Sensory Integration Disorder

ADD/ADHD and Sensory Integration Disorder: More common than you think

It’s not as unusual as you may first think, really. As a parent with a child who has ADD/ADHD or an adult who deal with it daily, you may already recognize some of the symptoms. What am I talking about? Sensory Integration Disorder.

The chances are good that you haven’t heard of it, yet. Simply put, sensory integration disorder is the inability of the brain to fully utilize the information it gathers through all the senses in any organized or effective way.

Without the proper processing, your child (or you) may have difficulty finding what others would consider to be the right balance in reaction to this information. A person with sensory integration disorder reacts in extremes to normal things that he sees, hears, smells, tastes and feels – objects, sounds and other sensory stimuli that we take in stride as a daily part of life.

Your first instinct – especially if your child is responding like this – is to think that he is trying to get attention through his extreme behavior. This though entirely misses the mark if he really does have sensory integration disorder.

You may recognize some of the symptoms because they’re so similar to the ones associated with ADD/ADHD. The list of symptoms is rather long:

  • Short attention span
  • Sensitivity to sounds
  • Unusually sensitive to smells
  • Fascination with lights
  • Walking on the toes
  • Coordination problems
  • Indifference to pain or temperature
  • Refusal to wear certain types of clothing (your child may want to wear long sleeved shirts all year round so his skin isn’t showing)
  • Difficulty with accepting changes
  • Self-injury or aggression
  • Avoiding physical contact with people
  • Strongly reacts to any stimulation on the face, hands or the feet.
  • Dislike and avoidance of grooming (brushing his teeth, washing his face, having his hair brushed or cut.
  • Either a very high, or a very low activity level.
  • An very high level of awareness of background noises
  • Engaging in the habit of spinning items or taking items apart

When the brain isn’t interpreting incoming information properly, then the individual just can’t create what we would call a “proper” impression with the combined use of their eyes, ears, sense of balance and the other ways we grasp the world. And while you may see these reactions as “misbehavior” the person afflicted with this problem is bordering between fear and terror.

Imagine living in a world in which some of the smallest sounds, by our standards, are startling loud . . . not being able to dismiss or get beyond the background noise at a restaurant (or worse yet for your child, in a classroom!) . . . not being able to be comfortable when your feet aren’t touching the ground or floor.

Everyday activities can become quite traumatic.

But the oversensitivity of stimuli is just one way sensory integration disorder may manifest itself. Your child may show what you would consider an apathetic response to extreme hot or cold. He may not be engaged in activities as you think he should. Many individuals with this disorder actually display not hyperactivity – but an avoidance of activity.

Some children, moreover, experience profound problems with balance. For some being uncoordinated is just the tip of the iceberg. Children with SID have been known to have difficulty just sitting upright in at a classroom desk.

Extreme reactions to sensory stimuli are a problem that affects more individuals than you would initially believe. In children alone, according to The Diagnostic Manual for Infancy and Early Childhood, approximately five to 10 percent of children who display no other problems have sensory integration disorder.

Among children who are autistic, the rate of those with sensory integration disorder jumps to a staggering 88 percent.

Exact statistics are tough to come by though. Sensory integration disorder has yet to receive any recognition in the psychiatric literature. So in some medical quarters it’s a condition that doesn’t even exist.

Lucy Jane Miller though, head of the STAR Center in Denver, which specializes in treating children with SID, wants this disorder included in the next edition of the Diagnostic and Statistical Manual (the DSM), which identifies all psychiatric disorders. The fifth edition is scheduled for publication in 2012.

Acknowledgement in this diagnostic book, would lend the disorder greater credibility. For researchers, this means that winning grants to study the problem would be easier. For parents, it would mean that the chances of getting your child’s treatment paid for by insurance companies would improve.

That doesn’t mean that it’s a new disorder. A. Jean Ayres first identified this problem more than 35 years ago, in 1972. That’s when she first published a book on the condition.

