Do Sensory Processing Disorders Exist?


At the end of May 2012, the American Academy of Pediatrics issued a policy statement recommending doctors look for the presence of another developmental condition such as autism, developmental coordination disorder, attention-deficit hyperactivity disorder, etc. when a child shows signs of sensory issues.   They went on to say that this is recommended because, “there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed” and “. . . at this time, pediatricians should not use sensory processing disorder as a diagnosis.”  This statement leaves everyone asking, “do sensory processing disorders exist?”  If so, how and when do we provide treatment?

Sensory Processing Disorder (SPD) is a difficulty or difference in the brain’s ability to receive and process sensory stimulation from the body and the environment.  It is a neurological disorder where the connections in the brain appear to be too strong, too weak, or mis-wired, resulting in difficulty participating in normal daily activities.  It is estimated that around 20% of the population has some type of SPD, but it often goes undiagnosed.  SPD is often seen in conjunction with other diagnoses such as Autism Spectrum Disorders (ASD), Cerebral Palsy, ADD/ADHD, and many other childhood disabilities.

Children with Sensory Processing Disorder take in and process sensory information differently than the general population.  Normal sensory events and information are often reacted to in and under or over-responsive manner.  The senses impacted by SPD include our 5 senses of sight, sound, taste, smell, and touch.  It also includes 2 lesser-knows senses including the proprioceptive and vestibular systems.  The vestibular system is related to the inner ear, and processes our body’s position in space and sense of movement.  How we react to swinging, roller-coasters, or being upside down is determined by the vestibular system.  Proprioception is the body’s sense of placement in relation to itself and the environment and is sent to the brain through receptors in joints and muscles.  Proprioception is the ability to close your eyes and know what position your arms and legs are in.  Children with proprioceptive problems often have uncoordinated motor skills and frequently trip and run into objects.  Many children with SPD often crave this proprioceptive input and are constantly prefer wrestling, jumping and squishing activities that makes them feel secure by being aware of their bodies.

Occupational Therapy (OT) is the therapy domain that primarily treats SPD.  A sensory processing evaluation is done with a child and it is determined which senses are impacted and how it affects the child’s daily functioning.  Each system is examined and it is determined which senses are hyper-responsive or under-responsive.  Most children have a mixture of both, depending on the sensation.  Children with SPD usually have trouble with eating (picky eaters), dressing (tolerating the feel of certain clothing), play (avoiding messy textures, fear of movement, or playing too rough) and transitioning between activities and to different environments.

Treatment for SPD includes working with the child’s parents to create a Sensory Diet, which is a program designed for that child to provide his/her body with the sensations they need or crave to function optimally while also slowly and systematically exposing them to the sensations they do not tolerate well to desensitize their nervous system.  Through OT, we can actually re-wire those brain connections so children can function more effectively in their daily lives.

The important thing to realize is that SPD is a real disorder and effective treatment is available.

Yes, we do need further research to learn more about the long term effectiveness of specific sensory processing treatments. Yes, most children do exhibit sensory processing issues in addition to other primary diagnoses.  Yes, the treatment for sensory processing is different for each child.  However, we must remember that there have been numerous studies conducted showing that some children are diagnosed with SPD without other diagnoses present. As with all therapeutic treatments, we must also remember that each child is an individual and has their own individual needs and processes information differently based on their individual needs.

If a child is exhibiting signs of SPD, the treatment for sensory processing issues must be included in the child’s treatment protocol and must be developed by a trained and certified sensory integration professional.  If left untreated, these children with sensory processing issues may be misdiagnosed with other “behavior issues” and their underlying sensory processing issues will be left undiagnosed and untreated.  This could lead to more frustration for both the child and parents and a great emotional cost to the entire family.

The next edition of the DSM V (Diagnostic and Statistical Manual of Mental Disorders) will be released in 2013.  Several advocacy groups have lobbied for sensory processing disorders to formally be included in the new edition.  The final decision will be released later this year (2012).  If approved, sensory processing disorders will finally be recognized as a true disorder and children and adults with SPD will be able to get the services they need.  To stay updated on the final ruling, please visit the SPD Foundation.

For more information about Sensory Processing Issues, the following books and websites are recommended:

The Out of Sync Child by Carol Kranowitz
Sensational Kids by Lucy Jane Miller

Sensory Processing Disorder
SPD Foundation
Sensational Brain

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2 Comments

  1. denise

     /  December 25, 2012

    You raise the question of whether SPD exists, then answer it by just categorically claiming that it does but without addressing any of the reasons why the pediatricians group – along with neurologists and psychiatrists – doesn’t support it. There are already thousands of sites making the claims you are making. For people trying to gain an understanding of the differences of opinion between physicians and other professionals about what is wrong with these kids, there is really nothing to read. I’ve looked at many hundreds of sites and have found nothing that clarifies this for me.

    Someone needs to do the public the service of explaining point by point what the positions of physicians and proponents of SPD are, how they differ and what evidence there is supporting their positions. We don’t need another thousand sites telling us that SPD is real without giving us the information we need to judge or understand the issue. It seems to me that the burden of proof is on Occupational Therapists to show why they should be able to define a neurological disorder that is not recognized by neurologists.

    Reply
    • Denise – Thanks for your feedback. The diagnosis of sensory processing disorder is raising a lot of questions these days, and we know this can be confusing for parents and professionals. Our goal is to share information and help answer your questions. If we can’t, then we try to point you in the right direction. We know there is a lot of research going on right now to assess the diagnosis and treatment efficacy of sensory processing. More research and collaboration amongst occupational therapists, neurologists, psychologists, etc. is needed in order for everyone to be on the same page. There is a blog by AOTA (American Occupational Therapy Association) which addresses some of the points you raised. We hope you find this helpful and wish you luck in your further research. http://otconnections.aota.org/aota_blogs/b/aota_presidential_blog/archive/2012/08/07/essay-the-current-status-of-sensory-integration-therapy.aspx.

      Reply

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