| Sensory integration - symptoms of sensory integration disorder. Bright Tots - information on early childhood development |
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| 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.
Sensory processing disorder is usually recognized in early childhood or adolescence but may be seen throughout
the lifespan. These children do not “outgrow” the problem. Difficulties continue into adulthood, although
sometimes severity of symptoms may become less apparent as the child learns managing techniques.
Children with sensory processing disorder have difficulty with:
• Managing anxiety
• Handling high stress situations
• Dealing with frustration
• Staying on tasks to finishing point
• Effectively using fine and gross motor skills
When comparing children’s sensory processing problems with coping abilities, the sensory processing
problems were mostly related to the child’s difficulty with their ability to:
• Handle new situations
• Change plans / transition
• Appropriately learn new situations
• Understand independence and dependence
• Use self-defense successfully
• Have an proper activity level
• Control impulses
Sensory processing disorder is often associated with other diagnoses such as:
• Pervasive developmental disorder/ autism spectrum
• Learning disabilities/ attention deficit disorder
• Language disorders
• Behavioral disorders
• Anxiety disorder/ depression
Children with sensory processing disorder may display the following behaviors:
• May not like messy things or getting dirty
• May not like to be touched, hugged or cuddled
• Likes to touch objects and people to the point of becoming annoying
• May frequently put things in his/her mouth
• Refuses to brushing teeth
• May gag during tooth brushing
Sensory seeking children appear to desire touch because they need sensation that is intense, frequent and/or of long
interval. Touch systems around the head and face may contribute to over-sensitive to touch, leading to poor
tolerance of anything around the mouth.
Sensory Under-Sensitivity
Children with under sensitivity do not respond to and may seem uninterested or unresponsive to sensory
experiences. These children may exhibit the following traits:
• The child seems weak, slumps, and leans on people or furniture.
• The child has low energy and has a hard time waking up.
• The child gets tired easily, lies around and appears to have little motivation to walk around.
• The child does things very slowly.
• The child seems depressed or neutral.
Sensory Over-Sensitivity
Children with over sensitivity respond to sensations from just one sensory system faster, with more intensity or for
a longer period than typical peers.
• The child responds negatively or emotionally to loud people or places.
• The child has trouble concentrating in noisy environments
• The child frequently hums or makes other strange noises.
Some children who are overwhelmed by their environment over-react to sounds or even ‘shut them out’ so that it
seems like they are not hearing, while other kids make sounds to block the noises in their environment. These
children are sensory seeking and seem to have a craving for strong levels of sensation. Children with over-
sensitivity may become uncomfortable with changes to new situations.
Sensory Modulation Disorder
This sensory processing disorder causes problems with modifying responses to sensory inputs resulting in
withdrawal or strong negative responses to sensations that do not usually bother typical peers. Problems are often
seen in irregular emotions that are made worse by stress, and vary with the situation.
Signs of Sensory Modulation Disorder
• Easily distracted by sounds
• Extremely sensitive to sounds
• Difficulty with falling or staying asleep
• Reacts defensively to being touched lightly or unexpectedly
• Easily distracted by visual stimuli
• Overly active
• Outbursts of anger
Sensory Discrimination Disorder
Children with sensory discrimination disorder have trouble in recognizing and interpreting differences or similarities
in the nature of stimuli. It is commonly seen with problems in processing sensations from touch, muscles, joints
and head movements (vestibular or inner ear sensations).
Signs of Sensory Discrimination Disorder
• The child hits or pushes other people
• The child grips objects too tightly or uses too much strength
• The child frequently drops things or knocks things over
• The child mouths, licks, chews, or sucks on non-food items
• The child craves movement, such as spinning or jumping around
• The child is afraid of heights/ swings or slides
• The child has poor balance
Postural-Ocular Disorder
Postural-Ocular Disorder is a problem with control of posture or quality of movements seen in low muscle tone or
joint instability and/or poor functional use of vision. These children have difficulty stabilizing the body while
resting/moving and trouble with using both sides of the body together. This disorder is often seen with vestibular
(the inner ear) problems.
Sings of Postural-Ocular Disorder
• The child seems weaker than other children
• The child wears out easily
• The child often moves around repeatedly
• The child slumps while sitting
• The child has difficulty making eye contact/ following with the eyes, such as reading
• The child seems clumsy he/she may fall and tumble frequently
• The child may seek movements of swinging or spinning
Dyspraxia
Children with dyspraxia have trouble with planning, sequencing & executing unfamiliar actions resulting in
awkward & poorly coordinated motor skills typically seen with a sensory processing deficit. It is usually seen with
difficulty doing new activities or those that are done infrequently. Children with dyspraxia may be slow at learning
a new sequence of movement. Children who have dyspraxia have difficulty figuring out what movement they need
to make, planning how to move and accomplishing a plan. They need to be given more time between transitions.
Signs of Dyspraxia
• Difficulty following multi-step directions
• Strong desire for sameness or routines
• Has an awkward pencil grasp
• Has poor handwriting
• Dislikes or hesitant to participate in sports
• Easily frustrated
• Problems with daily life skills like dressing or using utensils
• Trouble figuring out how to get on swings or slides, play with new toys, get dressed or make certain speech
sounds
• Frequently trips, falls, bumps into things and drops toys
• Difficulty imitating simple movements with his hands, arms, legs or mouth
• Difficulty with changes in his routine or schedule
• May show separation anxiety / difficulty separating from caretaker
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.
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.
