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What is sensory integration? All of us depend on adequate sensory integrative functioning in order to carry out daily tasks in work, play and self-maintenance. Disorders in this domain can greatly influence our ability to function, but also can be so subtle that they easily go unrecognized. Particularly in the young child it is easy to attribute behaviors and reactions to other causes ("He's stubborn, lazy, or doesn't want to do it," or "She's spoiled, shy, or headstrong.") or to consider it within the norms of the wide range of personality and developmental characteristics of young children. However, it is important to identify and address sensory integrative dysfunction to enable the child to function at his or her optimum level and to minimize disruption in family life. This article will explain ways of addressing sensory integrative problems within the context of family life and the child's normal activities. Sensory integration, simply put, is the ability to take in information through senses (touch, movement, smell, taste, vision, and hearing), to put it together with prior information, memories, and knowledge stored in the brain, and to make a meaningful response. Sensory integration occurs in the central nervous system and is generally thought to take place in the mid-brain and brainstem levels in complex interactions of the portions of the brain responsible for such things as coordination, attention, arousal levels, autonomic functioning, emotions, memory, and higher level cognitive functions. Because of the complexity of the various areas which are dependent upon and interact with each other as well as the child's own personality and environment, it is not possible to have a single list of symptoms which identify sensory integrative dysfunction. A. Jean Ayres, Ph.D., was an occupational therapist who first researched and described the theories and frame of reference which we now call sensory integration. In her book, Sensory Integration and the Child, Dr. Ayres makes several analogies which describe sensory integration and its dysfunction. She describes sensory information as food for the brain similar to the food which nourishes our physical bodies. Difficulty in processing and organizing sensory information causes dysfunction which can be compared to indigestion which occurs when the digestive tract malfunctions. Another analogy compares the brain to a large city with traffic consisting of the neural impulses. She states: "Good sensory processing enables all the impulses to flow easily and reach their destination quickly. Sensory integrative dysfunction is a sort of `traffic jam' in the brain. Some bits of sensory information get `tied up in traffic,' and certain parts of the brain do not get the sensory information they need to do their jobs." (Ayres, p. 51) Various characteristics of sensory integrative dysfunction will be discussed under four categories: attention and regulatory problems, sensory defensiveness, activity patterns, and behavior. Young children are, by nature, active. We expect the toddler to be "into things" and the preschooler to be curious, to explore and to play vigorously. We don't expect the young child to have a very long attention span. Characteristics which indicate problems in one child may be perfectly normal in a younger child. Here are some warning signals related to activity levels: 1. The child is disorganized and lacks purpose in his or her activity. This is the child who goes through the room like a tornado. Even though the child may appear to be interested in a toy or object initially, once he gets it he may throw it aside, dump it out of the container, or immediately be distracted by something else. Another characteristic is that the child lacks exploration or manipulation; he may dump objects out of a container or off a shelf without stopping to manipulate, visually examine, or play creatively with them. On the playground the child may run around a lot but does not organize his activity to climb, swing, or explore equipment. 2. The child does not move around or explore the environment. This is the "good" baby or toddler who is content to stay in one place and does not make many demands on his or her caretakers. This child may be content to watch things in his environment although he is physically able to move around and interact. The older child may use good verbal skills to engage the adult in conversation as a way of avoiding manipulating with his hands or actively engaging in activity. 3. The child lacks variety in play activities. Some children become very repetitive or stereotypic in playing with toys. Everything may be flung aside, tapped on a surface, or brought to the mouth. Another child may prefer only visual activities (TV, videos, looking at books) while avoiding visual-motor or manipulative toys (coloring, drawing, clay, construction toys.) Other children may learn one way to interact with a toy or playground equipment without adding variations, creative play, or generalizing to other similar objects. For example, the child may line up toy cars but does not pretend they are going places or experiment with rolling them down an incline. 