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Pediatricians: Do NOT Diagnose Sensory Processing Disorders

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AAP: Don't Use Sensory Disorder Diagnosis
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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

Action Points
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."
by on Jun. 2, 2012 at 8:37 AM
Replies (11-14):
by on Jun. 8, 2012 at 6:07 PM

Don't get discouraged. You may have to fight more to get what your child needs but do not give up. Here is a huge issue I have with this: SPD happens due to what happens with the brain. That is real. I feel if it goes ignored, other issues will pop up over time and compound to a point that could be detrimental for a child and that child's family. For example, the family avoids certain outings or experiences to avoid SPD symptoms. That child (and the siblings) miss out on typical experiences other children learn from regularly and this further delays or elimates neurological connections. Those early neural pathways are literally the pathways that will make up who your child becomes and cannot be "handled" later when doctors get around to figuring it all out. By ignoring these children and their families it is the same as saying this child's brain doesn't matter. No, we cannot definitely say this therapy creates this change and at this level of correction. What we can say is stimulation activates the neurons so that the pathways for development can form and a lack of stimulation allows slow development and a pruning away of those neural pathways. If we are going to choose to not treat SPD as the brain difference that it is medically, there needs to be public access to regular early childhood centers that meets the need.

I know it is frustrating and it is unfair. The best we can do for our children no matter the difference is to fight for what they need and to do that you have to already know what they need since medical professionals have taken it upon themselves to keep that from you. We have to be our own medical researchers. We have to be our own teachers. We have to be our therapists. I'm constantly having to teach my son's pediatrician about his different neurological issues and she's with a top children's hospital. I try to tell myself not to get worked up over these issues but if parents of children with special needs don't get worked up, nobody else will!   

Quoting Valerieeee:

This frustrates me. I mean, I understand why it was written, but I am just now getting somewhere with our diagnosis. Evan was diagnosed with SPD, hyperkinesis, and possible ASD. The SPD is the only thing that was confirmed already.

by on Jul. 7, 2012 at 2:46 PM

WE had to have a diagnoses from a pedi, to get in to the occupational therapy program.

by on Jul. 7, 2012 at 2:59 PM

My child's OT and SLT is the one who had others from the center she worked for come and do a survery for SPD and they are the ones who diagnoised him. Our pedi does not even seem to notice always seems to be not listening if we try to inform her of things about our son that she doesnt directly have to deal with :(

by on Jul. 7, 2012 at 3:59 PM
My son is being evaluated by a neuropsychologist soon and after reading about SPD and other things here in the group I'm starting to wonder if that's the diagnosis that Cam may get instead of ADHD. I'm pretty worried about it honestly but I'd rather him be diagnosed with something we can get him help for than him not get diagnosed and miss out on opportunities for a better life! His pediatrician has nothing to do with him getting his referral though it's our neurologist who's always gotten everything we've needed through the yrs. Like the referral for pt/ot/speech therapies, his foot brace, & now the neuro psych eval.
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