Sunday, June 13, 2010

Got ADHD? It could be SPD....

I was at the pool the other day where I ran into the mother of one of Danny's old classmates. D was in Danny's preschool class, but is now entering 2nd grade. D's mom informed me that her son was recently diagnosed with ADD, but she isn't sure she agrees with the diagnosis. That's when I suggested she do some research into Sensory Processing Disorder, since so many of the symptoms are similar between the two.

She didn't seem interested, which doesn't surprise me all that much. SPD is not well understood by many childcare professionals and so most people haven't heard much about it. Some experts estimate that half of all kids diagnosed with ADHD actually have Sensory Processing Disorder, which says to me that even the medical professionals, teachers, and therapists don't understand the difference between SPD and ADHD.

I think this is a big problem, because many, many kids are going undiagnosed, which means they are not getting the help they need. How can you really help your child unless you know exactly what is going on with him? If your child actually has sensory problems, but his doctor just medicates him for ADHD, you aren't getting to the root cause of the problem, which I would think would just mean more problems down the line.

Part of Sensory Integration Therapy is teaching a child to cope with his sensory needs and eventually regulate himself. SPD is treated primarily with therapy in the form of fun games that don't have any scary side effects, like medicine can. (Some kids are also medicated, but that is only one small part of the treatment.) These are exercises that help strengthen a kid's muscles and improve his coordination. How could that be bad? It definitely takes time and doesn't necessarily have immediate results like medicine can, but in the long run, it rewires their brains so that they don't have as many sensory problems. This treats the actual problem, not just the symptoms.

I do understand that many kids need medication for ADHD and SPD. I am not contesting that. I just wish more doctors, therapists and teachers knew about SPD so they could help kids get the proper diagnosis and help.

Lucy Jane Miller, an expert on Sensory Processing Disorder addresses ADHD in her book Sensational Kids: Hope and Help for Children with Sensory Processing Disorder. She even has a very clear and informative chart that outlines how to tell the difference between the two disorders.

Here are some of the differences, according to Miller: (See Sensational Kids for a complete list of differences and for a very clear and comprehensive explanation of SPD.)
Acts Impulsively
Can stop impulsive behavior if sensory input is sufficient
Cannot stop impulsive behavior regardless of sensory input

Extraordinarily Active
Crave activity that is specifically related to sensation (usually vestibular and sometimes proprioceptive
Craves novelty and activity that is not necessarily related to specific sensations

Seems Disorganized
Looks more organized after receiving intense sensory input
Does not become more organized after receiving intense sensory input

Lacks Self-Control
Touches, pulls, and/or pokes people or objects; frequently seems to need more tactile input than most children
Tends to talk all the time, impulsively interrupting; has trouble waiting turn in a conversation.

Has difficulty focusing attention
Often in a daze; seems not interested in material enough to focus on it
Interested, but makes careless mistakes; focus gets diverted easily

Does not follow directions well
Unaware of directions being given; has trouble discriminating sounds or has difficulty with motor planning and thus appears to be not following directions
Gets started, but has difficulty remembering or following through on a long list of verbal directions; no motor component contributes to difficulty with directions

I highly recommend reading this book, especially if you suspect your child might have sensory issues. And if you wonder whether your child actually has ADHD or some other disorder, this book might be a good place to start.


Pseudonymous High School Teacher said...

I found your post fascinating. My son is 17 and had struggles for most of his life with impulsive behaviors and difficulty focusing.

Evenspor said...

Great post. Thanks. I'm going to have to link to this.

danette said...

Great post, the confusion between the two is part of why SPD awareness is so important.

I think for a lot of medical professionals it's a case of "if your main tool is a hammer, everything looks like a nail." They're not always familiar with SPD and they don't go searching for alternate possibilities.

A lot of ppl have suggested to us over the years that our twins have ADHD and I suppose it's possible that they have that too but they definitely have autism / SPD and so far the hyperactivity seems to be related to that...

@jencull (jen) said...

My son has autism/spd and he really doesn't have ADD/ADHD, I just know. It never crossed my mind that ADHD and SPD could be mixed up, they just are so different but I guess I am looking at it from the inside out. Our son was diagnosed by multi-dis assessment so that is probably better than a Paed, it can give a more focused diagnosis? Wow, that is a big error for a child to have to endure!!


Sarah said...

Fantastic post Patty and we are dealing with this very same thing with Jack. For the first time, he now has a sensory diet written specifically for his needs at school and staff will be held accountable for it because it is part of his IEP. I fought with his "team" last year over their insistence that ADHD was the crux of his problem---I have held firm that I won't put him on a stimulant until we have exhausted all other means....

I think you may have found another calling for yourself :)

Mrsbear said...

That's good information, Patty. I know my neighbor's daughter struggles with some of this stuff, but as far as I know they haven't really put any efforts in to putting a name to some of her challenges. A lot of times, I think they assume it's just bratty behavior. But it's more than that, I just wouldn't even know how to begin suggesting they get her evaluated. I think part of it too is fear of having to put their 7 year old on meds or even just getting a diagnosis I'm sure is scary.

Danette said...

I like your list of differences between ADHD and SPD. I have referenced your article in my newsletter to my website followers. Thanks for the info!