Sensory Processing Disorder article - washpost today

Anonymous
Anonymous wrote:How does a three year old get SPD?


I don't think you "get" SPD. From what I can tell, folks have underlying conditions. At least I don't believe these are contagions.
Anonymous
Anonymous wrote:
Anonymous wrote:How does a three year old get SPD?


I don't think you "get" SPD. From what I can tell, folks have underlying conditions. At least I don't believe these are contagions.


Every child I know with SPD also was in vitro.
Anonymous
My daughter (almost 7) was 'diagnosed' SPD around age 4, when it was evident to her pre-k teacher that how she handled her body in relation to the world, other people, etc, was not quite right. She DID have core-strength issues, and did (does?) have sensory issues. My wife and I are convinced she is borderline symptoms for Aspbergers (is that term still even used?) but testing done at several locations has not called it that, or anything. I keep making the point, its a "SPECTRUM" and just-off-the-spectrum in one direction is a whole bunch of people who dont cross the line but are right up on it. She has some anxieties but they are not interfering with her life, essentially.

Anyway, she had a 504 plan in school for "executive functioning" and now has an IEP for speech. And is doing better. But sometimes, only at home I think, she seems in her own world. Especially when I ask her to do something. part of that might just be being a kid.

The crux of all this...she had open heart surgery at 7 months old. So the core-strength OT stuff was very real and very helpful. And there is this constellation of squishy sensory symptoms around pediatric heart patients that has not been fully explored and documented, but it is definitely there.

Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:How does a three year old get SPD?


I don't think you "get" SPD. From what I can tell, folks have underlying conditions. At least I don't believe these are contagions.


Every child I know with SPD also was in vitro.


Mine wasn't in vitro.
Anonymous
My child never had SPD as a diagnosis, but many of the symptoms mentioned are familiar. Difficulty with loud noise, crowds of people and wanting to play with friends but having difficulty were all symptoms of auditory and language difficulties. Lack of control of knowledge of body had more to do with dyspraxia/developmental coordination disorder and slow processing than an actual correctable muscular strength problem. Many have mentioned ADD as the "true" diagnosis of a child previously categorized with SPD, but auditory processing or language processing difficulties or developmental coordination disorder aka dyspraxia can also cause some of these symptoms.

My child probably could have benefitted from working with an OT on skills that were difficult due to the dyspraxia but could have been repeated/practiced enough with the OT until they became part of muscle memory and automated brain function which would have been a way to get around the dyspraxia. Eating with utensils and writing and drawing are examples of skills an OT could have improved with explicit instruction. Instead the OT seemed to want to focus on general play even though she acknowledged that there was no muscular/OT problem. She recommended 1 hour a week of some program that had absolutely no research to support it.

Our money was better spent on time per week with explicit handwriting instruction and speech/language therapy to help with the auditory processing and language issues. (Although, in the end, nothing really ameliorates the sensitivity to noise.)
Anonymous
[url]http://tinyurl.com/lv6o5ud
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decent read, take from it what you wish.

Lots of things weren't in the DSM, until they were.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:How does a three year old get SPD?


I don't think you "get" SPD. From what I can tell, folks have underlying conditions. At least I don't believe these are contagions.


Every child I know with SPD also was in vitro.


None that I know were in vitro.
Anonymous
But the thing is, wouldn't classifying it as a "real" diagnosis enable more people to get treatment, by making it insurance worthy? Even if it came with an upper age limit while you figure out what else is going on? Other diagnoses in the DSM come with age brackets.


A diagnosis should be recognized when there is some scientific basis for recognizing it as a distinct disorder, not so parents can get insurance to pay for their child's "treatment". SPD is a symptom, not a disorder.