And the official lack of recognition doesn’t mean no research is currently being performed. Quite the contrary. A growing and concerned group of medical experts have slowly been building a very fine research base. In fact, some of the studies have already identified neurological differences between children who have SID and those who respond to stimuli normally.

One set of experiments, for example, expose children to a variety of stimuli including a siren, the strong scent of wintergreen, and the light brush of a feather against the cheek. The reactions of the children are measured through electrodes attached to the hands. This measures nervous system activity.

Each stimulus is presented to every participant eight times.
With the first exposure each child – whether he has SID or not – reacts with a strong electrodermal reading. However, with repetition the healthy child displays little response, having become accustomed to the stimulus.

By contrast, the children with sensory integration disorder never become accustomed to the stimuli, reacting with the same strong response with every encounter.

Normally, SID treatment is conducted by an occupational therapist. Sensory Therapies and Research – also called STAR Center just outside of Denver Colorado treats nearly 50 children weekly for Sensory Integration Disorder.

Other sites to read about Sensory Integration Disorder:

Do you have any experiences or comments about sensory integration disorder? Please share them in the comments below.

Best,

Dr. Kenny

[tags] Sensory Integration Disorder, Sensory Processing Disorder, ADHD [/tags]

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Comments

  1. Dr. Kelly,

    I’m the father of an 8 y/o boy with a learning disability. He has seen a child-psychologist and a neurologist. The neurologist saw my son when he was 6 years old and was very careful not diagnose him. He was under the impression that my son had Dyspraxia and now 2 years later the more we (my ex wife who is a family physician and I) learn on it the more we think our son has it. He is now in grade 2 but his reading and writing skills are at least 2 years behind curriculum.

    Our son show’s no signs of hyperactivity and can concentrate very well when doing tasks such as building LEGO spaceships or Bionicles. He can sit still in front of the television and watch a program or movie for a long time. His mother has been wanting to try and put him on Ritalin in order to help his concentration at school. In light of the very latest news about Ritalin (CTV Canada AM: Tom Kennedy on rejecting Ritalin http://watch.ctv.ca/news/latest/rethinking-ritalin/#clip95418 ) I’m wondering if we really should try medication as the last option for our son and for now to really try to do classroom accommodations and try to see what we could do in order to maximize his learning.

    My ex also wanted to put our son on bio-feedback but I feel that he really would not understand the principles of bio-feedback at his age in order to make the best use of it. I’m just afraid that his mother might be trying to desperately seek anything that she might think might be useful for our son. I want to try to avoid the panic attacks and go methodically and slowly at what might work best for our son.

    Also I was wondering if Dyspraxia was a Sensory Integration Disorder.

    Your input would be greatly appreciated.

    Thank you.
    Louis Chaloux

  2. According to my psychiatrist SID is a dysfunction disorder under ADD/ADHD. I found a site about it, after researching why I had such sensativity to smell, sound and touch. The sight calls it Sensory Processing Disorder, instead of SID, now. There are different check list pages to see if you or a loved one might meet the criteria. When I did it, I was amazed. I met almost everything. Its very interesting, I wondered, since I take ADD medication if that could actually make the sensory sensitivity worse. I also have PTSD. But after 9 years of being misdiagnosed, I am happy to be functioning pretty well with the ADD medication. As long as I dont let a rebound effect take over, I metabalize the stuff fast, and that even if it is XR. I can also take a Clonazapam to relieve my oversensitivity at those times. For me the ADD medication, while still activly working in my brain, even makes the SID normal. All of the meds and diagnosis are tricky and time consuming, plus alot of trial and error and if lucky a positive!!

