How do you know when to seek a screening for your child? Your child needs to be screened when adverse behavior occurs with more frequency, intensity, and duration than typical children, negatively impacting your child and your family’s daily life. There are many red flags to indicate that a child has disordered sensory processing. While there is no single indicator, any of these in combination suggests that sensory processing should be evaluated, especially if the indicator is typical of the child most of the time.

·         Attention problems—fixating (excessively focused), perseverating (to repeat insistently), distractibility.

·         Difficulty maintaining an optimal alert state—hyperactivity or hypoactivity (lethargic).

·         Avoidance of touch or movement.

·         Self-stimulation, especially when it is persistent and interferes with the ability to do other things.

·         Stereotypic behaviors (e.g., hand flapping/distal cupping, spinning or lining up objects).

·         Rigidity, inflexibility, or difficulty adjusting to even routine changes that are a natural part of daily living.

·         Unpredictable emotional explosions.

·         Disregard of, or impaired ability to interact with others, even a familiar person who provides routine daily care.

·         Difficulty catching on, giving the appearance of trying hard but just not quite “getting it.”

To facilitate a screening, one must find an occupational therapist. If the child is 3 years of age or younger, parents can choose to participate in “The Birth to 3 Program” or locate a private OT. “The Birth to 3 Program” is a federally mandated program (Part C of the Individuals with Disabilities Education Act—IDEA) to support families of children with delays or disabilities. States have discretion in setting the criteria for child eligibility, including whether to serve at risk children. As a result, definitions of eligibility may vary significantly from state to state. States also differ concerning which state agency has been designated "lead agency" for the Part C program.

To find “The Birth to 3 Program” contact information for your state, visit the Early Childhood Technical Assistance Center at http://www.etaccenter.org, click the tab “Resources” at the top of the page, and scroll down to “Part C Coordinators.” Click on your state and click the “Refer Website” link, then click on “Find a local CFC Office” and fill in your county to receive a list of providers. Select the office or provider closest to you and contact that office to start the process of obtaining a developmental screening or evaluation. If your child qualifies for the Birth to 3 Program, you will be assigned a service coordinator who will organize the requisite services for your child. Some states have a parental cost-share system, in which parents who are deemed financially able must share in the cost of early intervention services for their children. In addition, if your child is deemed eligible for Medicaid or any other state programs, you will be asked to apply.

Private therapy is also an option for children under three if your insurance policy covers the therapy and the expense is affordable. For children over 3, private therapy is the only option. A multidisciplinary clinic is ideal for private therapy, which encompasses several therapists who practice different disciplines, such as occupational therapists, speech-language therapists, physical therapists, and mental health professionals. Having said this, multidisciplinary clinics are not available in all areas. Alternatively, locate an occupational therapist with specialized training in SPD, if there is not a multidisciplinary clinic available. You may also inquire at your local hospital whether they provide occupational therapy using a sensory integrative framework. Family and friends can be a great resource for referrals as well.

 Once you have located an occupational therapist, an intake appointment will be scheduled. Prior to this appointment, you may be asked to fill out one or more parent checklists and a developmental history to supplement the observations of the evaluators. Some clinics may perform a screening (a professional evaluation for atypical childhood development) as a next step or proceed straight to an assessment, if presenting problems are significant. The clinic will screen your child for SPD through distinguishable behaviors not biological means. There is no biological test such as a blood draw or brain scan that can be administered to a child to detect sensory processing disorder. The presence of SPD is determined by observing social, emotional, motor and attention behaviors.1    If screening identifies differences to warrant further evaluation, an assessment will follow. An assessment for SPD may involve standardized testing, detailed clinical observations, and parent and teacher feedback.

A formal assessment by an occupational therapist with advanced training in SPD resulting in a Sensory Integration Praxis Test (SIPT) certification is preferred to determine whether the observed behaviors are the result of sensory issues or other problems. An accurate assessment is critical as appropriate intervention relies upon the diagnosis. At the conclusion of the assessment, the evaluating therapist will review the results, and the clinic will assign your child’s treating therapist. Meet and interview your child’s treating therapist in advance to ensure the right fit for you and your child.

The process will involve few steps if you live in a rural area. There may be only one occupational therapist available, or you may have to travel to obtain an assessment from a SIPT-certified therapist. Should the results indicate that your child would benefit from therapy, the evaluating therapist may assemble a treatment plan that provides guidelines for your local treating therapist. Formal assessments of sensory modulation and sensory-based motor disorder utilize different tools.

Assessment of pure modulation disorders and referrals for occupational therapy are based on clinical observations, caregiver reports, and developmental and sensory history.2  While there is no standardized diagnostic test to identify sensory modulation disorder to date, most clinicians who have been practicing for a number of years are very astute in their clinical observation and identification of this disorder.

There are several standardized diagnostic tests that measure motor function and sensory discrimination which may result in a diagnosis of dyspraxia and/or postural disorder. One of these is the SIPT, mentioned above. The SIPT was created and standardized through the work of A. Jean Ayres, the founder of sensory integration, SPD theories and treatment techniques. Because the SIPT is standardized for children aged four to eight, other assessments will be used for those who do not fall in this age range.

Once your child has been screened, and a diagnosis is provided, treatment may be recommended. For more information on treatment, see the “Let’s Play Now” blog.

1. Miller, Lucy J. A Sensible Approach to Sensory Processing Disorder: Overview of all Types. Video Course #1101, 1:10, SPD University.

2. Dunn Winnie. Sensory Profile. San Antonio, TX: Psychological Corporation, 1999. Johnson-Ecker, Cheryl. L and Diane L. Parham. The evaluation of sensory processing: A validity study using contrasting groups. American Journal of Occupational Therapy. 54, (September/October 2000):494–503.