SENSE-ABLE BABYTM                                                                                                                               


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FREQUENTLY ASKED QUESTIONS

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  • My baby has sensory processing problems, will that always be the case? Not necessarily. Babies are resilient and their brains are "plastic" and easily adaptable. Some babies might have poor sensory processing due to being born early or due to environmental reasons such as neglect. In these cases, addressing the sensory processing problems early on may change things quicker than waiting. Other babies have diagnoses such as syndromes or neurological problems in which the sensory processing problems are ongoing. Even though sensory processing deficits may be a part of the diagnosis, addressing the problems early on may minimize the symptoms and decrease secondary problems. For babies who have no diagnosis but seem to have poor sensory processing, addressing the problems may prevent the child from incurring developmental delays such as with motor and language skills.

  • Is it my fault that my baby has poor sensory processing? In most cases, "no", unless there was severe neglect by the parent for long amounts of time or wreckless behavior such as prolonged illegal drug use during pregnancy. Even though it is not the parent's fault,the parent may need to alter their interaction style or the environment to help the baby better respond to his world and people within it. An infant with poor sensory processing may have difficulties adapting to us, so we can help by adapting ourselves to meet their needs. On the "alertness & crying" page there are ideas on how to provide calming and alerting input to help the baby better process sensations he receives from himself and from the world. 

  • I tried all of your ideas on the "alertness & crying" and "play and daily routines" page, but it isn't working. My baby cries alot and still wants to just be left alone. What should I do? It is recommended that you discuss these concerns with the child's physician. A medical problem may co-exist with a sensory processing problem, or the medical problem may make it appear that the child has a sensory processing problem. This could be the case with some medicines that have side effects which alter the child's perception of sensory input. In addition, the information listed on this website is for educational purposes and does not replace an individualized plan created by a professional such as a physician or an occupational therapist.

  • I'm getting confused with what is typical and what is not typical for a baby. Can't babies be fussy because of teething pain and other normal baby issues? Yes, babies can be fussy because of normal baby issues, yet symptoms should differ from those of poor sensory processing. When a baby is teething, he may fuss when his tooth is touched and he may drool, gnaw on his hand, and stick toys in his mouth to alleviate the pain. In comparison, a baby who is over-responsive to touch on his face and mouth, might be fussy at times other than when he is teething. There are many good sources (books, internet, etc.) on typical child development and baby care issues. Familiarize yourself with those issues and that might help you to better differentiate what the true problem is. 

  • I heard that children diagnosed with autistic spectrum disorders have sensory processing problems. Does that mean my baby who has sensory processing problems will be autistic? Not necessarily. Although children with autism typically have sensory processing problems, not all children with sensory processing problems have autism. Much research is still being conducted on autism and its causes, and hopefully one day, identification of children who will be autistic will occur much earlier in life such as during infancy.  Diagnosing has improved over the years and autism is sometimes identified as early as the toddler years.

  • I am reading these symptoms and my child seems to be different on different days. Sometimes he seems sensitive to touch and doesn't want to be hugged and other days he loves to cuddle. Why is that? No one, children included, is the same everyday of their life. Children with sensory processing problems tend to have fluctuating symptoms. On a "good" day when they received plenty of rest, they may be able to tolerate sensations that make them miserable on a "bad" day. Maybe on the good day, the environment was less chaotic and the routines of the day happened in a predictable manner.

  • My child seems to be over-responding to noises as noted by screaming when things get too loud but under-responds to movement as noted by loving to be bounced and held up in the air, even crying when we stop. Why is that? Everyone's brain is wired differently and it is not uncommon for a person to have mixed responses in which they over-respond to one sensation and under-respond to another.

  • I am confused with all of these terms I find on the internet and in books, so what is sensory integration therapy anyway? It is an approach used to help the children learn to better integrate and process sensations in order to improve function during daily life. The concept began in the 1970's and was originated by an occupational therapist (OT) named Jean Ayres; since then other OTs have added to the knowledge and research that is now known about sensory integration. When going to a clinic to receive sensory integration therapy,(AKA "SI" therapy), it is common to see the child moving on suspended equipment such as specialized swings and balance boards. Also seen are large balls, trampolines, ball pits, obstacle courses, and bolsters. Through these activities, the child receives appropriate amounts of touch, vestibular, and proprioceptive input to better help with sensory processing. Additionally, the suspended equipment encourages movement against gravity in a fun way. For a child with low muscle tone, this equipment might help him to learn to balance and use his large upper body muscles. Then he will have more stability to start working on improving fine motor skills such as manipulating toys, buttoning, and handwriting. The therapist is looking for an "adaptive response". An example of an "adaptive" response is a preschooler who is initially too scared to sit on a swing with his feet off of the ground, and then through therapy the child is willing to sit on the swing and let someone push him. Through these adaptive responses, daily life improves as the child can now play with other children on the playground or let the parents "rough house" with him while his feet are off of the ground. An example of an adaptive response for a baby might be that he is initially so over-responsive to touch that he can't tolerate tummy time, then with SI strategies, he begins to enjoy lying on his tummy and even begins to reach for toys in this position or rolls over. 

