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Sensory processing disorder or SPD is a group of neurological disorders in which the person has difficulties with the neurological process known as multisensory integration. The fail to organize sensation coming from multiple modalities, such as proprioception, vision, auditory system, tactile, olfactory, vestibular, interoception, and taste result in difficulties in function. This whole process is called Sensory processing.

Previously known as Sensory Integration, Sensory processing was defined by Ayres in 1972 as "the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment". Hence, a sensory processing disorder is characterized by problems to organize sensation coming from the body and the environment and manifested by a significant difficulty in one of more of the main areas of occupation: productivity, leisure and play or activities of daily living.[1]

Classification[edit]

Sensory processing disorders are classified into 3 broad categories: Sensory modulation disorder, Sensory based motor disorders and Sensory discrimination disorders.

  • Type I - Sensory Modulation Disorder
    • Subtypes: Over-responsivity, Under-responsivity and Sensory Craving (Seeking)
  • Type II - Sensory Based Motor Disorder
    • Subtypes: Postural disorder, Dispraxia
  • Type III - Sensory Discrimination Disorder
    • Subtypes: Visual, Auditory, Tactile, Taste/Smell, Position/Movement, Interoception

Sensory Modulation Disorder (SMD)[edit]

Over, or under responding to sensory stimuli or seeking sensory stimulation. Sensory modulation refers to a complex central nervous system process[2] by which neural messages that convey information about the intensity, frequency, duration, complexity, and novelty of sensory stimuli are adjusted.

This group may include a fearful and/or anxious pattern, negative and/or stubborn behaviors, self-absorbed behaviors that are difficult to engage or creative or actively seeking sensation.[3]

Sensory Based Motor Disorder (SBMD)[edit]

Shows motor output that is disorganized as a result of incorrect processing of sensory information affecting postural control challenges and/or developmental coordination disorder.

Sensory Discrimination Disorder (SDD)[edit]

Sensory discrimination or incorrect processing of sensory information. Incorrect processing of visual or auditory input, for example, may be seen in inattentiveness, disorganization, and poor school performance.

Causes[edit]

People with SPD have less sensory Gating (electrophysiology) than typical subjects.[4][5]

People with SOR might have increased D2 receptor in the striatum, related to aversion to tactile stimuli and reduced habituation. In animal models, it has been observed the effect of prenatal stress on tactile avoidance, where prenatal stress significantly increased the avoidance.[6]

Signs and symptoms[edit]

Symptoms may vary according to the disorder's type and subtype present,

People suffering from over responsivity might:

  • Dislike textures in fabrics, foods, grooming products or other materials found in daily living, to which most people would not react to and this dislike interferes with normal function. Like a child who refuses to wear underwear or a grown up who is so "picky" he can't go to restaurants with friends.
  • Get so car sick they refuse to be in a moving vehicle.
  • Refuse to kiss or hug, not because they don't like the person, but because the sensation of skin contact can be very negative
  • Feel seriously discomforted, sick or threatened by normal sounds, lights, movements, smells, tastes, or even inner sensations as heartbeat.

Under responsivity can cause:

Diagnosis[edit]

Treatment[edit]

Epidemiology[edit]

History[edit]

Relationship to other disorders[edit]

Autistic spectrum disorders and difficulties of sensory processing[edit]

Sensory processing disorder is a common comorbidity with autism spectrum disorders.[7] Although responses to sensory stimuli are more common and prominent in autistic children and adults, there is no good evidence that sensory symptoms differentiate autism from other developmental disorders.[8] Differences are greater for under-responsivity (for example, walking into things) than for over-responsivity (for example, distress from loud noises) or for seeking (for example, rhythmic movements).[9] The responses may be more common in children: a pair of studies found that autistic children had impaired tactile perception while autistic adults did not.[10]

Other disorders[edit]

Controversy[edit]

