P A R E N T  t o  P A R E N T

Sensory Integrative Dysfunction

A pediatric neurologist explains this more fully:

Imagine you are sitting in a stiff back chair (uncomfortable) trying to read a book (concentrating) but there are huge speakers on each side of your head booming loud music (auditory overload) and a bucket of bleach sitting at your feet (smell overload) and you were simultaneously trying to watch your favorite TV program....you would literally be completely sensory overloaded...you would not be able to recall the words you were reading, the conversations etc. on the TV you were watching ...right? This would be extremely frustrating if you couldn't get away from the speakers, the bleach or the stiff chair no matter how hard you struggled. More or less a low sensory threshold issue is the same for these kids, and ADHD just complicates it because they literally pay attention to all of these things to the same high degree (attention deficit ... cannot ignore anything) and how would you react to such over stimulation with no route of escape...your body would do it even if you didn't....you would physically try to destroy the thing compromising your thought.

Signs of Sensory Integrative Dysfunction
What can I do in my family to help my child?
What is sensory integration?
Who has problems with sensory integration?
Minnesota: Help with Sensory Integration Issues
What steps can be taken?
Where can I learn more?
Books for parents to read
Products available to make life easier for you and your child.

FUN with SI Kids:
Finger Plays to encourage touch

What are some signs of Sensory Integrative Dysfunction?

Hypersensitive (overly-sensitive)
 to touch, sound, smell, movement,  and/or visual stimuli

Hyposensitive (under-sensitive)  
to these same types of stimuli

Hypersensitive to some types of stimuli  
and Hyposensitive to others

  • Overly sensitive to touch, movement, sights, or sounds
  • Under reactive to touch, movement, sights, or sounds
  • Easily distracted
  • Social and/or emotional problems
  • Activity level that is unusually high or unusually low
  • Physical clumsiness or apparent carelessness
  • Impulsive, lacking in self control
  • Difficulty making transitions from one situation to another
  • Inability to unwind or calm self
  • Poor self concept
  • Delays in speech, language, or motor skills
  • Delays in academic achievement
  • Loves to spin, swing and jump--this will seem to calm them down after several minutes.
  • Complains of how clothing feels, do not like tags left in their clothing and have to have their socks on just so or a certain kind of sock.
  • Picky eaters--get stuck on one certain food and is basically impossible to get them to eat anything else.
  • Over sensitivity to smells. Or under sensitivity--may sniff people, objects, food.
  • Over sensitivity to sounds--will frequently cover ears. Or under sensitivity.
  • May have an exceptionally high pain tolerance
  • May tire easily
  • Unusually high or low activity level
  • Resists new situations
  • Problems with muscle tone, coordination, motor planning
  • Can be very impulsive or distractible.
  • Persistently walks on toes to avoid sensory input from the bottom of the feet.

Sensory seekers are children who are always on the go with a short attention span and will often respond positively to increased sensory input in repetitive activities, which work muscles (muscle resistance/heavy work) -- this helps children focus their attention and actions.

Sensory avoiders are children who react deeply, are sensitive or distressed by everyday sounds like vacuum cleaners, blenders, being touched lightly, tickling, lights in the room, sunlight, but find others enjoyable like bear hugs, sleeping under quilts or massage.

An occupational therapist can help you 
understand how to help your child more fully.

What can I do in my family to help my child

One thing you will learn is that what works for most kids does not work when your child has an SI disability. Most tactics that are used are behavioral. Which is fine if it is behavior you want to change. This isn't behavior. This is an inability to do something.  Would you punish a child who needed glasses for not being able to see the blackboard. No you would provide the glasses and allow the child to move up close to the black board (make the environmental changes necessary).

You must remember that each child with SI is different, but here are some things families have done to help their children cope with SI issues. Remember quiet spaces are for regrouping and calming, not for punishment.

