Intervention for adults who have sensory processing disorders
Posted Jan 14 2009 8:57pm
I received this email today, and I thought it was a great question:
I am an adult who has Sensory Integration problems that were diagnosed three years ago. I also have central auditory processing disorder and was recently diagnosed with Asperger's. I have had some OT in the past for the SI difficulties, and was wondering if you knew of services for adults with these problems.
Sensory integration refers to an 'unseen' process that has not yet been clinically defined - people have suggested that it may be a neurochemical problem, or perhaps a neuromigrational problem, or perhaps something else entirely. However, occupational therapists are claiming that it is SOMETHING that has to do with neurological processing - a lot of current research is looking at sympathetic and parasympathetic sensory processing of information.
There are also some occupational therapists who claim that the prevalence of SPD can be as high as 5% (in the 'normal' population), and I have seen this number posted around the Internet, but have not been successful in finding any source documentation for this claim. The prevalence may be higher in populations of people who have other developmental disabilities.
So you see the problem here is that we have a relatively undefined problem that is occuring with a relatively undefined prevalence - and there does not seem to be face validity to the concept that 5% of all adults are walking around with some kind of sensory processing problem. The problem seems to be notable in children but why does it seem to mediate with age/maturity? Is it likely that if there was some structural neurological problem that it would all just 'disappear' with age?
Now I don't doubt that some people process sensory information differently than other people. I also don't doubt that people have different learning styles and different neuropsychological profiles that cause them to have strengths and needs in relation to their abilities. I am not sure that these all represent some distinct clinical disorder.
I spent quite a bit of time researching sensory processing abilities of adults, and I even spent some effort in trying to link sensory processing patterns with known neurophysiologic patterns of hypersensitivity (complex regional pain syndrome). I found that adults who had complex regional pain problems all had differences in the way that they processed sensory information but that those differences were not in the directions that one might expect (toward hypersensitivity, for example).
Yes, I am guilty of not attempting to publish my own doctoral work (perhaps I will someday, with a larger sample). Very little else has been published about adult sensory processing disorder. For as little as we know about sensory processing problems in children, we know even less about whether or not this is an issue that carries through to adulthood.
Now I know that I will undoubtedly get emails from some people who are 'treating' adult SPD and they will provide evidence that they learned about it from a video or from some newsletter that is not peer-reviewed. I will state in advance that I can't consider these as adequate resources of information.
So for people who receive this 'diagnosis' I encourage them to sit with their occupational therapist and discuss what the functional problems are that are interfering with daily life functioning. I would encourage people to use tried and true (and evidence based) interventions relating to anxiety control, situational coping, and stress management. Simple behavioral techniques can provide structure and sameness that can help ameliorate problems with sensory modulation. Education about activity participation and organization/planning around potential 'triggers' or 'stressors' also seems to be pragmatic and functional.
Please note that none of these interventions denies the presence of anyone's sensory processing disorder. Rather, I am just encouraging the use of rational intervention that is time limited, functionally based, and directly oriented to the individual's problems.
I would also strongly discourage anyone from trying unproven 'sensory' interventions that involve 'brushing' or 'deep pressure protocols,' 'therapeutic listening,' 'Brain Gym,' or whatever else happens to be popular at the moment.
I am interested in anyone else's ideas on this topic, and will graciously publish all comments in full.