Canada's Homeschool

Is your child especially sensitive to the tags on his clothing? Does your son have poor motor skills, including poor handwriting? Do bright lights irritate your daughter to the point that she cannot focus on anything else? 

While there is a good possibility that you may not have heard of this condition, chances are you will be learning more about it in the future. Sensory Processing Disorder, or SPD, is a neurological condition in which the affected child (or adult) is unable to receive and respond to information from the senses in a meaningful way. To this end, the child will over- or under-respond to certain stimuli, experience perceptual problems, and/or engage in sensory-seeking behavior.

With SPD, one or more of the child’s senses may be affected. Classical science has taught us that humans have five senses: touch, smell, taste, vision, and hearing. SPD researchers are concerned with the five senses, along with an additional two: vestibular and proprioceptive. Vestibular refers to our ability to maintain balance and process motion. Without our vestibular sense in proper working order, we might not know where to position our head in order to read the words on this page. Proprioception refers to our ability to sense the position, location, and orientation of our body and its various parts. For example, I am aware that my hands are now in front of me, typing on a keyboard. Even if I close my eyes, I will still know where my hands are. These latter two senses form part of our unconscious nervous system.

Along with over-/under-responsiveness and misprocessing of stimuli, other signs of SPD include slow gross- and fine-motor maturation, inability to calm oneself, being easily overwhelmed and/or distracted, and atypical cognitive development. These problems can manifest themselves in many ways including dyslexia, clumsiness, behavioural problems, poor math skills, academic failure, depression, and anxiety. And while we all might have a little difficulty with processing sensory information from time to time, for the person with SPD, this behaviour is chronic and disruptive.

One research study theorizes that 1 out of every 20 persons suffers from SPD. Similar to autism - in that it is a ‘spectral’ disease - SPD also occurs in varying degrees, from the mildly irritated to the severely affected. 

Here’s the rub: your doctor or pediatrician may not have heard of sensory processing disorder. Here’s a little history to help explain why.   

It all started in the late sixties with American researcher and occupational therapist, A. Jean Ayres. Occupational therapy (OT) involves the therapeutic development of an individual’s physical and emotional skills (including eating, dressing and bathing) to enhance their daily living skills. (Please refer to the Fall 2010 issue of Homeschooler’s Guide for an article about OT written by an occupational therapist.)

Dr. Ayres believed that “in order to fully develop both motor and cognitive skills, the human brain has to internally digest and route (process) continuing feedback from all the senses, particularly tactile, proprioceptive and vestibular.” If any of that information is hampered in any way, then that may result in a variety of developmental issues, such as those signs named above. Her theory was widely disputed by the medical profession, including her colleagues in the field of occupational therapy. Ayres spent two decades developing her developing her theory, until her death in 1988 at the age of 68. By then, Ayres had gathered considerable support and respect for her ‘sensory integration’ theory.

During her studies, Ayres mentored fellow American, Lucy Jane Miller, PhD, and registered occupational therapist whose dedication and perseverance have had considerable impact on bringing SPD to the forefront of the medical profession and to concerned parents everywhere. In 1977, Miller founded the Sensory Processing Disorder Foundation (SPDF), a research hub located near Denver, Colorado, responsible for coordinating SPD trials throughout the States and Canada. Currently, Miller is considered the foremost sensory processing researcher in America.

Back to our previous dilemma, however: why a doctor or pediatrician might shrug her shoulders when asked about “sensory processing disorder.” Simply put, the condition is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The DSM, as it’s known in its short form, is the definitive encyclopedia of mental disorders used by health and mental health professionals in the United States and Canada, and published by the American Psychiatric Association (APA). 
The fifth edition of the DSM will be published in 2012. The SPDF and SPD Canada have been working diligently to get SPD included in the upcoming edition. However, there is a costly and challenging process that must be followed in order for a ‘new’ condition to be considered for inclusion in this essential manual. 

Now with their hard work complete at this point (in terms of consideration in the DSM-V), there is a very good indication that SPD will be included in the upcoming edition - as a “novel diagnostic entity” that merits more study. No doubt the late Dr. Ayres would be proud. In the meantime, Dr. Lucy Miller has been highly encouraged by the additional documentation requested by the APA during the association’s deliberation process over the past two years. 

