AUTHOR=Camarata Stephen , Miller Lucy Jane , Wallace Mark T. 

TITLE=Evaluating Sensory Integration/Sensory Processing Treatment: Issues and Analysis

JOURNAL=Frontiers in Integrative Neuroscience

VOLUME=Volume 14 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/integrative-neuroscience/articles/10.3389/fnint.2020.556660

DOI=10.3389/fnint.2020.556660

ISSN=1662-5145

ABSTRACT=For more than 50 years, “Sensory Integration” has been a theoretical framework for diagnosing and treating disabilities in children under the umbrella of “sensory integration dysfunction” (SID). More recently, the approach has been reframed as “the dimensions of sensory processing” or SPD in place of SID, so that the review herein describes this framework as sensory integration/sensory processing treatment (SI/SP-T). Broadly, the approach views a plethora of disabilities such as ADHD, ASD, and disruptive behavior as being exacerbated by difficulties in modulating and integrating sensory input with a primary focus on contributions from tactile, proprioceptive, and vestibular systems hypothesized to contribute to core symptoms of the conditions. SI/SP intervention features include sensory activities designed to enhance tactile, proprioceptive and vestibular experiences using equipment (e.g., lycra swings, balance beams, climbing walls, trampolines), devices (e.g., weighted vests, sensory brushes) and activities (e.g., placing hands in messy substances such as shaving cream, sequenced movements) hypothesized to enhance sensory integration and sensory processing. The approach is reviewed herein with the goal of providing a framework for testing SI/SP-T using widely accepted clinical trials and event coding methods used in applied behavior analysis and other behavioral interventions. In addition, a related but distinct neuroscientific paradigm, multisensory processing, is presented as an independent test of whether SI/SP-T differentially impacts sensory integration and/or multisensory processing. Finally, because SI/SP-T activities include many incidental behavioral events that are known developmental facilitators (e.g., contingent verbal models/recasts during verbal interactions), there is a compelling need to control for confounds in order to study the unique impact of sensory based interventions. Note that SI/SP-T includes very specific and identifiable procedures and materials so that it is reasonable to expect high treatment fidelity when testing the approach. A patient case is presented that illustrates this confound with a known facilitator (recast intervention) and a method for controlling potential confounds to conduct unbiased studies of the effects of SI/SP-T approaches that are faithful to SI/SP-T theories of change.