Sensory Processing Disorder

Andrew McIntosh, M.D.

Andrew McIntosh, M.D.

What is a sensory processing disorder? Well, that depends on who you ask. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) it doesn’t exist and information in the mainstream medical literature is sparse. In my practice, the issue comes up almost every day. Often, sensory processing disorders are part of another, better defined, condition such as an autism spectrum disorder, ADHD or associated with an intellectual disability. However, I follow many children in my practice who have disabling and potentially treatable sensory processing issues but clearly do not meet diagnostic criteria for other common behavioral/neurological disorders. This month, an expert on sensory processing disorder, Betsy Aasland OTR, has written an excellent article for the blog that helps clear up some common questions.

Betsy Aasland, MS, OTR

Betsy Aasland, MS, OTR

Sensory Processing Disorder
“There is just something not right with my little girl!” says a frantic mom to me on the phone. “Her preschool teacher said she has difficulties with fine motor activities and some problems making friends. I just don’t understand because she really is so smart! The school district assessed her and she didn’t qualify for services and the pediatrician doesn’t seem to be concerned. Our family life is so hard because we never know how she is going to react when we go out anywhere! I have just about given up, but my friend from MOPS said she takes her son to occupational therapy for similar problems . . . Can you help?” “It’ll be okay,” I reply. “You’ve come to the right place. I think we can help. Now, tell me a more about your little girl.”

This conversation has taken place over and over again in my practice. As an occupational therapist specializing in the treatment of Sensory Processing Disorder (SPD), I encounter this scenario with parents and children across all ages, race, and socio-economic status.

Sensory processing (also known as sensory integration) is a term that refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses. It is thought that SPD occurs when an individual cannot put all of the information from their senses together in an efficient manner. Therefore, they can’t produce an appropriate response. For example, a child may demonstrate an over-reaction to unexpected loud noises, or conversely, not seem to notice a fire alarm. SPD doesn’t just affect the sense of hearing, but all of the senses, including vision, taste, smell, touch, as well as our sense of movement (vestibular sense) and our sense of where our body is in space (proprioceptive sense).

The idea of SPD was first introduced to the public in the 1960’s by A. Jean Ayers, PhD. She was an occupational therapist and neuroscientist who compared SPD to a neurological “traffic jam” that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. In addition to inappropriate sensory responses, children with SPD may demonstrate poor attention span, difficulty following directions, inability to sit still, poor coordination and balance, difficulty making friends, behavioral outbursts, and low self-esteem.

SPD is many times referred to as a “hidden disability” as it can be very difficult for the untrained eye to detect. Historically, SPD has often been misdiagnosed as ADD/ADHD, Autism, and others. While it is true that SPD can co-exist with many other disorders, it can also stand alone as a debilitating issue. Children who suffer from SPD can be very misunderstood. Teachers may label them as a problem child. The pediatrician may say “he’ll grow out of it.” Parents even think that their child is simply quirky, high-energy, or just clumsy. What sets this child apart from his peers? It may be Sensory Processing Disorder. Fortunately, when treated effectively, the symptoms of SPD can be greatly reduced or even resolve completely!

Although some studies suggest that as many as 1 in 20 children suffer from SPD, information and help for those with this disorder is still very limited. A lack of knowledge and resources, combined with the fact that SPD often looks like other disorders frequently results in misdiagnosis and inappropriate treatment. Even when parents do obtain a diagnosis, it can be difficult to find a qualified professional to provide treatment. On top of that, most insurance companies do not cover the cost of treatment. Fortunately, there are more and more medical professionals in Southern California who are familiar with SPD and provide appropriate referrals and diagnostic coding. This improves the prompt delivery of appropriate care and greatly improves the chances of insurance coverage.

The most common treatment for SPD is occupational therapy (OT). An occupational therapist that treats SPD has generally received additional specialized training. OT with a sensory integrative approach typically takes place in a sensory-rich environment. Such specialized centers provide opportunities for sensory-based motor development in the “gym”, tactile art and fine motor activities, and self-regulation in a quiet room. During OT sessions, therapists guide the child through a series of play activities that are subtly designed to provide the “just right challenge” (constantly challenging a child, but always with a successful end result).

Although the recognition and treatment of SPD is gradually becoming more accepted in mainstream medicine, there are still many children suffering with SPD having received an inaccurate diagnosis and inadequate therapies. Well informed doctors, therapists, psychologists and other healthcare professionals/educators being aware of SPD and community resources can greatly improve the quality of life for affected children.

If you would like more information about SPD or to arrange an appointment at Beach Kids Therapy Center please visit their website or call (949) 498-5100.

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