This is an interesting thread.
I do definitely believe that some people have acuteness of senses that others lack, which can be truly troublesome to them (that is, I am not dismissing the real problems people have).
At the same time, I would like to see some real scientific testing to define the parameters of SPD and the science of how it works. I have not been able to find any credible scientific writing about this type of disorder. Until it's understood or at least well described as a phenomenon in the peer-reviewed literature, what can they put into the DSM?
I also personally don't think that most occupational therapists have enough education to provide a diagnosis. Unlike PTs, who need a really intense master's degree, in many places OTs can practice with a bachelor's degree; for me, that's not enough education when you talk about differentiating disorders that may look very alike. Discernment requires education.
And as far as I can see in my own community, SPD is diagnosed almost exclusively by OTs, which also drums up business for them to treat the people they have diagnosed. This is a real red flag for me.
DeeDee
DeeDee and others who may desire more information on OT and SPD:
The SPD Foundation focuses on continuing the work of A. Jean Ayres, OTR, PhD, who first published research on what she called sensory integrative dysfunction in 1972. Her book should be read by anyone looking to gain a deeper understanding of sensory integration theory:
http://www.amazon.com/Sensory-Integ...mp;ie=UTF8&qid=1280546985&sr=1-6Dr. Ayres also wrote a book for parents and laypeople to better understand sensory integration which is a bit easier to read. I recommend it to all the parents I work with:
http://www.amazon.com/Sensory-Integ...mp;ie=UTF8&qid=1280546985&sr=1-1The SPD Foundation has a library of research and related articles on SPD that you can review as well:
http://www.spdfoundation.net/library.html#researchThe American Occupational Therapy Association also has resources on theory, intervention and research related to sensory integration, including a compendium of recent scholarly publications related to SI:
http://www1.aota.org/shop_aota/prodview.aspx?TYPE=D&PID=842&SKU=1248As an OT I am trained and qualified to assess a person for functional skill deficits that result in impairments in occupational performance. Occupational performance tasks for a child include activities of daily living (eating, dressing, bathing, toileting, etc), play, academics and/or school, and social roles (peer, parent/child interactions). OT practice involves using task analysis to determine what impairments or obstacles are present that limit the person from successful participation in daily activities. We then provide interventions that address the impairments (direct interventions, environmental adaptations, training and education of patient/family, etc) to achieve the goal of more successful participation in meaningful roles and occupations.
As an SI trained OT I am fully qualified to assess a child's performance and determine if there are clinical signs that suggest the presence of sensory integrative dysfunction which is impacting on functional performance. OTs are NOT qualified to "diagnose" a child with a sensory processing disorder since there really is no such "diagnosis." Only when, and if, it is officially entered in the DSM can ANYONE label a child with SPD as a diagnosis. Until then it is only description of a cluster of symptoms which fits Dr. Ayres' descriptions of sensory integrative dysfunction. Funny thing is though, I often receive prescriptions from doctors for a child to have an OT evaluation and treatment with the "diagnosis" listed as "sensory issues," "sensory disorder," or "sensory based movement disorder" among other descriptions.
In terms of your phrase "acuteness of senses" I am assuming that you are referring to sensory sensitivities. This is but one subtype of SPD as described by Lucy J. Miller, OTR, PhD, in her book The Sensational Child. Children often present with more than one subtype of SPD and can have a combination of modulation disorders (over or under responsive to sensory information) and motor disorders that are the result of poor sensory processing. It is very important to understand that SPD presents in different ways. It is much more than just tactile defensiveness. And sometimes doesn't even include sensitivity to tags or socks!
Sensory integration theory and treatment is based upon the integration of vestibular, proprioceptive and tactile processing, with auditory and visual systems more recently being investigated. But that is the topic of my next post.