  • Reduce distractions if child is easily over stimulated
    • Provide quiet place for the child who gets too wound up to go . When you see the child getting excited say "you know, it looks like you could use a quiet place now, you look a little excited." 
      • Bean bag under a table with a blanket over it works well, with blanket, pillow, stuffed animal, dimmer lighting and soft music or whatever the child finds calms them.
      • Behind the couch or under a bed
      • In the persons' room or private place
      • A large box
      • Use your imagination
    • Make a sandwich with couch cushions and apply pressure (harder or softer) based on what the child says.
    • Roll into a cocoon or jelly roll with blankets
    • Practice slow movement finger plays. See Finger Plays
    • Warm bath or hot tub
    • Sound blocking headphones
    • Tree house or garden place
  • Encourage appropriate social behavior through non-conventional strategies
    • Drink from a straw use a covered glass or bottle
    • Have the child get up and get whatever someone forgot to put on the dinner table allowing a break from sitting still
    • Use a weighted lap blanket to help child remain seated for a longer time
  • Provide a variety of movement experiences
    • Provide indoor movement opportunities
      • have child push the shopping cart, carry groceries help put them away.
      • knead bread or tenderize meat
      • crumple newspaper for the fireplace
      • carry pots of cold water to stove (not hot)
      • mix ingredients for cooking
    • Make an obstacle course to practice hopping, skipping, jumping, running, crawling, climbing, swinging. See Indoor play ideas.
    • Rock in a rocking chair - reading and singing
    • Let the child help vacuum, move furniture, dust, scrub floors
    • Let the child dig in the garden
    • Swimming
    • Trampolines (use safety precautions) - bounce balls to each other
    • Pull a heavy wagon or push a heavy doll buggy
    • Swing sets and jungle gyms with climbing, sliding, swinging opportunities
  • Offer various tactile experiences  
    • Playing with play dough, Gak, Fimo or wax
    • Paint with shaving cream, silly soap or soap lather
    • Walk in grass, leaves, sand or snow
    • Rub oils or lotions on skin
    • Scrub with washcloth or hand cloth in tub
    • Fill a container with snow, sand, beans or water for play
    • Try different sheets and pillow cases 
    • Massage, scratch, brush or write on back prior to bed
    • Discover the appropriate hugs or kisses that work for your child
    • Using ankle weights while walking - this discourages toe-walking and aids in balance awareness
    • Using hand weights while coloring
    • Sleeping under a weighted blanket
  • Encourage child to join in sequential movement games
    • Hopscotch, sidewalk games
  • Situations to avoid
    • Standing in long lines
    • Crowded hallways/spaces
    • Unstructured environments (lunchrooms, auditorium)
    • Loud and busy parties (secure a quiet available place for time away if needed)
  • Home organization
    • Keep routines and possessions in the home organized
    • Make a list of daily routines and post so everyone can see. May use pictures for younger children
    • Be consistent with daily rules and consequences
    • Keep a large calendar or schedule posted with event stickers or notes so you can limited surprises for the child. 
    • Create specific routines for difficult times of day
      • Bath time
      • Morning program
      • School program
      • Bed time (break each task into small steps)
        • go into room
        • get undressed
        • get out pj's
        • put on pj's
        • put away clothes
        • pick out a book
        • brush teeth
        • climb into bed
        • snuggle with mom and read book
        • turn off the lights for a 10 STAR BED TIME
  • Exposure and experience! - This is the tough one. Sometimes you have to try something many times until the child will actually enjoy it. Break the experience down into very small pieces and add one new piece at a time. 

What is sensory integration?

The senses work together. Each sense works with the others to form a composite picture of who we are physically, where we are, and what is going on around us. Sensory integration is the critical function of the brain that is responsible for producing this composite picture. It is the organization of sensory information for on-going use.

For most of us, effective sensory integration occurs automatically, unconsciously, without effort. For some of us, the process is inefficient, demanding effort and attention with no guarantee of accuracy. When this occurs, the goals we strive for are not easily attained.

