Is this SPD?

by w
(massachusetts)

During our 28month old daughters evaluation for Early Intervention, we were told that she had many "red flags", however they were convinced that she is not on the spectrum because even with her speech delays, she still attempts to connect socially which I'm told is not the case for kids on the spectrum. We do know that something is going on and from what we've read on this site, it sounds like our daughter has SPD.




She is very oral sensitive, she drools a lot and is not teething. She tends to eat things of yogurt consistency, if its anything that requires a great deal of chewing, she will spit it out.

She does a lot of flapping of her arms, especially when excited/anxious, she W-sits, has frequent tantrums, toe-walks at times, and she twirls her hair into knots excessively at times requiring them to be cut out. She hates having her hair brushed and will not wear anything in her hair i.e. barrettes, elastics.

We are wondering what type of diagnosis is SPD, who makes the diagnosis, and is it considered a medical condition that is covered by insurance for treatment. We are very concerned for her and want to do anything we can to help her. We would appreciate any suggestions at this point.



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May 24, 2009
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starstarstarstarstar 		Hope this helps
by: rae.baird@yahoo.com

My daughter is 19mths old her verbal along with social skills are very advanced. Her communication level is at 21 mths and her receptive language is 27mths. I'm by no means trying to brag, but even with her high verbal skills, reading The Out-of-Sync Child and this website was like reading my daughter's life story, written by me.

Not every child is going to have every red flag and some may only show one or two, but if those red flags interrupt their daily life and it's interfering with public interaction, then I personally can call it SPD.

We all have red flags, but most of us can handle them appropriately and in an acceptable manner in society. Now I am no OT, which will be the one to have to diagnose this, but I'm sure your child could qualify has having SPD. And most therapists and peds wont classify it as Autism, but it's a branch off of Autism.

Fortunately we have my daughter in EI and it's paid for by the system, so I am unable to give you insurance advice, but the way the medical world sees this most likely it will not be. There are many codes and ways to get around it, it just takes alot of fighting. And always remember, your child deserves the right to live in society as normal as possible and they only way to do this is to get help as early as possible. Good Luck and please keep me informed!
May 24, 2009
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by: Anonymous

Your child seems to have symptoms of SPD, but needs an OT eval to determine for sure. SPD is not a medical diagnosis that would be covered by insurance directly at this time, but may in the future. The therapist doing the evaluation needs to bill for a "working diagnosis", which means what symptoms they are working on: mechanical, motor, and sensory problems are working diagnoses as well as muscle weakness and hypotonia.

I am a therapist trained in sensory integration therapy, and have figured out how to bill insurance companies so that they will pay (if possible in that plan). First, if your insurance plan says it will pay for OT, then good. If it only pays based on medical necessity, then the evaluator needs to emphasize those areas such as feeding problems, low muscle tone, orthopedic abnormalities of the w-sitting, and safety concerns due to the behavior.

Then, when billing for the evaluation, they need to bill for codes other than sensory integration in order to get reimbursed. For example, the ICD codes of 97110, 97112, and 97530 can be used for balance, exercises, and activities taught during therapy. These are codes that are used in any therapeutic frame of reference (orthopedic, neurological, sensory integration, etc.). These codes are not a lie of what the OT was doing during a visit using SI therapy, but they are also not controversial.

I am not willing to lie as a therapist, but I am willing to play the "insurance game" and bill as I must to help the family receive the services they deserve. Now, if your plan does not cover occupational therapy, then that is a whole other problem, and you may have to pay privately. If the child receives school system services, remember that the OT at school is only addressing issues that are deemed educationally relevant.

Also, when seeking an OT eval for the SPD, feel free to ask questions beforehand and make sure you have an OT with enough training in SI. The SIPT is a standardized test for children ages 4-8 years requiring extensive training by the therapist. The De-Gange Berk Test of Sensory Integration is used for 3-5 year olds. Other than that, screenings and non-standardized tests are used to gather information. You mention your child has feeding issues, and not all OTs are trained in feeding, so in that case you may also need an SLP. Good resources on feeding help are: "Just Take A Bite" book and "Food Chaining", both give help for children similar to yours.

Also, free advice is on: www.new-vis.com when you go to "feed your mind" and information papers, there are tons of suggestions on feeding help, and the website is that of a well-known speech therapist. A good source from an OT who is also researching SPD is "Sensational Kids", and it is written in parent-friendly terms. Hope this helps, and good luck!
May 23, 2009
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by: Anonymous

It does sound like it may be SPD. You need to get an OT eval done. Some insurances do cover this. Good luck!
May 23, 2009
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starstarstarstarstar 		IS this SPD?
by: Anonymous

Hi W,

I am a parent of a boy with autism and although he may not speak like you and me, he has some social connections, like imitation skills with his peers and tries to connect with people. He is not your typical autistic boy, rocking etc. And a fellow classmate of his who is autistic is a very social boy and in that sense doesn?t appear autistic. Although your daughter may have SPD I think there are some similarities in both and perhaps it is too soon to say whether she is or isn?t but I?d try and get another opinion. From one mom to another, just to be on the safe side I?d get another opinion.

Hang in there.

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