Sensory processing disorders: fact or fiction?

I often get phone calls and letters asking, "Do you do sensory integration?" I thought as the year gears up for another nine months of school, explaining what is and isn't sensory integration would be very helpful as parents seek therapy and other therapeutic activities for their child.

Insurance companies often won't reimburse for it, some doctors have never heard of it, teachers don't understand it, and many parents use the words as a "mantra of the day."

It is very important that occupational therapists communicate just what sensory integration is so that parents, teachers, doctors, and others will not only hear, but also understand.

It is important to decipher fact from fiction.

Basic Facts

* Sensory disorders are real.

* They can happen in isolation or in combination with other sensory systems.

* They can distort the way we interpret our environment.

* Sensory disorders can be manifested in behavioral dysfunctions.

* Emotional reactions to sensory malfunctions are common.

* Symptoms such as behaviors, tasks, skills, etc. are more easily treated than sensory issues.

* They are often mistaken as "educational issues."

* They can impact memory abilities.

* Social skills can be altered.

* Left untreated, sensory disorders can lead to lifelong issues that have a global negative impact.

* These behaviors do not "look" like what they are. In other words, the child may look as if he or she is exhibiting resistive behavior, when actually the child is so disoriented they cannot discern what to do.

Popular Sensory Fiction

* If they try harder, they (the children) can get over it.

* It is all in their minds.

* They can control it if they want to.

* They are doing this for attention.

* These children are being manipulative.

* They cannot do things because they have marginal abilities.

* They do not need therapy to resolve this; all these issues can be handled in the school/class situation.

* It is an emotional disorder.

* This is something that occupational therapists "dreamed up" to get parents' money.

* Left alone they will "outgrow" these issues.

* There is no medical basis; it is all hypothetical thinking.

To counter these widely held "fictional realities," it is very important for the occupational therapist to understand the theory behind the therapy. It is crucial that there be a clear understanding of what and how our bodies receive and translate environmental cues. In order to do this, it is essential that OTs stay current with the latest neurological research. With the Internet, that is really not so hard to do. Many Web sites make this information readily accessible.

Some sites that I have found most helpful are:

* Medscape.com

* Cedars-Sinai Hospital

* Tel Aviv University Hospital

* Colleen Giblin Laboratories for Pediatric Neurology/Neurological Institute of New York 

* Children's Hospital of Pittsburgh

The ability of an OT to be able to tell a parent or teacher that a child with he or she is working is not processing the information readily and this is how you can tell is valuable information. It allows the parent or teacher to change the approach and to "buy into" the process, not as a "mechanic" but as a participant in the child's learning process.

So, now we have the understanding. How can it be communicated?

Key tools of communication are the evaluations that occupational therapists write. It is important to outline what was tested, why those (standardized and clinical) tools, and what they revealed about the child. These evaluations go to a myriad of professionals, and it is an OTs most valuable form of communication.

OTs, get yourselves invited to PTA meetings, faculty meetings, and make appointments with family doctors and pediatricians, to let them know who you are and what you do. Physicians can be hard to "nail down," but they almost always want to talk about a patient in their practice. So, if you are treating John in Dr. Smith's practice, call Dr. Smith and let him know how John is doing!!

Often insurance companies ask for clarification of services. How an OT writes that response will not only impact the family's reimbursement, but it can also educate the insurance company as to what occupational therapy is and how it is done.

The "power of the pen" is still a mighty tool that can be used not only to cut through red tape, but also to carve new paths of understanding.

And so, all puns intended: Righting oneself against the "winds of disbelief" is as important as writing about oneself to correctly communicate the needs and anticipated outcomes to therapeutically address sensory disorders.

Thanks for listening and reading!

--Susan

Susan N. Schriber Orloff, OTR/L, is the author of Learning Re-enabled, a guide for parents, teachers, and therapists. The book is featured by the National Education Association and is carried in the EP Bookstore (www.EPBookstore.com). Susan also writes "Ask the Therapist," this monthly column in Exceptional Parentmagazine and is CEO and executive director of Children's Special Services, LLC, an occupational therapy service for children with developmental and learning delays in Atlanta, GA. She can be reached on the Web at www.childrens-services.com or at [e-mail].