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Sensory Integration Disorders

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November Focus of the Month…

What is Sensory Integration Disorder (SID)?
It is a neurological disorder causing difficulties with processing information from the five senses (vision, hearing, touch, smell, and taste), the sense of movement (vestibular system), and positional sense (proprioception, which tells the body where a particular body part is at any given moment).  Sensory integration is the body’s ability to receive or take in sensory stimuli, organize and interpret the stimuli, process the stimuli, and appropriately respond to the stimuli.  SID affects the way the brain interprets the information it takes in and also how the person reacts to the information.  Individuals with SID misinterpret everyday sensory information and information may be interpreted by the brain in an unusual way that may cause discomfort or confusion.

What causes SID?
There is no verifiable research in this area, but it is believed there could be a number of causes such as genetics, prematurity, birth trauma, exposure to toxins or viruses, and prenatal exposure to drugs or alcohol.

What are Characteristics of SID?
There are several types of Sensory Integration Disorders.  Each may result in a number of different behavioral and sensory patterns, depending on severity.  Some of the most common are described below.

Sensory Avoiding:
These children are over responsive to sensation.  Their nervous systems feel sensation too easily or too intensely and they feel as if they are constantly being bombarded with information. Also, sensory input is recognized as being threatening.  Consequently, these children have a “fight or flight” response to sensation, which is a condition called “sensory defensiveness.”  They may try to avoid certain sensations (events) from occurring by either withdrawing or engaging in an emotional outburst and misbehavior that enables them to get out of the threatening situation.  These children tend to be picky eaters, sensitive to touch and noises, engage in disruptive behaviors, very particular about clothing and textures, and/or have difficulty with transitions and changes in their routine.

Sensory Seeking:
These children are under responsive to sensations.  Their nervous systems do not always recognize the sensory information that is coming into the brain.  As a result, they seem to have a desire for and are constantly seeking sensory stimulation. They add sensory input to every experience in daily life and may make noises while working/playing, fidget, rub their skin, chew on things, jump, or crash into things.  They may take part in unsafe activities, enjoy loud sounds, act hyper, have difficulty focusing, and/or appear oblivious to pain.

Dyspraxia (Motor Skill Problems):
Some children with SID have trouble processing information properly, resulting in problems with planning and carrying out actions.  These children are often clumsy, awkward, and accident prone.  These children may have poor fine motor skills (such as handwriting), poor gross motor skills (kicking, catching, throwing a ball), and trouble with balance and coordination.

How is SID diagnosed?
SID can only be properly diagnosed by an occupational therapist (OT). Standardized tests, observations, and interviews with family members are methods used by the OT to help make the diagnosis.   SID difficulties can occur alone or along with many other diagnoses such as ADHD and Autism.

How is SID treated?
SID can not be cured, but with treatment can be minimized, the nervous system can be
changed, and the ability to process sensations can be improved.  Treatment may include therapy sessions with an OT one to two times a week and home activities done by the parent to help regulate the child’s nervous system throughout the day.  The OT will focus on activities which will meet the needs of the child’s nervous system.  This will promote better sensory integration and help the child develop appropriate behavioral responses to sensory input.  When a child’s nervous system feels properly organized and nourished, it is able to achieve optimum attention to tasks and performance of activities.  It has not been found that a child will grow out of this during adulthood, but the symptoms appear to lessen, as by then they have become more flexible and have gained coping skills.

Sensory Diet:
A sensory diet is a daily list of activities that a child can do during their day to feed their nervous systems and help them maintain a normal state of arousal (normal response to stimuli).
 
Tips for School:
What teachers need to know is that each type of child requires a different kind of environment.  Many children fluctuate between sensory avoiding and sensory seeking and thus, you will need to incorporate a combination of all the tips listed below. 
“Sensory avoiding” children overreact to sensations, panic easily and need a lot more soothing, slower transitions, and more patience.  They should not be placed in noisy, busy environments where they can get over loaded and thus, become anxious, aggressive, tantrum or withdraw.

