What is Sensory Integration Dysfunction by pharmphresh23


									                                What is Sensory Integration Dysfunction?
                                     By Barbara Luborsky, OTR/L of Way to Grow, LLC

          Sensory integration is a term which refers to the process of taking sensory information into the
brain, sorting it, interpreting it, and responding to it appropriately. The concept is based on the work of
Dr. A. Jean Ayres, who spent over 30 years bringing together her knowledge of neuroscience and
occupational therapy to pioneer and create the theory, assessments, and treatment principles of sensory
integration. At its heart, this theory teaches that play is the work of children. Through play, children
learn about themselves and the world- as the things they see, hear and feel make sense to them, sensory
integration is occurring. Sensory integration is a process in which information from the environment, as
well as sensations from within our own bodies are taken in, processed and a response is generated.
          We have all heard of the 5 senses- sight, hearing, taste, touch and smell. The concept of sensory
integration deals with these 5 senses as well as 2 “special” senses: vestibular and proprioceptive. The
vestibular system relies on receptors located in the ear, and it is responsible for providing the brain with
information about the position of the head, and if the head is moving, what direction and how fast. The
proprioceptive system relies on receptors located in the joints and muscles and it gives the brain
information about the position of the body in space.
          It is a formidable task for the central nervous system to receive all of the sensory information,
process it, and organize our behaviors appropriately. Every one of us has strategies that assist our
systems in accomplishing this task. For example, if we are on the way to work, and are still feeling a
little sleepy, we may turn the music up, have a cup of coffee, or call a friend on the phone. If we’ve
been at the mall shopping for several hours and are feeling over-stimulated, we may head for a hot bath
and a cup of warm tea as soon as we get home. For most of us, these are things we do without even
thinking about it.
          From a sensory integrative perspective, learning occurs when a person receives accurate sensory
information, processes it, and uses it to organize behaviors. In some instances, the system does not
function as it should, and the individual does not do a good job with noticing input, sorting it,
prioritizing it, or responding appropriately. When children receive inaccurate or unreliable sensory
input, their ability to process the information and create responses is disrupted (Dunn, 1991). Poor
sensory integration can lead to problems with attention, motor control, activity level or ability to
experience, learn, and interact with the environment and others. Deficits can impact behaviors in many
ways and must be inferred from observing a child’s behavior and performance. In such cases, if the
deficiencies are severe, there may be what is called Dysfunction of Sensory Integration (DSI), also
known as Sensory Processing Disorder, (SPD). Children who experience DSI demonstrate a wide range
of symptoms, which are often misinterpreted as misbehavior.

Behaviors that might indicate DSI
This list is not inclusive, although it should give you a good idea of the kinds of behaviors that indicate
problems with sensory integration. Usually, besides having these behaviors, children with DSI may
have behavioral responses that seem inconsistent, and often they are children who do not like change.
They cling to familiar routines as a way of organizing themselves and when routines are disrupted, this
can really set them off.


Withdraws from touch or overreacts to bumps and scrapes or to being touched accidentally
Strikes out at other children when they come near
Dislikes standing in line
Dislikes being held or cuddled, or wants to be held all the time
Bothered by labels in back of shirt or by seams in socks
Touches everything - walks touching the wall
Does not react to falls, scrapes or bumps
Constantly puts things in mouth
Dislikes messy play (mud, finger paint, glue on fingers, sand table)
Pinches or bites self or others
Poor concentration
Hates haircuts, having face washed, nails clipped


Walks on toes
Stamps feet, plays too roughly, deliberately falls, bumps or crashes
Throws ball too hard, holds pencil too hard (or too softly), writes too hard (or too softly)
Trouble with buttons or with dressing self
Wiggles constantly during seated activities
Poor jumping skills, poor posture, tires easily, clumsy, seems unaware of body
Handles toys roughly, lots of banging and breaking
Confused about motions when eyes are closed


Does not focus on objects
Poor eye contact
Unable to locate things with eyes - does not localize eyes to sounds
Does not follow movement with eyes/ difficulty catching a ball
Visually distractible - looking at bulletin boards and shelves


Craves spinning, swinging, or turning upside down, constantly in motion, rocks while sitting or standing
Is fearful of movement, often carsick
Very still, makes few postural adjustments
Avoids slides and swings, will not climb, disoriented and fearful when moved out of vertical posture
Very clingy, no “terrible twos”, can learn to become intellectual and/or manipulative to avoid motion
Difficulty walking downstairs, fears escalators, elevators and airplanes
Afraid to sit on toilet
Messy eater, frequent spills
Seems to have poor balance, difficulty learning to ride a bike


Overly aware of smells in the environment, smells everything or ignores unpleasant odors
Complains that food smells bad, uncomfortable and wiggly at lunch
Notices how people smell

Has trouble relating appropriately to peers, fearful of social situations (older kids)
Does not play with other children, cannot sustain play with an adult
Difficulty identifying emotions correctly, may laugh when someone expresses anger
Does not spontaneously interact in a group
May not read social cues, may not use appropriate facial expressions/give appropriate social cues


Performance is inconsistent
Hyper-active, or hyper reactive and hard to calm
Difficulty with transitions from one area or activity to another
Startles easily and reacts violently or is difficult to arouse and somewhat non-responsive

        If you suspect that your child may be having difficulty in this area, consult with an occupational
therapist (OT) who has been specially trained in sensory integration theory and treatment. Through
close examination of a child’s medical, social and school history, along with administration of specific
tests and observations, a qualified OT can help you determine if your child has DSI. If that is the case,
the O.T. can treat the child and help to modify the way he or she is integrating sensory information.
There are also many things that parents and teachers can do to optimize performance for children with
DSI. Unfortunately, this disorder is little known and often misunderstood, but with support from
appropriate professionals, there is help for children with DSI.

Barbara Luborsky, OTR/L is a pediatric OT and co-owner of Way to Grow, LLC, a pediatric therapy
practice in Frederick. She has been studying sensory integration and treating children with DSI for the
past 15 years.

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