The New Attention Deficit Disorder
Section: Health
Adults can remember kids like these from their own childhood. They were the ones called losers, loners, klutzes and troublemakers. The Sensory Therapies and Research [STAR] Center, just south of Denver, which treats about 50 children a week for a curious mix of problems that can be treated. Some can't seem to get their motors in gear: they have low muscle tone and a tendency to respond only minimally to conversation and invitations to play. Others are revved too high: they annoy other children by crashing into them or hugging too hard. Many can't handle common noises or the feel of clothing on their skin. A number just seem clumsy. At STAR Center they wear a more benign label: children with sensory processing disorder (SPD).
Never heard of it? You're in good company. Neither have many pediatricians, neurologists, psychologists and teachers. But in the parallel universe of occupational therapy, which focuses on the more primal "occupations" of life--dressing, eating, working, playing--SPD is commonly treated. Last month, at a conference on SPD in New York City, 350 occupational therapists (OTs) and others gathered to hear about the latest research and therapies.
OTs has been treating SPD, also known as sensory integration dysfunction, since 1972, when A. Jean Ayres, a UCLA psychologist and occupational therapist, published the first book on the condition. As defined by Ayres and others, SPD is a mixed bag of syndromes, but all involve difficulty handling information that comes in through the senses--not merely hearing, sight, smell, taste and touch, but also the proprioceptive and vestibular senses, which tell us where our arms and legs are in relation to the rest of us and how our body is oriented toward gravity. Some kids treated for SPD can't maintain an upright position at a desk; some are so sensitive to touch that they shriek when their fingernails are trimmed or if they get oatmeal on their face. Sounds and smells can be overwhelming. When lawn mowers roar outside the home of Lizzie Cave, 4, a STAR child, she's been known to vomit.
OTs has been treating SPD, also known as sensory integration dysfunction, since 1972, when A. Jean Ayres, a UCLA psychologist and occupational therapist, published the first book on the condition. As defined by Ayres and others, SPD is a mixed bag of syndromes, but all involve difficulty handling information that comes in through the senses--not merely hearing, sight, smell, taste and touch, but also the proprioceptive and vestibular senses, which tell us where our arms and legs are in relation to the rest of us and how our body is oriented toward gravity. Some kids treated for SPD can't maintain an upright position at a desk; some are so sensitive to touch that they shriek when their fingernails are trimmed or if they get oatmeal on their face. Sounds and smells can be overwhelming. When lawn mowers roar outside the home of Lizzie Cave, 4, a STAR child, she's been known to vomit.
No one can say with certainty how many kids are severely affected by sensory problems, studies conducted by Alice Carter, professor of psychology at the University of Massachusetts, Boston, suggest that 40% of children ages 7 to 10 are so sensitive to touch that tags in clothing annoy them, and 11% overreact to sirens. But no one would claim that all these kids have a sensory disorder. Carter thinks SPD is too vaguely defined for prime time in the DSM. Instead, she favors adding it to a section at the back of the manual on disorders that warrant further study. Granting it such provisional status would open the door to more research funds. Then, if validated, SPD could have a shot at being included in the DSM VI--due out somewhere around 2025.
