Doubt Cast on Usefulness of ‘Sensory’ Therapies for Autism

MONDAY, May 28 (HealthDay News) — Sensory therapies using brushes,
swings and other play equipment are increasingly used by occupational
therapists to treat children with developmental issues such as autism, but
a large pediatricians organization says there isn’t much evidence that
such therapies actually work.

Still, the group isn’t completely discounting the potential of sensory
therapies — it’s a ripe area for research, it noted.

But before parents spend the time and money on taking children to
sensory therapy, they should know that, as of now, the techniques are
largely unproven.

“It’s OK for parents to try these types of therapies, but there is
little research backing up the effectiveness of these therapies and
whether or not they improve long-term outcomes for kids with developmental
disabilities,” said Dr. Michelle Zimmer, an assistant professor of
pediatrics at Cincinnati Children’s Hospital Medical Center.

Zimmer is the co-author of a new American Academy of Pediatrics policy
statement on what is often referred to as “sensory integration therapy.”
The policy statement appears online May 28 and in the June print issue of
Pediatrics.

According to the pediatrician group, “sensory processing disorder
should not be used as a standalone diagnosis.

No one disputes that children with conditions such as autism can have
abnormalities in their responses to sensory stimuli, including sight,
taste, touch and sound. For example, autistic children may have aversions
to loud noises, to certain food textures or to being touched unexpectedly,
Zimmer said.

But that doesn’t necessarily mean the problem is with their brain
pathways for processing sensory information, as the term “sensory
processing disorder” implies.

Instead, some other issue could underlie their reactions to stimuli,
such as a behavioral issue, said Dr. Susan Hyman, chair of the American
Academy of Pediatrics subcommittee on autism and an associate professor of
pediatrics at University of Rochester Medical Center, in Rochester,
N.Y.

Instead of chalking up various aversions or compulsions to sensory
processing disorder, health care providers need to consider what other
developmental issues may be going on with the child, such as autism,
attention-deficit hyperactivity disorder (ADHD) and so on, Zimmer
said.

“There has never been a study that has shown that a child can have just
sensory processing disorder, isolated from another developmental
disabilities, such as autism or ADHD,” Zimmer said.

Sensory integration therapy got its start in the 1970s, when an
occupational therapist described a theory for how a well-organized sensory
system develops. Children, the therapist postulated, gradually learn to
make use of information from a variety of sources at the same time in
order to understand the world. The theory is that sensory dysfunction
occurs when these systems don’t develop correctly.

In sensory integration therapy, occupational therapists put children on
a “sensory diet,” exposing them to different sights, smells, sounds and
sensations, to improve the brain’s ability to process the information.

For now, however, whether it works remains a theory, Zimmer said.

Zimmer noted that occupational therapists in her hospital’s autism
center uses sensory therapies, and anecdotally, she’s seen sensory therapy
appear to help some children.

“We are happy to support parents who want to try to these therapies,
but we also need to use caution in making sure that the use of these
therapies is improving some outcome for their child,” Zimmer said.

In the absence of controlled clinical trials testing whether sensory
therapies work, parents have to try to be objective, ask themselves tough
questions about whether the treatment is really working, set specific
goals and determine if the child is moving toward the target.

“Is it improving the child’s ability to function? That’s where more
research needs to happen,” Zimmer said.

Hyman, who studies sensory differences in children with autism, agreed.
“The scientific testing of this intervention has not demonstrated that it
is effective for all children as a standalone treatment,” she said.
“However, for individual children, it may be an important part of a total
therapy package.”

Pediatricians should counsel families about the information out there
on sensory therapies, she added.

“You don’t want to spend a lot of time money and energy on a treatment
if it’s not right for them. They have to be prudent,” Hyman said. “In the
absence of data, parents have to utilize the information that’s available
to them in making choices.”

More information

The U.S. National Institute on Mental Health has more on autism.

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