Do You Know What (SPD) Sensory Processing Disorder Is?

[neonds13]

About SPD

Sensory processing (sometimes called "sensory integration" or SI) 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. Whether you are biting into a hamburger, riding a bicycle, or reading a book, your successful completion of the activity requires processing sensation or "sensory integration."

Sensory Processing Disorder (SPD, formerly known as "sensory integration dysfunction") is a condition that exists when sensory signals don't get organized into appropriate responses. Pioneering occupational therapist and neuroscientist A. Jean Ayres, PhD, likened SPD to a neurological "traffic jam" that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. A person with SPD finds it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks. Motor clumsiness, behavioral problems, anxiety, depression, school failure, and other impacts may result if the disorder is not treated effectively.

Research by the SPD Foundation indicates that 1 in every 20 children experiences symptoms of Sensory Processing Disorder that are significant enough to affect their ability to participate fully in everyday life. Symptoms of SPD, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children and adults with SPD, these difficulties are chronic, and they disrupt everyday life.

What SPD looks like

SPD can affect people in only one sense–for example, just touch or just sight or just movement–or in multiple senses. One person with SPD may over-respond to sensation and find clothing, physical contact, light, sound, food, or other sensory input to be unbearable. Another might under-respond and show little or no reaction to stimulation, even pain or extreme hot and cold. In children whose sensory processing of messages from the muscles and joints is impaired, posture and motor skills can be affected. These are the "floppy babies" who worry new parents and the kids who get called "klutz" and "spaz" on the playground. Still other children exhibit an appetite for sensation that is in perpetual overdrive. These kids often are misdiagnosed - and inappropriately medicated - for ADHD.

SPD is most commonly diagnosed in children, but people who reach adulthood without treatment also experience symptoms and continue to be affected by their inability to accurately and appropriately interpret sensory messages.

These "sensational adults" may have difficulty performing routines and activities involved in work, close relationships, and recreation. Because adults with SPD have struggled for most of their lives, they may also experience depression, underachievement, social isolation, and/or other secondary effects.

Sadly, misdiagnosis is common because many health care professionals are not trained to recognize sensory issues. The SPD Foundation is dedicated to researching these issues, educating the public and professionals about their symptoms and treatment, and advocating for those who live with Sensory Processing Disorder and sensory challenges associated with other conditions.

The Causes of SPD

The exact cause of Sensory Processing Disorder–like the causes of ADHD and so many other neurodevelopmental disorders–has not yet been identified. However, preliminary studies and research suggest some leading contenders.

- from Sensational Kids: Hope and Help for Children With Sensory Processing Disorder by Lucy Jane Miller, PhD, OTR

What causes Sensory Processing Disorder is a pressing question for every parent of a child with SPD. Many worry that they are somehow to blame for their child's sensory issues.

"Is it something I did?" parents want to know.

The causes of SPD are among the subjects that researchers at SPD Foundation and their collaborators elsewhere have been studying. Preliminary research suggests that SPD is often inherited. If so, the causes of SPD are coded into the child's genetic material. Prenatal and birth complications have also been implicated, and environmental factors may be involved.

Of course, as with any developmental and/or behavioral disorder, the causes of SPD are likely to be the result of factors that are both genetic and environmental. Only with more research will it be possible to identify the role of each.

A summary of research into causation and prevalence is contained in Sensational Kids: Hope and Help for Children With Sensory Processing Disorder (New York: Perigee, 2006).

Emotional and other impacts of SPD

Children with Sensory Processing Disorder (SPD) often have problems with motor skills and other abilities needed for school success and childhood accomplishments. As a result, they often become socially isolated and suffer from low self-esteem and other social/emotional issues

These difficulties put children with SPD at high risk for many emotional, social, and educational problems, including the inability to make friends or be a part of a group, poor self-concept, academic failure, and being labeled clumsy, uncooperative, belligerent, disruptive, or "out of control." Anxiety, depression, aggression, or other behavior problems can follow. Parents may be blamed for their children's behavior by people who are unaware of the child's "hidden handicap."

Effective treatment for SPD is available, but far too many children with sensory symptoms are misdiagnosed and not properly treated. Untreated SPD that persists into adulthood can affect an individual's ability to succeed in marriage, work, and social environments.

How SPD is treated

Most children with Sensory Processing Disorder (SPD) are just as intelligent as their peers. Many are intellectually gifted. Their brains are simply wired differently. They need to be taught in ways that are adapted to how they process information, and they need leisure activities that suit their own sensory processing needs.

Once children with SPD have been accurately diagnosed, they benefit from a treatment program of occupational therapy (OT) with a sensory integration (SI) approach. When appropriate and applied by a well-trained clinician, listening therapy (LT) or other complementary therapies may be combined effectively with OT-SI.

