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The treatment concepts related
to sensory integration come from a body of work developed by A. Jean Ayres,
PhD, OTR in the 1950s and 1960s. As an occupational therapist, Dr. Ayres
was interested in the way in which sensory processing and motor planning
disorders interfere with daily life function and learning. This theory
has been developed and refined by the research of Dr. Ayres, as well as
other occupational and physical therapists. In addition, literature from
the fields of neuropsychology, neurology, physiology, child development,
and psychology has contributed to theory development and intervention
At Memorial Hospital's Outpatient
Therapy Clinic, an occupational therapist who has had numerous hours of
training in the theory and assessment of sensory integration disorders,
will perform the evaluation.
Contact: Danielle Banks,
Outpatient Therapy Clinic
What is Sensory Integration?
Signs of Sensory Integrative Dysfunction
Summary of Points
is Sensory Integration?
Our senses give us the information
we need to function in the world. The senses receive information from
stimuli both outside and inside our bodies. The five senses of hearing,
seeing, taste, smell and touch respond to external stimuli that come from
outside our bodies. The vestibular, proprioceptive, and tactile senses
are the three body-centered sensory systems that provide the sense of
oneself in the world. To do their job well Ð so that we respond appropriately,
the senses must work together. Together, they provide a well balanced
diet for the brain. A brain that is nourished with many sensations operates
well, and when our brain operates smoothly, so do we.
Sensory integration is the
neurological process of organizing the information we get from our bodies
and from the world around us for use in daily life. Sensory integration
provides a crucial foundation for later more complex learning and behavior.
For most children, sensory integration develops in the course of ordinary
childhood activities. The organization of behavior, learning and performance
is a natural outcome of the process, as is the ability to adapt to incoming
sensations. But for some children, sensory integration does not develop
as efficiently as it should. When the process is disorder, a number of
problems in learning, development, or behavior may become evident to families
Sensory integration dysfunction
is a problem in processing sensations which causes difficulties in daily
life. Sensory integration dysfunction is a complex neurological disorder,
manifested by difficulty detecting, modulating, discriminating or integrating
sensation adaptively. This causes children to process sensation from the
environment or from their bodies in an inaccurate way, resulting in "sensory
seeking" or "sensory avoiding" patterns or "dyspraxia",
a motor planning problem. Carol Stock Kranowitz states the sensory integration
dysfunction may affect 12% to 17% of children and throws some kids "out
of sync" emotionally, socially, and behaviorally.
of Sensory Integrative Dysfunction
When the process of Sensory
Integration is disordered, a number of problems in learning, motor development
or behavior may be observed:
- Overly sensitive to touch,
movements, sights, or sounds. Behavior issues: distractible, withdrawal
when touched, avoidance of textures, certain clothes, and foods. Fearful
reactions to ordinary movement activities such as playground play. Sensitive
to loud noises. May act out aggressively with unexpected sensory input.
- Underreactive to sensory
stimulation. Seeks out intense sensory experiences such as body
whirling, falling and crashing into objects. May appear oblivious to
pain or to body position. May fluctuate between under and over-responsiveness.
- Unusually high/low activity
level. Constantly on the move or may be slow to get going, and fatigue
- Coordination problems.
May have poor balance, may have great difficulty learning a new task
that requires motor coordination, appears awkward, stiff, or clumsy.
- Delays in academic achievement
or activities of daily living. May have problems in academic areas,
despite normal or above normal intelligence. Problems with handwriting,
scissors use, tying shoes, buttoning and zipping clothes.
- Poor organization of
behavior. May be impulsive, distractible, lack of planning in approach
to tasks, does not anticipate result of actions. May have difficulty
adjusting to a new situation or following directions. May get frustrated,
aggressive, or withdraw when they encounter failure.
- Poor self concept.
May appear lazy, bored, or unmotivated. May avoid tasks and appear stubborn
Our assessments are designed
to answer some of the questions families have as they seek to provide
and advocate for the child's special needs at home, in school and in the
community. For many families, the initial assessment is the first step
toward understanding the learning and behavior difficulties their children
are experiencing. Assessments are individualized and may be a combination
of standardized tests and functional observations of performance in a
variety of activities. An interview with family members helps us understand
how the child perceives and responds to sensation and what the child and
family already know about what works and doesn't work to support or compromise
activities of daily living. This information is most valuable in determining
the child's abilities in sensory processing and sensory integration. The
assessment process also includes trying some intervention strategies to
determine whether treatment is warranted or not and what activities might
be immediately implemented.
Treatment services are varied
and designed to address individual needs of children of all ages. Our
philosophy is to support what the child already knows about the way their
system processes and uses sensation and activity to interact with their
environment. The sensory integration approach is rich in vestibular, proprioceptive,
and tactile inputs; areas where many children with neurological issues
have deficits. The approach seeks to encourage the nervous system to process
and integrate sensory input in organized and meaningful ways, which will
ultimately enhance the ability of the nervous system to function more
adequately. Each adaptive response, as it provides feedback into the nervous
system, encourages maturation and organization of the nervous system at
increasingly higher levels. Ultimately the individual is able to interact
with his/her environment in more successful and adaptive manners.
FOR MORE INFORMATION:
Contact: Danielle Banks,
Outpatient Therapy Clinic
- A Parent's Guide to Understanding Sensory Integration (1991)
Torrance, CA, Sensory Integration International
- Anderson, E. and Emmons, P. (1996). Unlocking the mysteries of
sensory integration. Arlington, TX: Future Horizons.
- Ayres, A.J. (1979) Sensory Integration and the Child. Los Angeles,
CA. Western Psychological Services.
- Fisher, A.G. & Murray, E.A. (1991). Sensory integrative theory
and practice. Philadelphia, PA: F.A. Davis.
- Greenspan, S.I. (1995). The challenging Child. New York, NY.
- Greenspan, S.I. & Wieder, S. (1998). The child with special needs.
Encouraging intellectual and emotional growth. MA. Amerloyd Lawrence
Book, Addison- Wesley.
- Kranowitz, C.S. (1998). The out-of-synch child: Recognizing and
coping with sensory integration dysfunction. New York: A Perigree
- Quirk, N.J. & Dimatties, M.E. (1990). The relationship of learning
problems and classroom performance to sensory integration. Cherry
Hill, N.J.N. Quirk & M. DiMatties.
- Trott, M.C., Laurel, M.D. and Windeck, S.L. (1993). Senseabilities:
Understanding sensory integration. Tuscon: Therapy Skillbuilders
To Top Of Page
1. Sensory integration is the
organization of sensations for use.
2. Sensory information is constantly entering your brain from all 7 of
your senses. The sensory systems are inter-related.
3. A strong basis in sensory integration enhances development of higher
level gross and fine motor skills. It also contributes to better self-esteem,
self control and improved attention span.
4. Sensory integration therapy provides controlled sensory input with
the goal being increased adaptive behaviors/responses.
5. Behaviors are in many cases involuntary and are reactions to the child's
internal and external environments and their inability or attempt to sort
out this information.
6. There is no cookbook recipe for intervention. Each child is unique
in strengths, interests, deficits and degrees to which deficits manifest
7. SI is one treatment approach amongst many. Different treatment approaches
address different deficit areas and different needs.
8. SI is not a profession. It is a treatment approach used by occupational
and physical therapists who have special training in assessment and treatment
of sensory processing disorders.
9. Sensory stimulative programs and SI therapy are two very different