Sensory Integration

The therapists at Kiddos’ Clubhouse have gone through extensive training in sensory integrative techniques. This training allows us to be able to better evaluate the needs of your child and how to best form an individual plan to benefit your child. When children with sensory integrative dysfunction (DSI) are accurately identified, they can begin a program which is conducted in a sensory-rich environment. This helps these children to manage their responses to sensations and to behave in a more functional manner. Kiddos’ Clubhouse is set up with this type of therapy in mind. We have set up a sensory-rich environment that will meet the needs of your child and to again allow them to engage in their primary occupation – PLAY!

Millions of people across the world go through life with undiagnosed sensory related difficulties. They may not know why they have to rip the tags out of their shirts but it must be done to be able to wear it. In their popular brand of tee shirts, Hanes caught on to this and now is capitalizing on people with sensory issues! You may not know why you chew your pen cap, but you realize you do it once it is torn apart at the end of a meeting. You might not know why you can’t go barefoot over sand or grass, but you know you need to have your shoes on when you are doing so. These are just some of the examples of cases of people with sensory integrative difficulties.

What about the notes home from school about your child who can’t stand in line and wait? And when they finally are able to wait in line they have pushed the child in front of them to the ground! How about your child who has a tantrum when he/she is eating in the cafeteria? How about your child who can’t keep their head up in class and is lethargic and does not “pay attention”? Does your child cover their ears at loud sounds? How about the notes home saying your child does not play at recess?

Any of this sound familiar and frustrating to you? Are these behavioral problems? Most likely the answer is ‘no’! At the root of most of these issues is a sensory system that is not integrating the information it needs/receives in a functional manner. One thing all of the above problems have in common is this: the therapists at Kiddos’ Clubhouse can help you and your child with these difficulties.

What is Sensory Integration Dysfunction (DSI) or the more recently proposed term Sensory Processing Disorder (SPD)?

Sensory integrative dysfunction (DSI) is the inability to process incoming information from the environment and information received and interpreted by one’s own body. These sensations come from touch, sound, joints, and movement. People with DSI can fell like they are receiving too much information, too little information or they are not able to interpret the sensations in a typical fashion. When any of these situations occur there can be negative affects such as behavioral problems, difficulties with coordination/motor planning and/or other problems.

What is Sensory Integration (SI)?

Sensory integration is the organization of sensation for use. Our senses give us information about the physical conditions of our body and the environment around us. Integration take place at core brain structures from the information gathered from the spinal cord, brain stem, cerebellum, and cerebral hemispheres. These structures gather information regarding body awareness, perception, and knowledge, and to produce body posture, movements, and the planning and coordination of movements, emotions, thoughts, memories, and learning.

The brain must organize all of these sensations if a person is to move and learn and behave normally. The brain locates, sorts, and orders sensations – somewhat as a traffic policeman directs moving cars. When sensations flow in a well-organized or integrated manner, the brain can use those sensations to form perceptions, behaviors, and learning. When the flow of sensations is disorganized, life can be like a rush-hour traffic jam.

Sensory integration is the neurological process that organizes sensation from one’s own body and from the environment and makes it possible to use the body effectively within the environment. The spatial and temporal aspects of inputs from different sensory modalities are interpreted, associated, and unified. Sensory integration is information processing.

The mere presence of sensory stimuli from the environment and the body through intact peripheral receptors and sensory channels is insufficient to form purposeful actions. The sensory stimuli must be processed; that is, the brain must select, enhance, inhibit, compare, and relate organism-environment interaction. The brain must select, enhance, inhibit, compare, and associate the sensory information in a flexible, constantly changing pattern; in other words, the brain must integrate it. Neuromotor skill alone is also insufficient for adaptive interaction. The brain must be able to generate transactional concepts and to plan a suitable course of action.

Sensory integration and praxis are functionally interdependent. Sensations from the body, especially during purposeful activity, provide the means by which a neuronal model or percept of the body is established. The body percept, sometimes referred to as the body scheme, is a concept introduced by Head (1920). An accurate body scheme is necessary for practical tasks, for a sense of directionality, and for relating the body to space. At the same time, conceiving, planning, and executing adaptive action is a major means by which sensation is made meaningful and translated into a body percept.

