ED478564 2003-05-00 Understanding

Sensory Integration. ERIC Digest.

ERIC Development Team

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Understanding Sensory Integration. ERIC Digest............................ 1

WHAT IS SENSORY INTEGRATION?..................................... 2

WHAT IS SENSORY INTEGRATION DYSFUNCTION (DSI)?......... 3

HOW IS DSI IDENTIFIED?................................................... 4

INTERVENTION FOR DSI.................................................... 4

INTERVENTIONS BASED ON SENSORY INTEGRATION THEORY 5

TRADITIONAL SENSORY INTEGRATIVE THERAPY...................5

SUMMARY....................................................................... 6

REFERENCES.................................................................. 6

ERIC Identifier: ED478564

Publication Date: 2003-05-00

Author: DiMatties, Marie E. - Sammons, Jennifer H.

Source: ERIC Clearinghouse on Disabilities and Gifted Education Arlington VA.

Understanding Sensory Integration. ERIC

Digest.

THIS DIGEST WAS CREATED BY ERIC, THE EDUCATIONAL RESOURCES

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ED478564 2003-05-00 Understanding Sensory Integration. ERIC Digest. Page 1 of 7
Michael is a third grade student who is waiting for the school bus. He is challenged by

sensory experiences during everyday activities that most of us don't even think about.

While he's still reeling from the battle with mom over brushing his teeth (that peppermint

toothpaste tastes like fire in his mouth) the school bus pulls up. Michael runs past the

bus monitor's haze of perfume and sits at the back of the bus. In his heightened state,

he becomes even more aware of his new school shirt with its stiff label and that awful

feeling like a wire brush being poked into the back of his neck. The sensory experiences

of the movement of the bus, the sound of his excited classmates laughing and yelling

above the roar of the bus engine all contribute to his increased agitation. By the time

Michael arrives at school he is wound up and ready to unravel. There is no time to wait

for the bus monitor's direction...getting off the bus quickly becomes a matter of survival

and he resorts to pushing, shoving and finally kicking his way out. Unfortunately, there

is a price to pay for this seemingly outward aggression...he can expect another trip to

the principal's office.

This digest defines sensory integration and sensory integration dysfunction (DSI). It

outlines evaluation of DSI, treatment approaches and implications for parents and

teachers, including compensatory strategies for minimizing the impact of DSI on a

child's life.

WHAT IS SENSORY INTEGRATION?

Sensory Integration is a theory developed more than 20 years ago by A. Jean Ayres, an

occupational therapist with advanced training in neuroscience and educational

psychology (Bundy & Murray, 2002). Ayres (1972) defines sensory integration as "the

neurological process that organizes sensation from one's own body and from the

environment and makes it possible to use the body effectively within the environment"

(p. 11). The theory is used to explain the relationship between the brain and behavior

and explains why individuals respond in a certain way to sensory input and how it

affects behavior. The five main senses are:

* Touch - tactile

* Sound - auditory

* Sight - visual

* Taste - gustatory

* Smell - olfactory

In addition, there are two other powerful senses:

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a) vestibular (movement and balance sense)-provides information about where the

head and body are in space and in relation to the earth's surface.

b) proprioception (joint/muscle sense)-provides information about where body parts are

and what they are doing.

WHAT IS SENSORY INTEGRATION

DYSFUNCTION (DSI)?

Dysfunction in sensory integration is the "inability to modulate, discriminate, coordinate

or organize sensation adaptively" (Lane et al., 2000, p. 2).

How efficiently we process sensory information affects our ability to:

a) discriminate sensory information to obtain precise information from the body and the

environment in order to physically interact with people and objects. An accurate body

scheme is necessary for motor planning, i.e., being able to plan unfamiliar movements.

It involves having the idea of what to do, sequencing the required movements, and

executing the movements in a well-timed, coordinated manner.

Michael frequently bumps into others and drops items on the way to class because of

his poor body scheme. He often hands in crumpled assignments that reflect the

challenges of holding a pencil in his hand and making precise movements to achieve

legible handwriting. Concentrating on his school work intensely may lead him to fall off

his chair. To most people, Michael appears to be a sloppy, clumsy, and forgetful child.

