Sensory Integration:

What is Sensory Integration?

Every day, we receive a great deal of information from our senses. We use this information to organize our behavior and successfully interact in the world. Our senses give us information about the physical status of our body and the environment around us. Think of the senses—sight, hearing, touch, taste, and smell. Yet, there are many other sensations which are just as essential to survival. Our nervous system also detects changes in movement and gravity. These sensory systems include: 1) balance and movement (our vestibular sense); the knowledge of the position of one’s head in relation to gravity and movement which is used to come down a slide, or ride a playground swing without falling off, and 2) muscle and joint sense (proprioception); the internal awareness of the position of one’s joints and muscles in space which allows you to lift a spoon to your mouth without spilling your soup.

Our brains must organize this information so that we may function in everyday situations such as the classroom, at home, on the playground, and during social interactions. When one recalls all of the sensory modalities, it is truly amazing that one brain can organize and input from all senses simultaneously, and still come up with a response to the demands of the environment. The complex nature of this interaction is reflected in the following example: "Johnny, please put your coat on."

1. Focusing your attention on the person speaking and hearing what they say.
2. Screening out other incoming information going on around you.
3. Seeing the coat and adequately making a plan for how to being.
4. Seeing the armhole openings and sensing muscle and joint position (which allows you to know where your arms are and where to put your arms in relation to the coat sleeves).
5. With your sensitive touch awareness, you feel that the coat is on your body correctly.
6. Adequate motor planning, touch awareness, and fine motor skills to enable you to zip or button your coat.

We could continue with this breakdown, but the point is that the central nervous system is constantly focusing, screening, sorting and responding to sensory information both from the external environment, and from internal receptors in order to perform purposeful activity. Imagine the amount of SENSORY INTEGRATION needed to sit in a chair, pay attention in an active classroom, copy an assignment, or read a book!

Sensory Processing Disorders

What happens if one or more of our senses are not being interpreted properly? A child with vague or hazy feedback about his sense of touch, body position, or movement and gravity is in a world totally foreign to ours. Imagine yourself in a world where something as basic and reliable as the pull of gravity or other children’s touch upon you is perceived as something unreliable, inconsistent, or threatening. The child would not feel the usual security, safety, and fun that other children experience.

SENSORY INTEGRATION INFORMATION SHEET

Some Signs of Sensory Processing Disorder
Typically, a child with a sensory processing disorder will show more than one of these signs:

• Overly sensitive to touch, movement, sights, or sounds
• Easily distracted
• Activity level that is unusually high or unusually low
• Impulsive, lacking in self-control
• Inability to unwind or calm self
• Poor self concept
• Under-reactive to touch, movement, sights, or sounds
• Social and/or emotional problems
• Physical clumsiness or apparent carelessness
• Difficulty making transitions from one situation to another
• Delays in speech, language, or motor skills
• Delays in academic achievement

What is Sensory Processing?
Sensory experiences include touch, movement, body awareness, sight, sound, and the pull of gravity. The process of the brain organized and interpreting this information is called sensory integration. Sensory integration provides a crucial foundation for later, more complex learning and behavior.

For most children, sensory integration develops in the course of ordinary childhood activities. Motor planning ability is a natural outcome of the process, as is the ability to adapt to incoming sensations. But for some children, sensory integration does not develop as efficiently as it should.

When the process is disordered, a number of problems in learning, development, or behavior may become evident.

The concept of sensory integration comes from a body of work developed by A. Jean Ayres, Ph.D., OTR. As an occupational therapist, Dr. Ayres was interested in the way in which sensory processing and motor planning disorders interfere with daily life function and learning. This theory has been developed and refined by the research of Dr. Ayres, as well as other occupational and physical therapists. In addition, literature from the fields of neuropsychology, neurology, physiology, child development, and psychology has contributed to theory development and intervention strategies.

What Can Be Done?
If a child is suspected of having a sensory processing disorder, an evaluation can be conducted by a qualified occupational or physical therapist. Evaluation usually consists of both standardized testing and structured observations of responses to sensory stimulation, posture, balance, coordination, and eye movements. After carefully analyzing test results and other assessment data along with information from other professionals and parents, the therapist will make recommendations regarding appropriate therapy.

If therapy is recommended, the child will be guided through activities that challenge his or her ability to respond appropriately to sensory input by making a successful, organized response.

Training of specific skills is not usually the focus of this kind of therapy. Adaptive physical education, movement education, and gymnastics are examples of services that typically focus on specific motor skills training. Such services are important, but they are not the same as therapy using a sensory integrative approach.

One important aspect of therapy that uses a sensory integrative approach is that the motivation of the child plays a crucial role in the selection of the activities. Most children tend to seek out activities that provide sensory experiences most beneficial to them at that point in development. It is this active involvement and exploration that enables the child to become a more mature, efficient organizer of sensory information.

Occupational Therapy Treatment

Occupational therapists with training in sensory integration theory, assessment, and treatment provide therapeutic activities to facilitate child-directed treatment sessions. The child with sensory processing disorder may participate in play activities but he does not play in manner that is integrating or organized. The child needs an environment with suspended equipment especially designed to meet his needs. The therapist designs an environment to enable the child to interact more effectively. Following diagnosis of the child’s sensory system, the therapist encourages and assists the child in choosing activities that provide the appropriate amount of sensory input.

The therapist tries carefully to balance structure and freedom in a way that leads to constructive exploration. This balance is not easily achieved. Free play does not inevitably, in itself, further sensory integration. If it did, many children with dysfunction would have solved their own problems. But too much structure does not allow growth either. With this balance of structure and freedom, the therapist helps the child to develop both his neural organization and his inner direction. The child is given as much control over therapy as he can handle, as long as his activity is therapeutic. The therapist controls the environment, while the child controls his own actions. Self-confidence, or an improved attitude about one’s self, is often the first change parents notice in their children after they have started therapy. The child becomes more in command of his life because he develops better control of his body as his nervous system functions better.

Adapted by: Janet McLaughlin, OTS and Karyn Russell, OTS
From A. Jean Ayres (1979) and Ginger Grass, OTS, Cincinnati Public Schools
Revised February 1992 by Linda Palmstorm, MS, OTR/L

Our Occupational Therapist’s are certified in the administration and interpretation of the Sensory Integration and Praxis Tests, a standardized assessment tool designed to identify the presence of Sensory Processing Disorder (SPD). Using a Sensory Integrative approach, our Occupational Therapist’s provide treatment in a state-of-the-art facility designed for maximal therapeutic gains as well as emotional and physical safety. This is accomplished with a variety of equipment and opportunities for improved sensory integration.

For more information on SPD please visit The SPD Network.