Whether SPD becomes officially recognized by the APA in 2012 or not, there are treatment options for those affected by the disorder, keeping in mind that SPD is not curable, cannot be outgrown, and does not “go away.” Parents are urged to be patient and understanding with their affected child and to first visit their physician and/or pediatrician to rule out any other disorders or illnesses. If he or she has heard of SPD, then they may be able to offer you direction with treatment options. One option is to look for an OT who has Sensory Integration Praxis Training (S.I.P.T.) and/or has mentored under Dr. Miller.  
An experienced OT will either administer a Sensory Processing Measure (SPM) or a ‘Winnie Dunn Sensory Profile.’ Both are standardized surveys which offer a starting picture of your child’s sensory functionality at home and in the school and community. Diagnosis should also be combined with hands-on clinical observation. 

Naturally, after reading about SPD, some parents may wonder if their particular child has the disorder. After other conditions are ruled out, an SPM or sensory profile should be able to provide the answer to that question. Having said that, all young children demonstrate some of the tendencies experienced by persons with SPD and may, in fact, benefit from the support strategies offered by occupational therapy.

It is important to note that SPD is often associated with Tourette syndrome, attention-deficit hyperactivity disorder (also referred to as ADHD, AD/HD or ADD), obsessive-compulsive disorder (OCD), or autism spectrum disorder (ASD). Part of the challenge for researchers is getting SPD established as its own disorder, proving that it exists in persons without any other psychopathology. An important term to define at this point is co-morbidity. Co-morbidity is the existence of two disorders or illnesses in the same person either at the same time, or one after the after, where each condition is affected by the other. For example, drug abuse and depression often exist co-morbidly. It is the burden of research to establish SPD as a stand-alone diagnosis.       

Currently, it is unknown what causes sensory processing disorder. There is, however, research supporting the theory that SPD has a hereditary component to it (up to a 40% probability).    

Because SPD is generally not recognized by government health plans, parents will probably not receive insurance coverage for its treatment. Parents may be covered, however, if their plans cover OT and/or physical therapy, or naturopathic treatments.

In the meantime, parents with children with SPD are encouraged to deal with the disorder by gaining control of their child’s environment. One married couple stopped going to family and social gatherings in order to gain control over their child’s atypical conduct during these functions. They wanted to make sense of their child’s behaviour on their own terms first. When they did that, then friends and family were able to be understanding with their situation.

What do you do, however, if you are met with rolling eyes when you tell someone that your child might have SPD? Certainly, some diseases and conditions are stigmatized, such as depression and ADHD. SPD Canada advises parents to follow the old saying: “take care of yourself first.” And be assured that diagnostic and treatment options do exist.    

Researchers and health professionals aren’t the only ones recognizing SPD. Watch for the clothing industry to take more notice over the next few years. In the meantime, look for flat-seamed, soft-brushed and tagless garments to provide more comfort for your child.  

To become more informed about sensory integration and sensory processing disorder, check out www.spdcanada.org in Canada and www.spdfoundation.net in the States. Parents can also join a Yahoo support group facilitated by the SPD Bay Area Resource Group (www.spdbayarea.org) in California. Their program, SPD-TIPS (Sensory Processing Disorder-Treatment Interventions for Parents), is a worldwide internet-based resource group aimed at supporting parents who have a child(ren) with SPD. Another forum can be found at www.spdparentshare.com.

In addition, here are a few books to check out on the subject: Sensational Kids: Hope and Help for Children with Sensory Processing Disorder (SPD) by Lucy Jane Miller; The Mislabeled Child by Brock Edie, M.D., M.A., and Fernette Eide, M.D; The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder by Carol Kranowitz; and Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues by Lindsay Biel. The website of the SPD Foundation also provides CDs created especially for children with SPD.

For a list of OT practitioners in Canada with sensory integration training, you will find a comprehensive list
at Western Psychological Services, a publisher of health-related books and resources based in Los Angeles, California.
Please note that SPD may also be referred to as Sensory Integration Dysfunction (SID) or Dysfunction of Sensory Integration (DSI). 

Resources

SensoryProcessingDisorder.com
www.sensory-processing-disorder.com

Sensory Processing Disorder Canada
www.spdcanada.org

 Sensory Processing Disorder Foundation

www.spdfoundation.net

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