Sensory integration refers to the processing, integration, and organization of sensory information from the body and the environment.
Simply put, this means how we experience, interpret and react to (or ignore) information coming from our senses. Sensory integration is important in all the things that we need to do on a daily basis, such as getting dressed, eating, moving around, socializing, learning and working.
Sensory information is received from our senses, which include:
Sensory integration, or sensory processing, is an automatic neurological process that occurs throughout our life. Sensory integration develops naturally during ordinary childhood activities, however, for some people, it does not develop as efficiently as it could and can affect activities of daily living, academic achievement, behavior or social participation.
Sensory integration challenges or difficulties can be described as:
“A decreased ability to process and integrate sensation [that results] in difficulty producing appropriate actions, which, in turn, may interfere with learning and behavior” (Bundy and Lane, 2020)
Our understanding of sensory integration was initially developed in the late ’60s and ’70s by Dr A Jean Ayres, an occupational therapist with advanced training in neuroscience and educational psychology, working in the USA. Ayres defined sensory integration as:
“The neurological process that organizes sensation from one’s own body and from the environment and makes it possible to use the body effectively with the environment.” (1972).
Sensory Integration Therapy is based on the theory she developed, which is now known as Ayres Sensory Integration ® (ASI).
The terms “sensory integration” and “sensory processing” both refer to the processes in the brain that allow us to take the signals from our senses, make sense of those signals and respond appropriately.
The concept of sensory integration was first developed and described by Dr A Jean Ayres in the 1970s. In 2006, Dr Lucy Miller published a model of “sensory processing disorder” based on Ayres Sensory Integration.
Therapists and authors tend to use a particular term depending on where they trained.
What happens if the signals coming from our senses are too weak? Or too strong? Or if our brain over or under reacts to the signals? Or if the brain can’t make sense of those signals? The individual will experience sensory integration difficulties and this may be evident in their behaviour. Some individuals may experience the sensory inputs as overwhelming and upsetting, leading to ‘sensory overload’. Individuals may be over sensitive to sensory input, under sensitive, or both.
It’s common for all of us to occasionally feel under or over sensitive to sensory inputs; for example, music or bright lights may feel too much if you have a headache; you can feel uncoordinated or find it hard to focus if you are tired. But these feelings are temporary and wouldn’t normally affect your day-to-day functioning in the long-term. Sensory integration or sensory processing difficulties are long-term and have a big impact on everyday life and learning. But with professional advice and, if appropriate, therapy, much can be done to support improvements in a person’s daily functioning.
Some individuals may have difficulty processing input from one particular sense (eg, visual processing), whereas other individuals may experience difficulty integrating inputs from more than one sensory system. Note that sensory integration difficulties are different from sensory impairments such as hearing loss, although sometimes the two result in similar behaviors. For example, an individual with perfect hearing can find it difficult to follow conversations if they have difficulties processing the incoming auditory signals.
Some individuals may experience one or both categories of sensory integration differences.
There are also subtypes under each broad category.
People with over-responsivity may have heightened reactions to sensory input. They may:
People with under-responsivity may have a reduced reaction to sensory input. They may:
People with this subtype may experience difficulties in processing vestibular and proprioceptive sensations, and it affects the ability to control body extension, balance, bilateral integration, sequencing of movements and motor planning of movements.
Somatodyspraxia relates to difficulties in coordinating and executing new, rather than habitual, motor tasks. It also involves poor tactile, vestibular and proprioceptive processing. People with somatodyspraxia may:
Therapists qualified in sensory integration use this framework to assess and help children and adults with these sensory difficulties. They create individually tailored strategies and activities that can improve how individuals process and respond to sensory information, ultimately enhancing their daily life functioning, social interactions, and academic performance. Therapists will also advise on accommodations that can be made to home, school and work environments.
Because sensory integration difficulties can co-occur with other diagnoses (including autism, ADHD, OCD, genetic syndromes and learning disabilities), as well as with no other diagnosis at all, it’s difficult to put an exact figure on the prevalence.
One 2009 *study, found that 1 in every 6 children has sensory processing issues that make it hard to learn and function in school. Other studies have found that **66% of autistic children (65-90% of autistic children, depending on the research study), and 32% of children with special education needs (who were not autistic) show definite differences in sensory behaviors.
More recently, a 2020 paper*** found that sensory processing difficulties predicted executive and cognitive dysfunctions in inhibitory control, auditory sustained attention, and short-term verbal memory in autistic children within a school context.
SI therapy (or SI interventions) include structured exposure to sensory input, movement therapy, balance treatments, carefully designed and customized physical activities and accommodations (eg, changes to the environment or routine). An SI Practitioner may work with the client, their family, carers, school, other allied health professionals or employer (as appropriate) to create a ‘sensory diet’ for that specific client. A sensory diet is a recommended suite of activities and accommodations (that can be carried out both in therapy sessions and at home or school) to help give that individual the sensory input they need.
For many people, small adjustments to their environment or to the way they are allowed to move at school or at work can make a huge difference to how they manage their day-to-day life.
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