Updated by Molly Shaw Wilson MS OTR/L BCP
Sensory integration is the process through which we sense the world around us. We use our sensory organs to receive information and, on a higher level, we organize it so we understand our surroundings and respond appropriately.
To sum it all up: we perceive, organize, modulate and interpret sensory information.
Most people don’t realize that breakdowns in sensory processing can affect:
When we hear the buzz of a bee near our head, we immediately swat in an attempt to avoid being bitten. The smell of burning in the kitchen alerts us to the possibility of a fire and we act in order to prevent danger.
Our body is naturally equipped to both protect us and make sense of information so that we can effectively participate in daily life. When sensory integration works smoothly we feel prepared and comfortable in our surroundings.
However, sometimes for certain people, they simply don't process their sensory input quite right. This is called sensory processing disorder or SPD.
When SPD is present, life can be quite miserable. Children may even shut down and completely disengage from their surroundings if they experience extreme sensory overreactions.
To help alleviate the issues of SPD, the most common strategy is Sensory Integration Therapy.
According to the STAR Center, sensory processing disorders affect up to one in every twenty children and the numbers keep rising. More research is being done to look at the causes and frequency of Sensory Processing Disorder (SPD).
In fact, the name has even been changed from Sensory Integration (SI) Dysfunction as our understanding and knowledge base has increased. Sensory integration was first identified by the work of Dr. A. Jean Ayers, an occupational therapist, in the 1970s.
SPD is a complex disorder of the brain, which results in difficulty with processing information that comes from our senses.
It is common for sensory processing disorder to be present in those individuals that also experience developmental disabilities. In fact, research by the American Academy of Pediatrics (and other sources) on Autism tells us that sensory processing issues are very common in those with spectrum disorders.
It is important to realize that there are more than just the five senses that most of us are familiar with.
Information is taken in from:
Vestibular receptors are responsible for detecting changes in position in space, balance, and movement.
Proprioceptive receptors provide information about body awareness, position, and posture.
Interoception involves the internal regulation responses in our body such as hunger, thirst, blood pressure, and even toileting urges.
Throughout our lives, we are constantly bombarded with information we receive through our senses, and we must successfully integrate this information to make sense of it and form an appropriate response. There are times when the response we form does not match the information we have received.
For example, a student may have a panic type response when another child simply brushes against him in line. Another example is when a student feels pain when wearing clothing with tags or seams.
What’s interesting about sensory processing, is that most activities require us to combine information we obtain from different senses at the same time! When you close your eyes to wash your hair, you know exactly where to place your shampoo-filled hands.
Even though you’re not looking, you use your fingers to rub in the shampoo and feel when your hair is soapy. This activity uses tactile (touch), proprioception (position in space), and vestibular (balance so you don’t fall over with your eyes closed).
If a person gets dizzy when her eyes are closed, she would have a great deal of difficulty washing her hair since she must keep her eyes open, and getting soap in her eyes is a real possibility!
If you learn better with video, we created this video while doing a Facebook Live that is all about sensory integration. Give it a watch to learn more about sensory integration and its related therapy.
For example, a child comes to therapy with difficulty functioning in daily life. She has great difficulty bathing, dressing, getting her hands and feet dirty and her sensory issues cause her great stress each day at home.
The OT begins by assessing the child’s sensory system. Specially designed checklists are filled out by both caregiver and therapist in order to determine which systems are affected.
Sensory integration therapy is one technique used by occupational therapists (OTs). Through fun and play-based activities, OTs attempt to change how the brain reacts to touch, sound, sight, and movement.
Sometimes, one sensory area is over-responsive (hyperresponsive) while another needs more information (hyporesponsive). We all have ways of protecting ourselves from danger, but if a child’s tactile system is over-responsive, she may feel pain or discomfort touching something sticky. Further, she may completely shut down and show behavioral issues.
OTs have the clinical knowledge to design sensory experiences specific to the child. It may start with a certain form of sensory stimulation to elicit the desired response. While every session will be different depending on your child's needs, here is an example session with some sensory integration therapy activities.
The OT may begin the treatment session with an obstacle course which the child views as a fun challenge. However, the course was carefully designed to provide sensory input to her joints and calming pressure to her body. Large motor, physical activities are organizing to the senses, the OT may include playing in ball pits to target the tactile system. The purpose of this sensory stimulation is to regulate and prepare her system for the next activity.
Next comes a fun puzzle. However, the puzzle pieces may be placed into a sticky or wet substance such as Jell-O or water beads placed into a bin.
The child often has so much fun playing the game that she forgets she’s placing her hands into the very thing she doesn’t like! With this sensory experience, now the child is starting to adapt her hyperresponsivity to the messy texture.
Common items seen in clinics where occupational therapists use sensory integrative techniques include swings, trampolines, soft brushes, and scooters.
While the room may look like a play place or a gym setting, sensory integration therapy requires training and education that the OT must obtain in order to perform therapy safely and effectively.
In their studies for degree attainment, OTs learn about the work of Dr. A Jean Ayers and her treatment approach known as Ayers Sensory Integration or ASI. They have a strong background in developmental disabilities and should have experience in treating developmental disorders, learning disorders, and sensory processing issues. OTs will have studied the effectiveness of sensory integration theory and applied it to treat individuals with sensory integration dysfunction.
The problem is that other professionals or untrained clinicians make claims or improperly complete activities that are labeled as SI.
It is important for consumers to ask the therapist, when scheduling the appointment, about specific training or courses the therapist has taken. For example, specific knowledge of how movement, such as spinning, affects the child’s system is critical for safe and effective treatment.
You want to know that the therapist has a strong understanding of sensory integration theory, its effectiveness, and can use their clinical skills to treat related sensory integration dysfunction.
Educate yourself about SI by reading websites such as the STAR Center and documents prepared by the American Occupational Therapy Association. Check out this link to one on sensory integration.
Additionally, this study backs up parent reports that sensory integration therapy improves daily function in children with autism. The research, led by occupational therapists at Philadelphia’s Jefferson School of Health Professions, was funded by an Autism Speaks treatment research grant.
Since sensory processing affects many body systems, the effects of inefficient processing can be seen in many functional areas. A child may show extreme intolerance during mealtime, by eating a very limited diet and prefer only certain temperatures and textures. The goal would be to increase the variety of food in his diet and decrease gagging and vomiting so he can comfortably eat a meal.
Another child who becomes extremely upset when dressing and bathing might require techniques such as adding a sensory activity regularly throughout her day. This helps to ‘balance’ and regulate her sensory system so she can tolerate daily self-care without behavioral issues.
Your child’s behavior is a form of communication and a qualified occupational therapist can help to tease out SPD issues. SPD can stand alone or go along with many medical, cognitive, and stress-related conditions. When provided correctly, and if the child’s system responds well, sensory integration therapy can significantly help children live an improved quality of life.
And remember, you can provide your child with appropriate sensory activities at home. Consult with your child’s OT in order to follow a sensory diet designed to meet your child’s specific needs. Check out our article on creating your own Sensory Tool Box!
Do you have more questions about sensory integration therapy or how to find the right therapist? Let us know in the comments!
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