Well, my number one recommendation is to NOT follow any guidelines your pediatrician says. They are NOT experts in this area. My son had sensory integration disorder. I felt like something was "off" with him from the time he was a baby. I started asking for help for him and the pediatricians really kind of blew me off. They did agree to get him evaluated by ECI, but even ECI said that he was on the low end of normal but "okay". I kept pushing the issue because I really felt like something was off with him. I did finally get the pediatrician to get him a speech therapy eval and so he FINALLY was submitted for speech therapy. It was the speech therapist who recognized the sensory issues and asked for a Occupational Therapy eval. He finally was offered OT and PT to deal with the sensory stuff. Luckily for me, he was 2 when the therapy started and by the time he was 4, you could barely see any of his issues. He is now 6 and I don't see anything strange about him.
But, my whole point of all of this is to PUSH hard for what you WANT. If your pediatrician is not listening, then just skip the pediatrician. Go directly to a therapy place and ask for an evaluation. The only problem with going this route is that it falls outside of the State guidelines and you have to use your own insurance to pay for it. In my experience, my son was not severe enough to qualify for the State resources, but he definitley needed help. And, thank god, my insurance did cover it (I had to pay the deductible).
In regards to the sensory integration disorder, early intervention is the KEY. So, I advocate pushing for help earlier rather than later. At 4, if the issues are sensory, your son is in the key age group to really benefit from some help.
Good luck!
L.