Sensory Integration Therapies for Children With Developmental and Behavioral Disorders abstract

Sensory-based therapies are increasingly used by occupational therapists and sometimes by other types of therapists in treatment of children with developmental and behavioral disorders. Sensory-based therapies involve activities that are believed to organize the sensory system by providing vestibular, proprioceptive, auditory, and tactile inputs. Brushes, swings, balls, and other specially designed therapeutic or recreational equipment are used to provide these inputs. However, it is unclear whether children who present with sensory-based problems have an actual “disorder” of the sensory pathways of the brain or whether these deficits are characteristics associated with other developmental and behavioral disorders. Because there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed. Other developmental and behavioral disorders must always be considered, and a thorough evaluation should be completed. Difficulty tolerating or processing sensory information is a characteristic that may be seen in many developmental behavioral disorders, including autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorders, and childhood anxiety disorders. Occupational therapy with the use of sensory-based therapies may be acceptable as one of the components of a comprehensive treatment plan. However, parents should be informed that the amount of research regarding the effectiveness of sensory integration therapy is limited and inconclusive. Important roles for pediatricians and other clinicians may include discussing these limitations with parents, talking with families about a trial period of sensory integration therapy, and teaching families how to evaluate the effectiveness of a therapy. Pediatrics 2012;129:1186–1189 BACKGROUND: DEVELOPMENT OF THE SENSORY SYSTEM Sensory integration is a framework first described by occupational therapist A. Jean Ayres, PhD, in the 1970s. It refers to the body’s way of handling and processing sensory inputs from the environment.1 Ayres felt that the sensory system develops over time, much like other aspects of development (language, motor, etc), and that deficits can occur in the process of developing a well-organized sensory system. A well-organized sensory system can integrate input from multiple sources (visual, auditory, proprioceptive, or vestibular). Ayres postulated that sensory integration dysfunction occurs when sensory neurons are not signaling or functioning efficiently, leading to deficits in development, learning, and/or emotional regulation. SECTION ON COMPLEMENTARY AND INTEGRATIVE MEDICINE and COUNCIL ON CHILDREN WITH DISABILITIES