Sensory Integration Dysfunction Signs, Symptoms and Background Information

Sensory Integration Dysfunction (SID) is a neurological disorder pioneered 40 years ago by A. Jean Ayres, Ph.D., OTR. Dr. Ayres developed the sensory integration theory to explain the relationship between behavior and brain functioning. As described in Williams & Shellenberger's work entitled, How Does Your Engine Run? A Leader's Guide to The Alert Program for Self-Regulation, "Countless bits of sensory information enter our brain at every moment, not only from our eyes and ears, but also from every place in our bodies”. The brain must organize and integrate all of these sensations if a person is to move and learn normally.

It is commonly held that we have five senses: touch - taste - smell - hearing - vision. These basic senses or far senses" respond to external stimuli from the environment. The truth is, we have many more senses than that. Some hold that we can divide the senses into internal and external senses: that the “sense of well-being” is a sense too, but an internal one. So too “homeostasis” or the sense of having returned to even keel, essential for the regulation of temperature, heart rate, and breathing.

Our mind and body are superbly interwoven to meet the demands of today's world. The feelings, thoughts and actions we experience occur through the complex actions of our brain. How we process environmental and internal information has a major impact on our feelings, thoughts and actions.

The slightest change in our brain processes can influence how we manage daily living skills, academic progress and social interaction. Sensory integration dysfunction is one example of what can go wrong in the processes of the brain. This article will explain sensory integration dysfunction to the point of understanding the nature of this unseen (and often misdiagnosed) disability, as well as its psychological, emotional, learning and social effects on the individual.

Types of SI Problems

Problems of sensory integration were first thought to fall into three categories. The person either was thought to be
under-processing
over-processing
processing with interference / “white noise"

This being the case, an accurate investigation had to be made to find out which applied to the client, because treatment strategies would differ.

Signs of SI problems

The following is a description of some of the commonly seen behaviors in children who exhibit sensory integrative difficulties.

Table 1. Symptoms of Sensory Integration Dysfunction. (Reproduced with permission from the Apraxia-Kids Web page)

Sensory	Symptoms
Auditory	Responds negatively to unexpected or loud noises Holds hands over ears Cannot walk with background noise Seems oblivious within an active environment
Visual	Prefers to be in the dark Hesitates going up and down steps Avoids bright lights Stares intensely at people or objects Avoids eye contact
Taste/Smell	Avoids certain tastes/smells that are typically part of children's diets Routinely smells nonfood objects Seeks out certain tastes or smells Does not seem to smell strong odors
Body Position	Continually seeks out all kinds of movement activities Hangs on other people, furniture, objects, even in familiar situations Seems to have weak muscles, tires easily, has poor endurance Walks on toes
Movement	Becomes anxious or distressed when feet leave the ground Avoids climbing or jumping Avoids playground equipment Seeks all kinds of movement and this interferes with daily life Takes excessive risks while playing, has no safety awareness
Touch	Avoids getting messy in glue, sand, finger paint, tape Is sensitive to certain fabrics (clothing, bedding) Touches people and objects at an irritating level Avoids going barefoot, especially in grass or sand Has decreased awareness of pain or temperature
Attention, Behavior And Social	Jumps from one activity to another frequently and it interferes with play Has difficulty paying attention Is overly affectionate with others Seems anxious Is accident prone Has difficulty making friends, does not express emotions

When one sensory system does not adequately expand the neuron cell's dendrites and synapses, the inadequacies may limit the connecting neuron cell, and so on and so on. The following are brief examples of problems that may develop:

Attention and Regulatory Problems. Linda C. Stephens, MS, OTR, in an article entitled "Sensory Integrative Dysfunction in Young Children" stated, "The ability to attend to a task depends on the ability to screen out, or inhibit, nonessential sensory information, background noises, or visual information." An individual with sensory integration dysfunction may respond to sensory input without this screening ability. This can produce distractibility, hyperactive, or uninhibited output. They may be unable to calm or console themselves and may overreact or be unresponsive to "far" sense stimuli. Attention and regulatory problems occur in the modulation, inhibition, habitation or facilitation brain processes.

