Diagnosis Sensory processing disorder and tablets on a wooden taOur bodies are wired for sensory input. Touch, (which includes temperature, texture and pressure), taste, sound, sight and smell are the ways in which we explore the world, from the moment we enter it. When all systems are functioning, we experience a feedback loop. For example, if you were shivering from the cold and wanted to feel warmth, you might put on a cozy sweater or wrap a fleece blanket around your shoulders. Your body would likely respond by relaxing, followed by an emotional relief and perhaps even a sigh. The next time you felt chilly, you would remember what it took to remedy that sensation and follow through. If you inadvertently put your hand on a hot surface, you would immediately remove it, lest you do damage. If you happened to be in a position for that to recur, you would like be attentive. Your body remembers.

When neurological complications ensue, our relationship with the outer environment can become a confusing and frustrating maze.

What Is SPD?

Dr. Jean Ayres, PhD, OTR coined the term Sensory Processing Disorder (SPD), “a condition that exists when sensory signals don’t get organized into appropriate responses. SPD Foundation research has found 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.”

SPD is not yet recognized as a diagnosis in the DSM-V. There are both professionals and family members who advocate for its inclusion, so that treatment is likely to be covered by insurance. One includes Lucy Jane Miller, PhD, OTR, author of Sensational Kids: Hope and Help for Children with Sensory Processing Disorder. She, along with other professionals in the field, recommend early diagnosis and treatment.
It is generally identified in childhood; estimates are that a minimum of one in every 20 children in the United States have SPD. There are some adults who have gone undiagnosed. This disorder carries with it a long laundry list of indicators that include:

Overstimulated in these areas:

  • Discomfort with clothing that either feels too tight or too loose
  • Dislike being touched
  • Doesn’t like shoes or socks on feet or gloves/mittens on hands (seams seem to be particularly uncomfortable)
  • Reluctant to walk barefoot on grass or dirt
  • Feels that tags on clothes are too scratchy
  • Limited food preferences
  • Doesn’t like nails or hair cut
  • Fidgets or jumps up often
  • Overwhelmed by noise or crowds

Seeking stimulation in these areas:

  • May consistently bump into and hit objects
  • Climbing on and then jumping off structures
  • Lying upside down on furniture
  • Fascinated with spinning objects
  • Limited sensitivity to what might be uncomfortable or painful to others
  • Seems to be tuning out sounds
  • Excessively touching objects, people and animals even when asked to refrain
  • Putting non-food items in their mouths or licking objects

Causes Are Uncertain

The prevailing wisdom is that the cause for SPD is still unknown, although researchers are spending much time learning more about the condition. Some of the potential causes for SPD may include:

Genetic: Children born to adults who are on the autism spectrum may have an increased likelihood for developing sensory processing disorder. Additionally, children with Asperger syndrome or autism are at a higher risk for developing SPD. Boys are more likely than girls to have SPD.

Co-Occurring Disorders
The most common co-occurring disorders include:

  • Autism
  • Asperger syndrome
  • Attention-deficit hyperactivity disorder
  • Language disorders
  • Learning disabilities
  • Post-traumatic stress disorder
  • Fragile X syndrome

Treatment Is a Delicate Dance Between Child, Parent and Therapist

Once the condition is recognized, whether by a parent, teacher, occupational therapist, medical doctor, psychotherapist, treatment can commence.

One type of therapy is called the Developmental, Individual Difference, Relationship-based (DIR) model. The therapy was developed by Stanley Greenspan, MD, and Serena Wieder, PhD.

The modality utilizes the “floor-time” method which includes multiple sessions of play with the child and parent. The sessions last about 20 minutes. The beauty of the technique is that the child is the leader of the experience. For many children who exhibit symptoms experience extreme frustration and this allows a modicum of control. When parents allow for this dynamic in the therapeutic relationship, they ‘enter’ into the child’s world, which also relieves a sense of helplessness for both parties. For example, if the youngster spins an object, they too spin.  If he or she rocks, the parent rocks. It is not mimicking, but rather, joining.  

A Family Affair

‘Max’ is a seven- year old first grader in a public -school system. He came to a therapist’s office with his father for an intake. He had already been receiving services of an occupational therapist via his school district. He was in a mainstream grade class and most of the time, is capable of functioning well in the school setting. He has a few friends there. The home environment is loving and supportive and consists of his parents and a 10-year-old sister named ‘Emily’. What the parents note, is that he exhibits many of the previously mentioned signs, with many them related to being overly stimulated by touch. His father mentioned that Max “takes forever to get dressed, since what he has on is either too tight, too loose or not the right color or fabric. He can’t stand tags on the back of his shirts and we need to cut them off before he wears them.” When re-directed, he “sometimes has a melt down and all we can do at that moment is step back and let it happen. We’ve learned that if we insist, it is prolonged and it isn’t pretty.” He acknowledges that it isn’t something Max has control over most of the time and it isn’t always predictable. They do what they can to anticipate triggers and plan accordingly. He admits that it takes its toll on their home life and “Patience is a learned virtue for all of us.”  He acknowledges that Max’s situation has brought them closer together as a family, when it could easily have created a rift between the parents. He notes that Emily enjoys being part of what they call “Team Max,” as she works with them to calm him when he is overstimulated and enjoys the therapeutic games and activities that they play together. The parents make sure that she receives 1:1 time with them, since it would be understandable that she might feel that her brother receives the lion’s share of their parents’ attention.

The therapist offered a comprehensive resource called Sensory Processing Disorder Parenting Support as a means of assisting this family in developing strategies to help their child and maintain emotional stability in the process. Created by the mother of two children who experience these conditions, it is a vast storehouse of information on clothing, interactive toys, activities, therapists, articles, as well as a parents’ forum.