Sensory experiences include touch, movement, body awareness, sight, sound, and the pull of gravity. The process of the brain organizing and interpreting this information is called sensory integration. Sensory integration provides a crucial foundation for later, more complex learning and behavior.

For most children, sensory integration develops in the course of ordinary childhood activities. Motor planning ability is a natural outcome of the process, as is the ability to adapt to incoming sensations. But for some children, sensory integration does not develop as efficiently as it should. When the process is disordered, a number of problems in learning, development, or behavior may become evident.

The concept of sensory integration comes from a body of work developed by A. Jean Ayres, PhD, OTR. As an occupational therapist, Dr. Ayres was interested in the way in which sensory processing and motor planning disorders interfere with daily life function and learning. This theory has been developed and refined by the research of Dr. Ayres, as well as other occupational and physical therapists. In addition, literature from the fields of neuropsychology, neurology, physiology, child development, and psychology has contributed to theory development and intervention strategies.

Who has problems with sensory integration?

You may know a child who, although bright, has difficulty using a pencil, playing with toys, or doing self-care tasks, like dressing. Perhaps you have seen a child so fearful of movement that ordinary swings, slides, or jungle gyms generate fear and insecurity. Or maybe you have observed a child whose problems lie at the opposite extreme uninhibited and overly active, often falling and running headlong into dangerous situations. In each of these cases, a sensory integrative problem may be an underlying factor. Its far-reaching effects can interfere with academic learning, social skills, even self esteem.

Research clearly identifies sensory integrative problems in children with developmental or learning difficulties. Independent studies show that a sensory integrative dysfunction can be found in some children who are considered learning disabled by schools (reference: Daems, Joan (Ed).(1994). Reviews of Research in Sensory Integration. Torrance, CA: Sensory Integration International)
Sensory integrative problems are not confined to children with learning disabilities, however. They transect all age groups as well as all intellectual levels and socio-economic groups. 

Consider the following human problems:

  • Premature birth - More and more premature infants survive today; they enter the world with fragile, easily over stimulated nervous systems and multiple medical complications. Parents need to learn how to give their premature infant the sensory nourishment their child requires for optimal development, and how to avoid detrimental over stimulation .
  • Autism and other developmental disorders - Although autism is rare, it occurs more often than blindness. Severe difficulty with sensory processing is a hallmark of the disorder. Autistic children seek out unusual quantities of certain types of sensations and are extremely hypersensitive to other types. Similar traits are often seen in other children with developmental disorders. Improving sensory processing leads these children to more productive contacts with people and environments.
  • Learning Disabilities - As many as 30% of school-aged children are estimated to have learning disabilities. Research indicates that a majority of these children, although normal in intelligence, are likely to have sensory integrative problems. These children are also more likely than their peers to have had a premature birth, early developmental problems, and poor motor coordination. Early intervention can improve sensory integration in these children, minimizing the possibility of school failure before it occurs.
  • Delinquency and substance abuse - Numerous studies indicate that learning disabled children are at risk for later delinquency, criminality, alcoholism, and drug abuse. Repeated failure in school opens the door to self-destructive activities. By interrupting the vicious cycle of failure, intervention to help children with sensory integration and learning problems may also prevent serious social problems later in life.
  • Stress related disorders - Sensory integrative difficulties that appear in childhood often are not outgrown. When sensory inefficiencies in adults do not allow them to perform optimally in the workplace, stress can build up. Additionally, there is mounting evidence that stress in parents can lead to child abuse, violence in the home, and problems that pass from generation to generation. Recognition of the sensory processing component of these problems contributes an important element in aiding people to achieve greater satisfaction in their home life and competence in their work.
  • Brain injury - Trauma to the brain from accidents and strokes can have profound effects on sensory functioning. People who suffer from these effects deserve treatment that will lead to the best possible recovery. In order for this to occur, their sensory deficits must be addressed by the health professionals who serve them.

