Sensory Integration Therapy
Sensory integration therapy was pioneered by Dr. Jean Ayres in the 1970’s. Dr. Ayres theorized that children who had difficulty learning in school, interacting with others, or had coordination difficulties, had underlying challenges in how they process sensory information in their environments. Dr. Ayres groundbreaking researching has helped us understand more about child development and how we can help children with sensory challenges. Today, sensory integration therapy is a respected field of practice for occupational therapists, physical therapist, speech therapists, teachers, and other individuals who consider the whole child.
Let’s Build a House!
Sure windows and tile are nice for building a house, but what’s more important is laying the foundation so you can build a strong house! This is a good way to look at child development.
Part of that important foundation for child development is the ability to take in, process, and act in a responsive way in our environments (sensory integration). Adequate touch processing leads to better coordination of our bodies. Adequate sound processing leads to better ability to take in communication from others and understand sounds in our environment. Underlying sensory processing abilities are part of the foundation for higher level skill development.
Visual is from Yack, E., Sutton, S., and Aquilla, P. (1998). Building Bridges through Sensory Integration
Our Sensory Systems
Visual: Visual processing refers to the brain’s perception of the visual environment. We rely on our vision to provide spatial relationships between object and locate objects in our environment. Your visual system works closely with your vestibular system for balance and also so one can organize their bodies in relation to their surrounding space.
Tactile: The tactile system refers to how we process touch sensations. We use touch to discriminate sensations and understand objects. It also helps us determine danger in our environment. For instance, if something is sharp.
Olfactory: The olfactory system refers to things that we smell.
Oral: Oral processing refers to one’s ability to process sensations inside their mouth.
Auditory: Auditory processing refers to one’s ability to orient and respond to sounds. It includes the ability to filter out the important auditory information and interpret this information.
Proprioception: Proprioception refers to our understanding of our bodies in space. The proprioceptive system includes our muscles, ligaments, and tendons. This proprioceptive system works with the tactile system to give us awareness of our bodies.
Vestibular: Vestibular processing refers to how an individual processes movement. This sensory system gives us awareness of the position of our head in space.
Interoception: Understanding the cues from inside of our body, such as knowing when we need a drink or need to use the restroom.
Differences in Sensory Processing Between Children
We all process sensory information in different ways. Some of us love getting deep tissue massages or going on the rides at Hershey park. Some of us get sick just looking at those rides! There is a large spectrum in sensory processing. We may seek out or avoid certain sensations according to our own sensory preferences. You may have hypo-reactivity within one sensory systems and hyper-reactivity within another sensory system. Our assessment process helps us better understand your child’s individual sensory profile.
Hypo-reactive
The term “hypo-reactive” means that an individual requires more than the typical amount of sensory stimulation to elicit a response. An example of this would be a child who is “hypo-reactive” to proprioceptive information. This child may fall frequently or be considered clumsy with everyday tasks. The child is not receiving enough signals telling them about their body in relation to the world around them.
Versus
Hyper-reactive
The term “hyper-reactive” means that an individual requires less than the typical amount of sensory stimulation to elicit a response. For instance, a child who is “hyper-reactive” to sounds may hear sounds that others do not, or they may be bothered by sounds. This child may demonstrate difficulty with learning in noisy environments. They may also demonstrate more defensive characteristics.
Can we talk more about that amazing vestibular system!
The Vestibular sense is one of our 8 senses. This sense monitors where our body is in space in terms of movement and positioning. In other words, vestibular system answers to life questions: which way is up? Where am I going? It is basically our internal GPS system! It works closely with our visual (sight) and auditory (hearing) systems to understand where and how our body is moving. For example, in our ears, there are canals filled with fluid and when you move your head in different directions, it triggers certain fluid movements to bend the appropriate hair cells to understand where we are in space. Our eyes then work together with our brain and ears to help our body understand where we are and where our world is. So, if you turn your head to the left your whole world doesn’t turn to the left! This is as important as it sounds! And because of that, it impacts several things we do day to day. Our vestibular system processing and functioning impacts our balance, using the right and left sides of our body together, crossing midline, strength, regulation, attention, visual spatial skills, and so much more.
Fun Facts on our Vestibular System:
Our semicircular canals (in our ears) are responsible for processing movements of our head and body. There are lateral, anterior, posterior canals.
There are three main parts of our ear: outer, middle, inner
When we move our body (or even just our head) our inner ear, middle ear, and brainstem work together with our whole brain to know where we are! Things like riding a bike, bending forward to look between our legs, or doing a back bend!
Our vestibular sense begins development in utero and helps our body with reflex integration. Come on, how cool is that!
