SENSORY PROCESSING DISORDER

Tarek was diagnosted with SPD sensory processing disorder in May 2008. I suspected that tarek has something going on . His teachers said that he was OK but inside me I new tarek need extra help because he wasn't the regular kid with DS,he wasn't the lovable kid that hug you and like been around other children, he had so many mealt downs out of the blue during the day, transition times were HORRIBLES! he hates haircuts and nail clipping we were no able to take tarek to a hair salon anymore, tarek will only eat some type of food, he will hate crowed places or to many people in a small space, he was extremelly scare with some loud noises like the vaccuum and the blender,he will get scare in the swings and he will not climb the ladders in the playground, and other symptoms. So I decided to request an evaluation for possible SPD and the results showed than tarek has some areas were he present sensory integration difficulties.

We found the most amazing OT here in Ogden that help tarek every week. and he is CHANGING FRIENDS! I'm so happy lately....for so long I didn't know what was tarek problem and I coudn't help him but now I'm seen the light again. Tarek is having less tamtrums, less fears, he is able to brush his teeth again, climb a ladder, play in a swing, he seem more happy and more conected. He is also going to Speech therapy and with the help of his therapist tarek sometime is able to put 2 words together but more than anything he is able to comunicate his basic needs.

I feel so Bless! My shoulders feel everyday less heavy. Tarek has a long way to go with both therapies but if this is only the beggining imagine what is next!~

I will advice all the moms and families of children with disabilities that are observing some similars issues to please request a test for possible SPD to their school. The test is for free and later they will qualify for OT therapy. Also if your kids has medicaid the therapy will be FREE!.

I will adjunt some information about SPD I hope It will help. Email me if you need any help at cmora1@hotmail.com.

Sensory processing (sometimes called "sensory integration" or SI) is a term that refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses. Whether you are biting into a hamburger, riding a bicycle, or reading a book, your successful completion of the activity requires processing sensation or "sensory integration." SPD can affect people in only one sense–for example, just touch or just sight or just movement–or in multiple senses. One person with SPD may over-respond to sensation and find clothing, physical contact, light, sound, food, or other sensory input to be unbearable. Another might under-respond and show little or no reaction to stimulation, even pain or extreme hot and cold. In children whose sensory processing of messages from the muscles and joints is impaired, posture and motor skills can be affected. These are the "floppy babies" who worry new parents and the kids who get called "klutz" and "spaz" on the playground. Still other children exhibit an appetite for sensation that is in perpetual overdrive. These kids often are misdiagnosed - and inappropriately medicated - for ADHD.

Red flags for Sensory Processing Disorder
Signs Of Tactile Dysfunction:

1. Hypersensitivity To Touch (Tactile Defensiveness)

__ becomes fearful, anxious or aggressive with light or unexpected touch__ as an infant, did/does not like to be held or cuddled; may arch back, cry, and pull away__ distressed when diaper is being, or needs to be, changed__ appears fearful of, or avoids standing in close proximity to other people or peers (especially in lines)__ becomes frightened when touched from behind or by someone/something they can not see (such as under a blanket)__ complains about having hair brushed; may be very picky about using a particular brush__ bothered by rough bed sheets (i.e., if old and "bumpy")__ avoids group situations for fear of the unexpected touch__ resists friendly or affectionate touch from anyone besides parents or siblings (and sometimes them too!)__ dislikes kisses, will "wipe off" place where kissed__ prefers hugs__ a raindrop, water from the shower, or wind blowing on the skin may feel like torture and produce adverse and avoidance reactions__ may overreact to minor cuts, scrapes, and or bug bites__ avoids touching certain textures of material (blankets, rugs, stuffed animals)__ refuses to wear new or stiff clothes, clothes with rough textures, turtlenecks, jeans, hats, or belts, etc.__ avoids using hands for play__ avoids/dislikes/aversive to "messy play", i.e., sand, mud, water, glue, glitter, playdoh, slime, shaving cream/funny foam etc.__ will be distressed by dirty hands and want to wipe or wash them frequently__ excessively ticklish__ distressed by seams in socks and may refuse to wear them__ distressed by clothes rubbing on skin; may want to wear shorts and short sleeves year round, toddlers may prefer to be naked and pull diapers and clothes off constantly__ or, may want to wear long sleeve shirts and long pants year round to avoid having skin exposed__ distressed about having face washed__ distressed about having hair, toenails, or fingernails cut__ resists brushing teeth and is extremely fearful of the dentist__ is a picky eater, only eating certain tastes and textures; mixed textures tend to be avoided as well as hot or cold foods; resists trying new foods__ may refuse to walk barefoot on grass or sand__ may walk on toes only

