Sensory processing disorder
Sensory processing disorder (SPD, formerly known as sensory integration dysfunction) is a condition in which multisensory input is not adequately processed in order to provide appropriate responses to the demands of the environment. Sensory processing disorder is present in many people with dyspraxia, autism spectrum disorder and attention deficit hyperactivity disorder. Individuals with SPD may inadequately process visual, auditory, olfactory (smell), gustatory (taste), tactile (touch), vestibular (balance), proprioception (body awareness), and interoception (internal body senses) sensory stimuli.
Sensory processing disorder | |
---|---|
Other names | Sensory integration dysfunction |
![]() | |
An SPD nosology proposed by Miller LJ et al. (2007)[1] | |
Specialty | Psychiatry, occupational therapy, neurology |
Symptoms | Hypersensitivity and hyposensitivity to stimuli, and/or difficulties using sensory information to plan movement. Problems discriminating characteristics of stimuli. |
Complications | Low school performance, behavioral difficulties, social isolation, employment problems, family and personal stress |
Usual onset | Uncertain |
Risk factors | Anxiety, behavioral difficulties |
Diagnostic method | Based on symptoms |
Treatment |
Sensory integration was defined by occupational therapist Anna Jean Ayres in 1972 as "the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment".[2][3] Sensory processing disorder has been characterized as the source of significant problems in organizing sensation coming from the body and the environment and is manifested by difficulties in the performance in one or more of the main areas of life: productivity, leisure and play[4] or activities of daily living.[5]
Sources debate whether SPD is an independent disorder or represents the observed symptoms of various other, more well-established, disorders.[6][7][8][9] SPD is not included in the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association,[10][11] and the American Academy of Pediatrics has recommended in 2012 that pediatricians not use SPD as a stand-alone diagnosis.[10]
Signs and symptoms
Sensory integration difficulties or sensory processing disorder (SPD) are characterized by persistent challenges with neurological processing of sensory stimuli that interfere with a person's ability to participate in everyday life. Such challenges can appear in one or several sensory systems of the somatosensory system, vestibular system, proprioceptive system, interoceptive system, auditory system, visual system, olfactory system, and gustatory system.
While many people can present one or two symptoms, sensory processing disorder has to have a clear functional impact on the person's life:
Signs of over-responsivity,[12] including, for example, dislike of textures such as those found in fabrics, foods, grooming products or other materials found in daily living, to which most people would not react, and serious discomfort, sickness or threat induced by normal sounds, lights, ambient temperature, movements, smells, tastes, or even inner sensations such as heartbeat.
Signs of under-responsivity, including sluggishness and lack of responsiveness.
Sensory cravings,[13] including, for example, fidgeting, impulsiveness, and/or seeking or making loud, disturbing noises; and sensorimotor-based problems, including slow and uncoordinated movements or poor handwriting.
Sensory discrimination problems, which might manifest themselves in behaviors such as things constantly dropped.
Symptoms may vary according to the disorder's type and subtype present.
Relationship to other disorders
Sensory integration and processing difficulties can be a feature of a number of disorders, including anxiety problems, attention deficit hyperactivity disorder (ADHD),[14] food intolerances, behavioral disorders, and particularly, autism spectrum disorders.[15][16][17] This pattern of comorbidities poses a significant challenge to those who claim that SPD is an identifiably specific disorder, rather than simply a term given to a set of symptoms common to other disorders.[18]
Two studies have provided preliminary evidence suggesting that there may be measurable neurological differences between children diagnosed with SPD and control children classified as neurotypical[19] or children diagnosed with autism.[20] Despite this evidence, that SPD researchers have yet to agree on a proven, standardized diagnostic tool undermines researchers' ability to define the boundaries of the disorder and makes correlational studies, like those on structural brain abnormalities, less convincing.[21]
Causes
The exact cause of SPD is not known.[22] However, it is known that the midbrain and brainstem regions of the central nervous system are early centers in the processing pathway for multisensory integration; these brain regions are involved in processes including coordination, attention, arousal, and autonomic function.[23] After sensory information passes through these centers, it is then routed to brain regions responsible for emotions, memory, and higher level cognitive functions.
Mechanism
Research in sensory processing in 2007, is focused on finding the genetic and neurological causes of SPD. Electroencephalography (EEG),[24] measuring event-related potential (ERP) and magnetoencephalography (MEG) are traditionally used to explore the causes behind the behaviors observed in SPD.
