Sensory-Based Therapy: Pediatricians Raise Caution

NEW YORK (Reuters Health) - Occupational therapy for kids who are over- or under-sensitive to sound, touch or other senses could help improve their symptoms -- but parents and doctors should be careful not to miss an underlying disorder in those children, pediatricians said today.

So-called sensory integration therapy, in which occupational therapists use brushes, swings, balls, music and other tools to help kids adapt to external stimuli, has been controversial among doctors.

One issue is whether kids who are overly sensitive to noise, for example, actually have problems with pathways in their brains involved in processing and responding to sound -- or if that's just one sign of a developmental disorder, such as autism.

That's the concern -- sensory processing disorder might just be a symptom of another underlying developmental problem, said Dr. Michelle Zimmer, from Cincinnati Children's Hospital Medical Center, who co-wrote new guidelines on sensory integration therapy for the American Academy of Pediatrics.

It actually could be that working with an occupational therapist is helpful, but the only caution is that we would like to diagnose the other underlying disorders that go along with sensory problems, she told Reuters Health.

Young kids who have difficulty with sensory processing may cover their ears when a bell rings or they hear loud voices, chew and suck on inedible objects or rock back and forth in their chairs, for example.

Children with a range of developmental disorders -- including attention-deficit/hyperactivity disorder, anxiety and autism spectrum disorders -- may have those types of symptoms, according to the recommendations published in Pediatrics.

But sensory-related problems don't tend to show up on their own as isolated issues, Zimmer said.

There are no studies out there that really show that there's such a thing as a stand-alone diagnosis of a sensory processing disorder, she said.

For that reason, the recommendations aimed at pediatricians include not using sensory processing disorder as its own diagnosis, but instead evaluating kids for underlying developmental problems.

They also call for talking to families about the limited evidence supporting therapy focusing on sensory processing.

Roseann Schaaf, an occupational therapist from Thomas Jefferson University in Philadelphia, said she agrees there shouldn't be a separate diagnosis for sensory processing disorder, but said sensory-related treatment can still be a useful part of therapy for kids with other underlying issues.

The recommendation paper does not consider that the intervention is individually tailored to each child's needs, Schaaf, who has studied sensory problems and their treatment, told Reuters Health in an email.

Unfortunately, it is likely that pediatricians will interpret this article to mean that occupational therapy using sensory integration is not helpful -- when in fact, the evidence is mounting that it is helpful for many children, she concluded.

SOURCE: bit.ly/jsoh2P Pediatrics, online May 28, 2012.