Sensory Processing and Integration
Sensory processing and sensory integration can be confusing and complex topics for many parents and professionals alike to grasp. They have been misunderstood and misused in practice for many years. As such, they have received an undeserved bad reputation as either an area of challenge that doesn't exist in children in the case of sensory processing, or an area of treatment that isn't effective for children in the case of sensory integration. Neither of these is the case when a clinician has sought out and received the proper training, education, and experience. I have been a certified sensory integration practitioner since 2004, able to administer and interpret the only complete standardized measure of sensory discrimination and sensory-based motor planning or praxis to date. I also practice what is called Ayres Sensory Integration, or ASI, which is what the founder of sensory integration, A. Jean Ayres, envisioned and recommended when she originated the theory and practice. Many of her ideas have been overly simplified and watered down and therefore have become ineffective clincially, which led those adhering to her original methods to separate themselves out and identify as practitioners of ASI. I am one such practitioner, and one of the only ones that I am aware of in the greater Dayton area. Having a private practice has enabled me to offer this evidenced-based practice to area residents and their families. Below are some descriptions of the various senory processing challenges children (and adults) may experience.
Sensory Discrimination refers to the ability to identify and distinguish the source, location, and various properties of a sensory stimulus in order to respond to or act upon that stimulus safely, skillfully, and successfully. Properties can include such things as size, shape, texture, weight, distance, volume, velocity, etc., depending on the sensory system involved. We have 8 sensory systems including visual, auditory, tactile, gustatory, olfactory, proprioceptive, vestibular, and interoceptive.
Sensory-Based Motor Challenges
Sensory-based motor challenges present in two main categories including postural control and praxis. Postural control involves the development of a stable base and upright posture from which fluid and controlled movement of the head and limbs can be produced. Praxis involves involves the initiation, planning, and execution of a motor plan. It also involves such things as timing, organizing, and sequencing of movements. Children with difficulties in these areas are often mislabeled or mischaracterized as being clumsy or lazy.
Sensory modulation is often what people think of first when they think of sensory processing challenges and refers to the registration of sensory input and how it is perceived by the individual with respect to intensity. Children can have over-responsivity or hyperresponsivity, under-responsivity or hyporesponsivity, or seeking. Children are often characterized as being hyperactive, intrusive, "too much," or too sensitive and fragile, overwhelmed by the world. On the other hand, they may appear to be checked out or overly calm. To complicate matters further, a child can have a mixture of all of these presentation not only across all sensory systems, but within them as well.
Why Does Sensory Matter?
When children have holes or gaps in their develpment in the lower levels of the develpmental pyramid, it can affect all areas of development above. So, for example, if a child has problems with autonomic nervous system regulation and, therefore, is often operating in a state of hyperarousal or fight/flight (represented by the lowest level of the pyramid - the central nervous system), this can affect their ability to tolerate some of the early sensorimotor experiences necessary to bring all of the sensory systems and movement motor programs "online." This, in turn, can affect their ability to produce the higher level gross and fine motor coordinated movements of mobility, object manipulation, feeding, and speech. These children will also spend so much time, effort, and energy trying to get their brains and bodies to work for them instead of agianst them, they will have little left to dedicate to language, cognition, and academic pursuits. They are also likely to suffer from emotional, social, and behavioral dysregulation and disruption from being unable to achieve and maintain a regulated state, integrate and make sense out of all of the sensory inputs from within and outside of their bodies, and produce an adaptive response suitable for the situation at hand. This causes frustration for both the child and their caregivers, who may not recognize what is causing the chid to be unsuccessful in their daily activities, or who may have expectations that exceed present abilities. The goal with ASI is to set up sensory and motor scenarios that will provide children with the "just right" challenge, moving them from where they are to where they have the potential to be at a rate and order that won't overwhelm them or set them up for failure.