  3. ADD/ADHD is completely seperate from Sensory processing disorder. Sensory processing disorder can not be fixed with meds. This disorder causes developmental delays. I have a son that was diagnosed with SID when he was 16 months old. He’s been through numerous amounts of therapy through out his little life. He’s only 9 years old now and is in another set of occupational therapy to help his body get trained to be able to deal with school. He has fine motor skill issues as well as past gross motor skill issues. His life is a daily struggle for him and once school is out he’s completely whipped. Most of the time he’ll fall asleep and take a small nap just so he can make it through his homework. Even though he looks normal from the outside and is highly intellectual, and he’s precieved by others as normal from first impressions, he actually struggles through everything he does, from writing, reading and comprehension, to tying his shoes and dressing himself, to coordination and keeping a rhythim like jumping jacks more than 10 or crossing his arms back and forth infront of his chest more than 10 times etc. In order for him to do what others do like riding a bike and running and jumping over a puddle etc, it’s 10 times more challenging for him. While the average person takes for granted how easy it is to jump up and down and move there hands from their head to their side to do a jumping jack, he has to literally think about it and tell himself ok push off with your feet and jump into the air, now raise both arms from the side to above your head, now spread your legs and close them all at the same time. Oops did I miss a step something seems off, and not quite right. Oh I forgot drop my hands back to my side or I can’t keep up with all the steps that my body is just jumping up and down in one place while my arms are moving but I’m not spreading my legs etc. This is how he lives his entire day all day everyday of his life. Having to think through every step of every action in order for him to be able to perform the movement or activity. He has mastered some things that at first sight it looks like he’s a natural but after doing the same thing over and over he messes up because he can’t keep the rhythum. He is easily frustrated and is exhausted after any activity, but he still pushes himself to go go go. This causes him to seem hyperactive and he’s very impulsive. I’ve tried on many occassions to get him to slow down but he tells me he can’t because he feels like he’ll fall asleep. He uses a weighted vest to help him focus in school. It’s funny because no matter how much documentations from doctors and therapists and recommendations he gets from these facilities, his current teacher refuses to accept his diagnosis and has been regularly pushing me to medicate him for ADD. People need to understand that this disability even though at first sight looking like ADD/ ADHD, it’s actually completely seperate and different. For the longest time he would cry while doing his homework and beg me to not make him. He constantly would ask me ” mommy how do I make the letter A.” I’d show him but he wouldn’t understand I’d tell him to trace it, he didn’t know how to start. He’s been labeled by past teachers as lazy and disruptive. He’s so far from that. I had to hold his hand in mine and tell him what we were doing as we were moving his hand to form the letters. It took him until the end of first grade to be able to write his letters without assistance, however even to today on occassions he still will get stumped and forget how to form a letter or he’ll write a different letter for the one he wants. At first I thought he was dyslexic because of this but I’ve been told he’s not. He does know the difference between letters when he sees them but he’s not always able to differenciate the sounds when he says them. B’s and P’s are the same sound to him etc. He is very strong willed and I believe that because of this he’s made leaps and bounds through his life. He’ll do what ever he can to make it look like he can do something just so he gets to do what the same things as other children. He doesn’t let his disability hold him back, this has also made it difficult for him to get help in school and why his teacher’s are unwilling to give him the accomodations his doctors say he needs.

  4. I have a child who is thirteen who has sensory intergration disorder and nnon verbal learnign disorder one of the most difficulty I am having istelling when she is sick. For example recently she got a double ear infection. I did not know until she had a 101 fever and was vomitting. she also does not relize when she is hurt. I have had to home school her because she is considered difficult to teach. Some teachers ask if I have had her tested for adhd and if so why have I not giving her medication. I provide documents on her condition and it does not seem to help.

  5. I wondered whether you may be able to offer some advice.

    I’m an Occupational Therapist working for the NHS in Sheffield;UK. A group of professionals have started to plan an ADHD group for Adults and we are generally involved in developing a service for this client group (very little support available currently).

    We are struggling to find information / research / examples of groups which we can learn from.

    We have a number of ideas including using psychosocial and behavioural interventions and have flirted with the idea of incorporating a sensory integration approach. However we are concerned about the little evidence on sensory integration and ADHD.

    My question to you is this: Can you point me in the direction of any evidence / journal name or particular paper /examples of good practise / contact name / ….etc for Adult support groups and Sensory Integration.

