Sensory Intergration

Sensory integration disorder or dysfunction (SID) is a neurological disorder that results from the brain's
inability to integrate certain information received from the body's five basic sensory systems. These sensory
systems are responsible for detecting sights, sounds, smell, tastes, temperatures, pain and he position and
movements of the body. The brain then forms a combined picture of this information in order for the body to
make sense of its surroundings and react to them appropriately. The ongoing relationship between behavior and
brain functioning is called sensory integration (SI). Sensory integration provides a crucial foundation for later,
more complex learning and behavior.

Sensory experiences include touch, movement, body awareness, sight, sound, smell, taste, and the pull of gravity.
Distinguishing between these is the process of sensory integration (SI). While the process of SI occurs
automatically and without effort for most, for some the process is inefficient. Extensive effort and attention are
required in these individuals for SI to occur, without a guarantee of it being accomplished. When this happens,
goals are not easily completed, resulting in sensory integration disorder (SID).

The normal process of SI begins before birth and continues throughout life, with the majority of SI development
occurring before the early teenage years. For most children sensory integration develops in the course of ordinary
childhood activities. But for some children, sensory integration does not develop as efficiently as it should. This is
known as dysfunction in sensory integration (D.S.I.). When the process is disordered, a number of problems
in learning, motor skills and behavior may be evident. The ability for SI to become more refined and effective
coincides with the development process as it determines how well motor and speech skills, and emotional stability
develop.

The concept and theory of sensory integration comes from a body of work developed by A. Jean Ayres, PhD,
OTR, and an occupational therapist that was based in California, U.S.A. As an occupational therapist, Dr. Ayres
was interested in the way in which sensory processing and motor planning disorders interfere with activities of
daily living and learning. The beginnings of the SI theory by Ayres instigated research that looks at the foundation
it provides for complex learning and behavior throughout life.

Causes and Symptoms

The presence of a sensory integration disorder is typically detected in young children. While most children develop
SI during the course of ordinary childhood activities, which helps establish such things as the ability for motor
planning and adapting to incoming sensations, others' SI ability does not develop as efficiently. When their process
is disordered, a variety of problems in learning, development, or behavior become obvious.

Those who have sensory integration dysfunction may be unable to respond to certain sensory information by
planning and organizing what needs to be done in an appropriate and automatic manner. This may cause a primitive
survival technique called "fright, flight, and fight" or withdrawal response, which originates from the "primitive"
brain. This response often appears extreme and inappropriate for the particular situation.

The neurological disorganization resulting in SID occurs in three different ways: the brain does not receive
messages due to a disconnection in the neuron cells; sensory messages are received inconsistently; or sensory
messages are received consistently, but do not connect properly with other sensory messages. When the brain
poorly processes sensory messages, inefficient motor, language, or emotional output is the result.

According to Sensory Integration International (SII), a non-profit corporation concerned with the impact of
sensory integrative problems on people's lives, the following are some signs of sensory integration disorder (SID):

• Over sensitivity to touch, movement, sights, or sounds
• Under reactivity to touch, movement, sights, or sounds
• Specific learning difficulties /delays in academic achievement
• Difficulty in making transitions from one situation to another
• Tendency to be easily distracted / Limited attention control
• Activity level that is unusually high or unusually low
• Social and/or emotional problems
• Difficulty learning new movements
• Delays in speech, language, or motor skills
• Physical clumsiness or apparent carelessness
• Impulsive, lacking in self-control
• Inability to unwind or calm self
• Poor self concept / body awareness

While research indicates that sensory integrative problems are found in up to 70% of children who are considered
learning disabled by schools, the problems of sensory integration are not confined to children with learning
disabilities. SID transfers through all age groups, as well as intellectual levels and socioeconomic groups. Factors
that contribute to SID include: premature birth; autism and other developmental disorders; learning disabilities;
delinquency and substance abuse due to learning disabilities; stress-related disorders; and brain injury.
Research has identified autism and attention-deficit hyperactivity disorder (ADHD) as two of the biggest
contributing conditions as well as learning disorders (i.e. Specific learning difficulties), developmental disabilities
and fragile X syndrome.

Diagnosis

In order to determine the presence of SID, an evaluation may be conducted by a qualified occupational or physical
therapist. An evaluation normally consists of both standardized testing and structured observations of responses to
sensory stimulation, posture, balance, coordination, and eye movements. These test results and assessment data,
along with information from other professionals and parents, are carefully analyzed by the therapist who then
makes recommendations about appropriate treatment.

Treatment

Occupational therapists play a key role in the conventional treatment of SID. By providing sensory integration
therapy, occupational therapists are able to supply the vital sensory input and experiences that children with SID
need to grow and learn. Also referred to as a "sensory diet," this type of therapy involves a planned and scheduled
activity program implemented by an occupational therapist, with each "diet" being designed and developed to meet
the needs of the child's nervous system. A sensory diet stimulates the "near" senses (tactile, vestibular, and
proprioceptive) with a combination of alerting, organizing, and calming techniques.

Motor skills training methods that normally consist of adaptive physical education, movement education, and
gymnastics are often used by occupational and physical therapists. While these are important skills to work on, the
sensory integrative approach is vital to treating SID.

The sensory integrative approach is guided by one important aspect-the child's motivation in selection of the
activities. By allowing them to be actively involved, and explore activities that provide sensory experiences most
beneficial to them, children become more mature and efficient at organizing sensory information.

Alternative treatment

Sensory integration disorder (SID) is treatable with occupational therapy, but some alternative methods are
emerging to complement the conventional methods used for SID.

Therapeutic body brushing is often used on children (not infants) who overreact to tactile stimulation. A specific
non-scratching surgical brush is used to make firm, brisk movements over most of the body, especially the arms,
legs, hands, back and soles of the feet. A technique of deep joint compression follows the brushing. Usually begun
by an occupational therapist, the technique is taught to parents who need to complete the process for three to five
minutes, six to eight times a day. The time needed for brushing is reduced as the child begins to respond more
normally to touch. In order for this therapy to be effective, the correct brush and technique must be used.

Remember - An important step in promoting sensory integration in children is to recognize that it exists
and that it plays a vital role in their development