Resources/What is SPD?

I strongly advise any parent who's child has been diagnosed to get in contact with Early intervention as soon as possible.  They have been instrumental in Lucas's therapy.  They have tons of family resources and help listed on their site.

Learn the early signs, watch the video.

Sibling Pen Pal Program - I think this is a fabulous idea for siblings.  They can connect with other children who are going through the same struggles with a child on the spectrum.

Early Intervention in New Jersey

Sensory Processing

Sensory Processing Disorder Foundation

The SPD Blogger Network

This is a really good explanation of SPD taken from Wikipedia.   This summed up the best description of SPD that I've seen. 

Sensory Processing Disorder
From Wikipedia, the free encyclopedia

Sensory processing disorder or SPD is a neurological disorder causing difficulties with processing information from the five senses (vision, auditory, touch, olfaction, and taste), the sense of movement (vestibular system), and/or the positional sense (proprioception). 

For those with SPD, sensory information is sensed, but perceived abnormally. Unlike blindness or deafness, sensory information is received by people with SPD; the difference is that information is processed by the brain in an unusual way that may cause distress or confusion.

SPD is its own diagnosis, but it can be linked to other neurological conditions, including autism spectrum disorders, attention deficit disorder, dyslexia, Developmental Dyspraxia, Tourette syndrome, multiple sclerosis, and speech delays, among many others. The meaning of SPD falls under the DSM-IV criteria for Asperger syndrome. There is no known cure; however, there are many treatments available.

Diagnosis is increasing by developmental pediatricians, pediatric neurologists, and child psychologists. While it is not included in the American Psychiatric Association's Diagnostic and Statistical Manual as a discrete diagnosis, Regulatory-sensory processing disorder is an accepted diagnosis in Stanley Greenspan’s Diagnostic Manual for Infancy and Early Childhood and The Zero to Three’s Diagnostic Classification.


There are now three types of Sensory Processing Disorder, as classified by Stanley I. Greenspan as supported by the research of Lucy J. Miller, Ph.D., OTR. These new terms are meant to increase understanding between Occupational Therapists and other professionals who frequently encounter SID and physicians and other health professionals who approach sensory integration dysfunction from a more neurobiological vantage.

This understanding is critical as physicians are responsible for diagnosing SPD, which is a necessary step in accessing reimbursement (eventually from insurance companies) for professional services to treat SPD.
Sensory Processing Dysfunction is being used as a global umbrella term that includes all forms of this disorder, including three primary diagnostic groups:
  • Type I - Sensory Modulation Disorder
  • Type II - Sensory Based Motor Disorder
  • Type III - Sensory Discrimination Disorder

Type I - Sensory Modulation Disorder (SMD). Over, or under responding to sensory stimuli or seeking sensory stimulation. This group may include a fearful and/or anxious pattern, negative and/or stubborn behaviors, self-absorbed behaviors that are difficult to engage or creative or actively seeking sensation.

Type II - Sensory Based Motor Disorder (SBMD). Shows motor output that is disorganized as a result of incorrect processing of sensory information affecting postural control challenges and/or motor planning dyspraxia.

Type III - Sensory Discrimination Disorder (SDD). Sensory discrimination or incorrect processing of sensory information. Incorrect processing of visiual or auditory input, for example, may be seen in inattentiveness, disorganization, and poor school performance.
This information is adapted from research and publications by: Lucy, J. Miller, Ph.D., OTR, Marie Anzalone, Sc.D., OTR, Sharon A. Cermak, Ed.D., OTR/L, Shelly J. ,Lane, Ph.D, OTR, Beth Osten, M.S,m OTR/L, Serena Wieder, Ph.D., Stanley I. Greenspan, M.D..

Sensory Modulation

Sensory modulation refers to a complex central nervous system process by which neural messages that convey information about the intensity, frequency, duration, complexity, and novelty of sensory stimuli are adjusted.

Behaviorally, this is manifested in the tendency to generate responses that are appropriately graded in relation to incoming sensations, neither underreacting nor overreacting to them.

Sensory Modulation Problems
  • Sensory registration problems - This refers to the process by which the central nervous system attends to stimuli. This usually involves an orienting response. Sensory registration problems are characterized by failure to notice stimuli that ordinarily are salient to most people.
  • Sensory defensiveness - A condition characterized by over-responsivity in one or more systems.
  • Gravitational insecurity - A sensory modulation condition in which there is a tendency to react negatively and fearfully to movement experiences, particularly those involving a change in head position and movement backward or upward through space.

