A neurologist I am familiar with recently stated that she did not believe in sensory processing disorders “at all” and refused to read an assessment suggesting a contributing relationship between it and a child’s delay in the area of social-emotional development. The neurologist instead stated that the 2-year-old child in question had ADHD (attention deficit hyperactivity disorder) with anxieties. I find this response to the idea of sensory processing disorders common and offer the following for consideration.
Sensory processing disorders (SPD) are not yet listed in the current “Diagnostic and Statistical Manual of Mental Disorders,” though significant lobbying to have it included in the next revision (Miller, Cermak, Lane, Anzalone, and Koomar, 2004) is being done. Nancy Pollack (2006) states that the debate about the existence of SPD is due to limited evidence of treatment efficacy (due to small sample sizes and large variance among therapist approaches and treatment protocols). She suggests that therapists who decide to use SPD treatment with parents and children should help families understand the questions surroundinng the efficacy research, help parents approach treatment as a trial, and help establish guidelines for measuring improvement in the individual case of the child. SPD is listed in the “Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised” (Diagnosis Classifications: 0-3), under the term “regulation disorders of sensory processing.” Clinical experience and developmental research does reveal the importance of environmental stimulation on a children’s social, emotional, physical and cognitive development (National Research Council, 2000). We are all familiar with examples of extreme of environmental neglect (e.g. children raised in orphanages) that provide clear evidence of the profound impact of a lack of stimulation on development.
Despite the debates about treatment efficacy, and problems in the classification system of regulatory dysfunctions, children who have SPD are clearly distinguishable from those who do not, in their behaviors, emotions and central nervous system reactions to sensory stimuli (Miller et al., 1999; Schaaf, Miller, Seawell, and O’Keefe, 2003).
So what does all this mean? Well, studies by experts in child development show that the different types of sensory stimulation during the first several years of life set the stage for ongoing development (National Research Council and Institute of Medicine, 2000). An estimated 5-15 percent of children suffer from one form or another of SPD. Primary symptoms of SPD include impaired ability to process and organize an effective response to sensory stimuli in the environment. This impairment to respond adequately to the environment leads to secondary consequences in the form of relational and mental health challenges for the child with SPD. What starts out as a neurological problem quickly leads to mental health difficulties, including anxiety, depression, aggression, low self-esteem and behavioral problems (Greenspan and Wieder, 1998; Kranowitz, 1998; Miller et al., 2004). These difficulties in turn can present as laziness, stubbornness, being spoiled (Stephens, 1997), rejection of others, resistance to direction, severe introversion, pickiness, obsessive fear or antisocial behavior.
SPD afflicts up to 15 percent of children. Many of these children will develop emotional and social problems because of missed social and cognitive interactions (Schaaf, Miller, Seawell, and O’Keefe, 2003). When a child’s individual sensory needs have been met they will be most available for social interaction and learning. As professionals and as parents, we need to keep this in mind as we try to do what’s best for our children. It is now widely known that early experiences, particularly those during the first several years of life, set the stage for ongoing development (National Research Council and Institute of Medicine, 2000). Other studies by experts in child development show that the different types of sensory stimulation children receive through their environment can have a profound impact on their development and mental health. Evidence-based studies regarding the efficacy of sensory processing interventions remain limited, but are growing. Hopefully, in the near future, sensory processing disorders will be included in the next “Diagnostic and Statistical Manual of Mental Disorders.”
Bob Trapani is an occupational therapist in Auburn and owner of Therapy Partners