Pediatricians: Do NOT Diagnose Sensory Processing Disorders
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By Todd Neale, Senior Staff Writer, MedPage Today
Published: June 01, 2012
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Sensory processing disorder should not be used as a diagnosis, according to a policy statement from the section on Complementary and Integrative Medicine of the American Academy of Pediatrics.
Note that the statement expresses concern about overuse of sensory-based therapies without adequate evidence of effectiveness, and recommends pediatrician involvement in a diagnosis and limited use of sensory-based therapies as part of a comprehensive treatment plan.
Pediatricians should not use sensory processing disorder as a diagnosis, according to a policy statement from the American Academy of Pediatrics.
Although there are standardized measures of a child's sensory processing abilities, there is not a widely accepted framework for diagnosing the disorder, members of the AAP's Section on Complementary and Integrative Medicine wrote in the June issue of Pediatrics.
They noted that the committee developing the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has called for further research before officially recognizing sensory processing disorder.
In addition, the authors wrote, "it is unclear whether children who present with sensory-based problems have an actual 'disorder' of the sensory pathways of the brain or whether these deficits are characteristics associated with other developmental and behavioral disorders."
Instead of diagnosing sensory processing disorder, pediatricians should perform a thorough evaluation -- usually with appropriate referral to a developmental and behavioral pediatrician, child psychiatrist, or child psychologist, according to the recommendations.
And consideration should be given to other developmental and behavioral disorders that may be associated with difficulty tolerating or processing sensory information, including autism spectrum disorders, attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorders, and childhood anxiety disorders, the authors wrote.
But even if a diagnosis of sensory processing disorder should not be used, occupational therapy with sensory-based therapies -- which include activities believed to organize the sensory system -- "may be acceptable as one of the components of a comprehensive treatment plan," the authors wrote, adding that parents should be told that there is limited and inconclusive evidence about the effectiveness of sensory integration therapy.
And pediatricians have an important role to play in helping families understand whether sensory-based therapies are working for their children, the authors said.
For example, doctors can help families develop simple ways to monitor the effects of treatment, including the use of behavior diaries and pre/post behavior rating scales, and help create specific treatment goals at the beginning of therapy. They can also set a time limit for when the family should come back to discuss whether the therapy is working.
"Pediatricians should inform families that occupational therapy is a limited resource, particularly the number of sessions available through schools and through insurance coverage," the authors wrote. "The family, pediatrician, and other clinicians should work together to prioritize treatment on the basis of the effects the sensory problems have on a child's ability to perform daily functions of childhood."