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Sensory Processing Difficulties or Attention Deficit and Hyperactivity Disorder (ADHD)?

It is often hard to tell what is the source of the difficulty when children are very active and struggle to keep their attention on task. Parents of children with sensory processing difficulties and parents of children with ADHD often describe very similar features. In addition, some children have both sensory processing difficulties and ADHD.

My experience taught me that it is very important to try and understand what affects your child most. My assessment will help to identify sensory processing difficulties but will not conclusively answer the question if your child also has ADHD. It is through the outcome of the therapy sessions that your child’s needs will be better understood.

In cases, where the eventual diagnosis is ADHD then an Ayres Sensory Integration approach may be less effective. However, it is a useful tool to establish the diagnosis and to identify sensory strategies to help your child calm down.

If you are thinking that your child might have ADHD it is recommended to see a paediatrician and discuss your concerns with her/him in addition to seeking occupational therapy support.

I hope that the case of S described below will help to illustrate the kind of support that I offer children who are very active and struggle to keep their attention on task.

S, an 8-year-old boy with attention and behaviour difficulties, and problems to maintain positive peer relationships.

It was S’s clinical psychologist who referred S to me. She was not sure if his difficulties are related to sensory processing difficulties or to ADHD. His mother was worried about him frequently getting into trouble at school, his poor safety awareness, his impulsivity and the fact that he did not have friends.

S attended 6 sessions in the clinic where I used the Ayres Sensory Integration approach. During the sessions S engaged in activities such as swinging, climbing, pushing and pulling. I asked S to plan and execute the activities and I constantly added challenges that required slowing down and planning. I tried to help S use the therapy room to think about and come up with a safe way to complete an activity. This meant that S was able to try activities that would be unsafe outside the soft play clinic space (e.g. climbing and standing on a ball without ensuring that it is stable or swinging while having foam objects close by) and could see and experience the result in a safe manner. This allowed him to reflect on actions he has to take first to make the environment safe. S enjoyed the sessions and his mother, school teacher and SENCo (Special Needs Coordinator) reported that he is calmer and more attentive.

At the end of the block of sessions, I wrote a report with recommendations to help adults in S’s life better understand his needs. In addition, I observed S in class and attended a few meetings at school to think with school staff about appropriate suggestions for the classroom and problem solve together around difficult behaviour.

S, his mother and his teacher became more aware of his needs and would often use activities such as chewing a gum or being covered by weighted blanket to help S attend to task and calm down. This awareness and support helped S be calmer and as a result his peer interactions were more positive.

S was discharged when his mother and the school team said that they felt confident to support him.

Later on, after a few years, S received a diagnosis of ADHD as he struggled to keep his attention for the longer work required at school. However, I heard that he continued to do well using the strategies we introduced.

S's progress highlighted that some children with ADHD have additional sensory processing difficulties and can benefit from occupational therapy support using the Ayres Sensory Integration approach.


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