I acknowledge that there is the potential for over diagnosis. However, I would tend to disagree with your professional opinion with regard to inclusion of SPD into the DSM V.

First, the DSM serves as a gatekeeper for services. With inclusion, children will no longer be treated for the catch all “lack of coordination” or the like. Once available as a diagnostic tool, professionals will have the opportunity to offer accurate clinical diagnoses that are supportable. After all, we live in an age of managed medicine.

Second, the practice of medicine is a profession, hopefully tempered by integrity and not monetary pressures and concerns. Should the American Psychiatric Association give credence to the possibility of over exposing the risk pools for insurance providers? Without a doubt abuses have and will occur. But this argument lends itself to the exclusion of large portions of the past DSM publications and current recognized diagnoses. The DSM provides tools for both credible and dishonest medical providers to use. Isn’t it appropriate for the next generation’s treatment providers possess a wide variety of tools? It is not the purpose of the DSM to regulate necessarily how those tools are used, just to make the tools available and provide the diagnostic criteria to guide the treatment providers.

Third, the DSM has historically has had some zany and unflattering diagnoses grace its contents. Did the exclusion of these mark a greater understanding of the human psyche or some quest to increase profitability, which appears to be the tone of you comment?

Fourth, as a parent of a child who clearly has sensory sensitivities, it is clear that SPD can and should be a tool in the arsenal of medical professionals. Excuse my insensitivity, but I have never been a strong supporter of the diagnoses ADD and ADHD. However, a group of very learned professionals with much more education and expertise determined that there is a psychiatric compenent to attention deficit issues. Regardless of my own thoughts on the potential for abuse, to exclude these diagnoses from the DSM would have a detrimental impact on those who actually suffer from these issues. With regard to SPD, I have a son who has difficulty with noises and touch. Not the natural, behavior concerns indicative of a young child, but deep inbred fears and struggles attempting to conceptualize and process certain sensations. My wife and I have known about his difficulties seemingly since birth, but have grown accustomed to accommodating them. The world does not accommodate them. In the world, in school, on the playground, that is where his difficulties are most noticeable and least manageable. How then as a parent can I educate myself to help my child through his unique struggles if he is denied access? Without the foothold offered by DSM-V, what avenues to other parents of similiarly situated children have?

Our knowledge and grasp of medicine has vastly improved in all areas. It makes sense that the tools by which we diagnose conditions evolve to keep pace with the treatments we subject our children to and the medications we ask them to ingest. Lastly, the saying, “If it looks like ___, and smells like ___, then it probably is ___,” seems adequate. As a parent, it looks like SPD… include it.

I completely understand what you are saying. This is a double edged sword. On one side we want to see improved access to services for kids with sensory processing challenges. On the other is the risk of over diagnosis as you state. If you look hard enough for something you will see it. Without objective diagnostic criteria, this could be a real problem. Researchers including Dr. Lucy Miller are working hard to provide the objective measures needed and I greatly hope they are successful in that effort.

I personally am not in favor of labelling children, but do want them to receive the services needed to be happy, healthy, and productive in their lives, with the right opportunities to achieve their individual and innate potential.

Alex