Case Study: Sensory Processing Disorder

Mainly associated with how the brain processes sensory information, Sensory processing disorder (SPD) is a disease which mainly affects the things an individual can either touch, taste, smell or hear. This mainly implies that the individual is too sensitive to typical sensory information. According to Miller (2014), the main cause of Sensory Processing Disorder is not yet known.  Initial studies suggest that SPD is genetically related. Certain environmental, as well as pregnancy and birth complications have also been implicated as causal in Sensory Processing Disorder. Even though SPD is largely associated with, adults are also known to exhibit signs of Sensory Processing Disorder. However, most adults who exhibit SPD symptoms are likely to have existed for them since childhood.

The most common treatment for SPD includes developing intentional choices and coping mechanisms to live positively with the disorder. Depending on whether the symptoms are under-sensitive or oversensitive, these coping skills and strategies are highly customized and offered by a trained therapist. One of the most applied methods of treatment for SPD is sensory integration therapy, a process that involves engaging in fun activities in a stimulating and controlled environment.

Patient’s profile; Tamara Adkins

Tamara Adkins, which is not a real name to ensure her confidentiality is protected as per following the requirement of the NMC code of conduct (Nursing & Midwifery Council, 2018) is a senior citizen working as a Financial Analyst living in Toronto and working at HSBC Bank in Toronto. Tamara was 14 years and 11 months when she started to exhibit sensory offensiveness; loud voices became intolerable, any kind of perfume (mild or strong) was simply sickening. This affected Tamara’s ability to relate to others, study and learn, participate in sports and group activities, and eventually lead to total distraction in her life. Tamara eventually became physically affected due to loss of appetite emanating from her dislike in taste on any kind of food. Any kind of noise was emotionally unbearable and extremely distracting leading her to become distressed at all times. 

At the age of sixteen, any kind of loud noise was too much for Tamara. During thunderstorms, for example, Tamara could put on her sound cancelling headphones and zone out until the thunderstorms were over. At the age of twenty, Tamara became alienate herself socially and became to avoid family gathering so as not to participate in family photos. The bright flashes were a total set off for Tamara. At the age of forty, Tamara bean experiencing articulation delays. Currently, Tamara is sixty six years of age and presentations have now become her worst nightmare. No matter how much Tamara practises, she always stumbles over words when giving presentations at work.

Treatment Plan

After assessing Tamara’s feelings, and anxiety while trying the best level best to understand her as much as possible, it will be helpful if a treatment plan is developed to help her manage her condition with ease. Following the initial assessment of Tamara, it can be notable that her needs would be best met by a multidisciplinary team (MDT). This team would include a psychiatrist, a psychologist, nurses, and a nutritionist. Her family will also be involved, as part of the MDT in ensuring long term concordance. In the MDT meeting, it will be agreed that the nursing care plan for Tamara should focus on controlling symptoms to support her normal functioning. Since Tamara was very sensitive to noise, and therefore work-related group activities or tasks in a noisy setting were difficult for her to tolerate, this treatment plan will be largely informed by Mutsatsa (2015), who asserts that this can be effectively achieved by psychological interventions.

The aim will be to ensure a reduction in her aggressive symptoms, including reducing the frequency, severity and duration of her episodes (Naja, and Halaby, 2017; Podsobinski, 2018; Freudenreich et al., 2018). The nutritionist will be involved in planning for a diet for Tamara. He/she will inform the MDT about the approach she would use to ensuring that Tamara was actively involved in deciding what she wanted to eat in line with the patient-centred principle (Granholm and Harvey, 2018). This will also be communicated to the family to ensure Tamara is actively involved in planning for her meals at home, including being involved in the preparation of the same. This will ensure that Tamara is confident that the meals would be alright and that she would not suffer any harm, as she will be responsible for preparing her meals.

Although the care and intervention provided to Tamara could be considered as effective, it is highly recommended to the MDT the need to consider a relapse. This is based on the understanding of literature that relapse is possible in adult patients with PSD such as Tamara. As noted by Emsley et l., (2013), preventing relapse is critical to ensure the gains achieved are not lost, besides ensuring the individual can continue their lives normally. According to Laws et al., (2018), patient or family education can focus on areas of vulnerability for Tamara or the stressors that could be affecting her condition. Relapse indicators include stress levels, non-concordance with recommended activities, as well as the lack of sleep (Goh and Agius, 2010).

Further, psychological interventions are suggested as effective in minimising the chance of a relapse. According to Morrison (2009), CBT intervention is effective in improving patient outcomes. Moreover, psychoeducation will be offered to Tamara and her family, and it’s aimed at ensuring that the family, including Tamara, understood what PSD is and the factors that could prevent relapse, as well as the necessary course of action (Laws et al., 2018). Aguglia et al., (2007) reports that psychoeducation is an effective strategy in minimising relapse in the long term. In these psychoeducational sessions, Tamara will be taught on the strategies and skills she can apply to manage PSD effectively while recognizing the strength, abilities, and her other interests in life.

Conclusion

In conclusion, this paper has provided a detailed account of an episode of care with a senior citizen with Sensory Processing Disorder. The specific attention has been on how Sensory Processing Disorder affected the quality of life for Tamara, including her social and personal lifestyles. It has also examined the psychoeducation as well as the role of psychoeducational interventions such as good diet improving the health and wellbeing of Tamara. Throughout the paper, confidentiality has been kept, as no real names were revealed (NMC, 2018).

Overall, it is apparent that there is no known cure for Sensory Processing Disorder but healthcare professionals can deliver person-centred interventions to minimise adverse behaviours while improving the quality of life for the individual affected, such as Tamara. The interventions offered are mainly aimed at maintaining the condition while ensuring relapse is prevented as much as possible through an effective inclusion of the patient and the family in the overall care framework.

References

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Granholm, E, and Harvey, D, P. (2018). Social Skills Training for Negative Symptoms of Schizophrenia, Schizophrenia Bulletin. 44(3): 472–474,

Laws, K.R., Darlington, N., Kondel, T, K, McKenna, J, P, and Jauhar, S. (2018). Cognitive behavioural therapy for schizophrenia – outcomes for functioning, distress, and quality of life: a meta-analysis. BMC Psychol 6,32. https://doi.org/10.1186/s40359-018-0243-2

Morrison, A, K. (2009). Cognitive behaviour therapy for people with schizophrenia. Psychiatry. 6(12): 32–39.

Mutsatsa, S. (2015) Physical healthcare and promotion in mental health nursing. SAGE. London

Miller, J., L. (2014). Sensational Kids: Hope and Help for Children with Sensory Processing

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Naja, J, W, and Halaby, A. (2017). Anticholinergic Use and Misuse in Psychiatry: A Comprehensive and Critical Review. Journal of Alcoholism & Drug Dependence. 5(2): 1-4

Nursing and Midwifery Council. (2018). The Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates. London: Nursing and Midwifery Council

Podsobinski, L. (2018). In the grip of paranoid schizophrenia. (3rd ed.). London: LULU