Sensory Integration Therapy
First developed in the 1970s by occupational therapist A. Jean Ayres to help children with sensory processing difficulties, Sensory Integration Therapy (SIT) helps organize the information received from the senses. This is important in all aspects of daily life, from getting dressed, washing hands and eating to moving around, socializing, learning and working.
Sensory integration is a part of young children’s normal development and activity, including rolling, crawling, walking and playing. In some children, however, sensory integration is less well developed.
The Senses
- Sight (vision)
- Hearing (auditory system)
- Touch (tactile system)
- Taste (gustatory system)
- Smell (olfactory system)
- Proprioception (senses of body awareness and position)
- Vestibular (awareness of movement, balance and coordination)
- Interoception (a system indicating what happens internally, such as hunger, needing the rest room, fatigue, emotions)
Four Categories of Sensory Integration Difficulty
Sensory modulation problems occur when the brain either over or under responds to sensory information. For example, if a teen over responds to touch, he may be aware of the label on the back of his shirt. If a girl is under responsive to touch, she may not notice someone tapping her on the shoulder. People can be over or under responsive in all the senses, over responsive in one sense and under responsive in another or over and under responsive within the same sense. Responsiveness can be dependent on a situation. A stressful situation can make an individual more and less aware of sensation.
Sensory discrimination and perceptual problems occur when the brain has difficulties making sense of the sensory information it receives. In problems with touch, an individual can seem clumsy or use too much or little force when doing things. In visual perceptual problems, an individual may not easily find objects in a cluttered room or a word on a page.
Vestibular bilateral functional problems results in poor balance and difficulties with coordinating two sides of the body.
Praxis problems (also called praxis dyspraxia or developmental coordination disorder) occurs when individuals trying to make sense of different, incoming sensory information may struggle to work out where their body is and how much force, speed and direction is needed to do a new movement. For children, this can be learning to jump; for adults, learning to drive or use chopsticks.
Treatment
OT clinicians can address sensory integration and modulation disorders across the lifespan (age-appropriate sensory integration) and in all environments. They can provide a variety of sensory activities and exercises, including structured exposure to sensory input, movement therapy, balance treatments and customized physical activities and accommodations (changes to the environment or routine). OT clinicians use a “strengths-based” approach (focusing on personal strengths, not deficits) to enhance existing skills, while adding new ones.
As part of the treatment, the trained clinician also assesses how the child responds to treatment, checks whether the child becomes more or less dysregulated and then make changes to ensure correct processing, integration and modulation of the sensory input.
The OT clinician also works with the individual’s parents or family members, other health professionals, schools or employers to create a sensory diet or recommended suite of activities and accommodations outside of therapy to ensure the individual gets the necessary sensory input.
For many, a small adjustment to the environment or to the way individuals are allowed to move at school or work can help them manage their daily lives. For children, SIT can challenge them in fun, playful ways to help them learn to respond appropriately, function more normally and tolerate new people and experiences more easily.
Age-appropriate Sensory Integration
Infants and toddlers, with disabilities or at risk for developmental problems, receive interventions that facilitate self-regulation (wake–sleep cycles, alertness level, self-soothing), motor development and adaptive behavior. This allows children to be successful in areas essential for development: play, sleep, daily activity, mealtime routines, socialization.
School-aged children can receive direct sensory-based approaches that address life skills, participation and behaviors needed at home, in the classroom or in the community. Modifications can be made to home and classroom environments to assist children’s participation and independence, including making friends and focusing in order to learn. Challenges create opportunities for the child to master important skills in relating, communicating, and thinking.
Adolescents and young adults might need sensory integration interventions to help with fear of movement, sensitivity to touch, poor motor planning or decreased awareness of body position in space. This includes learning to drive, making vocational choices, engaging in leisure activities and developing independence and romantic relationships and navigating transitions to college and work.
Adults may never have been diagnosed with sensory integration problems, so have not had opportunity to develop coping skills and adaptive performance mechanisms. As a result, many have trouble with interpersonal relationships, vocational skills, leisure activities and general quality of life. They can receive direct services, accommodations and supports, such as headphones for an adult easily distracted at work or moving a desk to minimize external sensory input.
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