Differences in tactile and auditory over-responsivity show moderate genetic influences, with tactile over-responsivity demonstrating greater heritability.[25] Differences in auditory latency (the time between the input is received and when reaction is observed in the brain), hypersensitivity to vibration in the Pacinian corpuscles receptor pathways and other alterations in unimodal and multisensory processing have been detected in autism populations.[26]
People with sensory processing deficits appear to have less sensory gating than typical subjects,[27][28] and atypical neural integration of sensory input. In people with sensory over-responsivity, different neural generators activate, causing the automatic association of causally related sensory inputs that occurs at this early sensory-perceptual stage to not function properly.[29] People with sensory over-responsivity might have increased D2 receptor in the striatum, related to aversion to tactile stimuli and reduced habituation. In animal models, prenatal stress significantly increased tactile avoidance.[30]
Recent research has also found an abnormal white matter microstructure in children with SPD, compared with typical children and those with other developmental disorders such as autism and ADHD.[31][32]
One hypothesis is that multisensory stimulation may activate a higher-level system in the frontal cortex that involves attention and cognitive processing, rather than the automatic integration of multisensory stimuli observed in typically developing adults in the auditory cortex.[26][29]
Diagnosis
Sensory processing disorder is accepted in the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R). It is not recognized as a mental disorder in medical manuals such as the ICD-10[33] or the DSM-5.[34]
Diagnosis is primarily arrived at by the use of standardized tests, standardized questionnaires, expert observational scales, and free-play observation at an occupational therapy gym. Observation of functional activities might be carried at school and home as well.
Though diagnosis in most of the world is done by an occupational therapist, in some countries diagnosis is made by certified professionals, such as psychologists, learning specialists, physiotherapists and/or speech and language therapists.[35] Some countries recommend to have a full psychological and neurological evaluation if symptoms are too severe.
Standardized tests
Classification
Sensory integration and processing difficulties
Construct-related evidence relating to sensory integration and processing difficulties from Ayres' early research emerged from factor analysis of the earliest test the SCISIT and Mulligan's 1998 "Patterns of Sensory Integration Dysfunctions: A Confirmatory Factor Analysis".[41] Sensory integration and processing patterns recognised in the research support a classification of difficulties related to:
- Sensory registration and perception (discrimination)
- Sensory reactivity (modulation)
- Praxis (meaning "to do")
- Postural, ocular and bilateral integration
Sensory processing disorder (SPD)
Proponents of a new nosology SPD have instead proposed three categories: sensory modulation disorder, sensory-based motor disorders and sensory discrimination disorders[1] (as defined in the Diagnostic Classification of Mental Health and Developmental Disorders in Infancy and Early Childhood).[42][43]
1. Sensory modulation disorder (SMD)
Sensory modulation refers to a complex central nervous system process[1][44] by which neural messages that convey information about the intensity, frequency, duration, complexity, and novelty of sensory stimuli are adjusted.[45]
SMD consists of three subtypes:
- Sensory over-responsivity.
- Sensory under-responsivity
- Sensory craving/seeking.
2. Sensory-based motor disorder (SBMD)
According to proponents, sensory-based motor disorder shows motor output that is disorganized as a result of incorrect processing of sensory information affecting postural control challenges, resulting in postural disorder, or developmental coordination disorder.[1][46]
The SBMD subtypes are:
- Dyspraxia
- Postural disorder
3. Sensory discrimination disorder (SDD)
Sensory discrimination disorder involves the incorrect processing of sensory information.[1] The SDD subtypes are:[47]
- Visual
- Auditory
- Tactile
- Gustatory (taste)
- Olfactory (smell)
- Vestibular (balance, head position and movement in space)
- Proprioceptive (feeling of where parts of the body are located in space, muscle sensation)
- Interoception (inner body sensations).
Treatment
Sensory integration therapy
![](../I/Tire_Swing.JPG.webp)
Typically offered as part of occupational therapy, ASI that places a child in a room specifically designed to stimulate and challenge all of the senses to elicit functional adaptive responses. Occupational Therapy is defined by the American Occupational Therapy Association (AOTA) as "Occupational therapy practitioners in pediatric settings work with children and their families, caregivers and teachers to promote participation in meaningful activities and occupations". In childhood, these occupations may include play, school and learning self-care tasks. An entry level Occupational Therapist can provide treatment for sensory processing disorder however, more advanced clinical training exists to target the underlying neuro-biological processes involved.
[48] Although Ayres initially developed her assessment tools and intervention methods to support children with sensory integration and processing challenges, the theory is relevant beyond childhood.[49][50][51]
Sensory integration therapy is driven by four main principles:[52]
- Just right challenge (the child must be able to successfully meet the challenges that are presented through playful activities)
- Adaptive response (the child adapts their behavior with new and useful strategies in response to the challenges presented)
- Active engagement (the child will want to participate because the activities are fun)
- Child directed (the child's preferences are used to initiate therapeutic experiences within the session)
Serious questions have been raised as to the effectiveness of this therapy[53][54][55][56] particularly in medical journals where the requirements for a treatment to be effective is much higher and developed than its occupational therapy counterparts which often advocate the effectiveness of the treatment.[57][58]
Sensory processing therapy
This therapy retains all of the above-mentioned four principles and adds:[59]
- Intensity (person attends therapy daily for a prolonged period of time)
- Developmental approach (therapist adapts to the developmental age of the person, against actual age)
- Test-retest systematic evaluation (all clients are evaluated before and after)
- Process driven vs. activity driven (therapist focuses on the "just right" emotional connection and the process that reinforces the relationship)
- Parent education (parent education sessions are scheduled into the therapy process)
- "Joie de vivre" (happiness of life is therapy's main goal, attained through social participation, self-regulation, and self-esteem)
- Combination of best practice interventions (is often accompanied by integrated listening system therapy, floor time, and electronic media such as Xbox Kinect, Nintendo Wii, Makoto II machine training and others)
While occupational therapists using a sensory integration frame of reference work on increasing a child's ability to adequately process sensory input, other OTs may focus on environmental accommodations that parents and school staff can use to enhance the child's function at home, school, and in the community.[60][61] These may include selecting soft, tag-free clothing, avoiding fluorescent lighting, and providing ear plugs for "emergency" use (such as for fire drills).