4. The child appears clumsy, trips easily, has poor balance. The child may experience an excessive number of bumps, bruises, stitches, or broken bones. Sometimes this child seems always to be in a hurry and impulsive, does not "look where he is going." Other children may always be bumping their heads because they lack protective responses and do not "catch themselves" when they begin to fall. 5. The child has difficulty calming himself after exciting physical activity or after becoming upset. After this child "loses it" he cannot be consoled. Tantrums may last for hours, or the child may become so excited after vigorous play that he continues high activity levels long after the event. Some children regularly escalate their activity levels during the day without experiencing "down time" or being able to engage in quiet activity. Dinner time becomes chaotic and the child has extreme difficulty falling asleep at bedtime. 6. The child seeks excessive amounts of vigorous sensory input. Many children like to jump, swing, and spin; but when this is excessive, it may be problematic. The child may spin himself on playground equipment or twirl around a room for prolonged periods without experiencing dizziness. Another child may continually throw himself on the floor, deliberately hurl himself against people and things, or jump excessively. Feel free to post below on this topic.... |
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I found this info on another site, and figured it might help some parents. Question: What is Sensory Integration Dysfunction (DSI) and how can it be treated? The Condition What is Sensory Integration Dysfunction? Dysfunction in Sensory Integration (DSI) is a problem in processing sensations which causes difficulties in daily life. DSI is a complex neurological disorder, manifested by difficulty detecting, modulating, discriminating or integrating sensation adaptively. DSI causes children to process sensation from the environment or from their bodies in an inaccurate way, resulting in "sensory seeking" or "sensory avoiding" patterns or 'dyspraxia," a motor planning problem. What does DSI look like? DSI and Sensory Seeking These children have nervous systems that do not always process that sensory input is "coming in" to the brain. They are under-responsive to sensation. As a result, they seek out more intense or longer duration sensory experiences. Some behaviors that can be observed are: - Hyper-activity as they seek more and more movement input
- Unawareness of touch or pain, or touching others too often or too hard (may seem aggressive)
- Engaging in unsafe behaviors, such as climbing too high
- Enjoying sounds that are too loud, such as TV or radio volume
DSI and Sensory Avoiding
These children have nervous systems that feel sensation too easily or too much. They are overly responsive to sensation. As a result, they may have "fight or flight" responses to sensation, a condition called "sensory defensiveness." Some behaviors that can be observed are: - Responding to being touched with aggression or withdrawal
- Afraid of, or becomes sick with movement and heights
- Very cautious and unwilling to take risks or try new things
- Uncomfortable in loud or busy environments such as sports events, malls
- Very picky eater and/or overly sensitive to food smells
DSI and Dyspraxia
These children are clumsy and awkward. They have particular problems with new motor skills and activities. Some behaviors that can be observed are: - Very poor fine motor skills such as handwriting
- Very poor gross motor skills such as kicking, catching, throwing balls
- Difficulty imitating movements such as "Simon Says"
- Trouble with balance, sequences of movements and bilateral coordination
The Treatment
What is the Treatment for Sensory Integration Dysfunction? Occupational Therapy (OT) is used to treat Sensory Integration Dysfunction. The goal of OT is to enable children to take part in the normal "occupations" of childhood - such as playing with friends, enjoying school, eating, dressing and sleeping - which are often problems for children with DSI. Each child is provided with an individualized treatment plan. Direct treatment often occurs at a Children's Hospital or in a private practice setting. Therapists sometimes also consult at home or school. Parents are directly involved in treatment sessions so that they can learn more about their child and, together with the therapist, can figure out how to incorporate their family's priorities into treatment. What does Occupation Therapy look like? Treatment is fun! It occurs in a large, sensory-enriched gym with lots of swinging, spinning, tactile, visual, auditory and taste opportunities. Using an approach we call "STEP-SI" (pronounced "step - S - I") with input from parents, we begin to understand how the child perceives sensation and how that affects his/her attention, emotions, motor skills or learning abilities. We evaluate for each child: - Sensory - the responses in each sensory system (e.g. movement, touch, taste, etc.)
