Sensory integration

Sensory integration IQ Academy - education, support, development - Iwona Pikora

Sensory integration - what is it?

Method of sensory integration (abbreviation: SI) was established in the 70’s of 20th century in the USA. Its author is J. Ayres, a doctor of psychology, occupational therapist, a research fellow at the University in California, who showed a relationship between neurophysiological functions and learning and behavioural processes. For this purpose, she construed research tools (tests) and commenced a range of tests which proved posed working hypotheses. Thus, J. Ayres distinguished factors, measured with tests, which occur in children with neural system dysfunctions. The author called them disorders (deficits) of sensory integration and defined their interdependence with muscle tension, planning motion, eyeballs movement, behaviour, development of speech and cognitive functions. The method of sensory integration is, therefore, based on neurophysiology and supported with many years of tests conducted by J. Ayres and her continuators in the USA and countries in West Europe. The sensory integration (SI) method reached Poland in 1993.
The Sensory integration (SI) is a method of learning through senses. We develop and learn by stimuli which reach our body with our sensory organs. Senses provide information on physical condition of our body and our environment. They are not only five most known senses (eyesight, touch, hearing, taste and olfaction), but also sense of proprioception (in other words, deep sensation - sense informing the brain about the body location and its movements) as well as vestibular system (sense of balance). The sensory integration starts in the first weeks and moths of foetal life and has its most intensive course between the 3 years of life and first classes of primary school, but it is also possible and successfully applied as therapy for older children.
In SI, the basic senses are:
  • Touch
  • Vestibular system (sense of balance)
  • Proprioception (sense of body, deep sensation)

The sensory integration is a neuronal process which takes place in the nervous system of each human. It consists in collection of sensory information and their integration for purposeful functioning. To understand the sensory integration processes and connect them with skills and behaviours of child is an enormous challenge for each SI therapist. The sensory integration processes with normal course are bases of motor, reading, writing skills and speech. In many children, both those within an intellectual norm and children with abnormal development, deficits (disorders, dysfunctions) of sensory integration can be observed. They are visible both in the motor field (clumsiness, problems with movement coordination, difficulties with balance maintenance, avoiding motor activities, difficulties with self-maintenance activities) as well as in the tactile field (intolerance of touch of other persons, foods, reluctance to manipulate with objects) or in the auditory field (intolerance of sounds, auditory hypersensitivity, delayed speech development). Children in whom the aforementioned symptoms occur can have difficulties in school education and, most of all, in everyday functioning.
Sensory integration as a method successfully used at work with children developing normally as well as in children with developmental disorders. However, it must be clearly highlighted that the method of sensory integration is not a substitute of integration and, particularly, in relation to children with developmental disorders, it constitutes an supplementary method. Classes conducted with this method are in the form of play (this method is called a method of scientific play) during which a child learns while playing (exercising) with the use of specialist equipment. Nevertheless, it is a well-planned time, directed at providing stimuli in a specified manner.

SI therapy is also used in work with children with:

  • autism;
  • Asperger’s syndrome;
  • intellectual disability;
  • cerebral palsy;
  • Down’s syndrome;
  • other conjugated disorders;
  • risk groups: premature infants, children upon perinatal injuries;
  • delayed speech development, with a stutter:
  • with dyslexia, dysgraphia and dysorthographia
  • hyperactive and with emotional disorders, including children with ADHD

Application of self-regulation in neonates

One of the many threats connected with early period of child’s life are self-regulation disorders  (regulation disorders, sensory modulation disorders). They are included in theClassification of neonatal and infantile disorders DC: 0-3 R. Regulation disorders are included in the field of incorrect modulation of behavioural conditions. 
Modulation is a process consisting in inhibition or enhancement of neuronal activity so that it is consistent with other functions of the nervous system. Children with modulation disorders have serious problems in everyday functioning. Their reactions can be either very strongly expressed or absent in case of relatively strong stimuli.
Regulation disorders concern the child difficulties in regulating their own emotions and behaviours as well as motor functions in response to sensory stimulation which consists of tactile visual, auditory, olfactory sensations as well as sense of movement or awareness of their own body in space. These difficulties impact everyday functioning and general child development and manifest themselves in different situational contexts.
Self-regulation disorders manifest themselves in child difficulties in regulating emotions and behaviours (including motor ones) in response to sensory stimulation which is understood as tactile visual, auditory, olfactory sensations as well as sense of movement or awareness of their own body in space. Each child differently reacts to stimuli from environment, but there are such children who have a clear problem in regulating their relations with the world. Incorrect regulatory patterns impact the total child functioning and manifest themselves in different situational contexts. They interfere with social, emotional development, motor skills (postural reactions, muscle tension, motor planning), behavioural reactions (irritability, tearfulness, concentration problems) and limit participation in differentiated activity.