Sensory processing disorder is usually recognized in early childhood or adolescence but may be seen throughout
the lifespan. These children do not “outgrow” the problem. Difficulties continue into adulthood, although
sometimes severity of symptoms may become less apparent as the child learns managing techniques.
Children with sensory processing disorder have difficulty with:
• Managing anxiety
• Handling high stress situations
• Dealing with frustration
• Staying on tasks to finishing point
• Effectively using fine and gross motor skills
When comparing children’s sensory processing problems with coping abilities, the sensory processing
problems were mostly related to the child’s difficulty with their ability to:
• Handle new situations
• Change plans / transition
• Appropriately learn new situations
• Understand independence and dependence
• Use self-defense successfully
• Have an proper activity level
• Control impulses
Sensory processing disorder is often associated with other diagnoses such as:
• Pervasive developmental disorder/ autism spectrum
• Learning disabilities/ attention deficit disorder
• Language disorders
• Behavioral disorders
• Anxiety disorder/ depression
Children with sensory processing disorder may display the following behaviors:
• May not like messy things or getting dirty
• May not like to be touched, hugged or cuddled
• Likes to touch objects and people to the point of becoming annoying
• May frequently put things in his/her mouth
• Refuses to brushing teeth
• May gag during tooth brushing
Sensory seeking children appear to desire touch because they need sensation that is intense, frequent and/or of long
interval. Touch systems around the head and face may contribute to over-sensitive to touch, leading to poor
tolerance of anything around the mouth.
Sensory Under-Sensitivity
Children with under sensitivity do not respond to and may seem uninterested or unresponsive to sensory
experiences. These children may exhibit the following traits:
• The child seems weak, slumps, and leans on people or furniture.
• The child has low energy and has a hard time waking up.
• The child gets tired easily, lies around and appears to have little motivation to walk around.
• The child does things very slowly.
• The child seems depressed or neutral.
Sensory Over-Sensitivity
Children with over sensitivity respond to sensations from just one sensory system faster, with more intensity or for
a longer period than typical peers.
• The child responds negatively or emotionally to loud people or places.
• The child has trouble concentrating in noisy environments
• The child frequently hums or makes other strange noises.
Some children who are overwhelmed by their environment over-react to sounds or even ‘shut them out’ so that it
seems like they are not hearing, while other kids make sounds to block the noises in their environment. These
children are sensory seeking and seem to have a craving for strong levels of sensation. Children with over-
sensitivity may become uncomfortable with changes to new situations.
Sensory Modulation Disorder
This sensory processing disorder causes problems with modifying responses to sensory inputs resulting in
withdrawal or strong negative responses to sensations that do not usually bother typical peers. Problems are often
seen in irregular emotions that are made worse by stress, and vary with the situation.
Signs of Sensory Modulation Disorder
• Easily distracted by sounds
• Extremely sensitive to sounds
• Difficulty with falling or staying asleep
• Reacts defensively to being touched lightly or unexpectedly
• Easily distracted by visual stimuli
• Overly active
• Outbursts of anger
Sensory Discrimination Disorder
Children with sensory discrimination disorder have trouble in recognizing and interpreting differences or similarities
in the nature of stimuli. It is commonly seen with problems in processing sensations from touch, muscles, joints
and head movements (vestibular or inner ear sensations).
Signs of Sensory Discrimination Disorder
• The child hits or pushes other people
• The child grips objects too tightly or uses too much strength
• The child frequently drops things or knocks things over
• The child mouths, licks, chews, or sucks on non-food items
• The child craves movement, such as spinning or jumping around
• The child is afraid of heights/ swings or slides
• The child has poor balance
Postural-Ocular Disorder
Postural-Ocular Disorder is a problem with control of posture or quality of movements seen in low muscle tone or
joint instability and/or poor functional use of vision. These children have difficulty stabilizing the body while
resting/moving and trouble with using both sides of the body together. This disorder is often seen with vestibular
(the inner ear) problems.
Sings of Postural-Ocular Disorder
• The child seems weaker than other children
• The child wears out easily
• The child often moves around repeatedly
• The child slumps while sitting
• The child has difficulty making eye contact/ following with the eyes, such as reading
• The child seems clumsy he/she may fall and tumble frequently
• The child may seek movements of swinging or spinning
Dyspraxia
Children with dyspraxia have trouble with planning, sequencing & executing unfamiliar actions resulting in
awkward & poorly coordinated motor skills typically seen with a sensory processing deficit. It is usually seen with
difficulty doing new activities or those that are done infrequently. Children with dyspraxia may be slow at learning
a new sequence of movement. Children who have dyspraxia have difficulty figuring out what movement they need
to make, planning how to move and accomplishing a plan. They need to be given more time between transitions.
Signs of Dyspraxia
• Difficulty following multi-step directions
• Strong desire for sameness or routines
• Has an awkward pencil grasp
• Has poor handwriting
• Dislikes or hesitant to participate in sports
• Easily frustrated
• Problems with daily life skills like dressing or using utensils
• Trouble figuring out how to get on swings or slides, play with new toys, get dressed or make certain speech
sounds
• Frequently trips, falls, bumps into things and drops toys
• Difficulty imitating simple movements with his hands, arms, legs or mouth
• Difficulty with changes in his routine or schedule
• May show separation anxiety / difficulty separating from caretaker
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.
| ________________________________________________________________________________________________________________________ Copyright © 2004 Bright Tots® Inc. - Educational Toys & Resource Guide to Child Development - All rights reserved. ________________________________________________________________________________________________________________________ |
| Sensory Integration / Occupational Therapy |
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