In gym class, Michael cannot master jumping jacks, somersaults make him feel sick,

and he has given up on ever being able to connect with a baseball. His timing was

always off. He resorts to being the class clown to cover up for his difficulties. Michael

certainly doesn't feel good about himself. He can't do what other kids seem to do so

effortlessly-and then there is the teasing...

b) modulate sensory information to adjust to the circumstances and maintain optimum

arousal for the task at hand. Sensory modulation is the "capacity to regulate and

organize the degree, intensity and nature of responses to sensory input in a graded and

adaptive manner" (Miller & Lane, 2000).

Sensory defensiveness, a type of sensory modulation problem, is defined by Wilbarger

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ED478564 2003-05-00 Understanding Sensory Integration. ERIC Digest. Page 3 of 7
and Wilbarger (1991) as "a constellation of symptoms related to aversive or defensive

reactions to non-noxious stimuli across one or more sensory systems" (Wilbarger &

Wilbarger, 2002a, p. 335) It can affect changes in the state of alertness, emotional tone,

and stress (Wilbarger & Wilbarger, 2002a).

Michael demonstrates many symptoms of sensory defensiveness, which affect his

attention, learning, and behavior. His teacher's instructions get lost in competition with a

clock ticking, the echo of peers walking and talking in the hall. He is off task and he

finds solace in humming or chewing on the end of his pencil, sensory seeking behaviors

that help ease the discomfort. Fortunately, he has gym class before lunch. Running

bases in gym class gives him a legitimate opportunity for the "heavy work" that his body

needs. It sure makes him feel better and prepares him for the biggest challenge of alleating lunch in the school cafeteria.

HOW IS DSI IDENTIFIED?

DSI is identified through evaluation by an occupational therapist who has advanced

training in sensory integration, using one or more of the following practices:

* Gathering information about the child's performance in daily life tasks within the

context of the classroom, school, and/or home environment.

* Skilled observation of the child: the therapist sets up a play environment and observes

the child's responses to different types of sensory input and motor planning ability.

* Parent/caregiver sensory questionnaires /standardized checklists, e.g., Sensory

Profile (Dunn, 1999), non-standardized checklists.

* Parent/caregiver interview: the therapist identifies specific functional problems related

to problems with sensory processing.

* Standardized tests of general development and motor functioning, e.g., Sensory

Integration and Praxis Test Battery (SIPT) (Ayres, 1989).

* Clinical observations of posture, coordination, etc.

INTERVENTION FOR DSI

Fostering the child's participation in normal everyday childhood activities or

"occupations" is the main goal of occupational therapy. Intervention starts when

teachers and parents are taught about DSI and intervention so they can develop

strategies that help with adaptation or compensation for dysfunction (Bundy & Koomar,

2002). Based on information gathered, the therapist collaborates with teachers and

parents to design an intervention plan to address the child's sensory integration

problems.

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Page 4 of 7 ED478564 2003-05-00 Understanding Sensory Integration. ERIC Digest.
INTERVENTIONS BASED ON SENSORY

INTEGRATION THEORY

Therapist consultation aims to educate teachers, parents, and older children about

sensory integration and to develop strategies to adapt to and compensate for

dysfunction such as:

* environmental modifications

* adaptations to daily routines

* changes in how people interact with the child (Wilbarger & Wilbarger, 2002)

Examples are reducing distracting visual materials in the classroom, giving the child an

alternative to a messy art activity, or refraining from wearing perfume or bright, floral

clothing.

A sensory diet is a strategy that consists of a carefully planned practical program of

specific sensory activities that is scheduled according to each child's individual needs.

Like a diet designed to meet an individual's nutritional needs, a sensory diet consists of

specific elements designed to meet the child's sensory integration needs. The sensory

diet is based on the notion that controlled sensory input can affect one's functional

abilities (Wilbarger & Wilbarger, 2002b). A sensory diet can help maintain an age

appropriate level of attention for optimal function to reduce sensory defensiveness.

Wilbarger & Wilbarger's (200b) comprehensive approach to treating sensory

defensiveness includes education and awareness, a sensory diet, and other

professional treatment techniques. One such technique is the Wilbarger Protocol, which

uses deep pressure to certain parts of the body followed by proprioception in the form of

joint compressions. It is critical that this protocol is not used in isolation and that it is

initiated and monitored by an appropriately trained therapist.