2. Hyposensitivity To Touch (Under-Responsive):

__ may crave touch, needs to touch everything and everyone__ is not aware of being touched/bumped unless done with extreme force or intensity__ is not bothered by injuries, like cuts and bruises, and shows no distress with shots (may even say they love getting shots!)__ may not be aware that hands or face are dirty or feel his/her nose running__ may be self-abusive; pinching, biting, or banging his own head__ mouths objects excessively__ frequently hurts other children or pets while playing__ repeatedly touches surfaces or objects that are soothing (i.e., blanket)__ seeks out surfaces and textures that provide strong tactile feedback__ thoroughly enjoys and seeks out messy play__ craves vibrating or strong sensory input__ has a preference and craving for excessively spicy, sweet, sour, or salty foods

3. Poor Tactile Perception And Discrimination:

__ has difficulty with fine motor tasks such as buttoning, zipping, and fastening clothes__ may not be able to identify which part of their body was touched if they were not looking__ may be afraid of the dark__ may be a messy dresser; looks disheveled, does not notice pants are twisted, shirt is half un tucked, shoes are untied, one pant leg is up and one is down, etc.__ has difficulty using scissors, crayons, or silverware__ continues to mouth objects to explore them even after age two__ has difficulty figuring out physical characteristics of objects; shape, size, texture, temperature, weight, etc.__ may not be able to identify objects by feel, uses vision to help; such as, reaching into backpack or desk to retrieve an item
Vestibular Sense: input from the inner ear about equilibrium, gravitational changes, movement experiences, and position in space.

Signs Of Vestibular Dysfunction:

1. Hypersensitivity To Movement (Over-Responsive):

__ avoids/dislikes playground equipment; i.e., swings, ladders, slides, or merry-go-rounds__ prefers sedentary tasks, moves slowly and cautiously, avoids taking risks, and may appear "wimpy"__ avoids/dislikes elevators and escalators; may prefer sitting while they are on them or, actually get motion sickness from them__ may physically cling to an adult they trust__ may appear terrified of falling even when there is no real risk of it__ afraid of heights, even the height of a curb or step__ fearful of feet leaving the ground__ fearful of going up or down stairs or walking on uneven surfaces__ afraid of being tipped upside down, sideways or backwards; will strongly resist getting hair washed over the sink__ startles if someone else moves them; i.e., pushing his/her chair closer to the table__ as an infant, may never have liked baby swings or jumpers__ may be fearful of, and have difficulty riding a bike, jumping, hopping, or balancing on one foot (especially if eyes are closed)__ may have disliked being placed on stomach as an infant__ loses balance easily and may appear clumsy__ fearful of activities which require good balance__ avoids rapid or rotating movements

2. Hyposensitivity To Movement (Under-Responsive):

__ in constant motion, can't seem to sit still__ craves fast, spinning, and/or intense movement experiences__ loves being tossed in the air__ could spin for hours and never appear to be dizzy__ loves the fast, intense, and/or scary rides at amusement parks__ always jumping on furniture, trampolines, spinning in a swivel chair, or getting into upside down positions__ loves to swing as high as possible and for long periods of time__ is a "thrill-seeker"; dangerous at times__ always running, jumping, hopping etc. instead of walking__ rocks body, shakes leg, or head while sitting __ likes sudden or quick movements, such as, going over a big bump in the car or on a bike

