Not Everything is a Disorder

In the past few years I have had more and more parents calling me for help with their children who have been diagnosed with "Sensory Integration Dysfunction." Hearing this diagnosis certainly tells me something about how these children function in the world, but parents need to be aware that it is not in any of the diagnostic manuals as a specific disorder in and of itself.

Many of us wonder if it is a disorder at all, or if it falls into the area which Elaine Aron described in her books about highly sensitive people, where she argues that high sensitivity is not always a negative thing, and in fact can be channeled in positive ways.

I took a quick glance at Wikipedia to see how SID is being defined for the public, and it was defined as: "a neurological disorder causing difficulties with processing information from the five classic senses, the sense of movement, and/or the positional sense. Sensory information is sensed normally, but perceived abnormally.

Many neurologists and neuropsychologists argue that SID is not a disorder in and of itself because it is usually not seen in the absence of other symptoms or other diagnoses. In fact, Wikipedia even alludes to this, stating that it is often a characteristic of other neurological disorders, such as autism, attention deficits, or even multiple sclerosis. There is no problem with parents becoming aware of certain symptoms, such as those of sensory difficulties, and I am all for leaving no stone unturned and addressing every issue we can, but sometimes I will see parents wanting to address only some of their child’s issues and not the others. So, for example, a parent who is resistant to medication may not address the ADD medically but feel more comfortable bringing the child to an occupational therapist to deal with sensory issues. Another parent who is fearful of opening up an emotional can of worms may forego counseling in favor of having the child get stroked with a brush to increase his sensitivity. I am even in the process of testing a child who is on a "sensory diet." I am afraid, quite frankly, to ask what this means, but I guess I will have to before I write up my report.

Sensory issues, as I said, often go hand in hand with other disorders. Children with attention problems tend to seek out huge amounts of stimulation and may seem immune to certain input, such as loud noises, excessive stimuli, even pain. Children who are diagnosed with disorders on the autistic spectrum often need things "just so" and are so sensitive to their surroundings that any change causes chaos. Many of us are just very sensitive to our environments without it negatively affecting our day-to-day lives. Dr. Aron explains that these are the artists among us, those who see the nuances in the world, who can describe a color in great detail, and who allow themselves to feel their emotions strongly. I would argue that we also make good therapists.

I say "we" because I consider myself a highly sensitive person, and who knows, if SID was in our vernacular when I was in elementary school in the 1970s I may have been brought to weekly appointments so I could rock gently in a quiet room. To this day the things that set me off surprise me. I can enjoy a loud rock concert without a problem, but certain sounds will send me into a tailspin. There are few sounds I can tolerate less than a baby crying or my dishes clanking together when I put them away. A tag in the back of my shirt can distract me all day. (Did I mention I am distractible too?) I am always the person who, when driving down the street, will say to myself, "Oh, that sign is new!" when no one else even notices. Then there are the emotional sensitivities; even as a child I would read magazine articles about some tragedy and feel empathy for the victim. I would insist on sending money to the blind. As an adult I have an enormous laugh but I also cry easily. I would argue that this tendency to tap into not only my own emotions, but those of other people makes me a better therapist. It also happens to make me pretty intense as a human being in general, but well, we take the good with the bad.

I guess what I am wondering as I have more and more kids showing up at my door with "sensory issues" is this: are we trying to eliminate something that we shouldn’t be? Should we let the hypersensitive child have his hypersensitivities and guide him towards a career in poetry? Should we encourage the hyposensitive child to channel his bold, brash personality into a career where he can safely take risks? I am not saying that certain children don’t need medication or other therapies to allow them to function in the mainstream. I am an advocate for medicating a child whose ADD is so severe that he can’t function in school, or to help a child whose sensitivities make it impossible to deal with the ins and outs of a classroom and playground. I just worry when I see children in the normal range described as pathological, or when one thing is addressed to the exclusion of others. I had one mother in such denial of her child’s pretty major psychiatric condition that she asked me what I thought of exorcism and was it perhaps something she should pursue. I stopped seeing this child shortly afterwards.

I understand that parents want what’s best for their children, and it is very painful to think that your child has a disorder, so we put pleasant labels on things, we change those labels as they become derogatory in the vernacular, and we sugar-coat what is wrong. That can become a quandary if we ignore the problems that are harder to swallow in favor of those we feel have no stigma. If you have a child who is struggling, keep in mind that many disorders and symptoms go hand in hand, and we need to address the whole child, not just the symptoms from column A. Also keep in mind that the vast majority of us eventually find our niche, even if we struggle a bit to get there. People with ADD do extremely well in three vocations in particular: emergency room medicine, working on the stock-trading floor, and on the stage, as musicians and roadies. Children with Asperger’s [developmental disorder involving difficulties with social interaction] often gravitate towards computers and other technical careers such as engineering. And I maintain that we sensitive types do quite well as therapists because we intuitively know where to go in a session since we easily experience the feelings in the room.

For parents who are told their child has SID: caveat emptor [let the buyer beware]. Keep in mind that SID usually does not occur on its own, and a thorough evaluation can help determine which issues to address and which to leave alone. Therapy might help a child learn to tolerate the tag in his shirt, but there are most likely a myriad of other issues that get ignored if we don’t treat the whole child. And as for some children, if their symptoms are not severe, they might be best ignored. Let the child find his niche, let her be an individual, and help the children to accept their own uniqueness. And simply cut the tags out of the shirt like I do. Lying down for a nap doesn’t hurt either.

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About the Author: Dr. Barbara Kapetanakes