Evaluation of treatment effectiveness
A 2019 review found sensory integration therapy to be effective for autism spectrum disorder.[62] Another study from 2018 backs up the intervention for children with special needs,[63] Additionally, the American Occupational Therapy Association supports the intervention.[64]
In its overall review of the treatment effectiveness literature, Aetna concluded that "The effectiveness of these therapies is unproven",[65] while the American Academy of Pediatrics concluded that "parents should be informed that the amount of research regarding the effectiveness of sensory integration therapy is limited and inconclusive."[66] A 2015 review concluded that SIT techniques exist "outside the bounds of established evidence-based practice" and that SIT is "quite possibly a misuse of limited resources."[67]
Epidemiology
It has been estimated by proponents that up to 16.5% of elementary school aged children present elevated SOR behaviors in the tactile or auditory modalities.[68] This figure is larger than what previous studies with smaller samples had shown: an estimate of 5–13% of elementary school aged children.[69] Critics have noted that such a high incidence for just one of the subtypes of SPD raises questions about the degree to which SPD is a specific and clearly identifiable disorder.[21]
Proponents have also claimed that adults may also show signs of sensory processing difficulties and would benefit for sensory processing therapies,[70] although this work has yet to distinguish between those with SPD symptoms alone vs adults whose processing abnormalities are associated with other disorders, such as autism spectrum disorder.[71]
Society
The American Occupational Therapy Association (AOTA) and British Royal College of Occupational Therapy (RCOT) support the use of a variety of methods of sensory integration for those with sensory integration and processing difficulties. Both organizations recognise the need for further research about Ayres' Sensory Integration and related approaches. In the USA this important to increase insurance coverage for related therapies. AOTA and RCOT have made efforts to educate the public about sensory Integration and related approaches. AOTA's practice guidelines and RCOT's informed view "Sensory Integration and sensory-based interventions"[72] currently support the use of sensory integration therapy and interprofessional education and collaboration in order to optimize treatment for those with sensory integration and processing difficulties. The AOTA provides several resources pertaining to sensory integration therapy, some of which includes a fact sheet, new research, and continuing education opportunities.[73]
Controversy
There are concerns regarding the validity of the diagnosis. SPD is not included in the DSM-5 or ICD-10, the most widely used diagnostic sources in healthcare. The American Academy of Pediatrics (AAP) in 2012 stated that there is no universally accepted framework for diagnosis and recommends caution against using any "sensory" type therapies unless as a part of a comprehensive treatment plan. The AAP has plans to review its policy, though those efforts are still in the early stages.[74]
A 2015 review of research on Sensory Integration Therapy (SIT) concluded that SIT is "ineffective and that its theoretical underpinnings and assessment practices are unvalidated", that SIT techniques exist "outside the bounds of established evidence-based practice", and that SIT is "quite possibly a misuse of limited resources".[67]
Some sources point that sensory issues are an important concern, but not a diagnosis in themselves.[75][76]
Critics have noted that what proponents claim are symptoms of SPD are both broad and, in some cases, represent very common, and not necessarily abnormal or atypical, childhood characteristics. Where these traits become grounds for a diagnosis is generally in combination with other more specific symptoms or when the child gets old enough to explain that the reasons behind their behavior are specifically sensory.[77]
Manuals
SPD is in Stanley Greenspan's Diagnostic Manual for Infancy and Early Childhood and as Regulation Disorders of Sensory Processing part of The Zero to Three's Diagnostic Classification.
Is not recognized as a stand-alone diagnosis in the manuals ICD-10 or in the recently updated DSM-5, but unusual reactivity to sensory input or unusual interest in sensory aspects is included as a possible but not necessary criterion for the diagnosis of autism.[78][77]
History
Sensory processing disorder as a specific form of atypical functioning was first described by occupational therapist Anna Jean Ayres (1920–1989).[79]
Original model
Ayres's theoretical framework for what she called Sensory Integration Dysfunction was developed after six factor analytic studies of populations of children with learning disabilities, perceptual motor disabilities and normal developing children.[80] Ayres created the following nosology based on the patterns that appeared on her factor analysis:
- Dyspraxia: poor motor planning (more related to the vestibular system and proprioception)
- Poor bilateral integration: inadequate use of both sides of the body simultaneously
- Tactile defensiveness: negative reaction to tactile stimuli
- Visual perceptual deficits: poor form and space perception and visual motor functions
- Somatodyspraxia: poor motor planning (related to poor information coming from the tactile and proprioceptive systems)
- Auditory-language problems
Both visual perceptual and auditory language deficits were thought to possess a strong cognitive component and a weak relationship to underlying sensory processing deficits, so they are not considered central deficits in many models of sensory processing.