The "How Does Your Engine Run?" Program (Williams & Shellenberger, 1994) is a

step-by-step method that teaches children simple changes to their daily routine (such as

a brisk walk, jumping on a trampoline prior to doing their homework, listening to calming

music) that will help them self-regulate or keep their engine running "just right." Through

the use of charts, worksheets, and activities, the child is guided in improving awareness

and using self-regulation strategies.

TRADITIONAL SENSORY INTEGRATIVE

THERAPY

Traditional sensory integrative therapy takes place on a 1:1 basis in a room with

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ED478564 2003-05-00 Understanding Sensory Integration. ERIC Digest. Page 5 of 7
suspended equipment for varying movement and sensory experiences. The goal of

therapy is not to teach skills, but to follow the child's lead and artfully select and modify

activities according to the child's responses. The activities afford a variety of

opportunities to experience tactile, vestibular, and proprioceptive input in a way that

provides the "just right" challenge for the child to promote increasingly more complex

adaptive responses to environmental challenges. The result is improved performance of

skills that relate to life roles, e.g., player, student, (Schaaf & Anzalone, 2001). This type

of intervention may be used along with other treatment approaches.

SUMMARY

DSI can have a profound effect on a child's participation in everyday childhood

"occupations," including play, study and family activities. Collaboration between the

therapist, teacher, and parent is the most efficient way to understand the child's

behavior and unique sensory needs. Together, they can implement strategies to support

the child's performance in roles and occupations across multiple environments.

REFERENCES

Ayres, A. J. (1972). Sensory integration and learning disorders. Los Angeles: Western

Psychological Services. Ayres, A. J. ( 1989). Sensory integration and praxis tests. Los

Angeles: Western Psychological Services.

Bundy, A. C., Lane, S. J., & Murray, E. A. (2002) Sensory integration: Theory and

practice. Philadelphia: F. A. Davis.

Dunn, W. (1999). Sensory Profile. San Antonio: Psychological Corporation.

Kranowitz, C. S. (1998). The out of sync child. New York: The Berkley Publishing

Group.

Lane, S. J., Miller, L. J., & Hanft, B. E. (2000). Towards a consensus in terminology in

sensory integration theory and practice: Part 2: Sensory integration patterns of function

and dysfunction. Sensory Integration Special Interest Section, 23(2), 1-3.

Miller, L. J. & Lane, S. J. (2000). Towards a consensus in terminology in sensory

integration theory and practice: Part 1: Taxonomy of Neurophysiological Processes.

Sensory Integration Special Interest Section, 23(1), 1-4.

Quirk, N. J. & DiMatties, M. E. (1990). The relationship of learning problems and

classroom performance to sensory integration. Haddonfield, NJ: Author. Available:

www.amazon.com.

Wilbarger P. & Wilbarger, J. (1991). Sensory defensiveness in children aged 2-12: An

intervention guide for parents and other caregivers. Denver, CO: Avanti Educational

Programs.

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Page 6 of 7 ED478564 2003-05-00 Understanding Sensory Integration. ERIC Digest.
Williams, M. S., & Shellenberger, S. (1994). How Does Your Engine Run? Albuquerque:

Therapy Works.

Sensory Integration Resource Center - provides links to Internet resources and

research about Sensory Integration Dysfunction (DSI) for parents, educators,

occupational therapists and physicians. Available: http://www.sinetwork.org/

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ERIC Digests are in the public domain and may be freely reproduced and disseminated,

but please acknowledge your source. This digest was prepared with funding from the

Institute of Education Sciences (IES), U.S. Department of Education, under Contract

No. ED-99-C0-0026. The opinions expressed in this publication do not necessarily

reflect the positions of IES or the Department of Education.

Title: Understanding Sensory Integration. ERIC Digest.

Note: Digest number E643.

Document Type: Information Analyses---ERIC Information Analysis Products (IAPs)

(071); Information Analyses---ERIC Digests (Selected) in Full Text (073);

Target Audience: Parents, Practitioners

Available From: ERIC Clearinghouse on Disabilities and Gifted Education, 1110 North

Glebe Rd., Arlington, VA 22201-5704. Tel: 703-620-3660; Tel: 800-328-0272 (Toll

Free). For full text: http://www.ericcec.org.

Descriptors: Disabilities, Disability Identification, Elementary Secondary Education,

Evaluation Methods, Intervention, Self Management, Sensory Integration, Student

Characteristics, Theories

Identifiers: ERIC Digests

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