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ADhD, Anxiety, Autism, Behaviour, Book, Children, Depression, Environmental Psychology, HSP Issues, Overwhelmed, Parenting HSC, Sensitivities, sensory integration, Toxicity

The Sensory Connection


The notion of sensory processing difference is also controversial within the medical community. On one hand, the DSM-V no longer includes sensory processing as a stand-alone phenomenon, in essence denying its existence. On the other hand, researchers such as Dr. Lucy Jane Miller, author of Sensational Kids: Hope and Help for Children with Sensory Processing Disorder, and Director of the STAR Center, who has been working on this issue for more than thirty years, provide scientific evidence that Sensory Processing Disorder is an actual, physiological condition.

In the article “ The Phantom Menace: Do 1 in 20 kids really have Sensory Processing Disorder?”, by Vivian Manning-Schaffel, Dr. Miller explains that :

medical professionals often misdiagnose SPD as ADHD and/or autism because the lines between the disorders are slightly blurred. “It’s not in the autism spectrum, but almost all children who have autism or Asperger’s syndrome have sensory problems, sometimes very significantly. But the majority of kids who have sensory problems don’t have autism,” says Dr. Miller.

The distinction gets even more confusing when it comes to ADHD. “We’ve found that about 40% of kids who have one, have the other, so there is overlap,” says Dr. Miller. “But they are two separate diagnoses that coexist – they are not the same thing. A child with ADHD has an impulse control issue, and extra sensory information doesn’t help. A sensory-seeking child calms down if you give them what their brain needs.”[1]

If the doubt of the medical community dominates the discussion on sensory processing, researchers from the University of California San Francisco, have recently confirmed that it is real but also began to pin point its affect on the brain (UCSF, 2013)[2]. In this process, they have established that it affects a different part of the brain than Autism and ADHD.

Furthermore, according to the University of Virginia Health System, sensory processing issues and preferences may be completely normal, especially in young children whose nervous systems are still in the process of development:

“When these preferences become a concern is when the child’s sensory tolerance or need (whether seeking sensation or avoiding it) interferes with functioning in the environments of family, school or the playground,” explains Goldeen. “For instance, if a family has stopped going anywhere because it’s too difficult, or a 3-year-old child has been kicked out of several preschools, then we’re talking about quirks that have become dysfunctional.”[3]

The term Dysfunctional is, in itself, misleading, so are labels such as sensory processing disorders. Extreme sensory reactions do not necessarily mean there is something wrong with the child. Some research in developmental psychology provides further evidence that individuals differ in their sensitivity. According to the differential susceptibility hypothesis by Belsky and Pluess (2009)[4] individuals vary in the degree they are affected by experiences or qualities of the environment they are exposed to.

Their research suggests that individuals should be differentially susceptible to environmental influences, with some people being not just more vulnerable than others to the negative effects of adversity, but also disproportionately susceptible to the beneficial effects of supportive and enriching experiences (or just the absence of adversity). They believe that individuals differ in plasticity, some individuals being more malleable or susceptible than others to both negative and positive environmental influences. In other words, it is “normal” for some people are easily overwhelmed or underwhelmed by sensory input that does not bother others.

Such findings are echoed in other areas of research. In the essay “The Science of Success,”[5] Journalist David Dobbs writes about two types of children: “orchids” and “dandelions.” Dandelion children, who are in majority, tend to do pretty well no matter what environment they grow up in. Orchid children, meanwhile, may develop behavior or mood problems in abusive or neglectful homes — but in loving ones, they may thrive even more than dandelions. While abuse is meant as emotional or neglect, in the context of sensory processing issues it must be understood to also include attacks on the senses that can be caused by the environment, a topic we will explore in chapter 4.