In 1998, Mulligan found a similar pattern of deficits in a confirmatory factor analytic study.[81][82]
Quadrant model
Dunn's nosology uses two criteria:[83] response type (passive vs. active) and sensory threshold to the stimuli (low or high) creating four subtypes or quadrants:[84]
- High neurological thresholds
- Low registration: high threshold with passive response. Individuals who do not pick up on sensations and therefore partake in passive behavior.[85]
- Sensation seeking: high threshold and active response. Those who actively seek out a rich sensory filled environment.[85]
- Low neurological threshold
- Sensitivity to stimuli: low threshold with passive response. Individuals who become distracted and uncomfortable when exposed to sensation but do not actively limit or avoid exposure to the sensation.[85]
- Sensation avoiding: low threshold and active response. Individuals actively limit their exposure to sensations and are therefore high self regulators.[85]
Sensory processing model
In Miller's nosology "sensory integration dysfunction" was renamed into "Sensory processing disorder" to facilitate coordinated research work with other fields such as neurology since "the use of the term sensory integration often applies to a neurophysiologic cellular process rather than a behavioral response to sensory input as connoted by Ayres."[1]
The sensory processing model's nosology divides SPD in three subtypes: modulation, motor based and discrimination problems.[1]
See also
- Auditory processing disorder – Developmental or acquired neurological disorders
- Catatonia – Psychiatric behavioral syndrome
- Hyperacusis – very rare and extremely debilitating hearing disorder characterized by unusual intolerance to ordinary environmental sounds
- Hyperesthesia – exaggerated sensations of tactile stimuli
- Misophonia – Disorder of decreased tolerance to specific sounds
- Music therapy – Health profession
- Neurologic music therapy – Health profession
- Occupational science – scientific discipline
- Sensory friendly – Sensory processing disorder accommodation
- Sensory integration therapy – therapy designed to treat sensory processing disorder
- Sensory overload – State of overwhelm caused by an excess of sensory input
- Sensory processing sensitivity – Personality trait of highly sensitive people
- Snoezelen – Form of therapeutic relaxation
- Somatosensory disorder – human disease
References
- Miller LJ, Anzalone ME, Lane SJ, Cermak SA, Osten ET (2007). "Concept evolution in sensory integration: a proposed nosology for diagnosis". The American Journal of Occupational Therapy. 61 (2): 135–40. doi:10.5014/ajot.61.2.135. PMID 17436834.
- Ayres AJ (1972). Sensory integration and learning disorders. Los Angeles: Western Psychological Services. ISBN 978-0-87424-303-1. OCLC 590960.
- Ayres AJ (1972). "Types of sensory integrative dysfunction among disabled learners". The American Journal of Occupational Therapy. 26 (1): 13–8. PMID 5008164.
- Cosbey J, Johnston SS, Dunn ML (2010). "Sensory processing disorders and social participation". The American Journal of Occupational Therapy. 64 (3): 462–73. doi:10.5014/ajot.2010.09076. PMID 20608277.
- "Sensory Processing Disorder Explained". SPD Foundation. Archived from the original on 2010-05-17.
- Brout J, Miller LJ. "DSM-5 Application for Sensory Processing Disorder Appendix A (part 1)". Research Gate. Retrieved 26 November 2018.
- Arky B. "The Debate Over Sensory Processing". Child Mind Institute. Retrieved 26 November 2018.
- Walbam, K. (2014). The Relevance of Sensory Processing Disorder to Social Work Practice: An Interdisciplinary Approach. Child & Adolescent Social Work Journal, 31(1), 61-70. doi:10.1007/s10560-013-0308-2
- "AAP Recommends Careful Approach to Using Sensory-Based Therapies". www.aap.org. Retrieved 2017-12-27.
- Neale T (June 2012). "AAP: Don't Use Sensory Disorder Diagnosis". Medpage Today. Everyday Health. Retrieved 26 November 2018.
- Weinstein E (2016-11-22). "Making Sense of Sensory Processing Disorder". Psych Central. Retrieved 26 November 2018.
- Van Hulle C, Lemery-Chalfant K, Goldsmith HH (2015-06-24). "Trajectories of Sensory Over-Responsivity from Early to Middle Childhood: Birth and Temperament Risk Factors". PLOS ONE. 10 (6): e0129968. Bibcode:2015PLoSO..1029968V. doi:10.1371/journal.pone.0129968. PMC 4481270. PMID 26107259.
