Understanding

Sensory Integration

In 1989 Jean Ayres defined Sensory Integration (SI) as follows:

Sensory Integration is the neurological process that organises sensation from one’s own body and from the environment and makes it possible to use the body effectively within the environment. The spatial and temporal aspects of inputs from different sensory modalities are interpreted, associated and unified. Sensory integration is information processing… The brain must select, enhance, inhibit, compare and associate the sensory information in a flexible, constantly changing pattern, in other words the brain must integrate it.”

Learn more

What is Sensory Reactivity?

Difficulties with sensory reactivity can present as over- or under-responsivity to sensory input and the modulation of sensory information.

A child with a well-modulated nervous system adapts effectively to changes in the environment and is able to maintain a level of arousal and attention appropriate to the task at hand.

The child is able to block out irrelevant information, attend to relevant information and respond appropriately and adaptively. This enables the child to engage in a meaningful manner in activities of daily life.

A child who is over-responsive to sensations, experiences difficulties with filtering sensory inputs and may experience sensory inputs more intensely than most other children. Over-responsiveness may lead to a fight, flight or freeze response to non-threatening stimuli.
A child who is under-responsive to sensations may not respond, or show a less intense response, to normal sensory stimuli. These children may appear to “miss” sensory information from their bodies or the environment.

What is Sensory Perception?

Children who struggle with discriminating the spatial and temporal characteristics of sensory input will have problems with tasks such as knowing how hard to press on their pencil, finding an object in a bag without looking, adapting the body during balance activities or learning the spatial orientation of numbers and letters.

What is postural and ocular control and bilateral integration?

Postural and ocular control and bilateral integration difficulties will be noticeable in the performance of daily tasks.

Children may struggle with postural and ocular control, which may present as a slouched posture during table-top activities, problems with making postural adaptations while moving during sporting activities, or struggling to maintain visual contact with a moving object such as an approaching ball.
They may also experience challenges with integrating the two sides of the body. This may lead to difficulties with bilateral tasks such as throwing and catching a ball, cutting, dressing and motor sequences like skipping and galloping.

What is Praxis?

Children can experience challenges regarding visual- and visual-motor planning, tactile perception and difficulties with imitating, planning and/or sequencing motor actions.

Challenges may also occur in the planning and coordination of new motor actions (this function is known as “praxis”). Children who struggle with praxis may appear clumsy, and uncoordinated, may be hesitant to engage in new motor activities, or may appear as though they do not know what to do with or how to use objects in the environment.

Evaluation

Evaluation in SI is an on-going process. Continued discussion with caregivers, teachers etc. is vital.

A combination of the following is used to gather data:
• Interviews with parents, caregivers, teachers etc.
• Sensory history questionnaires
• Observations in natural settings, i.e. home / school / playground.
• Clinical observations and formal observations during standardized testing.
• Formal assessment / Standardized testing
• Continued observation during therapy and continued interaction with parents is of the utmost importance

Treatment

Therapeutic activities are designed to provide the child with opportunities to master challenges during participation in activities and meet demands presented by the environment. In doing so, the therapist aims to effect change in the naturally malleable nervous system of the young child towards more effective sensory processing.

Once the child is processing and organising sensory information more effectively, he/she will find it easier to interact positively with his/her peers, play creatively and achieve success in all of his/her occupational performance areas at home and at school.

ASI® intervention can only be provided by occupational therapists with post-graduate training in ASI® and is characterised by certain unique features.

References:

1. Ayres, A.J. 1972. Sensory Integration and Learning Disorders. Los Angeles, CA: Western Psychological Services.

2. Ayres, A.J. 1989. Sensory Integration and Praxis Tests. Los Angeles, CA: Western Psychological Services.Parham, L.D., Cohn, E., Spitzer, S., Koomar, J.A., Miller, L.J., Burke, J.P., Brett-Green, B., Mailloux, Z., May-Benson, T., Smith Roley, S., Schaaf, R.C., Schoen, S.A., Summers, C.A. 2007. Fidelity in sensory integration intervention research. American Journal of Occupational Therapy, 61(2), 216-227.Schaaf, R.C. & Mailloux, Z. 2015. Implementing Ayres Sensory Integration®. 2015. AOTA Press: Bethesda.Van Jaarsveld, A. 2015. The realities of SI assessment and intervention in 3rd world countries. Presentation at European Sensory Integration Congress, Birmingham, UK.