Sensory Defensiveness. This is the fright, flight and fight response mentioned in the crossing the street example given earlier. An individual with sensory defensiveness typically has a "highly aroused nervous system which prepares the body for survival, but does not recognize that the input is non-threatening" (Stephens). The behavior exhibited by an individual in this category may be aggression, avoidance, withdrawal and intolerance of daily routines. Sensory defensiveness can occur in the auditory, visual, vestibular or tactile senses.

Activity Levels. Children with sensory integration dysfunction may show problems in their activity level. "The child may appear disorganized or lacking purpose in his or her activity. The child does not explore the environment or lacks variety in play activities. He or she may appear clumsy and has poor balance. The child may have difficulty calming down after physical activity or seeks excessive amounts of sensory input" (Stephens). These characteristics can come from improper functioning in any of the sensory systems or a combination of them.

Behaviors. A child may exhibit negative behaviors that have an underlying cause. The child may "lack flexibility, be explosive, or have difficulty with transitions". The child may show unexplainable irritability or crying until the discovery of the underlying cause. Underlying causes could be that the child is fearful of certain sounds or visual stimuli or intolerant to the wrinkles in his or her socks.

In light of the problems that may develop due to sensory integration dysfunction, it is no wonder a child may lack emotional stability and social skills. The way a child behaves or interacts influences how individuals will interact with them. A child with sensory integration dysfunction may feel insecure in completing daily tasks because of their uncertainty of the environment. The fact that sensory integration dysfunction is generally not a visible disability, the child may be treated unfairly or the disability not be given consideration. All of us depend on adequate sensory integration to carry out daily tasks in work, play and self-maintenance. Disorders in the sensory integration domain greatly influence our ability to function, but also can be so subtle that they easily go unrecognized.

Sensory Modulation

More recent information supports the thinking that the issue at stake is one of a disorder of sensory modulation, which means that the person cannot properly regulate his sensory input, and that the ability to maintain a situation-appropriate state is faulty. i.e. just as the eye should respond differently to bright light and to darkness by adjusting the aperture of the pupil, so should the acuity of sensory processing fit the sensation. But these children and adults have senses that respond with random and variable effectiveness. - i.e. are ineffective for learning.

SI is the organization of sensations for use

Sensations flow constantly into our brain at a rapid rate. These sensations need to be acted upon, organized and co-coordinated if a person is to learn efficiently. If these sensations can be well managed, the brain can form perceptions, then concepts and derive meanings, and so can learn.

The flow of sensations into the brain activates brain potentials, and one can think of sensations as “food for the brain providing energy “ as well as “knowledge needed to direct the body and mind”.

Sensory deprivation is a state where the senses are deprived of stimulation totally or severely, e.g. where the subject is placed in a soundproof room, with no light at all, and no touch sensations. In these experiments, the subjects have been found to very quickly become disorientated, and show signs of severe mental disturbances.

Studies like these lend weight to the theory that sensory input is essential for adequate brain function - that the stimulation produces “brain tone”. They are responsible for the “alpha” or baseline brain waves of the conscious state. Dr A Tomatis and others believe that auditory input is the most vital sensory input for this function.

It is easy to conceptualize that the sensory system provides the input that stimulates the Reticular Activation System of the brainstem to arousal. The RAS is responsible for the regulation of alertness, and coordination and regulation of focus (attention) and the efficient management of input and of output. The proper functioning of this system is essential to learning and to behavior management.

Efficiency of Modulation

What needs to be done is to bring the sensory modulator up to a level of efficiency, and then there is less sensory overload evident. This may be one of the reasons that AIT is helpful for hyper-acute hearing, since it works to stimulate auditory sensory processing.

We can better understand the role of AIT in the treatment of learning and developmental problems, if we understand the concept of SENSORY INTEGRATION.

