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Making Sense of the Senses: The Ins and Outs of Sensory Processing Disorder

C.B. Gavant

At 4 p.m., Shimmy* looks like any other cheder kid. His blue eyes sparkle with mischief as he whizzes past on his bike. Just 2 hours later, you’ll see a different picture. As Shimmy’s mother serves supper Shimmy turns away at just about everything his mother offers. Tonight, Shimmy is not at the table at all. He’s in his bed, hiding under the covers. He will probably remain there for several hours; or at least until the antibiotics kick in. Shimmy is not spoiled or crazy. He has sensory processing disorder

Wednesday, July 28, 2010

First defined in the 1970s by psychologist Dr. Jean Ayres of the University of Southern California, sensory processing disorder — also called sensory integration disorder or sensory integration dysfunction — is explained as a disconnect between the nervous system and the brain. Simply put, a child or adult with SPD is unable to interpret the messages he gets from his physical surroundings — the things he sees, hears, tastes, smells, or touches — the way other people can. Depending on the severity and manifestation of the case, this can lead to the child overreacting to loud or high-pitched noises, for example, or underreacting to pain because he can’t interpret an immunization shot as something painful.

But it goes much further than that. Carol Stock Kranowitz, in her groundbreaking book The Out-of-Sync Child (New York: Berkley Publishing Group, 1998), defines eight main categories of senses: the fives senses listed above, referred to as the “far senses,” and three less familiar ones, called the “near senses”: the vestibular sense (balance), the tactile sense, and the proprioceptive sense (movement). A child whose sensory issues manifest themselves in balance or movement difficulties may find climbing stairs a challenge, enjoy extensive rocking (as a method of self-therapy), or be excessively fearful of merry-go-rounds or other fast-moving rides, whereas children who are disturbed by the far senses are often sensitive to bright lights, dislike certain smells, and have very defined food preferences.

Does any of this sound familiar? Interestingly enough, many of us have minor forms of sensory issues — or, as Carol Kranowitz explains, we all experience sensory overload or underload at times, especially when we’re tired, overwhelmed, or in pain. The question, though, is whether the problem is excessive; occurring frequently, repeatedly, and intensely, to the point where it interferes with the one’s normal functioning. In such cases, one can officially be classified as having SPD.

While a child with only minor sensory issues does not usually require intervention, the number of children who have this disorder today is astonishing. Some studies suggest that as many as 5 or 10 percent of children have SPD — and only a few of these are getting the attention they need. Though it may have been unknown in our grandparents’ day, SPD is recognized as an official disorder in the ICDL-DMIC (Diagnostic Manual for Infancy and Early Childhood, by Stanley Greenspan, put out by the Interdisciplinary Council on Developmental and Learning Disorders), and occupational therapists have been dealing with it for decades.

Still, it is important to remember that SPD exists on a spectrum, with some children manifesting more extreme symptoms (like Shimmy), and some manifesting very mild symptoms. In some cases, SPD can be so extreme that the child may be misdiagnosed as having ADD/ADHD, retardation, or even autism. To further complicate things, children who have ADD/ADHD or learning disabilities, and those with developmental disorders such as autism, Down syndrome, and Fragile X syndrome, often have sensory issues as well, which makes it difficult to diagnose and treat the problem.


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