Thursday, July 03, 2008

Sensory Perception Disorder: The Real Deal? Part Two

So your child doesn't like getting his feet wet. Sensory Perception Disorder. Your kid doesn't like balloons. Sensory Perception Disorder. Doesn't like being touched. SPD. Can't tie his shoes. SPD. Doesn't eat squishy veggies. SPD. Tantrums? You get the idea.

Ah, love to read someone turning a critical eye towards this current darling among the diagnostic set. Vivian Manning-Schaffel takes on Sensory Perception Disorder (Phantam Menace: Do 1 in 20 kids really have "sensory processing disorder"?) over at Babble.

Basically, I question a diagnosis given to children that behave and respond so differently from one another. Personally, I know more a couple children who've been labelled SPD. No, I'm not a clinical psychologist, though I did my stint in clinical psychology and did clinical assessments of children for a couple years, but I have to say the kids I know with so-called SPD all seem very different from one another. And there's not single test that assesses it. Maybe that's why it's not yet made it to the Diagnostic Statistical Manual, the official bible of mental health practionners. Course it also means insurance companies do not recognize it. So, as one occupational therapists admits, she labels SPD children with ADD (attention deficit disorder) or feeding problems in order to get insurers to shell out for it.

2 comments:

Anonymous said...

I have two kids with SPD.. IT IS REAL my dear.. do you have children with this problem? Do you have kids who scream in the store because of the noise? Or scratch themselves rare because of the feel of diapers? Or how about covering their ears and crying when the bus picks them up, or inability to handle a toothbrush feel in their mouths? Or how about freaking out because of glue on the hands? Or climbing furniture, jumping, throwing objects for gross motor work...Come over to my house for one afternoon, live my life, deal with my marriage handling the stresses of two kids on the spectrum with full blow SPD... and then write a blog about "so called" SPD. Do us mom's a favor.. don't blog about something you never personally have experienced.. Your Top 100 blog is at the bottom of my list.

Dr. Polly said...

Dear Anonymous,

Thank you for taking the time to read and comment. I appreciate your thoughts and realize there are children and families struggling with many hardships. I don't doubt for a minute that your children's symptoms are very real. I'm sorry if my posts have offended you but you'll see I turn a critical eye on just about every childhood disorder and health issue I've covered from attention deficit disorder to the benefits of breast feeding. I do this in part because few people do - at least those in the health industry. I do it because the experts and the media often don't get the details right.
I also do so because these are terribly important issues, in this case, in deciding what to include in the DSM - it's the difference between receiving insurance reimbursement plus often times federally mandated preschools and other therapies, so no small matter. The stakes are high.

I do object to more minor symptoms being treated like major disorders. I've assessed children with very serious symptoms and those with minor ones. I hate to see kids who are functioning pretty well being compared to those who are in dire straits. And if you have a child who has serious issues I would think you'd object to children with more minor symptomatology being treated just like yours. I also think it's fair to question a disorder that's shown a wide range of symptoms both in type and degree.

If you'll re-read both my posts about SPD you'll note I've voiced doubts about the number of kids who are labeled, especially those with minor issues. The children I know with this label do not seem to fit the current diagnostic criteria all that well- and they seem very different from one another. This means we may or may not want to include all these childrens and symptoms into one disorder. If we include a whole host of symptoms into one disorder it's sometimes like comparing apples and oranges. And what works for one child might not work for the other. Just because we call it one thing doesn't mean it is and thus, that there's one treatment.

I know kids have all kinds of symptoms that present all kinds of difficulties. I believe what you say about your kids' symptoms. But I don't think we necessarily need to lump all the behaviors and symptoms together into one neat disorder. I understand the desire to do so in order to get treatment, but that's another issue altogether. That's a consequence of our current health care system and not something residing within the brains or bodies of our kids. Often I wish insurance companies would pay for treatment of symptoms and not disorders.

I'm hardly the only one questioning whether these symptoms should be arranged into a single new disorder. Right now folks within the American Psychiatric Association are trying to decide whether SPD should be included in the next DSM. We'll see what they decide.

Thanks again and I wish you well.