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    Joined: Jun 2011
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    petunia Offline OP
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    Hi, all, this is a bit of a follow up to my post "Gifted and ADHD". I've been reviewing the results from the school's assessment. My husband and I filled out a Sensory Profile that is grouped into three sections: Sensory Processing, Modulation, and Behavioral and Emotional Responses. Typical performance (TP) corresponds to scores at or above 1 standard deviation from the mean; Probable difference (PD) is at or above 2 SD below the mean; Definite Difference (DD) is below 2 SD below the mean (lowest 2%). This is indexed in relation to age-related peers. My son (now 11) was 10.8 at the time. Here are the scores:

    Factor Summary
    1. Sensory Seeking: 53/85 DD
    2. Emotionally Reactive: 33/80 DD
    3. Low Endurance/Tone: 22/45 DD
    4. Oral Sensory Sensitivity: 33/45 TP
    5. Inattention/Distractibilty: 18/35 DD
    6. Registration: 21/40 DD
    7. Sensory Sensitivity: 13/20 DD
    8. Sedentary: 8/20 DD
    9. Fine Motor/Perceptual 10/15 TP

    Section Summary
    A. Auditory Processing: 20/40 DD
    B. Visual Processing: 35/45 TP
    C. Vestibular Processing: 43/55 DD
    D. Touch Processing: 47/90 DD
    E. Multisensory Processing: 23/35 DD
    F. Oral Sensory Processing: 46/60 TP

    Modulation
    G. Sensory Processing Relating to Endurance/Tone: 22/45 DD
    H. Modulation Related to Body Position and Movement: 45/50 TP
    I. Modulation of Movement Affecting Activity Level: 17/35 DD
    J. Modulation of Sensory Input Affecting Emotional Resposes: 9/20 DD
    K. Modulation of Visual Input Affecting Emotional Responses and Activity: 9/20 DD
    L. Emotional/Social Response: 45/85 DD
    M. Behavioral Outcomes of Sensory Processing: 15/30 DD
    N. Items Indicating Thresholds for Response: 9/15 TP

    (That's a lot of DDs!)
    The above indicate that son is experiencing difficulty with sensory processing at home. A teacher completed the Sensory Profile School Companion and everything came up Typical Peformance.

    Summary: Scores on the SPSC indicate that son is not demonstrating sensory processing difficulties in the school environment. However, the Sensory Profile indcates that he does struggle in the home environment in several areas. Given this, he is managing quite well at school and able to attend and participate academically. The teacher noted that he appears ".. a little socially immature but works well with others and is making good grades". Note: He is grade skipped and two years younger than many classmates.

    So, that's a lot of information and I don't know what to make of it. Sometimes I think that the rating scales my husband and I fill in are biased by our frustration, exhaustion, and impatience with him. Other times, I think we see best what the issues are. So, I don't know how to take this.

    I referred in my post "Gifted and ADHD" that he could have ADHD or ASD but rereading this report, I'm wondering if we need to have the sensory stuff looked at first.

    Can anyone shed any light on this? Give me ideas on where to go from here? What does any of it mean? I don't understand half of the categories. Why is he so different at home and at school? Is he using his high intelligence to help him compensate? We have an appointment with a neuropsych but not until June. I really need to do something before then as we are all frustrated and my son seems to be getting depressed ("I hate myself", "I'm so stupid", "I hate you; go away" - talking not to us but "whatever it is that makes me this way".)

    Thanks again for your input and insight and suggestions and comments.

    Last edited by petunia; 11/15/12 11:56 PM. Reason: fixed typos

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    Sensory stuff is, to my mind, a symptom/comorbid not a cause. Remediation via OT and careful activity choices helpe my DD a lot. Not enough, so THEN we admitted the likely ADHD/ASD and wet seeking help, but it's hard enough to diagnose a gifted, high functioning / borderline kid without having done the therapy they will recommend BEFORE attempting diagnosis. So my advice to myself 3 years ago would have been - don't put the cart before the horse.

