Monday, June 23, 2014

What is SPD?

Dear Melissa,
My 4-year-old son is very smart.  He knows all of his colors, numbers, and ABCs. Therefore, I was shocked when his preschool teacher said that he can’t sit in his chair, throws frequent tantrums and even occasionally hits the other kids. At home he has always been very active, but I thought that was typical for a four-year-old boy. His teacher suggested that we seek help from an occupational therapist to see if he has Sensory Processing Disorder. What is sensory processing disorder, and how could therapy help?

Sensory Processing Disorder (SPD), formerly known as Sensory Integration Dysfunction (SID), occurs when a person has difficulty regulating the sensory input from his environment.  This challenge relates to the 5 basic senses of sound, touch, taste, sight and/or smell. It can also relate to the 2 movement senses of vestibular input (which gives input for balance and where your body is in relation to the ground) or proprioceptive input (which gives input as to where your joints/limbs are in space). 

Children (and adults) who have SPD can have a wide range of difficulties. Some children with SPD are very timid and seem to be overly sensitive to the world around them. Other children tend to be “crashers”. They run, jump, climb (and often fall), and it seems like nothing phases them! When a child has difficulty interpreting the world around them, he can often react in inappropriate and unpredictable ways.  It is for these reasons that SPD can often mimic other illnesses such as Oppositional Defiant Disorder, behavior problems, anxiety, depression or ADHD. 

SPD is NOT a medical diagnosis but rather a symptom, often stemming from an immature neurological system. This does not mean, however, that one should neglect treating SPD. For example, fever is also simply a symptom. The fever could be from a virus, strep throat, ear infection, etc. However, you would still give your child plenty of fluids and possibly medication to bring the fever down. 

The treatment of SPD generally involves working with an occupational therapist (OT) with special training for children with sensory difficulties. Ideally, much of this treatment would take place in a sensory-rich gym area with swings, ball pits, trampolines, etc. True sensory therapy often looks like play, but it involves working with the child to carefully regulate their sensory system. This may mean encouraging the timid child to try new things or teaching the “crashing” child to choose activities which can help him obtain the sensory input he needs while learning safety awareness. Once the OT and child learn which activities work to help regulate his sensory system, then they can work together to educate parents, teachers, etc. about activities that can take place in the home and school settings. These activities can help with regulation in all areas of life. Once the child's senses are regulated, then other areas of deficit such as strength/coordination, handwriting, and dressing skills can be addressed far more effectively.

For more information on Sensory Processing Disorder, please refer to:
The Out-of-Sync Child by Carol Kranowitz