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talk to me about SPD


ktgrok
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My son is 11, and has always had anger/behavior issues. He gets violent and hits wall, punches his hand, bangs his head on things, etc. Or he hides and curls up in a ball. He had other issues when younger, mostly hypersensitivities, but that got better. but today I looked a a checklist for SPD and realized he had EVERY single symptom listed for sensory seeking behavior, in the category of proproceptive disorder. Could this be what is causing these behaviors? And can it be fixed/helped? Could SPD also explain why he doesn't like to speak to adults he doesn't know, or make eye contact with them?

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My son is 11, and has always had anger/behavior issues. He gets violent and hits wall, punches his hand, bangs his head on things, etc. Or he hides and curls up in a ball. He had other issues when younger, mostly hypersensitivities, but that got better. but today I looked a a checklist for SPD and realized he had EVERY single symptom listed for sensory seeking behavior, in the category of proproceptive disorder. Could this be what is causing these behaviors? And can it be fixed/helped? Could SPD also explain why he doesn't like to speak to adults he doesn't know, or make eye contact with them?

 

I would say that it could, but it could also be something else different or along with the SPD. I would try to set up a full evaluation with him---occupational therapy for the SPD and then either a pediatric neuropsychologist, developmental pediatrician, psychiatrist, etc. I would also ask your doctor for a full physical and blood work for blood sugars, anemia, thyroid, etc. as those things can affect behavior as well.

 

My daughter was in therapy for sensory issues and it helped some but her real underlying issue was bipolar. Once we treated that with medication most of the sensory stuff went away.

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He has an appointment with his regular pediatrician next week for a checkup, and I emailed the doctor a letter about what is going on with him. How awful is it that I am terrified to try to get blood from this kid? He really should have it done, he has always been underweight and I worry about nutritional deficiencies....but he is afraid of needles. We selectively vaccinate so he has had very few...the last injection he had was in 1st grade when he was so dehydrated and sick that he couldn't fight it. But now...at 11.....I don't even know if he would let us.

 

sigh.

 

katie

 

I would say that it could, but it could also be something else different or along with the SPD. I would try to set up a full evaluation with him---occupational therapy for the SPD and then either a pediatric neuropsychologist, developmental pediatrician, psychiatrist, etc. I would also ask your doctor for a full physical and blood work for blood sugars, anemia, thyroid, etc. as those things can affect behavior as well.

 

My daughter was in therapy for sensory issues and it helped some but her real underlying issue was bipolar. Once we treated that with medication most of the sensory stuff went away.

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My son is 11, and has always had anger/behavior issues. He gets violent and hits wall, punches his hand, bangs his head on things, etc. Or he hides and curls up in a ball. He had other issues when younger, mostly hypersensitivities, but that got better. but today I looked a a checklist for SPD and realized he had EVERY single symptom listed for sensory seeking behavior, in the category of proproceptive disorder. Could this be what is causing these behaviors? And can it be fixed/helped? Could SPD also explain why he doesn't like to speak to adults he doesn't know, or make eye contact with them?

 

There is currently disagreement among professionals about whether SPD is a stand-alone diagnosis. Most think it is not. SPD is part of many other conditions, such as ADHD, autism spectrum, etc. (I once thought ds had only sensory integration issues. Now I know that he has several specific learning disabilities and ADHD as well. That type of thing has happened to some others I know who once thought SPD was the only issue.)

 

SPD would not in and of itself lead to anger issues. However, punching the wall, banging his head, etc. give intense proprioceptive input (input from muscles and joints) , which is has a calming, organizing effect on the neurological system. So though they look like manifestations of anger (and are), they are paradoxically also responses which are primitive coping mechanisms for anger as well. The curling up in a ball would not be characteristic of a stimulus-seeker but of a stimulus avoided--and it sounds like it happens when he's overwhelmed with emotion rather than environmental sensory input. My ds had eye contact issues before OT--he was *trying* to maintain eye contact and kept bringing his eyes back, but he couldn't keep his gaze fixed to hold eye contact. The fact that this is an issue with strangers is again, more of an emotional-social than a sensory issue.

 

On the general board, I commented that the way the therapist approached the first appointment for anger issues was appropriate. However, now reading that there are major SPD issues as well as social issues (eye contact), in addition to the anger stuff, I would continue with the therapy inasmuch as it can teaching coping skills (if that's her ultimate approach) but I would also look for a fuller eval for mood disorder or autism spectrum issues. You'd want a developmental pediatrician or neuropsychologist for this type of evaluation.

