The infant/child with SPD should never be Iron, Vitamin B, or Magnesium deficient.

• Iron is crucial for sound, uninterrupted sleep - the infant/child with SPD will typically struggle to sleep.
• Vitamin B fends off anxiety and depleted levels have a nasty effect on the infant/child with SPD - remember that the infant/child with SPD struggles with unrelenting levels of anxiety by default.
• Magnesium helps with the relief of muscle tension (also relaxing the colon) - the infant/child with SPD will often struggle to fully relax.

Having said all this, you would typically need to have a blood test done to determine Iron, Vitamin B or Magnesium levels in the body. I was unfortunate in that I could never expose Hein-Chris to the trauma of drawing blood. He simply did not (and still does not) have the emotional and physical resources to cope with the pain and fear. It would only reinforce his belief that everything on earth is dangerous.

I had to guess he might be suffering Iron, Vitamin B and Magnesium deficiencies based on what I saw him eat. The infant/child with SPD will often not tolerate a balanced diet. While you might be able to convince/bribe/force/coax an infant/child without SPD to eat a variety of foods (healthy foods children typically don’t like), the infant/child with SPD will not be swayed. In most cases they simply cannot tolerate the smell, taste and texture of the food, making it physically impossible to consume. It is not an act, and parents with infants/children without SPD will not get it. I don’t blame them. I can hardly understand it myself, but it is a stark reality in the life of an infant/child with SPD. Make peace with it.
 
My strategy was to:

• Offer Hein-Chris a chewable multi-vitamin - that contains Magnesium - which he could tolerate. We had to try quite a few brands before finding one he was willing to eat, and it had a lot to do with the smell of the tablet. Hein-Chris uses Dischem’s Gold Yummy Vites - a chewable multi-vitamin in delicious mixed berry flavour. While it might not have been my first choice, I am thrilled that my son takes one of these tablets daily - in the morning.
• Add a smidgen of Liquid Iron to Hein-Chris’ juice/milk every day. I chose Ferrimed® Syrup, because it is safe for use by infants and children, and I could easily mask 2mL of the syrup - once a day (in the morning) - in his baby bottle of formula when he was small.
• Supply him with extra Vitamin B every day - in the morning. Hein-Chris most recently started using BetterYou® Boost B12 Oral Spray - two sprays per day directly into his mouth. It has a delicious taste.

I never discussed this strategy with Hein-Chris’ paediatrician. My decision to use supplements was based on my own research and instinct - and the dosages were such that there was no risk to Hein-Chris. However, talk to your paediatrician about these supplements before administering them - especially if your infant/child is taking medication of any kind. 

As per my first blog post, your Team of Experts has diagnosed your child with SPD. After blog post two, his/her treatment plan is now in place. For the time being, you visit the occupational therapist (OT) once a week.

While you are relieved that you now know your child has SPD, he/she is just as difficult to manage as before the diagnosis. The meltdowns, the outbursts and the constant crying are unrelenting. You remain in a state of chronic fatigue, and spend every moment your precious sprout is sleeping, trawling the internet for advice and support.

The very last thing you want to consider, is leaving the confines of your home and go anywhere other than the OT’s rooms (and only because you know you absolutely have to).

I found myself in this exact state a little more than four years ago. I had two choices: (1) stay home, draw the curtains, and do whatsoever kept Hein-Chris calm and anxiety-free; or (2) force him out the front door - kicking and screaming - and spend as much time as possible doing normal, age-appropriate activities like other mommies were doing. I opted for the latter, as I somehow instinctively knew that keeping him safely ensconced in a darkened room might provide short-term relief, but that this, in the long-run, would be detrimental to his development.