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    His statements remind me of my DS8 last year, and my god it's depressing and scary!

    I would really recommend finding a counselor/therapist in the mean time. A third party, that your kiddo can talk to/unwind with and can maybe help give you some ideas on how to help him.


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    Originally Posted by petunia
    Why is he so different at home and at school? Is he using his high intelligence to help him compensate?

    Probably. My DS8/gr3 has a history of sensory issues (he would have had lots of DDs as well). He would do his very best to behave in class and then turn into a hurricane as soon as he left the school.

    He has "severe" combined type ADHD. His sensory issues were present at home and the classroom, but as he's gotten older they've faded away (he's never been medicated - we haven't ruled that out but he just hasn't been that challenged or deficient). Last year in grade 2 two he would BURST out of the school like a human hurricane after holding himself together during class time. This year he saunters out like the other kids and on a recent SNAP-IV filled out by his teacher, all of his impulsive/hyperactive/sensory behaviours have disappeared, leaving only inattentive as his challenge.

    Note - my DS isn't grade skipped like yours, although he is in French immersion. Isn't it interesting, though, that their behviours change with their environments.

    Fyi, re discussion about the sensory stuff (which presented early on with our DS and was problematic in KG & grade 1), the school went right to ASD. To make a long story short, he's been seen by numerous professionals (including a full psycho-ed assessment done by a psychologist) and the general consensus seems to be ADHD (the psychologist said no way to ASD). The school still says yes to ASD, so we're wait listed for yet another opinion.

    Anyway, the sensory stuff was like this huge, blaring siren for me, but none of the doctors thought much of it. Sure enough, the behaviours have faded.

    What kinds of behaviours does your son engage in? Mine was a chewer (EVERYTHING went in his mouth... the other grade 1 kids wouldn't play with him because he was "yucky" and destroyed so many shirts). Gum has solved this (fyi, he's never had a cavity). Now he's orally very typical.

    He also used to love to run and crash into things, as well as jump and land on his knees (shudder). He swore it never hurt. He has this obsessive need to run, as well. He's never been a climber, but anything that could be jumped on was fair game. We exercise him a lot (walking, running, skating, gymnastics, swimming) and this has also improved.

    Anyway, there are/were so many more behaviours... (spinning was another huge one) I could write a novel... but basically a) the sensory stuff seemed to be ignored by our doctors, and b) I just give him outlets for it, and it's drastically improved.

    (When I say "seemed to be ignored" I mean he's never been diagnosed with SPD.)

    I don't know if that helps. Imho, whether sensory issues are from SPD, ASD or ADHD, the "treatment" is still the same.

    My feeling about sensory issues is to get the child moving and active, and get his senses what they crave. (Fyi my DS has had the emotional stuff too, which again is improving with age and lots of talking together).


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    Originally Posted by petunia
    I referred in my post "Gifted and ADHD" that he could have ADHD or ASD but rereading this report, I'm wondering if we need to have the sensory stuff looked at first.

    No. I'd find a neuropsychologist who can look at all of it together.

    I say that because sensory processing differences are often part and parcel of ASD or ADHD; you might as well evaluate the whole set of issues rather than one part.

    Sensory processing, if looked at on its own, is usually evaluated by OTs, who are not qualified to evaluate for the other things you are trying to rule in or out. That's a good reason to see a neuropsych instead.

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    Sensory Processing Disorder was a big aha! moment for me with my DS now 9. Up through first grade he had a lot of trouble at school, keeping his hands to himself, the rough play and crashing that CCN mentions. For my ds once we recognized his sensory needs (we had him evaluated by an OT and he had therapy for this for about 6 months), things became more manageable, although he still has behaviors that drive me nuts (but like your son is able to "save" them for home now).