 

Also, given this additional information, I would make it my first proactive priority at home to make sure ds gets LOTS of heavy exercise, and to give him an acceptable alternative for getting proprioceptive input when he is angry--like a punching bag, being able to leave the house and go run hard, etc. Your basic mental health therapist is not as aware of physical issues such as SPD as cognitive-emotional issues, so this is something you may want to do on your own. Or, you could ask how familiar she is with SPD and if not, show her the list. If she's not super-familiar with it, you'll need to get separate treatment for those issues. OT will help some, but at his age, the improvement may not be as dramatic as for some younger kids ; however, OT's are usually really good at teaching work-around strategies and coping skills.

Edited by Laurie4b
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Ok, you've given me more to think about. ugh....a large part of me thinks i'm blowing this out of proportion and he's totally normal, just acting up. Another part of me thinks back to when he was a baby and couldn't get comfortable, and constantly squirmed and fussed and cried, and my mom kept telling me there was something not normal about him. (she said it nicer than that). So..there is a neuropsychologist in the area that takes my insurance. I guess I need to make an appointment? If he is totally normal will they think I'm crazy for bringing him there? If it is mostly SPD issues will they be able to identify that? I guess if nothing else they could reaffirm or give me more information on the non specific "processing speed disorder" that the educational pyschologist said he had, when she did his IQ testing years ago.

 

So...do I need to do this? I know my mother has been saying there is "something" going on with him, but he is sooooo sweet and normal and fun a good portion of the time. Could someone with some kind of problem be fun and outgoing some of the time, with his friends? With us? sigh. I just don't know.

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Reading Laurie4b's post made me think of the book Healing ADD by Dr. Amen. He discusses SPD as though it were an element of ADD. I just read that book and I had never thought of ADD in that way before. The copyright is around 2000. I thought perhaps his approach was outdated, but Laurie's post made me think that maybe it's not.

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There is currently disagreement among professionals about whether SPD is a stand-alone diagnosis. Most think it is not. SPD is part of many other conditions, such as ADHD, autism spectrum, etc. (I once thought ds had only sensory integration issues. Now I know that he has several specific learning disabilities and ADHD as well. That type of thing has happened to some others I know who once thought SPD was the only issue.)

 

I think this opinion is fairly controversial even among experts. Our neuropsych definitely feels SPD or sensory issues can be a stand alone diagnosis (defined as "anxiety issues" for insurance purposes) and that is indeed how he classified ds. We had him evaluated for a range of things including autism spectrum and we were told no on all but SPD/sensitivities.

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With the more information you have posted, you might want to check out early onset bipolar symptoms. Not saying this is a mood issue but it sounds a lot like my daughter before she was properly treated. Certainly a specialist is in order.

 

I would make a list of all concerning things--even from infancy and toddlerhood for the doctor as lots of little pieces help make the puzzle.

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My language wasn't very specific. By "is part of" I mean that it is found "in conjunction with" other disorders much (some think all) of the time.

 

The Sensory Sensitive Child is a good book by two psychs ( each of whom has a child with SPD. ) They give several case examples about how recognizing and treating the SPD component makes a difference in the overall functioning.

 

By treating the SPD issues in a kid with ADHD for instance, you may signficantly reduce the symptoms of what looked like only ADHD. I know for my child who was SPD and is dx'd with ADHD, he was hyperactive as all get out before OT for the SPD. He's been pretty normal as far as hyperactivity goes since then. He still has the working memory/attentional issues. A lot of OT type interventions can help his concentration.

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Ok, you've given me more to think about. ugh....a large part of me thinks i'm blowing this out of proportion and he's totally normal, just acting up. Another part of me thinks back to when he was a baby and couldn't get comfortable, and constantly squirmed and fussed and cried, and my mom kept telling me there was something not normal about him. (she said it nicer than that). So..there is a neuropsychologist in the area that takes my insurance. I guess I need to make an appointment? If he is totally normal will they think I'm crazy for bringing him there? If it is mostly SPD issues will they be able to identify that? I guess if nothing else they could reaffirm or give me more information on the non specific "processing speed disorder" that the educational pyschologist said he had, when she did his IQ testing years ago.

 

So...do I need to do this? I know my mother has been saying there is "something" going on with him, but he is sooooo sweet and normal and fun a good portion of the time. Could someone with some kind of problem be fun and outgoing some of the time, with his friends? With us? sigh. I just don't know.

 

I really think OT's do the best job of dxing SPD. So maybe you could make an appt with an OT and a neuropsych. Take the OT's report to the neuropsych so that it will be incorporated into the overall eval. (You'll have to go to an OT for treatment anyway).

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