User:Kolby Arnold/sandbox

Article evaluation - Sensory Processing Disorder

Choose an article on Wikipedia related to your course to read and evaluate. As you read, consider the following questions (but don't feel limited to these):

Overall the article did a good job of succinctly summarizing sensory processing disorders. There was nothing in the article that seemed extraneous and I did not notice any obvious bias.

There were a few errors in referencing that have been pointed out by previous users. Some of the standardized tests and outcome measures should be given references. There were also a few claims under the Other Methods section discussing hypo- and hyper-reactivity that could use references. References 3, 4, 25, 31, and 85 were all over 20 years old. Only a fraction of the references were from the last 5 years, so it will be important to add what the newest research is saying.

I also noticed that under the signs and symptoms section, some of the bullet points have unnecessary periods. I do like that the previous authors used bullet points, because it makes for an easy read for the audience while still providing all of the essential information.

The article may also benefit from the addition of a few more images to give something besides words for the readers to look at.

There is another article for "Sensory Dysfunction Disorder" that needs a lot of work, but portions could be added to "Sensory Processing Disorder" to improve detail.

Introduction - may want to include some in diagnosis instead of intro

Sensory processing disorder (SPD) is also referred to as sensory dysfunction disorder or sensory integration disorder. SPD is characterized by an inability of the brain to properly perceive and integrate, and therefore appropriately act upon, sensory input. Presentations of this disorder may include under responding or over responding to one's environment or atypically seeking out sensory experience. Kranowitz (2005) states presentations of SPD may include deficits either in sensory-motor timing, differentiation, or motion problems in response to tactile and body movement stimuli.

It is difficult to differentiate SPD from other disorders. Byrne (2008) states that disorders such as "attention deficit hyperactivity disorder (ADHD), learning disorders, dyslexia, pervasive developmental disorder including autism and Asperger syndrome, nonverbal learning disorder, mental and emotional disorders, selective mutism, genetic syndromes (Down, Fragile X, fetal alcohol syndromes, and fetal alcohol effect)" often exhibit overlapping symptoms to SPD. SPD can also exist as a comorbidity to these disorders. Currently SPD is not apart of the Diagnostic and Statistical Manual (DSM) and not used as an official diagnostic label. SPD is often suspected based on behavioral observation and missing developmental milestones.

Treatment (more in depth)

Sensory Systems

Visual (sight) Auditory (sound) Tactile (touch) Gustatory (taste) Olfactory (smell) Vestibular (balance) Proprioception
 * Eyes are used to distinguish colors, light, shape, and size
 * Ears are used to perceive sounds
 * Skin receptors are used to discern shape, size, texture, temperature
 * Tongue is used to determine texture and flavor
 * Nose is used to interpret odors
 * Inner ear is used to determine body's position in relation to gravity and the ground
 * Receptors in the muscles and joints are used to determine where parts of the body are located in space


 * Vestibular
 * The vestibular system sends information of head and body position to the brain. Treatment of this system may include swings and different balance techniques. Different swing attachments can increase or decrease the difficulty of the balance perturbations such as nets or balance boards. The treatment focuses on retraining the brain. The brain will regulate and integrate the amount of vestibular information entering the brain.
 * Visual
 * Prism Glasses: These assist in spatial localization and awareness and correct for possible visual deficits.
 * Accommodation: This is when the person switches focus from a close object to a distant object, this improves the ability of the eye to switch and maintain focus on different objects.
 * Tracking: The person keeps their head still and follows an object (finger or pen) with their eyes. The tracking exercises trains ocular muscles and improves the ability to track moving objects.
 * Perception: This aspect of therapy focuses on the ability to gather information from looking at objects or pictures.
 * Environment Changes
 * Hypersensitivity: Over stimulation can be harmful to these people and cause anxiety and perpetuate the avoidance behavior. Minimizing stimuli by reducing clutter around the house and avoiding bright/flashy objects.
 * Hyposensitivity: These people will seek visual stimuli and will benefit from bright colors and excessive visual stimuli.
 * Smell
 * Encourage smelling new and different things, avoid very strong and noxious smells.
 * Soak cotton balls in different scents and have the child guess the smell.
 * Acknowledge smell hypersensitivity and explore the emotions attached to them and encourage self managing behavior.
 * Desensitize smells in small increments, starting with exposure to smells in small doses and small increments and gradually increasing frequency and dose.
 * Taste
 * Provide food of different temperatures, textures, and categories of taste which include salty, sweet, sour, bitter and umami.
 * Provide something for the child to chew on throughout the day.
 * Auditory
 * music, especially during normal activities to integrate auditory cues with everyday tasks
 * Proprioceptive
 * swaddle, allow push pull and carrying activities
 * Tactile
 * Used for people who are hypersensitive or hyposensitive to touch. With hypersensitivity, light sensory cues are used, avoiding aggressive and promoting light touch. Hyposensitivty benefits more from excessive stimulation. Use of different textures and exposure to multiple textures a day train the brain to recognize and reorganize sensory information.
 * Wilbarger Protocol: Performed by a licensed Occupational Therapist who is trained in sensory integration and the Wilbarger Protocol.
 * Brushing: Therapist starts with brushing the person every two hours they are awake. The head, neck, stomach, arms and legs are common areas of treatment.
 * Joint Compression: The therapist compresses large and small joints of the body and encourages the person to engage in pushing and pulling activities.
 * Oral: Final stage of the protocol is oral integration. A finger it used to brush along the persons mouth. This is used for people with oral defensiveness or those who perceive brushing or certain foods as noxious based on texture.