There is linear acceleration and rotary. Rotary is moving in a more circular direction and linear is going in a straight line. Think of a playground swing moving forwards and backwards (linear) vs. spinning around in a circle (rotary).
Vibration goes to our 6 receptors in your ears and communicates with each other before sending those messages to your brain.
Motion sickness happens when there is miscommunication between your eyes and your vestibular system. Your body thinks you are moving because your eyes are telling you that!
Becoming dizzy from movement is not always a bad thing! It just means your vestibular system is activated. Some people become dizzier quicker than others. Some people can spin around 10 times and not be dizzy (maybe figure skaters or dancers). Other people may feel dizzy from bending down to look between their legs.
Frequent ear infections can impact the vestibular and auditory systems.
Our therapists have advanced training in sensory integration therapy
Sensory Processing Disorder
Sensory processing disorder (SPD) exists when the brain is unable to organize sensory information into appropriate responses (Miller, 2014). Children with SPD experience sensory information differently than other children and may experience sensations more intensely, less intensely, or have difficulty interpreting the difference between sensations which may result in an unexpected response (Miller, 2014 p. 6).
As discussed earlier, we all receive information from our eight senses, five external senses as well as three internal or “hidden” senses (Miller, 2014, p. 7): tactile, oral, olfactory, visual, auditory, vestibular, proprioception, and interoception. Children with SPD may have difficulties with processing information from one of more of these senses.
For example, a child with SPD may be challenged with attending in a busy classroom because of difficulty blocking out some of the background noise. Another example would be a child who may take unnecessary safety risks during play.
These difficulties cause disruptions in their everyday life and may appear to be behavioral, emotional, or attentional challenges. They can impact motor abilities, organization, social participation, self-regulation, and self-esteem (Miller, 2014, p. 6). In children with sensory processing disorder, “sensory difficulties are chronic and disrupt their everyday life” (Miller, 2014, p. 17).
SPD appears in three patterns: Sensory Modulation Disorder (SMD), Sensory Based Motor Disorder (SBMD), and Sensory Discrimination Disorder (SDD). These patterns may occur independently or in combination with each other. Additionally, difficulties may fall along a spectrum with experiences ranging from mild to severe (Miller, 2014, p. 14 and 15).
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Sensory Modulation Disorder refers to a difficulty turning sensory messages into an appropriate response. The three sub types of Sensory Modulation Disorder (SMD) are sensory over-responsivity, sensory- under responsivity, or sensory craving (Miller, 2014, p. 27).
Sensory over-responsivity: the child responds to sensory messages more intensely, more quickly, and for longer periods of time. You may notice your child covering their eyes or ears because it is too bright or too loud. Children can be over responsive in one sensory system, or in multiple sensory systems (Miller, 2014, p. 28).
Sensory under-responsivity: the child has a lesser response to sensory information, it may take longer for them to respond, and they may require intense or long-lasting sensory information to react (Miller, 2014, p. 31 and 32). Children who are under-responsive often prefer individual activities rather than social activities with peers (Miller, 2014, p. 32).
Sensory craving: these children have an intense craving for sensory experiences and actively seek them out, however obtaining these sensations often dysregulates or disorganizes them (Miller, 2014, p. 34).
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Sensory Based Motor Disorder refers to difficulty with motor planning movements based on incoming sensory information (Miller, 2014, p. 41).
Dyspraxia: These children may appear to have difficulties with translating sensory information into physical movement which may impact performance in novel movements or movements requiring multiple steps (Miller, 2014, p. 42)
Postural Disorder: Children with postural disorder often present with a weak core or postural stability leading to difficulty with completing novel or familiar motor tasks (Miller, 2014, p. 45)
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Sensory Discrimination Disorder (SDD) refers to difficulty with interpreting sensory input and determining similarities and difference between input (Miller, 2014, p. 37).
Occupational Therapy Can Help
Occupational therapy can help children with SPD better function in their daily lives by introducing strategies that are unique to the child and their needs. These strategies will be suggested based on what works best for the child and are developed in collaboration with the child, the family, and the occupational therapist to assist with daily occupations such as self-care/grooming, eating, play, and learning to name a few. Occupational therapists may also suggest a “sensory diet” which consists of at-home activities that would be completed as determined by the occupational therapist based on the child’s individual needs. This would be monitored and adapted as needed by the child’s occupational therapist (Sensory Processing Disorder, 2022).
Information was gathered from the following sources:
Miller, L. J. (2014). Sensational Kids: Hope and Help for Children with Sensory Processing Disorder. The Penguin Group.
Sensory Processing Disorder. Psychology Today. (2022). Retrieved January 19, 2022, from https://www.psychologytoday.com/us/basics/sensory-processing-disorder