Sensory Integration What does it mean for infants and toddlers? Definition n The ability to organize sensory for use in daily life n Taking in the sensations of touch, movement, sight, and sound coming from their bodies and the environment, putting it together with prior information, , and and responding in a well-regulated manner n The work together to form a picture of where we are and what is going on around us Dr. A. Jane Ayres

n An who first researched and described the that are now sensory integration n Defines sensory integration dysfunction as a sort of “traffic jam” in the Quiz… n Without looking, tell me… n Are your legs crossed or are your feet flat on the floor? n Are you holding a pencil or pen? n Can you feel the tag in your shirt? n How do you know? How do we take in information? n The far senses respond to external stimuli that come from outside our bodies n Smell, , vision, , touch n The near senses respond to what is happening in our own bodies n Tactile, vestibular, proprioceptive The Near Senses n Tactile – information about touch received through the skin n Vestibular – information about movement, gravity, and balance received through the inner n Proprioceptive – information about body position and body parts received through muscles, ligaments, and joints Four Levels of Sensory Integration n Level 1 – Primary n Level 2 – sensory systems Perceptual Motor n Tactile Foundations

n Vestibular sense n Body Percept n Proprioceptive n Bilateral sense Coordination

n Visual and auditory n Lateralization senses n Motor Planning Four Levels of Sensory Integration

n Level 3 – Perceptual- n Level 4 – Academic Motor Skills Readiness n Academic skills n Auditory n Complex motor skills n Visual perception n Regulation of n -hand coordination n Organized behavior n Visual-motor n Specialization of body and integration brain n n Purposeful activity n Self-esteem and self- control Inefficient Sensory Integration n AKA Sensory Integration Dysfunction n The brain’s inability to process sensations efficiently n Inefficient sensory intake

n Neurological disorganization n Inefficient motor, language, or emotional output Five Caution Statements n The child with sensory integration dysfunction does not necessarily exhibit every characteristic. n Inconsistency is a hallmark of neurological dysfunction. n The child may exhibit characteristics of a particular dysfunction yet not have that dysfunction. n The child may be both hypersensitive and hyposensitive. n Everyone has some sensory integration problems now and then. Comparison of SI and SID

Typical Atypical What The ability to absorb the information from the environment Inefficient, unusual, or incorrect processing of basic sensory and from the body. Then to take this sound, touch, vision, information. Consequently, this creates stress in balance, or movement and organize it into information to and growing, which results in difficult social and cultural use in daily life. interactions with others. Where In the central nervous system, as a balanced process that In the central nervous system, but with difficulty screening involves screening out the information that is not important out unimportant elements (or noise) from the environment. and acting on the information that is important. Most of As a result, interaction with the basic environment can be this process is automatic – not at a cognitive level. stressful. The more forms of input, the higher the difficulty and frustration. Why Typical sensory integration is important on various levels: Inefficient central nervous system processing creates for survival, making sense of the world, interacting with the problems with appropriate interactions with internal and environment, and interacting with other people. All require external environments. This results in dysfunctional effective . behavior and social and survival difficulties. How The process happens automatically as the person takes in The central nervous system is unable to process sensory sensations from the skin, , nose, , , information efficiently or appropriately. There may be over- muscles, and joints. or under-responsiveness to normal . When Begins before birth and continues developing throughout Begins before birth and continues throughout childhood and childhood, with most functions established by adolescence. Without intervention providing the appropriate adolescence. In normal development with a nurturing enriched therapeutic sensory experiences, integration is environment, sensory integration happens naturally and stressful and inefficient. without effort. Tactile Sense n Smoothly functioning – tactile stimulation keeps us organized and functioning n Received through sensory receiving cells in the skin n Touch sensations of pressure, vibration, movement, temperature, and activate tactile receptors 2 Tactile Components n Protective (defensive) System n Alerts us to potentially harmful stimuli n We need it to survive n We become less conscious of this system as we mature – we learn to tolerate sensations n Discriminative System n Tells us we are touching something or that something is touching us, where on our body the touch occurs, whether the touch is or deep n Messages between the two systems continue throughout our lives so that we can interpret tactile information The Out-of-Sync Tactile System n Inefficient processing n The child may: in central nervous n Have difficulty with system of sensations touching or being perceived through the touched skin n Be unable to distinguish between n Hypersensitive different sensations n Hyposensitive n Misinterpret touches n Poor tactile n Be unable to discrimination discriminate physical properties of objects Hypersensitivity – Tactile Defensiveness n Fight or flight n Withdraw passively n Craves deep touch Hyposensitivity – Under-responsiveness n Underreacts to tactile experiences n Constantly touch objects and people n May seem unaware of all but very intense sensations Poor Tactile Discrimination n Information about how things feel is not registered n Needs to touch and handle familiar objects repeatedly to learn about their weight, texture, and shape How Does the Tactile Sense Affect Everyday Skills? n Tactile perception n Body n Motor planning n Visual perception n Academic learning n Emotional security n Social skills Characteristics of Tactile Dysfunction Vestibular Sense n Smoothly functioning – tells us where our and bodies are in relation to the surface of the earth n Takes in sensory messages about balance and movement from the neck, eyes and body n Helps generate muscle tone n Tells us whether we are moving, what direction we are going, and how fast we are going 2 Vestibular Components n Defensive n Helps us survive – senses danger and reacts to it n Counteracts gravity – reactions n Discriminative