  • Just because my little one has poor sensory processing does that mean he also has sensory processing disorder (SPD)? Not necessarily. We all have difficulties processing sensations at some point in our life, yet it is only labeled as SPD if it is to the point that it interferes with function such as the ability to interact with others or learn from the environment on a regular basis. For example, an adult may like to wear his socks inside out because the seam is bothersome, yet if he doesn't wear his socks inside out, he can still function such as going to work, talking with others, and walking with the socks on. Yet, some people are so sensitive to the touch sensation that if they didn't fix the socks to be inside out, then they would be too distracted to function at work, home, or in social situations. In the last case, that may be a part of SPD. Another example of how we all have difficulties with sensory processing from time to time is how we seem to be over-responsive to sensations on a "bad day". Imagine that after having a generally "bad day", on the way home from work a policeman pulls you over and gives you a speeding ticket. Then, you come home and your children have the television on. The volume of the television may be perceived as too loud and the room may seem chaotic and messy, yet the volume is the same it always is and the room looks no messier than it did the day before. But the day before you weren't bothered by those things. If on a daily basis you over-reacted to the sound of the telephone, a vacuum, crowds, and public places, then it may be more of a problem and be considered a part of SPD. Just the same, a baby may display poor sensory processing from time to time. Some babies will tolerate lying in the "tummy time" position on a good day but maybe not on a bad day. A parent who does not want to "rock the boat" may quit putting the baby on the floor on his tummy altogether.  However, this does not allow the baby to learn to process the sensations he receives when in this position. Secondary problems can result from this such as delayed motor skills and sensitivity to touch on his tummy. To determine if that baby truly has SPD, he needs a thorough evaluation by a professional with this training, which is usually an occupational therapist (OT). Not all OTs are trained to work with sensory processing problems nor are they all trained to work with infants. Working with infants is quite different than working with preschoolers or older children. When looking for a pediatric occupational therapist to evaluate your child, ask about their experience in working with babies with sensory processing problems. Another place to seek an evaluation is with an early intervention (EI or ECI) program. These programs work with infants and toddlers with medical diagnoses or developmental delays up until their third birthday. These programs have various professionals on their team including occupational therapists and early intervention specialists who typically are familiar with sensory processing problems. For a listing of programs in each of the states (USA), visit the bottom portion of the "links" page.

  • What is sensory integration dysfunction (SID) and how does it differ from sensory processing disorder (SPD)? Sensory processing disorder and sensory integration dysfunction are synonymous with one another.  In 2004, a committee, including researchers (visit http://www.spdfoundation.net/), agreed on common terms to describe this disorder and its sub-types. The main categories of SPD include: Sensory Modulations Disorder (SMD), Sensory-Based Motor Disorder (SBMD), and Sensory Discrimination Disorder (SDD). The name of the disorder was switched from SID to SPD to be less confusing to the medical community. One way that Sensory Integration Dysfunction was confusing was that SI was often used for an abbreviation for the disorder as well as the therapy. Another way that the name SID tended to be confusing was that is was easily confused with SIDS (sudden infant death syndrome). Many sources on sensory integration therapy and SID varied greatly in the wording that was used, so the committee officially updating terms was helpful to most professionals working with these children. Books and other resources written prior to 2004 may use "old" terms.  

  • Is Sensory Processing Disorder (SPD) a real diagnosis? At this time, it is a "working" diagnosis which means the symptoms of poor sensory processing are being worked on during intervention such as by an occupational or physical therapist. If more research is deemed credible before 2010, then it may soon be added to the Diagnostic and Statistical Manual (DSM-V), which is a book that classifies official mental health diagnoses for physicians and third-party payers (insurance, medicaid, etc). Whether SPD is included in the DSM-V or not, it can be a real problem for the children and family members to deal with. The Sensory Processing Disorder Foundation (SPDF) is seeking 20,000 professionals/advocates to sign an online petition; to find out more and possibly sign the petition, go to www.spdfoundation.net/petition.php. In addition, SPD has already been acknowledged outside of the occupational therapy (OT) profession in the: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (AKA as DC:0-3R), the Diagnostic Manual for Infancy and Early Childhood, and the Psychodynamic Diagnostic Manual.

  • I see alot of websites with ideas on helping with sensory integration and sensory processing. Can't I just follow this advice and skip the OT evaluation? You need to decide what is best for you and your child. Some children may benefit from some generic advice whereas others really need an individualized intervention plan that is developed after a thorough evaluation is conducted. This is especially the case for preschoolers and school-aged children whose sensory processing problems are impacting their ability to function in the education setting, within their family, group sports, or their ability to socialize with their peers. Since sensory processing impacts motor skills, the older children with problems may also exhibit poor handwriting, dexterity, and balance as well as inattentiveness and impulsivity. They may also have a low self-esteem as they are likely to be the last child picked to play with the other children on the school playground and may be seen as a "problem" child due to behavior difficulties that may accompany the poor sensory processing.

  • What are the sub-types of Sensory Processing Disorder (SPD)? Within the three categories, there are sub-types. They are:  A)Sensory Modulation Disorder: sensory over-responsivity (SOR), sensory under-responsivity (SUR), and sensory seeking/craving. B) Sensory-Based Motor Disorder (SBMD): dyspraxia and postural disorders.  C) Sensory Discrimination Disorder can happen in only one, a few. or all of the seven senses.

  • Does insurance pay for sensory integration therapy? Sometimes. But if not, the therapist can bill for activities that are done during SI therapy, versus using only a sensory integration code (97533). For example, there is a billing code known as neuromuscular reeducation (97112) which can be used for balance activities, another code for therapeutic procedure (97110) such as exercises for strength and endurance, one for therapeutic activities (97530), and still another for massage (97124). Analyzing what was done by the occupational therapist (or physical therapist (PT)) during the session is a better way to code.  Since SPD is only a "working" diagnosis, meaning that is what the therapist is working on, then maybe billing can occur under the primary diagnoses the child has such as hypotonia, cerebral palsy, feeding disorder, etc. It is NEVER suggested that you should lie to your insurance company, just think smart when completing the paperwork.

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