According to Dobbs’ research, the difference between dandelions and orchids may be genetic. For instance, kids with a certain variant of a dopamine-processing gene are at greater risk of ADHD and “externalizing behavior” (i.e. “acting out”) than other children. But in one study, these kids also improved much more in response to a video-based behavioral intervention than did kids who didn’t have the at-risk variant. Similarly, rhesus monkeys with another gene variant (one associated with depression in humans) are worse at processing serotonin than their peers if they are raised as orphans. But when raised by a loving monkey mother, these seemingly at-risk animals process serotonin more efficiently than other monkeys, and are also more socially successful. These and other studies suggest that certain genes confer not risk per se, but a kind of openness to environmental stimuli, positive or negative. Thus the importance of dealing with sensory processing in positive ways.

The work of Dr Amen and other researchers demonstrate that many areas of the brain and different chemical balance create different type of behavioral change, the label of ADHD and autism can easily be assigned to children who simply have different reaction to stimuli.

If this is indeed the case, the use of ADHD or autism medications are inappropriate and potentially dangerous to their well-being. These drugs are not as safe as we are led to believe. On Wed Sep 26 2012, David Bruser,News Reporter, and Andrew Bailey, Data Analyst, reported in the Toronto star article: “ADHD drugs are suspected of hurting Canadian kids”, that a growing number of doctors, nurses, pharmacists and parents are reporting that they believe attention deficit drugs are causing major health problems in patients, many as young as 6 and 7 years old.[6] They found that in the past 10 years, nearly 600 cases of Canadian kids suffering serious, sometimes fatal side effects suspected to have been caused by ADHD medications.   The side effects include strokes, convulsions, hallucinations, depression and suicide:

Though the number of Canadian kids with the disorder is unclear — one estimate puts it at one in 20 children — parents are increasingly turning to these drugs to deal with the diagnosis. In the 10 years reviewed by the Star, 76 kids on ADHD medications thought about killing themselves. One-third of these were children younger than 10, some as young as 6. (…) In 52 of these suicidal ideation reports, the attention deficit drug Strattera is listed as the suspected cause of the side effect. In 12 of the reports, Concerta is listed as the suspected cause. It is also listed as the suspected cause of one completed suicide.”[7]

Scarier still, ADHD medications Strattera and Concerta were the second- and third-highest suspected causes of reported serious side effects suffered by Canadian kids taking any drug in the past 10 years:

“More than any cancer drug. More than any powerful antipsychotic for kids with serious mental illness. More than nearly 1,800 other drugs reported to have been the suspected cause of a serious side effect in a Canadian youth since 2001. In more than 40 per cent of all cases where a youth thought about suicide, an ADHD drug is listed as the suspected cause. The Star found side effects on most parts of the body — the brain, respiratory system, several major organs, blood, skin, eyes, ears, and hair“[8]

While Health Canada, collects these adverse reaction reports, it does not alert the public to the magnitude of these side effects. Because the regulator has not analyzed the data it collects, it has allowed the industry to largely police itself. If parents do not pay close attention to what is affecting their children, they run the risk of damaging them for life. These dangers make it worth investigating with a child does have a sensory processing sensitivities that are affecting his or her ability to be focused.

Sensory Processing Sensitivity

A great deal of confusion exist sensory processing definitions, which makes it difficult to diagnoses to an untrained eye or without knowing a child intimately. Sensory processing sensitivities cannot be pined down to one type of behavior because they can impact any one sense or a combination of several. They can affect the auditory, visual, tactile, vestibular (movement), proprioception (awareness of joint/body position), but can also affect the chemical body. As Ruth Goldeen, an occupational therapist, explains:

We all have a unique nervous system with preferences and distastes for sensory input. One person might prefer to spend free time in an arcade with plenty of noise and hustle and bustle; another might want to sit in a quiet space and read a book. Both are ‘normal’ but definitely opposite extremes. And certainly some people may know they don’t like loud noises or crowds and find ways to adjust their environments accordingly.”[9]

People’s responses to sensory input exist on a continuum of behaviors, which will have at one end of the spectrum sensory defensiveness and at the other end of sensory seeking, as we saw in the introduction. These differences translate into a wide range of behaviors:

“Sensory defensiveness: A child who is sensory defensive doesn’t like touch, sound or input they don’t create themselves. It sends them into “fight or flight” mode, an acute stress response triggered by real or perceived threat that causes the release of hormones and increases heart, breath and blood pressure rates.