Symptoms of sensory integration disorders (dysfunctions)

Incorrect sensory integration manifests itself in so-called dysfunctions, that is, disorders. They are visible when the nervous system incorrectly organises the sensory stimuli. Dysfunctions are not connected with damage of sensory organs, e.g. hearing or myopia. Of course, if there are symptoms concerning the efficiency of particular analysers, it is necessary to consult a doctor. Sensory integration dysfunctions concerns the abnormalities in the scope of processing sensory stimuli within the following systems: sensory (tactile and proprioceptive), ventricular, hearing, visual, olfactory and taste. The symptoms of sensory integration dysfunction most often manifest in: 

  1. Increased or decreased sensitivity to stimuli,
  2. Incorrect level of balance,
  3. Decreased level of movement coordination,
  4. Delayed speech development,
  5. Incorrect level of motor activity,
  6. Behavioural difficulties. 

These dysfunctions can be diagnosed in children who are within the intellectual norm, but have difficulties with learning, in children with intellectual, motor disability, autism, psychomotor hyperactivity, cerebral palsy. Their intensity may differ from mild to significant. The sensory integration dysfunctions impact learning and social-emotional child development. 

The selected symptoms of sensory integration dysfunction:

  1. A child is anxious, tearful, has problems with falling asleep,
  2. A child has difficulties with independent drinking, chewing and swallowing meals (prefers pulpy meals),
  3. A child poorly tolerates performance nursing and hygienic activities towards him, such as: cutting hair, nails, washing face, teeth, cream application, combing, cleaning nose, ears, etc.
  4. A child performs many self-maintenance activities with difficulty, slowly, in a clumsy manner,
  5. A child has difficulties with independent washing themselves, dressing up, especially, fastening buttons and tying shoelaces,
  6. A child has a poor sense of balance: trips and falls more often than peers, almost often has a bruise or scratch,
  7. During longer period of sitting down, a child has difficulties with holding their head in the vertical position, supports it with a hand, lays it down on the table, etc.
  8. A child is hyperactive, cannot sit/stand in one place,
  9. A child has concentration difficulties, easily gets distracted,
  10. A child is impulsive, emotionally hypersensitive, often gets offended,
  11. A child tends to be stubborn,
  12. In comparison with other children or situational requirements, a child moves too fast or too slow,
  13. Acquisition of new motor skills constitutes a significant difficultly, e.g. riding a bike, throwing and catching a ball, swimming,
  14. Going up/down the stairs, holds the rail, makes their steps in the uncertain manner more often than other children,
  15. A child unintentionally climbs or hits furniture, walls, other children,
  16. A child holds incorrectly or even strangely different objects of everyday use, e.g. scissors, cutlery or writing devices,
  17. A child avoids fooling around with parents or siblings,
  18. A child loves motion, looks for it, pursues it. A child is constantly in motion - runs, jumps, often changes body position,
  19. A child shows significant fear of falling down or heights, manifests anxiety when has to detach feet from the floor, e.g. go up high stairs, ladder, sit on a high chair,
  20. In a new place, a child feels lost, needs a lot of time to achieve orientation in space,
  21. A child often mistakes the left and right side within the scope of their own body and in the surrounding space, during team games, it can happen that they run in the other direction than their team, in the other direction than the ball which they are supposed to catch, a child is disoriented, has poor sense of distance,
  22. A child does not have one hand-dominancy,
  23. A child has difficulties with reading and writing, make more mistakes more often than other children at his age,
  24. A child reverses graphical signs, has difficulties in rewriting, redrawing from the board,
  25. A child has difficulties in using scissors, tracing, calking, etc.
  26. A child seems to be weak, gets tired quickly,
  27. A child does not like a merry-go-round, swing, or just the opposite - loves it,
  28. Poor motor efficiency - avoiding motor or efficiency games, plays,
  29. Hypersensitivity to touch, sound, movement, smells,
  30. A child often mistakes directions as well as right and left side of the body,
  31. Children at so-called risk of dyslexia
  32. Dyslexia, dysgraphia, dysgraphia
  33. ADHD