Occupational therapy with a sensory integration approach typically takes place in a sensory-rich environment sometimes called the "OT gym." During OT sessions, the therapist guides the child through fun activities that are subtly structured so the child is constantly challenged but always successful.

The goal of OT is to foster appropriate responses to sensation in an active, meaningful, and fun way so the child is able to behave in a more functional manner. Over time, the appropriate responses generalize to the environment beyond the clinic including home, school, and the larger community. Effective occupational therapy thus enables children with SPD to take part in the normal activities of childhood, such as playing with friends, enjoying school, eating, dressing, and sleeping.

Ideally, occupational therapy for SPD is family-centered. Parents are involved and work with the therapist to learn more about their child's sensory challenges and methods for engaging in therapeutic activities (sometimes called a "sensory diet)" at home and elsewhere. The child's therapist may provide ideas to teachers and others outside the family who interact regularly with the child. Families have the opportunity to communicate their own priorities for treatment.

Treatment for SPD helps parents and others who live and work with sensational children to understand that Sensory Processing Disorder is real, even though it is "hidden." With this assurance, they become better advocates for their child at school and within the community.

Red flags of Sensory Processing Disorder

If more than a few of the symptoms listed below fit your child, refer to the complete SPD Checklist in Our Library. For a Spanish-language copy of the Red Flags, click here.

Infants and toddlers
____ Problems eating or sleeping
____ Refuses to go to anyone but me
____ Irritable when being dressed; uncomfortable in clothes
____ Rarely plays with toys
____ Resists cuddling, arches away when held
____ Cannot calm self
____ Floppy or stiff body, motor delays

Pre-schoolers
____ Over-sensitive to touch, noises, smells, other people
____ Difficulty making friends
____ Difficulty dressing, eating, sleeping, and/or toilet training
____ Clumsy; poor motor skills; weak
____ In constant motion; in everyone else's face and space
____ Frequent or long temper tantrums

Grade schoolers
___ Over-sensitive to touch, noise, smells, other people
___ Easily distracted, fidgety, craves movement; aggressive
___ Easily overwhelmed
___ Difficulty with handwriting or motor activities
___ Difficulty making friends
___ Unaware of pain and/or other people

Adolescents and adults
___ Over-sensitive to touch, noise, smells, and other people
___ Poor self-esteem; afraid of failing at new tasks
___ Lethargic and slow
___ Always on the go; impulsive; distractible
___ Leaves tasks uncompleted
___ Clumsy, slow, poor motor skills or handwriting
___ Difficulty staying focused
___ Difficulty staying focused at work and in meetings

Subtypes of SPD

As the field of sensory integration (SI) has matured and researchers have learned more about this condition, many people have realized that it is time to clarify terminology. Although occupational therapists (OTs) usually understand one another when using the term "sensory integration dysfunction" (sometimes abbreviated DSI), physicians and other health professionals without familiarity with the theory, assessments, and intervention of SI often lack the same knowledge base and may hold a more neurobiological view of the term.

Since physicians are responsible for the total care of the child and in many cases provide a referral for OT services that requires a diagnosis, using a diagnostic term for SI that is more consistent with the physician's perspective seems appropriate. At the same time, due to the wealth of literature related to SI in occupational therapy theory and intervention, the continued use of the term SI when applied to those aspects of SI seems appropriate to retain historical and current information published related to the SI frame of reference within the occupational therapy profession.

We are, therefore, proposing to update the diagnostic terminology used in sensory integration. This article describes a proposed system for sensory integration terminology differentiating the disorder from both the theory and the intervention (using occupational therapy with an SI frame of reference).

The new nosology proposed for the diagnostic categories uses Sensory Processing Disorder as a global umbrella term that includes all forms of this disorder, including three primary diagnostic groups (Sensory Modulation Disorder, Sensory Discrimination Disorder, and Sensory-Based Motor Disorder), and the subtypes found within each (see figure below).

Detailed Description

Dr. A. Jean Ayres, a researcher and pioneer of this field, coined the term Sensory Integration Dysfunction. She used the term throughout her professional career (1954-1988) to describe atypical social, emotional, motor, and functional patterns of behavior that were related to poor processing of sensory stimuli.

Dr. Ayres chose the term for two reasons. First, it related to her hypothesized theoretical model, which posited an underlying neurological impairment in the ability to transfer sensory information efficiently between sensory systems in the brain. Second, the term referred to her proposed intervention model, which used sensory stimuli in one domain to affect performance in another domain (e.g., the use of deep pressure/proprioceptive input to decrease over-responsivity in the tactile domain). During intervention – occupational therapy using a sensory integration frame of reference – activities in two or more sensory domains are actively used concurrently. Often, action in one or more sensory systems (or provision of one or more sensory stimuli) supports the child as she or he makes an adaptive response to a challenging situation involving another sensory system. An adaptive response occurs when a child engages in activities of increasing difficulty and makes a successful response.

