Thinking about Sensory Processing Disorder (SPD)

After some interesting discussions with my colleagues, I wanted to share my thoughts on SPD. As occupational therapists (OTs), we work every day with individuals who experience the world differently through their senses. One term that often comes up in both clinical practice and conversations with families is Sensory Processing Disorder (SPD). However, it’s important to approach SPD thoughtfully and accurately, especially when discussing diagnosis, intervention, and professional guidelines.

What is Sensory Processing Disorder?

Sensory Processing Disorder is often described as a condition where the brain has trouble receiving, interpreting, and responding appropriately to sensory information. This can affect how someone experiences touch, sound, movement, sight, and even internal sensations like hunger or pain. People with sensory processing differences might seem unusually sensitive to sensory input, seek out certain sensory experiences, or appear unusually unresponsive to sensory stimuli.

As OTs, we often see sensory processing difficulties in individuals with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), developmental coordination disorder (DCD), dementia and in those who have experienced trauma. These sensory challenges can have a significant impact on daily life, influencing participation in school, work, play, and self-care activities.

Is SPD an Official Diagnosis?

Despite its common usage, it is crucial to clarify that Sensory Processing Disorder is not recognised as a standalone medical diagnosis in two of the major diagnostic manuals used internationally: the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11). While sensory processing challenges are acknowledged within the criteria for other conditions (for example, sensory issues are a core diagnostic feature of autism), SPD itself does not have an independent diagnostic status. This distinction is important for clinical practice, research, and service provision.

Guidance from the Royal College of Occupational Therapists (RCOT)

In 2021, the Royal College of Occupational Therapists (RCOT) issued a position statement regarding sensory integration and sensory-based interventions. The RCOT highlighted that while sensory-based needs are very real and impactful for many individuals, it is essential that occupational therapists avoid presenting SPD as a distinct, standalone diagnosis. The RCOT encourages OTs to focus on assessing functional needs and delivering evidence-based interventions that address the individual's occupational performance, rather than labelling difficulties solely under the banner of SPD. Their guidance reinforces the importance of holistic, person-centred approaches, where sensory processing challenges are understood in context with other developmental, emotional, and environmental factors.

What Does This Mean for Occupational Therapy Practice?

As occupational therapists:

• We validate sensory experiences: Even though SPD is not formally recognised as a standalone diagnosis, we fully acknowledge that sensory challenges are real and impactful for many individuals and families.

• We assess function: Our assessments focus on how sensory processing differences affect a person's daily activities, participation, and quality of life.

• We provide evidence-informed interventions: Therapy may involve sensory integration approaches, adaptations to environments, development of self-regulation strategies, and empowering individuals and families with knowledge and tools.

• We communicate clearly: Explaining that SPD is not a diagnosis can be a difficult conversation, particularly as families have often fought hard to secure this or other diagnoses for their child. We must explain the status of SPD sensitively and accurately, from the outset, to families, teachers and other stakeholders, avoiding confusion while still addressing their concerns and needs.

• We collaborate across disciplines: Understanding sensory processing differences often requires input from a multidisciplinary team, including psychology, speech and language therapy, and education professionals.

Final Thoughts

Sensory processing challenges have a significant impact on many people's lives, necessitating understanding, support, and effective interventions. These should enable people of all ages to live full and meaningful lives, embracing and navigating the sensory world in a way that works best for them.

You might want to look for the SIE logo or the CLASI certificate logo.

As OTs, we are uniquely positioned to help individuals navigate these challenges in practical, meaningful, and empowering ways without overstepping current diagnostic frameworks.

That’s why a thorough and accurate sensory assessment by a health care professional appropriately trained in sensory integration is key.

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