- Peters SU, Horowitz L, Barbieri-Welge R, Taylor JL, Hundley RJ (February 2012). "Longitudinal follow-up of autism spectrum features and sensory behaviors in Angelman syndrome by deletion class". Journal of Child Psychology and Psychiatry, and Allied Disciplines. 53 (2): 152–9. doi:10.1111/j.1469-7610.2011.02455.x. PMID 21831244.
- Ghanizadeh A (June 2011). "Sensory processing problems in children with ADHD, a systematic review". Psychiatry Investigation. 8 (2): 89–94. doi:10.4306/pi.2011.8.2.89. PMC 3149116. PMID 21852983.
- Lane AE, Young RL, Baker AE, Angley MT (January 2010). "Sensory processing subtypes in autism: association with adaptive behavior". Journal of Autism and Developmental Disorders. 40 (1): 112–22. doi:10.1007/s10803-009-0840-2. PMID 19644746. S2CID 31901138.
- Tomchek SD, Dunn W (2007). "Sensory processing in children with and without autism: a comparative study using the short sensory profile". The American Journal of Occupational Therapy. 61 (2): 190–200. doi:10.5014/ajot.61.2.190. PMID 17436841.
- Kern JK, Trivedi MH, Grannemann BD, Garver CR, Johnson DG, Andrews AA, et al. (March 2007). "Sensory correlations in autism". Autism. 11 (2): 123–34. doi:10.1177/1362361307075702. PMID 17353213. S2CID 26074710.
- Flanagan J (2009). "Sensory processing disorder" (PDF). Pediatric News. Kennedy Krieger.org. Archived from the original (PDF) on 2012-09-19. Retrieved 2018-11-23.
- Owen JP, Marco EJ, Desai S, Fourie E, Harris J, Hill SS, et al. (June 17, 2013). "Abnormal white matter microstructure in children with sensory processing disorders". NeuroImage. Clinical. 2: 844–53. doi:10.1016/j.nicl.2013.06.009. PMC 3778265. PMID 24179836.
- Chang YS, Owen JP, Desai SS, Hill SS, Arnett AB, Harris J, et al. (July 2014). "Autism and sensory processing disorders: shared white matter disruption in sensory pathways but divergent connectivity in social-emotional pathways". PLOS ONE. 9 (7): e103038. Bibcode:2014PLoSO...9j3038C. doi:10.1371/journal.pone.0103038. PMC 4116166. PMID 25075609.
- Palmer B (2014-02-28). "Get Ready for the Next Big Medical Fight Is sensory processing disorder a real disease?". Slate. Retrieved 12 September 2018.
- "Sensory Processing Disorder". HowStuffWorks. InfoSpace Holdings LLC. 2008-06-17. Retrieved 27 November 2018.
- Stein BE, Stanford TR, Rowland BA (December 2009). "The neural basis of multisensory integration in the midbrain: its organization and maturation". Hearing Research. 258 (1–2): 4–15. doi:10.1016/j.heares.2009.03.012. PMC 2787841. PMID 19345256.
- Davies PL, Gavin WJ (2007). "Validating the diagnosis of sensory processing disorders using EEG technology". The American Journal of Occupational Therapy. 61 (2): 176–89. doi:10.5014/ajot.61.2.176. PMID 17436840.
- Goldsmith HH, Van Hulle CA, Arneson CL, Schreiber JE, Gernsbacher MA (June 2006). "A population-based twin study of parentally reported tactile and auditory defensiveness in young children". Journal of Abnormal Child Psychology. 34 (3): 393–407. doi:10.1007/s10802-006-9024-0. PMC 4301432. PMID 16649001.
- Marco, Elysa J.; Hinkley, Leighton B. N.; Hill, Susanna S.; Nagarajan, Srikantan S. (May 2011). "Sensory Processing in Autism: A Review of Neurophysiologic Findings". Pediatric Research. 69 (8): 48–54. doi:10.1203/PDR.0b013e3182130c54. ISSN 1530-0447. PMC 3086654. PMID 21289533.
- Davies PL, Chang WP, Gavin WJ (May 2009). "Maturation of sensory gating performance in children with and without sensory processing disorders". International Journal of Psychophysiology. 72 (2): 187–97. doi:10.1016/j.ijpsycho.2008.12.007. PMC 2695879. PMID 19146890.
- Kisley MA, Noecker TL, Guinther PM (July 2004). "Comparison of sensory gating to mismatch negativity and self-reported perceptual phenomena in healthy adults" (PDF). Psychophysiology. 41 (4): 604–12. doi:10.1111/j.1469-8986.2004.00191.x. PMID 15189483. Archived from the original (PDF) on 2012-10-25.
