Every classroom has one: the kid who bangs against things incessantly, won't make eye contact and acts up whenever the school bell sounds. He or she may be autistic or in need of Ritalin. But there's a chance such children are simply overwhelmed by their own senses.
According to Roya Ostovar, a neuropsychologist at Harvard Medical School, some children have problems receiving and organizing sensory input from the environment. Known as sensory processing disorder, the condition involves the visual, tactile, oral, auditory and olfactory senses, as well as the senses used to balance and locate oneself in space.
For children with SPD, normal clothing may feel like sandpaper and school lighting can seem like a laser beam burning their eyes. It's an intensely stressful disorder that interferes with everyday functioning, says Dr. Ostovar, author of The Ultimate Guide to Sensory Processing in Children: Easy, Everyday Solutions to Sensory Challenges.
Speaking to The Globe and Mail, she explains what causes SPD and why it's far more than the diagnosis du jour.
Symptoms of SPD include picky eating, frequent meltdowns, clumsiness and difficulty getting to sleep without a parent. Isn't this normal kid behaviour?
Yes. However, what distinguishes this disorder is that children with SPD really can't live a normal life and [can't]go about their day-to-day functioning without interference from these symptoms.
What causes sensory processing disorder?
It seems there are hereditary and genetic factors involved, and prenatal issues if the mother used drugs, alcohol or some prescription medications while pregnant. During birth, sometimes there are traumas that cause, for example, a lack of oxygen to the brain. Or once the child is born, there may be neurological or medical conditions and trauma such as falls, injuries, surgery or even chronic abuse and neglect.
Autistic children are known to have sensory issues. What makes SPD a standalone disorder?
Many children with SPD do not have other symptoms of autism - they have good adaptive skills, they can communicate well with their peers and they have good social skills. But they really have difficulty processing sensory information accurately and effectively.
How do these kids do in school?
We know for sure that 5 to 13 per cent of children entering school experience the symptoms of this disorder - and 73 to 75 per cent are boys. They walk into school already feeling there's too much to deal with. Faced with the crowd at school, all the noises, all the tactile information and the various lights, their sense system feels quite overwhelmed. So it's very difficult for students with SPD to function successfully in school without appropriate treatments.
Parents without special-needs kids may wonder if SPD is just an elaborate excuse for bad behaviour.
SPD is a real disorder. And there are ways that you can distinguish between SPD and a behavioural disorder. You can consider the child's reaction and responses to sensory input, especially those to touch and movement. Children with SPD seem truly pained and uneasy when they're experiencing sensory information that their bodies cannot process well.
If there is no standard diagnostic test for SPD, how do health professionals make sense of the cluster of symptoms?
Occupational therapists have the tools to test for this disorder and many psychologists and neurophysiologists can work with families to get the necessary diagnosis. Pediatricians are becoming informed about this disorder and referring children and their families to occupational therapists.
What kind of therapies help children with SPD?
The main form of treatment is occupational therapy that is focused on sensory integration and developing what is called a sensory diet. The child is given a prescription, a method to calm down and organize the senses. Activities and items are chosen by the therapist to be fun, enjoyable and encouraging to the child and meet the specific needs of the child. They may include listening to certain music or doing yoga, but the activities are not random or sudden the way day-to-day life is.
Why is there such a push to have SPD included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, due out in 2012?
If it's not included as a disorder, it's more difficult for families to get services and coverage for treatments through their insurance.
Skeptics argue this is a vague disorder that represents a growth industry for occupational therapists, and that parents are paying upward of $10,000 a year for unproven therapies.
I can understand their position. This is a new disorder. However, this is a real disorder. If we go back and look at autism, Asperger's syndrome and well-known disorders such as ADHD and schizophrenia, you can see that in most of these cases from the time the first cases were described in the literature to the time when they were officially recognized as a diagnosis it took 40 or 50 years.
What's the best-case scenario for a child with SPD?
If a child begins to see an occupational therapist and has sensory integration therapy, you begin to see an improvement in all the areas of functioning: their attention, concentration, socialization and even their self-esteem. They start to participate more fully at home and at school - typically, between six months to a year.
This interview has been condensed and edited.