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March, 2011:

Sensory Processing Disorder

Sensory processing disorder or SPD is a neurological disorder causing difficulties with taking in, processing and responding to sensory information about the environment and from within the own body (visual, auditory, tactile, olfaction, gustatory, vestibular and proprioception).

For those with SPD, sensory information may be sensed and perceived in a way that is different from most other people. Unlike blindness or deafness, sensory information can be received by people with SPD, the difference is that information is often registered, interpreted and processed differently by the brain. The result can be unusual ways of responding or behaving and finding things harder to do.

Difficulties may typically present as difficulties planning and organising, problems with doing the activities of everyday life (self care, work and leisure activities including work and play), and for some with extreme sensitivity to sensory input, sensory input may result in extreme avoidance of activities, agitation, distress, fear or confusion.

Difficulty taking in or interpreting this input can lead to devastating consequences in:

daily functioning
social and family relationships
behavioral challenges
regulating emotions
self-esteem
learning

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ADHD

Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness.

Attention deficit disorder (ADD) is a type of ADHD.

Common symptoms of ADHD include: a short attention span, restlessness, being easily distracted and constant fidgeting. Many people with ADHD also have additional problems, such as sleep disorders or learning difficulties. However, ADHD has no effect on intelligence.They often have sensory processing problems and modulation difficulties (hence behaviour can be out of control).

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Asperger Syndrome

Children with Asperger syndrome have milder symptoms that affect social interaction and behaviour. Their language development is usually unaffected, although they often have problems in certain areas of language. For example, understanding humour or figures of speech, such as ‘she’s got a chip on her shoulder’ or ‘it’s raining cats and dogs.’

Children with Asperger syndrome usually have above-average intelligence. Some children are skilled in fields requiring logic, memory and creativity, such as maths, computer science and music. (But only 1 in 200 children are exceptionally skilled, so-called ‘autistic savants.’)

Children with AS are often severely affected by sensory processing and this is often overlooked during typical health assessments. Behaviour therefore is a big problem for these children who fear change and are often oversensitive by nature.

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Autistic Spectrum Disorders

Autistic spectrum disorders (ASD) are a range of related developmental disorders that begin in childhood and persist throughout adulthood. ASD can cause a wide range of symptoms, which are grouped into three broad categories:

Problems and difficulties with social interaction such as a lack of understanding and awareness of other people’s emotions and feelings.

Impaired language and communication skills such as delayed language development and an inability to start conversations or take part in them properly.

Unusual patterns of thought and physical behaviour. This includes making repetitive physical movements, such as hand tapping or twisting. The child develops set routines of behaviour, which can upset the child if the routines are broken.

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Dyslexia

Dyslexia is a common type of learning difficulty that primarily affects the skills involved in the reading and spelling of words. Dyslexia should be recognised as a spectrum disorder, with symptoms ranging from very mild to very severe. In particular, people with dyslexia have difficulties with: phonological awareness, verbal memory, verbal processing speed.

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Dyspraxia

Dyspraxia, also known as DCD (developmental co-ordination disorder), is a disability that affects movement and co-ordination. It is thought to be caused by a disruption in the way messages from the brain are transmitted to the body.

Dyspraxia is characterised by difficulty in planning smooth, co-ordinated movements. This leads to:clumsiness, lack of co-ordination, problems with language, perception and thought. Symptoms are normally noticeable from an early age and often have difficulties with fine motor control with handwriting, fastenings and scissors causing problems.

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Assessment of your child

Usually following a referral to Therapy Space I am able to provide a full, detailed assessment followed up with a report and it may be clear they have one or a number of the following conditions.(see list below). As an OT I am able to identify and provide potential diagnoses of Dyspraxia, DCD and Sensory Processing Disorder. It is recommended that this is backed up by another member of a medical team. I am also able to pick up on many of the other conditions listed and can steer you in the right direction for getting support. Understanding your child’s problems helps parents move forward in gaining support for their child who is often struggling in mainstream school.

Full Assessment

Duration – 3 hours

Parents and school staff are asked to complete a number of questionnaires prior to visit. Assessment will look at and consists of clinical observations, handwriting, fine and gross motor skills, sensory processing assessment. The child usually enjoys the session as there is fun equipment available to use alongside a structured task orientated session. Observation is key to understanding behaviour. During assessment I often pick up on behavioural problems and ask parents to complete questionnaires prior to visits to enable less questioning during session. Liaison with school is helpful and schools are asked to complete questionnaires prior to assessment. I also find it useful to read copies of other professionals reports prior to visit especially Educational Psychologists, OT etc.

Mini observational assessment

Duration – 1.5 hours

Parents will be asked to complete questionnaires and an informal assessment will consist of clinical observations and play in sensory integration environment. Verbal feedback is given so parents are asked to bring a pad and paper to make notes. This is often a quick and useful way to get a quick basic breakdown of strengths and difficulties but I do recommend full assessments as can cover everything in much more detail.

Reports

A report is completed ideally within a 2-4 week period and sent directly to referrer which is often the parent. Parents are then free to distribute to who they would like. Sharing information is essential if attending other health professional clinics. E.g. If any child is being seen by NHS OT services the staff should be aware of each other’s involvement and this is primarily the reponsibilty of parent to share. N.B. I am able to offer legal reports required for tribunals and have qualifications to do this.