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.