A great article in the NYTimes about the debate over a sensory integration disorder:
The problem, these therapists say, is in the brain, which is not properly integrating the onslaught of information coming through the senses, often causing anxiety, tantrums and problems in the classroom. Such difficulties, while common in children with developmental disorders like autism, also occur on their own in many otherwise healthy youngsters, they say.
No one has a standard diagnostic test for these sensory integration problems, nor any idea of what might be happening in the brain. Indeed, a diagnosis of such problems is not yet generally accepted. Nor is there evidence to guide treatment, which makes many doctors, if they have heard of sensory problems at all, skeptical of the diagnosis.
Yet in some urban and suburban school districts across the county, talk of sensory integration has become part of the special-needs vernacular, along with attention deficit disorder and developmental delays. Though reliable figures for diagnosis rates are not available, the number of parent groups devoted to sensory problems has more than tripled in the last few years, to 55 nationwide.And now this subculture wants membership in mainstream medicine. This year, for the first time, therapists and researchers petitioned the American Psychiatric Association to include "sensory processing disorder" in its influential guidebook of disorders, the Diagnostic and Statistical Manual. Official recognition would bring desperately needed research, they say, as well as more complete coverage for treatment, which can run to more than $10,000 a year.
But many psychiatrists, pediatricians, family doctors and school officials fear that if validated, sensory processing disorder could become rampant -- a vague diagnosis that could stick insurers and strapped school districts with enormous bills for unproven therapies. The decision is not expected for three or four years, but the controversy is well under way.
Read the whole thing.
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I'm curious why no one has sought to establish a neurological basis for this. It seems like the first step would be to determine whether there was hypereceptivity peripherally or whether all the normal information was warped during processing. I'd also want to see what happens with GABAergics, like antiepileptic drugs. I would think that trying to turn down the volume on the thalamus would help. Has someone started that kind of work?
But mostly, I want to know if this is more common in women. I know a few women that are just waaaay to sensitive and finicky, and now I wonder if they live at the mild end of this potential spectrum disorder. For now, I'll just attribute this to my previous theory that women can be nutty.
"Official recognition would bring desperately needed research, they say, as well as more complete coverage for treatment, which can run to more than $10,000 a year."
This whole sentence seemed a bit spurious to me. Surely we need to research first, before we can officially recognise the condition and work out how best to treat it??
Actually, the NY Times article was somewhat misleading. This condition IS officially recognized in several sources, i.e., Regulatory-Sensory Processing Disorder is an accepted diagnosis in Stanley Greenspan's Diagnostic Manual for Infancy and Early Childhood and the Zero to Three's Diagnostic Classification. It just hasn't made it into the APA's DSM, which until fairly recently included homosexuality as a mental illness.
As far as I know, there has not been a statistically valid gender breakdown of incidence, but you can be sure women are more verbal about sensory preferences and intolerances :)
Meanwhile, as an OT and the coauthor of Raising A Sensory Smart Child (www.sensorysmarts.com), I can say that an enormous amount can be done to help both children and adults overcome their sensory issues. I take a very functional approach to treatment, focusing on skills that need strengthening, and taking the underlying sensory issues into account. For example, if a child has difficulty with handwriting, I do not spin him around and around. That is pretty stupid and indefensible, and unlike what the NY Times seemed to imply, not a practice done by most OTs. However, if a child has vestibular (movement and balance) issues, he or she WILL have difficulty sitting still with stable upright posture, and possibly with handling subtle changes in head position. He might have difficulty interpreting sensory input in the proprioceptors (joint receptors) of his hands. He might have difficulty with visual perceptual skills, so that he cannot perceive which direction lines are going or discriminate between a diagonal and vertical line. So, I, like the vast majority of OTs take a "whole child" approach to any skill impairment, including assessing and enhancing sensory integration skills in order to improve the daily life skills needed for learning, playing, and so on.
Lindsey Biel, OTR/L, New York City
Lindsey, I just mentioned you the other day on one of my sites (I forget which one).
What I have found with many OT's is that they are trained in Occupational Therapy, not Sensory Integration and lack that knowledge. Although they have probably been exposed to the disorder, it is certainly not something they are well versed in and thus can not effectively integrate sensory therapy.
We have had to create our own sensory diet based on our child's needs and then "supplement" with the OT at school, not vice-versa. In a more perfect world it would be the other way around.
Mom of a hypo-hypersensitive child with vestibular, proprioceptive, tactile, auditory, oral motor, and visual dysfunction. Hmmm, did I forget anything? Little Pickel is a FUN kid!
Pickel
http://adopttwoboys.blogspot.com
http://www.discussingautism.com
The complete version of the article was a reasonably good and well balanced, but there were two important errors.
There is empirical research about the effects of sensory integrative techniques. The landmark articles is "Improving Academic Scores through Sensory Integration" by A. Jean Ayres published in the Journal of Learning Disabilities in 1972.
There are also standardized tests of sensory integration and related issues, most importantly "Sensory Integration and Praxis Test" available through Western Psychological Services.
While I firmly subscribe to the fact that there is much more to learn, more then 30 years of practice confirms that we have a solid basis from which to proceed.
Sue Sonkin, MS, OTR/L