Sensory Integration Disorder / Sensory Processing Disorder

Sensory integration disorder or what is now commonly referred to as Sensory Processing Disorder (SPD) is a neurological disorder that results from the brain's inability to integrate certain information received from the body's five basic sensory systems. These sensory systems are responsible for detecting the position and movement of the body as well as visual, sounds, smell, tastes, pain and temperature sensations. The brain then forms a combined picture of this information in order for the body to make sense of its surroundings and react to them appropriately. The ongoing relationship between behavior and brain functioning is called sensory integration (SI), a theory that was first pioneered by A. Jean Ayres, Ph.D., OTR in the 1960s.

Sensory experiences include touch, movement, body awareness, sight, sound, smell, taste, and the pull of gravity. Distinguishing between these is the process of sensory integration (SI). While the process of SI occurs automatically and without effort for most, for some the process is inefficient. Extensive effort and attention are required in these individuals for SI to occur, without a guarantee of it being accomplished. When this happens, goals are not easily completed, resulting in sensory integration disorder (SPD).

The normal process of SI begins before birth and continues throughout life, with the majority of SI development occurring before the early teenage years. The ability for SI to become more refined and effective coincides with the aging process as it determines how well motor and speech skills, and emotional stability develop. The beginnings of the SI theory by Ayres instigated ongoing research that looks at the crucial foundation it provides for complex learning and behavior throughout life.

The presence of a sensory processing disorder is typically detected in young children. Most children develop optimal sensory processing during the course of ordinary childhood activities, which helps establish such things as the ability for motor planning and adapting to incoming sensations. However, some children do not develop as efficiently. When their process is disordered, a variety of problems in learning, development, or behavior become obvious.

Those who have sensory integration dysfunction may be unable to respond to certain sensory information by planning and organizing what needs to be done in an appropriate and automatic manner. This may cause a primitive survival technique called "flight or fight," or a withdrawal response, which originates from the "primitive" brain. This response often appears extreme and inappropriate for the particular situation.

The neurological disorganization resulting in SPD occurs in three different ways: the brain does not receive messages due to a disconnection in the neuron cells; sensory messages are received inconsistently; or sensory messages are received consistently, but do not connect properly with other sensory messages. When the brain poorly processes sensory messages, inefficient motor, language, or emotional output is the result.

The following are a list of some of the common presenting symptoms that are typically seen in children with a Sensory Processing Disorder.

  • oversensitivity to touch, movement, sights, or sounds
  • under-reactivity to touch, movement, sights, or sounds
  • tendency to be 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 in making transitions from one situation to another
  • inability to unwind or calm self
  • poor self concept

While research indicates that sensory integrative problems are found in up to 70% of children who are considered learning disabled by schools, the problems of sensory integration are not confined to children with learning disabilities. SPD transfers through all age groups, as well as intellectual levels and socioeconomic groups. Factors that contribute to SPD include: Autism, premature birth and other developmental disorders; learning disabilities; delinquency and substance abuse due to learning disabilities; stress-related disorders; and brain injury. Two of the biggest contributing conditions are autism and attention-deficit hyperactivity disorder (ADHD). This connection between attention deficit disorder in particular has consistently been noted by Linda Kramer, OTR/L during Neurofeedback therapy.

In order to diagnose and determine the presence of SPD an evaluation should be conducted by a qualified Occupational therapist. An evaluation normally consists of both standardized testing and structured observations of responses to sensory stimulation, posture, balance, coordination, and eye movements. These test results and assessment data, along with information from other professionals and parents, are carefully analyzed by the therapist who then makes recommendations about appropriate treatment.

Occupational therapists play a key role in the conventional treatment of SPD. By providing sensory integration therapy, Occupational therapists are able to supply the vital sensory input and experiences that children with SPD need to grow and learn. Also referred to as a "sensory diet," this type of therapy involves a planned and scheduled activity program implemented by an Occupational therapist, with each "diet" being designed and developed to meet the needs of the child's nervous system. A sensory diet stimulates the "near" senses (tactile, vestibular, and proprioceptive) with a combination of alerting, organizing, and calming techniques. These techniques are utilized during the Neurofeedback session at our Clinic in order to impact upon the childís arousal level so that the therapy session is better impacted.

The sensory integrative approach is guided by one important aspect - the child's motivation in selection of the activities. By allowing them to be actively involved, and explore activities that provide sensory experiences most beneficial to them, children become more mature and efficient at organizing sensory information. At our Clinic we actively engage the child in the therapy process but still maintain control in terms of how the activities are selected so they best meet the individual needs of the child.

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