You may have heard the term “sensory processing” or “sensory integration” related to your child’s behavior. You may have been told by a therapist or done an internet search which resulted in the conclusion that your child has Sensory Processing Disorder (SPD). We want to dispel some of the myths surrounding this “diagnosis.”

Myth #1: SPD is a diagnosis.
That’s right. It is NOT a diagnosis. I hear many families tell me that their child has SPD and I wonder who told them this. The internet? Sometimes. Often, however, it’s from another occupational therapist. (Did you know that as occupational therapists we do not hold a license that allows us to make a formal diagnosis? However, we can choose a diagnostic treatment code for insurance that support our treatment in therapy; this is not the same as a formal diagnosis though). SPD is not a recognized diagnosis in the DSM-V, the diagnostic manual that clarifies which symptoms must be present for a variety of diagnoses, including autism and ADHD. There was hope from many parents and therapists that SPD would be included in the latest revision of the manual, but because research is lacking to clarify the criteria for a diagnosis, it was omitted. Along those lines, we do not have a valid way to assess this in therapy either. There are no cut and dry criteria that allow us to differentiate this as separate from other diagnoses. The assessments available are limited to observations and questionnaires. While these can give us a lot of information about a child, they do not provide concrete evidence of a diagnosis that excludes other possible ones. For instance, some children with ADHD or those who have a history of trauma often have behaviors that appear to be sensory-based. OT alone may not be sufficient to meet a child’s needs if that is the case. In the past we were able to assess sensory processing with a test called the Sensory Integration and Praxis Test (SIPT). This required weeks of training for a LOT of money. The test itself is also expensive. Insurance companies would not reimburse sufficiently to make it a cost-effective training worthy of a therapist’s time and money. And guess what? This training is no longer available. As our profession has moved towards using evidence-based practice this test has not met the standards of our own profession.

TRUE STORY: I worked with a child a few years ago who, based on observations and questionnaires would have been labeled with SPD. However, with medical testing it was revealed that he had lead poisoning. I have also worked with numerous children who appear to have SPD but their sensory issues no longer affect their function after they start medication for ADHD.

Because it is not a formal diagnosis, you should use caution if you are seeking therapy for sensory-related issues and expecting insurance to cover it. Insurance will not cover sensory integration therapy or recognize SPD as a diagnosis that warrants coverage. This does not mean that your OT won’t be covered by insurance, however. Contact us to learn more if you plan to seek insurance reimbursement for therapy.

MYTH #2: If you are sensitive to tags in your clothing (or smells, or sounds or whatever) then you have SPD.
We are all on a spectrum when it comes to our tolerances and needs for sensory input. Some of us can’t stand noise, while others must have music or TV on all of the time. See #4 below for what constitutes a need for intervention with regard to sensory areas.

MYTH #3: SPD is the reason my child can’t function at school (daycare, etc.).
There are so many factors that affect behavior and adding a swing (or trampoline or other sensory tools) in the classroom will not be enough to address behaviors that appear to be sensory-related. If that were the case then the behaviors would disappear completely with the inclusion of the swing. Instead, you must teach children that there is a purpose for the swing or sensory tool and use behavioral strategies as well. Even children with significant communication delays can learn this.

MYTH #4: My child needs OT to be able to tolerate sensory input
Okay, I’m not telling you that we don’t have something to offer. What I’m saying is that many kids adapt on their own, and they don’t always need formal intervention. Their need for OT is affected by how it impacts their function and behavior.

Just because there isn’t an official diagnosis doesn’t mean that your child does not have sensory issues affecting their everyday lives. For instance, it’s a problem if Miranda, who is hypersensitive to touch, hits a peer who accidentally touches her when walking by. Or if Max can’t go into the bathroom because he fears the noise from the automatic toilet when it flushes.

(On a side note—it is often the anxiety surrounding sensory sensitivities that needs to be addressed along with using sensory tools and strategies. But we’ll have to get into that in another post.)

There are definitely things OT can do to address the sensory symptoms your child may have, but we urge parents and other therapists to use caution when using the term “sensory processing disorder,” especially if you are seeking coverage from insurance. We want consumers to be able to make informed decisions when seeking services for their children. We hope you found this information helpful.