Sensory Processing Disorder & Sensory Integrative Treatment Approach
Sensory processing (sometimes called "sensory integration" or SI) is a term that refers to the way the nervous system receives messages from our 7 sensory systems (touch, vision, auditory/hearing, taste, smell, vestibular and proprioception - movement of the head and body parts respectively). With this information or ‘data’ our body is able to immediately recognize what is happening to us (directly to our bodies, around us, and within the environment). Given this information, we are able to rapidly (in times of threat in less than 1/10th of a second) respond to the demands of the situation. This input is turned into appropriate motor and behavioral responses. Whether you are sitting doing desk work, putting on shoes, riding a bicycle, climbing a tree or getting into a car fastening your seatbelt, preparing a meal, etc., your successful completion of any activity requires accurate and immediate processing of sensation or "sensory integration."
Examples of over-reactivity, defensiveness to certain sensory experiences:
- Clothing styles (waist bands), characteristics (sock seams), textures (only soft or loosey-goosey is OK)
- Specific sounds or certain environments are intolerable, overwhelming, hands over the ears
- Some or many smells, tastes, or food textures intolerable; very narrow diet choices
- Light sensitivity or busy visual fields (stores, classroom walls) overwhelming, painful
- Touch from others is avoided, stays on the periphery of a group
- Tooth brushing, hair brushing, face and hand washing irritating and painful
Examples of under-reactivity (hyposensitivity) to certain sensory experiences:
- Unaware of what is happening around themselves, inattentive to surroundings and others
- Poor body awareness, clumsy, accident prone, walking into door jambs and furniture
- Unaware of painful bruises, falls, cuts
- Not responsive when spoken to, not aware of environmental sounds
- Lack of any tickle response, startle, or gag response
- No sign of dizziness with lots of spinning play
- May be a sensory seeker and show little satiation with excessive stimulative crash and diving or rough and tumble play; can’t get enough.
Sensory Processing Disorder (SPD, formerly known as "sensory integration dysfunction") is a condition that exists when sensory signals are not clearly recognized or understood by the nervous system. As a result these individuals are unable to organize an appropriate response and show difficulty with emotional regulation, learning, behavior, and participation in daily life. Sensory integrative theory originated with pioneering occupational therapist and neuroscientist A. Jean Ayres, PhD, in the 1950s into the 1980’s. She likened SPD to a neurological "traffic jam" that prevents certain parts of the brain from receiving the information needed to interpret the sensory ‘data’ correctly. Her research has been followed and supported by many others.
This difficulty processing and subsequently acting upon a lack of or inaccurate information received through their senses creates challenges in performing countless everyday tasks. Motor clumsiness, disorganized motor planning, behavioral problems, anxiety, depression, school failure, inattention, impulsivity, disorganization, poor problem solving, and other impacts may result if the disorder is not treated effectively.
Prevalence of SPD in the general population:
- Two studies (Ahn, Miller, Milberger, McIntosh, 2004; Carter, 2011) show that at least 1 in 20 children’s daily lives is affected by SPD.
- A research study by the Sensory Processing Disorder Scientific Work Group (Ben-Sasson, Carter, Briggs-Gowen, 2009) suggests that 1 in every 6 children experiences sensory symptoms that may be significant enough to affect aspects of everyday life functions.
In a review of literature looking at SPD in premis, now at ages birth-3yrs.: 46% showed evidence of SPD. (Mitchell, A.W., 2015)
Symptoms of Sensory Processing Disorder, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children and adults with SPD, these difficulties are chronic, and they disrupt everyday life.
Sensory Integrative Treatment:
A sensory integrative (SI) approach to intervention is one that has been shown to be effective for those with specific sensory processing disorders. This treatment approach has been trademarked as Ayres Sensory Integration™ in hopes that both researchers, professionals, and the consumer recognize that this is a specialized method that requires a therapist (most often a licensed Occupational Therapist but also physical and speech therapists) to have specialized training, mentoring and experience to gain adequate expertise in order to effectively evaluate a patient, interpret the results, and to then provide effective hands-on intervention with an appropriate and concomitant home program.
The process of intervention encompasses an evaluation that determines which (if any) of our sensory systems are showing abnormal processing, whether the nervous system is aware of sensory input presented to it and showing a typical response or is the individual showing an under-reactive response (hyposensitivity) or is it over-reactive (hypersensitive). Because sensory processing enables and supports the development of many fundamental skills, it is essential to determine whether SPD has impacted any areas of motor, emotional-relational, communicative development, or attention and learning skills.
An SI therapeutic program will initially help patients and their families identify those situations that may be triggering an over-reactive, often painful experience, leading to a defensive response so that they can be avoided until the therapist is able to work to modulate or desensitize the nervous system to that input. If the patient is showing underreactive responses, is not fully aware of what is happening to them is certain situations, the therapists will work to sensitize their nervous system so that their responses are appropriate to the demands of the situation.
Occupational therapy with a sensory integration approach will work to normalize the sensory systems that are involved so that the process of development is facilitated. Other related areas of developmental and learning, if showing dysfunction, will need to be attended to concomitantly. It is not uncommon that SPD may cause or in may contribute to additional areas of developmental delay directly or indirectly. It is important that because these issues are interdependent that they be treated as such. They include:
- Self-regulation for attention and impulse control
- Emotional-relational development – engagement, self-confidence, decreased anxiety, self-motivation and initiative, empathy and consideration of others
- Muscle tone, postural stability, motor coordination (fine motor and gross motor skills)
- Motor planning (praxis)
- Oral-Motor skills for eating, articulation, hygiene
- School adaptations, learning supports
- Problem solving to multiple steps and from concrete to logical and abstract thinking
- Organizational skills for school and home – homework, chores
- Interpersonal and social skills