Hyposensitivities and Hypersensitivities

Sensory integration disorders vary between individuals in their characteristics and intensity. Some people are so mildly afflicted, the disorder is barely noticeable, while others are so impaired they have trouble with daily functioning.

Children can be born hypersensitive or hyposensitive to varying degrees and may have trouble in one sensory modality, a few, or all of them. Hypersensitivity is also known as sensory defensiveness. Examples of hypersensitivity include feeling pain from clothing rubbing against skin, an inability to tolerate normal lighting in a room, a dislike of being touched (especially light touch) and discomfort when one looks directly into the eyes of another person.

Hyposensitivity is characterized by an unusually high tolerance for environmental stimuli. A child with hyposensitivity might appear restless and seek sensory stimulation.

In treating sensory dysfunctions, a "just right" challenge is used: giving the child just the right amount of challenge to motivate him and stimulate changes in the way the system processes sensory information but not so much as to make him shut down or go into sensory overload.

The "just right" challenge is absent if the activity and the child's perception of activity do not match. In addition, deep pressure is often calming for children who have sensory dysfunctions. It is recommended that therapists use a variety of tactile materials, a quiet, subdued voice, and slow, linear movements, tailoring the approach to the child's unique sensory needs.

While occupational therapy sessions focus on increasing a child's ability to tolerate a variety of sensory experiences, both the activities and environment should be assessed for a "just right" fit with the child. Overwhelming environmental stimuli such as flickering fluorescent lighting and bothersome clothing tags should be eliminated whenever possible to increase the child's comfort and ability to engage productively. Meanwhile, the occupational therapist and parents should jointly create a "sensory diet," a term coined by occupational therapist Anna Jean Ayres.

The sensory diet is a schedule of daily activities that gives the child the sensory fuel his body needs to get into an organized state and stay there. According to SI theory, rather than just relying on individual treatment sessions, ensuring that a carefully designed program of sensory input throughout the day is implemented at home and at school can create profound, lasting changes in the child's nervous system.

Parents can help their child by realizing that play is an important part of their child's development. Therapy involves working with an occupational therapist and the child will engage in activities that provide vestibular, proprioceptive and tactile stimulation. Therapy is individualized to meet the child's specific needs for development. Emphasis is put on automatic sensory processes in the course of a goal-directed activity. The children are engaged in therapy as play which may include activities such as: finger painting, using Play-Doh type modeling clay, swinging, playing in bins of rice or water, climbing, etc.


Relation to other disorders 

Autism spectrum disorders 

Unusual responses to sensory stimuli are more common and prominent in autistic children and adults, though there is no good evidence that sensory symptoms differentiate autism from other developmental disorders. Differences are greater for under-responsivity (for example, walking into things) than for over-responsivity (for example, distress from loud noises) or for seeking (for example, rhythmic movements). The responses may be more common in children: a pair of studies found that autistic children had impaired tactile perception while autistic adults did not. 

Other disorders 

Some argue that sensory related disorders may be misdiagnosed as Attention-Defficit/Hyperactivity Disorder (ADHD) but they can coexist, as well as emotional problems, aggressiveness and speech-related disorders such as aphasia. Sensory processing, they argue, is foundational, like the roots of a tree, and gives rise to a myriad of behaviors and symptoms such as hyperactivity and speech delay. 

For example, a child with an under-responsive vestibular system may need extra input to his "motion sensor" in order to achieve a state of quiet alertness; to get this input, the child might fidget or run around, appearing ostensibly to be hyperactive, when in fact, he suffers from a sensory related disorder. Researchers have described a treatable inherited sensory overstimulation disorder that meets diagnostic criteria for both attention deficit disorder and sensory integration dysfunction. 

Sensory Integration Therapy

Several therapies have been developed to treat SID. Some of these treatments (for example, sensorimotor handling) have a questionable rationale and no empirical evidence. Other treatments (for example, prism lenses, physical exercise, andauditory integration training ) have had studies with small positive outcomes, but few conclusions can be made about them due to methodological problems with the studies. Although replicable treatments have been described and valid outcome measures are known, gaps exist in knowledge related to sensory integration dysfunction and therapy. Empirical support is limited, therefore systematic evaluation is needed if these interventions are used.

