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Attention Deficit Hyperactivity Disorder

Sensory Integration Issues

10/30/2006

Question:

My 8 year old has been diagnosed ADHD since the middle of 1st grade. He was on Adderall XP, but got switched to Concerta because of vocal tics about 6 weeks ago.

Through all this and even before, he has the tendency to hug people really hard. He even goes up to his classmates at school and hugs them, sometimes swinging them around if they aren`t very heavy. Naturally, the kids are not happy with this treatment, but I haven`t been able to get my child to stop. What is the deal with this? Initially I thought he had a sensitivity disorder. I contacted the school the beginning of first grade. The OT observed him, and said he was "borderline" so the school wouldn`t provide services. Then I went to our dr. who diagnosed him with ADHD and sent us to an educatinal therapist. This still hasn`t addressed the hugging issue. Is this part of ADHD? I haven`t found too much in my personal research about this. Your advice is appreciated.

Answer:

Sensory integration issues frequently co-occur with ADHD (I don't have an actual percentage to give you). Whether or not this is what is going on with your son I am unable to tell but I asked for help on this one from one of the experts I work with from The Affinity Center here in Cincinnati, Dr. Christine Mayhall. She is the psychologist in our practice who works most with the children who have both ADHD and sensory integration concerns.

Some of the first things I ask about are if the child has any other sensory sensitivities such as great difficulties with the tags inside his clothes, textures of foods, or particular problems with certain sounds.  

Dr. Mayhall mentioned that many parents find it helpful to look at the book The Out-of-Sync Child by Carol Stock Kranowitz. It can help you to learn a bit more about what sensory issues are like, then determine whether it's worth hooking up with an OT privately who has expertise in assessing sensory integration issues. Not all OTs have this training/expertise.  Kranowitz's book is easy to read and doesn't require reading entirely from start to finish to get the picture; it should be available at the library and it's on the shelves in all the bookstores. There's a brief Sensorimotor History Questionnaire in the book which lists the kinds of things you might see in a child with sensory issues.  If you see quite a number of these things, then the need to pull in a specialist to address those issues is indicated.

Dr. Mayhall also suggested what looks like a great website by a Physical Therapist named Othena Oden who sets up 'Motor Labs' at schools for kids with sensory issues.  Her website is below (Ready Bodies. Learning Minds). So it's another great place to learn more about sensory issues and the types of things that can be done to help address them. 

If you are writing from around the Cincinnati area, there is an ongoing group for parents of kids with sensory issues at COTI (the Cincinnati Occupational Therapy Institute) in Blue Ash. I added their website below. If from elsewhere, you may want to call an OT office and ask if any such group exists nearby, or check on the SP Network website I added below.

Treating ADHD is not usually as successful when co-existing conditions such as sensory integration issues are present but not addressed. You are very wise to have continued to pursue this. It may end up not being a major concern, which would of course be wonderful. But if it is, an OT who specializes in these things can do wonders, and that would be wonderful as well.

I (we) wish you the best.


Related Resources:

Ready Bodies, Learning Minds
SPD Network
COTI

For more information:

Go to the Attention Deficit Hyperactivity Disorder health topic, where you can:

Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati