Sensory Integration

Sensory Integration and Occupational Therapy-

Sensory integration therapy is an integral part of occupational therapy. Occupational therapist practices, sensory integration (SI) mostly in the pediatric population. Sensory integration is nothing but a developmental process, which everyone goes through.

Overview-

The theory of sensory integration was developed by A. Jean Ayres (Ayres 1972, 1979, 1989). She was an occupational therapist. The theory of sensory integration assumes the adequate processing and integration of sensory information is an important foundation for adaptive behavior.

Ayres believed that sensory integration provides an important function for engagement in meaningful, health-promoting activities that support participation in life. Occupational therapy using sensory integration is designed to improve sensory processing and integration as a basis for enhancing successful participation in daily occupations (Parham & Maillowx, 2001).

What is sensory integration?

Sensory integration is the normal neurological process of organizing sensation for effective response in our daily life. We use sensation to survive, to satisfy our needs, to learn, and to function normally.

Sensory integration is a normal procedure in which our brain receives sensory information from our bodies and surrounding environment, interpret these sensory information, and organize or “integrate” our purposeful responses.

This integration allows us to respond automatically, efficiently, and comfortably in response to the specific sensory input we receive.

The Basics of Sensory processing/ sensory integration-

What is Sensory Input?

Stimuli we receive from the sensory organs is the sensory input. This input (movement, pressure, touch, vision, hearing, taste, and smell)   goes to brainstem mostly via the cranial nerves. All sensory input needs to be registered for integration.

The Senses-

The development of sensory system begins in the womb and continues throughout our lives. The development of those senses is more in the early childhood that’s why this phase is called as sensory-motor years.

The child starts to refine those sensory processing through childhood activities. We know the most common senses (vision, hearing, smell, taste, and touch), but there are some more vital senses are present in our body. i.e vestibular and proprioceptive senses.

1. The Tactile sense- which provides sensory information through the surface of our skin. It helps us to know the texture, shape, and size of an object or surface. It also helps us to distinguish between two surfaces.
2. The Vestibular sense– which provides sensory information about the balance and movement. The vestibular sense organ is present in the inner ear and helps us to know the position of our body in space.
3. The Proprioceptive sense- which provides information through our muscles and joints. It helps us to know the movement of joints, whether its flexing or extending.

What is Sensory registration?

It occurs when the sensory input registered in the nervous system.  After the successful registration of input, the next process is sensory processing or integration.

Now, what is sensory processing?

Sensory integration, which is basic to sensory perception, is the ability to organize (or integrate) sensory information (or input) at the brainstem level. We perceive and learn through our senses, and sensory input precedes a motor output. Sensory integration affects the efficiency of higher center function after the sensory information has been processed. There is more efficient brain output when both hemispheres work together.

What are the results of successful sensory integration?

Sensory integration is a normal developmental process help us to achieve mastery in many areas of development. As a result of typical sensory processing, we learn to self-regulate, self-control, motor skills, and higher level cognitive functions like attention, memory.

Sensory Integration is important for these everyday functions:

• Academic skills
• Hand Preference
• Attention
• Healthy relationships with others
• Auditory discrimination
• Balance
• Muscle tone
• Bilateral coordination
• Postural stability
• Body awareness
• Praxis, including motor planning
• Body position
• Emotional security
• Self-esteem
• Eye-hand coordination
• Self-regulation
• Fine motor skills
• Social skills
• Speech and language skills
• Force, or grading of movement
• Tactile discrimination
• Gravitational security
• Gross motor skills
• Visual discrimination

Difficulty in these areas may be caused by Sensory Processing Disorder.

What is Sensory Processing Disorder (SPD)?

Sensory processing disorder (SPD), previously called Sensory Integration Dysfunction (SID), occurs when the brain is unable to process the sensory information coming from the body or from the environment efficiently.

It happens when the brain is not receiving inputs, or the inputs that are received are inconsistent, or the sensory information is consistent but does not integrate properly with the nervous system.

 Sensory processing disorder’s symptoms and problems may vary from person to person. SPD may coexist with attention deficit hyperactive disorder, Asperger syndrome, autism, cerebral palsy, down syndrome, etc.

