Tuesday, June 05, 2007

Sensory Processing / Sensory Integration Disorders...A Long Way to Go

The New York Times has an article on sensory processing disorders and interviews Dr. Lucy Miller. It's a reminder of how far the field needs to go to improve recognition of disturbing sensory behaviors.

Excerpt: "...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."

The problems are several:

- the differences in how people perceive pain cannot be easily quantitated
- studies without quantifiable endpoints and blinding (e.g. most therapy research) can be suspect to bias
- children with sensory processing difficulties are often so heterogenous, that it may be difficult finding appropriate control populations (it is not impossible, of course - more groups have examined Williams, Fragile X, and autism...researchers, how about school age children with a history of low birth weight, next?)
- the sensory system is integrally related to diverse brain systems like arousal, emotion, and automatic escape reflexes
- sensory regulation is in constant balance with other environmental and biological factors, and it changes over the course of development; experimental studies need to be chosen to account for these variables.
- sensory processing disorders should be approached from an interdisciplinary perspective; our feeling is that ideally a neurologist should be involved in the diagnosis (and not diagnosis by a therapist's checklist), and that more standardization is necessary in many therapists' interventions
- that being said, most medical professionals underestimate the impact that sensory processing / regulation disorders have on normal childhood development; and specifically directed therapy can have profound benefits on all aspects of a child's functioning - emotional control, physical activity and exploration, personal and interpersonal behaviors and awareness, and fine and gross motor coordination.

Perhaps the most surprising thing from this latest New York Times article is how little has changed over the past ten years. This same article could have been published a decade ago.

NYT: The Disorder Is Sensory; the Diagnosis, Elusive
Eide Neurolearning Blog: Sensory Processing Links
Eide Neurolearning Blog: Sensory-Motor Incongruence Causes Pain
Eide Neurolearning Blog: The Biology of Sound Sensitivity
Sensory Processing Pages at MislabeledChild.com

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(HT: Kristine)

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