"Imagine driving a car that isn't working well. When you step on the gas the car lurches forward or doesn't respond. The horn sounds blaring. The brakes sometimes slow, but not always. The blinkers work occasionally, the steering is erratic, and the speedometer is inaccurate. You are engaged in a constant struggle to keep the car on the road, and it is difficult to concentrate on anything else."
This is how Dr. Stanley Greenspan, the late psychiatrist and leading authority on child development, described Sensory Processing Disorder (SPD), also known as Sensory Integration Disorder. A. Jean Ayres, PhD, an occupational therapist (OT) and neuroscientist who pioneered the research and treatment of SPD, calls it a neurological traffic jam. In short, it's the inability to process multiple sensory inputs from the environment in a self-regulatory and functional way.
SPD is a relatively unknown and often invisible disorder that currently has no official medical diagnosis. But it is a real and constant struggle for the estimated 5 percent of children -- and their families -- affected by it. And it manifests itself differently in every individual. Some children can't process messages from their joints or muscles and constantly bump into their classmates. Some kids get distracted by clothing that feels like sandpaper, while others seek out stimuli in order to feel calm. Tantrums, withdrawal, poor academics, battered self-esteem -- these are the all-too common fallouts.
How do you know if your child may have SPD? The Sensory Processing Disorder Foundation website has a list of red flags and urges parents to seek an evaluation if more than a few of the symptoms fit their child. Some of these behaviors in infants and toddlers include motor delay, or irritability when being dressed. For pre-schoolers, it asks about sensitivities to touch, noise or smells, difficulty in making friends, frequent or long temper tantrums. In grade-schoolers, it may be aggressiveness or distractibility, handwriting problems, social issues, oversensitivity. And the symptoms are as varied as the children themselves.
But how do you distinguish between simply being human, with sensory likes and dislikes, and having a neurological disorder?
Jennifer Rosenberg, OTR/L and director of Way to Grow, a pediatric occupational therapy practice in the DC area says when something goes from being a quirk to having to plan your child's life around that particular feature, that's when there's an issue.
"It's one thing if a kid only eats three types of food," she says. "But if you can't take your child to a family Thanksgiving dinner, that's a whole other level."
She believes a consultation is warranted when a child's sensory needs begin to interfere with their ability to do the things they want or need to do -- whether socially, academically or behaviorally. And she always thinks about the child in the context of the family since SPD affects interactions with parents and siblings, and a family's overall ability to function as a unit.
But Sensory Processing Disorder is not the only piece of the puzzle and Elizabeth Tallaksen, an occupational therapist who has been working with children in the New Jersey schools for over 20 years, cautions against simply using SPD as a scapegoat for bad behavior, or worse, missing other underlying issues like autism, ADHD or a learning disorder. Research shows that sensory issues and autistic spectrum disorders are linked, with anywhere from 70-90 percent of autistic children exhibiting signs of SPD. This does not mean, however, that all children with SPD are autistic.
"The social piece is what distinguishes autistic spectrum disorders from sensory processing disorders," says Tallaksen. "If a child only has SPD, he or she can engage socially. Likewise, occupational therapy won't solve the social issues for a child with Aspbergers."
Furthermore, so many of the symptoms of SPD -- inattention, fidgetiness, distractibility -- mirror those of ADHD. So how do you tease apart the real issue? Oftentimes, it's through finding out what helps to mitigate the impact. If stimulant medication works, then that's what the child's system needed. If occupational therapy helps a child to self-regulate and attend to the task at hand, then the issues are more sensory based.
Intervention can help reduce the intense anxiety commonly associated with autism. And oftentimes, sensory stimuli can help a child with ADHD regain focus.
So what is this intervention?
Occupational therapists work with kids in a sensory-rich environment. Activities are tailored to a child's needs and are meant to be fun, yet still challenging. There are swinging, spinning, tactile, visual, auditory and taste opportunities that seem more like a giant playground than a therapy center. The goal is for the child to develop a greater tolerance to the world around him, learn to advocate for herself and meet his or her needs in an appropriate way.
In other words, grow up with a healthy self-esteem and become the wonderful, thriving, independent adults that they are meant to be -- quirks and all.