Over the years, in practice, the root term "sensory integration" has been commonly used in four different ways. It is used to refer to:

• A theory (sensory integration theory)
• A diagnosis (based on a sensory integration assessment)
• A functional pattern (normal sensory integration abilities)
• A remediation approach (sensory integration intervention)

Notably, none of these uses correspond to the neurobiologic meaning of the term sensory integration, which refers to a neuronal process that can only be measured using electrophysiologic recording techniques (e.g., EEG). Generally referred to as multi-sensory integration, the function depends on the convergence of excitatory signals from multiple sensory modalities onto a) a single neuron, or b) networks of neurons. Sites where convergence of sensory input from different sensory modalities occurs are present in many regions of the brain, including the cortex.

We selected the term Sensory Processing Disorder for two reasons. First, common use in the neurobiology literature indicates that the clients with this condition have deficits in taking in, interpreting, and responding appropriately to sensory input. Second, the lay use of the word "process" refers to a particular method of doing something, generally involving a number of steps or operations that lead to a specific outcome. We propose that the word "process" within the context of Sensory Processing Disorder captures the series of steps that are disrupted as a result of impairments in sensory detection, modulation, and/or interpretation in children with this disorder. In this disorder, atypical behaviors occur in the "process" of discerning a sensory stimulus and making a motor or behavioral response. At this time, we believe that Sensory Processing Disorder constitutes a more effective label for facilitating communication about the condition when OTs are discussing it with other professionals.

[neonds13]

Sep. 30, 2009 at 4:26 AM

PLEASE VOTE POPULAR & BUMP!!!!

Here is a book & a website about Sensory Processing Disorder I'd like to suggest to anyone that may be interested.

Book:  The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder, Revised Edition by Carol Stock Kranowitz  (book link takes you to Amazon.com)

Website:  http://www.spdfoundation.net/

      

(Original Poster)

[toolmommy]

Sep. 30, 2009 at 10:01 AM

I have a daughter with SPD. We were so lucky to have people in our lives who recognized what was going on with her early on and helped up get her the proper treatment. There are not enough teachers and health care professionals who know what SPD is or how to support a child with this disorder. Knowing that the statistics on SPD say that 1 in 20 children can be affected by this problem means that there has to be more screening and education. These kids are far too often misdiagnosed and medicated when OT-SI has been amazingly affective. My daughter spent 1 year in OT and we saw a 100% improvement. I also suggest that anyone with an SPD child consider play/talk therapy for the child if symptoms of anxiety persist. These children can learn to live and thrive with this disorder!! We just have to get the information out to parents so they can recognize the problems early and intervene appropriately.

[gypsysmiles]

Sep. 30, 2009 at 12:28 PM

I was diagnosed with ADHD as a child, but I (along with a few others who work directly with children who have SPD) am convinced that this is what's wrong with me.

[jennient3]

Oct. 1, 2009 at 10:59 AM

thank you for putting this out there, My son was DX-ed at 3. He has come a long way in being able to tolerate certain things. It took the right doc to give me a dx, i was told so many things. His first signs were touching and gagging, I couldn't understand what the two had to do with each other. He still has trouble with foods, but I am happy he loves play dough and is recieving, OT and PT and speech. At 6 I am happy with how far he has come in 3 years.

[Joyful6and12]

Oct. 2, 2009 at 6:02 PM

Thank you for posting this.  Parents who are struggling need to know what this is.  

We found out my 6 yr old has SI after his OT did a Sensory Integration Praxis Test (or SIPT).  Here is a link that explains what the SIPT consists of.

http://www.way2grow.com/pdfs/sipt_desc.pdf

If only I had known this years ago.  I'm still struggling to understand why all the doctors, teachers and other professionals weve encountered never once mentioned getting an evauluation by an OT.    

Understanding now what he challenges are is like putting a new frame on an old photo - we understand him so much more.

[alisha385]

Dec. 9, 2010 at 5:26 AM

Sensory processing disorder is called the neurological disorder. A common disorder most probably have in children is called Sensory Integration Disorder or SID. Sensor processing disorder is commonly associated with pregnancy and childbirth. SPD is a dysfunction that is belongs from pelvic girdle pain. The main symptom of SPD is that, usually pain or discomfort in the pelvic region. The basic treatments are use by the health experts such as  elbow crutches, pelvic support devices and prescribed pain relief.