Hyper-active. Loner. Picky eater. Troublemaker. Fussy. Downright klutzy.

Some children may be misunderstood and mislabeled because of their actions.

Therapists are finding that “bad-behaved“ children are often diagnosed with other related conditions such as ADHD or autism, when they may actually be suffering from a sensory issue or “sensory processing disorder” (SPD). Learn more about SPD and how sensory integration therapy is helping families attain peace in their homes.


A 3 year old screams and covers her ears any time she hears the sound of a lawnmower. A 5 year old vomits when she smells fishsticks cooking in the oven. A 6 year old runs on the playground, falls down, and cuts his knee – but fails to notice the pain. These odd behaviors likely baffle the children's parents, leading them to ask: “Is this behavior normal?”

It may be that the child has sensory processing disorder (SPD), a condition that exists when sensory signals aren’t responding appropriately. It prevents parts of the brain from receiving the information needed to translate sensory information properly – similar to a neurological “traffic jam”.

SPD can affect  a person in only one sense, such as just taste or in multiple senses – touch, movement, sound, sight, etc. A sensory issue will cause a person to either seek out strong sensations or avoid even mild sensations; thus, the reason for the strange behavior. This is often why ”hyperactive” children or ”withdrawn” children are misdiagnosed.

SPD is not commonly recognized by healthcare physicians. Unfortunately, typical activities like eating, dressing, riding a bike or making friends can challenge their daily lives. Fortunately, however, awareness of sensory issues has been spreading, for a number of years, among therapeutic modalities.

Recently, an increase of therapists have been identifying sensory-integration methods and techniques to help children struggling with daily activities such as buttoning a shirt, listening or accepting a hug. And, parents are finding solace in those who are aware of SPD and how to treat such as pediatric, occupational, and physical therapists.

A Sensory Stoplight

When Michelle Morris first learned that her son, Michael, was diagnosed with SPD, her mind was flooded with questions. For instance, she wondered: “What exactly [is] SPD? Is there something wrong with my son’s brain? Is it a disease? What causes it? Will he grow out of it? Is there medicine for it? Is it my fault? Do a lot of children have this? Do adults have it? Can he get better? How can I help him? A thousand questions, a thousand fears.”

Morris discovered that SPD is a complex brain syndrome that affects the way people process sensations in touch, taste, smell, sound, sight, movement or body awareness.

She is just one of many parents who is grateful for the study and research that Lucy Jane Miller, PhD, OTR, has been doing at the Sensory Therapies and Research (STAR) Center, located just south of Denver. Miller is the director at STAR Center and executive director of the SPD Foundation.

“Our uniqueness,” says Miller, is “based on an emphasis of parent learning, mentorship programs for OTs to be personally guided by PhD-level mentors, a combination of OT and listening therapy three times a week to ‘jump start’ client development, a research program that all [patients] participate in, as well as research and education.”

The research/therapy team at STAR treats disorders and conditions such as ADHD, dyslexia, auditory-processing disorders, autistic spectrum disorders, and more.

However, the facility specializes in occupational therapy with a sensory-integration approach for children and adults with sensory issues. For the past 30 years, Miller has been working toward a personal goal inspired by Jean Ayres, PhD, OTR.

An occupational therapist and neuroscientist, Ayres is nationally renowned for discovering that children suffered from a misunderstood disability – a neural disorder that resulted in inefficient organization of sensory input received by the nervous system. It was through Ayres’ pioneering work that Miller decided in the ‘70s that she would spend her life promoting the understanding, accurate diagnosis, and effective treatment of sensory-integrative disorders.

In her recent book Sensational Kids: Hope and help for children with sensory processing disorder, (Penguin, 2006), Miller provides insight for many parents – like Morris – who don’t understand the yelling, hitting, and tantrums being thrown by their kids at the dinner table each night.

A Sensational Kid: Lillian

No parent wants to receive a call from their child’s teacher informing them that their kid has been displaying inappropriate behavior at school, but this was an all-too-familiar scenario for Kathy Martin.

Martin says that she was “frequently called into school to pick her up or meet with [Lillian’s*] teachers to address her behavior issues. One [teacher] even asked if we had put her on medication,” she says. ( * Denotes a change in the original name for privacy.) “I wanted to take offense to this, but then I realized how different my child truly was.”

Her daughter’s preschool teacher relayed to Martin how she noticed that Lillian would get frustrated easily when she played with her peers – and, she often lashed out or hit other classmates.

