Post to BLOG I have been asked to support a diagnosis SPD.
As noted in the following article, there was an attempt to get SPD considered as a diagnosis in the DSM- 5 but it failed likely because SPD is part of other diagnoses but there were small gains toward recognition of SPD as a diagnosis.
"Sensory processing disorder (SPD) is reported to be highly co-incident with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs). However, it is also clear that children can have sensory processing dysfunction without the degree of attention, language, or social challenges that would meet criteria for ADHD or ASD. This has been referred to in the literature as isolated SPD. The Diagnostic Classification of Mental Health and Developmental Disorders in Infancy and Early Childhood includes a diagnostic label for Regulation Disorders of Sensory Processing (Zero to Three, 2005), but the Diagnostic and Statistical Manual 5 (DSM-V) does not include SPDs as a standalone category. They do now, however, include hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment in their revised ASD criteria. in "https://www.frontiersin.org/articles/10.3389/fnana.2015.00169/full
Note that in that article as well as the following one from the same authors in 2013 there is an "s" at the end of sensory processing disorders - a category not a diagnosis: https://www.sciencedirect.com/science/article/pii/S2213158213000776
With further research, it is possible that there will be several diagnoses.
From my understanding, OT's do not currently have the right to diagnose anything but in America, the minimum education level has risen to PhD and they are trying to get the right to diagnose along with that.
As far as I know, there is no benefit in terms of funding to get the SPD diagnosis, but DCD can be worthwhile because accommodations are officially documented.
It is important to not waste a client's benefits, out of pocket money, or tax payers money on a non-diagnosis. Therefore, it is essential to determine why this assessment is requested. If it is for school accommodations be sure to not use FSCD funding for that.
A sensory processing assessment such as the SPM questionnaire along with observations about how the issues interfere with function is adequate to indicate the child has sensory processing issues. Your report can be valuable without diagnosis because it will specify accommodations and strategies that are not the same as for other kids.
I find the m-ABC assessment valuable for supplementing the DCD-Q parent questionnaire. Especially, in combination with observations on the fluidity of movement which is often very poor on novel tasks such as jumping over a low string. Even better would be observational assessment based on Mary Kay Benson's informal assessment of motor planning.
Your report will need to be carefully worded and sent to someone who does diagnose. The child's doctor can diagnose DCD based on your report which will make statements such as "... consistent with a diagnosis of DCD." Do not get rushed into anything. Diagnosis should always be a careful thoughtful, drawn out process so it reflects a stable deficit requiring a long term plan.
My recommendation is as follows:
if the DCD-Q comes back as Definitely Different (>2 standard deviations from the average) then
... offer to assess further to support a DCD diagnosis. Your report summary may also include a statement of “severe sensory processing issues" and “based on these, extensive accommodations" and/or "individualized, multidisciplinary team support" depending on who it is for.
Post to BLOG
ReplyDeleteI have been asked to support a diagnosis SPD.
As noted in the following article, there was an attempt to get SPD considered as a diagnosis in the DSM- 5 but it failed likely because SPD is part of other diagnoses but there were small gains toward recognition of SPD as a diagnosis.
"Sensory processing disorder (SPD) is reported to be highly co-incident with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs). However, it is also clear that children can have sensory processing dysfunction without the degree of attention, language, or social challenges that would meet criteria for ADHD or ASD. This has been referred to in the literature as isolated SPD. The Diagnostic Classification of Mental Health and Developmental Disorders in Infancy and Early Childhood includes a diagnostic label for Regulation Disorders of Sensory Processing (Zero to Three, 2005), but the Diagnostic and Statistical Manual 5 (DSM-V) does not include SPDs as a standalone category. They do now, however, include hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment in their revised ASD criteria. in "https://www.frontiersin.org/articles/10.3389/fnana.2015.00169/full
Note that in that article as well as the following one from the same authors in 2013 there is an "s" at the end of sensory processing disorders - a category not a diagnosis: https://www.sciencedirect.com/science/article/pii/S2213158213000776
With further research, it is possible that there will be several diagnoses.
From my understanding, OT's do not currently have the right to diagnose anything but in America, the minimum education level has risen to PhD and they are trying to get the right to diagnose along with that.
As far as I know, there is no benefit in terms of funding to get the SPD diagnosis, but DCD can be worthwhile because accommodations are officially documented.
It is important to not waste a client's benefits, out of pocket money, or tax payers money on a non-diagnosis. Therefore, it is essential to determine why this assessment is requested. If it is for school accommodations be sure to not use FSCD funding for that.
A sensory processing assessment such as the SPM questionnaire along with observations about how the issues interfere with function is adequate to indicate the child has sensory processing issues. Your report can be valuable without diagnosis because it will specify accommodations and strategies that are not the same as for other kids.
I find the m-ABC assessment valuable for supplementing the DCD-Q parent questionnaire. Especially, in combination with observations on the fluidity of movement which is often very poor on novel tasks such as jumping over a low string. Even better would be observational assessment based on Mary Kay Benson's informal assessment of motor planning.
Your report will need to be carefully worded and sent to someone who does diagnose. The child's doctor can diagnose DCD based on your report which will make statements such as "... consistent with a diagnosis of DCD." Do not get rushed into anything. Diagnosis should always be a careful thoughtful, drawn out process so it reflects a stable deficit requiring a long term plan.
My recommendation is as follows:
if the DCD-Q comes back as Definitely Different (>2 standard deviations from the average) then
... offer to assess further to support a DCD diagnosis. Your report summary may also include a statement of “severe sensory processing issues" and “based on these, extensive accommodations" and/or "individualized, multidisciplinary team support" depending on who it is for.
Charlene Wright
Occupational Therapist
Charlene@otyyc.ca
403 277 8508
Thanks for the input Charlene! Those articles are super useful.
ReplyDelete