Sensory Integration

Sensory Integration (SI) and Sensory Defensiveness are terms most parents and educators have never heard of.  Sadly, many pediatricians are also unaware of this field of knowledge or are skeptical of its benefits. In spite of the low profile of SI, it has improved the life of many individuals. I believe, as do most occupational and physical therapists, that SI therapy provides one of the “missing pieces” for many children and teens who do not find complete help or explanations for their behaviors and peculiarities any where else. Additionally, it is my belief that SI theory and therapy one day will not be viewed with skepticism by educators and physicians, but will be accepted as mainstream health practice.

One description of Sensory Integration is that it “helps the body learn, organize, and process the information it receives from the environment through sensory experiences.”  A. Jean Ayres, PhD, OTR, a pioneer in the development of this body of knowledge, has carried out research in the field of Sensory Integration for many years. In 1972, she established the Sensory Integration International organization, which continues research and offers educational programs on SI.

What Does Sensory Defensiveness Look Like?

Many people wonder what behaviors a parent would notice if their child had sensory defensiveness.  A child with SI dysfunction or sensory defensiveness could exhibit a number of different symptoms or behaviors, such as:

1. Sensitivity to clothing labels or seams of clothes.
2. Extreme dislike of washing or combing hair
3. Super-sensitivity to certain food textures and taste (oral defensiveness)
4. Sensitivity to loud noise or bright lights
5. Protests or complaints leading to avoidance of crowds or multisensory experiences (such as fairs, carnivals, even large birthday parties
6. Difficulty falling asleep or napping
7. History of “fussiness” or crankiness as a baby or infant
8. Difficulty with coordination, especially between right and left side of body movements (lateralization)
9. Seeking out of unusual experiences, such as going to a corner or a tight space (makes them more calm) or just the opposite (seeks out repetitive swinging or pulling motions)
10. Delays in speech, language, motor skills, or academic achievement

Sometimes a child will desire more stimulation experiences or just the opposite. As you study your child more closely, certain patterns may emerge and make clearer sense in light of Sensory Integration theory. You may notice that many of the complaints or protests of your child fall into one of several categories, such as: tactile defensiveness (or sense of touch), vestibular or sense of movement and body position, motor planning (or how they interact with their environment) and organization of the senses. SI theory and therapy can help parents identify and address such concerns, and cause many children and their families to avoid needless suffering.

From a personal viewpoint, many of my own family outings were disastrous experiences until information on SI was discovered. Then I understood why the state fair excursion did not “work” and was not fun for my child, and why she cried when she saw fireworks or balloons at a birthday party (fear of popping sound/ auditory sensitivity). Until I discovered this information, I was told that my children were “just spoiled” and “weird” and that I was an overly protective mother. Imagine my relief when I learned that my intuition was true. My daughters did have a scientifically identifiable cause or reason for their behaviors! Neither our pediatrician, nor any other professional referred us for this help. Persistence and our local laboratory school (associated with a university) were our best resources.

Depending upon the affectedness of your child, it may be wise to ask your school district to do SI testing. Request that the S.I.P.T. (Sensory Integration and Praxis Test) be assessed. Sometimes the schools will try to convince you that this test is not needed, or that they can obtain similar information through a much simpler exam by a physical therapist or occupational therapist. Be as informed as possible so you will know what to request. The SIPT is the best assessment for any SI problem, but it is targeted for children from 4 to 8 years of age.  One should also know that it is a four hour examination and must be done by an OT that is certified in SI. Many school districts do not have a certified therapist of this type on staff and therefore have to consult with outside services. To conserve costs, school districts will typically deter this type of testing, or substitute less helpful assessments. Know your rights as a parent and be assertive. Your child deserves the best information to make school and life less frightening and confusing.

What is the Treatment Program?

A Sensory Diet is often included as part of the treatment or therapy plan. Sensory Diet consists of skin brushings and joint compressions done every 2 to 3 hours. The therapist will show you the type of brush to use and the areas of the body to avoid. In addition, certain activities that stimulate and integrate the senses are done. Initially, these exercises and therapy are done with a physical or occupational therapist. School districts can provide this therapy two or three times per week. In between the therapy sessions, parents can be taught what to do to help their child. Some activities we have used are:

1. Swinging/ learning to pump with both legs (requires coordination between the two hemispheres (lateralization)
2. Riding on stomach on a skateboard (being pushed or pulled)
3. Squeezing rubber balls with their fingers
4. Hugging (firm pressure) or wearing weighted backpack (schoolpack)
5. Sitting on rubber chair cushion which provides constant feedback to the system
6. Sitting on large round ball and balancing or lying on stomach on very large ball
7. Soccer or kick ball
8. Sand play; find hidden object in sand

In summary, let me encourage you to investigate Sensory Integration for yourself if your child has any behaviors or symptoms that have not been explained to your satisfaction. It is well worth the time and effort to find answers and assistance for your child.

Related Web Sites

The American Occupational Therapy Association (AOTA -- www.aota.org)

References

A. Jean Ayres. (1979). Sensory Integration and the Child. Los Angeles: Western Psychological Services.

Sensory Integration International, Inc. (1991). “A Parent's Guide to Understanding Sensory Integration”, Torrance: SI Int. 

For More Information

MMFK is available for fee-based private consultation, lectures, and speaking engagements.  For more information and fee schedule, please contact us.