    If you do – I’ll think yer amazing and tell all my colleagues about how wonderful you are!!! Does this encourage you?!*

    Anyway thanks for the website – it’s already proved very useful and I look forward to reading the updates, Liz.

  6. I am a mother of a daughter with SID my husband also has suffered with severe ADD his entire life. Many people have told me my daughter probably has ADD as well. Its not that we dont want to have a doctor diagnose our daughter with ADD we just dont want the medications that go with it, in many cases parents are forced to give there children. But, since my daughter has been working with an OT she has truly showed quite the improvement. Her attention span has increased, her speach, her activity leavel is much closer the average child than before, and even her memory and interaction with people has improved. Even my husband has tried some strategies suggested by the OT and has felt better in his own body since doing so. He to has seriouse sensory issues though he is not diagnosed with SID he exibits many of the same sensory quarks my daughter does. As a mother and a wife I have seen great strides in both my daughter and husband with simple OT and no medication. I can first handedly see the link between ADD and SID.

  7. We just wanted to let you know that one of our very dear friends wrote a very personal account of her experiences with SPD on our website today.

    We thought we’d share the link with you so that you might read it and refer others to it as well. The link is: http://www.fivehens.com/adhd-maybe-not-spd/

    Please feel free to comment on the post. We’d love to hear your feedback.

  8. I would encourage anyone out there looking for information on Sensory Processing Disorder to contact the Sensory Processing Disorder Foundation. There is a link in the article above. They conduct some really great research on SPD and while the verdict is still out on APA DSM inclusion, they do have quite a bit of data that spells out the differences and similarities between ADHA and SPD.

  9. It’s always such an encouragement to see other families dealing with SID.

    My son (6yrs) was diagnosed with SID with speech/language delay when he was 2. We’ve been in heavy (and expensive) therapy since then. Before kindergarden, when we were seeing very little improvement from the OT, he was also diagnosed with ADHD. As what I felt was a last resort, we chose to try medication (a patch–Daytrana–that administers meds only when on). I was so concerned about how he would be able to function in a classroom setting.

    For you doctors and researchers out there, I think this is worth noting:
    My son’s speech was pretty bad. Low understanding of language, and an often flipping of phrases–almost as if every sentence was a word scramble with conjunctions rarely used.
    Within 3 hours of administering his first patch, my son began talking at lightning speed, AND FULLY CORRECT! It was as if a knotted ball of string that once was his words and thoughts had been pulled straight. IT WAS AMAZING !

    And he seemed to know that he was speaking correctly. He talked for about 8 hours straight. For the first time, words were coming out the way he meant them.

    The medication hasn’t been a cure-all, but it has enabled him to focus on his work and sit still at school, follow complex instructions from parents and teachers, and helped him with social interaction.

    I know that’s not what some of you want to hear, but I think research needs to be done on how ADHD meds can benefit SID kids.

  10. Even after research on ADHD causes, the scientists are not sure what is the main reason of this disorder. Some suggestions are that genes play a large role, brain injuries, nutrition, and the social environment might contribute to ADHD. Looking at the family background if any one suffering from this disorder it is possible that children’s also suffer the same.
    http://www.disorderscentral.com/sensory-processing-disorder.html

  11. Your readers seem a lot more educated on Sensory Integration Disorder than I am.
    I am writing about my 14 year old grandson (son of my son who has suffered with – what we thought was ADD for the last 30 years.

    My grandson, Randal, can not stand to hear singing – among other things, but singing is by far the worst. He had to leave my College graduation when they started to sing the school anthem. We have to turn of the radio is a song comes on. He likes music, but as soon as he hears singing he covers his ears, yells at everyone and runs to his bedroom. This is a problem because his sister loves to sing and the family in general is very musical.

    They had his ears tested and had him examined by several doctors. No one knows what is causing the problem.