What steps can be taken?

If a child is suspected of having a sensory integrative disorder, an evaluation can be conducted by a qualified occupational or physical therapist. Evaluation usually consists of both standardized testing and structured observations of responses to sensory stimulation, posture, balance, coordination and eye movements. After carefully analyzing test results and other assessment data along with information from other professionals and parents, the therapist will make recommendations regarding appropriate treatment.

If therapy is recommended, the child will be guided through activities that challenge his or her ability to respond appropriately to sensory input by making a successful, organized response. Standards are available from Sensory Integration International.

Training of specific skills is not usually the focus of this kind of therapy. Adaptive physical education, movement education and gymnastics are examples of services that typically focus on specific motor skills training. Such services are important, but they are not the same as therapy using a sensory integrative approach.

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. Most children tend to seek out activities that provide sensory experiences most beneficial to them at that point in development. It is this active involvement and exploration that enables the child to become a more mature, efficient organizer of sensory information.

Where can I learn more?

The most important step in promoting sensory integration in children is to recognize that it exists and that it plays an important role in the development of a child. By learning more about sensory integration, parents, educators and caregivers can provide an enriched environment that will foster healthy growth and maturation.

For more information:

  • Write to Sensory Integration International at: 1514 Cabrillo Avenue, Torrance, CA. 90501-2817.
  • Contact your local Occupational or Physical Therapy Clinic.
  • Order a publication list from SII. Call 310.320.2335.

Books available

The Out of Sync Child Carol Stock Kranowitz has been teaching music, movement, and drama to preschoolers since 1976. Having observed many out-of-sync children, she began to study sensory integration ("SI") theory in order to help identify their needs and to steer them into early intervention. In addition to The Out-of-Sync Child: Recognizing and Coping with Sensory Integration Dysfunction, Carol is the author of 101 Activities for Kids in Tight Spaces (St. Martin's Press, 1995). She is the co-author of Hear, See, Play! Music Discovery Activities for Preschoolers (Peg Hoenack's MusicWorks, 1989) and of The Balzer-Martin Preschool Screening Program Manual.

101 Activities for Kids in Tight Spaces : At the Doctor's Office, on Car, Train, and Plane Trips, Home Sick in Bed
by Carol Stock Kranowitz

 


Products to make life easier for you and your child

Sensory Comfort   Making Life More Comfortable for Children and Adults with Sensory Processing Differences  Sensory Comfort sells products for children and adults who have sensory processing differences (also called Sensory Integration Dysfunction or tactile/sensory defensiveness).

Products are carefully chosen for individuals who are:

  • hypersensitive (overly-sensitive) to touch, sound, smell, movement,  and/or visual stimuli
  • hyposensitive (under-sensitive) to these same types of stimuli
  • hypersensitive to some types of stimuli and hyposensitive to others
Sensory Comfort is where you'll find:
  • socks without uncomfortable toe-seams
  • headphones that really reduce noise level
  • toys to delight the senses                                    
  • towels that provide some firm pressure
  • car-safety and comfort devices for children
  • the latest informational books and cassettes about sensory processing differences and sensory integration
  • plus lots more!

Special thanks to FASlink support persons and SI support persons.
We hope the information and links provided here make you 
and your child's life easier.

 

B R E A K I N G D O W N B R I C K W A L L S F O R F A S D

Minnesota Organization on Fetal Alcohol Syndrome
P.O. Box 131911, Roseville, Minnesota 55113-0021
 (612) ----------   email: jodee@connetworks.com

B U I L D I N G   N E W   F O U N D A T I O N S   F O R    H E A L T H Y   G R O W T H

ABOUT | TEACHING | PARENTING | INDIVIDUALS | SUPPORT | PREVENTION | RESOURCES

This site is provided as informational only. 
It is not a direct endorsement of any clinic, professional or web site.