Sensory Integration

Sensory Integration (SI) is also referred to as Sensory Integration Dysfunction (SID), or Sensory Processing Disorder (SPD) and is a neurological disorder where there is difficulty processing information from the five main senses (vision, auditory, touch, olfaction, and taste) as well as sense of movement (vestibular) and sense of position (proprioception). See Sensory Definition

With SI, there is not a loss of sensation, but the sensory information that is taken in is not processed in a normal way, and that is what causes the problems. Sensory Integration is the ability to take in information through the senses of touch, movement, smell, taste, vision, and hearing, and to combine the resulting perceptions with prior information, memories, and knowledge already stored in the brain, in order to make sense of it all.

Sensory Integration Dysfunction is not related to Autism or Autism Spectrum Disorder. SID is a disorder in and of itself, but it can also be a characteristic of other neurological conditions, including autism spectrum disorders, attention deficit disorder, dyslexia, Developmental Dyspraxia, Tourette Syndrome, multiple sclerosis, and speech delays, among many others. Our daughter who is on the Autism Spectrum, does have difficulty with sensory integration, but our youngest has SID all on its own.

When the integration of the sensory input doesn't work right, a number of problems in learning, motor development or behavior may be observed:

Overly sensitive to touch, movements, sights, or sounds
Behavior issues: distractible, withdrawal when touched, avoidance of textures, certain clothes, and foods. Fearful reactions to ordinary movement activities such as playground play. Sensitive to loud noises. May act out aggressively with unexpected sensory input.

Under reactive to sensory stimulation
Seeks out intense sensory experiences such as body whirling, falling and crashing into objects. May appear oblivious to pain or to body position. May fluctuate between under and over-responsiveness.

Unusually high/low activity level
Constantly on the move or may be slow to get going, and fatigue easily.

Coordination problems
May have poor balance, may have great difficulty learning a new task that requires motor coordination, appears awkward, stiff, or clumsy.

Delays in academic achievement or activities of daily living
May have problems in academic areas, despite normal or above normal intelligence. Problems with handwriting, scissors use, tying shoes, buttoning and zipping clothes.

Poor organization of behavior
May be impulsive, distractible, lack of planning in approach to tasks, does not anticipate result of actions. May have difficulty adjusting to a new situation or following directions. May get frustrated, aggressive, or withdraw when they encounter failure.

Poor self concept
May appear lazy, bored, or unmotivated. May avoid tasks and appear stubborn or troublesome.

Example Behaviors

Below is a list of example behaviors exibited by children with SID/DSI. These are the things you observe in your child and tell the doctor about when you see him.

Sensory Sensitivity

Children with sensory integration dysfunction can be born hypersensitive (overly sensitive) or hyposensitive (lacking or seeking sensation) to different degrees and may have trouble in one sensory area, a fewof them, or all of them. Hypersensitivity is also known as sensory defensiveness. Examples of hypersensitivity include feeling pain from clothing rubbing against skin, an inability to tolerate normal lighting in a room, a dislike of being touched (especially light touch) and discomfort when one looks directly into the eyes of another person.

Hyposensitivity is characterized by an unusually high tolerance for environmental stimuli. A child with hyposensitivity might appear restless and seek sensory stimulation.

Of course, our daughter has to be complicated. Can't have one or the other, she is a combination of both Hypersensitivity and Hyposensitivity. She is constantly seeking (upside down, Daddy, Spin me around, Daddy) and yet is bothered by crowds, noise, and chaos. Bright lights and some textures, especially with food bother her greatly. She can fall smack on her head and not utter a sound, but throw such a tizzy over "it's too loud!"

Just Right

In treating sensory dysfunctions, a "just right" challenge is used: giving the child just the right amount of challenge to motivate him and stimulate changes in the way the system processes sensory information but not so much as to make him shut down or go into sensory overload.

The "just right" challenge is absent if the activity and the child's perception of activity do not match. In addition, deep pressure is often calming for children who have sensory dysfunctions. It is recommended that therapists use a variety of tactile materials, a quiet, subdued voice, and slow, linear movements, tailoring the approach to the child's unique sensory needs.

Sensory Diet

While occupational therapy sessions focus on increasing a child's ability to tolerate a variety of sensory experiences, both the activities and environment should be assessed for a "just right" fit with the child. Overwhelming environmental stimuli such as flickering fluorescent lighting and bothersome clothing tags should be eliminated whenever possible to increase the child's comfort and ability to engage productively. Meanwhile, the occupational therapist and parents should jointly create a "sensory diet," a term coined by occupational therapist Anna Jean Ayres.

The sensory diet is a schedule of daily activities that gives the child the sensory fuel his body needs to get into an organized state and stay there. According to Sensory Integration theory, rather than just relying on individual treatment sessions, ensuring that a carefully designed program of sensory input throughout the day is implemented at home and at school can create profound, lasting changes in the child's nervous system.

Therapy Through Play

Parents can help their child by realizing that play is an important part of their child's development. Therapy involves working with an occupational therapist and the child to engage in activities that provide vestibular, proprioceptive and tactile stimulation to help with sensory integration. Therapy is individualized to meet the child's specific needs for development. Emphasis is put on automatic sensory processes in the course of a goal-directed activity. The children are engaged in therapy as play which may include activities such as: finger painting, using Play-Doh type modeling clay, swinging, playing in bins of rice or water, climbing, etc.

Playtime at home can include many of these kinds of activites, so that often if the child is making good progress and you are able to work with them and support them at home, you are actually able to continue the therapy without actually having to go to the OT. My daughter, after two years, just graduated from her Occupational Therapy, and will soon graduate from her Physical Therapy, too. We are just continuing her exercies and activities at home.

For the definition and explanation of some of the terms used with Sensory Integration Dysfunction here is your own glossary of Sensory Definitions