Please note first that there is no formally recognized clinical designation of 'sensory processing disorder.' It is a term constructed by occupational therapists that has not been formally recognized by the larger medical community. In our clinic we receive many referrals from local pediatricians when parents have concerns about children being overly sensitive to their clothing. Most often the children referred are from four to seven years old and the families are severely disrupted by the children's behaviors and responses to clothing issues. Commonly, children will have severely constricted tolerance for certain outfits, want to wear the same clothes repeatedly, complain that clothing is itchy/scratch/bumpy/wiggly/ouchie, and this all leads to disruption of daily dressing routines. There is no doubt that the behavioral concerns are very real. The pediatricians tend to be appropriately conservative and provide families with good behavioral management suggestions
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 am sometimes hesitant to extend my commentary to the academic editorializing that happens in the occupational therapy literature of other countries, but I am unable to remain silent. Too often the ideas expressed elsewhere slither their way into the thinking of academics in the United States. And, of course, any objection to these ideas immediately causes one to be branded xenophobic, and usually worse, so I will simply gird myself for that criticism; I know it is coming. Over time I have raised the issue of international 'goodness of fit' of philosophical constructs - initially in OT24VX presentations. I talked about the incompatibility of 'occupational justice' models in societies that had health systems that had elements of free-market construction as opposed to those that are more fully socialized. For a while I tried to discuss reverse colonialism, thinking that if I spoke the language of those who perceived themselves to be oppressed by Western OT thinking
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