- Brett-Green BA, Miller LJ, Schoen SA, Nielsen DM (March 2010). "An exploratory event-related potential study of multisensory integration in sensory over-responsive children" (PDF). Brain Research. 1321: 67–77. doi:10.1016/j.brainres.2010.01.043. PMID 20097181. S2CID 38720244. Archived from the original (PDF) on 2012-10-24.
- Schneider ML, Moore CF, Gajewski LL, Larson JA, Roberts AD, Converse AK, DeJesus OT (2008). "Sensory processing disorder in a primate model: evidence from a longitudinal study of prenatal alcohol and prenatal stress effects" (PDF). Child Development. 79 (1): 100–13. doi:10.1111/j.1467-8624.2007.01113.x. PMC 4226060. PMID 18269511. Archived from the original (PDF) on 2013-05-12.
- Owen JP, Marco EJ, Desai S, Fourie E, Harris J, Hill SS, et al. (2013). "Abnormal white matter microstructure in children with sensory processing disorders". NeuroImage. Clinical. 2: 844–53. doi:10.1016/j.nicl.2013.06.009. PMC 3778265. PMID 24179836.
- Chang YS, Owen JP, Desai SS, Hill SS, Arnett AB, Harris J, et al. (2014). "Autism and sensory processing disorders: shared white matter disruption in sensory pathways but divergent connectivity in social-emotional pathways". PLOS ONE. 9 (7): e103038. Bibcode:2014PLoSO...9j3038C. doi:10.1371/journal.pone.0103038. PMC 4116166. PMID 25075609.
- ICD 10
- Miller LJ. "Final Decision for DSM-V". Sensory Processing Disorder Foundation. Archived from the original on 4 October 2013. Retrieved 3 October 2013.
- "Course information and booking". Sensory Integration Network. Archived from the original on 10 June 2013. Retrieved 23 July 2013.
- Eeles AL, Spittle AJ, Anderson PJ, Brown N, Lee KJ, Boyd RN, Doyle LW (April 2013). "Assessments of sensory processing in infants: a systematic review". Developmental Medicine and Child Neurology. 55 (4): 314–26. doi:10.1111/j.1469-8749.2012.04434.x. PMID 23157488.
- Ermer J, Dunn W (April 1998). "The sensory profile: a discriminant analysis of children with and without disabilities". The American Journal of Occupational Therapy. 52 (4): 283–90. doi:10.5014/ajot.52.4.283. PMID 9544354.
- Bolaños C, Gomez MM, Ramos G, Rios Del Rio J (June 2016). "Developmental Risk Signals as a Screening Tool for Early Identification of Sensory Processing Disorders". Occupational Therapy International. 23 (2): 154–64. doi:10.1002/oti.1420. PMID 26644234.
- Miller-Kuhaneck H, Henry DA, Glennon TJ, Mu K (2007). "Development of the Sensory Processing Measure-School: initial studies of reliability and validity" (PDF). The American Journal of Occupational Therapy. 61 (2): 170–5. doi:10.5014/ajot.61.2.170. PMID 17436839. Archived from the original (PDF) on 2018-05-19.
- Glennon TJ, Miller Kuhaneck H, Herzberg D (2011). "The Sensory Processing Measure–Preschool (SPM-P)—Part One: Description of the Tool and Its Use in the Preschool Environment". Journal of Occupational Therapy, Schools, & Early Intervention. 4 (1): 42–52. doi:10.1080/19411243.2011.573245. S2CID 36558429.
- Mulligan, Shelley (1998-11-01). "Patterns of Sensory Integration Dysfunction: A Confirmatory Factor Analysis". The American Journal of Occupational Therapy. 52 (10): 819–828. doi:10.5014/ajot.52.10.819. ISSN 0272-9490.
- Miller LJ, Nielsen DM, Schoen SA, Brett-Green BA (2009). "Perspectives on sensory processing disorder: a call for translational research". Frontiers in Integrative Neuroscience. 3: 22. doi:10.3389/neuro.07.022.2009. PMC 2759332. PMID 19826493.
- Zimmer M, Desch L (June 2012). "Sensory integration therapies for children with developmental and behavioral disorders". Pediatrics. 129 (6): 1186–9. doi:10.1542/peds.2012-0876. PMID 22641765.
- Schaaf RC, Benevides T, Blanche EI, Brett-Green BA, Burke JP, Cohn ES, et al. (2010). "Parasympathetic functions in children with sensory processing disorder". Frontiers in Integrative Neuroscience. 4: 4. doi:10.3389/fnint.2010.00004. PMC 2839854. PMID 20300470.
- Miller LJ, Reisman JE, McIntosh DN, Simon J (January 2001). Roley SS, Blanche EI, Schaff RC (eds.). An ecological model of sensory modulation: Performance of children with fragile X syndrome, autistic disorder, attention-deficit/hyperactivity disorder, and sensory modulation dysfunction (PDF). pp. 75–88. ISBN 9780761615156. OCLC 46678625. Archived from the original (PDF) on 2012-10-25. Retrieved 2013-07-26.
