October 27th, 2008
01:20 PM ET

When should parents ask the experts for help?

By Caleb Hellerman
CNN Medical Senior Producer

My son, who’s 4 1/2, just used the bathroom at his after-school class. Big deal, huh? It was, for us. Up to now, using the potty away from home has been too stressful, which leads to a lot of frantic planning on our part. It’s not just that. He’s been high-strung since birth. He stopped taking a nap around his first birthday. He doesn’t like crowds, tenses every muscle when he gets his hair washed – hey, at least he no longer screams non-stop – and he’s extremely hesitant about trying new things, be it a new food, a new lesson at pre-K or a new slide on the playground.

Don’t all 4-year-olds act that way? Some days, that’s what I think. Other days, not so much. My son is bright and gets along with other kids, but he’s a handful. After commiserating with a few other parents, last year we took our son to see a therapist. She told us he might have something called sensory processing disorder. There’s a lot of disagreement over how to define SPD, but basically some children are extremely sensitive to stimuli including noises, tastes, certain feelings on their skin or even all the above. In severe cases, it’s so distracting, the child has trouble functioning at all.

It’s not a well-understood diagnosis, and I was a little skeptical. But we started taking my son to an occupational therapist once a week. After a couple of visits, she told us my son didn’t have SPD, but he did have “sensory issues.” And what do you know, therapy seems to help. He loves the sessions (lots of climbing and games), he’s a lot less anxious, he’s proud about trying new foods and now even the bathroom isn’t too scary. Is it the therapy? Or is he just growing up?

How do you know when it’s time to seek help for your child?

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soundoff (14 Responses)
  1. san

    Dr Gupta,
    I have been listening to the health care pitches from both Obama and McCain candidates. I have heard your comments and it seems that they are unclear as to which candidates health care plan is best. Well, I am a nurse and have been in case management since 1995. This is the worst I have ever seen. The only thing McCain offers is $5,000 dollars/yr. As a case manager my premiums for a family of 4 is over $1000/month with a $500/monthly allowance for an hmo plan. The HMO plans are nothing like they used to be where you have no out of pocket cost as long as you see participating providers. Now, I have copays, coinsurance, and deductibles that are well over $5,000/yr. My husband has DM and needs meds which increase the out of pocket cost for my family. Guess what $5,000 can do for my family that is struggling? Not much.

    October 28, 2008 at 10:36 | Report abuse | Reply
  2. Lee

    My son had trouble going to the bathroom in public places and it was because he was afraid of the toilets being too loud. Some he said were so loud they hurt his ears. He also has an extremely sensitive nose. He can smell the smell from a group of ants. I am not kidding.

    October 28, 2008 at 13:17 | Report abuse | Reply
  3. Sara C.

    It's not so much an issue of when to seek help for us, but how do you get the right help? This 4 1/2 year old boy sounds just like my son, also nearing the 4 1/2 year mark. Last year the early intervention services identified him as possible SPD, but their own occupational therapy services were less than adequate – we got a handout in the mail on things to do at home that might help! No, that didn't work well. Taking matters into my own hands, I have been trying to find him treatment. No luck yet. "Your insurance won't cover..." "We don't treat children under 6..." The excuses are endless, and my son is getting worse. Now the anxiety and emotional issues are becoming behavioral. The preschool doesn't want to deal with him, the school system "doesn't do therapy", and the lack of services available to HMO subscribers in our area is disgusting. So, will he grow out of it? Will it keep getting worse? Where do you turn after knowing for a year something is wrong and not being able to fix it???

    October 28, 2008 at 13:19 | Report abuse | Reply
  4. Christina

    Sara C. is right – it can be hard to get good help, especially if you live in a small town. I work with kids and often see "sensory issues" or SPD and refer to occupational therapists. But often there is a long waiting list for treatment or insurance won't pay. Also, not all occupational therapists are trained in sensory integration therapy, so parents are often confused about where to turn. And the issues can be manifested in behavior, making a child seem "bad" because he hits or runs around too much. Parents who are not familiar with this disorder also often see it as unnecessary therapy and just another thing they have to get done, so even if the help is available, they don't take advantage of it because it's low priority. It can be a difficult problem to fix and there are no easy answers.

