, as it is a potent source of the maternal

odor. Even on the first day of life, infants orient to their mother's odor and are soothed when

crying by their mother's odor (Sullivan et al., 2011).[1]

Other Senses

[1] Psyc 200 Lifespan Psychology. Authored by: Laura Overstreet. CC BY: Attribution

[2] The Brain in the First Two Years. Provided by: Lumen Learning, Lifespan Development

CC BY: Attribution

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7.3.2 A142749 7.4: Perceptual Development

Introduction to Perceptual Development

Infants' perceptual skills are at work during every waking moment. For example, those skills can

be observed when an infant gazes into a caregiver's eyes or distinguishes between familiar and

unfamiliar people. Infants use perception to distinguish environment features, such as height,

depth, and color. "The human infant is recognized today as 'perceptually competent';

determining just how the senses function in infancy helps to specify the perceptual world of

babies" (Bornstein 2005, p 284). Infants explore objects differently depending upon object

features such as weight, texture, sound, or rigidity (Palmer 1989). Parents and professionals

may have observed young children exploring a slope, such as a slide, by touching it with their

hands or feet before deciding whether to slide down it. Research by Adolph, Eppler, and Gibson

(1993) suggests that learning plays a part in young children's decision-making in physically risky

situations, such as navigating slopes, and that exploratory behavior may be a means to this

learning. Perception is also strongly related to the social-emotional domain, such as when

young children perceive the differences between various facial expressions and come to

understand what they may mean.[1]

[1] California Department of Education (CDE Press). Perceptual and Motor Development .

Is used with permission.

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7.4.1 A142750 7.5: Perception and Action

Cycle of Perception and Action

A diagram with an arrow pointing both ways best describes the relationship between perception

and action. Perception selects targets for action and helps us correct errors as we execute

actions. Broadly speaking, there are 2 kinds of actions: navigation (moving around our

environment) and reaching/grabbing.[1]

Figure : shows the relationship between perception and action, described as a cycle or arrows

pointing back and forth. An 7.5.1 example of this cycle is when you reach out for a bottle sitting

on a slanted surface: Banks et al (2000) showed that your sense of touch updates your visual

estimates of the surface slang.). ([1])

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7.5.1 A142751 7.6: Studying Sensory Development

The Study of Sensory Development

There continues to be ongoing discussion and debate as to whether the development of

multisensory processes is innate (though undoubtedly also tuned by environmental

experiences) or instead develops after the child has several months of experiences with the

sensory world (Dionne-Dostie et al. 2015). While objective and quantitative studies in very

young children are challenging, a study by (Lewkowicz and Turkewitz 1980) measured 3–4

week-old infants' heart rates. It showed that these children could associate light and sound

intensities. More recent results have shown that newborn infants can match numerosity across

the senses (Izard et al. 2009) and that 4-month-old infants are sensitive to the spatial

congruence of auditory-tactile events (Thomas et al. 2018). However, one constraint of most

studies on infants and young children is that they are typically based on child-appropriate

behavioral measures, such as preferential looking. Consequently, they provide limited insights

into the putative neurobiological mechanisms and maturation of multisensory processes.[1]

[1] Maitre, N.L., Key, A.P., Slaughter, J.C. et al. Neonatal Multisensory Processing in

Preterm and Term Infants Predicts Sensory Reactivity and Internalizing Tendencies in Early

Childhood. CC BY

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7.6.1 A142752 7.7: Sensory Processing Differences

Understanding Sensory Processing Differences

Sensory processing and integration are complex neurodevelopmental functions that allow

children to regulate, perceive, discriminate, and use sensory input experienced from the

environment and their bodies to respond, learn, and adapt daily effectively. Sensory processing

disorder (SPD) has been described as a distinct neurodevelopmental disorder in the literature

(Schoen et al., 2009; Jorquera-Cabrera et al., 2017; Crasta et al., 2020). It now has been

recognized in the most recent version of the diagnostic classification of mental and

developmental disorders of infancy and early childhood-revised (DC: 0–5, zero to three).

Sensory processing abilities develop naturally and play essential roles in child learning,

behavior and emotional regulation, motor development, and task performance. Sensory

processing disorder has been defined as the brain's inability to organize sensory input for

appropriate use. As stated in the DC: 0–5, zero to three-manual, SPD is diagnosed based on

difficulties in detecting, modulating, interpreting, or organizing sensory stimuli to the extent that

these deficits impair daily functioning and participation. However, the question of whether

deficits in sensory processing represent the symptoms of another disorder, such as autism

spectrum disorder (ASD), developmental coordination disorder (DCD), or SPD is its distinct

condition remains (Borkowska and Sklodowska, 2017).[1]

The American Academy of Pediatrics [AAP], 2012 recommended that SPD generally should not

be diagnosed citing that there is no universally accepted framework for the SPD diagnosis.

