Monday, August 19, 2019

Sensory Integration

sensory integrationSensory Integration is a theory of brain-behavior relationships, which occur automatically and naturally. It refers to the brain’s ability to organize the sensory information that comes from our surroundings and from our own bodies, and to utilize that information for adaptive and fulfilling interaction with the environment. The way we learn about the world is through the senses – sensory integration. Countless bits of sensory information enter our brain at every moment – from every place in our bodies. The senses consist not only of Touch, Hearing, Vision, Taste, Smell; but also the Vestibular and Proprioceptive Senses, which detect the pull of gravity and the movements of our body in relation to the earth and the space around us.

Sensory Integration – Perception
The proprioceptive system gives information about active movements of one’s own body. The input from muscles and joints enables the brain to know where each body part is and how it is moving. The vestibular System responds to the position of the head in relation to gravity and movement. Vestibular receptors are the semicircular canals, utricle and saccule of the inner ear.

Sensations come in as perception, but then the brain must organize (i.e. locate, sort and order) all of these sensations. It is not enough to simply be able to receive a sensation — we must be able to make sense of it. Hearing, for example, is the passive reception of sound. Audition or Listening is the active process that requires attention, volition, motivation, and then the brain’s ability to process and make meaning of the sound it has received.

Sensory Integration is the term we use to refer to the brain’s process of organizing the sensations for use. The streams of electrical impulses (vibrations), which are sensations, must be integrated to turn sensation into perception, and then to give them meaning.

These sensations involved in sensory integration are what Jean Ayers called “food for the brain,” and are essential for the normal, healthy development of intelligence. Sensations provide the energy and knowledge needed to direct the body and mind, but the brain must provide well-organized sensory processing in order for sensations to be digested and able to nourish the brain.

From birth to about age 7, the brain is primarily a sensory processing machine. The child mainly senses things and then moves his body in relation to those sensations. We call these the years of sensory-motor development. As we grow, mental and social responses replace some of this sensory-motor activity, however the brain’s development of mental and social functions is based upon a foundation of sensory-motor processes.

Academic abilities as well as behavior and emotional growth rest upon healthy sensory integration and a healthy sensory-motor foundation. The problems you note in your children may not just be a matter of personality — but may reflect actual physical problems in processing information — sensory integration.

A person with dysfunctional sensory-processing will not be able to receive the necessary stimulation for the brain to develop properly. He may be hearing. However, if he is overly sensitive to sound, or if he can’t make sense of the words; if he can’t selectively pay attention to communication and block out the background noise; if what he sees doesn’t coordinate with the words being used to describe it; then he will have great difficulty learning language. In the process, he may block out the distressing stimuli, and, as a result, miss the sensory-motor stimulation so necessary for proper development.

A sensory integration challenged child may be deprived of a rich sensory diet for many different reasons. It may be due to environmental factors. We see this in the case of many children who have been adopted from Eastern European orphanages. They lived amidst white walls in cribs for their early years, and received little to no stimulation. A child might have missed this “diet” for organic reasons, such as blindness or deafness. It has also been well research and shown that ear infections during the first 3 years of life affect our brain’s ability to process auditory information efficiently. AutismLearning Disabailities, and Attention Deficit Disorders are associated with hypersensitivity to sensations, and these hypersensitivities might cause a child to actually block those sensations from stimulating their brains. Some premature babies who spend time in the NICU may have been exposed to too much stimulation too soon (lights, sounds, touch) that could cause breakdowns in any of the sensory systems that impair sensory integration.

If these senses are disordered, it can actually make a child clumsy, awkward, tired easily, and hyperactive. They can become sensitive and picky (over-reactive or under-reactive) when their systems are overloaded thus disrupting sensory integration. In addition, these children may have difficulty developing speech and language.

Sensory Integraton Problems – Traffic cop/ Traffic jam
A child with good sensory integration has a nervous system that is able to sort and direct sensations into a smooth flow, like a traffic cop. The child can use this “integrated” information to form concepts, develop relationships, and otherwise adapt to the environment and enjoy and learn from it. This child can make adaptive responses – that is, their actions are purposeful responses directed to sensory stimulation.

