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What is Sensory Integration?

Every day, we receive a great deal of information from our senses which we use to organize our behavior, learn, and successfully interact in the world. Our senses give us input about the physical status of our body and the environment around us.  Sensory experiences include touch, taste, smell, sight, sound, as well as body awareness, movement and the pull of gravity.  The movement and balance system is called the vestibular sense, which gives us knowledge about our head position in relation to gravity and understanding of how we are moving in space.  This allows us to do skills like riding a bicycle or playground swing without falling off.  The muscle and joint sense, called proprioception, provides an internal awareness of the position of our joints and muscles, important for developing body awareness and motor coordination. Proprioception is that sense that makes it easy to lift a spoon to your mouth without spilling your soup. 

Our brains must organize this information so that we can function in everyday situations such as the classroom, at work, on the playground, at home, and during social interactions.  Sensory integration is this ongoing process within the nervous system of taking in and responding to sensory events. It is truly amazing that one brain can organize input from all senses simultaneously, and still come up with a response to the demands of the environment.  The complex nature of this interaction is reflected in the following example:

"Johnny, please put your coat on."

  1. Focusing your attention on the person speaking and hearing what they say.
  2. Screening out other incoming information going on around you.
  3. Seeing the coat and adequately making a plan for how to begin.
  4. Seeing the armhole openings and sensing muscle and joint position (which allows you to know where your arms are and where to put your arms in relation to the coat sleeves).
  5. With your sensitive touch awareness, you feel that the coat is on your body correctly.
  6. Adequate motor planning, touch awareness, and fine motor skills to enable you to zip or button your coat.

This example illustrates how the central nervous system is constantly focusing, screening, sorting and responding to sensory information both from the external environment and from internal receptors in order to perform purposeful activity.  Imagine the amount of sensory integration needed to sit in a chair, pay attention in an active classroom, copy an assignment or read a book!

Sensory Integrative Disorders

What happens if one or more of our senses are not being interpreted properly?  A child with vague or hazy feedback about his sense of touch, body position, or movement and gravity is in a world totally foreign to ours. Imagine yourself in a world where something as basic and reliable as the pull of gravity or other children's touch upon you is perceived as something unreliable, inconsistent, or threatening.  The child would not feel the usual security, safety and fun that other children experience.

When the process of sensory integration is disordered, a number of problems in learning, motor development or behavior may be observed:

Sensory problem                                      Signs or behavior

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.

 

 

Under reactive 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 easily

 

 

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, scissor use, tying shoes, buttoning and zipping clothes.

 

 

Poor organization of behavior

May be impulsive, distractible, lack 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 or troublesome.
   


Sensory Integration Intervention

Occupational therapists with training in sensory integration provide therapeutic activities to facilitate child-directed therapy sessions, as children learn through experience and play.  The therapist designs an environment to enable the child to interact more effectively.  Following assessment of the child's sensory systems, the therapist encourages and assists the child in choosing activities that provide the appropriate amount of sensory input and adapts the skill level in appropriate developmental increments to facilitate integration. One important aspect of therapy that uses a sensory integrative approach is that the motivation of the child plays a crucial role in the selection of the activities. 

In sensory integration intervention the therapist creates a careful balance of structure and freedom in a way that leads to constructive exploration.  This balance is not easily achieved.  Free play does not inevitably, in itself, further sensory integration.  If it did, many children with dysfunction would have solved their own problems.  But too much structure does not allow growth either.  With this balance of structure and freedom, the therapist helps the child to develop both his neural organization and his inner direction.  The child is given as much control over therapy as he can handle, with the therapist aiding and assisting to keep the activity at an appropriate challenge level.  The therapist controls the environment, while the child controls his own actions.  Self-confidence, or an improved attitude about one's self, is often the first change parents notice in their children after they have started therapy.  The child becomes more in command of his life and world because he develops better control of his body as his nervous system functions more efficiently.