Sensory Processing Disorders

Growing up, every kid’s birthday party involved soda, pizza and lots of noisy, screaming children.  I remember a child who always stood apart—literally.  He avoided the raucous crowd.  He couldn’t stand the taste of soda pop or anything carbonated, and the melted cheese on pizza made him gag.

He had other quirks—the loudness of the toilet flushing would send him running from the bathroom, he never particularly enjoyed sports, and he could never wear corduroy pants because he hated the sound they made when walking and the way they felt on his skin.

  His parents often got upset when he would seem not to listen to them.  At school, he would always seem “spacey,” ultimately leading to a diagnosis of attention deficit disorder. 

He grew into a high-functioning adult.  Most of the sensitivities he had as a child went away.  His distaste for crowds remained, though, and to this day, he cannot stand being in a shopping mall for more than a few minutes at a time.  He needs to take regular breaks during social events to step outside and be alone for a while.  

What Are Sensory Processing Disorders?

Did this kid have a diagnosable problem?  Or was he just a little strange?  Could he have benefitted from treatment?  

Just how sensory processing disorder (SPD) should be defined is a big question.  Thousands of parents have recognized symptoms similar to my friend's in their own children.  Some recoil from loud noises or refuse to wear certain clothes.

  Others have the opposite problem, where they show little reaction to pain, and may constantly seek sensory stimulation through loud music and constant activity.  These children often seem spacey, may be bad at sports, and can be very picky about foods.

Sensory processing disorder is one term used to describe these children.

   A previous term was sensory integration disorder.  Neither term, though is recognized by the mainstream medical community. 

In 2012, the American Academy of Pediatrics stated that it was unclear whether children with sensory problems actually had a distinct disorder, or rather some combination of autism, ADHD and/or anxiety.  There was no mention of sensory processing disorder as a distinct entity in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM V), which instead lumped sensory processing in with autism spectrum disorders. 

But while many kids with autism do have problems with sensory processing, many children with sensory hypersensitivity or hyposensitivity have no other sign of autism. People with autism usually lack some social ability.  My friend was very good with people, and enjoyed them, so long as they didn't arrive in overwhelming crowds.  In smaller social settings, he was a fun, interesting, and, well,  sensitive guy. 

Why the Controversy? 

Some suspicion about the diagnosis of sensory processing disorders stem from existing therapies across the country.  Parents can pay hundreds of dollars to have their child learn “sensory integration” techniques, such as playing with shaving foam, spinning in slings, or play with several brightly colored toys at once.  Little evidence supports such techniques, and some believe them to be pure quackery.  It is easy then to extend that belief towards the diagnosis of a sensory processing disorder altogether.  Cynics can easily view the diagnosis as the invention of people looking to make money off credulous and sometimes desperate parents. 

Beyond just taking advantage of people, pursuing false diagnoses can distract from actual diagnoses such as anxiety, autism or ADHD, symptoms of which often overlap with the purported symptoms of SPD, which then go untreated.  On the other hand, if SPD is real, children could be receiving treatments for these disorders despite not actually having them.

There’s also a sense of wariness at labeling children with yet another diagnosis we don’t fully understand.  ADHD was rampantly over-diagnosed for a period of time.  Why can’t we accept some “strangeness” as part of a normal childhood?

It is true that many of the symptoms of sensory processing disorder seem universal, including picky eating, difficulty listening, or difficulty falling asleep.  What child doesn’t have this?  How can any rational person not be skeptical of the need to treat someone who has such symptoms with therapies costing thousands of dollars?

What’s the Evidence?

There is some more solid evidence that SPD is a distinct disorder.  For example. MRI studies suggest that those identified as having a sensory processing disorder have different wiring than other children, including those with autism.  Briefly, while the white matter changes in sensory pathways were similar, social emotional pathways were only impacted in autism, not in sensory processing. 

Even if there is growing evidence that SPD is a distinct disorder, however, this does not necessarily mean the treatments targeting the disorder are actually effective.  More good studies are needed to thoroughly understand people who fall into this spectrum. 


Yi-Shin Chang , Julia P. Owen, Shivani S. Desai, Susanna S. Hill, Anne B. Arnett, Julia Harris.Autism and Sensory Processing Disorders: Shared White Matter Disruption in Sensory Pathways but Divergent Connectivity in Social-Emotional Pathways.  PLOS ONE. July 30, 201 DOI: 10.1371/journal.pone.0103038

Elysa J. Marco.  UCSF Memory and Aging Center Grand Rounds, San Francisco, California September 25, 2015. 

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