The 8 Senses
In sensory integration we are focused on all 8 senses. There are 5 that are immediately thought of – seeing, hearing, tasting, smelling and the sense of touch. So, what about the other 3......
Often described as 'Knowing where your body is in space'. To explain this further, our muscles and joints have tiny sensory receptors that tell our brain where our body parts are. When you put a fork to your mouth, you don’t need to look at the fork to see where it is or feel for your mouth to know where to place the fork; you know where your hand is in relation to your mouth. It is largely your proprioceptive receptors giving you this information. Your brain then uses this information to plan movements so that you can coordinate your body. See this short video.
Known as 'the movement sense'. Lets explain a little....In our inner ear we have small, fluid filled canals, the fluid in these canals moves every time we move our head. Receptors in these canals pick up the direction of movement and send this information on to our brain. So we know if we are moving forwards, backwards, side to side, tilting our head, turning round or moving up and down.
Once again, our brain uses this information to plan for movements and help us maintain our balance.
Interoception: this is a fairly new area for discussion in sensory integration; interoception is how our body tells our brain what is going on inside our body, when we are hungry or feel full, when our heart is beating fast or when we have that sensation of butterflies in the stomach.
Jean Ayres was particularly interested in the interaction between and development of the vestibular, proprioception, touch, vision, and hearing. She saw these as important in supporting our ability to use our body, concentrate, develop self-esteem and confidence as well as having self-control and academic skills.
Do you know me poster. Click the link
Sensory integration therapy
Sensory integration is a subconscious and automatic neurological process that occurs in every person at all stages of life. Our brains take in information through our senses and organise it so that we are able to respond appropriately to particular situations and environmental demands. Sensory experiences include touch, movement, body position, vision, smell, taste, sound and the pull of gravity.
For most people sensory integration develops in the course of ordinary childhood activities. When a person has good sensory integration then they are able to process information automatically and efficiently. But for some people, sensory integration does not develop as efficiently as it should and can affect activities of daily living, academic achievement, behaviour or social participation.
Children can present with different types of sensory integration difficulties (also known as sensory processing difficulties). These include:
Hyper (over) Reactivity
Fear of heights
Dislike of touch experiences eg nail cutting, messy play, hair cutting
Dislike of loud and sudden sounds
Avoidance of playground equipment (swings and slides)
Hypo (under) Reactivity
Appears to have no fear or doesn’t feel pain
Seeks movement or touch opportunities (fidgets, rocks, runs about, leans on peers)
Mouths or chews things
Poor attention to the environment or people around
Motor Planning (praxis)
Difficulty creating movement ideas
Difficulty planning and executing new movements
Slouches at desk
Fidgets/difficulty sitting in one position for extended period of time
Impact on fine motor coordination & ball skills
Sensory integration provides occupational therapists with a framework for assessing and treating children who present with the difficulties outlined above.
Different ways an occupational therapist may use an sensory integration approach:
Assessment - Both standardised and informal. Our Therapists have had full training and the necessary formal qualifications to deliver a SIPT (Sensory Integration Praxis Test) - Please see sub section below for more information - as well as an ongoing process of assessment, tailored to the clients' needs.
Provision of a sensory diet and sensory based therapeutic activities for home and school
Direct 1:1 therapy using specialised equipment
Environmental adaptations at home and school
Consultation & education with carers and school
The Sensory Integration and Praxis Tests (SIPT) measure the sensory integration processes that underlie learning and behaviour. By showing you how children organize and respond to sensory input, it helps pinpoint specific neurological problems that impact on a child’s daily functions. The SIPT can help to explain why some children do not learn or behave in the way we would expect.
Sensory integration is the neurological process by which sensations (such as from the skin, eyes, joints, gravity, and movement sensory receptors) are organized for use. Praxis is the ability by which we figure out how to use our hands and body in skilled tasks like playing with toys, using a pencil or fork, building a structure, straightening up a room, or engaging in everyday self-help or school based activities.
The SIPT It is composed 17 sub tests, which provide a comprehensive assessment of sensory processing, perception and praxis. It measures:
Visual perception, discrimination and processing
Kinesthetic perception and processing (awareness of body position, weight, or movement of the muscles, tendons, and joints.)
Praxis (balance, posture, accuracy of motor movements)
Sensorimotor (integration of information all the different senses)
Following the assessment, a detailed report is provided, which provides standardised scores that build a clear profile of your child’s strengths / difficulties. Advice and recommendations will also be provided, including a personalised programme of activities.
The SIPT can only be perfomed by SI certified therapists.
Jean Ayres defined sensory integration as:
“The neurological process that organises sensation from one’s own body and from the environment and makes it possible to use the body effectively with the environment”
Photo credit: By family member (personal photo) GFDL, via Wikimedia Commons.
ASD (Autistic Spectrum Disorder) and Sensory integration
Children with autism and attention deficit hyperactivity disorder (ADHD) tend to exhibit significantly different patterns of sensory processing to their peers and to children with other special educational needs (SEN).
It is estimated that 60 to 70 per cent of children with autistic spectrum disorder (ASD) present with sensory modulation/processing disorder (Adamson, 2006). Studies have shown that people with autism are slower to integrate inputs coming in from their senses, making their processing speed much slower. This may go some way towards explaining why children with ASD are often subject to “meltdowns”. Children with autism lack the appropriate “filters” to screen out irrelevant information and this can cause meltdown as each input builds and builds without being filtered out appropriately. They may be still processing, for example, the earlier noise in the corridor at the same time as trying to deal with new inputs from the teacher and fellow students in the classroom. As one student said to me recently, “I cannot keep reading because my eyes are full up at the moment”.
Sensory overload can present itself in many ways, such as challenging behaviour, withdrawal and complete shutdown.
The diagnosis process for ASD can feel daunting and challenging in the beginning. It can be a minefield of mixed information and sometimes conflicting opinions. Below are the NICE guidelines for the referral and diagnostic process. As you see, Occupational therapy is included on the exclusive list of health professionals that should be involved in the 'Autism Team' for 1.1 Local pathway for recognition, referral and diagnostic assessment of possible autism.
Formal occupational therapy assessments, combined with Sensory Integration tests can be performed with thorough reports produced, to assist with the diagnostic process. We can work independently as well as along side NHS health professionals, to gain a bigger picture of the Clients' needs and how to formulate a plan to progress. Our therapists have experience of this process with great success and useful contacts within the local area. We are being recommended more and more by GPs and Paediatricians to be the first port of call when a child is showing signs of sensory processing difficulties.