- Task - the need for more vs. less complexity and structure in completing activities
- Environment - the responses to "enriched' compared to "simple" surroundings
- Predictability - the necessity for having expected vs. new experiences
- Self-Monitoring - the child's ability to preview and adjust responses before acting
- Interactions - the need for less or more intense interactions with others
The overall goals of Occupational Therapy are to improve Social Participation, Self-Esteem, Self-Regulation and Sensory-motor Abilities. In addition, we strive to give parents a toolbox of ideas to use in helping their child become regulated and coordinated. We support parents perception that their child's disability is real, even though it is a "hidden handicap." We also help parents to become strong advocates for their child at school and in other situations
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Here is another definition to Definition 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 the 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), a theory that was first pioneered by A. Jean Ayres, Ph.D., OTR in the 1960s. Description 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. The ability for SI to become more refined and effective coincides with the aging process as it determines how well motor and speech skills, and emotional stability develop. The beginnings of the SI theory by Ayres instigated ongoing research that looks at the crucial 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): - oversensitivity to touch, movement, sights, or sounds
- underreactivity to touch, movement, sights, or sounds
- tendency to be easily distracted
- social and/or emotional problems
- activity level that is unusually high or unusually low
- physical clumsiness or apparent carelessness
- impulsive, lacking in self-control
- difficulty in making transitions from one situation to another
- inability to unwind or calm self
- poor self concept
- delays in speech, language, or motor skills
- delays in academic achievement
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. Two of the biggest contributing conditions are autism and attention-deficit hyperactivity disorder (ADHD). 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. A report in 1998 indicates the use of cerebral electrical stimulation (CES) as being helpful to children with conditions such as moderate to severe autistic spectrum disorders, learning disabilities, and sensory integration dysfunction. CES is a modification of Transcutaneous Electrical Nerve Stimulation (TENS) technology that has been used to treat adults with various pain problems, including arthritis and carpal tunnel syndrome. TENS therapy uses a low voltage signal applied to the body through the skin with the goal of replacing painful impressions with a massage-like sensation. A much lower signal is used for CES than that used for traditional TENS, and the electrodes are placed on the scalp or ears. Occupational therapists who have studied the use of CES suggest that CES for children with SID can result in improved brain activity. The device is worn by children at home for 10 minutes at a time, twice per day. Music therapy helps promote active listening. Hypnosis and biofeedback are sometimes used, along with psychotherapy, to help those with SID, particularly older patients. Prognosis By providing treatment at an early age, sensory integration disorder may be managed successfully. The ultimate goal is for the individual to be better able to interact with his or her environment in a more successful and adaptive way. Key Terms - Axon
- A process of a neuron that conducts impulses away from the cell body. Axons are usually long and straight.
- Cortical
- Regarding the cortex, or the outer layer of the brain, as distinguished from the inner portion.
- Neurotransmission
- When a neurotransmitter, or chemical agent released by a particular brain cell, travels across the synapse to act on the target cell to either inhibit or excite it.
- Proprioceptive
- Pertaining to proprioception, or the awareness of posture, movement, and changes in equilibrium and the knowledge of position, weight, and resistance of objects as they relate to the body.
- Tactile
- The perception of touch.
- Vestibular
- Pertaining to the vestibule; regarding the vestibular nerve of the ear which is linked to the ability to hear sounds.
For Your Information Periodicals
- "Body Brushing Therapy for Tactile Defensiveness." Latitudes (April 30, 1997).
- "Brain Stimulation for Autism?" Latitudes (October 31, 1998).
- Morgan, Nancy. "Strategies for Colic." Birth Gazette (September 30, 1996).
- "Sensory Integration Therapy." Latitudes (December 31, 1994).
Organizations
- Sensory Integration International/The Ayres Clinic, 1514 Cabrillo Avenue, Torrance, CA 90501-2817.
Other
- Sensory Integration International. http://www.sensoryint.com.
- Sensory Integration Dysfunction. http://home.ptd.net/blnelson/SIDEWEBPAGE2.htm.
- Sensory Integration Network. http://www.sinetwork.org.
- Southpaw Enterprises, Inc. http://www.southpawenterprises.com.
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