'Sensory Integration Therapies' Lack Evidence, AAP Says

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Woody Sims was a gifted boy. His mother said he began reading at a very early age, and he was a bright student in preschool.

To those around him, his development in his early years seemed normal. But in his college essay, Woody, now 18 years old, described a childhood experience marked by "deep fears of loud noises, cooked carrots and handwriting.

"I was over-stimulated, which meant I couldn't handle certain textures, and freaked out at loud noises," Woody wrote in his essay. "I also had problems managing tasks with multi-sensory inputs, like handwriting and catching a ball. These sensory problems meant that sports, driving, and concerts would all be things I couldn't ever do or see without a great deal of difficulty."

For Woody, the diagnosis of sensory processing disorder, or SPD for short, came very early, at age 4. His mother, Pam Sims, had arranged for him to be tested for his school's gifted program. It was the tester who informed her that he believed her son fit the bill for the disorder.

"We thought his physical development stuff was more related to his height," said Pam Sims, now 52, of Denver, Colo. "We didn't know anything about sensory processing disorder."

In a coincidence that Pam Sims calls a "luck of the draw," a center devoted to the research and treatment of this disorder happened to be located in Denver, where they live. It was here, at the STAR Center, that Woody engaged in sensory-based therapies aimed at improving his coordination and social and interactive therapies to help him deal with stimuli in his environment that he found harsh and jarring.

"It is amazing what it did for him," Pam Sims said. "As time went on, we had more treatments. We stopped when he was about 7 or 8 years old, as he had learned to regulate himself."

Stories like Woody's appear to support the existence of SPD -- and there are many such stories. Nevertheless, solid research confirming the existence of SPD is in far shorter supply, many in the medical community say. And on Monday, it would seem that new recommendations from the American Academy of Pediatrics have dealt another blow to the legitimacy of SPD. Specifically, the AAP recommends, "At this time, pediatricians should not use sensory processing disorder as a diagnosis."

The recommendations also suggest to pediatricians that they inform families that the evidence for sensory-based therapies is limited and that outcomes from these therapies should be monitored closely.

"I think the academy statement reinforces the decision that there is not enough information at this time to conclude that this is a distinct disorder," said Dr. Michelle Zimmer, a professor in the UC Department of Pediatrics and a lead author of the recommendations. "Moving forward, there needs to be a lot more research in this field."

Dr. Larry Desch, director of developmental pediatrics at Advocate Health Care and also a lead author on the recommendations, said that he did not anticipate that the recommendation would be well-received among parents and doctors who believe sensory processing disorder should have its own place as an official condition.

"I think they'll be unhappy, some of them," he said. "But I'm hoping it will lead to more research studies being done."

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