Taking Hein-Chris out of the house was a huge production. I needed two fully packed bags of clothes and wet wipes. He would scream to the point that he’d vomit all over himself, multiple times, during every outing. However, I did not let this deter me from taking him to every mommy-and-baby class in town - kicking and screaming. We visited the mall, the park, any local restaurant that could stand us, the animal farm, and the beach - kicking and screaming (I don’t mention kiddies’ parties as you don’t want to get me started on those; they are not for the faint-hearted). At first, Hein-Chris screamed and cried and vomited all over the place until we would leave after five minutes. Then 10 minutes. Then 15 minutes. Later he’d scream and cry and vomit, and then settle - at long last - for five minutes of not screaming and crying and vomiting. He’d take in his surroundings and watch what others were doing. Tomorrow we’d do the same. And the next day. And the next. And the next. For years.

Five minutes turned to six, then seven, and later thirty minutes. Today I can take Hein-Chris almost anywhere of my choosing - mostly. However, we have to do these outings regularly. If we skip a single week without going somewhere other than school or home, Hein-Chris will get really anxious when next we try to go anywhere.  

I truly believe that the infant/child with SPD needs to be exposed to the sights, sounds, smells, and uncertainties the world has to offer, from as early an age as possible. It is tough taking a two-year-old child with SPD to an unfamiliar place filled with harsh smells and loud noises. Now imagine trying this with a four-year-old child with SPD whose been sitting in a darkened room for the last two years. I shudder. Based on my own experience, the infant/child with SPD needs to start being desensitised to the world immediately in order to have a fighting chance of surviving it as an adult.  

Today I am grateful I never waivered in exposing Hein-Chris to the outside world - despite his best efforts to make it almost impossible. He has slowly been getting used to the world since he’s been eight weeks old (before I knew he had SPD), and that has certainly given him a solid start to learning how to cope with SPD.

Hein-Chris has journeyed a world away from his infant self. He has worked very hard, every day, every week to be able to engage with a world that is filled with sight, sound, smell, touch, taste and movement. He is a warrior against SPD, and my role is to provide him with whatever reinforcement he needs, even if he resists at first - kicking and screaming.      

You have seen the paediatrician, the neurodevelopmental paediatrician, and at least an occupational therapist (OT), and all agree your child has sensory processing disorder (SPD).

The next step is to discuss an appropriate treatment plan with your child’s paediatrician. Keep the neurodevelopmental paediatrician’s report handy as it will probably contain a list of suggested interventions. Most likely your child’s paediatrician (and your child’s neurodevelopmental paediatrician) will recommend visits to an OT - likely the same OT that helped diagnose your child as he/she was recommended by your child’s paediatrician in the first instance.

Ask your paediatrician to phone the OT to inform him/her of your decision to place your precious sprout under their care. This makes the OT accountable to you, as well as your child’s paediatrician and I found that this cements the close relationship you need to foster amongst your Team of Experts.

Occupational Therapy is hands down the most effective treatment for SPD (provided the OT is trained and experienced in the field of Sensory Integration (SI)). Your OT will advise you on the frequency and length of your visits based on your child’s unique requirements. I write “unique requirements”, because apart from their need for sensory integration, children with SPD tend to have low muscle tone and weak cores. These are also treated during Occupational Therapy sessions.

Hein-Chris started with weekly, 45-minute sessions for the first year and a half of Occupational Therapy straight after his diagnoses, and then twice weekly sessions the year after. He is now back to weekly, 45-minute sessions, and all indications are that these will continue for at least the next two years.

Occupational Therapy is certainly not a quick fix. The magic of Occupational Therapy happens gradually over many years, but once it takes effect, the results are astounding. In our case - for instance - Hein-Chris’ vestibular system (associated with movement) was hugely compromised and extremely immature. It took almost two years to get him used to the OT’s swings - swings that posed a huge challenge to his vestibular system. I found, however, that once his vestibular system matured and the anxiety associated with movement subsided, all his other senses followed suite, and sensory defensiveness started a slow, universal decline. Tactile defensiveness (touch), auditory sensitivities (ears), fear of unfamiliar places and situations, and sensitivity to light and smells (eyes and nose), all seemed to improve markedly. My conclusion is: Your child’s vestibular system is the portal to the rest of his/her senses. Help your child’s OT, in whichsoever manner, to get that vestibular system working properly. If the OT recommends a home-based programme in conjunction with weekly or bi-weekly Occupational Therapy sessions, make sure to follow it religiously.  

