Sensory Integration Therapy Effectiveness Remains Questionable

Sensory integration therapy (SIT) has been commonly used in the treatment of individuals with autism since the 1970s. The primary theory behind SIT is that some children with intellectual/developmental disabilities commonly have sensory needs (related to the five senses of sight, sound, taste, touch, and smell) that are not adequately met.  The goal of this method – which includes the brushing of skin, swinging and/or wearing a weighted vest — is to improve attention, reasoning and perception and decrease disruptive or repetitive behaviors. However, because this form of therapy remains largely untested, the success rate cannot be validated and the effectiveness of SIT remains questionable.

“Parents want to provide the best and most useful treatment for their children.  They mean well when they specifically request this method because it is popular” said Bruce Golde, Little Star Center Occupational Therapist. “Some 80% of occupational therapists working with children today still use sensory integration as a basis for treatment.  Sensory integration proponents believe it helps a child learn and develop normally, purporting to influence behaviors, improve learning and help with motor development.  However, after more than forty years in practice, sensory integration still has very few studies that include a control group, making it difficult to determine if improvement a child may realize could be due to other factors such as natural maturation.  Over the past eight years, more objective analysis has found other treatment inventions to be more effective than sensory integration.”

The 2012 Research in Autism Spectrum Disorders journal features an article on a research project on this topic which reviews and analyzes 25 studies on sensory integration therapy: Sensory Integration Therapy for Autism Spectrum Disorders: A Systematic Review by Russell Lang, Mark O’Reilly, Olive Healy, Mandy Rispoli, Helena Lydon, William Streusand, Tonya Davis, Soyeon Kang, Jeff Sigafoos, Giulio Lancioni, Robert Didden, and Sanne Giesbers.  Because many of these 25 studies were flawed, the reviewers determined that the evidence does not support the use of SIT as a treatment for children with autism spectrum disorders (ASD).

In addition, a recent article in the June 2012 issue of ADVANCE for Occupational Therapy Practitioners, titled “AAP Against SPD Diagnosis,” describes a new policy released by the American Academy of Pediatrics (AAP) recommending that pediatricians no longer diagnose sensory processing disorder (SPD) for children with sensory issues.  This decision is based on the lack of research on SPD as a condition unique from other developmental disabilities and the limited and inconclusive research on the effectiveness of sensory integration therapy on children with autism spectrum disorder. (The AAP Policy Statement “Sensory Integration Therapies for Children with Developmental and Behavioral Disorders” appears in the June issue of Pediatrics, an official peer-reviewed journal of the American Academy of Pediatrics that serves authors and readers of the general medical profession as well as pediatricians.)

“The truth of the matter is…we simply don’t know what is going on in the brain of a child with autism,” said Golde.  “We don’t know why a particular child has a preference for repeated touch.  Certainly, a child may enjoy the sensory integration activity, but beyond that, the therapy doesn’t result in significant behavioral changes.  Other forms of proven therapy are a better use of the child’s time.  Parents should explore and discuss treatment options before making a decision.”

Mary Rosswurm, Executive Director of Little Star Center and the parent of a young adult with autism, says “Bottom line, there is a difference between enjoyment and benefit.”

Little Star Center highly recommends parents visit the Association for Science in Autism Treatment (ASAT) website as a reference for unbiased and reliable information not only on sensory integration therapy but other intervention methods they may be considering. ASAT is a not-for-profit organization established in 1998 to disseminate accurate, scientifically-sound information about autism and its treatment and combat inaccurate or unsubstantiated information.