JoAnn knew her son Alexander’s behavior was different even when he was a baby. But once he entered preschool, his problems really surfaced. Zander exhibited overly aggressive behavior. He regularly tackled and punched the other children, called them names, and put everything in his mouth, much like a teething baby would.
JoAnn went to her pediatrician, who said there was no clear diagnosis for Zander. He wasn’t autistic. He didn’t have ADHD. According to JoAnn, “He was not clearly anything, but he was clearly having problems.”
Zander’s preschool suggested using the Child Care Solutions program, which provides mental health specialists to observe children struggling in licensed child care settings. The specialist immediately recognized Zander’s symptoms as Sensory Processing Disorder. She then connected Zander and JoAnn with the Contra Costa Child Care Council’s Inclusion Project, which provides one-on-one support to help children with special needs thrive in licensed child care.
Zander’s case is not unique. According to research by the SPD Foundation, 1 in every 20 children experiences problems with sensory processing.
Examples of sensory processing problems include the child who does not like his diaper changed and says “it hurts,” the child who bumps into things and other children unintentionally, or the child who hits and kicks his peers when they barely touch him. Sensory issues may cause behavior problems and/or delayed motor and social emotional development. Some children exhibit an appetite for sensation that is in perpetual overdrive and are often misdiagnosed and inappropriately medicated for ADHD.
Sensory Processing Disorder occurs when a child’s nervous system has difficulty making use of sensory information. It is the job of the nervous system to take in the information around us through our senses and organize that information so we can attach meaning to it and act on it. The lack of control over sensations like touch, smell, sound, taste, balance, and body positioning, can make it very difficult for a child to manage his own behavior, especially when he or she is expected to sit in circle time or participate in structured activities with peers.
“Far too many children with sensory symptoms are misdiagnosed or not properly treated,” said Ange Burnett, the Contra Costa Child Care Council’s Inclusion Project Coordinator. “As a result, these children often have problems making friends, and are labeled unfairly as disruptive, aggressive, clumsy, or uncooperative by teachers or peers. Many are kicked out of child care.”
Children diagnosed with SPD need occupational therapy treatment, but most insurance companies do not pay for it because SPD is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a manual of currently recognized mental health disorders published by the American Psychiatric Association. SPD has made the final list for new disorders being considered for recognition in the revised DSM-5 due out in 2013, which advocates say will help prevent misdiagnosis and inappropriate treatment, and may improve the likelihood insurance companies will cover the cost of treatment.
For now, First 5 Contra Costa-funded programs like the Inclusion Project can provide much needed help. For example, some of the solutions the Inclusion Project provided at Zander’s preschool included:
- Getting Zander a “chew bracelet” – his providers now direct him to use it when he puts other items in his mouth.
- Having him use a weighted blanket and slightly heavy back pack that provide pressure to help keep him calm (a similar effect as swaddling a baby).
- Using a wobble cushion filled with air at circle time so he can be constantly moving and wiggling without being disruptive to the other children.
Sensory Processing Disorder Red Flags:
- Rubs off kisses or casual touches and pushes others away to avoid closeness
- Bothered by certain types of clothing and particularly sensitive to sock seams, shoes and tags in shirts
- Touches people and objects constantly
- Seems unaware of touch unless it is intense
- Uncomfortable on stairs, clinging to walls or banisters
- Enjoys being upside down, hanging over the bedside or swinging while lying on tummy
- Bumps into objects and furniture, apparently on purpose
- Has problems with touch or with balance and movement as well
- Has a poor sense of body awareness
- Stiff, uncoordinated, and clumsy, falling and tripping frequently
- Leans, bumps, or crashes against objects and people, and invades others’ body space
- Pulls and twists clothing, stretches his tee shirt down, or chews sleeves or collars
- Sensitive to sounds
Talk with your child’s pediatrician or health care provider if you have any concerns about your child’s development.