  • Structure, consistency, and routine are critical.
  • Keep visual and auditory distractions to a minimum.
  • Keep a visual schedule on their desk. Warn then ASAP about changes in the schedule for the day.
  • Use firm pressure on their shoulder to get their attention versus light touch (can help organize their nervous system)
  • Give them a five minute warning about transitions.
  • Use a time out card that the child can raise when a time out is needed.  This allows the child to go to a quiet, supervised place, which can help him/her cope when things get overwhelming.
  • Put the child in charge of the back of the line (line monitor) where they are less likely to be unexpectedly bumped.

“Sensory seeking” children become more organized and attend better to task if they receive periodic movement input and proprioceptive input (sensations form the joints and muscles that leads to body awareness and can be obtained by lifting, pushing, and pulling heavy objects).

  • Structure, consistency, and routine are critical
  • Get eye contact when giving directions and have them repeat them back to you (Remember they have difficulty focusing)
  • Have the child sit on a inflatable pad filled with a small amount of air (allows for movement)
  • Suggest swinging, climbing or play on the monkey bars during break times
  • Have opportunities for extra movement (i.e., send them on errands, keep a rocking chair in class, have them wash desks, erase the blackboard, etc.)
  • Allow them to keep a Koosh ball in their hand or chew on a straw for sensory input
  • Have them push or carry heavy objects (i.e., move desks, carry books or backpacks, take out the trash)
  • Never take away recess privileges, which will intensify the random movements, fidgeting, and outbursts

Tips for Home:  These are general tips that can be helpful whether your child is sensory seeking or
 avoiding.  Also, all tips from above apply at home.

  • Do the home activities your OT recommends (will be individualized to your child’s needs.
  • and they assign these because your child’s nervous system needs them)
  • Keep frequent communication with their teacher.
  • Keep routine and structure and prepare them for changes in their schedule.
  • Catch them doing well and praise them.
  • Rewards and incentives work better than punishment.  Create a token system with a list of tasks/behaviors and rewards/points earned for each.

“Sensory avoiding”

  • Create a quiet area for the child to retreat when things get overwhelming
  • Avoid situations with too much stimulation if possible.  They will overwhelm the nervous system- (i.e., situations with too much noise, people, changes, demands, etc.)
  • Identify triggers to melt downs and make a plan to help avoid them.  When they can not be avoided, talk softly and remain calm.  They will feed off of your energy.

“Sensory seeking”:  See list below for ways to incorporate movement and proprioceptive activities at home.

  • Let them help with meal preparation- mix ingredients, roll dough, tenderize meat
  • When grocery shopping have them push the heavy cart or carry groceries
  • Encourage then to eat chewy or crispy foods and drink out of a straw
  • Have them vacuum, move furniture, carry laundry baskets, garden, etc.
  • Encourage play activities of jumping, use a rocking chair, swinging, climbing, pulling someone in a wagon, play in the sandbox, etc.

References/Resources:

The Out-Of-Sync Child:  Recognizing and Coping with Sensory Integration Dysfunction   (1998).  Carol Stock Kranowitz
 
The Out-Of-Sync Child Has Fun:  Activities for Kids with Sensory Integration Dysfunction (2003).  Carol Stock Kranowitz
 
The Sensory Sensitive Child (2004) Karen A. Smith, PhD and Karen R. Gouze, PhD
 
Sensory Processing Network (SPD)
www.spdnetwork.org
 
Buzzle.com
www.buzzle.com  (search word: sensory integration)
 
Sensory Processing Disorder Resource Center
www.sensory-processing-disorder.com
 
About.com
www.about.com   (search word: sensory integration)
 
Incredible Horizons
www.incrediblehorizons.com    (search word: sensory integration)
 
Sensory Smarts
www.sensorysmarts.com
 
Comeunity
www.comeuntiy.com

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