    Two things really helped our understanding. First, as a sensory seeker he literal craves contact so instead of punishing him or getting frustrated with him for this behavior we sought out alternative acceptable contact activities. Does your son enjoy sports? This has been fantastic for our ds. At the risk of appearing like the overinvolved sports parent, we keep him enrolled in something constantly because it just helps his overall mood and calmness. Even if sports isn't the thing for your ds, any kind of regular physical activity, especially things that involved pushing/hitting seem to help. And its not about aggressiveness but more like he has this need to feel his body make contact with something. He also really likes jumprope/shooting baskets/push-ups/sit-ups, things like that.

    The second observation that helped was that part of SPD is often being unaware of where your body is in space and difficulty gaging strength of contact. So DS used to have trouble with peers because he would bump into them (sometimes rather hard) and they would think he was doing it on purpose when he really just couldn't gage how far away he needed to be to get past. And since he is a seeking he would often hug or put his arm around his friends, but because he couldn't gage the strength of his movement he would do it too hard and they would feel like he was being aggressive rather than affectionate. Thankfully, this has significantly improved over time.

    Overall, the therapy helped some, but I think the big difference was our ability to recognize the source of the behaviors and to intervene differently. Instead of seeing it as aggression or misbehavior we saw that it was because of this physical need and his inability to regulate his movement. We were also able to explain this to him, especially as he got older, and that made a big difference. As he has matured he has developed more self control and is able to understand when and why he needs to turn to different activities (at 9 this still isn't perfect, but he has made tremendous improvements!).

    So, while in 1st grade I was a mess trying to figure out why my kid was in the office all the time and having meltdowns in class, now in 3rd grade his behavior at school is fantastic and I no longer live in dread of the phone call from the school. smile I also think that in 1st grade his intellectual needs were grossly ignored by his teacher which added an additional level of frustration for him in the classroom.

    And the last thing I wanted to say was that, for my DS there does not appear to be another diagnoses such as ADHD or ASD attached. All of the "ADHD" like behavior he exhibited seems to be explained by the SPD and he never really exhibited any ASD characteristics. So, unless there is something else specifically that would lead you to suspect those other diagnoses, it might be worth addressing the SPD first and seeing how much of a difference it makes. It used to be thought that SPD was only found in kids with these other diagnoses, but more recently they are suggesting that SPD does often show up on its own. It also seems to be related to giftedness along the lines of the physical overexcitabilities, etc. On its own, it may be dismissed as quirkiness, misbehavior or aggression though. And I think alot of kids and families learn to address it without really recognizing the disorder. I am pretty sure, for example, that my DH also has SPD but took up weightlifting in junior high as a way to fill the physical needs he had. I also have a pet theory that kids that sensory seekers are probably over-represented in football, wrestling, and sports like that! lol

    I totally feel your frustration with the behaviors, believe me. It is NOT an easy thing to deal with, especially if you have other children. But the bright side is that he IS able to control it at school. This shows maturity and significant self control. If you think about how much it must take out of them to keep it together during the day, it makes it a little easier to understand what's going on at home (but doesn't necessarily make it less frustrating in the moment!).

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    Originally Posted by CCN
    Anyway, there are/were so many more behaviours... (spinning was another huge one) I could write a novel... but basically a) the sensory stuff seemed to be ignored by our doctors, and b) I just give him outlets for it, and it's drastically improved.

    (When I say "seemed to be ignored" I mean he's never been diagnosed with SPD.)


    Also, when I was looking into this, my pediatrician told me that it is a relatively new area of study that is only recently making into medical school curriculums. She admitted to me that she knew very little about it, but seemed to see it as a legitimate issue so she was happy to refer us to an OT. So it is not unusual for doctors to miss it, especially since it can appear to be more of a behavior issue.

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    Originally Posted by LNEsMom
    Originally Posted by CCN
    Anyway, there are/were so many more behaviours... (spinning was another huge one) I could write a novel... but basically a) the sensory stuff seemed to be ignored by our doctors, and b) I just give him outlets for it, and it's drastically improved.

    (When I say "seemed to be ignored" I mean he's never been diagnosed with SPD.)


