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Presentation 5: What are sensory integration (SI) and Disfunction of SI? M. Windsor, ScD, OTR/L

Ideas and concepts associated with sensory integration and
Sensory Integration Theory

Sensory integration is a natural, neurologic phenomenon that occurs throughout the life span. The brain takes in information from the sensory receptors of the body (i.e., ears, eyes, skin, muscles, etc.), then processes and organizes it, which results in integration of information for use. This means that sensory integration allows the individual to act adaptively (e.g., engage, function, learn, be comfortable in experiences that are known or novel).

We are all "sensory processors;" usually this occurs automatically, and we function well in our dynamic worlds. If there is a disruption in sensory processing (e.g., caused by lack of sleep), we may become grumpy and behave badly, have trouble focusing on what we are doing, or become less coordinated. Fortunately, for us this is a temporary condition. However there are many possible "disruptors" that may have brief or long term effects, and there are people who do not automatically process sensory information effectively or efficiently. We don't completely understand why all disruptions in the natural process of sensory integration occur. We think that for some children it may be a result of deprived environmental conditions (sensory, motor, and social) that are associated with institutionalization, as well as neurobiological factors influenced by heredity and environment (e.g., toxins, malnutrition, etc.).

Sensory Integration Theory (SI), developed by A. Jean Ayres, PhD, OTR, motivates many occupational therapy assessment and intervention strategies. Initially, Dr. Ayres studied children who had learning problems. Using insightful observation and knowledge bases in development and psychology, she theorized that higher brain functions such as reading and skilled movement were impeded by poor sensory integration, an outcome of neural processing in lower brain regions (e.g., brainstem and midbrain). The problem is not in the peripheral receptor mechanisms (e.g., ear, eye, touch, muscle, or balance systems) but central processing of sensory information within the brain.

Dr. Ayres particularly focused on the body sensory systems: tactile (touch), vestibular (movement, vibration, equilibrium), and proprioception (muscle position, movement, stretch). She developed unique, sensory experiences and equipment that provide powerful sensory input; this facilitates neural processing necessary to sensory integration.

The improved neural capacity supports the child's self-directed action (the child initiates and controls movement that is neither passive nor imposed) in response to the environmental challenge (the physical or social event occurring during therapy). The performance of an intentional, successful behavior elicited by an environmental demand is called an Adaptive Response/Reaction (AR).

Poor sensory processing interferes with the normal process of sensory integration which allows the child to perform adaptive functions and to acquire higher learning. The proposed patterns of Sensory Processing Disorders are: Sensory Modulation Dysfunction (addressed later); Poor Sensory Discrimination: difficultiess are associated with visual perceptual problems in reading (seeing "b" for "d") audition (hearing "berry" rather than "very"); and Dyspraxia and Postural Disorders (addressed later).

Sensory Integration Treatment involves providing intense sensory experiences that result in self-directed performance of new, adaptive behaviors (e.g., an adaptive response). Selection of specific sensory activities is based upon previous assessment of the child's sensory systems, real-time awareness of the child's state (e.g., organized/disorganized, alert, agitated), and the affordances (characteristics such as suspended, stationery, able to rotate, soft, etc.) of the equipment/activity to elicit desired adaptive responses. This coupling of sensory input and an adaptive response differentiates Sensory Integration Treatment from other sensory-motor-based interventions. The process involves a "reciprocity or dance" between the child and the therapist that results in collaborative choices for use of equipment, activities, and expected results. This allows child-directed activities, not imposed or initiated by the therapist. Sensory Integration Treatment is easily distinguished from therapy using sensory-motor activities performed under the therapist's directions, choices, and prescriptive results.

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Last update on January 5, 2018