Although sensory processing problems were recognized as important to identify and address,

the AAP stated that there lacked evidence to solidly demonstrate that children presenting with

sensory-based problems have an actual "disorder" of the brain's sensory pathways. They

concluded sensory processing deficits were likely associated with other developmental and

behavioral disorders. This view, however, does not account for children who present with

sensory processing deficits affecting their daily life who do not meet the diagnostic criteria for

any other disorder[1].

Experts in the field characterized tSPD as having three main types: [1]

sensory modulation disorder (SMD): Sensory modulation refers to the ability to notice and react

to, regulate, adapt to, and grade responses that are appropriate to the sensory situations

experienced in daily life.

Sensory discrimination disorder (SDD); Sensory discrimination disorder refers to problems with

accurately perceiving and

interpreting sensory information coming in or experienced from one or more of the sensory

systems (Miller et al., 2007; Lane

and Reynolds, 2020; Parham and Mailloux, 2020). Discrimination abilities allow for recognizing

qualitative and quantitative

sensory features and differences among various objects and experiences processed through

the sensory systems. People with

this type can register sensory stimuli. However, appreciating or detecting the qualities of a given

stimulus is a challenge and can

occur with one or more sensory systems.

Sensory-based motor disorder (SBMD), is further divided into subtypes (Miller et al., 2007).

Sensory over-responsivity (SOR): Atypical behaviors associated with SOR are characterized by

intense, exaggerated responses to sensory events that most children do not perceive as

negative or obnoxious, often resulting in withdrawal and avoidance behavior.

Sensory under-responsivity (SUR): Atypical behaviors with SUR include muted or slowed

responses to sensory experiences, often with an apparent lack of awareness, lethargy and/or

indifference, or diminished responsivity.

Sensory craving (SC); is sometimes referred to as sensory seeking. Atypical behavior

associated with SC includes a need for more intense sensory input than what one would

typically want, or that would naturally occur, often manifesting as inappropriate, disruptive,

disorganized and/or risky behavior (Miller et al., 2007, 2017; James et al., 2011; Schoen et al.,

2014).

Prevalence estimates of iSPD range from 5 to 16% of children in the general population, while

60–90% of children with coexisting neurodevelopmental conditions such as autism spectrum

disorder (ASD) have been estimated to have sensory problems (Ahn et al., 2004; Ben-Sasson

et al., 2009; James et al., 2011; Galiana-Simal et al., 2020; Jussila et al., 2020). Mulligan et al.

(2019) reported that 20% of the children in their sample had a co-occurring disorder while the

remaining 80% had not been diagnosed with another neurodevelopmental disorder. [1]

Unfortunately, there are a limited number of diagnostic assessment tools available to evaluate

the sensory processing abilities of children, and no tool is available for explicitly identifying and

measuring the SPD types as described by Miller et al. (2007).[1]

Research evidence is building regarding how sensory processing deficits manifest within

various populations and how iSPD may be differentiated among children with other

neurodevelopmental conditions. As high as 90% of children with ASD have sensory

7.7.1 A142753 processing difficulties, with the most common pattern of SPD being the SOR

modulation subtype (Schoen et al., 2009; Tavassoli et al., 2014; Tomchek et al., 2014; Little et

al., 2018). Children with ASD were more under-reactive to auditory stimuli but over-reactive to

taste and smell.

Sensory under-responsivity has been associated with depressive symptoms and internalizing

behaviors, while externalizing behaviors have been more related to sensory craving, and over-

reactivity. Studies demonstrating how the symptoms of children with iSPD differ from those seen

in children with other neurodevelopmental conditions, including ADHD and ASD are particularly

relevant for supporting SPD as its own diagnostic entity. Miller et al. (2012) compared clinical

assessment findings among samples of neurotypicals, children with ADHD, those with SMD,

and those with dual diagnoses. All clinical groups had significantly more sensory, attention,

activity, impulsivity, and emotional difficulties than typical children. [1]

[1] Mulligan S, Douglas S and Armstrong C (2021) Characteristics of Idiopathic Sensory

Processing Disorder in Young Children

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