Sunday, January 31, 2016

Do You Have ADHD, SPD or Both?

Do you find yourself easily distracted or hyperactive and also startle when the phone rings and jump when someone touches your shoulder?  If so, you might have ADHD, officially diagnosed or self-diagnosed, and sensory processing disorder?  This is not unusual. There’s a lot of overlap between SPD and ADHD.  

Both can cause you to be:
·      Distracted
·      Impulsive
·      Hyperactive
·      Disorganized
·      Anxious
·      Socially awkward
·      Depressed

So the question is -- how do they differ?  This is hotly debated. Researcher and OT Lucy Miller, fortunately has identified ways to distinguish ADHD from SPD.
Those with ADHD,
·      Cannot stop impulsive behavior regardless of sensory input
·      Crave novelty and activity that is not necessarily related to specific sensations.
·      Do not become more organized after receiving intense sensory input.
·      Have difficulty waiting or taking turns.
·      Wait or takes turns better with cognitive than sensory input.
·      Tend to talk all the time, impulsively interrupting, and have trouble waiting for turn in any conversation.
·      Stimulating meds work with ADHD but not with SPD
So do you have ADHD or SPD or both?
Actually Lucy Miller found around 50 to 70% to have both. For instance, ADHD children commonly demonstrate aggression, sensation seeking, and tactile sensitivity, suggesting sensory modulation difficulties, as well as clumsiness, dyspraxia and sensitivity to movement (poor vestibular processing) and become easily dizzy.
But it’s also possible that in some cases ADHD is mimicking SPD and mistaken for SPD. 
Ways ADHD Mistaken for SPD
Noise:  If noise distracts you, it is hard to concentrate and focus on what you are reading.  
Seeing:  If your brain scrambles what you see, you may ignore, or have difficulty following written instructions and seem distracted.
Hearing:  If your brain scrambles what you hear, you may ignore, or have difficulty following verbal instructions and seem distracted.
Sensory defensiveness:  If you are bothered by the tags in your shirt or, when you were a child other children sitting too close to you, you will squirm, wiggle or jump about and appear hyperactive. If you are auditory defensive, noise makes it hard to concentrate and focus. If you are visually defensive, hypersensitivity to lights, patterns, and movement make it hard to focus.
Overstimulation:  If your work environment overwhelms you with people too close, constant chatter, buzzing fluorescent lights, intense colors, and cold air conditioning, your mind will be in a fog and, finding it hard to make sense of what you see, hear, or feel, you appear spacey. 
Sensation seeking:  If you are a sensation seeker, you get too easily bored to focus on anything but the next buzz and might appear hyperactive and distracted. This is because your cortex lacks sufficient dopamine to engage in the world and you seek activity to boost it. 
Hypo-responsiveness:  If you are hypo-responsive to sensation, you tune out to your world easily and may not pay attention, appearing unfocused and out of it and have poor memory.
Discerning whether you have SPD, only ADD, or both conditions is crucial as the treatments differ. For instance, if distractibility and hyperactivity result from SPD, taking the psycho-stimulant Ritalin has no effect and it will delay your progress as the sensory issues that underlie the behavior will persist. 
Treating ADHD & SPD
Stimulating Meds -Helps with ADHD but ineffective with SPD.
FYI:  One of the ways to know if you have SPD misdiagnosed as ADHD is whether or not the meds work.
Sensori-Motor InterventionsHelps both SPD and ADHD. 
FYI:  Studies show interventions such as deep pressure and strenuous exercise can significantly improve problem behaviors such as restlessness, impulsivity and hyperactivity.
CBT - Helps change thinking patterns and self-defeating   thoughts in both ADHD & SPD.
Talk Therapy - Helps both those with SPD & ADHD to feel better understood and validated, building self-esteem.


  1. Sharon, so glad to see this piece. I'm VERY interested in the ADD/SPD connection and as you know, not much is written about it. So glad you continue to sort things out for us!

    Terry Matlen, ACSW
    Author, "The Queen of Distraction"

  2. Yes. Very little is written about it and many people with ADHD are clueless about SPD, not treating it and suffering as a result. Let's see if we can help to change that!

  3. I'm trying! I promote your book all the time! Looking forward to reading Rachel Schneider's new book, as well.

  4. Thank you Sharon, this is very useful. Do you think ADHD and SPD could in some people have a common source? I'm recently discovering a lot of useful information about joint hypermobility and correlated symptoms/diagnoses (panic disorder, dizziness/fainting, heat sensitivity). Very interested in what we can learn from these complex body/mind/response/behaviour conditions and experiences. Thank you for your work, I'm enjoying your book "Too Loud..." right now.

  5. Pascale, you've hit at the heart of my work. To me, SPD and ADHD represent an imbalanced nervous system. My question then becomes -- what is causing the imbalance. And this is what I seek to discover and treat that. Joint hypermobility has a a genetic component. At the same time, people with hyper-mobility syndrome have wobbly ankles and feet and therefore poor balance. Their panic and the other symptoms may be set off by this instability, in other words by vestibular dysfunction, as well as a faulty gene sequence. So they need much vestibular input which, in our lifestyle we don't get unless we make every effort to get it. One excellent way is vinyasa yoga in which you keep changing head position. Also, everything in the house should move. Ideally, you want to sit on an exercise ball chair at your computer, watch TV in a glider or rocking chair, relax in a hammock and so forth. There's much more but this is a start.