Sensory processing disorder

Sensory Processing Disorder (SPD) is a term used to classify individuals who have trouble receiving, interpreting, and responding to various sensory stimuli, including tactile, auditory, visual, vestibular, proprioception, interoception, taste, and smell.

The exact cause of Sensory Processing Disorder has not yet been identified although there are a few theories. SPD may be inherited, prenatal and birth complications may also play a causal role along with certain environmental factors.

Sensory processing difficulties can influence other areas in our lives including emotional regulation, behavior, social interactions, self-awareness, academics, career, relationships, and activities of daily living tasks. In addition, motor clumsiness, behavioral problems, anxiety, depression, school failure, and other conditions may result if the disorder is not effectively treated.

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Is there an ICD-10 code for Sensory Processing Disorder?

Currently, there is not an ICD-10 code for Sensory Processing Disorder as there is not a true diagnostic criterion for SPD within the Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-V).

However, clinicians will utilize various ICD-10 codes for individuals who exhibit signs and symptoms of sensory processing disorder, one which includes F84.9.

“This code falls under the broader category of Pervasive Developmental Disorders. Pervasive Developmental Disorders encompass a group of neurological conditions that affect communication, social interaction, and behavior.”

Another code that can be utilized is F88, which includes other disorders of psychological development which include “mental, behavioral, and neurodevelopmental disorders,” which involve sensory integration issues.

Furthermore, sensory processing disorder may be associated with other diagnoses such as ADHD and/or Autism Spectrum Disorder, or Developmental Coordination Disorder (DCD).

Clear, concise, and accurate documentation specifically including the use of ICD-10 codes is important for therapists to provide and facilitate effective treatment. It also allows for appropriate billing and reimbursement for the therapist or facility.

In addition, it provides data specifically on the prevalence of SPD in geographic locations, populations, and contributes to future developments such as research and evidenced-based practice.

Occupational therapy assessment and intervention for Sensory Processing Disorder

While there is not a true diagnosis for sensory processing disorders, there are assessment methods and tools that occupational therapists can utilize to evaluate sensory-based challenges. These challenges may include sensory sensitivity, sensory avoidance, sensory-seeking over-responsiveness, under-responsiveness, low registration, motor planning, and/or other sensory differences.

Occupational therapists utilize various sensory assessments and clinical observations to evaluate sensory processing patterns across all age groups including pediatrics, adults, adolescents. Some common assessments include the Sensory Processing Measure (SPM), Sensory Profile (SP), and Adult/Adolescent Sensory History (AASH).

Providing sensory integration therapy is a fundamental area of occupational therapy. Intervention strategies may focus on specialized programs tailoring specific sensory areas including auditory, oral, proprioception, tactile, and vestibular.

Intervention methods may include the following:

• Auditory: Auditory-based interventions are tailored to improve auditory processing skills, improve tolerance to noise, and overall exposure. Activities include auditory desensitization, sound discrimination, auditory processing activities focused on sequencing and memory, and auditory integration activities such as listening programs such as iLS or therapeutic listening.

• Vestibular: Vestibular sensory intervention methods involve movement related activities and balance. Activities include swinging, balance challenges, spinning, and rocking in order to improve motor planning, balance and coordination.

• Proprioception: Proprioceptive intervention methods refers to body awareness and input that is received by the muscle and joints. Proprioceptive input involves activities that require pushing, pulling, squeezing, jumping, or carrying heavy objects which improve body awareness, self-regulation, and motor planning.

• Tactile: Tactile input can include deep pressure touch which calms and organizes the nervous system and tactile stimulation which involves exploring different textures.

• Taste/Oral: Oral input-based interventions are designed to address issues related with picky eating, sensitivity, and oral-motor skills. Activities may involve gradual desensitization and slow introduction to new foods, textures, and smells. It may also involve multi-sensory exposure and experiences, food chaining, oral-motor exercises and exploration, and positive mealtime environments.

• Vision: Visual sensory intervention strategies are focused primarily on environmental modifications, visual schedules, timers, and checklists. It can also incorporate visual tracking and eye-hand coordination activities such as throwing and catching a ball.