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Why "Sensory Integration Disorder" Is a Dubious Diagnosis
Peter L. Heilbroner, MD, PhD
Anecdotal evidence from parents is often used to support the existence of SID and the effectiveness of treatment. A review of the literature on sensory integration disorder reveals mostly poorly designed studies and flawed methodology. Studies with tiny sample sizes (as small as one patient!) are common [3-7]. Other studies investigate sensory symptoms in children with a serious underlying disorder such as autism [8-12], or mental retardation [13-16], and are therefore unlikely to be especially relevant to more normal children. Still other research assesses sensory therapies in the treatment of tangentially related conditions, like learning disability [17-23] or neuromotor delays [24-27]. In some cases where treatment appears to benefit, the therapies may simply be a calming influence on a nervous child. However, there are no adequate controlled studies either supporting the existence of SID as a distinct and definable entity, or clearly demonstrating the effectiveness of the therapies used for SID compared to no treatment at all [28-30]. In my experience, children diagnosed with "SID" are simply very anxious and come from a family that includes others who suffer from an anxiety disorder.
It should be remembered that most children develop and improve their behavior spontaneously. Given the fact that few (if any) adult patients have sensory integration disorder, it is reasonable to question whether costly interventions are really necessary for what is a most likely a self-limiting problem of neurodevelopmental immaturity and anxiety. I also believe that children or families whose behavioral or anxiety disorders could benefit treatment would be better off seeking standard treatment than wasting time and money on unproven or irrational approaches.
Well-designed scientific studies are needed to determine whether or not SID is indeed a disorder, and even if so, whether the treatments currently prescribed are effective or necessary. Until studies along these lines are conducted, the diagnosis of SID should prompt a healthy degree of skepticism.
Why "Sensory Integration Disorder" Is a Dubious Diagnosis
Peter L. Heilbroner, MD, PhD
Anecdotal evidence from parents is often used to support the existence of SID and the effectiveness of treatment. A review of the literature on sensory integration disorder reveals mostly poorly designed studies and flawed methodology. Studies with tiny sample sizes (as small as one patient!) are common [3-7]. Other studies investigate sensory symptoms in children with a serious underlying disorder such as autism [8-12], or mental retardation [13-16], and are therefore unlikely to be especially relevant to more normal children. Still other research assesses sensory therapies in the treatment of tangentially related conditions, like learning disability [17-23] or neuromotor delays [24-27]. In some cases where treatment appears to benefit, the therapies may simply be a calming influence on a nervous child. However, there are no adequate controlled studies either supporting the existence of SID as a distinct and definable entity, or clearly demonstrating the effectiveness of the therapies used for SID compared to no treatment at all [28-30]. In my experience, children diagnosed with "SID" are simply very anxious and come from a family that includes others who suffer from an anxiety disorder.
It should be remembered that most children develop and improve their behavior spontaneously. Given the fact that few (if any) adult patients have sensory integration disorder, it is reasonable to question whether costly interventions are really necessary for what is a most likely a self-limiting problem of neurodevelopmental immaturity and anxiety. I also believe that children or families whose behavioral or anxiety disorders could benefit treatment would be better off seeking standard treatment than wasting time and money on unproven or irrational approaches.
Well-designed scientific studies are needed to determine whether or not SID is indeed a disorder, and even if so, whether the treatments currently prescribed are effective or necessary. Until studies along these lines are conducted, the diagnosis of SID should prompt a healthy degree of skepticism.
Why "Sensory Integration Disorder" Is a Dubious Diagnosis