    From what I have read so far, I think that his sensory integration may be off. They moved to Lakewood, just outside of Denver, CO. 5 months ago. Can you suggest some where in the Denver area that they can find help for my grandson?
    J Young

  12. After struggling for years with a child that hates his clothes – particularly socks. I realized that indeed the seams, tags and embellishments of most fashionable clothing were more than my child could handle. Diagnosed with ADHD, Auditory Processing Disorder and a mild speech delay at age 5 – I was always aware that he had difficulty with sensory input (lights, sound and tactile sensitivity). I searched for a seamless sock and finally found a company (SmartKnitKIDs) that made a sock specific for kids with severd tactile sensitivity. My child loved these socks – here was a kids who would refuse to wear socks (sometimes refused for up to 45 minutes prior to school to wear them ) now loving his new seamless socks from SmartKnitKIDS. What a break through! I started to look at all his clothes in a different way – I love fashion – wanted my little guy to look cool. This was something I could do for him – despite often standing out in the crowd as the extra high energy impulsive kid. Fashion was my motherly way of helping him fit in.

    I decided to start LUVMUM – comfortable clothing for sensational kids – an online shop selling comfortable clothing for children with tactile sensitivities. I found it difficult to locatecool clothing for my child that was fashionable and comfortable and new that there must be other parents like me who felt the same. Parents with children with tactile sensitivities and SPD often become frustrated about buying clothing for their child that they will not wear – I hope that my online store will help those many families.

    I am a stay at home mom – living in Oakville Ontario – and would luv to help all Canadian families find comfort! We have seamless socks, undies and organic clothing designed specifically for kids with tactile sensitivity! My online shop http://www.luvmum.com provides comfort to sensational kids. Spread the word! We are also on facebook – http://www.facebook.com/luvmum – LIKE us on facebook and we’ll luv you back with a 20% off promo code to use toward you first order!

  13. Sensory Processing Disorder is a neurological condition that causes some children to be overly seeking or overly sensitive to touch, sounds, tastes, smells, movement, and/or visual stimuli. Sensory Processing Disorder affects 1 in 20 children. Sensory Integration Therapy helps children with Sensory Processing Disorder, ADD/ADHD, Autism Spectrum Disorder, and other learning and behavioral challenges. Sensory Integration Therapy helps children live their lives purposely, functionally, and successfully.

    Watch this video to see examples of fun, highly effective treatment activities for Sensory Processing Disorder and other challenges. http://www.uniqueprintstherapy.com.

    Here is a list of the services we provide at Unique Prints.

    Pediatric Occupational Therapy
    Sensory Integration Occupational Therapy
    Pediatric Speech Therapy
    SAMONAS Sound Therapy
    Listening with the Whole Body Sound Therapy
    Wilbarger Protocol for Sensory Defensiveness
    “How Does Your Engine Run? Alert Program
    Handwriting Without Tears Program
    Music Therapy
    Art Therapy
    Counseling
    Nutritional Consultations
    Jin Shin (Acupressure)
    Body Talk
    Craniosacral Therapy
    Brain Integration Technique
    Social Skills Groups
    Fine Motor Skills Groups
    Boot Camp for developing self esteem, self empowerment and focus through physical activities

    http://www.youtube.com/watch?v=02JlnqUhXeU

  14. So what really can be done to help these children? I have one myself and I am struggling to find help and the financial support to provide the help that I do find. The programs that I have found are very expensive (7,000.00) and my insurance does not consider SPD a medical condition. If anyone could please help!!

    • My daughter has a diagnosis of sensory processing disorder. In the end I took her out of school and am home educating her. This was a good move she has made great progress. Although I have the diagnosis my borough don’t treat spd and very few professionals actually understand it. I myself have been using brushing technique which has helped with tactile defensiveness. also having access to trampoline a huge help. Wheel barrow also helpful for my daughter. She can stand when she writes take breaks when she needs. But the biggest thing helping her improve is lots of time to play, climb, jump, swing etc
      Hope this helps! S

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