3. Poor Muscle Tone And/Or Coordination:

__ has a limp, "floppy" body__ frequently slumps, lies down, and/or leans head on hand or arm while working at his/her desk__ difficulty simultaneously lifting head, arms, and legs off the floor while lying on stomach ("superman" position)__ often sits in a "W sit" position on the floor to stabilize body__ fatigues easily!__ compensates for "looseness" by grasping objects tightly__ difficulty turning doorknobs, handles, opening and closing items__ difficulty catching him/her self if falling__ difficulty getting dressed and doing fasteners, zippers, and buttons__ may have never crawled as an baby__ has poor body awareness; bumps into things, knocks things over, trips, and/or appears clumsy__ poor gross motor skills; jumping, catching a ball, jumping jacks, climbing a ladder etc.__ poor fine motor skills; difficulty using "tools", such as pencils, silverware, combs, scissors etc.__ may appear ambidextrous, frequently switching hands for coloring, cutting, writing etc.; does not have an established hand preference/dominance by 4 or 5 years old__ has difficulty licking an ice cream cone__ seems to be unsure about how to move body during movement, for example, stepping over something__ difficulty learning exercise or dance steps
Proprioceptive Sense: input from the muscles and joints about body position, weight, pressure, stretch, movement, and changes in position in space.

Signs Of Proprioceptive Dysfunction:

1. Sensory Seeking Behaviors:

__ seeks out jumping, bumping, and crashing activities__ stomps feet when walking__ kicks his/her feet on floor or chair while sitting at desk/table__ bites or sucks on fingers and/or frequently cracks his/her knuckles__ loves to be tightly wrapped in many or weighted blankets, especially at bedtime__ prefers clothes (and belts, hoods, shoelaces) to be as tight as possible__ loves/seeks out "squishing" activities__ enjoys bear hugs__ excessive banging on/with toys and objects__ loves "roughhousing" and tackling/wrestling games__ frequently falls on floor intentionally__ would jump on a trampoline for hours on end__ grinds his/her teeth throughout the day__ loves pushing/pulling/dragging objects__ loves jumping off furniture or from high places__ frequently hits, bumps or pushes other children__ chews on pens, straws, shirt sleeves etc.

2. Difficulty With "Grading Of Movement":

__ misjudges how much to flex and extend muscles during tasks/activities (i.e., putting arms into sleeves or climbing)__ difficulty regulating pressure when writing/drawing; may be too light to see or so hard the tip of writing utensil breaks__ written work is messy and he/she often rips the paper when erasing__ always seems to be breaking objects and toys__ misjudges the weight of an object, such as a glass of juice, picking it up with too much force sending it flying or spilling, or with too little force and complaining about objects being too heavy__ may not understand the idea of "heavy" or "light"; would not be able to hold two objects and tell you which weighs more__ seems to do everything with too much force; i.e., walking, slamming doors, pressing things too hard, slamming objects down__ plays with animals with too much force, often hurting them
Signs Of Auditory Dysfunction: (no diagnosed hearing problem)

1. Hypersensitivity To Sounds (Auditory Defensiveness):

__ distracted by sounds not normally noticed by others; i.e., humming of lights or refrigerators, fans, heaters, or clocks ticking
__ fearful of the sound of a flushing toilet (especially in public bathrooms), vacuum, hairdryer, squeaky shoes, or a dog barking
__ started with or distracted by loud or unexpected sounds
__ bothered/distracted by background environmental sounds; i.e., lawn mowing or outside construction
__ frequently asks people to be quiet; i.e., stop making noise, talking, or singing
__ runs away, cries, and/or covers ears with loud or unexpected sounds
__ may refuse to go to movie theaters, parades, skating rinks, musical concerts etc.
__ may decide whether they like certain people by the sound of their voice

2. Hyposensitivity To Sounds (Under-Registers):

__ often does not respond to verbal cues or to name being called
__ appears to "make noise for noise's sake"
__ loves excessively loud music or TV
__ seems to have difficulty understanding or remembering what was said
__ appears oblivious to certain sounds
__ appears confused about where a sound is coming from
__ talks self through a task, often out loud
__ had little or no vocalizing or babbling as an infant
__ needs directions repeated often, or will say, "What?" frequently
Signs Of Oral Input Dysfunction:

