Question: “What is your opinion on “sensory processing delay”and OT therapy? Is this being overly diagnosed in your opinion and the new catch phrase? Thank you.”



Dear K:

Thank you so much for submitting this question.  I  think there are many parents like yourselves who share the same concerns. To provide you the most accurate and comprehensive answer to your question,I forwarded your inquiry on to my good friend and colleague Danielle Shulman, Occupational Therapist from Write Steps (  

 As she will explain, sensory processing disorder (SPD) is indeed accepted as a veritable condition within the health care/medical community, and some new studies are providing it with more empirical validation than we have had previously.

I do agree, however, that there is more education needed to ensure that we are accurately identifying children who demonstrate sensory challenges so that appropriate referrals are being made. A thorough evaluation by a trained occupational therapist is always the best route to take should you have suspicions. Also an assessment by a trained developmental psychologist can help to tease out any other associated behavioral or emotional challenges that may be at play (e.g. inattention, impulsivity, anxiety, etc).

 Ok, enough from me, – over to Danielle Shulman ……!

 Answer:  These are great questions and two that I am asked on many occasions by both parents and many different disciplines.

First let me tell you a little background about what it is for many that do not know what it means.

The term was first coined in the 1960’s by occupational therapist, psychologist, and neuroscientist A. Jean Ayres, Ph.D.

Here is a brief description of taken from the Sensory Processing Disorder Foundation. “Sensory Processing Disorder (SPD) acts like a neurological “traffic jam” that prevents certain parts of the brain from receiving the information needed to understand and respond to sensation.”

Recent statistics show that SPD affects about 5-16% of children in the general population. People with SPD may misinterpret everyday sensory information, such as touch, sound, and movement. “They may over-respond and find clothing, physical contact, light, sound, food, or other sensory input unbearable. Or they may under-respond and show little or no reaction, not even to pain or extreme hot and cold. A third option is sensory-motor problems, including weakness, clumsiness, awkwardness or delays in acquiring gross and/or fine motor skills.”

Many people have questioned the biological basis for SPD and whether it really is a disorder. Recently, “a groundbreaking new study from UC San Francisco showed that children affected with Sensory Processing Disorder (SPD) have quantifiable differences in brain structure, confirming a biological basis for the disorder that sets it apart from other neurodevelopmental disorders such as ADHD and autism.”


What is your opinion of SPD?

Although some people may be skeptical about SPD, it is very real to children and adults that must deal with it. A child can become very anxious over many things that may seem insignificant in our day to day life.

I have been treating children with sensory processing delays for many years. However, I think it was my first hand experience with my own son that made it the most real and heartbreaking for me as a parent. If I had not had the prior experience with SPD in other children, I would have felt very confused and alone as to why my child acted certain ways around things that other children loved. For example, when he was much younger, he could not be around any loud noises, wear any clothing with certain fabrics, was resistant to certain forms of touch or ground coverings like grass or sand. We were so excited to buy our first Disneyland passes and show our 4 year old how much fun it would be. However, it was so overwhelming for his senses and anxiety provoking for him, with the unexpected noises, even just walking around, that he spent almost the whole time hiding in his stroller. It took all of my knowledge of sensory processing in order to incorporate sensory strategies and activities into his day to help him to deal with many of these things that were uncomfortable for him. Is he all better and did I cure him of his “sensory processing disorder?” No, but I was able to understand him and treat him with many of the new techniques that are out there to help calm him when he is feeling anxious about something related to his sensory environment.


Is it being used as a catch phrase?


No. I believe what people are discovering is that there are many sensory strategies that can help children with different diagnosis as well. For example, sensory processing issues can be seen a lot in children with other existing conditions such as autism and ADHD. It is important to receive the proper diagnosis for optimal treatment. I see a lot of children in my private practice with a variety of different diagnoses and have seen them benefit from sensory integration treatment and strategies.

It is important to note that a child can only receive the formal diagnosis of having a Sensory Processing disorder by a clinician specially trained in the Sensory Integration Praxis Test. However, there are many children that can display many different sensory issues that can benefit from intervention without the formal diagnosis.

The important thing for the parent to think about is if these sensory difficulties are impacting their ability to function optimally in their environment. Are they demonstrating certain behaviors that are a result of the child having some sensory issues? Are they able to maintain friendships even though they are nervous to have a child bump into them? Is their classroom too loud for them and they have trouble completing their work? Are they afraid to climb the monkey bars because they don’t like having their feet leave the ground? Do they constantly get in trouble by their teacher because they cannot sit still for seated activities in class?

I have worked as an OT for over 13 years and have seen the positive changes for many children receiving intervention for their sensory processing difficulties. Many parents ask me if it is completely curable. I don’t believe it is, however, I have seen the treatment benefit many children, as well as my own, in areas that can include: improving undesirable behaviors that can result from having sensory processing issues, increasing self-awareness and confidence in children, improving ability to participate in activities that involve motor planning. It is also important to discern whether the behavior stems from a sensory processing disorder that an OT provides treatment for, versus a child psychologist that is trained in treating children with behaviors that do not stem from a sensory origin.


Please refer to my website for further explanation of sensory integration or to view a checklist of symptoms a children with sensory processing difficulties may exhibit.


Danielle Shulman is the owner of WriteSteps Pediatric Occupational Therapy, located in the Del Mar/Carmel Valley area. She has been an OTR/L, for over 13 years and has worked in many different school settings before opening her private practice 9 years ago. She graduated with her Bachelor’s from Emory University and her Masters in Occupational Therapy from Tufts University in Boston. She specializes in evaluation and treatment of fine motor skills, handwriting, sensory integration, and feeding therapy and works with children aged 2 and older. When Danielle is not working, she is spending time with her 2 beautiful boys, her husband, and the family dog, Waffles.

Please feel free to visit Danielle’s website at or contact her at 8585-401-2677 for a complimentary phone consultation.