Sensory Integration and Sensory Processing Disorder
By Kelly Budnick, MOT, OTR/L
What is Sensory Integration?
Our understanding of sensory integration was first developed in the 1960’s and 1970’s by Dr. A Jean Ayres. Ayres defined 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 with the environment.” (Ayres, 1972). Sensory Integration Therapy is based on the theory she developed and years of subsequent evidence-based research.
What is Sensory Processing Disorder (SPD)?
As we develop as babies and then into toddlers, it is through our sensory systems that we learn information about our world. Through these early interactions with the environment and the people around us, we build our body’s neurological foundation, learn about the world around us and create relationships with our caregivers.
Our bodies take in input from several different sensory systems, organizes each system in the brain, and then sends out signals to the rest of the body to create an appropriate response (Kiley, 2014).
In individuals with appropriately operating sensory processing, this happens automatically. However, for people who are not able to interpret and respond to this information efficiently, they may experience Sensory Processing Disorder (SPD).
Studies have shown that 5%-16% of children exhibit symptoms of SPD (Ahn, Miller et. al., 2004; Ben-Sasoon, Carter et al., 2009). The STAR Institute (Sensory Therapies and Research), states, “Sensory Processing Disorder (SPD), exists when sensory signals are either not detected or don't get organized into appropriate responses. Pioneering occupational therapist, educational psychologist, and neuroscientist A. Jean Ayres, PhD, likened SPD to a neurological "traffic jam" that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. A person with SPD finds it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks.”
What are the different types of sensory integration challenges?
There are three subtypes of sensory processing difficulties:
Sensory Modulation Disorder,
Sensory-Based Motor Disorder
Sensory Discrimination Disorder
(Star Institute, 2024)
First, individuals with SPD may have modulation difficulties, this means they may be under-responsive or over-responsive to sensory input. “Individuals with SOR (sensory overresponsivity) are more sensitive to sensory stimulation than most people. Their bodies feel sensation too easily, too intensely, or for too long. Often these people have a “fight, flight, or freeze” response to a sensation (e.g., being touched unexpectedly, loud noise).” (Collins, Britt. et. al., 2012). Individuals may also be overresponsive to stimuli meaning. “A classic symptom of SUR is hyporesponsivity to touch and deep pressure stimulation. This often leads to inadequate body awareness, poor endurance, and movements that are not appropriately graded...those with SUR (sensory underresponsivity) may not perceive objects that are too hot or cold, and classically do not notice pain in response to bumps, falls, cuts, or scrapes.” (Collins, Britt. et. al., 2012).
They may also have difficulty with discrimination or with determining the qualities of objects, places, people or other environments. They may have difficulty with balance and motor coordination. Commonly, individuals with SPD have a combination of symptoms above (STAR Institute, 2024).
Overall, SPD may impact a person’s capacity to do their daily self-care routine, to learn in school, and/or to participate in extracurricular activities.
What are the different sensory systems?
We have eight sensory systems. These are: sight (visual), taste (gustatory), touch (tactile), hearing (auditory), and smell (olfactory), vestibular (balance), proprioceptive (movement) and interoceptive (internal). Sensory Processing disorder may occur in each sensory system or multiple systems at once.
At Columbia Pediatric Therapy, we have education on each of these individual sensory systems available for further in-depth knowledge. Please click here to view, or use this link to learn more about the eight sensory systems.
How are sensory processing abilities assessed?
There are several strategies to assess sensory processing modulation, discrimination, and balance/postural skills. In occupational therapy, OT’s use parent report measures, standardized assessments in clinic and functional, skilled observations doing various activities to determine a child’s sensory processing skills.
What does a sensory integration treatment session Look like?
Each treatment session will be very different depending on the client’s interests, abilities and needs. Sensory integration therapy is highly personalized.
The occupational therapist may provide structured exposure to sensory input through engagement with various sensory equipment, movement and balance activities. The OT will provide personally designed and customized activities. The OT will engage the child with sensory equipment and may incorporate environmental accommodations (or changes to the environment) to reach functional goals.
The occupational therapists at Columbia Pediatrics incorporate child-led, play based and purposeful, functional activities to promote their clients’ sensory health.
How long will it take my child to improve sensory integration?
Every child progresses differently with sensory integration therapy. One child may see changes in a few weeks while others may take many months. Progression in SPD depends on many factors including the duration the child engages in recommended sensory activities at home, the child’s environment, the type of activities they do in the community, and if the child is regularly attending occupational therapy. Each child’s sensory needs are different, so a highly individualized approach is recommended. Your OT can give you more detailed information during your treatment sessions.
What can parents/guardians do to help their child at home?
An occupational therapist will educate the client, their family, caregivers, possibly school, and/or other health professionals to create a ‘sensory diet’ (also called a sensory daily schedule or sensory routine).
The sensory diet is created specifically for the client, based on their individual needs and abilities, usually for both the home and the community.
A sensory diet is a spectrum of personalized activities and environmental recommendations that facilitate the sensory input the child needs. Parents can help their child with this by consistently implementing it into the child’s daily routine.
An OT may also educate the parent and/or caregivers on environmental modifications or adaptive equipment that may benefit the child to be more independent and participatory in daily activities. The OT may also provide recommended reading to further expand your knowledge on sensory strategies to best suit your child.
References:
Ahn RR, Miller LJ, Milberger S, McIntosh DN. Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy. 2004;58(3):287–293.
Ayres, A.J. (1972a). Sensory integration and learning disorders. Los Angeles: Western Psychological Services.
Ben-Sasson A, Carter AS, Briggs-Gowan MJ. Sensory over-responsivity in elementary school: Prevalence and social-emotional correlates. Journal of Abnormal Child Psychology. 2009;37:705–716.
Collins, Britt. MS, OTR and Miller, L.J., PhD, OTR. Sensory Overresponsivity. Autism Aspergers Digest. January-February 2012.
Collins, Britt. MS, OTR and Miller, L.J., PhD, OTR. Sensory Underresponsivity. Autism Aspergers Digest. March-April 2012.
Healthy Children.org. (2019, October 7). Sensory Integration Therapy. https://www.healthychildren.org/English/health-issues/conditions/developmental-disabilities/Pages/Sensory-Integration-Therapy.aspx#:~:text=Therapy%20sessions%20are%20play%2Doriented,to%20calm%20an%20anxious%20child
Kiley, C. (2014, October 5). An Introduction to the Sensory System. Mama OT. https://mamaot.com/introduction-to-the-sensory-systems/
Koscinski, Dr. C. (2019, May 4). What is Sensory Integration Therapy and Can it Help Your Child? https://harkla.co/blogs/special-needs/sensory-integration-therapy
Star Institute. (2024). Sensory Health and Wellness. Sensory Processing - STAR Institute. https://sensoryhealth.org/
Star Institute. (2024). Subtypes of SPD. Sensory Processing - STAR Institute. https://sensoryhealth.org/basic/subtypes-of-spd
Sensory Integration Education. (2024). What is Sensory Integration. https://www.sensoryintegrationeducation.com/pages/what-is-si
how to help a child with sensory processing disorder, sensory processing disorder symptoms