1. Hypersensitivity To Oral Input (Oral Defensiveness):

__ picky eater, often with extreme food preferences; i.e., limited repertoire of foods, picky about brands, resistive to trying new foods or restaurants, and may not eat at other people's houses)
__ may only eat "soft" or pureed foods past 24 months of age
__ may gag with textured foods
__ has difficulty with sucking, chewing, and swallowing; may choke or have a fear of choking
__ resists/refuses/extremely fearful of going to the dentist or having dental work done
__ may only eat hot or cold foods
__ refuses to lick envelopes, stamps, or stickers because of their taste
__ dislikes or complains about toothpaste and mouthwash
__ avoids seasoned, spicy, sweet, sour or salty foods; prefers bland foods

2. Hyposensitivity To Oral Input (Under-Registers)

__ may lick, taste, or chew on inedible objects
__ prefers foods with intense flavor; i.e., excessively spicy, sweet, sour, or salty
__ excessive drooling past the teething stage
__ frequently chews on hair, shirt, or fingers
__ constantly putting objects in mouth past the toddler years
__ acts as if all foods taste the same
__ can never get enough condiments or seasonings on his/her food
__ loves vibrating toothbrushes and even trips to the dentist
Signs Of Olfactory Dysfunction (Smells):

1. Hypersensitivity To Smells (Over-Responsive):
__ reacts negatively to, or dislikes smells which do not usually bother, or get noticed, by other people
__ tells other people (or talks about) how bad or funny they smell
__ refuses to eat certain foods because of their smell
__ offended and/or nauseated by bathroom odors or personal hygiene smells
__ bothered/irritated by smell of perfume or cologne
__ bothered by household or cooking smells
__ may refuse to play at someone's house because of the way it smells
__ decides whether he/she likes someone or some place by the way it smells

2. Hyposensitivity To Smells (Under-Responsive):

__ has difficulty discriminating unpleasant odors
__ may drink or eat things that are poisonous because they do not notice the noxious smell
__ unable to identify smells from scratch 'n sniff stickers
__ does not notice odors that others usually complain about
__ fails to notice or ignores unpleasant odors
__ makes excessive use of smelling when introduced to objects, people, or places
__ uses smell to interact with objects
Signs Of Visual Input Dysfunction (No Diagnosed Visual Deficit):

1. Hypersensitivity To Visual Input (Over-Responsiveness)

__ sensitive to bright lights; will squint, cover eyes, cry and/or get headaches from the light
__ has difficulty keeping eyes focused on task/activity he/she is working on for an appropriate amount of time
__ easily distracted by other visual stimuli in the room; i.e., movement, decorations, toys, windows, doorways etc.
__ has difficulty in bright colorful rooms or a dimly lit room
__ rubs his/her eyes, has watery eyes or gets headaches after reading or watching TV
__ avoids eye contact
__ enjoys playing in the dark

2. Hyposensitivity To Visual Input (Under-Responsive Or Difficulty With Tracking, Discrimination, Or Perception):

__ has difficulty telling the difference between similar printed letters or figures; i.e., p & q, b & d, + and x, or square and rectangle
__ has a hard time seeing the "big picture"; i.e., focuses on the details or patterns within the picture
__ has difficulty locating items among other items; i.e., papers on a desk, clothes in a drawer, items on a grocery shelf, or toys in a bin/toy box
__ often loses place when copying from a book or the chalkboard
__ difficulty controlling eye movement to track and follow moving objects
__ has difficulty telling the difference between different colors, shapes, and sizes
__ often loses his/her place while reading or doing math problems
__ makes reversals in words or letters when copying, or reads words backwards; i.e., "was" for "saw" and "no" for "on" after first grade
__ complains about "seeing double"
__ difficulty finding differences in pictures, words, symbols, or objects
__ difficulty with consistent spacing and size of letters during writing and/or lining up numbers in math problems
__ difficulty with jigsaw puzzles, copying shapes, and/or cutting/tracing along a line
__ tends to write at a slant (up or down hill) on a page
__ confuses left and right
__ fatigues easily with schoolwork
__ difficulty judging spatial relationships in the environment; i.e., bumps into objects/people or missteps on curbs and stairs
Auditory-Language Processing Dysfunction:

