Thursday, January 22, 2015

Overcoming Behavioral Issues: Sensory Processing Disorder

Last year I blogged a series of posts related to Patrick's behavior. I called these series "Overcoming Behavioral Issues" and I identified 4 main reasons that were triggering Patrick's bad behavior:


  1. Speech delay
  2. Nutrition
  3. Sensory issues
  4. Medical condition

I wrote separate posts to explain with more detail his communication and nutritional issues, but I really never got the chance to talk at length about how his medical condition was affecting his behavior.

This week is the perfect time to resume the series, Why is that? Because this past Monday we had a really, really, really bad day. But before I tell you what happened on Monday, I think is important to explain what is Sensory Processing Disorder, or Sensory Integration Dysfunction.

I found the best explanation (everything in blue) on the SPD Foundation's website:

Sensory processing refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses. Whether you are biting into a hamburger, riding a bicycle, or reading a book, your successful completion of the activity requires processing sensation or "sensory integration." 
So basically, we are wired to respond to everything we feel and perceive through our senses. What we hear, what we eat, what we touch, what we see, and what we smell - everything is processed in our brain and then in turn this emits a response, like if we hear something too loud, we may cover our ears, or if something is too spicy, we may spit it out and get some water! 

Sensory Processing Disorder  exists when sensory signals don't get organized into appropriate responses. It's a neurological "traffic jam" that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. Motor clumsiness, behavioral problems, anxiety, depression, school failure, and other impacts may result if the disorder is not treated effectively. 
Imagine a classroom with 10 children, and suddenly the fire alarm goes off. Five kids get surprised and maybe a little scared, they immediately look at the teacher waiting for her reaction to explain what's happening and what to do next. Two other kids are too busy playing to get too concerned, they do notice the noise, but they just wait to see if it goes away. Two younger kids get scared and cry, but as soon as the teacher explains that it was a false alarm and everything is OK, they calm down. And then there is one kid, he panics, he hides, he cries and screams and shakes... it's hard to calm him down, it's hard to get him to listen and it takes a lot longer and much more effort to get him to stop screaming. This last child shows an overreaction to a loud noise, this reaction is an indication that the "cause" is provoking an "effect" that isn't within the norm, hence, it shows that there is a disorder in the way he process this sensation. 

Symptoms of Sensory Processing Disorder, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children and adults with SPD, these difficulties are chronic, and they disrupt everyday life. 
My husband tolerates spicy food more than I do (and I'm the Mexican one, you would think I could eat a jalapeno and no complain!) but does my sensitiveness to spicy food mean that I have a sensory issue? No, it doesn't. The key to identifying the difference in "every person perceives things different" from an actual sensory disorder, is when that "different perception" affects your life. When it's affecting significantly the way you socialize, the way you learn and the way you are, that's when you know it stops being a normal thing and it becomes a more serious issue that needs to be addressed. 

Sensory Processing Disorder can affect people in only one sense–for example, just touch or just sight or just movement–or in multiple senses. One person with SPD may over-respond to sensation and find clothing, physical contact, light, sound, food, or other sensory input to be unbearable. Another might under-respond and show little or no reaction to stimulation, even pain or extreme hot and cold. In children whose sensory processing of messages from the muscles and joints is impaired, posture and motor skills can be affected. 
The child in that classroom who panicked at the fire alarm, may only have an issue with loud noises, while the sensations coming from his nose, mouth, touch and eyes are perfectly OK. While this child overreacted to the situation, there are also children with SPD who may show no emotion, no reaction whatsoever to a sensation that otherwise would cause reaction in most people.

Still other children exhibit an appetite for sensation that is in perpetual overdrive. These kids often are misdiagnosed - and inappropriately medicated - for ADHD. 
A child who is often pushing other kids, throwing things and actively searching for physical input, might be thought to have ADHD, when all he needed was to get his need for physical stimulation taken care of. These kids benefit from taking a break from the classroom activities to enjoy a few minutes of physical activity, and after receiving the input they needed, they get back to their classrooms and work perfectly fine along their peers.  

Often I feel like SPD is the new ADHD or the new Autism, in the sense that SPD sometimes is treated like a trend: More and more often kids are (mis)diagnosed with it. A child that's too shy has Autism; a child that is too active, has ADHD; and today, a child that may fall in either or has SPD. Do all the kids diagnosed with SPD really have a legitimate medical problem in the way they process their sensations, or are we not letting kids be kids anymore?  We need to be careful when applying any of these terms to our precious little ones, because there are kids who really have SPD, ADHD and Autism, and are looked down by other people who are so tired of all these disorders on the rise. On the other hand, there are many children that don't have these conditions yet are diagnosed and treated as if they did, causing real problems in the child. 

For the parents that believe their children may be affected by SPD, you can read this article that talks more about the trend vs the real issue. I encourage you to get your child evaluated by a professional Occupational Therapist who will be able to tell you if your child has SPD or something else, if anything. We have known about Patrick's sensory issues for a couple of years, even though he was officially diagnosed until recently. Coming to terms with "he actually has it" vs "he is just a child going through a phase" was somewhat easier for us because we have seen a scan of his brain. His MRI actually showed a somewhat messy and underdeveloped cerebellar vermis - the part to be believed to control the way we react to things. Luckily for him and for us, it isn't affecting all his senses, but for the senses that are affected, well, let's just say I had a real taste of it last Monday, and it wasn't good.  We had been managing his SPD just fine -learning what to do and what not to do... but last Monday was rough. It's just so hard to see your child suffering and not being able to help.

Stay tuned for the next post, this is To Be Continued...

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