Sensory Integration / Occupational Therapy
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What is Sensory Integration?
Sensory integration disorder or dysfunction (SID) is a neurological disorder that results from the brain's
inability to integrate certain information received from the body's five basic sensory systems. These sensory
systems are responsible for detecting sights, sounds, smell, tastes, temperatures, pain and he position and
movements of the body. The brain then forms a combined picture of this information in order for the body
to make sense of its surroundings and react to them appropriately. The ongoing relationship between
behavior and brain functioning is called sensory integration (SI). Sensory integration provides a crucial
foundation for later, more complex learning and behavior.
Sensory experiences include touch, movement, body awareness, sight, sound, smell, taste, and the pull of
gravity. Distinguishing between these is the process of sensory integration (SI). While the process of SI
occurs automatically and without effort for most, for some the process is inefficient. Extensive effort and
attention are required in these individuals for SI to occur, without a guarantee of it being accomplished.
When this happens, goals are not easily completed, resulting in sensory integration disorder (SID).
The normal process of SI begins before birth and continues throughout life, with the majority of SI
development occurring before the early teenage years. For most children sensory integration develops in the
course of ordinary childhood activities. But for some children, sensory integration does not develop as
efficiently as it should. This is known as dysfunction in sensory integration (D.S.I.). When the process is
disordered, a number of problems in learning, motor skills and behavior may be evident. The ability for SI
to become more refined and effective coincides with the development process as it determines how well
motor and speech skills, and emotional stability develop.
The concept and theory of sensory integration comes from a body of work developed by A. Jean Ayres,
PhD, OTR, and an occupational therapist that was based in California, U.S.A. As an occupational therapist,
Dr. Ayres was interested in the way in which sensory processing and motor planning disorders interfere
with activities of daily living and learning. The beginnings of the SI theory by Ayres instigated research that
looks at the foundation it provides for complex learning and behavior throughout life.
Causes and symptoms
The presence of a sensory integration disorder is typically detected in young children. While most children
develop SI during the course of ordinary childhood activities, which helps establish such things as the
ability for motor planning and adapting to incoming sensations, others' SI ability does not develop as
efficiently. When their process is disordered, a variety of problems in learning, development, or behavior
become obvious.
Those who have sensory integration dysfunction may be unable to respond to certain sensory information
by planning and organizing what needs to be done in an appropriate and automatic manner. This may cause a
primitive survival technique called "fright, flight, and fight" or withdrawal response, which originates from
the "primitive" brain. This response often appears extreme and inappropriate for the particular situation.
The neurological disorganization resulting in SID occurs in three different ways: the brain does not receive
messages due to a disconnection in the neuron cells; sensory messages are received inconsistently; or
sensory messages are received consistently, but do not connect properly with other sensory messages.
When the brain poorly processes sensory messages, inefficient motor, language, or emotional output is the
result.
According to Sensory Integration International (SII), a non-profit corporation concerned with the impact of
sensory integrative problems on people's lives, the following are some signs of sensory integration disorder
(SID):
• Over sensitivity to touch, movement, sights, or sounds
• Under reactivity to touch, movement, sights, or sounds
• Specific learning difficulties /delays in academic achievement
• Difficulty in making transitions from one situation to another
• Tendency to be easily distracted / Limited attention control
• Activity level that is unusually high or unusually low
• Social and/or emotional problems
• Difficulty learning new movements
• Delays in speech, language, or motor skills
• Physical clumsiness or apparent carelessness
• Impulsive, lacking in self-control
• Inability to unwind or calm self
• Poor self concept / body awareness
While research indicates that sensory integrative problems are found in up to 70% of children who are
considered learning disabled by schools, the problems of sensory integration are not confined to children
with learning disabilities. SID transfers through all age groups, as well as intellectual levels and
socioeconomic groups. Factors that contribute to SID include: premature birth; autism and other
developmental disorders; learning disabilities; delinquency and substance abuse due to learning disabilities;
stress-related disorders; and brain injury.
Research has identified autism and attention-deficit hyperactivity disorder (ADHD) as two of the
biggest contributing conditions as well as learning disorders (i.e. Specific learning difficulties),
developmental disabilities and fragile X syndrome.
Diagnosis
In order to determine the presence of SID, an evaluation may be conducted by a qualified occupational or
physical therapist. An evaluation normally consists of both standardized testing and structured observations
of responses to sensory stimulation, posture, balance, coordination, and eye movements. These test results
and assessment data, along with information from other professionals and parents, are carefully analyzed by
the therapist who then makes recommendations about appropriate treatment.
Treatment
Occupational therapists play a key role in the conventional treatment of SID. By providing sensory
integration therapy, occupational therapists are able to supply the vital sensory input and experiences that
children with SID need to grow and learn. Also referred to as a "sensory diet," this type of therapy involves
a planned and scheduled activity program implemented by an occupational therapist, with each "diet" being
designed and developed to meet the needs of the child's nervous system. A sensory diet stimulates the "near"
senses (tactile, vestibular, and proprioceptive) with a combination of alerting, organizing, and calming
techniques.
Motor skills training methods that normally consist of adaptive physical education, movement education, and
gymnastics are often used by occupational and physical therapists. While these are important skills to work
on, the sensory integrative approach is vital to treating SID.
The sensory integrative approach is guided by one important aspect-the child's motivation in selection of the
activities. By allowing them to be actively involved, and explore activities that provide sensory experiences
most beneficial to them, children become more mature and efficient at organizing sensory information.
Alternative treatment
Sensory integration disorder (SID) is treatable with occupational therapy, but some alternative methods
are emerging to complement the conventional methods used for SID.
Therapeutic body brushing is often used on children (not infants) who overreact to tactile stimulation. A
specific non-scratching surgical brush is used to make firm, brisk movements over most of the body,
especially the arms, legs, hands, back and soles of the feet. A technique of deep joint compression follows
the brushing. Usually begun by an occupational therapist, the technique is taught to parents who need to
complete the process for three to five minutes, six to eight times a day. The time needed for brushing is
reduced as the child begins to respond more normally to touch. In order for this therapy to be effective, the
correct brush and technique must be used.
Remember - An important step in promoting sensory integration in children is to
recognize that it exists and that it plays a vital role in their development.
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