__ unable to locate the source of a sound
__ difficulty identifying people's voices
__ difficulty discriminating between sounds/words; i.e., "dare" and "dear"
__ difficulty filtering out other sounds while trying to pay attention to one person talking
__ bothered by loud, sudden, metallic, or high-pitched sounds
__ difficulty attending to, understanding, and remembering what is said or read; often asks for directions to be repeated and may only be able to understand or follow two sequential directions at a time
__ looks at others to/for reassurance before answering
__ difficulty putting ideas into words (written or verbal)
__ often talks out of turn or "off topic"
__ if not understood, has difficulty re-phrasing; may get frustrated, angry, and give up
__ difficulty reading, especially out loud (may also be dyslexic)
__ difficulty articulating and speaking clearly
__ ability to speak often improves after intense movement
Social, Emotional, Play, And Self-Regulation Dysfunction:

Social:

__ difficulty getting along with peers
__ prefers playing by self with objects or toys rather than with people
__ does not interact reciprocally with peers or adults; hard to have a "meaningful" two-way conversation
__ self-abusive or abusive to others
__ others have a hard time interpreting child's cues, needs, or emotions
__ does not seek out connections with familiar people

Emotional:

__ difficulty accepting changes in routine (to the point of tantrums)
__ gets easily frustrated
__ often impulsive
__ functions best in small group or individually
__ variable and quickly changing moods; prone to outbursts and tantrums
__ prefers to play on the outside, away from groups, or just be an observer
__ avoids eye contact
__ difficulty appropriately making needs known

Play:

__ difficulty with imitative play (over 10 months)
__ wanders aimlessly without purposeful play or exploration (over 15 months)
__ needs adult guidance to play, difficulty playing independently (over 18 months)
__ participates in repetitive play for hours; i.e., lining up toys cars, blocks, watching one movie over and over etc.

Self-Regulation:

__ excessive irritability, fussiness or colic as an infant
__ can't calm or soothe self through pacifier, comfort object, or caregiver
__ can't go from sleeping to awake without distress
__ requires excessive help from caregiver to fall asleep; i.e., rubbing back or head, rocking, long walks, or car rides

Internal Regulation (The Interoceptive Sense):
__ becoming too hot or too cold sooner than others in the same environments; may not appear to ever get cold/hot, may not be able to maintain body temperature effectively
__ difficulty in extreme temperatures or going from one extreme to another (i.e., winter, summer, going from air conditioning to outside heat, a heated house to the cold outside)
__ respiration that is too fast, too slow, or cannot switch from one to the other easily as the body demands an appropriate respiratory response
__ heart rate that speeds up or slows down too fast or too slow based on the demands imposed on it
__ respiration and heart rate that takes longer than what is expected to slow down during or after exertion or fear
__ severe/several mood swings throughout the day (angry to happy in short periods of time, perhaps without visible cause)
__ unpredictable state of arousal or inability to control arousal level (hyper to lethargic, quickly, vacillating between the two; over stimulated to under stimulated, within hours or days, depending on activity and setting, etc.)
__ frequent constipation or diarrhea, or mixed during the same day or over a few days
__ difficulty with potty training; does not seem to know when he/she has to go (i.e., cannot feel the necessary sensation that bowel or bladder are full
__ unable to regulate thirst; always thirsty, never thirsty, or oscillates back and forth
__ unable to regulate hunger; eats all the time, won't eat at all, unable to feel full/hungry
__ unable to regulate appetite; has little to no appetite and/or will be "starving" one minute then full two bites later, then back to hungry again (prone to eating disorders and/or failure to thrive)

NOW WHAT TO DO

A Step By Step GuideFor SPD Parents:The Seven Steps For HelpingYour SPD Child


"I Think My Child Has SPD... Where Do I Begin?"
"Where Do I Go For Help?"
"What Do I Do Now?"
"How Do I Find An OT In My Area That Can Diagnose SPD?"