The child who avoids ordinary sensations or seeks excessive stimulation, whose behavior is uncontrollable, whose body is uncooperative, he/she comes under the category of sensory processing disturbance.

 They also get a similar kind of sensation from the environment, but they are unable to process it and give no response or a different response as compared to normal kids.

The sensory processing disorder is further divided into –

1. Sensory Modulation Dysfunction (over-responsive or under-responsive to the stimuli).
2. Sensory Discrimination Dysfunction (difficulty in differentiating between 2 or more stimuli).
3. Postural Disorder (problem with movement pattern)

What is Sensory Integration Therapy?

Occupational therapist frequently uses sensory integration therapy as an OT intervention. When SPD gets in a child’s way, sensory Integration based occupational therapy (“OT/SI”) is highly recommended. Sensory integration therapist or pediatric occupational therapist assesses the sensory and motor component of the child and plan intervention accordingly.

Sensory integration therapy is a technique which uses different sensory strategies to improve the sensory registration and processing and to overcome the sensory problems.

In sensory integration (SI) therapy, the kid (with SPD) is guided through the activities that challenge his/her ability to respond appropriately to sensory input by making a successful, organized response. SI therapy includes vestibular, proprioceptive, and tactile activities that are designed to meet the child’s specific needs for development.

SI therapists are more focused on the automatic sensory processes in the goal-directed activity, rather than instructing the child on how to respond.

SI therapy encourages the child to be an active participant during an activity, it enables the child to become more mature, efficient organizer of sensory information.

SI therapy includes different activities which are rich in sensory-motor, age-appropriate, fun and easy.

The sensory integration therapy uses different activities, these are-

• Vestibular activities
• Proprioceptive Activities
• Tactile Activities.

These activities can be a part of sensory diet.

Read More- What is Sensory diet?

Sensory Integration therapy is a FUN!

An Occupational therapist using sensory integrative procedures always provides fun for the child. The SI therapy room is full of appealing equipment: ramps to slide down, platforms to swing on, bolsters to climb over, inner tubes to jump into, trapezes to swing from.

For the child, therapy is play and may look like play to the adult observer as well. But it is also important to work under the guidance of a trained professional, the child is able to achieve successes that probably would not occur in unguided play. In fact, many children with sensory integrative disorders are unable to play productively in an organized manner without special help.

Creating a playful atmosphere during therapy is not done just for fun. It is advantageous because the child is more likely to be highly interested in the activities, and thus is more likely to benefit from time spent in therapy than a child who is disinterested or disengaged.

What to expect from the Sensory integration therapy?

When the sensory integration therapy is successful, the child is able to automatically process complex sensory information in a more effective manner than previously.

The child who previously exhibited the problem of over or under-responsiveness to sensory stimulation may improve after sensory integration therapy. The child may show better emotional adjustment, and improved personal-social skills. Some may show improvement in language or daily routine tasks.

Nowadays, sensory integration is also provided in the school set up to improve social behavior, academic problems, self-discipline, and gross motor skills and fine motor skills.

References –

1. Ottenbacher, Kenneth. “Sensory integration therapy: Affect or effect.” American Journal of Occupational Therapy 36.9 (1982): 571-578.
2. Case-Smith, Jane, and Teresa Bryan. “The effects of occupational therapy with sensory integration emphasis on preschool-age children with autism.” American Journal of Occupational Therapy 53.5 (1999): 489-497.
3. Cohn, Ellen S. “Parent perspectives of occupational therapy using a sensory integration approach.” American Journal of Occupational Therapy 55.3 (2001): 285-294.
4. Watling, Renee L., and Jean Dietz. “Immediate effect of Ayres’s sensory integration–based occupational therapy intervention on children with autism spectrum disorders.” American Journal of Occupational Therapy 61.5 (2007): 574-583.
5. Sue Larkey. Practical sensory programmes- for students with autism spectrums disorders. 2007.1st Ed. Jessika Kingsley Publishers.
6. Carol Stock Kranowitz. The Out of sync child has fun- activities for kids with a sensory processing disorder. 2003. Revised Ed. Penguin Books Ltd.