Tuesday, October 9, 2018

Sensory Processing Disorder - the diagnosis that doesn't exist

Sensory Processing Disorder - the diagnosis that doesn't exist

It is so difficult to explain sensory processing.  I've been trying and sometimes succeeding for almost 20 years.  Most of the time I talk about the 8 sensory systems and that they need to have a "balance" to work properly.  The children I see are "out of balance" with some sensory systems over responsive and others under responsive.  OT treatment seeks to regain this balance and improve functional outcomes.  My frustrations were supported by this recent blog post form the Anonymous OT (one of my favorite blogs).

https://theanonymousot.com/2018/10/09/sensory-processing-disorder-why-is-it-so-hard-to-explain/

As lots of professions are jumping on the sensory bandwagon I find there is more and more misinformation out there.  I've gotten prescriptions from physicians with a diagnosis of SPD recommending OT.  I've had other professionals - counselors and psychologists usually - talk about sensory regulation as though that is the same as sensory integration treatment.  When I first starting working in pediatrics in 2001 if you mentioned "sensory" everyone looked at you as though you were crazy.  Now it is part of the diagnostic criteria of Autism in the DSM-V.

SPD is not an officially recognized diagnosis.  The SPD foundation attempted to get it added to the DSM-V, but they were unsuccessful.  At the same time awareness and prevalence of sensory issues have exploded.  Parents and professionals are left in a diagnosis limbo.

It's no wonder the public is confused.  I like to point my parents or colleagues to these fact sheets from the Spiral Foundation. Its a good place to start the conversation.

Parent Factsheet

Educator Factsheet

Physician Factsheet

In Texas, Medicaid came out with a statement that they will not reimburse for auditory integration treatment or sensory integration treatment because these are not evidence based.  I could argue the opposite point, but it doesn't really matter.  As an OT, I focus on function.  My goals ALWAYS address functional outcomes.  "Sensory processing" isn't a goal.  Going to a public restroom without increased anxiety is a goal.  How I get my clients to reach that goal is up to me.  Results speak volumes.

There is SOOOO much to know about sensory processing.  It is a complex and not fully understood process.  Don't get discouraged, but keep seeking out good information from reputable sources.