SPD is not yet recognized in standard medical manuals such as the ICD-10[11] or the DSM-IV-TR,[12] Some state that sensory processing disorder is a distinct diagnosis, while others argue that differences in sensory responsiveness are features of other diagnoses.[13] The American Academy of Pediatrics, for example, advises against a diagnosis of SPD unless it is a symptom due to autism spectrum disorder, attention-deficit/hyperactivity disorder, developmental coordination disorder, or childhood anxiety disorder.[14] The American Psychiatric Association recently rejected SPD as a diagnosis to be included in the recently updated DSM-5.[15] On the other hand, SPD is in Stanley Greenspan’s Diagnostic Manual for Infancy and Early Childhood and as Regulation Disorders of Sensory Processing part of the The Zero to Three’s Diagnostic Classification.[16] Recent research by Owen and colleagues (2013) [17] at the University of California, San Francisco have found a neurological difference in children with SPD, compared to normal children and those with other neurological disorders such as autism and ADHD. The neuroscientist David Eagleman has proposed that SPD may be a form of synesthesia, a perceptual condition in which the senses are blended.[18] Specifically, Eagleman suggests that instead of a sensory input "connecting to [a person's] color area [in the brain], it's connecting to an area involving pain or aversion or nausea".[19]

Some argue that sensory related disorders may be misdiagnosed as attention-deficit hyperactivity disorder (ADHD) but they can coexist, as well as emotional problems, aggressiveness and speech-related disorders such as aphasia. Sensory processing, they argue, is foundational, like the roots of a tree, and gives rise to a myriad of behaviors and symptoms such as hyperactivity and speech delay.

For example, a child with an under-responsive vestibular system may need extra input to his "motion sensor" in order to achieve a state of quiet alertness; to get this input, the child might fidget or run around, appearing ostensibly to be hyperactive, when in fact, he suffers from a sensory related disorder

Researchers have described a treatable inherited sensory overstimulation disorder that meets diagnostic criteria for both attention deficit disorder and sensory integration dysfunction.[20] Because the amount of research regarding the effectiveness of SPD therapy is limited and inconclusive, the American Academy of Pediatrics advises pediatricians to inform families about these limitations, talk with families about a trial period for SPD therapy, and teach families how to evaluate therapy effectiveness.[14]

Sensory integration therapy[edit]

Main article: Sensory integration therapy

Several therapies have been developed to treat SPD.[21] Some of these treatments (for example, sensorimotor handling) have a questionable rationale and no empirical evidence. Other treatments (for example, prism lenses, physical exercise, and auditory integration training) have had studies with small positive outcomes, but few conclusions can be made about them due to methodological problems with the studies.[22] Although replicable treatments have been described and valid outcome measures are known, gaps exist in knowledge related to sensory integration dysfunction and therapy.[23] Empirical support is limited, therefore systematic evaluation is needed if these interventions are used.[24]

The main form of sensory integration therapy is a type of occupational therapy that places a child in a room specifically designed to stimulate and challenge all of the senses.

During the session, the therapist works closely with the child to provide a level of sensory stimulation that the child can cope with, and encourage movement within the room. Sensory integration therapy is driven by four main principles:

  • Just Right Challenge (the child must be able to successfully meet the challenges that are presented through playful activities)
  • Adaptive Response (the child adapts his behavior with new and useful strategies in response to the challenges presented)
  • Active Engagement (the child will want to participate because the activities are fun)
  • Child Directed (the child's preferences are used to initiate therapeutic experiences within the session).

See also[edit]

References[edit]