    October 28, 2008 at 14:08 | Report abuse | Reply
  5. ACinCincy

    I think he's just growing up.

    My oldest daughter was the same way. We had to cut the tags out of her baby clothes because they irritated her so much. As a newborn, we had to wrap her receiving blankets so that they covered her feet "just so" or she would scream and couldn't relax and sleep. Ribbed baby socks were out of the question. She screamed in the bath when it was time to wash her hair – insisting that plain water was burning her eyes. Noises bothered her. Certain smells bothered her.

    In fact, it never occured to us that anything was "wrong" until daughter #2 came along because we had nothing to compare it to. Daughter #2, on the other hand, was (and is) as calm as a cucumber and didn't care if we wrapped her in a burlap sack. Night and day difference.

    This continued until she was just turning 5, then she dramatically mellowed out. Either her brain had matured enough to handle the stimuli we all take for granted, or she just outgrew the sensitivity. Either way, it all disappeared almost overnight.

    No therapy needed. She was who she was and we adjusted accordingly. We figured she would outgrow it, and she did.

    Save your money...

    October 28, 2008 at 15:05 | Report abuse | Reply
  6. Tiffanie

    Sara C.

    I am sure that SPD is a real thing. Just as it is with any thing, there are levels of severity. Be pro-active and make phone calls to the insurance company and do research on the internet to find your own things to try in the mean time. Reach out to other parents whose kids suffer this also. Find out what worked for them and what didn't. Every kid is different so nothing is 100% to work for every kid.

    October 29, 2008 at 19:00 | Report abuse | Reply
  7. Joanne, Syracuse, NY

    Doesn't that sound like autism or asberger's syndrome. Isn't sensory issues a symptom not a diagnosis?

    October 30, 2008 at 10:45 | Report abuse | Reply
  8. Laurie from St. Louis

    Sensory issues are a common factor in Autistic kids, not that you child is autistic, but you could consider seeking out a DAN! Practitioner (you can find one in your area at the ARI website (autism.com). They are VERY familiar with the sensory issues, and can be a huge help. I have an autistic son, and am seeing a DAN! physician. She has provided us the alternate therapies and have provided us with real hope that our son will be fully mainstreamed by first grade. There are ways to help, and the sooner you get help the better the chances to permanently change (and improve) the behavior.

    October 30, 2008 at 18:40 | Report abuse | Reply
  9. LEB

    I think that therapy may be helping him, if for no other reason that he has a regular activity that he looks forward to and feels constructive to participate in. As someone who struggles with anxiety as an adult, having things to look forward to helps me cope better with life's unexpected stressors. When I don't have things to get excited about, I get listless and depressed, and don't enjoy life as much.

    This may be more acutely true if your son is bright. Just being bright may mean that he notices things and makes connections between stimuli that other kids don't, and that could lead his mind to be extremely active, which could lead to anxiety. The activities he does in the sessions are more "controlled," and less chaotic and unpredictable than what happens out in the real world.

    October 30, 2008 at 19:53 | Report abuse | Reply
  10. JudyBee

    Our son is the same way. You can do your own therapy. We do. I play catch with him with a 5 pound weighted medicine ball, let him swing and spin on the swings, crab walk, wheelbarrow walk, do headstands, jump off a mini trampoline, etc. Tae Kwon Do is supposed to help. We are doing a DVD to get him used to it before we put him in a class. You can get ideas online for occupational therapy for sensory issues. I am not sure if it's helping, but we do it. OT is expensive. You can get library books, too, or have an therapist teach you things to work on. See if you can't do one day/week for 15 minutes and see if it helps.

    November 15, 2008 at 19:18 | Report abuse | Reply
  11. Tyler Young

    plain old cotton socks are still the best for babies.*,~

    June 20, 2010 at 14:07 | Report abuse | Reply
  12. Bryan Jenkins

    cotton baby socks are the best, i don't like to put nylon socks over my baby feet-'~

    October 10, 2010 at 13:01 | Report abuse | Reply
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