For as long as I can recall most therapists talk about tactile defensiveness as being an oversensitivity to touch - and that it includes a sympathetic nervous system response that is allegedly 'out of proportion' to the incoming stimulus. The result of this characterization is that most people start looking AT the sense of touch as the primary culprit of the problem. This is why you then see therapists struggling to describe what textures a child tolerates and does not tolerate. This structural understanding of the problem is reinforced by sensory integration theory which posits that children are not able to process incoming sensory information accurately. In the real world this model is poorly described and subsequently notoriously unreliable - and again you will hear therapists explain the inconsistency in sensitivity as a "sensory modulation" problem because sometimes certain kinds of touch will be tolerated and other times it will not be tolerated. Still, the...
Each year I receive several emails from colleagues about 'retained primitive reflexes.' I am also seeing an increased number of reports from local 'health care' providers who are documenting these alleged problems so I thought I would write a summary of my opinion on this topic. Predatory 'health care' providers including some OTs, PTs, chiropractors, and behavioral optometrists are creating a new 'market' for treating this alleged 'problem.' Parents should be very wary of these practitioners and other professionals should challenge these practices whenever they are seen. The following is the kind of information that causes concern and was provided to me by a colleague as a sample from a student's IEP: The student continues to demonstrate the following retained primitive reflexes that at times interfere with his ability to demonstrate appropriate adaptive responses: Fear Paralysis Reflex, Moro Reflex, Palmer Reflex, Tonic Labyri...
I was happy to see the American Academy of Pediatrics publish their new policy statement about sensory integration. I know that a lot of people are up in arms about this policy but in my estimation the AAP presents a very fair and balanced assessment. Defenders of 'sensory processing disoder' are quick to point out that some more recent research was not included in the AAP review. I was disappointed when I read Dr. Miller's letter to the editor where she talked about the 2007 RCT. This was a great study and I think they did an impressive job of looking at limitations in previous studies but it was only a pilot study and it lacked statistical power, there were noted blinding problems, and it relied on GAS which many people believe opens up issues of expectancy and confirmation bias. My point here is not to rip apart people's efforts because actually it was a good step forward in our research. The problem is that we can't point to studies like th...
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