{{cite book}}
:|work=
ignored (help) - Bair WN, Kiemel T, Jeka JJ, Clark JE (2012). "Development of multisensory reweighting is impaired for quiet stance control in children with developmental coordination disorder (DCD)". PLOS ONE. 7 (7): e40932. Bibcode:2012PLoSO...740932B. doi:10.1371/journal.pone.0040932. PMC 3399799. PMID 22815872.
- Lonkar H. "An overview of sensory processing disorder". ScholarWorks at Western Michigan University. Western Michigan University. Retrieved 4 October 2017.
- Bundy AC, Lane SJ, Murray EA (2002). Sensory integration : theory and practice (2nd ed.). Philadelphia: F.A. Davis. ISBN 978-0803605459. OCLC 49421642.
- Watling, Renee; Bodison, Stefanie; Henry, Diana; Miller-Kuhaneck, Heather (2006-12-01). "Sensory Integration: It's Not Just for Children". Occupational Therapy Faculty Publications. 29 (4).
- Brown, Stephen; Shankar, Rohit; Smith, Kathryn (2009). "Borderline personality disorder and sensory processing impairment". Progress in Neurology and Psychiatry. 13 (4): 10–16. doi:10.1002/pnp.127. ISSN 1931-227X.
- Brown, Catana (2002-09-14). "What Is the Best Environment for Me? A Sensory Processing Perspective". Occupational Therapy in Mental Health. 17 (3–4): 115–125. doi:10.1300/j004v17n03_08. ISSN 0164-212X. S2CID 145139324.
- "What is Sensory Processing Disorder? | Meaning | Symptoms | Causes". Fluent. Retrieved 2023-04-07.
- Leong, H. M.; Carter, Mark; Stephenson, Jennifer (2015-12-01). "Systematic review of sensory integration therapy for individuals with disabilities: Single case design studies". Research in Developmental Disabilities. 47: 334–351. doi:10.1016/j.ridd.2015.09.022. ISSN 0891-4222. PMID 26476485.
- Section On Complementary And Integrative Medicine; Council on Children with Disabilities; Zimmer, M.; Desch, L. (2012). "AAP Login". Pediatrics. 129 (6): 1186–1189. doi:10.1542/peds.2012-0876. PMID 22641765. S2CID 140127951. Retrieved 2022-06-04.
- Hyatt, Keith J.; Stephenson, Jennifer; Carter, Mark (2009). "A Review of Three Controversial Educational Practices: Perceptual Motor Programs, Sensory Integration, and Tinted Lenses". Education and Treatment of Children. 32 (2): 313–342. doi:10.1353/etc.0.0054. ISSN 0748-8491. JSTOR 42900024. S2CID 143983625.
- Stephenson, Jennifer; Carter, Mark (2008-07-01). "The Use of Weighted Vests with Children with Autism Spectrum Disorders and Other Disabilities". Journal of Autism and Developmental Disorders. 39 (1): 105–114. doi:10.1007/s10803-008-0605-3. ISSN 1573-3432. PMID 18592366. S2CID 28121843.
- Schaaf, Roseann C.; Dumont, Rachel L.; Arbesman, Marian; May-Benson, Teresa A. (2017-12-13). "Efficacy of Occupational Therapy Using Ayres Sensory Integration®: A Systematic Review". The American Journal of Occupational Therapy. 72 (1): 7201190010p1–7201190010p10. doi:10.5014/ajot.2018.028431. ISSN 0272-9490. PMID 29280711. S2CID 4018104.
- Watling, Renee; Hauer, Sarah (2015-09-04). "Effectiveness of Ayres Sensory Integration® and Sensory-Based Interventions for People With Autism Spectrum Disorder: A Systematic Review". The American Journal of Occupational Therapy. 69 (5): 6905180030p1–6905180030p12. doi:10.5014/ajot.2015.018051. ISSN 0272-9490. PMID 26356655.
- Miller LJ, Collins B (2013). "The "So What?" of Sensory Integration Therapy: Joie de Vivre" (PDF). Sensory Solutions. Sensory Processing Disorder Foundation. Archived from the original (PDF) on 4 March 2016. Retrieved 11 January 2016.
- Peske N, Biel L (2005). Raising a sensory smart child: the definitive handbook for helping your child with sensory integration issues. New York: Penguin Books. ISBN 978-0-14-303488-9. OCLC 56420392.
- "Sensory Checklist" (PDF). Raising a Sensory Smart Child. Retrieved 16 July 2013.
- Schoen SA, Lane SJ, Mailloux Z, May-Benson T, Parham LD, Smith Roley S, Schaaf RC (January 2019). "A systematic review of ayres sensory integration intervention for children with autism". Autism Research. 12 (1): 6–19. doi:10.1002/aur.2046. PMC 6590432. PMID 30548827.