    Also, when I was looking into this, my pediatrician told me that it is a relatively new area of study that is only recently making into medical school curriculums. She admitted to me that she knew very little about it, but seemed to see it as a legitimate issue so she was happy to refer us to an OT. So it is not unusual for doctors to miss it, especially since it can appear to be more of a behavior issue.

    I think so... what you say makes sense: they see it as behavioural rather than neurological/medical. My DS also has the proprioceptive issues where he's not fully aware of those around him. This is one that we're still working on. Our sons sound very similar smile

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    petunia Offline OP
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    I'm back. CCN asked about his behaviors that led me to think about SPD. I found a SPD checklist online and had my son, my husband and I rate him. A "3" was "often" and so here are the ones that at least two of us scored a "3" for him.
    - fidget or fiddle with theings all the time
    - avoid amusement park rides that spin or go upside down
    - frequently tips chair on back two legs
    - restless when sitting through a lecture or presentation or movie
    - difficulty eating foods with mixed texture (can't eat applesauce, was 9 before he at Mac n Cheese "I want my noodles clean"
    - constantly biting or picking at fingers
    - seek out crashing or squishing activities (mainly with Dad so it may be a guy thing)
    - becomes overstimulated when people come to house or in crowded places
    - very high or very low energy level
    - avoids crowds
    - easily distracted by auditory or visual stimuli
    - cannot attend movies
    - loves to touch things (not so much now but when he was little, he had to touch everything)
    - difficulty locating items in a cupboard, drawer or closet
    - fearful of heights (so am I!)
    - difficulty remembering what is said to him
    - lethargic, hard to get going, appears lazy and unmotivated (he hides under the bed when he knows he should be working and isn't)
    - becomes engrossed in on esingle activity for a long time and seems to tune out the rest of the environment (especially with reading and video games)
    - gread difficulty settling body down for sleep or waking up in the morning (did you even hear your alarm? It's been going off for twenty minutes!)
    - handwriting hard to read and takes a long time
    - easily fatigued with physical tasks (enjoyed basketball but couldn't run up and down the court and asked to be taken out a lot to rest)
    - dislikes changes in plans or routinge
    - may be described as stubborn, defiant or uncooperative
    - can't seem to finish things
    - very emotional and sensitive
    - difficulty making decisions
    - rigid and controlling
    - prefers solitary activities, avoids groups
    - impatient and impulsive
    - trouble relating to peers
    - distractible and unorganized
    - difficulty falling asleep

    I know these aren't specific and we do have the appointment with the NP in June but I'm just trying to find ways to help us now. An OT evaluation is almost as expensive as the NP and my insurance won't pay for it. The school won't do it since the teachers don't see anything of significance at school.

    We've tried to get him to do more physical activities but he refuses. We've bought a basketball goal, trampoline, baseball rebounder, bike, balls, croquet set to get him interested. I'll send him out to jump on the trampoline for five minutes and look out and after 30 seconds he's sitting on the trampoline doing nothing. He rarely rides his bike. He loves playing baseball and going to baseball practice but won't get out and throw the baseball (which is ironic because one of his dearest wishes is to play catcher and the coach keeps telling him to practice his throwing and build his accuracy and he could the catcher but he won't do it). He also loves karate but doesn't practice it. We've even offered to pay him to practice but that doesn't work.

    I know there is something going on and I've been reading about SPD but it is very confusing. He doesn't seem to fit any of the categories. I'm so frustrated and he's so frustated. I am so tired of hearing "he's so well behaved" at other people's houses and at school. Over Thanksgiving, he spent a few days with my in-laws and they remarked when we showed up "he's a completely different kid when you aren't around". Makes me feel like a really good parent, right? Anyway, I know that only an OT or NP or someone can really give me answers but I'd appreciate your thoughts.


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    I'm not sure what you're reading about SPD, but I really liked the book Sensational Kids. Most people recommend The Out-Of-Sync Child, but I felt like that one had better descriptions.

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