A child with poor sensory integration is not able to direct sensorimotor “traffic” in an organized fashion. Their flow of information is like a traffic jam. And we all know the tension, anxiety and irritation that we feel when we are caught in a traffic jam!

Sensory Integraton – Modulation
Modulation is the brain’s regulation of its own activity; facilitating some neural messages to produce a greater perception or response, and inhibiting other messages in order to reduce excess or extraneous activity. This combination of facilitory and inhibitory messages is the nervous system’s process of self-organization, which is vital to learning.
In fact, most Sensory Integrative disorders in children are disorders of modulation. Consider the child who is over-reactive – he may seem unaware of your touch and then suddenly becomes reactive! We wonder “What happened to make him lose it? Change so quickly?” Well, he reached that overload point! Some children may also be under-reactive. You try to coo and make faces at your child, but he doesn’t laugh or react. In any one of the sensory systems, a person’s sensitivity may be hypersensitive, hyposensitive or mixed – he may be hypersensitive to some sound frequencies and hyposensitive to other frequencies. (see Carl Delacato – “The Ultimate Stranger”)

Sensory Integraton – Praxis
Praxis is the ability to conceive, organize and carry out a sequence of unfamiliar actions. Many people with Learning Disabilities have Dyspraxia or Motor Planning Dysfunction. You may be familiar with apraxia in association with aphasia. This is the situation when a person is physically capable of performing the action (automatically) but cannot do it on command (voluntarily). This is the same thing that happens when a person has Stage fright – you know all the lines, but as soon as you have to perform in front of that audience, you forget everything!

Obviously if a child is misbehaving or out of control not because of sensory integration dysfunction but because of a modulation disorder, or if he doesn’t do what he’s supposed to or spills his paint or papers because of a Motor Planning Dysfunction, no amount of punishment or behavior modification is going to help bring the child – or his problem – under control. We must work on the real source of the disorder.

Sensory Integraton – Indicators for Referral:

  • Sensory integration input – observe the child’s reactions to sensory input (visual, auditory, tactile, vestibular).
  • Sensory integration surroundings – observe in a variety of high stimulus settings, such as the cafeteria, gym, playground.
  • Sensory integration stimulation – appears confused or bothered by too much visual or auditory stimulation.
  • Clumsy, bumping into things, moving all the time; doesn’t like to jump or swing – or climbs too high; doesn’t recognize danger;
  • Very quiet, compliant child (under-reactive), withdrawn, avoids crowds.
  • May get carsick easily;
  • Frequent ear infections;
  • Messy eater or dislikes messy hands; dislikes certain textures.
  • Inappropriate social behavior; lack of awareness of others’ body space; flat affect.
  • Difficulty with transitions, changes.
  • Poor attending.
  • Likes enclosed spaces.
  • Covers ears or eyes, squints in bright light.
  • Frequent or violent tantrums.
  • Poor sleeper.
  • May have fine and/or gross motor deficits, but may not – you cannot rule out sensory integration deficit if fine and/or gross motor skills are okay.

Sensory Integration Evaluation – What to do?
If you have concerns about any of the above areas, Innovative Therapies can provide a Sensory Integration evaluation. To work with your child at home, our Occupational Therapist can then provide your child with a “sensory diet”.

Sensory Integration Sensory Diet
A sensory diet is a planned and scheduled activity program that includes a combination of alerting, calming, and organizing activities. It is based on the principle that certain activities will have a modulating effect on the nervous system for a limited period of time and therefore must be repeated throughout the day. Through the use of an individualized sensory diet, incorporating deep pressure touch, heavy work, and movement, a person becomes more focused, adaptive, and skillful in their daily activities.

Following a full evaluation, a child may receive clinic-based therapy. However, if a child cannot come in to the clinic regularly and/or for families who are overseas or live long distances from the clinic, we can evaluate a child via interviews, videotape and a variety of sensory questionnaires.

After this evaluation, a home Sensory Integration Sensory Diet is devised that can be carried out at home. Of course the school needs to cooperate as well, since many of these activities need to be performed several times throughout the day for short periods of time. Parents then send regular weekly reports for about a month. Depending upon the child’s responses and the progress of the program, you may be asked to continue to send weekly reports for awhile, then bimonthly, then monthly. The program usually continues for at least 3 to 6 months.