- Schaaf RC, Dumont RL, Arbesman M, May-Benson TA (2018-01-01). "®: A Systematic Review". The American Journal of Occupational Therapy. 72 (1): 7201190010p1–7201190010p10. doi:10.5014/ajot.2018.028431. PMID 29280711. S2CID 4018104.
- Bodison S, Watling R, Kuhaneck HM, Henry D (2008). "Frequently Asked Questions About Ayres Sensory Integration" (PDF). American Occupational Therapy Association. Retrieved 2020-01-25.
- "Sensory and Auditory Integration Therapy". Aetna Insurance. Retrieved 10 September 2018.
- Zimmer M, Desch L (June 2012). "Sensory integration therapies for children with developmental and behavioral disorders". Pediatrics. 129 (6): 1186–9. doi:10.1542/peds.2012-0876. PMID 22641765.
- Smith T, Mruzek DW, Mozingo D (2015). "Sensory integration therapy.". In Foxx RM, Mulick JA (eds.). Controversial therapies for autism and intellectual disabilities: Fad, fashion, and science in professional practice. Routledge. pp. 247–269. ISBN 9781317623830.
- Ben-Sasson A, Carter AS, Briggs-Gowan MJ (July 2009). "Sensory over-responsivity in elementary school: prevalence and social-emotional correlates" (PDF). Journal of Abnormal Child Psychology. 37 (5): 705–16. CiteSeerX 10.1.1.620.4830. doi:10.1007/s10802-008-9295-8. PMC 5972374. PMID 19153827. Archived from the original (PDF) on 2013-06-27.
- Ahn RR, Miller LJ, Milberger S, McIntosh DN (2004). "Prevalence of parents' perceptions of sensory processing disorders among kindergarten children" (PDF). The American Journal of Occupational Therapy. 58 (3): 287–93. doi:10.5014/ajot.58.3.287. PMID 15202626.
- Urwin R, Ballinger C (February 2005). "The Effectiveness of Sensory Integration Therapy to Improve Functional Behaviour in Adults with Learning Disabilities: Five Single-Case Experimental Designs". Br. J. Occup. Ther. 68 (2): 56–66. doi:10.1177/030802260506800202. S2CID 144366644.
- Brown S, Shankar R, Smith K (2009). "Borderline personality disorder and sensory processing impairment". Progress in Neurology and Psychiatry. 13 (4): 10–16. doi:10.1002/pnp.127.
- "Sensory Integration and Sensory- based Interventions".
- "Sensory Integration". The American Occupational Therapy Association, Inc. Retrieved 4 October 2017.
- "Autism Diagnoses Shouldn't Be One-Size Fits All". Fatherly. 2020-01-15. Retrieved 2020-07-12.
- Center for Autism and the Developing Brain
- Arky B. "The debate over sensory processing". Child Mind Institute. Retrieved 12 September 2018.
- Wood, Jessica K. (2020-07-01). "Sensory Processing Disorder: Implications for Primary Care Nurse Practitioners". The Journal for Nurse Practitioners. 16 (7): 514–516. doi:10.1016/j.nurpra.2020.03.022. ISSN 1555-4155. S2CID 225645232.
- Association., American Psychiatric (2013). Desk reference to the diagnostic criteria from DSM-5. American Psychiatric Publishing. ISBN 978-0-89042-556-5. OCLC 825047464.
- Ayres AJ, Robbins J (2005). Sensory integration and the child: understanding hidden sensory challenge (25th Anniversary ed.). Los Angeles, CA: WPS. ISBN 978-0-87424-437-3. OCLC 63189804.
- Bundy AC, Lane JS, Murray EA (2002). Sensory integration, Theory and practice. Philadelphia, PA: FA Davis Company. ISBN 978-0-8036-0545-9.
- Mulligan S (1998). "Patterns of Sensory Integration Dysfunction: A Confirmatory Factor Analysis". American Journal of Occupational Therapy. 52 (November/December): 819–828. doi:10.5014/ajot.52.10.819.
- Smith Roley S, Mailloux Z, Miller-Kuhaneck H, Glennon T (September 2007). "Understanding Ayres Sensory Integration" (PDF). OT Practice. 17. 12. Archived from the original (PDF) on 24 August 2014. Retrieved 19 July 2013.
- Dunn, Winnie (April 1997). "The Impact of Sensory Processing Abilities on the Daily Lives of Young Children and Their Families: A Conceptual Model". Infants & Young Children. 9 (4): 23–35. doi:10.1097/00001163-199704000-00005. Retrieved 2013-07-19.
- Dunn W (2001). "The sensations of everyday life: empirical, theoretical, and pragmatic considerations". The American Journal of Occupational Therapy. 55 (6): 608–20. doi:10.5014/ajot.55.6.608. PMID 12959225.
- Engel-Yeger B, Shochat T (June 2012). "The relationship between sensory processing patterns and sleep quality in healthy adults". Canadian Journal of Occupational Therapy. 79 (3): 134–41. doi:10.2182/cjot.2012.79.3.2. PMID 22822690. S2CID 8250123.