Step One
Read, print a copy, and fill out the following checklists as they apply to your child that you suspect has SPD:
Sensory Processing Disorder Checklist (all ages)
Infant / Toddler SPD Checklist (0-3)
Developmental Checklist (ages 0-5)
Adolescent / Adult Checklist (ages 12-100)

Step Two
Bring the completed checklists to your child's pediatrician, discuss it with him, and ask for a referral to an Occupational Therapist for an evaluation. If the pediatrician does not "believe in" SPD, or refuses to make a referral to a specialist for this evaluation, find a new doctor!
If the pediatrician wants to refer you to a developmental specialist as well, even better... they can rule out (or pick up) other developmental disorders. Keep in mind, many SPD kids have other diagnoses... not all, but many. So, now's the time to find out!
Additionally, a referral to a psychologist will help both you and your child deal with the multiple issues that have, and will continue to arise individually and as a family. Be proactive! Don't wait!

Step Three
Find out which clinic, hospital, program, or private therapist will be the best place to have an Occupational Therapist evaluate your child (or YOU, if you are an adult seeking a diagnosis and treatment). Note that ages 0-3 will want to find the "Early Intervention" program, and ages 3-5 will want the "Child Find" program in your area... both of which should be run by your town's school department.
Please read the following two articles carefully for help:
Tips For Finding OT Services
How To Find An OT For SPD
How To Find The BEST OT And What You Need To Know Before Starting Therapy
ALSO, make sure you call your insurance company AND ask the facility or the OT whether they accept your insurance for such an evaluation. Just a warning...often they will not, YET! These evaluations CAN BE quite costly (up to $800)...but, how can you really put a price on finding the proper diagnosis and treatment for your child? Believe me, it is MUCH more "costly" in both time, frustration, money to be given incorrect and unnecessary tests, diagnoses, and even medication! Once you receive the PROPER diagnosis, treatment will seem relatively "easy".
I can't tell you how many parents would have GLADLY shelled out the money necessary for a proper evaluation, had they only known!!! Years and years of doubts, blame, frustration, misdiagnoses, endless and unnecessary doctor's visits and treatment, as well as increasing symptoms/difficulties at home and school have all, LITERALLY, almost destroyed lives! Please don't let it get this bad for YOU!
One more thing on insurance... In MOST cases any form of Medicaid WILL cover evaluation and treatment as long as the therapist uses the "right" codes for reimbursement and the proper wording to justify it. This is precisely the reason my friend Michelle Morris has put together a nice list of "Commonly Reimbursed Diagnostic Codes" (see link below) which will apply to regular insurance as well as Medicaid. So, in most cases, using acceptable diagnostic codes, Medicaid covers almost all necessary OT services for SPD. Michelle adds, "Additionally, for instance, it will cover therapeutic interventions, right? But not cover equipment like Listening Therapy equipment, brushes, massager, companion programs (for example, Handwriting Without Tears) etc. UNLESS a person has CMS type Medicaid. If they DO, then a parent may apply to get a certain monetary allowance to cover specific therapeutic equipment, and these items can be purchased with the money. So... there are rules and then there are RULES, and depending on how savvy the OT is, and the wording USED this can be different. But yes, the general rule of thumb, using the appropriate diagnostic codes when requesting payment by Medicaid for SPD OT, they cover it... the evaluation AND treatment."
(More tips on insurance reimbursement and financial help listed under STEP SIX)

Step Four
While you are waiting for your evaluation, read, read, read everything about SPD you can get your hands on! Here are some recommended resources:

The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder, Revised Edition

Step Five
The Evaluation
The testing process is quite involved if done properly, as it should be! Testing should involve multiple disciplines (for input at the least), but can be done by one qualified professional such as an Occupational Therapist. It can be done within an early intervention program, school system, teaching hospital, children's hospital or at a special clinic that diagnoses and treats Sensory Processing Disorders. The following components should be included if possible:
interviews and questionnaires for the child, family, teachers, other people or professionals who interact with the child to guide testing and decide whether further evaluation is necessary (the questionnaires will be based on overall functioning, developmental milestones, and behavioral indicators of sensory dysfunction)
perform standardized tests and non-standardized tests with the child in a sensory/testing room which will include performing gross motor, fine motor, oral motor, and visual perception tasks, making observations regarding all sensory systems and developmental milestones, as well as reactions to (and processing of) oral, auditory, vestibular, proprioceptive, olfactory, tactile input, and performance of tasks.

