A major pediatricians’ group says doctors should no longer diagnose children with sensory processing disorder and is questioning the value of so-called “sensory integration therapy.”
In a policy statement released Monday the American Academy of Pediatrics said that doctors should look for the presence of another developmental condition such as autism, attention-deficit hyperactivity disorder, developmental coordination disorder or anxiety disorder when a child shows signs of sensory issues.
“Because there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed,” the pediatricians group said in the statement published in the journal Pediatrics. “At this time, pediatricians should not use sensory processing disorder as a diagnosis.”
The group is also warning that increasingly common sensory-based techniques employed by occupational therapists may not be the most beneficial for children with autism and other developmental and behavioral disorders.
The approach known as sensory integration therapy often relies on brushes, swings, balls and other specially-designed equipment to help kids become accustomed to various stimuli.
However, the pediatrics organization said that data on the effectiveness of the therapy is “limited and inconclusive.”
While the American Academy of Pediatrics did not go so far as to advise against the therapies, they said parents and doctors should carefully monitor the progress of children utilizing sensory integration therapy to assess whether its continued use is warranted.
I don’t agree that sensory integration therapy is not effective, my son was diagnosed with autism and had a lot of sensory issues, it tooks us 6 months to get ABA therapy services but meanwhile my son had speech therapy and sensory integration therapy at school and private, after these 6 months he was able to be moved to a preschool with typical kids because his sensory issues had calmed down sufficiently to where he could sit, attend and function in the classroom.
Meanwhile my son’s pediatrician did not agree my son had autism, he said he was just energetic with a speech delay even though we had diagnosis from 2 different sources. Some pediatricians are just not up to speed on autism and are close minded.
I just wrote a post about this. Sensory Processing Disorder is very real. The primary way to treat it is sensory integration therapy. While my son’s ADHD medication has helped with this SPD, it hasn’t “cured” it. The biggest help has been his OTs who have taught him self regulation. I think this does the SPD population a great disservice.
Hmmmm.
First they take away Asperger’s as a diagnosis and now this. Sensory issues are among my biggest impediments as a person on the autism spectrum. As one person before me has commented, OTs can be a big help with many of our issues. Personally I found self-regulation much more beneficial than say, using a brush to stimulate my skin to help cut down on the “ticklies”…But I do think that occupational therapists have much to offer those of us on the spectrum who struggle with sensory overload.
As to the effectiveness of sensory integration techniques, I have known many people who have used and benefited from them. Do they work for everyone? Perhaps not, but ask autistic adults, or those born with alcohol related neurological disorders (FAS/FAE), or the parents of autistic children or those born with alcohol-related neurological disorders, and see what they think about effectiveness of sensory integration techniques. I’ve personally witnessed the positive difference it makes for many people. And frankly, very few pediatricians and other health care practitioners have expertise in either autism spectrum conditions, alcohol-related neurological disorders, or sensory integration….so I question their ability to create a knowledgeable policy/position on the matter.
Wow, I don’t know what to say– work with autistic students and still tell me that most of their problems aren’t
Sensory….I strongly disagree.
What is needed in a system wide audit, I suspect that we will find that there are many costly therapies that are useless and ineffective, except to the non disabled folks getting paid to perform them. then we could use the limited funds in the most effective ways to help give these children a better chance in life.
I do NOT agree with this pronouncement. OT has been a tremendous help to my son with ADHD and SID. PLEASE tell me why they want to silence these voices??
The issue is not that sensory problems don’t exist. The issue is that the prescribed “SI” interventions might not be the best way to promote adaptation and function. Occupational therapists use many different interventions to help people who have atypical sensory responses. OTs need to continue researching these problems and at the same time offer effective, evidence based intervention plans to the children and families in their care. This includes adaptive/compensatory approaches, skill training, behavioral interventions, and others that all have good research and evidence regarding their effectiveness.
I would have to assume that the group of folks that came up with this have never experienced sensory issues of their own!
I totally disagree with this finding, and think this group needs to look at kids like my 12 year old son, who has ADHD and other diagnosis but also has a diagnosis of SPD, but he has lots of autistic traits such as arm-flapping, spacial issues, smells and tastes everything, and many many others (none of which could be attributed to his ADHD). We still don’t qualify for any help and can’t even get the insurance to pay for any type of therapy to help him address these issues, and they are life altering issues. And now this, I was hoping that this group would support this diagnosis more so that he could finally get help (as in our area this disorder is already not recognized). So sad, I am not a doctor and I know more about this than they do apparently!
The biggest problem with these sweeping pronouncements are they are usually offered by people who aren’t living with the issue at home for the most part. I welcome anyone from the AAP to come to my house and tell me to my face that sensory needs aren’t real after experiencing what I deal with day in and day out. Yes, sensory needs do tend to be in conjunction with another need–however, many times doctors don’t want to take the time to consider what the other needs might be when you are double booked for appointments. Also, there isn’t enough training provided to MDs to actually know the signs and be able to spot them. That is where the AAP are failing their members and the genral public. I don’t beleive we should stop providing these services until “comprehensive testing” can conclude they are beneficial–why not check with the families and classroom teachers on how these children behave differently after sessions? Just because you can’t see the results during an appointment doesn’t mean they are not effective. I shudder to think that this will bolster efforts by insurance companies and schools to cut services and therapies based on this statement. I live with TWO definative cases where OT & sensory therapies specifically have helped–and that was BEFORE official dignoses that were missed by trained medical professionals until specialists put the pieces together–including the sensory needs and deficits. Let’s not forget, we have evolved in our thinking of what is effective and appropriate for students. There was a time that having students with special needs of any kind in schools with their peers was considered “radical” and not deemed “effective.” Let’s not slide backward because we can’t chart something. Yes, why not “carefully monitor the progress of children utilizing sensory integration therapy to assess whether its continued use is warranted.” I just hope doctors are willing to overturn this statement if parents can show the progress in their children.