Example: A 3-year-old spends the day in daycare, which often means a chaotic, noisy atmosphere filled with unpredictable children. By the end of the day, the child, having spent 8 or 9 hours in a state of heightened anxiety, reacts to normal interactions as if to a threat, by running away, hiding or punching.

Sensory seeking: A child seeking sensory input will bang into everything, literally bounce off the walls, even chew things. Example: “They don’t seem reactive to the environment. The child will be finger painting and suddenly the paint covers their whole body. Or the child will walk right off the edge of the playset. And they don’t react at all. It’s a hyporeaction, an underresponsive reaction.” Goldeen explains that sensory seekers often end up in long-term hobbies that involve a great deal of physical stimulation, like rugby, football and horseback riding.”[10]

According to the article “ADHD… Is it? Or isn’t it?” posted on the SPD Support website:

“Sensory seeking children crave more sensory input. They seem to have a never ending desire for sensory stimulation. For example, they may seek out movement stimulation by rocking on their chairs and/or oral (mouth) stimulation by chewing on their shirts. Those who can’t meet their own sensory needs may complain of ‘being bored’.”[11]

Could some ADHD misdiagnosis be caused by behaviors of unchallenged and bored sensory seekers? M.D. Stanley Greenspan suggests that is indeed the case. He explains that a great number of children whom he sees in his medical practice for ADHD have motor planning and sequencing problems not ADHD. The children who often get misdiagnosed with ADHD are sensory-seeking children who are constantly looking for more touch, more sight, more sound, more movement and in the process are more active, distractible and inattentive (Greenspan, 2009, p. 6).

This is not to suggest that ADHD is not a real condition. Dr. Lucy Jane Miller, in her (Putnam, 2006) book “Sensational Kids: Hope and Help for Children with Sensory Processing Disorder”, outlines very clearly, what, according to her research, she believes are ADHD symptoms and what are SPD symptoms. Which behaviors and symptoms stand alone, and how they can overlap.

Dr. Miller wrote:

“Defining the difference between ADHD and SPD:

  • Cannot stop impulsive behavior regardless of sensory input.
  • Craves novelty and activity that is not necessarily related to specific sensations.
  • Does not become more organized after receiving intense sensory input.
  • Has difficulty waiting or taking turns.
  • Waits or takes turns better with cognitive rather than sensory input.
  • Tends to talk all the time, impulsively interrupting, has trouble waiting for turn in any conversation.”

According to the article “ADHD… Is it? Or isn’t it?” posted on the SPD Support website:

“(…) a leading OT who is also a published SPD researcher reported to me: “I am seeing significant improvements in diagnosed, medicated ADHD kids, using Sensory Integrative Therapy only. They are calmer, more focused and attentive, and we are going to do a study on these kids to find out just how much they are improving!”

And she and a couple other fine researchers did just that. They did two groups, starting with the SIPT test (Sensory Integration and Praxis Test) treating a little over half the kids for six months, then retesting. A majority of these kids did indeed respond to treatment and some were able to go completely off medications. These children did respond, neurological changes did appear to occur and they did show improvements per parent report and clinic testing.”[12]

Another important aspect of sensory processing difference is sensory under-responsiveness. According to The Children’s Hospital of Eastern Ontario:

Children who are under responsive to sensory input look quiet and passive. They seem to have no energy or motivation during everyday activities. These children may need much more sensory input to feel ‘just right’ and be ready to work or learn. Children may find it easier to focus on school work if they exercise a little before sitting down to desk work; have lots of chances for active, ‘hands-on’ learning.

Children can have a mix of sensory sensitivities and under responsiveness. For example, a child may be sensitive to touch, but seek out vestibular (movement) input. Things might also change from day to day. A child might be very sensitive one day, and not bothered by the same things at all on the next day. “[13]

In young children this quietness and passivity could be mistaken for autism.