Communication is an all-encompassing activity, but the aspect that overlaps with the concept of SI, refers to the processing of the stimuli delivered to the nervous system by the sensory end organs.

The Ear

The discipline of occupational therapy emphasizes the importance of the vestibular system of the inner ear, which affects balance and gravity response, and muscle tone. The importance of this aspect of sensory process to learning disorders, concentration and emotional well being has been demonstrated repeatedly in research and practice, and mention should be made of the contribution of Harold Levinson (“Smart But Feeling Dumb”).

However, the other equally crucial part of the ear, the cochlea, with its auditory function, is not of lesser importance in sensory integration. Focus on its role in learning and development has not been on auditory sensory integration. Audiologists, who deal with hearing issues, have dealt almost totally exclusively with hearing loss, and disorders of the cochlea that lead to degrees of deafness.

Auditory sensory integration has scarcely received mention. The information about the role of audition in neurological development and in emotional well-being has come from other sources, such as music therapy, and also from a French Ear-Nose and Throat specialist, whose work - has contributed a greater understanding of this matter.

Dr. Tomatis’s theory of auditory development suggested that the individual whose ability to “stretch out his ear” to listen is impaired for some reason, will suffer developmental problems, whether autism, dyslexia, or speech and language disabilities, and perhaps emotional problems. Dr Tomatis’s approach was a breakthrough in many ways, and here it is relevant to mention that he saw the role of the ear as a whole - both the vestibular as well as the cochlea - in the development of higher cognitive functions.

Occupational therapists who work with SI techniques, have reported changes across modalities, - e.g. speech may improve when the child is swung and bounced! Developmental optometrists, doing eye-integration and co-ordination exercises, have seen profound changes in speech and responsiveness…

It is clear that whatever is happening when we impact on one sensory modulating modality, spills over to affect other modalities too. This invites us to look into the function of that part of the brain that does sensory processing: the brainstem or mammalian brain, including the areas called the midbrain, the pons, the medulla, the cerebellum and the limbic system.

All children need sensory input and experiences to grow and learn, but this is even more crucial for the child with sensory integration dysfunction. Carol Kranowitz informs us that "Just as the five main food groups provide daily nutritional requirements, a daily sensory diet fulfills physical and emotional needs". As explained earlier, stimulation of the "near" senses (tactile, vestibular and proprioceptive) leads to the growth of the neuron cell's dendrites and synapses. A sensory diet includes a combination of alerting, organizing and calming techniques that lead directly to the "near" senses.

Many parents fear the stigma attached to sensory integration dysfunction and do not want their child to be labeled as a special needs child. That fear is normal, but it does not help the child. We must consider the identification of sensory integration dysfunction as a benefit because a child can get help before the problem turns into a serious learning disability. The psychological, emotional, learning and social effects of sensory integration dysfunction on an individual may be reduced with proper sensory integration treatment and an understanding from the medical and professional fields.

Theoretically, sensory sensitivity can be due to high transmitter levels that interact with hypothalamic functioning. Our Balance Formula 1supplement would be ideal in aiding in balancing the neurotransmitters and improving the sensory functions managed by the hypothalamus. The Hypothalamus (with the Cerebral Hemispheres) is intimately involved in the integration of all physiological stimulation, all 5 senses, including taste, smell, sight, sound, and touch, which it then translates, distills and assembles into one discernible "package," relating all the attributes of an experience, all the associated stimulation into one clear harmonious concept, one memory, one experience. Thus, yielding a succinct emotionally satisfying understanding and judgment of the experience itself.

When the Hypothalamus is not working correctly, when it’s not functioning up to par, the wrong neuro-signals are generated and the wrong neuro-messages are received, resulting in an inaccurate integration of all our sensory input, leading to faulty perceptions which can be very subtle but nonetheless powerful in how we experience life.

