What is Sensory Integration?

Sensory integration is a term that refers to the way the nervous system receives messages from the environment through the senses and turns them into appropriate motor and behavioural responses. Sensory integration is a framework ?rst described by occupational therapist A. Jean Ayres, PhD, in 1970s.

Sensory input are received and perceived through sights, sounds, touch, tastes, smells, movement and muscle and joints. For most of us, sensory integration occurs without conscious thought or effort.

What is Sensory Processing Disorder (SPD)?

Sensory Processing Disorder (formerly known as “sensory integration dysfunction”) may influence one, some, or all of the physical senses. One defective sense influences several different bodily functions. If one or more senses are disturbed, the sensory messages sent to the brain are incorrect. These messages become disarranged, causing the individual afflicted to perceive their environment in a different way.

Research study suggests that, SPD may be as high as 90% in individuals with Autism spectrum Disorder (Baranek et al., 2006; Leekam et al.,2007; Tomchek and Dunn, 2007; Baker et al., 2008) and at least 5% to 16% in the general population(Ahn et al., 2004; Ben-Sasson et al, 2009).

What are the Sign and Symptom of SPD?

Symptoms of SPD, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children and adults with SPD, these difficulties are chronic, and they disrupt everyday life. People with SPD experience their world as either Hypersensitive (over reactive, sensory avoidance) or Hyposensitive (under reactive, sensory seeker). They may also present with motor skill and emotional behaviours problems.

• Hypersensitive to touch, movement, sights, or sounds

• Hyposensitive to touch, movement, sights, or sounds* Impulsive, lacking in self-control

• Difficulty making transitions from one situation to another

• Inability to calm self

• Easily distracted

• Activity level that is unusually high or unusually low

• Physical clumsiness

How SPD related to Autism?

SPD are related to autism because they are common in children and adults on the autism spectrum, though most children with SPD are not on the spectrum. A recent meta-analysis of the sensory modulation literature in autism found support for the universality of these symptoms across the diagnostic spectrum (Ben-Sasson et al. 2009).

Individual with autism often have difficulty organizing, understanding and interpreting sensory information. They may not know when they are hungry or in pain, or have difficulties to interpret the touch input. Light and sounds may be overwhelming for some, while others may have a strong drive for movement activities such as jumping or spinning. Unusual reactions to sensation, unique and increased sensory needs, are often associated with unusual behaviors in children with autism. In addition, children with autism trouble knowing how to form ideas and plan actions, which is important in the development of a child. Sensory differences and difficulties in motor planning can interfere with all aspects of life and are often misunderstood behaviour problems in children with autism.

How to detect sensory processing disorder?

A health professional, often an occupational therapist can assess an individual’s response to sensory information from the body and the environment using standardized and non-standardized tests, clinical observation, and caregiver or teacher interviews.

What is the intervention for SPD?

Sensory integration therapy (SIT) is designed to restore effective neurological processing by enhancing each of the systems it focuses on activities that challenge the child just right sensory input. The therapist then helps the child to respond appropriately to this sensory stimulus. During therapy session, occupational therapist will usually provide activities that rich in tactile (touch), Proprioceptive (joint and muscle sense) and vestibular (movement sense) sensation as primary sensory input.

Sensory integration therapy should be child-directed, playful, and pleasant for the child. It is directed one to one to the child, in an environment providing a variety of sensory opportunities adhering to Sensory Integration fidelity tool (Parham 2007).

Source: pediatricrehabilitationmedicine.wordpress.com

General Points:

• Younger children respond better than older children.

• Sensory integration therapy provides a stimulus to the brain’s development & the momentum often continues for some time after the therapy ends.

• We cannot totally alleviate the SPD but the child usually improves to some extent.

• Sometimes, for the first few sessions, children may be unusually aware, excited or energetic after therapy.

• Often other treatment approaches are used together with sensory integration therapy or after it has provided the initial stimulus.

• After therapy, the child will become more aware of the environmental demands and will respond more positively and appropriately to it. It is then hypothesised that the child’s brain begins to allow the child to learn more effectively.

• When a sensory integrative approach is successful, a child is then able to automatically process complex sensory information in a more effective manner than previously. An improvement in motor organisation may become apparent by the child’s ability to perform gross & fine motor tasks with greater skill & at a higher level of complexity.

• For the child who initially presented with behaviour problems related to under & over responsiveness to sensory stimulation, a more normal response may lead to better emotional adjustment, improved interactive social skills or greater self-confidence.  Some children will demonstrate gains in language development while others will improve significantly in their attention control & learning as the brain begins to function more effectively.

  Source: Jabatan Pemulihan Carakerja Hospital Kuala Lumpur

The effectiveness of SIT can be identified through Goal Attainment scaling (Miller 2007) based on below areas:

• functional behavior

• motor skills

• attention

• cognitive skills

• social skills

• self-harming

• self-stimulation

For further information Kindly contact your occupational therapist.

References

1. Ahn R. R., Miller L. J., Milberger S., McIntosh D. N. (2004). Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. Am. J. Occup. Ther. 58, 287–302.

2. Ayres AJ. Sensory Integration and the Child. Los Angeles, CA: Western Psychological Services; 1979

3. Ben-Sasson A., Carter A. S., Briggs-Gowan M. J. (2009). Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. J. Abnorm. Child. Psychol. 5, 705–716.10.1007/s10802-008-9295-8

4. Baranek G. T., David F. J., Poe M. D., Stone W. L., Watson L. R. (2006). Sensory experiences questionnaire: discriminating sensory features in young children with autism, developmental delays, and typical development. J. Child Psychol. Psychiatry

5. Leekam S. R., Libby S. J., Wing L., Gould J. (2007). Describing the sensory abnormalities of children and adults with autism. J. Autism Dev. Disord. 37, 894–910.10.1007/s10803-006-0218-7

6. Tomchek S. D., Dunn W. (2007). Sensory processing in children with and without autism: a comparative study using the short sensory profile. Am. J. Occup. Ther. 61, 190–200.