Our colleague, Dr. Dan Fortenbacher, blogged last May about the natural synergy that we have with occupational therapists engaged in sensory integration therapy. I’ve been reminded of that repeatedly this month, in the midst of a stretch of continuing education seminars that I give to OTs, PTs, SLPs, and Educators for CMU Premier Education Solutions. Two more are upcoming in February, one in Toms River and the other in Atlantic City.
Here’s information about Sensory Integration from the Health Issue page on the website of the American Academy of Pediatrics:
Sensory Integration Training
“Dr Jean Ayres, an occupational therapist, developed the theory that much of the hyperactivity in today’s children is the result of poor sensory integration—that is, the failure of the brain to organize and make use of information derived from such senses as vision, hearing, smell, taste, touch, motion, and temperature. According to this theory, sensory integration dysfunction makes it difficult to concentrate and sit still, and puts children at risk for learning disabilities, problems with coordination, social difficulties, and touch sensitivity. Ayres claimed that sensory integration dysfunction is usually genetically inherited or acquired prenatally, during birth, or from environmental toxins. Recommended treatment includes exercises or experiences that provide the child with extrasensory stimulation and feedback—such as brushing and rubbing of the skin, deeppressure exercises, vibration, stretching, and so on.
While this approach has some intuitive appeal, feels good to children, can be calming, and is said to address the poor coordination and social difficulties that many children with ADHD experience, no convincing evidence has surfaced to prove that deficits in sensory integration are a cause of related disorders. Studies have not shown that sensory integrative training succeeds as a treatment for children with ADHD or learning or behavior problems. While not known to be harmful in any way, the expense and time demands are such that this approach cannot be recommended as a treatment for ADHD.”
Aside from the many wonderful examples of O.T. and O.D. collaboration in optometric and occupational therapy sources, I was reminded yesterday as I was giving my seminar that we have a major challenge in common. Despite all the good work we do, and the many thousands of patients we have helped, our interventions are dismissed by national medical organizations as unproven. These are the same organizations who uncritically peddle off-label experimental use of amphetamine derivative and anti-psychotic medications for children with attention and learning difficulties. I get a roomful of knowing nods when I ask OTs whether the AAP wouldn’t be better off not sticking its nose into an area where a little knowledge is a dangerous thing. That is why, when third parties look more closely at the fact that the AAP has joined ranks with the AAO in Policy Statements about optometric vision therapy, they can readily see that little meaningful light has been shed. And this is why, by the end of my seminar, attendees understand so well why it is pointless to have a child examined by an ophthalmologist when an informed opinion about visual function as related to learning is the intent of the referral.
We understand the power of SI therapy as related to sensory processing disorders, and OTs understand the power of VT as related to vision disorders. For every pediatric ophthalmologist who tells parents that optometric vision therapy is a waste of time and money, we have 50 occupational therapists who set the record straight. With each seminar that I do in NJ, that Dr. Fortenbacher does in Michigan, that Dr. Heying does in Iowa, that Dr. Morris does in Tennessee, that Drs. Appelbaum and Hillier and Hellerstein and Scheiman and Davis and many others do across the country, the truth will resonate exponentially.
- Leonard J. Press, O.D., FCOVD, FAAO