'Sensory Integration Therapies' Lack Evidence, AAP Says

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Dr. Lucy Miller, founder and executive director of the STAR Center Foundation, where Woody received treatment, said she, too, hopes the recommendations will lead to more research. But she said that there is no doubt in her mind that SPD is a distinct condition.

"There is an unbelievable amount of evidence not cited in [the recommendations]," Miller said, adding that much of the most recent research "just has not hit the mainstream pediatrics literature yet."

Miller agreed that more research is needed to further define the condition and those who suffer from it. But based on two studies that have looked at its prevalence, she estimated that 1 in 10 children may experience it to some degree -- maybe more.

But in light of the current research, SPD seems a tough sell.

"There is more that is anecdotal than anything else," Desch said. "There were a lot of problems with studies."

It probably doesn't help that the signs of SPD are a mixed bag. For some, it takes the form of an aversion to loud noises, rough textures in clothing and the taste and textures of certain foods. It is also said to manifest itself in what are known as "vestibular" effects -- poor balance, clumsiness and a delay in milestones such as learning to walk and talk. Some appear overstimulated by the world around them. Others are understimulated.

And then there is the treatment, part of which involves what is known as sensory integration therapy. This therapy is aimed at improving a child's ability to correctly process the stimulation he or she receives from surroundings. This usually means modifying the stimuli to which these children are exposed using swings, unstable platforms, weighted vests and a vast array of other equipment.

It is this therapy that the AAP recommendations singled out, encouraging pediatricians to "communicate with families about the limited data" on its use.

Critics of sensory integration therapy point out that the sensory issues targeted are signs of an underlying condition -- and that focusing on these symptoms ignores the larger problem, be it autism, ADHD or something else.

"Our concern is if children are being diagnosed with sensory processing disorder but we're really missing the big picture -- if it is something that is truly ADHD, autism or anxiety," Zimmer said. She added that if doctors focus solely on sensory integration therapy, "we're missing the other components of treatment that could help them."

But, Miller argued, the therapy has evolved drastically from its origins in the 1970s. She also said the AAP recommendation ignores the other, newer therapies for sensory processing disorder -- approaches that emphasize social participation and require that relationships and engagement be a priority of the treatment.

Still, the generally lukewarm assessment of the studies published to date suggests the broader medical community has not yet recognized the existence of this disorder as a standalone condition, and it is even less convinced of the legitimacy of its treatment. As a result, few insurance companies cover the therapies.

This can make this therapy an expensive proposition for parents. Pam Sims says Woody's treatment cost about $100 per hour and was not covered by the family's health insurance.

"I think that the cost prevents some people getting treatment they need," she said.

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