What do you mean "scientific basis for recognizing it"? What is the scientific basis for recognizing ASD or ADHD? What should you do with a set of symptoms that you don't have sufficient information to classify as ASD or ADHD or whatever diagnosis a kid may later end up with? How would you suggest the symptoms of SPD be treated? Or are you suggesting there's no value in addressing the symptoms? Do you realize that many medical treatments address symptoms only and not the underlying disorder/disease? Diabetes, hypertension, hypothyroid are the ones that come to mind first.

Like many of your DCs, my DS's behavior wasn't typical and he was suffering. The pediatrician and psychologist recommended an OT evaluation and he got the SPD diagnosis. I have to say that OT helped him tremendously and I'm very grateful we were able to afford it. Do I think it was a 'placeholder' diagnosis? No, it wasn't. The developmental pediatrician didn't have enough information for a diagnosis of something else (although he did note that DS was at risk for ADHD) and I think that's true for a lot of kids. Sometimes there just isn't enough information to identifying a 'disorder'. You do the best you can to address the issues you can identify and if others come up or you don't see improvement, you investigate further. Even if we'd gotten the ADHD diagnosis, it wouldn't have changed what we did. We sought interventions that helped the most challenging sympotoms first.

We had a similar experience with DS2. We knew he had issues long before DS1 and he had numerous evaluations by NIH, dev peds, psychologists, OTs/PTs/SLPs, etc - all by the time he was 28 months. His first diagnosis at 16 months was SPD and gross motor delay. There wasn't enough evidence to earn him a different one at that point - in fact, at that age, his speech/communication was age appropriate. We sought interventions that targeted his symptoms. As he got older, the primary diagnoses changed. By age 2, we recognized significant speech delays. At age 3, his primarly challenge was apraxia of speech; By age 7, although apraxia is still present, it's not the issue it was at age 3. He's now got an ADHD diagnosis and LDs that are more problematic. My older DS is the same way. Some years anxiety is a bigger issue for him than his ADHD.

If you don't think SPD is a 'real' disorder, what do you suggest be done with those symptoms that are life impairing but for which there isn't enough evidence for a different diagnosis?

Anonymous
^^ great points!
Anonymous
Anonymous wrote:
But the thing is, wouldn't classifying it as a "real" diagnosis enable more people to get treatment, by making it insurance worthy? Even if it came with an upper age limit while you figure out what else is going on? Other diagnoses in the DSM come with age brackets.


A diagnosis should be recognized when there is some scientific basis for recognizing it as a distinct disorder, not so parents can get insurance to pay for their child's "treatment". SPD is a symptom, not a disorder.


What do you mean "scientific basis for recognizing it"? What is the scientific basis for recognizing ASD or ADHD? What should you do with a set of symptoms that you don't have sufficient information to classify as ASD or ADHD or whatever diagnosis a kid may later end up with? How would you suggest the symptoms of SPD be treated? Or are you suggesting there's no value in addressing the symptoms? Do you realize that many medical treatments address symptoms only and not the underlying disorder/disease? Diabetes, hypertension, hypothyroid are the ones that come to mind first.

Like many of your DCs, my DS's behavior wasn't typical and he was suffering. The pediatrician and psychologist recommended an OT evaluation and he got the SPD diagnosis. I have to say that OT helped him tremendously and I'm very grateful we were able to afford it. Do I think it was a 'placeholder' diagnosis? No, it wasn't. The developmental pediatrician didn't have enough information for a diagnosis of something else (although he did note that DS was at risk for ADHD) and I think that's true for a lot of kids. Sometimes there just isn't enough information to identifying a 'disorder'. You do the best you can to address the issues you can identify and if others come up or you don't see improvement, you investigate further. Even if we'd gotten the ADHD diagnosis, it wouldn't have changed what we did. We sought interventions that helped the most challenging sympotoms first.

