Sensory Integration In Pediatrics

Sensory experiences include touch, movement, body awareness, sight, sound and the pull of gravity. The process of the brain organizing and interpreting this information is called sensory integration. Sensory integration provides a crucial foundation for later, more complex learning and behavior. For most children, sensory integration develops in the course of ordinary childhood activities. Motor planning ability is a natural outcome of the process, as the ability to adapt to incoming sensations. But for some children, sensory integration does not develop as efficiently as it should. When the process is disordered, a number of problems with learning, development or behavior may become evident.

The concept of sensory integration comes from a body of work developed by A. Jean Ayres, PhD,OTR. As an occupational therapist, Dr. Ayres was interested in the way in which sensory integration and motor planning disorders interfere with daily life function and learning. This theory has been developed and refined by the research of Dr. Ayres as well as other occupational and physical therapists. In addition, literature from the fields of europsychology, neurology, child development, and psychology has contributed to theory development and intervention strategies.

How sensory integration therapy typically works,its the main form of Sensory Integration Therapy is a type of occupational therapy that places a child in a room specifically designed to stimulate and challenge all of the senses. During the session, the therapist works closely with the child to encourage movement within the room. Sensory integration therapy is driven by four main principles.First principle Right Challenge the child must be able to meet the challenges through playful activities.Second principle is adaptive Response the child adapts behavior to meet the challenges presented.third principle is active Engagement the child will want to participate because the activities are fun.Finally the child-directed the child’s preferences are used to initiate therapeutic experiences within the session.

Sensory Integration therapy is careful to not provide children with more sensory stimulation than they can cope with. The occupational therapist looks for signs of distress. Children with lower sensitivity (hyposensitivity) may be exposed to strong sensations, while children with heightened sensitivity (hypersensitivity) may be exposed to quieter activities. Treats and rewards may be used to encourage children to tolerate activities they would normally avoid. Principles of sensory intergration therapy is to do accurate assessment of child’s difficulties is vital in order to find out where the child’s problems lie, and how to plan treatment effectively. * Child/therapist interaction (intensive)

* Child guided. (Often the child seeks out the sensory input he/she needs) * Therapist aims to help the child to find this out for him/herself and guides in the right direction so that he/she gets maximum benefit. * Aims to raising the child’s self-confidence and therefore get away from success and failure. * Does not aim to teach the child how to perform/carry out specific tasks but ‘helps the child to learn’, i.e. by using the sensory systems help the brain to organise itself. * Uses play and different types of equipment

* How child interacts appropriately with their environment.

Those with Sensory Based Motor Disorders (SBMD) have difficulty navigating this world. Their bodies simply don’t do what their brains tell them to do. SBMD has been broken down into two different categories. The first is Dyspraxia, taken from the Greek word ‘praxis’ (to do) and the Latin prefix ‘dys’ (badly), and involves poor motor coordination, timing, planning, organizing and sequencing. The second category of Sensory Based Motor Disorder is Postural Disorder. A sensory based Postural Disorder negatively impacts a person’s muscle tone, balance, and ability to operate their muscles and operate their own bodies successfully. Often labeled as lazy and clumsy, those with a Postural Disorder have a hard time matching their peer’s physical abilities and speed. Touch

The sense of touch varies widely between children on the autism spectrum. Many kids enjoy the feel of sticky textures. Try experimenting with glue, play dough, stickers, rubber toys, sticky tape. Other things that can be great for tactile sensation are water, rice, beans and sand. Children with Autism often enjoy a sense of firm overall pressure, such as wrapping them up in blankets, being squashed by pillows and big hugs. These can form a great basis for play, interaction and showing affection. Experiences that may be claustrophobic can be liked, such as being squashed between mattresses, and making tunnels or tents from blankets over furniture. Smell

Be aware of your child’s response to the smell of substances too. Experiment with putting different fragrances in play dough or rice. If your child actively likes strong odors, find toys that specialize in this. Sound

Experiment with talking toys, games on computers, musical instruments, squeaky toys and all sorts of music. Clapping together, rhymes, repeating phrases and tongue twisters are useful activities. Auditory Integration Therapy may help in dealing with sounds. Some children on the autism spectrum respond to music but not voices, in which case music therapy may help. Try speaking in a melodic or “sing-song” voice and see if the response improves. Try different tones of voice, pitches, and gauge your child’ reaction. Loud or unexpected sounds generally won’t be liked. Explain noisy toys to the child first then introduce it at a distance. In extreme cases, it may be worth introducing noise-making toys using social stories.

Sight
As you can gather, parents may need to play detective in finding the sensations their child is enjoying. Autistic kids were often reported as staring at nothing when young by their parents, when they were actually entranced by the movement of shadows on a wall, or listening to wind moving through the trees outside. Parents may need to work hard to find the things their child enjoys visually. It could be anything that is long and narrow. I might be things of a precise shade of orange. A preference for looking at straight lines is often reported. There are many toys that aim at stimulating sight with bright color schemes and flashing lights. Proprioceptive system

The Proprioceptive System helps children (and adults) to locate their bodies in space. Autistic children often have have poor proprioception and will need help to develop their coordination. Therapy may include playing with weights, bouncing on a trampoline or a large ball, skipping or pushing heavy objects. Vestibular system

The Vestibular System is located in our inner ear. It responds to movement and gravity and is therefore involved with our sense of balance, coordination and eye movements. Therapy can include hanging upside down, rocking chairs, swings, spinning, rolling, somersaulting, cartwheels and dancing. All these activities involve the head moving in different ways that stimulate the vestibular system.