This is terrible. SPD was my son’s first diagnosis and the sensory intergration therapy was life changing for him in the most positive way. He is also on the spectrum and has ADHD but that does not discount the value of the SPD diagnosis and how much the treatment helped and continues to help him.
When my daughter was 9 months old and unable/unwilling to sit up, cross midline, play with toys with her hands or put her feet on the floor, I was fortunate to have a neurologist tell me that while there is no medical platform for sensory integration therapy, it seems to work. He couldn’t tell me about intelligence, but he did say she would be a late walker. She had OT 2x/wk & PT 3x/wk from EI beginning prior to her 1st birthday. At 18 months a developmental pediatrician told me she had never seen a child like this, she was a full year ahead cognitively and linguistically, and a full year behind physically. At age 2 she was still not walking and had never crawled. In addition to EI, I took her to a sensory gym twice per week. The results were nothing short of miraculous. While there are some lingering minor issues (she learned to ride a bike at age 9 and struggles to tie her shoes), she plays football with the boys and will have a completely normal life. The sensory integration therapy early in her life enabled her to overcome rather than accommodate her challenges. We are so fortunate she did not have any of the other disorders which are so often accompanied by sensory integration difficulties. For us, sensory integration was largely a stand alone problem and I saw firsthand the benefit of this therapy and I am aware of no reason to discredit it. As to the Pediatrician’s Group’s statement that “Because there is no univerally accepted framework for diagnosis, sensory processing disorder should not be diagnosed,” I would say a framework should then be developed rather than a diagnosis discounted.
I am simply stunned. Sensory Integration is being considered for addition to the DSM, this pronouncement certainly won’t help the cause. Are insurance companies behind this as they don’t want to cover treatment? i can’t imagine a legitimate pediatrician having this position. My son was diagnosed with autism and sensory was CRUCIAL for his development. Thank goodness nonsense like this wasn’t available for me to read at the time; I may have skipped critical therapies for him.
I completely disagree with the Academy of Pediatrics. As a clinician in the field, I have first hand experience treating children with SI issues, and they are real! This is a politically based move and a means for protecting insurance companies.
Wow. Rather than asking for data from doctors, creating a study or in any way help contribute to the development of a “universally accepted framework for diagnosis”, the American Academy of Pediatrics would prefer that the diagnosis be eliminated “at this time”. Thus potentially suppressing the ability of actual data being collected in the future. We struggled to help my son for 6 years. No diagnosis fit him. Yet as a parent, you know when your child needs help. When a teacher mentioned SPD – nothing any doctor ever mentioned – it fit all of his issues. 6 years later, thanks to on-going spd treatments from wonderful OTs and their suggested home therapies, my son is a well-adjusted child on the cusp of becoming a teen. We work with self-regulation issues constantly, but from where he was to where he is today, it is an amazing transformation. If the AAP’s new directive is followed, children like my son may not receive treatment that will greatly benefit them. I implore all doctors to push back on this – ask for a study, ask for data to support this decision. Otherwise, you will do an enormous disservice to our children.
Probably paid off by the insurance companies, I think there is some sort of collusion going on.
The insurance company statement is that there is not enough data, now this. So for the past 15 years they couldn’t gather enough data…
Why am I not surprised? I am a parent with a child who a year ago was diagnosed with SPD. The treatment she received over the past several months in OT and ST is an integral part of her development. To hear that professionals do not believe that her issues exist is unthinkable. I work in Human Resources, and weekly meet with adult employees who show all of the characteristics of a sensory issues (and no the majority of them are not substance abusers) that as children were never diagnosed for nor received treatment. When I was child SPD was unheard of yet the condition was there. For the medical professionals please consider this information. We have a very small window of time to give these children the necessary treatment they require to develop to their fullest, and to hopefully lead full adult lives. The next time you have someone sitting across your desk who cannot make direct eye contact, sit in a chair without constantly fumbling with their pen, go into to overdrive on a daily basis to the point at which it drives the rest of the department crazy, or explode everytime they are met with a stressful situation, before assuming that it is just a bad employee think for a moment of why they act this way. There is a large population of adults who also suffer from SPD, and no it just does not simply go away as they get older. The cost for treatment for individuals with this disorder is staggering, and many families go into to bankruptcy trying to provide their loved ones with the necessary care needed. We do not wish to be ignored and misdiagnosed (as so many generations before us were), we need help to treat those who suffer, and we can no longer stand aside while well meaning medical professionals choose to ignore this crucial issue in our society. It was not too long ago that the medical profession did not recognize Autism as a disorder.
I do agree with the recommendation. They recommendation is not saying there are not sensory issues-they are saying it isn’t stand alone. It’s saying that the symptoms all of you are stating are not due to “disorders” of the sensory pathways. Some are issues of hyper-sensitivity. How do you treat these things?-you can swing, play, challenge you own child instead of paying hundreds of dollars to someone else. Why are you paying over $100 dollars (in my area parents pay up to $160) an hour for someone to have your child swirl their hand in a box of beans or shaving cream or swing on equipment you can find at the playground. You can do that and not bankrupt the insurance companies-that we ALL pay premiums for. I had heard about brushing….did it to my daughter who refused to wear long pants on cold days. It worked, cost the cost of the brush (well, I am an OT) and done. Didn’t look for any insurance companies to pay $1000s to fix her. You can do all these things in the natural environment. Read the Out of Sync Child to get ideas.