Ask the Pediatrician | Behavior | Preschool

Sensory therapies are poorly studied

Increasingly parents are asking me about sensory issues in their preschool aged children. Sometimes children cover their ears or need to have tags removed from clothes. Other children seem to crave sensory input and bump into everything and yell. Some children don’t want anything messy on their hands and others avoid or refuse to eat foods with a texture that is uncomfortable for them. These types of apparent sensory-related issues are common and usually represent a phase that is relatively quickly outgrown as time passes. Some preschoolers and older children persist with more extreme sensitivity or crave sensory input in a more intense way. These children can be challenging both at home and in the classroom where catering to these needs is disruptive.

Parents often don’t make much of it at home, accommodating or forging ahead with their child depending on their parenting style but increasingly preschool teachers are suggesting to parents that children may have issues with sensory integration. Sometimes occupational therapy is suggested as an approach to help children overcome what are intrusive sensory issues and yet little research exists to guide us as to which of these therapies is helpful.

Indeed, the American Academy of Pediatrics is even reluctant to acknowledge the diagnosis of sensory integration disorder in part because the vast majority of children with sensitivities to sensory input are also saddled with other developmental issues such as autism, anxiety, ADHD, or motor coordination issues. As a result, the sensory issues are real but secondary to another primary problem and addressing the primary issue with the appropriate approach will often improve the sensory issues as well. In addition, since sensory therapies such as brushing, swinging, or using other equipment to desensitize children is so poorly studied (and the few studies done have not shown consistent benefit) spending time on them may burn through the limited occupational therapy (OT) sessions allotted by insurance without any clear benefit.

It’s really tough as a parent of a child who clearly has more difficulty negotiating the world in part due to his apparent difficulty regulating sensory input not to want to do OT to help with these disruptive problems. It’s even more challenging because so few children easily fit into a clear cut diagnostic entity but given the lack of evidence to support its benefit, getting OT for sensory issues may not help much at all. Spending some time with your pediatrician discussing all of your child’s quirks and challenges may give a broader picture and make clearer what underlying issues are manifesting themselves with these sensory issues. By targeting interventions at the root cause, your child has the best chance to succeed at home and school.

Dr. Molly O'Shea
Dr. Molly O'Shea is a board-certified pediatrician who cares for families in her practice Birmingham Pediatrics + Wellness Center. She will answer your questions on babies, children, adolescents and families and address common concerns.