Concept Evolution in Sensory Integration: A Proposed Nosology for Diagnosis

Abstract

S ensory integration is a long-standing and growing area of practice in occupational therapy. Debate and discussion with colleagues have led us to develop a proposed taxonomy reflecting a new classification scheme to enhance diagnostic specificity. The nosology proposed here is rooted in empirical data first published by Ayres (Ayres, 1972b, 1989) that has evolved based on empirical and theoretical information. This new nosology provides a viewpoint for discussion and research. Two sociopolitical trends contribute to the timeliness of the ideas presented. First, a call exists throughout health and developmental services for evidence-based practice (Sackett, Richardson, Rosenberg, & Haynes, 1997). Diagnostic precision is crucial for homogeneity of samples in empirical research, affecting the validity of the research findings. Second, the condition of sensory processing disorders (SPD) has recently been acknowledged outside the occupational therapy profession in three diagnostic classification references: the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (known as the DC: 0-3R) (Zero to Three, 2005), the Diagnostic Manual for Infancy and Early Childhood of the Interdisciplinary Council on Developmental and Learning Disorders (ICDL, 2005), and the Psychodynamic Diagnostic Manual (PDM Task Force, 2006). Both manuals include diagnostic taxonomies with subtypes of SPD suggested by a committee of occupational therapists, who assisted in developing guidelines for diagnostic specificity related to sensory-based disorders (Miller, Cermak, Lane, Anzalone, & Koomar, 2004).

Alexithymia in Adolescents with Autism Spectrum Disorder: Its Relationship to Internalising Difficulties, Sensory Modulation and Social Cognition

“…Examples of items on the AASP low registration quadrant include "I seem slower than others when trying to follow an activity or task" or "I don't notice when my name is called". This quadrant describes individuals that have a high neurological threshold and passive behavioural responses to sensory stimulation; they have reduced awareness of sensory events that others readily notice and require high intensity input to become involved in a task or activity (Crane et al 2009;Dunn 2001;Miller et al 2007). …”

“…More generally, this sensory processing style has been associated with a behavioural profile of withdrawal, inattention and difficulty engaging (Miller et al 2007). …”

The Role of Sensory Modulation Deficits and Behavioral Symptoms in a Diagnosis for Early Childhood

“…This result found support in the OT classification system which primarily makes the diagnosis of SMD based on sensory criteria [50,51]. It could be important to consider this preliminary result, in the actual classification in OT field and Child Psychiatry field in order to analyze the discriminative ability of behavioral symptoms in other clinical samples.…”

Observational Characterization of Sensory Interests, Repetitions, and Seeking Behaviors

“…Occupational therapists often observe that some children demonstrate unusual behaviors that involve intense, often repetitive interactions with sensory stimuli (Miller, Anzalone, Lane, Cermak, & Osten, 2007). For example, a child may intensively rub or touch certain textures, visually focus on moving objects, or spin himself or herself in circles.…”

“…These behaviors, when extreme, are thought to negatively affect children's participation in daily activities (Dunn, 2001;Reynolds, Bendixen, Lawrence, & Lane, 2011). Such behaviors have been labeled in various ways, including sensory seeking or sensation seeking, in the occupational therapy literature (e.g., Dunn, 2001;Miller et al, 2007) or, alternatively, incorporated in a broader category of restricted and repetitive behaviors in the DD and ASD literature (e.g., Bodfish, Symons, Parker, & Lewis, 2000). In this study, we use the term sensory interests, repetitions, and seeking behaviors (SIRS), recently described by Ausderau et al (2014), to encompass the full range of behaviors of interest in this analysis.…”