There is no universally accepted framework for diagnosing children who present with sensory-based problems, according to the American Academy of Pediatrics.
In a recent policy statement, Michelle Zimmer, MD, Larry Desch, MD, and colleagues said it remains unclear whether children with sensory processing difficulties have an actual disorder of the sensory pathways or if they are presenting with symptoms characteristic of other developmental and behavioral disorders.
“Specifically, the behavioral differences seen in children with autism spectrum disorders, attention-deficit/hyperactivity disorders, and developmental coordination disorders overlap symptoms described in children with sensory processing disorders,” they wrote. “Studies to date have not demonstrated that sensory integration dysfunction exists as a separate disorder distinct from these other developmental disabilities.”
Sensory-based therapies, which include activities believed to organize the sensory system by offering vestibular, proprioceptive, auditory and tactile inputs by using tools such as brushes, swings, balls and other specially designed therapeutic equipment, are increasingly used by occupational therapists, according to the authors. However, of the few studies on the effectiveness of sensory integration therapy, results have been mixed.
Zimmer and colleagues gave the following recommendations for pediatricians when addressing sensory-based problems in children:
- Do not diagnose children with sensory processing disorder. When sensory symptoms are present, other developmental disorders such as autism spectrum disorders, ADHD, developmental coordination disorders and anxiety disorders must be considered and evaluated.
- Communicate with families about the limited data on the use of sensory-based therapies.
- If a pediatrician is managing a child whose therapist is using sensory-based therapies, the pediatrician should work with families to determine whether a therapy is effective. This includes helping families design simple ways to monitor the effects of treatments using diaries and rating scales that measure behavior before and after treatments, for example. Pediatricians can also help families create specific treatment goals designed at the onset of therapy that focus on improving the child’s ability to participate in everyday activities.
- Set a time limit for the family to come back and discuss whether the therapy is working to achieve the stated goals.
- Inform families that occupational therapy is a limited resource (especially due to the number of available sessions at school and through insurance coverage). The pediatrician, family and other clinicians should work together to prioritize treatment based on the degree to which the sensory problems affect the child’s ability to perform daily functions.
Disclosure: The authors report no relevant financial disclosures.