CONTENT
Introduction of Sensory processing disorders & its classification Sensory Processing Disorder (SPD) is a complex neurological condition that impairs the functional skills of 1 in 20 children. People with Sensory Processing Disorder (SPD) misinterpret everyday sensory information, such as touch, sound and movement. They may feel overwhelmed by sensory information, may seek out sensory experiences or may avoid certain experiences.People with SPD experience their world as either Hypersensitive (over reactive, sensory avoidance) or Hyposensitive (under reactive, sensory seeker). They may also present with motor skill problems. They may react with strong emotional behaviours and experience what may be described as ‘melt downs’. The brain and nervous system receive input from body parts as well as from the outside world. The central nervous system is also a means of transmitting messages throughout the body and functions somewhat like a computer system.

The messages that are transmitted, however, affect functions such as muscle movement, coordination, learning, memory, emotion, behavior and thought. As with a computer, a breakdown or malfunction in one part of the system often affects other functions of the system. Sensations from hearing, vision, taste, smell, touch, pressure, and movement provide the input to the brain which is organized for movement, cognition and learning. The richness of the sensory environment and the interactive experience of the individual with the environment contibute to optimal development of function.When there is a Sensory Processing dysfunction, it is hypothesized that the brain does not process or organise the flow of sensory impulses in a way that gives the child precise information about themselves and their world. As a result, learning can be difficult and children may feel uncomfortable, or have difficulty coping with the stress of daily sensory and organizational demands. This often results in additional or behavioural difficulties.

Sensory Processing Dysfunction is now being used as a global umbrella term that includes all forms of this disorder, including three primary diagnostic groups:

* Type I – Sensory Modulation Disorder
* Type II – Sensory Based Motor Disorder
* Type III – Sensory Discrimination Disorder

Type I – Sensory Modulation Disorder (SMD). Over, or under responding to sensory stimuli or seeking sensory stimulation. This group may include a fearful and/or anxious pattern, negative and/or stubborn behaviors, self-absorbed behaviors that are difficult to engage or creative or actively seeking sensation. Type II – Sensory Based Motor Disorder (SBMD). Shows motor output that is disorganized as a result of incorrect processing of sensory information affecting postural control challenges and or dyspraxia. Type III – Sensory Discrimination Disorder (SDD). Sensory discrimination or incorrect processing of sensory information. Incorrect processing of visual or auditory input, for example, may be seen in inattentiveness, disorganization, and poor school performance. Introduction to pervasive developmental disorders

The term “pervasive development disorders,” also called PDDs, refers to a group of conditions that involve delays in the development of many basic skills, most notably the ability to socialize with others, to communicate, and to use imagination. Children with these conditions often are confused in their thinking and generally have problems understanding the world around them. Because these conditions typically are identified in children around 3 years of age — a critical period in a child’s development — they are called development disorders. Although the condition begins far earlier than 3 years of age, parents often do not notice a problem until the child is a toddler who is not walking, talking, or developing as well as other children of the same age.

Various modalities used in sensory integration therapy

* nature sound machines
* white noise machines
* aromatherapy machines
* bubble tubes, rope lights, lava lamps etc.
* relaxation cd’s
* weighted blankets
* heavy work activities prior to bed
* relaxation products at The Serenity Health Store and The Relaxation Store
* or helpful hints for getting infants to sleep, with The Baby Sleep Solution
* vibrating mattresses and vibrating pillows

* unique children’s sleeping bags
* jumpolenes, indoor trampolines, water trampolines (for pool or lake), or backyard bouncers, swings and swingsets
* rocking toys
* ride on toys
* scooter boards

* music in motion roller coaster
* glider rockers
* seesaws and teeter totters
* therapy balls (bouncing or lying on them with someone helping you)
* twizzler
* tactile mats
* tactile balls

* hammocks, suspended relax and/or swing chairs, etc.
* vibrating recliners, pillows, chairs, toys and pads
* interactive bubble columns and tubes
* Fiberoptics
* Liquid light projector

* bubble machines
* weighted blankets and animals
* tactile toys
* whistles/blow toys and oral motor activities/products
* Somatron
* mats, ball pools, cushions or chairs (vibration and music!)

* suspended equipment, swings , ladders, bouncers, twirlers, Airwalker, zip lines and trolley rider etc.
* using raised lined paper for tactile feedback on proper lettering heights
*puzzles
* stringing beads
* playing games using play “tweezers” or “chopsticks”
* using pencil grips, weighted pens, and other adaptive equipment
* theraputty manipulation and games

Conclusion
Therapy using a sensory integrative approach is provided by a therapist who has special training in sensory integration theroy and treatment. The child or adult is guided through activities that challenge his or her ability to integrate and respond to sensory input by making a more successful organized response.Therapy often involves activities that especially provide vestibular, proprioceptive and tactile sensory input and is designed to meet the individual’s specific needs for development. Education and a home program are part of the treatment process.

When the underlying neurological processing dysfunction is identified and addressed, children and adults are often able to function more successfully. Benefits of Meeting Sensory Needs for Individuals decreased need to stimulate or injure self,improved ability to pay attention, participate, and learn,increased independence in functional activities,spontaneous expression of new skills and abilities,improved social skills,decreased fear and anxiety,improved communication,improved ability to handle distractions and interruptions,improved ability to adjust to changes,improved ability to experience joy and have more fun,increased positive interaction with others and improved ability to influence situations and take advantage of choices and training, work and employment, and community integration opportunities.

Refrences:

http://www.sensory-processing-disorder.com/sensory-integration-activities.html http://www.tsbvi.edu/seehear/fall97/sensory.htm
http://spdlife.org/symptoms/sensory-based-motor-disorder.html http://www.developmental-delay.com/page.cfm/133
http://www.romasis.com/sensory_integration_therapy.html
http://www.donnalederman.com/disorder-types/sensory-integration-disorder.php http://www.mugsy.org/asa_faq/definitions/sensory.shtml