What is Sensory Integration?
Sensory integration is the process by which the nervous system receives information from our environment through our senses and makes sense of that information. The senses from which this information comes are vision, hearing, touch, taste, smell, the vestibular sense (sense of balance and movement), and proprioception (sense of muscles and joints). While the sense of balance and movement helps us know where we are in space and the position of our head relative to gravity, the sense of muscles and joints informs us about how much force we are applying and the position of our body parts relative to our body. All these senses provide us with information about our body and our surroundings. This process of the brain organizing and interpreting sensory information is called Sensory Integration.
The development of sensory systems begins in the womb and continues throughout life. Senses are energies that stimulate or activate nerve cells and initiate neural processes. Sensory processing forms the basis of learning. Integration is a form of organization. In early childhood, the nervous system is in its most intense developmental phase, and sensory development is supported through typical childhood activities. Therefore, the first few years of childhood are considered the sensory-motor period and a crucial process for laying the foundations of our nervous system.
What is Sensory Processing Disorder?
Sensory Processing Disorder, sometimes also known as sensory integration dysfunction or sensory processing dysfunction, often goes unnoticed but can be seen in children with typical functionality, as well as in children with autism spectrum disorder, attention deficits, learning difficulties, and other neurological conditions. These individuals are unable to effectively process the information coming from their senses (touch, hearing, taste, vision, smell, and movement). The brain may be unable to perceive the senses, the received messages may be inconsistent, or the sensory information may be consistent but not properly integrated with sensory messages from other related systems. In such cases, sensory sensitivities, delays in motor skills, difficulties in social, perceptual, self-regulation, attention, and behavior issues may arise. This indicates that the child has problems with sensory integration. This issue is often referred to as Sensory Integration Disorder or Sensory Processing Disorder.
What are the Three Categories of Sensory Processing Disorder?
1. Sensory Modulation Disorder involves responding either “too much” or “too little” to sensory information that is typical and non-disturbing to others. Difficulties in this area may result in challenges with self-regulation, Sensory Over-Responsivity, Sensory Under-Responsivity, or Sensory Seeking.
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Sensory Over-Responsivity: This is an overreaction to sensory stimuli. It may manifest in children as discomfort from loud sounds, irritation from clothing tags, avoidance of hair/nail cutting, dislike of dirty hands, avoidance of certain textured foods, or a preference for calm and seated play activities.
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Sensory Under-Responsivity: Defined by the nervous system’s lower-than-typical responses to sensory stimuli. As a result, children may appear to not react to sensory information like noise, movement, or touch.
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Sensory Seeking: This is when the nervous system needs unusually high or intense levels of stimulation. It can be observed in children who frequently crash into things, chew on objects, bite themselves, or continuously touch things to get more sensory input.
2. Sensory Discrimination Disorder refers to difficulties in processing and interpreting the key characteristics of sensory information. It can involve problems in understanding head position, movement (moving/stable), how much force to apply when throwing a ball or petting an animal, or distinguishing symbols in a visually dense picture. Sensory discrimination allows the display of motor skills, and difficulties in this area can lead to problems in areas requiring postural control and motor skills such as sports, handwriting, coordination, and playing ball.
3. Praxis Disorders occur when a child’s nervous system cannot process or integrate sensory information from movement and the body. The child may experience difficulties with motor planning, coordinating both sides of the body, timing, and engaging in complex motor coordination activities. Praxis problems result in difficulties with daily motor tasks and activities such as dressing, using tools, playing, or organizing homework.
Intervention/Treatment: What Happens in Sensory Integration-Based Therapy?
Sensory integration-based therapy is applied according to each child’s individual needs. The therapy focuses on self-regulation, sensory processing, body awareness, motor planning, or the development of gross and fine motor skills. The therapist works with the family and child to set common goals that support the child’s development in these areas. The therapist structures the session by using the child’s ideas and guiding the child through meaningful activities. During therapy, it may appear that the child is simply playing, but both the child and the therapist are working hard through carefully planned activities to support sensory processing and skill development. Every activity in which the child engages during therapy has a purpose. These activities might be designed to support the development of the sensory systems, such as finding objects in a bean box or swinging on a special swing. Some activities might support the development of strength and postural control, such as climbing, pulling activities, balancing on a large pillow, or jumping on a trampoline. Other activities might support the development of motor coordination, planning, and motor skills involving timing and movement in space, such as obstacle courses, scooting in a specific direction on a scooter board, or throwing objects at a target. Initially, therapy focuses on improving sensory processing, postural control, attention, and regulation. As therapy progresses, it shifts towards more skill-based activities. Social skills can be developed in group sessions, provided each child participates alongside their therapist. The frequency of therapy may vary depending on the child’s individual needs.
References:
Emily Eastman, OTS & Teresa A. May-Benson, ScD, OTR/L, FAOTA/A Guide to Sensory Integration for Parents.
Sensory Processing Disorder Answer Book by Tara Delaney (2008).
Ben-Sasson, A., Cermak, S., Orsmond, G., Carter, A., Kadlec, M., & Dunn, W. (2007). Extreme sensory modulation behaviors in toddlers with autism. American Journal of Occupational Therapy, 61, 584– 592. doi:10.5014/ajot.61.5.584