Symptoms of self-regulation disorders in children from 0 to 3 years of life

In children from 0 to 3 years old, self-regulations are diagnosed on the basis of Diagnostic classification of mental health and development disorders of infancy and early childhood: 0-3 R (DC:0-3R Diagnostic Classification of Mental Health And Development Disorders Of Infancy and Early Childhood - Revised Edition). DC classification: 0-3 R is a set of all (for the present moment) development threats which can occur in the early period of child’s life, i.e. from birth till 3 year of life. Self-regulation disorders manifest themselves in child difficulties in regulating emotions and behaviours (including motor ones) in response to sensory stimulation which is understood as tactile visual, auditory, olfactory sensations as well as sense of movement or awareness of their own body in space. Each child differently reacts to stimuli from environment, but there are such children who have a clear problem in regulating their relations with the world. Incorrect regulatory patterns impact the total child functioning and manifest themselves in different situational contexts. They interfere with social, emotional development, motor skills and limit participation in differentiated activity.
How can you perceive abnormalities in the development of sensory integration? It is necessary to observe:
  • child’s motor development,
  • reactions to stimuli surrounding a child, e.g. toys, cloth textures, food, music,
  • activity,
  • attention,
  • speech development.
Diagnosis of sensory integration processes
The start of the therapy of sensory integration (SI) is preceded with a thorough child diagnosis based on standardised techniques. On the basis of the conducted examination with the use of tests, scales and clinical observations, individual therapy plans are prepared. Parents also receive therapeutical guidelines which they should implement at home.
Diagnostic process in the therapy of sensory integration contains a few stages and consists in conducting:
  • a talk with parents the components of which are, e.g. periods of prenatal development (foetal), perinatal (around delivery) and postnatal (upon birth), period of achievement of “mile stones” in the field of motor, cognitive development and speech development, health condition,
  • The Southern California Sensory Integration Tests (SCSIT) which evaluate, e.g. planning movement, oral apraxia, differentiation of tactile sensations, motor imitation, balance, visual-motor coordination.
  • Samples from the clinical observations evaluating, e.g. lateralisation, reflexes, muscle tension, eyeball functions, level of excitement of ventricular system, - additional tests with the use of observation scales.
    A therapist, however, has a wide range of research tools allowing for diagnosis of abnormalities in the development of sensory integration of Your child and establishment of a therapeutic program.
SI therapy consists in activity and motor exercise stimulating the aforementioned sensory systems. The Integration Sensory therapy is usually a pleasure for a child. The therapeutical environment is equipped in a differentiated devices, such as:
  • slides,
  • swinging platforms,
  • climbing lines,
  • circles for jumping in,
  • swinging trapezoids.

A therapy is a play for a child and it can look like this to adults. However, at the same time, it is hard work since a child, guided by a qualified therapist, can achieve success which probably would not be possible in a totally spontaneous play. It is a fact that many children with Sensory Integration problems cannot play effectively and in the organised manner without help. During a therapy, a child is encouraged and guided to perform activities the aim of which is to release and trigger appropriate, effective responses to sensory stimuli. During classes, activities appropriate for a child are performed, providing vestibular, proprioceptive and tactile stimulation. The level of difficulty of these activities is gradually increased so that more organised, advanced reactions are required from a child. Directed plays and activities freely performed by children, triggering automatic sensory reactions rather than particular instructed, imposed and practised reactions to stimuli are preferred in therapy.