Sensory integration defines the way the senses are used to understand the environment. The body takes in the information from the environment through the senses and delivers these sensations to the brain which processes and interprets the sensations and activates an appropriate physical response. Sensory integration disorder occurs when the flow of sensations is disorganized and the brain cannot interpret the sensations correctly, causing the body to feel overwhelmed, like being in rush hour traffic.

Thus, the brain, like a traffic policeman directing the flow of traffic, directs incoming sensations to the part of the brain that is specialized to handle them. When the flow of sensations is orderly, the sensations can be used to understand and negotiate the world, but when the flow of sensations is disorganized, the body can feel overwhelmed, like being in rush-hour traffic. Infants are born with millions of neurons which develop connections for the flow of traffic, and these neurons must be stimulated to develop these roadways. It is play and exploration of the environment by the developing child, opportunities for the sense organs to be in constant and repeated contact with the environment, that develop the process.

The individual may under- or over-react, depending on his sensitivity to the sensory input, behaving in ways that may be baffling to others. If a child’s reaction is over-sensitivity the individual may react negatively to any physical contact or avoid routine activities such as grooming, because these activities are too intense or painful. If a child’s reaction is under-sensitivity to sensory input, the individual may crave input to such extremes as flinging himself onto the floor or against the wall and seem not to feel pain.

We all know the familiar senses of taste, sight, sound, and smell, but we seldom think about touch, and most are less familiar with the two “hidden” senses which are equally important:  the vestibular and proprioceptive senses. These senses work closely together to help maintain balance and coordinate movement. When a new activity is attempted, such as walking on a balance beam, these senses integrate to give the body the information it needs to stay upright, maintain balance and move in a desired direction.

The vestibular sense provides the sense of movement across the balance beam. It coordinates the movements between the out-held arms and the stepping feet and permits the arms and legs to work together with the eyes to keep the body from falling off. The vestibular sense tells the individual where he is in relation to people and objects in the environment, allowing him to maneuver around in a crowded area without bumping into things, as well as know where he is in relation to the earth when climbing.

The proprioceptive sense gives the individual information about where the bones, joints and muscles are and what they are doing. It is this sense that helps him apply the right amount of strength to pick up an egg or hammer a nail without having to consciously think about how much force to use.

Because sensory integration disorder affects proprioception, the individual may experience difficulties with coordination, balance, movement and position in space. The vestibular system may be involved; the individual may not be able to stand in a queue and may be irritating to others because of proximity issues. Moreover, there may be mixed profiles of fluctuations between very high and very low activity levels, which seem to follow no specific pattern. For individuals with sensory integration disorder and difficulties regulating arousal levels, attention is usually discrepant, which makes it difficult to learn, to understand and express feelings, and to interact with others.

How do I know if my child has a sensory integration disorder?

There is a wide array of possible signs of a sensory integration disorder. Possible symptoms include:

• Exhibits extreme reaction to sudden, high-pitched, or loud noise
• Is easily distracted by background noise
• Is fearful of surprise touch, avoids hugs
• Does not enjoy swings and playground equipment
• Has poor balance
• Avoids or dislikes messy play
• Is distressed about brushing teeth, brushing hair, washing face
• Is fearful of feet leaving the ground
• Demonstrates constant need to touch people or textures, even when inappropriate
• Is clumsy or uncoordinated
• Has a high tolerance for, or indifferent to, pain
• Is in constant motion
• Craves fast, intense motion
• Is a “thrill-seeker” even when dangerous
• Seeks out jumping and crashing behavior
• Loves to be wrapped tightly in blankets
• Prefers clothes to be as tight as possible
• Frequently falls on floor intentionally

A sensory integration assessment conducted by an occupational therapist (OT) can determine whether your child’s specific sensory behaviors warrant intervention or are within normal limits.

How can occupational therapy help?

Occupational therapists (OTs) are trained to understand and address problems with sensory integration. Activities are planned which provide the “just right challenge” to enhance the individual’s ability to accurately interpret and respond to sensory input. The therapist builds on the individual’s strengths while providing motivation for participation in activities that help organize sensory input.

What can I do to help?

Participating in your child’s occupational therapy sessions can be beneficial for both you and your child. In sessions, you can learn strategies that can be beneficial to support your child’s sensory needs in other settings. Additionally, your child’s OT may suggest and teach you specific treatment methods that can be administered frequently throughout the week when not in therapy sessions to help your child make the most gains.