n Back & forth vs. side to side vs. up & down vs. rotary movement The Out-of Sync n Inefficient processing n The child may: in the brain of n Be oversensitive, undersensitive or both sensations perceived n Be late learning to walk through the inner ear n Be awkward, n Inefficient at uncoordinatied and clumsy integrating n Fall often and easily n Have difficulty processing information about language movement, gravity, balance, and . How Does the Vestibular Sense Affect Everyday Skills? n Gravitational security n Auditory-language n Movement and processing balance n Visual-spatial n Muscle tone processing n Bilateral coordination n Motor planning n Emotional security Characteristics of Vestibular Dysfunction Proprioceptive Sense n Smoothly functioning tells us about our own movement or body position. n Provides intake that helps integrate touch and movement sensations. n Receptors are in muscles, joints, ligaments, tendons, and connective tissue. n Functions of are to increase body awareness and contribute to motor control and motor planning. The Out-of-Sync Proprioceptive System n Inefficient processing of sensations perceived through the muscles, joints, ligaments, tendons, and connective tissue. n Usually accompanied by problems with the tactile and vestibular systems n Difficulty interpreting sensations about position and movement of and limbs n Poor sense of body awareness and body position n May have motor planning difficulty – appear clumsy. How Does the Proprioceptive Sense Affect Everyday Skills? n Body awareness n Motor planning and motor control n Grading of movement n Postural stability n Emotional security Characteristics of Proprioceptive Dysfunction Three Valid Reasons to Seek Help n Does the problem get in the child’s way? n If he struggles with natural skills – creeping, running, jumping, climbing, talking, listening, hugging, and playing n If he struggles with low self-esteem n Does the problem get in other people’s way? n If the problem causes behavior that may not bother the child, but bothers everyone else n If the child’s behavior differs dramatically in different situations n Should you listen when a teacher, pediatrician or friend suggests you seek help? n If they have dealt with many children and can recognize disorganized behavior Characteristics of Sensory Integration Dysfunction n Sensory processing – touch, movement, body position, sights, sounds, smells, n Behavior problems – unusually high/low activity level, impulsivity, distractibility, poor muscle tone or motor coordination, poor motor planning, lack of definite hand preference by age 4 or 5, poor eye-hand coordination, resistance to new situations, difficulty with transitions, frustration, self-regulation problems, academic problems, social or emotional problems Checklist for Adults 5 Cautions - again n The child with sensory integration dysfunction does not necessarily exhibit every characteristic. n Inconsistency is a hallmark of neurological dysfunction. n The child may exhibit characteristics of a particular dysfunction yet not have that dysfunction. n The child may be both hypersensitive and hyposensitive. n Everyone has some sensory integration problems now and then. So…what can you do? n Record troubling times AND terrific times! n Talk to parents n Talk to Occupational Therapist n Make referral n Be involved in services identified or follow- up necessary Activities to develop tactile integration

n Rub-a-Dub-Dub – rub different textures on skin – soap, scrubbers, lotions n play – tub with toys, cups, sponges n Water painting – outside with brush or squirt bottle (clean water) n Finger painting – with different textures or substances (peanut butter/shaving cream/pudding n Finger drawing – on the child’s back n Sand play – or beans, rice, pasta, cornmeal, pasta, popcorn, mud, coffee beans, etc. n Feelie box – guess what the toy is n Can you find it? – hide small objects in sandbox or feelie box n Can you describe it? – talk about textures, temperatures and weights Activities to develop tactile integration

n Oral activities – licking stickers, blowing whistles/kazoos, blowing bubbles n Hands-on cooking – mix the dough n Science activities – touching worms, planting seeds, collecting leaves n Handling pets n Box play – different sizes to nest, stack, paint, etc. n Swaddling – roll child up tightly in a blanket – provides deep pressure n Back rubs – deep firm pressure – rub downward n Dress up n Secret hideaway – build a fort with blankets, sheets, towels, sleeping bags, comforters, pillows, etc. Activities to develop vestibular integration n Rolling n Sitting on a t-stool n Swinging n Sitting on a ball n Spinning n Balancing on a therapy n Sliding ball n Riding vehicles n Tummy down, head up activities n Jumping n Going up and down stairs n Walking on unstable surfaces n Somersaulting n Rhythmic rocking n Running n Riding, balancing, and n Tightrope/walking on a walking on a seesaw line Activities to develop proprioceptive integration n Carry heavy loads n Pouring n Push and pull n Opening doors n Hanging by arms n Ripping paper n Tug-of-war n Pillow crashing n Bulldozer n Hermit crab n Playing catch n Joint squeeze n Roughhousing n Body squeeze n Leapfrog or any n Bear hugs contact sport