The main form of sensory integration therapy is a type of occupational therapy that places a child in a room specifically designed to stimulate and challenge all of the senses.

During the session, the therapist works closely with the child to provide a level of sensory stimulation that the child can cope with, and encourage movement within the room. Sensory integration therapy is driven by four main principles:
  • Just Right Challenge (the child must be able to successfully meet the challenges that are presented through playful activities)
  • Adaptive Response (the child adapts his behavior with new and useful strategies in response to the challenges presented)
  • Active Engagement (the child will want to participate because the activities are fun)
  • Child Directed (the child's preferences are used to initiate therapeutic experiences within the session).
Children with lower sensitivity (hyposensitivity) may be exposed to strong sensations such as stroking with a brush, vibrations or rubbing. Play may involve a range of materials to stimulate the senses such as play dough or finger painting.

Children with heightened sensitivity (hypersensitivity) may be exposed to peaceful activities including quiet music and gentle rocking in a softly lit room. Treats and rewards may be used to encourage children to tolerate activities they would normally avoid.

While occupational therapists using a sensory integration frame of reference work on increasing a child's ability to tolerate and integrate sensory input, other OTs may focus on environmental accommodations that parents and school staff can use to enhance the child's function at home, school, and in the community (Biel and Peske, 2005). These may include selecting soft, tag-free clothing, avoiding fluorescent lighting, and providing ear plugs for "emergency" use (such as for fire drills).

Some occupational therapists also treat adults with this condition.

Hartley's Life With 3 Boys posted a WONDERFUL explanation of what SPD is and I wanted to share it with our viewers!

"What is Sensory Processing Disorder?"

Recently I have seen a rise in the number of articles, Facebook posts, and even tweets claiming to define what Sensory Processing Disorder is. This should be good news, and it is -- mostly.  But, some of them are full of misinformation.

Although I am thankful that anyone wants to help spread awareness, it frustrates me personally that these people could very well be doing more harm than good. I have dedicated such a large portion of my life to spreading awareness that will hopefully benefit kids like mine all over our country and arguably the world, that I would really like to see people get good, solid and accurate information. Wouldn’t you?

It is with that goal in mind – the goal to educate and help – that I am taking my personal stab at answering the increasingly popular question, “What is Sensory Processing Disorder?”  My answer, and this article, will be specifically geared towards helping parents with SPD kids prepare a response for the dozens of strangers (and even family members) who might stare or judge us every day.  We are on the front lines of this disorder, and I believe have the highest stake in making sure that the message being sent about Sensory Processing Disorder is complete and accurate.

Now, I’d like to start with a few myth busting points before we go any deeper so we can all start fresh.

SPD is on the Autism Spectrum” or “SPD is a mild form of Autism” – FALSE. Although a significant portion of kids with ASD do have sensory issues (estimates range as high as 85%), the opposite is not true. Many children with SPD do not have ASD. So, to recap, SPD is NOT on the Autism Spectrum.

They are trying to get SPD added to the Autism Spectrum in the DSM” -- FALSE. The work being spearheaded by the SPD Foundation and Dr. Lucy Jane Miler is to get SPD recognized as a ‘stand alone disorder’ in the DSM-IV. You can find more info on their site by clicking here.

SPD just means that a child doesn’t like loud noises” – FALSE. SPD is not just a single symptom, nor is it about 'sensory preferences'.  Children with SPD have sensory differences severe enough to affect their social and academic development.  It is much more complex than 'not liking loud noises'.  And, although children with SPD can avoid sensory input, they can also seek sensory input.

SPD is the new ADD” – FALSE. I am not going to combat the theory that we as a country (or society in general) have become increasingly consumed by labels, because I agree.  However, I would like to say for the record, Sensory Processing Disorder is real.  Just ask any of the thousands of families that read my blog every month, this is a true health issue that needs to be recognized so that these children and families can get the help they need.