This disorder is often confused with ADHD. Carol Kranowitz is dedicated to the distinguishment of the two.

In my book, The Out-of-Sync Child, I define Sensory Integration Dysfunction (DSI) as the "inefficient neurological processing of information received through the senses, causing problems with learning, development, and behavior." Picture a child who has trouble processing and interpreting sensory messages about how things feel and what it feels like to be touched. Touch stimulation overwhelms this oversensitive child.

How does his problem play out? He is bothered by the label in his tee-shirt, the approach of a classmate, the lumps in his mashed potatoes, the stickiness of the playdough. Fidgeting and squirming, he pays a lot of attention to avoiding these ordinary sensations. Meanwhile, he is unable to pay much attention at all to the teacher's words or to playground rules.

Say a child with another form of SI dysfunction has trouble processing movement and balance sensations. Say this under-responsive child needs to move around -- much more than her peers -- in order to rev up and get going. What is the fallout of her problem? This impulsive "bumper and crasher" craves intense, vigorous movement. She often rocks, sways, twirls, jumps, climbs, leaps, gyrates and gets into upside-down positions. She pays a lot of attention to satisfying her need for movement, and not much attention to her mother's instructions or to where she left her shoes.

Inattention . . . impulsivity….fidgety movement . . . these are definitely symptoms of SI Dysfunction.

Now consider my definition for Attention Deficit Disorder (ADD): "a neurological syndrome characterized by serious and persistent inattention and impulsivity. When constant, fidgety movement (hyperactivity) is an additional characteristic, the syndrome is called Attention Deficit Disorder with Hyperactivity (ADHD)."

Inattention . . . impulsivity . . . fidgety movement . . . these are definitely symptoms of ADD/ADHD -- and of many other difficulties, as well.

In my book, I discuss other "look-alike" conditions which share symptoms with sensory integration dysfunction (pp. 17-20). SI Dysfunction may look like ADHD, and some symptoms may overlap. However, optimum treatment for the two problems is different. Before jumping to conclusions and leaping to drug therapy, parents and professionals need to look at the whole child. Then, we can thoughtfully determine what will help the most.

If the child is frequently -- but not always -- inattentive, it is useful to ask some questions: Where, when, and how often does this inattention occur? What is the stimulus? What does the child do as self-therapy? What is happening -- or not happening -- when the child concentrates well? What does the child need, and what helps?

An overloaded child needs less stimulation. So, dim the lights and turn down the radio. Comfort him with "deep pressure" bear hugs. Help him fix up a retreat, with pillows and blankets, under the dining room table.

An under-responsive child needs more sensory stimulation. So, take her to the playground each day, jog together around the block, engage her in gentle roughhousing, and provide her with a chinning bar, a punching bag, and a trampoline.

SI Dysfunction is a neurological problem, which affects behavior and learning. Medicine doesn't fix it. One needs a therapeutic sensory program that addresses the child's underlying difficulties processing sensations rather than just the symptoms of inattention, not psycho stimulants. A therapeutic sensory program may be a major component in treating the child with an attention problem. Taking a conservative approach can't hurt and often helps the inattentive child whose problem is not ADD, but developmentally delayed sensory processing.

For more information on sensory integration disorders, I highly recommend reading the book by Carol Stock Kranowitz, called The Out of Sync Child.

Our products that improve and spawn neural connections by increasing sensory input are our therapeutic music and light and sound programs.

Our cognitive training programs and Edufeedback system were designed to directly challenge students to build the neural networks necessary to pay attention.

Our nutritional supplement (Attend) naturally improves the bodies ability to allow smooth, balanced information processing to obtain a focused attention and improved concentration. Attend also helps increase the flow of nutrients, oxygen and energy to the brain.

They all have been heavily researched and have a consistent record of accomplishment in aiding their users to accomplish a level of optimum performance. Search the home page for the products that meet your needs and interests

For info related to brain plasticity and new brain research Click here. The brain can heal and be revitalized with new neuropathways.