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A Look at Sensory Integration: Promise, Possibility, and the Art of Placebo

By Steven R. Shaw, NCSP, Oct. 2002 Article found here
Anyone who works with children with autism, learning disabilities, or mental retardation has observed the child who craves being held tightly, the child with high pain tolerance, the child with tactile defensiveness, the child who is clumsy, and the child who cannot tolerate tags on the inside of
her shirt. Sensory integration (SI) dysfunction appears to be a productive explanation for these problems (American Occupational Therapy Association, 1997; Case-Smith & Bryon, 1999). Moreover, SI therapy seems a logical approach to addressing these issues.

Background of Sensory Integration Therapy
Sensory integration is a normal developmental process involving the ability of the central nervous system (CNS) to organize sensory feedback
from the body and the environment in order to make successful adaptive responses (Ermer & Dunn, 1998). The basic tenets of SI are:
1) the CNS is plastic;
2) SI matures along a predictable developmental sequence;
3) SI therapy attempts to revisit and restructure the development of sensory integration in cases where the normal developmental progression has
been disrupted;
4) SI therapy links an adaptive response to sensory input; and
5) children have an inner drive to integrate information (Bundy, Lane, Fisher, & Murray, 2002). Among the therapeutic techniques are deep brushing; swings for vestibular input; textures; bounce pads; scooter boards; weighted
vests and other clothing; ramps; and generally increasing or decreasing sensory diet, depending on the needs of the child.

When Jean Ayres (1979) first developed SI she proposed that, by revisiting the developmental
process of integrating information from the senses into an organized whole through a carefully controlled sensory diet, learning disabilities and other developmental disabilities could be cured (Carte, Morrison, Sublett, Uemura, & Setrakian, 1984; Kranowitz, Szlut, Balzer-Martin, Haber & Sava, 2001).

Evidence Belies Appeal of SI

There is one small problem. The problem is that it does not work. There is no evidence that SI therapy is or has ever been an effective treatment for children with learning disabilities, autism, or any other developmental disability. This is not one of those common cases where there is not enough information upon which to effectively evaluate the treatment.

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