Types of sensory integration problems (cont)

2. Under-Sensitivity

When the child receives too little information and therefore the event does not create an impression, this is referred to as "under-sensitivity". The under-sensitive child registers sensations less intensely than most children. The child does not receive enough sensory information from everyday events. Subsequently the child needs an increased amount of stimulation to achieve typical alertness levels. A child who is under-sensitive may respond to stimulation in one of two ways in an attempt to cope with the information: a) Sensory Seeking and b) Low Registration.

a) Sensory Seeking: The child who is a sensory seeker activelypursues sensory input to stimulate their system. This child seeks higher levels of sensory stimulation than peers. Sensory Seekers are very active children, continuously engaged in their environment, fidgety, and excitable.

b) Low Registration The child who has poor registration isopposite to the sensory seeker. This child has "dulled" sensory registration and accepts this dampened sensory state. The child does not go out of the way to engage in the environment. The child may lack initiative and have a tendency to be passive. The child may fatigue easily and appear lethargic or to be a bystander.

Please see separate leaflets for strategies to help 2012

Sensory integration and sensory processing

explained

Paediatric Occupational Therapy City Care Centre, Floor 1 Thorpe Road Peterborough PE3 6DB

We have our five senses, enabling us to …

See Hear Touch

Taste Smell

We also have a sense of movement, so we know where our bodies are in space.

If all our senses are integrated and organised smoothly, then we are successful.

If our brains are inefficient at organising sensory input, then we don’t know what to do with all this muddled information, and become frustrated.

Types of sensory integration problems

Children with sensory processing difficulties typically fit into two broad categories: Over-sensitivity and Under-sensitivity.

1. Over-sensitivityWhen a child cannot block out unimportant or irrelevant sensory input, too much sensory information is processed. This is referred to as "over-sensitivity". A child who is over-sensitive may respond to stimulation in one of two ways in an attempt to cope with the information: a) Sensory Sensitivity and b) Sensory Avoiding.

a) Sensory Sensitivity: The over sensitive child who does not tryto avoid the problematic sensations tends to be distractible and cannot concentrate, and may display hyperactivity. The child may even be totally overwhelmed by the most recent stimulation received, and may become quietly and chronically anxious.

b) Sensory Avoiding: The child who is a sensory avoideractively engages in reducing the frequency and intensity of sensory stimulation received in life. The child is resistant to change and develops rigid rituals in an attempt to create a predictable environment with sensory stimulation that can be tolerated. The sensory avoiding child can become overwhelmed and withdraw, appearing to be lethargic.

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In order to understand sensory integration better, we must consider the processing of information from each of the senses.

Vestibular processing

Vestibular Processing is the ability to interpret information relating to movement and balance. The vestibular system is in the inner ear, and receives information about movement, change of direction, change of head position and gravitational pull.

The vestibular system is one of the most important senses but not one that is familiar to many people. It detects movement and responds to gravity. It receives information about how fast or slow we are moving, balance, about movement from the neck, eyes and body, about body position and orientation in space. The vestibular system processes and organises this information and enables us to coordinate body movements in space, coordinate eye movements with head movements, develop and maintain normal muscle tone, coordinate both sides of the body together, maintain body postures and adjust levels of alertness.

Proprioception

Proprioception is the sense that tells us where the various parts of our body are located in relation to each other, and whether the body is moving with the right amount of effort. It combines information from the stretch receptors in our muscles and joints with information from the vestibular system.

The proprioceptive system tells us where our hand and feet and limbs are without looking at them. When we perform an action, it feeds back information to the brain, in order to grade the movement. For example what force is needed to pick something up without crushing it, or at what angle and how hard to throw a ball.

Touch processing

Touch discrimination is the ability to interpret information coming into the body via the skin. The tactile system uses receptors in our skin to receive touch

sensations. The touch system protects our body. We receive information about pressure, vibration, movement, temperature and pain. The touch system processes and organises this information and enables us to discriminate between threatening and non-threatening sensations. It affects the development of body awareness, motor planning and emotional security. The touch system is closely linked to the part in our brain that is responsible for "flight" or "fight" responses. This close connection to basic survival results in the touch system having a major association with our emotional state.

Visual processing

Visual Processing is the ability to understand and interpret information that is seen. A child may have normal or corrected eyesight and still have difficulties with visual

processing. Visual processing detects visual images. We receive information about contrast of light and dark, colour and movement. The visual system processes and organises this information and enables us to recognise similarities and differences between object forms, sizes and positions and remember what we see. Visual processing is important in developing hand-eye coordination and literacy skills.

Auditory processing

Auditory Processing is the ability to interpret information that is heard. A child may have normal hearing and still have a deficit in auditory processing.

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The auditory system detects sound, and receives information about volume, pitch and rhythm. It processes and organises this information and enables us to distinguish between sounds, to remember what we hear, and to develop communication and literacy skills.

Oral sensory processing

Oral sensory prosessing is the ability to interpret information regarding touch and taste in and around the mouth. The oral sensory system uses the skin around the mouth and the surfaces inside the mouth and the tongue

to process touch and taste, and the nose processes smell.

The oral sensory system protects our mouth and body. We receive information about texture, pressure, vibration, movement, temperature, pain, orders and flavours. The oral sensory system organises this information and enables us to discriminate between harmful and safe substances, discriminate between touch, taste and smell, develop oral motor control needed for eating, drinking and talking and to develop social skills.

Multisensory processing

Multisensory processing is the ability to receive, interpret and integrate information from more than one sensory system at a time. The multisensory processing system establishes a complex network of nerve pathways that enables successful sensory integration. It receives a combination of information about sound, visual images, movement, gravitational pull, touch sensations, odours and flavours. It enhances memory and learning, because learning that occurs in a multisensory environment is more easily recalled due to stronger associations.

‘Sensory integration’ is the term used for the brain processing information that comes though the senses. It is crucial for a child’s development and education.

Most children develop sensory integration through ordinary childhood activities, including play. But some children have continuing difficulties in processing sensory information, which show up in a variety of ways.

A child may need more input than normal in order to respond, or may over-react to stimulation and be easily distracted by quite low-level sounds, or recoil at being touched, or need constant motion of the hands, legs or mouth in order to concentrate. In fact, there are numerous different symptoms of poor sensory integration, which can only be accurately diagnosed by suitable tests.

The importance of sensory integration is that it lies at the base of the pyramid of learning. Each level of the pyramid is essential for the levels above it.

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