The American Occupational Therapy Association (AOTA) has been working on a project to help OTs begin to organize all of the research we‚Äôve done over the course of our profession. The goal of the AOTA Critically Appraised Topics (CAT) and Papers Series is to allow us to reference this research and use it to show evidence — which insurance companies look for — of what types of treatments are effective for what types of difficulties and disabilities.
This CAT is focused on finding out: What types of treatment are effective for children with Sensory Processing Disorder?
It is important to remember, as is the case with much of current research, that when there is a lot of diversity within a study — i.e. kids have different needs and different settings to learn in and different diagnoses — it limits the way that we can apply research. Basically, it‚Äôs harder to say ‚Äúit worked for those kids, it will work for this one‚Äù. Rather, we can say ‚Äúit seemed to work for those kids, it might work for this one‚Äù.
The research shows that, depending on the needs and circumstances for the child, two general methods of providing or delivering treatment can be equally effective: directly treating a child, and providing consultative services such as to a teacher or parent to allow them to treat the child.
One perspective to treating children begins with a motor learning approach. Motor learning is an approach in which we teach a child a specific movement pattern, such as specifically how to make a letter “a,” and then we repeat that movement or motor plan until the child begins to memorize it and can do it ‚Äúon autopilot‚Äù or it becomes natural for them.
Another perspective is to begin with an impairment-oriented approach which looks at the underlying cause for a difficulty. An example of an impairment-oriented approach would be the perspective that a child can‚Äôt write their letters because their arm or hand is too weak to control the pencil. Treatment would focus on strengthening those weak muscles with the view that the child will ultimately be able to write their letters if their muscles are made stronger.
The research in this review is the strongest to support motor learning approaches, but says that impairment-oriented approaches should not be ignored. It is important to understand that, typically in practice, OTs use a bit of both approaches. With handwriting we will not only teach the motor plan for letters, we will also work to strengthen the muscles needed to make those letters. So we not only direct the child along the path to a successful outcome, we also ensure that we‚Äôve set them up with the needed equipment to achieve that outcome. This is why you may hear us working on the same skill or activity over many sessions and asking you to do the same thing at home.
Ultimately the evidence shows that occupational therapy intervention is beneficial for children having sensory processing dysfunction which is impacting their performance in daily life. Motor learning approaches can be used to address specific skill deficits, and impairment oriented approaches can be used to address the underlying difficulties such as self-regulation and organization; and both types of approaches appear to be effective in treating this diagnosis.