  1. ^ "Sensory Processing Disorder Explained". SPD Foundation.
  2. ^ Schaaf RC, Benevides T, Blanche EI; et al. (2010). "Parasympathetic functions in children with sensory processing disorder" (PDF). Front Integr Neurosci. 4: 4. doi:10.3389/fnint.2010.00004. PMC 2839854. PMID 20300470. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  3. ^ James K, Miller LJ, Schaaf R, Nielsen DM, Schoen SA (2011). "Phenotypes within sensory modulation dysfunction" (PDF). Compr Psychiatry. 52 (6): 715–24. doi:10.1016/j.comppsych.2010.11.010. PMID 21310399.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  4. ^ http://www.sciencedirect.com/science/article/pii/S0167876008008519
  5. ^ Psychophysiology, 41 (2004), 604–612. Blackwell Publishing Inc. Printed in the USA. Copyright r 2004 Society for Psychophysiological Research DOI: 10.1111/j.1469-8986.2004.00191.x
  6. ^ Child Development, January/February 2008, Volume 79, Number 1, Pages 100 – 113 Sensory Processing Disorder in a Primate Model: Evidence From a Longitudinal Study of Prenatal Alcohol and Prenatal Stress Effects Mary L. Schneider, Colleen F. Moore, Lisa L. Gajewski, and Julie A. Larson University of Wisconsin-Madison Andrew D. Roberts Minnesota State University Alexander K. Converse and Onofre T. DeJesus University of Wisconsin-Madison
  7. ^ Russo N, Foxe JJ, Brandwein AB, Altschuler T, Gomes H, Molholm S (2010). "Multisensory processing in children with autism: high-density electrical mapping of auditory-somatosensory integration". Autism Res. 3 (5): 253–67. doi:10.1002/aur.152. PMID 20730775. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  8. ^ Rogers SJ, Ozonoff S (2005). "Annotation: what do we know about sensory dysfunction in autism? A critical review of the empirical evidence". J Child Psychol Psychiatry. 46 (12): 1255–68. doi:10.1111/j.1469-7610.2005.01431.x. PMID 16313426.
  9. ^ Ben-Sasson A, Hen L, Fluss R, Cermak SA, Engel-Yeger B, Gal E (2008). "A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders". J Autism Dev Disord. 39 (1): 1–11. doi:10.1007/s10803-008-0593-3. PMID 18512135.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  10. ^ Williams DL, Goldstein G, Minshew NJ (2006). "Neuropsychologic functioning in children with autism: further evidence for disordered complex information-processing". Child Neuropsychol. 12 (4–5): 279–98. doi:10.1080/09297040600681190. PMC 1803025. PMID 16911973.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  11. ^ "ICD 10".
  12. ^ "APA Diagnostic Classification DSM-IV-TR | BehaveNet".
  13. ^ Joanne Flanagan (2009). "Sensory processing disorder" (PDF). Pediatric News. Kennedy Krieger.org.
  14. ^ a b "Sensory Integration Therapies for Children With Developmental and Behavioral Disorders". Pediatrics: Official Journal of the American Academy of Pediatrics.
  15. ^ http://dsmfacts.org/materials/american-psychiatric-association-board-of-trustees-approves-dsm-5/
  16. ^ "Infants and Toddlers Who Require Specialty Services and Supports" (pdf). Department of Community Health—Mental Health Services to Children and Families.
  17. ^ 1.Julia P. Owen, Elysa J. Marco, Shivani Desai, Emily Fourie, Julia Harris, Susanna S. Hill, Anne B. Arnett, Pratik Mukherjee. Abnormal white matter microstructure in children with sensory processing disorders. NeuroImage: Clinical, 2013
  18. ^ Cytowic RE and Eagleman DM (2009). Wednesday is Indigo Blue: Discovering the Brain of Synesthesia. Cambridge: MIT Press.
  19. ^ The blended senses of synesthesia, Los Angeles Times, Feb 20, 2012.
  20. ^ Segal MM, Rogers GF, Needleman HL, Chapman CA (2007). "Hypokalemic sensory overstimulation". J Child Neurol. 22 (12): 1408–10. doi:10.1177/0883073807307095. PMID 18174562.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  21. ^ Cite error: The named reference Research Autism was invoked but never defined (see the help page).
  22. ^ Baranek GT (2002). "Efficacy of sensory and motor interventions for children with autism". J Autism Dev Disord. 32 (5): 397–422. doi:10.1023/A:1020541906063. PMID 12463517.
  23. ^ Schaaf RC, Miller LJ (2005). "Occupational therapy using a sensory integrative approach for children with developmental disabilities". Ment Retard Dev Disabil Res Rev. 11 (2): 143–8. doi:10.1002/mrdd.20067. PMID 15977314.
  24. ^ Hodgetts S, Hodgetts W (2007). "Somatosensory stimulation interventions for children with autism: literature review and clinical considerations". Can J Occup Ther. 74 (5): 393–400. doi:10.2182/cjot.07.013. PMID 18183774.

Category:Autism Category:Neurological disorders Category:Occupational therapy Category:Alternative diagnoses

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