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Book Reviews

Sensory Processing Challenges

Effective Clinical Work with Kids and Teens

Maulidi, Halima MD, MSc, FRACP

Author Information
Journal of Developmental & Behavioral Pediatrics: July/August 2015 - Volume 36 - Issue 6 - p 433
doi: 10.1097/DBP.0000000000000185
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Sensory processing refers to the way the nervous system receives sensory messages and turns them into appropriate motor and behavioral responses. Significant dysfunction may result when the responses are inappropriate.

Research estimates that 1 in every 6 children may be significantly affected by sensory symptoms. Despite this, sensory issues are not widely recognized or well understood beyond those with expertise in sensory assessment and intervention.

Lindsey Biel is a pediatric occupational therapist working in New York. She therefore writes from experience in this field. This is her second book in this specialty.

A number of books have been written about sensory processing challenges (SPC). What is different about this one is that it is targeted not just at parents and therapists but also at clinicians, pediatricians, and teachers.

The purpose of this book is to identify SPC and to empower practice by providing strategies that help at home, in the classroom, and in the community.

The first part of the book covers the basics, describing the different senses, how they mesh together, and factors that can affect the sensory experience. Lots of examples are offered to increase understanding. The writing is done such that it flows seamlessly. Biel uses biological underpinnings to describe how those with SPC interpret their sensory world.

The book provides screening sensory processing questionnaires, which are also available online at no cost. The questions in the screening tools are not age specific. I suspect this will reduce their effectiveness especially in the very young. The questionnaires are also not validated; and therefore, are not diagnostic tools. They do help provide a description of a child's sensory world.

Most of the book focuses on strategies for management of SPC including multidisciplinary involvement.

Biel does not provide evidence behind the management strategies used. Although research in this field is limited, presenting available research on outcomes would add weight to the interventions. This is not to say that the book is not well referenced.

I found the book to be well written. Biel uses a lot of patient vignettes to illustrate examples. However, the use of more extensive patient histories detailing the baseline behavior would have made a more realistic illustration as I struggled to be convinced at times that the source of the child's behavior was not anxiety or learned behavior.

Biel acknowledges that SPC can be a manifestation of other developmental and behavioral disorders rather than a single stand-alone diagnosis. The book does not get into this debate but rather focuses on educating the reader on how to recognize signs of SPC.

The book opened my eyes to aspects of the sensory experiences, which most people take for granted. Issues such as synesthesia, monochannel processing, auditory flooding, etc., are discussed along with their functional impact on behavior, development, and social interaction.

The advice given is practical and addresses everyday situations in a variety of settings. Recommendations are given regarding adaptive equipment, which may be useful. Commercially available options such as specific chairs and toys may not be available in low-resource setting, and the author does not address this.

The book is written in a Western cultural context. Other social groups may struggle to apply suggested strategies and tools to their specific circumstances.

In summary, Linsdey Biel has written an informative educational book to help parents and those working with children understand sensory processing and recognize instances when it goes wrong. Whether one is a believer in SPC as a discrete disorder, you cannot help but respect at how skillfully she describes the reality for those with these challenges.

Biel should be commended for reaching out to a wider audience about this topic. Everyone working with children should consider reading this book to understand how SPC may affect a child's behavior and what they can do about it. Ultimately, regardless of the underlying diagnosis, some children do have significant sensory challenges and the focus should be on improving their quality of life and function. Reading this book is a great starting point. I will certainly use and recommend strategies from the book as part of my practice.

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