Observing your child playing, your mother-in-law asks if she’s been evaluated for ADHD. Your doctor suggests that what you’re seeing could be Sensory Processing Disorder (SPD). Are these two conditions really that similar? What are some of the differences that can help you identify what you’re facing?
The Similarities of SPD and ADHD
In truth, there are a few outward similarities, and they are the kind that are easily noticeable. Because of that, these two conditions are sometimes confused for one another.
First, both conditions can make you appear restless, impulsive, and make it difficult to concentrate. So if your child can’t sit still or focus on a single task for a long period of time, it might appear to be either of these.
Second, meltdowns are common for both SPD and ADHD, as is social anxiety. Both children with ADHD and SPD may have a hard time regulating their emotions and may act out most often when they are in social situations.
Differences Between SPD and ADHD
That seems like very few similarities for these two conditions to be confused for one another so often. But the real challenge comes from the overlap in the differences, as they may present similarly, but stem from different causes.
ADHD is a neurodevelopmental condition, https://www.epa.gov/sites/production/files/2015-10/documents/ace3_neurodevelopmental.pdf, where there is an organic imbalance in neurotransmitters. ADHD brains have low levels of a neurotransmitter called norepinephrine. Norepinephrine is linked with dopamine. Dopamine plays a role in how we feel pleasure. It's a big part of our unique human ability to think and plan. https://www.webmd.com/mental-health/what-is-dopamine#1
Sensory Processing is a neurophysiological disorder where the sensory input from the environment or one's own body is inadequately perceived, therefore affecting behavior and learning. https://www.spdstar.org/basic/understanding-sensory-processing-disorder
For instance, children with ADHD may seem like they have a hard time concentrating, while a child with SPD also has difficulty focusing. But for the SPD child, the problem stems from the inability to filter out seemingly harmless sensory stimuli, process sensory stimuli, or even receive sensory information and produce suitable behavioral and emotional actions. The ADHD child is dealing with a more internal, neurological problem. A cognitive, brain based executive function condition.
Similarly, issues in social situations may, on the surface, appear similar, but come from different sources. A child with ADHD may avoid social situations, or become stressed during them because impulse control and a lack of understanding of social appropriateness make these situations confusing. For a child with SPD, crowded and noisy environments make it difficult to process what’s going on around them.
Further differences abound, however.
A child with ADHD won’t be able to concentrate even if placed in a quiet environment with few distractions, although in some instances they may hyperfocus. They tend to be disorganized and have a hard time following directions. They are also impatient and impulsive and can interrupt others frequently.
An SPD child, on the other hand may be more likely to concentrate when placed in a quiet, distraction-free environment, and is less prone to impulsivity, (there are exceptions of course, children who require more stimulation to reach a higher threshold to enable them to be better organized).
Now we need to mention that ADHD and SPD can exist together. Some say by 40%. There are other conditions that also have comorbidity with ADHD such as anxiety, ODD, Learning Disabilities etc, however we are focusing on ADHD and SPD. Figuring out where the behaviors are stemming from most significantly is first and foremost. You may need to address the sensory challenges first if they are most prevalent.
Who Can Help You Figure Out Which It Is?
Generally a Neuropsychologist or Psychotherapist will evaluate for ADHD difficulties and an Occupational Therapist of SPD difficulties. Treatment considerations are quite different and if addressing both issues, parent involvement, teacher input and all professionals working together is paramount.
When it comes to treatment, ADHD runs the gamut from behavior therapy to medication. Medical practitioners, psychologists, therapists, and neuropsychologists may all be part of your child’s care team.
Conversely, SPD will largely work through therapeutic professionals. Occupational therapists and psychologists will be the primary providers. A pediatrician may join the team if medication is needed for anxiety or panic control.
How You Can Help
Obviously, the home environment is the most important place of comfort and learning, whether you are dealing with ADHD or SPD. You should work closely with your team to determine how best to help your child at home or when in public together.
Children with ADHD should have rules set and daily routines to provide structure. Tasks can be broken down to make them more accessible, and you should help your child with the organization of their work, backpack, and space. They will need to learn, think, choose, what is important to attend to. Neuroplasticity is of great importance for treatment of ADHD https://edgefoundation.org/adhd-and-the-neuroplastic-brain/
For parents with an SPD child, remember sensory information is brain food. Your child may need less or more to make them feel just right. You need to understand how your child is wired differently and you may need to make environmental changes as your child is learning how to navigate their sensory world.
Both the ADHD child and the SPD child experience anxiety, so in either case you should do what you can to minimize that or prepare them for new situations. For instance, prepping your child before they go into public or new social situations can help get them ready for the experience. Other tactics, like weighted clothing and blankets, can help minimize anxiety for children with either condition.