Unfortunately, her behavior at home wasn’t any different. Lillian’s speech was slow, and she still had difficulty talking with others or following her teachers’ directions. Lillian also had frequent meltdowns during class activities. At this point, Martin says, the outbursts would last 20 to 30 minutes; it was extremely difficult to get her calm down – both at home and at school.

“We took our concerns to a child psychiatrist and she didn’t seem to think anything was wrong,“ she says. According to Martin, when Lillian was born, she weighed a meager 1 pound, 9 ounces. Lillian didn’t sit, walk or achieve the usual milestones like other children her age.

When she entered school, she was older than most kids in her class. “[The psychiatrists’] feeling was that she would socially/emotionally catch up with the other children,” says Martin. In the end, the psychiatrist gave the Martins some parenting advice and told them to follow up if the problems continued.

Sadly, the problems did not subside.

Martin noticed that even though Lillian displayed a strong vocabulary, she struggled with motor-planning skills. As she aged, says Martin, “It was impossible for her to ride a tricycle, and she became incredibly frustrated every time she attempted any skill that required complex movements.”

The Martins searched for the “right” diagnosis to explain the reason for their child’s behavior. Kathy and her husband, Mark, read studies and medical reports, but Lillian’s symptoms didn’t seem to correlate with the many descriptions, titles, and disorders – until they read an article discussing SPD, that is.

After countless hours of researching symptoms online, she came across an article about SPD, along with Miller’s name. After reading Sensational Kids, Kathy says that everything began to fall into place.

Convinced that her daughter suffered from sensory issues and unsure of how to address them, she phoned the STAR Center and made arrangements to have Lillian enrolled in an intensive therapy program along with diagnostic evaluations.

A Shining STAR

“When [Lillian] came to the STAR Center, she was a tiny, engaging little girl with two loving and supportive parents,” says Lynn Witzen, MA, OTR, supervisor of OT services. Although Lillian seemed motivated to try activities, her disorganization was profound and resulted in poor completion of play activities.

“Her gross motor difficulties challenged her, as well,” says Witzen, “so much, that she fell when running or trying to walk fast.”

When they attempted standardized testing, Lillian was unable to pay attention to complete specific tasks, and “[she] could not hold a marker or crayon long enough to complete more than a scribble,” Witzen says.

Lillian also demonstrated significant sensory processing issues. She did not accurately detect or interpret sensory input  – sound, touch, visual stimuli or information from her muscles or movement/position in space information.

Lillian completed two weeks of therapy for five days a week, and went through intensive occupational therapy, combined with integrated listening therapy, to address the underlying sensory processing impairments for the first five days.

In addition, every evening Lillian and her parents worked on applying the strategies. “By the end of the first two-week course of treatment, she was tired and ready to return home for a break,” says Witzen.

When Lillian returned to the STAR Center after a two-week period, she completed one final week of treatment, and that’s when her mother noticed improvement in all areas addressed as goals before therapy began.

After one more week of intense therapy, it was time to attempt the Center’s usual standardized post-treatment testing. The results: “[Lillian’s] final standardized testing abilities were remarkably different than her incoming assessment,” says Witzen.

In addition, Witzen says, “She held a marker and completed tasks at a much higher level than [during] the initial assessment. She completed the entire standardized test, and testing included the Miller Function and Participation Scale. [Lillian] demonstrated a change of more than two standard deviations (~ two years) in fine motor and visual-motor performance. It was an amazing gain for such a short time.“

No More "Meltdowns"

Since the completing therapy at the STAR Center, Lillian no longer has meltdowns, and she has been much more successful in school. For instance, she can sit still longer, stay focused, and she socializes more appropriately with her classmates. Also, “[Lillian’s] teachers noticed a huge difference between the child that started with them and the child that came back from Denver,” says Martin.

Lillian still has challenges, but overall, she has made amazing gains in therapy. Martin says, “We are extremely grateful to the STAR Center and everyone who took a personal interest in our daughter. I couldn’t imagine what road we would have been facing, or what her life might have looked like had we not been able to obtain their help and knowledge.”

“The changes [in Lillian] are amazing, to say the least,” she adds. And, just this spring, says Martin, Lillian made even more progress – she rode a bike for the first time.
 

— Haley K. Jestice is a staff writer for Therapy Times. Questions and comments can be directed to hjestice@therapytimes.com.