Psychiatry Focus: Sensory Processing Disorder

Sensory Processing Disorder (SPD) is a relatively new condition first described by an occupational therapist named Anna Jean Ayres in 1972. She described the state as the inability of the neurological process to organize sensation from one’s own body and the environment, makes it impossible to use the body effectively within the context (Midgley, 2014).  



It’s Not What It Seems 

Also known as Sensory Integration Dysfunction, SPD is slowly gaining recognition due to the increasing incidence of children manifesting the symptoms. Despite this progress, in the field of psychiatry, it is not included in the Diagnostic and Statistical Manual, the psychiatrist’s reference for mental disorders. Also, some medical practitioners are still hesitant in giving such diagnosis because SPD can manifest as a comorbid entity with other childhood disorders such as Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorders.  


The problem with SPD sometimes begins with the parents or guardians themselves. Parents might dismiss behaviors associated with SPD as playful temperament and childhood nuisance until a teacher might raise red flags about common disruptive behaviors. The first default reaction of the parent is dread because after all, raising a child with a disability or special needs takes all the needed patience and god-like management skills. Don’t forget to account for the expenses.

“It’s very clear sensory differences are real,” noted Dr. Lauren O’ Connell, M.D., a developmental behavioral pediatrician at Hurley Medical Center in Flint, Michigan. “But sensory processing difficulties are very often linked to specific causes or conditions such as prematurity, trauma or autism, so it’s important to disentangle them.”

The diagnosis of SPD is difficult to make and usually not given by pediatricians and clinicians. Due to the difficult detection and encompassing of different other disorders, there are debates regarding SPD as a diagnosis.  

“Other experiments have shown that children with sensory processing problems have abnormal brain activity when they are simultaneously exposed to light and sound,” Smitha Bhandari, M.D., a board certified in adult psychiatry, child and adolescent psychiatry, and forensic psychiatry, explains. “Still other experiments have shown that children with sensory processing problems will continue to respond strongly to a stroke on the hand or a loud sound, while other children get used to the sensations.”

It is an accepted fact that many children, and at times adults, may have difficulties in sensory responses, but considered as some criteria for other childhood disorders and not a standalone problem. Furthermore, the effectivity of the treatment offered by an occupational therapist on the overall functioning overtime is also questioned.  

Dr. Michael Rosenthal, a pediatric neuropsychologist explained the two sides of the debate. He claimed that, yes, identification of sensory difficulties and working hand in hand with occupational therapist results in lesser unmanageable tantrums and mood swings. Focusing on the child’s sensory summary, the therapist can equip the child, parents, guardians and family members ways to cope with the patient’s condition thus creating a more balanced environment. Conversely, there is no clear research or study done on the degree of benefits and whether it is necessary to group these sensory issues into one coherent disorder. 


It’s Not An Isolated Case 


While SPD is not recognized as a medical diagnosis, it doesn’t stop counselors, teachers, and therapists on minimizing the sensory issues of the child. There is often a team that consults and collaborates with each other to come up with the best action to take depending on the problems of the individual.

“Sensory dysregulation tends to get better with neurological maturation, but in many cases, it does not go away altogether,” says Allison Kawa, PsyD, a child psychologist in Los Angeles. “Most people learn coping strategies as they grow up.”

At times, the child’s pediatrician may give inputs, and a nutritionist might be needed when appropriate. Counselors and therapists can employ different strategies such as play-based. Children express themselves better through the language of play. It is observed that like any normal child, SPD patients also have varying playing styles that can affect social development; however, it is common for SPD children to prefer solitary and less complicated play as compared to their contemporaries. Due to this observation, play method and progression on social development can be an excellent focus for counseling. 


Reference: Midgley, L. (2014). Support sensory integration through messy play. Early Years Educator, 16(5), 38-44.