the OT will then score and evaluate all findings, deciding which, if any, sensory systems are significantly impacted, and if so, how much, when, and why.

a meeting with the parents, and child (if appropriate), to report all results, concerns, and specifics of testing outcomes, and educate all those present on sensory processing disorders as it relates to their child.

agree on a plan; if the child will have treatment, how much, how often, what the treatment will entail, any home or school programs, etc.

the therapist will then write and agree on goals/treatment with parents and/or child.

Remember this...
A good, thorough, proper diagnosis ALWAYS includes a questionnaire (or several). Generally speaking, the parents fill the questionnaire out, however, a child over 7 (or so) can be the one who "answers the questions" too. But, usually, the parent/teacher/professional fills it out, with or without the child's input, and the person testing the individual will ask the child further questions based on this questionnaire. So, technically, the child plays a pretty "active role" in the questionnaire process, but unless the child is of the teenage years (and that is not a be-all-and-end-all age requirement), someone else usually fills it out. There are adolescent and adult questionnaires designed specifically for that individual to fill out. When appropriate, we use them.
It will take many pairs of eyes and they should all be involved in the "questionnaire" or interviewing/gathering information process! We all see different things, and children act differently in different settings (especially kids with Sensory Processing Disorder!) based on many situational/contextual/environmental factors. The other thing to remember, is we are trying to identify these children as early as possible, so most of them are too young to fill a questionnaire out anyway. Sometimes, I had kids fill one out in addition to the parents to compare two different experiences and perspectives. It is very different living with it, and living WITH it!

Step Six
Begin treatment, if recommended. More often than not, this will be paid for by regular insurance, thank goodness! (Although, as previously mentioned, companion therapies may not be). Once the diagnosis is confirmed, treatment can focus on areas of dysfunction that are "billable". Are you wondering what some of those diagnoses and codes are?
Then click here for a list of commonly used diagnostic codes for SPD/SID therapy.
Also, keep in mind, if Sensory Integration therapy is being done before age 3, it is free when you go through your local Early Intervention Program (as long as there are developmental, physical, and/or social/emotional delays) And, ages 3-5 are also usually free through the Child Find Program (again, call your local school department for more on this).
Additionally, The Elks, if you have one in your area, has been a wonderful resource for parents... including evaluation, treatment, and therapeutic supplies/products when parents can not otherwise afford therapy. Look that one up if you are in this situation!
Be prepared to become a very active participant in your child's therapy! Therapy will not work, if you don't work it! It is a daily commitment since you will usually be asked to follow a Sensory Diet and/or certain activities/homework between therapy appointments. Make sure you are ready for this commitment... you will play a major role in the success of your child!
Know that there are many therapeutic products and programs that can be/are used in addition to direct OT sessions. Some of them can be expensive as well. But, again, the positive changes in your child and family will be priceless!
If money is a major hurdle for you during the evaluation and treatment phases, here is a great article about community resources that may help/be available to you "Financial Help For Sensory Products".

Step Seven
Connect with other parents of SPD kids (ASAP, even before evaluation if possible), give back to your community via online support groups/ forums, and/or by becoming an "SPD Parent Host".
Are you looking for support? Go to my all-time favorite yahoo groups SID-DSI_AllAboutKids (for parents, professionals, and families of children with SPD, or suspected SPD) OR SPDAdultSHARE (for adolescents and adults with suspected, or diagnosed, SPD).
Are you looking to be a support to others? Then go to http://www.spdparentshare.com/ Help yourself first, then think about helping others. We would love to have you on board!!
I do hope this information proves helpful to you in where to go next! If you have further questions, feel free to ask any of the SPD Parent SHARE Hosts.

Good luck on your journey and thank you so much for advocating for your children!! They need you and are lucky to have you!