Sensory Integration Dysfunction

Sensory integration is the process by which we receive information through our senses, organize this information, and use it to interact with the environment. Most people are familiar with five senses – sight, hearing, smell, taste, and touch. However, we also receive input through two additional senses:

  • The vestibular sense, or movement and balance sense, gives us information about where our head and body are in space. It allows us to stay up right while we sit, stand, and walk.
  • Proprioception, or body awareness sense, tells us where our body parts are relative to each other. It also gives us information about how much force to use in certain activities, allowing us to crack open an egg without crushing it in our hands.

Most activities require us to combine information from many different senses at the same time. For example, a toddler uses touch to explore the texture of his food, proprioception to bring the food to his mouth, smell and taste to identify different types of food, and the vestibular sense to sit upright during the meal. As they grow, children learn how to take in and process all this information at the same time, and focus their attention on particular sensations while ignoring others.

Signs of a Sensory Issue:
Some children have difficulties receiving and processing incoming sensations, making everyday tasks frustrating. Signs of a sensory issue may include:

  • Being overly sensitive or under responsive to sights, sounds, textures, or movements
  • Delays in reaching physical, speech, or language milestones
  • Trouble with attention and behavior
  • Displaying unusually high or low levels of activity

Occupational Therapy Interventions:

Early intervention focuses on infants and toddlers, birth to 3 years of age, with disabilities or at-risk for developmental problems and their families. Occupational therapists provide interventions to facilitate effective self-regulation (wake-sleep cycles, level of alertness, self-quieting), sensory processing, motor development and adaptive behavior.

School aged children may require occupational therapy to support educational needs as well as life skills. In addition to providing interventions that remediate the sensory integration issues influencing behaviors in the classroom, occupational therapy practitioners also make modifications to the classroom environment in order to assist children in participating and progressing at school, playing, making friends, and focusing in order to learn. Examples might be managing sensory information during school routines like riding the school bus, tolerating smells and noise in the cafeteria, and playing on the playground with others.  Occupational therapy strategies may help reduce stress and inappropriate or disorganized behavior caused by poor sensory registration, sensory defensiveness, sensory overload, and poor praxis.

Adolescents and young adults may benefit from strategies that help individuals understand their own sensory processing systems and the impact on leisure activities, vocational choices, and relationships. Individuals whose participation in everyday activities is limited because they are fearful of movement, sensitive to touch, or unaware of body position in space and have not had the opportunity to use their bodies to effectively explore the sensory (proprioceptive, tactile, vestibular) and physical environment may also benefit from occupational therapy using this frame of reference.

How to help in school:

  • Adjust lighting in classroom and monitor student responses. Consider modifying intensity and the impact of direct or natural lighting.
  • Design a quiet space within classroom for calming and for supporting the highly distractible child. A quiet corner that includes an indoor tent, blanket, earphones for classical music or beanbag chair may calm or soothe a student who may be experiencing too much stimulation from sights and sounds.
  • Offer alternative seating options such as therapy balls, which studies indicate may enhance engagement and in-seat behavior.
  • Check to see if the child is able to sit at his desk with his feet firmly planted on the floor. This may promote better sitting posture and less distraction during classroom time. Some students may even benefit from completing assignments while standing. Others may benefit from sitting on carpet swatches to set boundaries for personal space.

The Sensory Spectrum website explains:

What is Sensory Processing Disorder?

Sensory Motor Checklists (age by age checklists for age appropriate skills):
http://pathways.org/awareness/parents/sensory-integration/what-to-do-next#.UxPnd3l1Uds

Books:
“The Out-of-Sync Child” – both an excellent resource book and website on all things sensory

Internet resources for sensory integration dysfunction diagnosis and treatment:

Tips for Fidgety Kids:
http://lemonlimeadventures.com/sensory-hacks-focus-fidgety-child/#_a5y_p=2741270

Tips for Dressing a Sensory Sensitive Child:
http://www.friendshipcircle.org/blog/2012/03/28/10-tips-for-dressing-a-sensory-sensitive-child/

SPD, parent support, tips & tricks:
http://sensoryprocessing.yolasite.com

Tips for chewers and mouthers:
http://mamaot.com/2015/04/09/5-tips-help-kids-chew-everything/

A “Sensory Diet” is where we use heavy work or working muscles to help regulate the brain. It helps organize the child’s nervous system; maximizes attention, behavior, arousal level and body awareness: and assists with decreasing defensiveness (many children seek out this input in an attempt to calm and organize their systems.)

Heavy work activities include:

  • Whole body actions involving pushing, pulling, lifting, carrying and moving
  • Oral actions such as chewing, sucking and blowing
  • Use of hands for squeezing, pinching or “fidgeting”

Pushing or pulling activities:

  • toy shopping cart or helping with cart at grocery store
  • pushing or pulling friend/sibling or objects in a laundry basket across the floor or down hallway
  • pushing or pulling friend/sibling or objects in kids wagon or sled across grass and/or snow
  • tug of war with rope or sheet
  • push of war with partner using a ball and trying to push it over the line
  • toy/real vacuum or using mop/broom
  • shoveling snow, digging dirt, or raking leaves
  • pushing or pulling self or others on scooter board
  • riding bikes or scooters
  • theraband or other resistive material
  • helping to move furniture
  • push against the wall or perform chair push ups
  • perform animal walks (crab walk, bear walk, army crawl) or wheelbarrow walking
  • play wrestling
  • pull friend or sibling around while they are sitting on a blanket or sheet
  • fill pillowcase with toys such as stuffed animals and push/pull up a ramp or inclind
  • carry cushions to make obstacle course then put back when done
  • push chair in after meal
  • fill up small suitcase with objects such as books

Lifting/Carrying Activities:

  • carry heavy items such as groceries or weigh down some toys such as boxes in play kitchen or cardboard boxes
  • help move rocks in yard or boxes in garage/basement
  • collect objects in bucket such as rocks or toys
  • backpacks
  • stacking or moving chairs/books
  • watering can or hose

Moving:

  • jumping on a safe trampoline or other safe items such as a pile of pillows or cushions
  • rolling
  • hippity hop balls or therapy balls
  • hopscotch or jump rope
  • wash the table, windows, or car
  • playground or park for climbing and hanging activities
  • sports activities such as swimming and gymnastics
  • play “row, row, row your boat”
  • cooking activities
  • make a child “sandwich” between pillows or cushions and try to squeeze out
  • roll up in a blanket making a “hot dog”
  • use body sox or neoprene material for compression

Chewing/Sucking/Blowing:

  • eating chewy or crunchy snacks
  • drinking thickened liquids through a straw (milkshake, smoothie, applesauce)
  • drinking from a sports bottle
  • drinking from a crazy straw
  • playing instruments or noise makers such as whistles, recorders, kazoos, party horns
  • chew toys (chew sticks; chew necklaces for older children)