A Sensory Diet Example

Below is a sample of a sensory diet that could be prescribed by a therapy. The sample is not intended for therapeutic use, and therapy should also be directed by the therapist.

In the Morning

 * Massage feet and back to help wake up
 * Listen to music recommended by therapist
 * Use vibrating toothbrush and/or vibrating hairbrush
 * Eat crunchy cereal with fruit and some protein
 * Spin on swing as directed by your OT or PT
 * Jump on mini-trampoline as directed

After school

 * Go to playground for at least 30 minutes
 * Push grocery cart or stroller
 * Spinning as directed
 * Mini-trampoline. Add variety: play catch or toss toys into a basket while jumping.
 * Do ball exercises as directed
 * Listen to therapeutic listening CD
 * Oral work — suck thick liquids through a straw, eat crunchy and chewy snacks, or chew gum before and/or during tabletop activities

At dinnertime

 * Help with cooking, mixing, chopping, etc.
 * Have them smell different ingredients.
 * Help set table, using two hands to carry and balance a tray
 * Provide different textures for them to eat at dinner.

At night

 * Family projects: clay projects, finger painting and other crafts.
 * Warm bubble bath
 * Massage during reading time

Identification since it is hard to diagnose

Difference/Comparison between Autism and Sensory Processing Disorder

Advocacy

The American Occupational Therapy Association (AOTA) supports the use of a variety of methods of sensory integration for those with sensory processing disorder. The organization has supported the need for further research to increase insurance coverage for related therapies. They have also made efforts to educate the public about sensory integration therapy. The AOTA's practice guidelines currently support the use of sensory integration therapy and interprofessional education and collaboration in order to optimize treatment for those with sensory processing disorder. The AOTA provides several resources pertaining to sensory integration therapy, some of which includes a fact sheet, new research, and continuing education opportunities.

Distinguishing SPD from Autism

Recent studies have helped to physiologically differentiate typically developing children from children with SPD, and from children with autism. Approximately 1% of the United States child population has been diagnosed with autism, while approximately 5-16% of children have been found to have difficulty processing sensory input. In a recent study performed by Owen et al., diffusion tensor imaging (DTI) was used to exam white matter tracts in a group of children with sensory processing disorder compared to a group of typically developing children. Results of the study showed less white matter microstructure, particularly in the posterior cerebrum, in the children with SPD compared to the typically developing children. This finding illustrates a physiological variation in an area of the brain that involves sensory processing and integration, which may help to explain some of the challenges children with SPD have. This particular study suggested that DTI may be used in the diagnosis and differentiation of SPD and autism.

In a follow-up study pertaining to differentiation of SPD from autism, Chang et al. examined white matter tract differences in a group of children with SPD compared to a group of children with autism, and also in relation to a group of typically developing children. The results of this study showed significantly less white matter connectivity between the parietal and occipital lobes in the children with SPD and ASD compared to the typically developing children. As stated above, these connections play a large part in sensory perception and integration. However, the study only found reduced connectivity in the temporal lobe of the group of children with ASD. This area of the brain contributes to social-emotional processing. These findings reveal a significant association between white matter circuitry and cognitive progressing, particularly in the areas of auditory integration, social skills, memory, and attention. These findings may help guide treatment and provide more personalized interventions for children with SPD, ASD, and other diagnoses. However, more research needs to be done with larger groups and more attention to other neural circuitry changes. User:Sjandreau17/sandbox User:TaylorBuck15/sandbox

Hi Kolby,

I really like the additions that you made to the treatment section. I agree that this section needed to be expanded. I also like that you noticed how out of date some of the sources were. I have found that with many articles on wikipedia and I agree that it is important for the article to reflect the most recent research. Is there more current research on diagnosing sensory processing disorder? If more current research exists then that might be a helpful addition to the diagnosis section.

Sarah Gleeson

Hi Sarah, I was able to find a few new sources about diagnosing and distinguishing sensory processing disorder from autism. They are new studies that look at differences in brain activity and neuronal connections. I think if they keep discovering differences, sensory processing disorder will have its own section in DSM before we know it.