Abstract
Differential diagnosis between sensory modulation disorder (SMD) and attention deficit hyperactivity disorder (ADHD) is often challenging, since these disorders occur at a high rate of co-morbidity and share several clinical characteristics. Preliminary studies providing evidence that these are distinct disorders have focused solely on body functions, using sophisticated laboratory measurements. Moreover, no studies have compared participation profiles of these populations. This study is the first to compare the profiles of these populations regarding both “body functions” (attention and sensation) and “participation,” using measures applicable for clinical use. The study included 19 children with ADHD without SMD and 19 with SMD without ADHD (diagnosed by both pediatric neurologists and occupational therapists), aged 6–9, and matched by age and gender. All children underwent a broad battery of evaluations: the Evaluation of Sensory Processing, Fabric Prickliness Test (FPT) and Von Frey Test to evaluate sensory processing, and Test of Everyday Attention to evaluate attention components. The Participation in Childhood Occupations Questionnaire was used to evaluate participation. Results support significant group differences in all sensory components, including pain intensity to suprathreshold stimuli and pain “after sensation,” as well as in tactile, vestibular, taste, and olfactory processing. No differences were found in attention components and participation. This study has both theoretical and clinical importance, inter alia, providing further evidence of two distinct disorders as well as indications of specific clinical instruments that might enable clinicians to implement differential diagnoses. In addition, results accord with other previous statements, which indicate that the clinical diagnosis of children with disabilities may not be a major factor in determining their participation profile.
Highlights
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent and intensively studied childhood developmental disorders (Barkley, 2003)
The uniqueness of this study lies in it being the first to compare the profiles of ADHD and sensory modulation disorder (SMD) regarding both “body functions” and “participation,” through the use of clinically applicable measures
The fabric prickliness test Significant differences were found between the groups in the level of pain elicited by the application of the fabrics (Z = −2.367; p = 0.018), such that children with SMD reported higher scores compared to children with ADHD
Summary
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent and intensively studied childhood developmental disorders (Barkley, 2003). The subject of co-occurring deficits is one of the most frequently explored aspects of this disorder (Adesman, 2003; Gillberg et al, 2004). Findings of both clinical and community studies have revealed extremely elevated rates of co-occurrence between ADHD and other neuro-developmental disorders, predominantly related to motor (e.g., Pitcher et al, 2003), language (e.g., Cohen et al, 2000), cognitive (e.g., Frazier et al, 2004) and sensory functioning (e.g., Yochman et al, 2006). Pertaining to the sensory domain, children with ADHD frequently meet the criteria for sensory modulation disorder (SMD) as well (Miller et al, 2001)
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