Another element to be aware of, sensory processing sensitivity is very common amongst gifted children. Yet, in the article ” Asynchronous development and sensory integration intervention in the gifted and talented population”[14], Anne Cronin points out that most occupational therapists providing sensory integration do not have any training in the special developmental and behavior issues of gifted children and can not address some of their unique needs. This adds to the complexity of misdiagnosis, as the ADHD characteristics of over-stimulations are very similar to those potentially experienced by the gifted.

Previous: ADHD and Autism: an Umbrella Diagnoses Hiding Other Issues?
, Next: The gifted

Bibliography

[1] Manning-Schaffel, Vivian (2008). The Phantom Menace: Do 1 in 20 kids really have Sensory Processing Disorder?” Babble.com. downloaded from: http://www.babble.com/kid/children-sensory-processing-disorder-autism-symptoms-therapy/

[2]Bunim, Julinana (2013). Breakthrough Study Reveals Biological Basis for Sensory Processing Disorders in Kids. University of California, San Francisco. July 09, 2013. Retrieved from http://www.ucsf.edu/news/2013/07/107316/breakthrough-study-reveals-biological-basis-sensory-processing-disorders-kidsi

[3] University of Virginia Health System Blog (2012). Sensory Processing Disorder: Ambiguous but Real. Posted December 11, 2012

http://uvahealth.com/blog/2012/12/11/sensory-processing-disorder-ambiguous-but-real/

[4] Belsky, Jay and Pluess, Michael (2009). Beyond Diathesis Stress: Differential Susceptibility to Environmental Influences. American Psychological Association. Psychological Bulletin 2009, Vol. 135, No. 6, 885–908.

[5]Dobbs, David (2009). “The Science of Success” in The Atlantic Magazine. Retreaved from http://www.theatlantic.com/magazine/print/2009/12/the-science-of-success/307761/

[6] David Bruser, David, and Bailey, Andrew (2012). “ADHD drugs are suspected of hurting Canadian kids”. Toronto Star, Published Wed Sep 26 2012. Retrieved from http://www.thestar.com/news/canada/2012/09/26/adhd_drugs_suspected_of_hurting_canadian_kids.html

[7] David Bruser, David, and Bailey, Andrew (2012). “ADHD drugs are suspected of hurting Canadian kids”. Toronto Star, Published Wed Sep 26 2012. Retrieved fro http://www.thestar.com/news/canada/2012/09/26/adhd_drugs_suspected_of_hurting_canadian_kids.html

[8] David Bruser, David, and Bailey, Andrew (2012). “ADHD drugs are suspected of hurting Canadian kids”. Toronto Star, Published Wed Sep 26 2012. Retrieved fro http://www.thestar.com/news/canada/2012/09/26/adhd_drugs_suspected_of_hurting_canadian_kids.html

[9] University of Virginia Health System Blog (2012). Sensory Processing Disorder: Ambiguous but Real. Posted December 11, 2012

http://uvahealth.com/blog/2012/12/11/sensory-processing-disorder-ambiguous-but-real/

[10] University of Virginia Health System Blog (2012). Sensory Processing Disorder: Ambiguous but Real. Posted December 11, 2012

http://uvahealth.com/blog/2012/12/11/sensory-processing-disorder-ambiguous-but-real/

[11] Morris, Michelle (2007). ADHD… Is it? Or isn’t it? SPD Support website. http://spdsupport.org/articles/8-spd-or-adhd.shtml

[12] Morris, Michelle (2007). ADHD… Is it? Or isn’t it? SPD Support website. http://spdsupport.org/articles/8-spd-or-adhd.shtml

[13] http://www.cheo.on.ca/uploads/Sensory Processing/Sensory Processing ENG.pdf

[14] Cronin, A.F. (2002). Asynchronous development and sensory integration intervention in the gifted and talented population.Davidson Institute for Talent Development.

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Discussion

2 thoughts on “The Sensory Connection

  1. Just found your blog. Very excited about it. I have an 8 yr old boy who was born at 27 weeks and has exhibited sensory processing differences for as long as I can remember. It is nice to find the rare spaces like this in the internet that acknowledge the validity of these differences and put them into perspective.

    Posted by megan | June 1, 2014, 1:15 am

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