Apart from Occupational Therapy, discuss Educational Kinesiology and possibly also Play Therapy facilitated by a clinal psychologist, with your child’s paediatrician. Chances are he/she will ask you to wait a few months, even years, before calling on these professionals. It is likely your paediatrician wants to see how your child responds to Occupational Therapy before introducing other forms of intervention. This is quite reasonable. If you feel strongly that your child needs more than Occupational Therapy, voice this and I am confident your paediatrician will be open-minded enough to listen to your argument and assist you as best he/she can to identify the right professionals to treat your child.

In Hein-Chris’ case, he started weekly kinesiology sessions two years after starting OT and Play Therapy sessions (facilitated by two clinical psychologists) the next. Currently he visits his OT, his kinesiologist and his psychologists once weekly.  

Clearly your child’s Team of Experts will play a significant role in his/her life for anything from two to five (even more in certain cases) years after being diagnosed. Keeping your Team of Experts (with your trusted paediatrician at the core) well-informed about your child’s progress is crucial, and entirely your responsibility. You need to circulate (via email most likely) all quarterly/annual evaluation reports, progress reports, school reports, etc. among the entire team. You will - for instance - send your quarterly OT progress report to your child’s paediatrician, neurodevelopmental paediatrician, educational kinesiologist, and whomever else is involved in your child’s treatment/therapy (i.e., speech therapist, psychologist, physiotherapist, etc.) depending on his/her needs.

You will probably visit your paediatrician and neurodevelopmental paediatrician at least once a year to discuss your child’s progress and ensure your child’s treatment plan remains relevant given his/her progress (or maybe lack thereof) over the past year. In Hein-Chris’ case we visited his neurodevelopmental paediatrician twice a year, and his paediatrician as and when we deemed it necessary.

Get a diagnosis as early as possible as treatment needs to start from a very young age.

Follow these steps:

1. Make an appointment with a paediatrician you trust when your child is between 18 and 24 months old. Explain that your child might be suffering from SPD, and provide a list of examples of his/her behaviour as evidence. The paediatrician will most likely refer you to a neurodevelopmental paediatrician. Ask the paediatrician to help you make the appointment with this neurodevelopmental paediatrician, and obtain a letter from your paediatrician to take with you on your visit.
2. Once the neurodevelopmental paediatrian has examined your child, ask that a detailed report be provided to your paediatrician irrespective of whether the neurodevelopmental paediatrian gives you a detailed verbal explanation. Many paediatric neurologists (should a neurodevelopmental paediatrician not be available to you) tend to make a diagnosis at this stage, and it is usually that your child is borderline autistic (most children with autism have SPD, but not all children with SPD are autistic). My sense is that making a diagnosis at this stage, is premature.
3. Make another appointment with your paediatrician, so you can discuss the content of the neurodevelopmental paediatrian's report. During the appointment, ask your paediatrician to refer you to an occupational therapist (OT) who specialises in sensory integration (SI). Ask the paediatrician to help you make the appointment with this OT, and obtain a letter from your paediatrician to take with you on your visit. Take the neurodevelopmental paediatrian's report along too.
4. The OT will carefully evaluate your child and write a detailed report that should be returned to your paediatrician and to the neurodevelopmental paediatrian.
5. Once you and your paediatrician have both reports (neurodevelopmental paediatrician and OT) available to you, you are best equipped to decide whether you have a child with SPD.
6. At this point, if time and money allow, I would recommend your child with SPD visits an educational kinesiologist who will carefully assess the child's brain profile and help confirm the diagnosis. The educational kinesiologist’s report needs to be shared with your paediatrician, the neurodevelopmental paediatrician and the OT.