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Sensory Integration (SI) is a theory and type of treatment used primarily by occupational therapists (OTR). Its principles are applicable to all children and adults, but are particularly useful for helping children with autism, learning disabilities, attention problems, prematurity, general developmental delays, Down Syndrome, low muscle tone, and behavior problems.

The concept was first described by Jean Ayres, Ph.D., OTR in the 1960's but has since been the subject of much development and research. There are several books on the subject and the entire theory can be quite complicated involving various complex neurological processes. However, the more I learned about SI, the more simple and useful it has become as a tool to help children develop. I believe the principles have been used for eons by parents who just instinctively know what their child needs. Below is my interpretation of the theory as I know it.

Information from the world comes to us through our senses. Some of the things we are able to perceive include: sights, sounds, smells, tastes, temperatures, pressure, pain, our own body position, movement of our body parts, and movement of our body through space. We perceive a lot of different things at any given moment, hence we have a big job to do in sorting it out, determining what to react to, what to ignore, how to react, etc. This organization and integration of all the various perceptions that enables us to make sense of our world and react to it appropriately is sensory integration.

The process of sensory integration begins before birth and continues throughout life, although the majority of our SI development occurs before we are young teenagers. It is automatic and unconscious, for the most part, and gets refined and more effective as we develop. Sensory integration plays a part in how well we develop our motor and speech skills, our emotional stability (the world can be pretty threatening if you can’t interpret what is going on or if your perceptions change/are unreliable), attention (the brain should screen out irrelevant distractions rather than every little thing pulling your attention away from the main task you are working on), and our behavior.

Eventually, good sensory integration gives you a foundation for more complex skills; it enables you to put your attention on tasks that require more cognitive skills such as learning and communicating effectively.

Determining Sensory Integrative Problems

We all have different capabilities as far as how well we organize and integrate perceptions, and these abilities fluctuate within ourselves depending on such things as: stress level, if we are tired or hungry, how well we have eaten, alcohol intake, our mood, illness, etc. We could look at sensory integrative abilities along a continuum - at one end is a very functional, well developed system and at the other end is a system that is barely functioning. Everyone fits somewhere along this continual (with slight fluctuations depending on different situations). A person could be said to have a problem with sensory integration to the degree that their problem interferes with their life and ability to attain their goals.

Most children develop sensory integration through their daily play and interactions. When a child has inefficient sensory integration, they have to put a lot more attention and effort into simple things that we take for granted and they may experience a higher degree of failure in the new things they try to do or learn.

Some of the signs of a sensory integration problem include:

Overly sensitive to touch, movement, sights, or sounds
Under-reactive to touch, movement, sights, or sounds
Fearful of heights or moving playground equipment
No apparent awareness of dangers (lack of appropriate fear)
Easily distracted
Social and/or emotional problems
Activity level that is unusually high or unusually low
Physical clumsiness or apparent carelessness
Impulsive, lacking in self control
Difficulty making transitions from one situation to another
Inability to unwind or calm self
Poor organization of behavior
Poor self concept
Delays in speech, language, or motor skills
Delays in academic achievement

Children with SI problems may have just some of these characteristic and the degree to which they exhibit them may vary. Again, the important thing in determining a problem is how much it interferes with their life and how it effects their self esteem.

Research has found that up to 70% of children identified as having learning problems, also have SI problems. Some children with SI problems have no learning problems (some are geniuses who excel in school). Sensory Integration problems are more likely to be seen in children with the following conditions: premature birth, autism or pervasive developmental disorders, learning disabilities, attention deficits with or without hyperactivity, children born to substance or alcohol abuse mothers, children in neglect situations, and failure to thrive infants.

Determination of sensory integrative function is usually done by an occupational therapist who has specialized training in SI. Most therapists have a working knowlege of SI concepts, but without extensive training beyond what they receive in school, they are not likely to be qualified to accurately assess and treat a child with suspected problems. Therapists who are specialized in SI use a variety of standardized tests and clinical observations to determine problem areas and help determine the best course of therapy.

Sensory Integration Therapy

Sensory Integration therapy is usually oriented to engaging children in experiences which are fun and facilitate the child's active participation - it is very extroverting and helps them develop better sensory perception and more control over their bodies and their environment. The therapy is directed by the child - they generally get to pick the activities and be creative in their play.

Part of the therapist's role is to help guide activities in such a way as to maximize the therapeutic value of each treatment session and provide assistance for safety or when confidence may be lacking. SI therapy does not attempt to develop specific skills, but rather provides the sensory and motor activities which help the overall functioning of the nervous system (and hence enhances language, motor skills, attention, behavior, etc).

The therapy is usually done by an occupational therapist in a therapy room with very specialized equipment 1-3 times a week. This room is usually heaven for most children and siblings may be begging to participate also. I say this just so you get the idea that therapy is generally not something you have to drag your child in for ... quite the contrary.

Your therapist should give you a home program of specific types of activities you can do at home with minimal investment and some special adaptations. You may also get trained in special strategies that can help with specific problems your child might have in everyday life.

While activities done at home are not the same as sensory integration therapy, they can help a great deal and should be done even if you are getting professional therapy in a clinic. The more a child is exposed to the appropriate activities the faster they progress. Some children with mild difficulties which do not warrant professional therapy can benefit greatly from a home program and participation in sensory-motor related community activities.

Many children with sensory integration problems receive OTR in their school program. Unfortunately, most schools are not equipped to provide sensory integration therapy and only provide therapy which utilize other types of occupational therapy services. While this other type of therapy may be beneficial to your child, it is not the same as SI and is generally not as effective when a child has an SI problem. Rather than admit that they cannot provide what your child needs, your school may insist that your child doesn't need SI or that it is not educationally relevant. There may be legitimate reasons why providing SI therapy in your child's school setting is not feasible. The debate over this issue may go on for a long time and rather than wait for your school to provide the SI that your child needs, it is usually best to seek outside therapy while continuing to work with your district.

The best way to find a qualified therapist is to look in the Yellow Pages under therapy, occupational therapy or physical therapy and call clinics or hospitals that specialize in pediatrics. Ask for referrals to an OTR specialized in sensory integration.

Barb Henry, OTR
Copyright 1997

Barb Henry has been a pediatric occupational therapist since 1985 and is currently in private practice in Clearwater FL. Her specialty in sensory integration has resulted in extensive experience with children with autism, attention deficits, learning disabilities, prematurity and general developmental delays. She has a nationwide consulting practice in which she helps parents utilize natural health methods and in-home therapy to help their children overcome difficulties.
This article is for information only, and should not be considered as medical advice. It is supplied so that you can make an informed decision. Please consult with your health practitioner before considering any therapy or therapy protocol.

This article provided compliments of Born to Love

PLEASE NOTE:Born to Love has only posted this article to our site for the information provided. We have no personal knowledge or experience with this subject and we have lost contact with the author.

However, there are several organizations that may be able to help:

Sensory Integration Network :
Sensory Integration International :
Sensory Integration Resources : resources.html

Copyright 1997-2003 - Born to Love

Last updated - October 24, 2009