ADHD OR SPD?

by Kim
(Millville, NJ)

Let me start by saying that I have found your site useful and very educational. I have a 4 1/2 year old son named Scott. He was just diagnosed with speech and language delay, which was always so obvious. He had many problems with ear infections as an infant into a toddler. He has received 4 sets of tubes and also had his tonsils and adenoids removed by age 3 1/2. Each time he got his tubes I thought he would just speak clearly, but that never happened.

We always thought that because of so many ear infections, his hearing was impaired. This was not the case after he finally passed the hearing test he had taken so many times because he was scared of the sound proof room and would freak out if they put the ear phones on his ears.

Through all of this I noticed he had little "quirks." Things like fear of most noises, not liking certain textured food, always clumsy, inattention, fidgety, poor fine and gross motor skills, etc.; shall I go on... Anyway, he has been receiving services since he was 2 1/2. Right now he is enrolled in a pre-school program in which he receives OT 1x a week, PT every other week, and Speech Therapy 3x a week in conjunction with a regular pre-school program. He has blossomed greatly from this, but of course there are still some underlying issues.

He has been evaluated by a developmental pediatrician who was recommended by my pediatrician, and also a neurological psychologist who was recommended by the child study team. When I posed that Scott showed signs of SPD, both doctors felt that that diagnosis didn't exist and had no significance for his needs at the school. What both doctors did say was that their impression was ADHD. This was not an "official" diagnosis because he is too young for that yet.

My question is... could SPD be misdiagnosed for ADHD? And if it is, what route should I take toward getting the right diagnosis? I don't want to medicate him in the future if this is the wrong diagnosis. If I compare the two disorders, my son has more symptoms of SPD than ADHD. Also, do you think he should be receiving more OT?

Thank you so much!

Ah, yes indeed... SPD is often misdiagnosed as ADHD! They do share so many of the same qualities, but there are definitely differences. That said, there is also evidence coming out that sensory integrative therapy can help individuals with ADHD (check out this study... ADHD Improves With Sensory Integrative Therapy)

It is confusing, sometimes even for the professionals. It depends what their experience and education has been. But, the bottom line is that you will want to add one more person to your list of evaluating professionals... an Occupational Therapist, with experience in the evaluation and treatment of SPD. You say he currently receives OT through the school system, right?

My question to you is... does your current OT treat or diagnose SPD? There are many who can, many who can not, depending on their training and experience. I am assuming he/she cannot? So... what you need to do is get set up for an evaluation with a "SIPT Certified OT". Where he is already enrolled in OT, you may have to do some fancy footwork regarding insurance issues to get another OT evaluation, but this is a specialized evaluation... maybe the current OT can recommend someone or refer you? May I also suggest reading this article... Sensory Integrative OT; What You Need To Know; you will better understand where to start and what to expect from here.

My further suggestions for you? I would continue with the developmental pediatrician and neurophysiology evaluations and advice to rule out any other diagnoses. But, I would definitely get hooked up with OT's and other professionals who can are familiar with SPD and get this diagnosis checked out too! Get all the evaluations you can possibly get! Accurate diagnoses will be the key, as you already know... I see that from your questions and thinking. Great job!

If he does have SPD... yes, more therapy would be indicated and it would be best to not receive this therapy within the school system, as it will probably not fully address his needs. You can do more "privately" and compliment the school based therapies.

One of the best resources I can recommend for you to read, while you are getting all of this in place is an amazing book that may help direct you further and clarify all of this... The Mislabeled Child. What an amazing book!! Truly!! Also, the authors of this book have a wonderful website and blog that may help you out. You can check it out here... http://eideneurolearningblog.blogspot.com. They are always putting new information up that is amazing and research based. For YOU, I would also check out their archives and search for topics such as ADHD and SPD. Spend some time going through their site/blog and you should find some great, clarifying and relevant information! As far as I am concerned... they are the BEST in the neurological issues surrounding SPD and related disorders! Contact them too if you want... they are wonderful people. Let them know, Michele Mitchell from www.sensory-processing-disorder.com sent you and they will be glad to help you out.

You do need to know, ADHD and SPD are similar but separate diagnoses. They can overlap and a child can have both, or just one or the other. Given the initial research on the benefits of sensory integrative therapy on ADHD, I would go for OT before meds too. Just like your gut is telling you. Those meds can help many children, but not help many others. It will depend on the true underlying causes. Why not try "non-med" therapies first!

Did I answer your questions? I do hope so. Read the articles and resources I suggested and let me know if you need anything further.

I KNOW there are other parents who have had similar experiences and even adults who are now realizing they have probably been misdiagnosed with ADHD when they really have SPD. Are YOU one of them? Let this mom know your experiences and advice! She would greatly appreciate it. Thanks in advance.