Difficulty in Processing and Organizing Sensory Information (Sensory Integration Dysfunction)

Health & Safety Notes Difficulty in Processing and Organizing Sensory Information (Sensory Integration Dysfunction)

Sensory Integration is the ability to take in infor- depends on information that the brain receives from mation provided by all the sensations coming from three different sources—the eyes, the muscles and your body and the outside world, and to make sense joints (proprioception), and the vestibular organs in out of it. Sensory Integration is necessary in order to the inner ears. Proprioception helps us keep track be able to interact socially, to develop motor control, of where our body parts are in space and what they and to learn. Sensory Integration occurs in the brain. are doing without our having to look at them or We tend to think of the senses as separate, but they think about it.. For instance, when you close your work together to give us a dependable view of the eyes, how do you know where your right hand is? world. We depend on good integration of our sen- Children with proprioception problems may have sory functions to carry out our daily activities. problems with awkwardness, stiffness, or appear weaker than other children. They cannot feel where What is Sensory Integration their body is in space. They must actually look at Dysfunction? a body part to see where it is. Movement requires Difficulty in processing and organizing sensory in- conscious effort and can be hard work. formation, called Sensory Integration Dysfunction The vestibular system or organ of balance (SID), interferes with a child’s ability to: Proprioception works with the vestibular system, • learn, a fluid filled network within the inner ear, andis • to achieve important developmental milestones responsible for the sensation of balance and mo- • to have healthy social relationships tion. Vestibular sensations provide information with caregivers and other children about where the head and body are in relation to • to feel good about themselves the ground. Children with vestibular problems may Children with SID have normal intelligence. dislike movement (think of how it feels to be sea- SID occurs in 5 to 15% of children. sick) or, at the other extreme, crave it, like the child Disorders in this area can affect our ability to func- who spins constantly. They may also have problems tion, but also often go unrecognized. In young getting from one position to another or starting and children, problems with processing sensory informa- stopping movement. They may have problems plan- tion are often seen as behavior problems. Children ning and carrying out actions. with Sensory Integration Dysfunction (SID) may What are the signs and symptoms? suffer from anxiety, depression, poor self-esteem Sensory problems are highly variable in different and social isolation. It is important to identify these children and can range from mild to severe. Typical- children early and provide early intervention to ly, children with SID have inconsistent responses to avoid the emotional and developmental effects of sensory information. They may be oversensitive to the disorder. some types of sensory experiences and undersensi- There are actually six senses tive to others, or even oversensitive to an experience In addition to the five we were all taught about in one day and undersensitive to the same experience school (sight, smell, sound, taste and touch) there another day. For instance, a child may be hyper- also is another sense that we are not conscious- sensitive to the feeling of lotions or other slimy ly aware of. This sense is called proprioception substances on her skin and cry uncontrollably or act (pronounced PRO-pree-o-SEP-shun) and is our out when sunscreen is applied or her hair is sham- “position” sense, The ability to maintain balance pooed, while also being hyposensitive to hard or abrasive surfaces which she seeks out over and over with others, or achieve developmental milestones, again, even if it results in physical harm. It is like hav- she may need an evaluation for SID. The diagnosis ing a “volume control” for sensory experience that is best made by an occupational therapist who has doesn’t work properly and the child’s threshold for advanced training in sensory integration, after a thor- response is either too low or too high. For example, ough assessment. the child may hear a police siren from blocks away How is Sensory Integration Dysfunction treated? and start to shriek. Children with SID may also have Occupational Therapy (OT) can help a child process, difficulty screening out sensory information that and manage his responses to, sensory information. they don’t need. These children are very distractible Children with SID can make huge improvements because they don’t know what incoming sensory in- with early intervention. A planned practical pro- formation is important to pay attention to and what gram of specific sensory activities is developed to should be “background,” and best ignored, in order fit each child’s individual needs. The overall goals to attend to the task at hand. For instance, the child of OT are to improve the child’s social relationships, who cannot hear the teacher give a direction because self-esteem, and sensorimotor abilities. Children he is listening to the sound of the sprinklers outside. can be taught specific startegies for self-regulation All of this can be confusing for parents and caregiv- that help them achieve a sense of control over an ers. It may look like a behavioral problem or just a environment that otherwise often feels chaotic and child’s “quirky” personality rather than a problem threatening. In addition, the Occupational Thera- with how a child’s brain is “wired.” pist works with the child’s parents and teachers to What causes Sensory Integration Dysfunction? make changes in the child’s environment, to adapt SID may occur with another diagnosis like au- daily routines, and to make changes in how people tism or Attention Deficit Hyperactivity Disorder interact with the child that can allow the child to (ADHD) or anxiety disorder, but it can also occur succeed. on its own. There is evidence that children with SID The fact that SID can occur with, and look like, other have problems with their nervous system. There is disorders, means that it is often misdiagnosed and also some evidence that SID is inherited through misunderstood. It is important to think about SID genes. Premature babies are at higher risk for SID, when you observe children who are easily over- as are children adopted from orphanages in foreign whelmed by, or withdrawn from, the sensory world countries. This is because the environments in many (see the screening tool references below). Early in- foreign orphanages have limited resources and chil- tervention can change a child’s life! dren receive little exposure to sensory stimulation early in life. Environmental toxins may also play a By Vickie Leonard, RN, FNP, PhD role in SID. When should a child be referred for an evaluation for SID? Resources and References: The following behaviors may indicate a sensory The Sensory Processing Disorder Network processing problem: www.sinetwork.org/ • the child is disorganized Biel, L and Peske, N. (2005) Raising a Sensory Smart Child. • the child has difficulty focusing on an activity New York: Penguin Books. • the child crashes through his environment • the child is clumsy or has poor balance or Kranowitz, C (1998) The Out-of-Sync Child: Recognizing is accident-prone and Coping with Sensory Integration Dysfunction. • the child watches activities fearfully Sensorimotor History Questionnaire for Parents of Pre- from the sidelines school Children • the child consistently avoids a certain type of www.sinetwork.org/aboutspd/questionnaire.html sensory experience (for instance, loud noises.) THE SENSORY INTEGRATION OBSERVATION GUIDE If these behaviors seem to be interfering with a Level I: 0 - 12 month old scale child’s ability to have meaningful social relationships www.sinetwork.org/aboutspd/prof-siobsguide.pdf 9/08

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