SPD affects all 5 senses” -- INACCURATE. This is probably my biggest pet peeve. We have 7 senses – SEVEN SENSES!! Touch, Taste, Smell, Hearing, Sight, Vestibular and Proprioception. If you are reading anything (blog, tweet, Facebook, article, newspaper, etc) and they say that SPD affects 5 senses – STOP reading. If they do not know at a minimum that there are 7 senses, this person is not an expert.

Now, let’s get to a real and workable definition.

The Sensory Processing Disorder Foundation’s website says the following:

“Sensory processing (sometimes called "sensory integration" or SI) is a term that refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses.”

Let’s break that down so that we can get to a simple, easy to remember and crazy-easy to understand definition.

“…the way the nervous system receives messages…” -- this is referring to the messages received from all seven senses and how they are conveyed to the brain through the nervous system. The brain is the key component to the nervous system, as that is where the ‘processing’ occurs. By ‘processing’, we are in very basic terms referring to whether or not the brain ‘understands’ those signals. When the brain misinterprets the meaning of those signals, and can’t process them appropriately, it leads to an inability to turn them into appropriate motor and behavior responses.

“…appropriate motor and behavior responses…” – 'appropriate' here refers to the assumed way that a child should respond – if something is too loud, they should pull their ear back, if something is quiet, they shouldn't scream it is too loud. The word ‘motor’ refers to a physical response – how your body moves as a result of the information from the brain, and then ‘behavior’ how the child continues to respond (over or under reactions). Example: Loud unexpected BOOM! Kid cringes and covers his ears (motor), then screams and runs away (behavior).

I want to pause here to be sure that everyone knows there are three types of Sensory Processing Difficulties: Type I; Sensory Modulation Disorder, Type II; Sensory Based Motor Disorder and Type III; Sensory Discrimination Disorder. For the purpose of this post, which is simple understanding of SPD and increased ability to communicate what SPD is as a way to help spread awareness and understanding for our children, I am not going to go into them. You can find their definitions here.

Now that we all are on the same page with the formal information, let’s move on to the analogy that I find most helpful when discussing SPD with others, from the SPDF’s website:

“A. Jean Ayres, PhD likened SPD to a neurological ‘traffic jam’ that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly.”

Are you familiar with A. Jean Ayres? She is credited as being the pioneer for Sensory Processing dating back to the 1960’s. Her work is the foundation for current research and the modern understanding of SPD. More information on her here.

Now, on to how you and I can actually use these definitions for something useful: A 30 second sound bite.

This is what I use most often when talking to those around me who really don’t have the attention span to hear more, or when I have a time limit like when I am being interviewed (Radio/TV where my total spot might be 2-3 minutes, click here for an example).

It is also super helpful at the grocery store when my son’s need to touch everything on the aisle results in a virtual disaster or when he insists on swinging from the railings at the checkout counter. Or, at the playground when he seems to be consumed with pushing down some sweet and small little girl simply because she is too close to him, or even at my home while celebrating some holiday where my son is wound up like a top and crashing into everyone - head first into their butt -- while giggling nonstop.  Like me, I trust you will find many uses for the 30 second sound bite.  Here it is:

“Sensory Processing Disorder is a neurological disorder that is like a virtual traffic jam in the brain. The information from all seven senses is misinterpreted which causes my child to often act inappropriately.”

Obviously you don’t need to memorize my version – and it can be shorter or longer as necessary -- and said in many different ways.

The key points that are important to communicate when talking to someone about SPD are:

1. SPD is a neurological condition (not a behavior issue)

2. There are 7 senses

3. Information gets misinterpreted

4. Sensory issues cause my child to act the way he/she does

I feel when I cover these four areas I am most likely to accomplish my two main goals when talking to anyone:

1. Help them understand my child and his behavior

2. Spread SPD awareness

I hope that you find this information helpful for both your practical understanding of what Sensory Processing Disorder is and so I can add you as another person who can help me combat the intensely mis-informed, however well-intentioned, people out there.

Our kids need understanding – which starts with making sure we are providing solid accurate information people can use.

So, here’s to all of you raising a SPD kiddo and spreading the word!

For more information on Sensory Processing Disorder I recommend the following books:
The Ultimate Guide to Sensory Processing Disorder by Dr. Roya Ostovar
Sensational Kids:  Hope and Help for Kids with Sensory Processing Disorder, by Lucy Jane Miller Ph.D
The Out of Sync Child by Carol Kranowitz

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