Supporting Clinical Identification of Children with Sensory Integration Challenges: A Decision Guide for Primary Care Providers

Background: Children and youth often have challenges processing and integrating sensory information. These increasingly common challenges and can significantly impact development, learning, behavior, well-being, and participation in everyday activities. Since children with sensory integration challenges, with or without other concerns, are likely to present first to their primary care provider (PCP), it is important that they have resources about sensory integration challenges and their impact on the child or the need to refer these children for further assessment and intervention. Our aim is to assist PCPs in their clinical decision-making. Methods: We conducted a narrative review of CINAHL, PsychInfo, and Medline with no date restrictions, using the structure Population (children/youth with sensory integration/processing disorder/dysfunction/difference)/Concept (screening or referral)/Context (screening from PCP to occupational therapy) to identify the pertinent literature, providing (1) a description and synthesis of a circumscribed body of research on sensory integrative challenges; (2) findings related to screening and referral to occupational therapy by PCPs; and (3) the need for development of a Sensory Integration (SI) Decision Guide to support PCP clinical decision-making. Results: Findings from the narrative literature review search were integrated with information from the author panel of experts to provide a description of sensory integration challenges. Few screening tools were addressed in the literature, and no guidelines were identified to support PCP decision-making regarding referral. A Sensory Integration Decision Guide was developed to fill this gap. Conclusions: The Sensory Integration Decision Guide provides primary care providers with a systematic process for detecting sensory integration challenges and referring to specialized occupational therapy services. Future studies to examine the practical application of the tool for its accuracy and usefulness in clinical decision-making and effectiveness for referral decisions are needed.