Shedding Light on Sensory Integration Disorder
By Janet Willoughby
A: Children diagnosed with Sensory Integration Disorder have difficulty processing and acting upon sensory information received by the body. We receive sensory stimulation through sight, sound, touch, movement and taste. If you think about all the sensory stimulation you encounter throughout the day, it is amazing how our bodies are able to process and make the necessary adjustments without requiring too much of our attention.
For instance, when the body feels stimulation through touch, the nerves need to first feel the stimulation. The nerves then carry the stimulation to the brain for interpretation. If the brain interprets the stimulation as harmful, the body performs the fright-or-flight response, and acts instantly upon the stimulation. If the brain feels the stimulation is acceptable, the stimulation is moved farther into the brain to decipher what the touch was — a pat on the arm, a shirtsleeve, etc. The brain adjusts to the touch, and in most instances we are able to go about our day without constantly thinking about the shirtsleeve touching our arm.
Children with Sensory Integration Disorder have a breakdown in communication somewhere along the journey of the stimulation to the brain. In some children, the nerves don’t feel the sensation in a typical fashion, so the brain interprets the sensation as harmful when it would ordinarily process the stimulation as OK. Other children feel the sensation fine, but their brains have trouble interpreting the sensation and the stimulation gets stuck at the first stop in the brain, leading the body to react with an extreme response — crying, screaming, removal/avoidance of item, covering ears, etc.
Everyone has sensory stimulation we don’t like. Some people hate the movement of roller coasters, some don’t eat Jell-O because of the way it feels in their mouth and some cover their ears to the sound of fingernails running down a chalkboard. However, we are still able to function in all aspects of our lives and respond calmly and in a socially acceptable manner when faced with our dreaded stimulation! Imagine your life surrounded by that one sensation you cannot tolerate, and everywhere you went or looked, you would encounter that sensation. It would be very difficult to pay attention to your job, to focus on a conversation you are having with someone or try to learn a new task.
This is how children with Sensory Integration Disorder feel every day. Their bodies don’t feel organized or comfortable to them, so these children spend their time trying to regulate their body so they can focus and pay attention. A child with Sensory Integration Disorder might display any number of actions that parents, teachers and other professionals interpret as behavior problems or bad parenting. The children want to focus, but they are so distracted by their bodies’ sensory needs that they are unable to shift their focus to their teacher, parent, homework, etc.
Carol Stock Kranowitz wrote a parent-friendly book, “The Out-of-Sync Child,” which paints a clear picture of children with Sensory Integration Disorder and explains the variety of sensory concerns a child might encounter. With regard to Sensory Integration Disorder, there are several different classifications on how the children respond to sensory stimulation. The first is often termed “sensory over-responsivity,” and these children tend to become excitable or over-stimulated with the slightest sensory stimulation. Next is “sensory under-responsivity,” in which children require a lot of sensory stimulation to produce a change in their body. The final classification is the “sensory seeking/craving” children whose bodies are in need of stimulation, so they touch, taste, stare and listen to everything in their surroundings to try to provide their body with the needed sensation. Within each classification, there is a broad range of severity, depending on the child’s ability to function in everyday life while having these sensory needs.
How do we help these children feel comfortable in their bodies again, so they can focus and function in their surroundings? The primary intervention for children with Sensory Integration Disorder is Occupational Therapy. Occupational Therapy services can help determine what classification the child is and create a “sensory diet” with the family. A “sensory diet” is a timeline of sensory stimulation to be given to the child throughout the day to help the body stay regulated to maintain focus. If the child is provided with the appropriate sensory stimulation during the day, he or she will be less apt to act out inappropriately. As the children get older and more aware of their bodies, the hope is that they will be able to recognize what their bodies need and provide the necessary stimulation in order to focus on the task at hand.
Janet Willoughby, MS, OTR/L, is an occupational therapist at Moses Cone Outpatient Pediatric Rehabilitation. Please submit your questions to “Is My Kid OK?” via e-mail to Sherri.McMillen@mosescone.com.