Praxis is to the tangible, two- and three-dimensional, gravity-bound world as speech is to the social world. Both praxis and speech are learned, and both enable interactions and transactions. They also require the cognitive functions of concept formation and planning that enable expression through the neuromotor system. While speech is concerned with communicating with other people, praxis is concerned with “doing” in the world. Sensory integration and praxis make possible the organism-environment interaction that is the basis for much human development, learning, and behavior.

Praxis is a uniquely human aptitude that underlies conceptionalization, planning, and execution of skilled adaptive interaction with the physical world, in other words, how we move. Praxis is the ability by which an individual figures out how to use his or her hands and body in skilled tasks such as playing with toys, using tools (including a pencil or fork), building a structure (whether a toy block tower or a house), straightening up a room, or engaging in many occupations. Practic ability includes knowing what to do as well as how to do it. Practic skill is fundamental to purposeful activity. It is dependent upon both sensory integrative and higher cognitive processes.

What senses or bodily functions can be affected?

Visual system
Olfactory (smell) system
Auditory (hearing) system
Tactile (touch) sense
Touch
Pressure
Texture
Heat/Cold
Pain
Movement of the hairs of the skin
Vestibular (balance) sense.
Proprioceptive (muscle and joint movement) input

How do I know if my child has a sensory integration disorder?

What We Do to Satisfy Our Typical Sensory Needs

Calming
Excitatory
Organizing
Listen to music when working/reading
Spend time by ourselves
Turn down the lights
Get into bed (any warm place)
Rock in chairs/sit in rocking chairs
Take a warm bath
Hum while working
Listen to music when working/reading
Exercise
Chew crunchy foods
Listen to music when working/reading
Chew on pen caps
Chew bubble gum
Chew on fingernails
Rock in chairs/sit in rocking chairs
Hum while working

What Stereotypical Sensory Integration Deficits Might Look Like

“Sensory seekers”
“Sensory avoiders”
Always in motion (running, walking, jumping, rocking)
Constant talking or humming (demonstrating the need for “white noise”)
Easily distracted (won’t stay with one activity for a long duration)
Children who disengage from others
Only wear certain “types” of clothing
Only eat certain “types” of food
Do not like being touched

Early Signs of Possible Sensory Integration Deficits

Infants

Do not roll over, creep, sit, or stand at the same age as other children.
Cry if not being held or rocked
Do not like to be held
Do not put toys in mouths
Cry when new food items/textures are being introduced
Difficulties sleeping/Up all the time
Baby is difficult to calm after they are upset or crying
Only plays with toys with fingertips rather than whole hand

Children

Running is awkward
May seem clumsy
Frequently fall or stumble
May not play as skillfully as peers
May break things and have accidents more often than peers
May have trouble learning to tie their shoes
May demonstrate difficulties learning to ride a bike without training wheels
May have trouble playing with manipulative toys
Delays in language development is a very common problem

What Classroom/School Behaviors Might Look Like

Child has to work harder to do the same tasks as peers
Difficulties holding writing utensils
Difficulties changing from one task to another
Difficulties paying attention to instructions
Difficulties following 2 and 3 step directions
Child is always moving
Child breaks the lead in his/her pencil often
Child in a “loner” during play time
Child is docile
Doesn’t like to participate in art activities when he/she has to touch textured media
Child has a difficult time maintaining appropriate postures throughout the day
Child is generally disorganized
Short attention span
Daydreaming or inattentiveness
Aversion to touch
Hyper activity or hypo activity
Normal intelligence, but trouble learning to read or do mathematics

How can Occupational Therapy assist in SI?

Praxis and perception are both end products of sensory integration and usually develop so naturally they are taken for granted. What the treatment method of sensory integration used by occupational therapists (and some physical and speech therapists) does is to provide both staged situations and natural situations to work on ways to improve praxis, increase body scheme, and develop adaptive behaviors by providing “just right challenges”. These “just right challenges” allow the individual with sensory integrative dysfunction succeed with their skills and build upon them at their own pace with therapeutic backing and encouragement. We want to keep the individual motivated to engage in therapy, and through these challenges, they will demonstrate noticeable improvements in their adaptive behavior during each treatment session. We want the individual to stretch just a little beyond their current abilities, but that not so much that the task is difficult as to generate frustration or poor quality of response.

Ayres, A. J. (1989). Sensory Integration and Praxis Test. Los Angeles: Western Psychological Services.

Head, H. (1920). Studies in neurology (Vol. II). London: Oxford University Press.