Sensory Integration Disorder

[clori]

My dd10 was just recently seen by a psychiatric nurse to see if she would benefit from anxiety meds. While she definately has anxiety meds were ruled out for now. However the nurse said that besides anxiety dd has sensory integration disorder. The regular therapist (LISW) dd sees later told me senory dysfunction which I assume is the same thing.

In the past dd has had some evals done such as a core evaluation for school, psychologist eval and neuropsych eval. All of them have mentioned senory issues. For instance the school eval says that dd has auditory and tactile hypersensivity. The nurse said that dd has never officially had a SID label simply because then it would mandate services. At this point I don't know if a psychiatric nurse can even officially diagnose but we all agree that dd has sensory issues with sound and touch.

Basically dd is a bright girl who has no academic issues (a, B student for the most part). The core eval stemmed from behavioral issues at school that have majorly improved from 3rd to 5th grade though not perfect. There are things like being very literal, routine oriented, minor ocd type issues, executive functioning issues etc that all together have led to the idea of Aspergers. However the neuropsych results were that dd has many Aspergers traits but is too socially aware to actually have it. DD doesn't have an iep since her academics are fine. She does participate in a lunch bunch group at school with the adjustment counselor (LISW) to help increase her social skills.

Dd failed the hearing screening at school near the end of the year. After school ended she saw a audiologist who said she has mild to moderate hearing loss in her left ear. The ped referred dd to a pediatric ent at Mass Eye and Ear. The repeat hearing test confirmed hearing loss which I believe is senory neural. A CT scan confirmed that all was normal in the ear. The teachers are now aware of it and the school nurse said dd has a 504 plan for preferred seating but I doubt it officially since I never signed anything. Next week dd sees the ent for a follow up to make sure it is stable hearing loss.

Should I ask ear doctor about auditory processing disorder which I know nothing about? Most of the info I find on SID pertains to young kids or kids with other issues. Before I spend money ordering anything sight unseen to help does anyone know if The Out of Synch Child is usually for a preteen? Any other book or other suggestions.

 

[LMC]

Check your local library for the book. I used it when my DS was younger because we didn't know what was wrong. I knew it was something, everyone kept telling me nothing so I found that book and read it. I was checking off everything on the check lists. He saw a developmental neuro psych at age 8 and was dx'd with a plethora of things. SID being one of them. And of course, your school didn't want to put a label on it because then they have to provide services. Your DD could benefit from OT services at the school for her tactile issues. My DS had oral tactile issues (still does because it was not treated early) and of course the usual other tactile. The services would depend on what tactile defenses your dd displays that they need to work on. Remember, it probably won't "fix" itself without therapy and she needs to be prepared for life.

 

[bookwormde]

First Psychiatrics have virtually no training in SID so I would get to a specialist for that.
Second any Neropsych who would say that a child does not have "enough social skills deficits" without dong the analytical work to quantify it lacks competency. IF you did not fill out a WPS SRS evaluation form as part of the evaluation then you need to find another clinician (preferably a highly qualified clinical group at a major medical center). Seat of the pants diagnosing is no longer acceptable practice with the tools that are available today.
Auditory processing disorder is actually an executive function issue not a sensory issue, but is common and consistent with the genetic profile which you describe.
I would suggest calling Yale and see what there recommendations are for getting a full, highly qualified clinical evaluation for spectrum genetic characteristics.
Females mask and self adapt for social skills deficits much better than males (my theory is that it has something to do with maternal genetic abilities), so are misdiagnosed at a much higher rate.
Get a copy of Tony Attwood's "the complete guide to Aspergers" which is available on Amazon for about $17 and read it, then you will be much better able to make informed decisions.
Out of sync child is definitely worth reading also, as are the highly sensitive child by Elaine Aron and Too loud , too bright to fast to tight by Sharon Heller. Just remember that they focus on only 1 component of your child.
bookwormde

 

[SmallWorld71]

Your DD sounds just like my nephew. He is currently 11 years old and in 6th grade. He was diagnosed with SID at around 4 years old. His academics have always been strong, but I know he benefited greatly from services throughout his elementary years, particularly OT and social groups. The help he gets now is very minimal - gets some help with organization and is allowed to leave the room for high stakes standardized tests such as MCAS. He is still a bit awkward socially but maintains all A's and B's and made the transition to Middle School very well. Perhaps an occupational therapist would have some suggestions as to how to help your DD.

As far as an Auditory Processing disorder goes: the overwhelming majority of children I know who have been diagnosed (including DS15) have had great troubles learning how to read. Any many of the children had delayed speech as well. DS15 didn't start to string a couple words together until he was three; as opposed to his brother who was speaking in sentences long before his second birthday. Even now, you are likely to get "huh" and "what" a lot in conversations with DS15.

Also, the nurse you saw was a little confused. To qualify for special education (and an IEP) a child must have a Disability AND not be making effective progress as a result of the disability. To qualify for a 504 plan, you must also have a Disability but you can be making effective progress in school. 504 plans can include things like OT, but often just include classroom accomodations.

I hope you get everything sorted out.

 

[aandjmama]

Interesting. I just went to a meeting this week regarding children (in this case children with FASD) who have sensory issues. An occupational therapist did a presentation on things that she's able to do to help kids with sensory issues by prescribing a "sensory diet". It involves mixing differnt types of movements, pressure, and activities to help the child handle sensory-overload better. She said that it's tough to get insurance to pay for sensory only visits to an OT, but sometimes children just need 3 visits for her to determine what that child would need. HTH

 

[bookwormde]

One quick clarification, "not be making effective progress as a result of the disability" for our kids is typcially not about acedemics but is about the functional and developmental curriculum. Fed IDEA has clearly stated that these other 2 compentents are essental parts fo a free and public education so a child with straight A's still qualifies for an IEP if the disabiity impacts any of the 3 areas.

bookwormde

 

[SmallWorld71]

One quick clarification, "not be making effective progress as a result of the disability" for our kids is typcially not about acedemics but is about the functional and developmental curriculum. Fed IDEA has clearly stated that these other 2 compentents are essental parts fo a free and public education so a child with straight A's still qualifies for an IEP if the disabiity impacts any of the 3 areas.

bookwormde

I agree and thank-you for making this clearer. Sometimes, you have to fight to make this distinction clear with the school system (as many on here know). I had to fight for my nephew when he was in kindergarten. They kept telling his parents that he didn't need services because his IQ was so high. Yet, they also kept telling them he was spending much of his kind. day in the office because he was unable to complete any work in the regular classroom. Once the school system brought the right people on board, the services he received and the teachers who worked with him were fabulous. But, it took some educating of the initial team (at least the person in charge who kept shushing the other team members) to get where we needed to be.