We had a similar experience with DS2. We knew he had issues long before DS1 and he had numerous evaluations by NIH, dev peds, psychologists, OTs/PTs/SLPs, etc - all by the time he was 28 months. His first diagnosis at 16 months was SPD and gross motor delay. There wasn't enough evidence to earn him a different one at that point - in fact, at that age, his speech/communication was age appropriate. We sought interventions that targeted his symptoms. As he got older, the primary diagnoses changed. By age 2, we recognized significant speech delays. At age 3, his primarly challenge was apraxia of speech; By age 7, although apraxia is still present, it's not the issue it was at age 3. He's now got an ADHD diagnosis and LDs that are more problematic. My older DS is the same way. Some years anxiety is a bigger issue for him than his ADHD.

If you don't think SPD is a 'real' disorder, what do you suggest be done with those symptoms that are life impairing but for which there isn't enough evidence for a different diagnosis?


Why not address the root of these problems, and not just the symptoms? Why not learn how to create a more supportive home enviornment that can reduce the symptoms? What efforts at home have already been tried?
Anonymous
SPD is a symptom. Sometimes it exists alone, when the criteria for a specific diagnosis aren't met (and there are kids who don;t get a diagnosis, just a list of issues). Most of the time it is a symptom of something. In my experience there are far more children getting this "diagnosis" when there's really something else going on than who just have SPD. OTs are NOT diagnosticians. Yet they diagnosis kids with SPD and then the parents think they have "it" and they stop looking. Plus in my experience OTs see SPD everywhere. I know I was told my DS had SPD when it turns out . . . oops . . . he has an ASD. I also am unaware of any science behind all the swinging and brushing.
Anonymous
Anonymous wrote:Since an OT is not a doctor, they shouldn't be diagnosing anything. How convenient that the "disorder" they diagnose is treated only by them.

Rest assured though, once a pharmaceutical company claims they have a drug to treat SPD, it will then gladly be accepted by medicine and included in the next DSM.



You clearly lack the understanding on how disorders are placed in the DSM.
Anonymous
Anonymous wrote:
Anonymous wrote:The treatment for SPD is largely BS. Its all about OT mission creep.


I have heard people talk about the OT mission creep many times and I don't agree. I think the growth of the OT industry has been driven by the consumers, the worried parents. We'll try anything to help our kids. I think this mission creep view is incredibly cynical. Once there start to be studies saying X percentage of kids are not helped by OT, or only Y problem is helped by OT, people may think harder about going. Their are all sorts of neurological problems that are being diagnoses and addressed earlier and this is a field that, in a sense, has benefited from that trend.

I am a PP who considers SPD a part of other disorders and whose kids were not helped by OT. But I don't regret trying.



I regret trying! It was expensive. I believe in "mission creep" for OT. My ds has MERLD. The OT that shares space with the SLP tried to get me into OT. He has a speech problem. She tried telling me he was low tone and had sensory issues. His preschool (which has an inclusion program) always told me he was fine with everything but speech. I agree with other posters that feel SPD is not a disorder but rather a component of another issue.
Anonymous
Anonymous wrote:
Anonymous wrote:Since an OT is not a doctor, they shouldn't be diagnosing anything. How convenient that the "disorder" they diagnose is treated only by them.

Rest assured though, once a pharmaceutical company claims they have a drug to treat SPD, it will then gladly be accepted by medicine and included in the next DSM.



You clearly lack the understanding on how disorders are placed in the DSM.


You are clearly naive enough to think there is anything other than money behind the DSM and its constantly growing list of "disorders".
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Since an OT is not a doctor, they shouldn't be diagnosing anything. How convenient that the "disorder" they diagnose is treated only by them.

Rest assured though, once a pharmaceutical company claims they have a drug to treat SPD, it will then gladly be accepted by medicine and included in the next DSM.



You clearly lack the understanding on how disorders are placed in the DSM.



You are clearly naive enough to think there is anything other than money behind the DSM and its constantly growing list of "disorders".

I agree. The more dumbed down they can get busy and desperate parents, the faster they can grow their profits. It's the American way, isn't it? The rest of the civilized world is laughing at us.
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