Boston Ability Center - Making Fun and Function Go Hand In Hand

Boston Ability Center - Making Fun and Function Go Hand In Hand

News - February 2011

What is Sensory Integration?

by Elvira Fulchino, MS. OTR/L, MSW, LICSW.</p>

According to A. Jean Ayres, Ph. D., it is the “process of organizing sensory inputs so that the brain produces a useful body response and also useful perceptions, emotions, and thoughts.”

Organization is a key element to this definition. We are exposed to a variety of stimuli from our sensory systems that we respond to unconsciously and quickly. The ability to respond in an organized manner leads to a purposeful action (an adaptive response). When a person is unable to respond in an organized manner we may observe signs of inattention, distractibility, movement that is clumsy, avoidance of specific activities, or emotional upset.


What are the sensory systems that are involved?

We usually think of the five major senses; auditory, visual, tactile, olfactory, and taste.  However, there are two additional sensory inputs that are vital: the vestibular and proprioceptive systems.

The Vestibular system is based in the receptors of the inner ear. Through these receptors the vestibular system responds to movement of the head and body in relation to gravity. This process allows us to receive information regarding the speed and direction of movement which is essential to the development of balance and equilibrium.

The Proprioceptive system receives input from muscles and joints that gives us the sense of our body’s position in space. The vestibular and proprioceptive systems work together to help us move safely in our environments, negotiate around obstacles and know where we are without over-relying on our vision.

For example, when a child is on a playground there are a variety of heights and surfaces to walk on. When shifting from one to another it is necessary to keep balance, remain upright and continue moving forward. If there is any impairment in the vestibular or propiroceptive systems  it  would be more challenging  and could result in the possible avoidance of activities that require a child’s feet to be off the ground, such as climbing up ladders or swinging.  Ultimately the child’s gross motor skills could become delayed.


What do the terms sensory modulation and sensory discrimination mean?

Dr. Ayres speaks of two modes of response to stimuli, “defensive, or protective because it evolved to protect animals from danger and the other known as discriminative. Defensive processes are simple automatic reactions; discriminative processes involve complex refinement in the cerebral hemispheres.”

Modulation: When a child has the ability to modulate the stimuli in his/her environment we observe examples of attention, appropriate level of activity, and an ability to transition between activities. According to Dr. Ayres, “Unusual under-or over-responsiveness to sensation is often called a sensory modulation disorder”. For example, if a child is unable to modulate auditory stimuli a teacher may observe the student put his hands over the ears, or the student will talk out or speak loudly, or become distracted by sounds such as, noises in the hallway outside the classroom or cars driving by. The child is responding “defensively” to the stimuli.

In this situation an occupational therapist consulting to the classroom would provide specific strategies for the child and also make suggestions to modify the environment, which would enhance all the students’ experiences.

Discrimination: A child who discriminates input from the sensory systems can interpret what the sensations mean and use that information in a skillful way.  Dr. Ayres provides a description of tactile discrimination, “When we need to feel the difference between a penny and a dime in our pocket… we rely upon our discriminative mode.” In the classroom a child who has poor tactile discrimination may have difficulty using classroom tools or managing his belongings. He may also not detect when his face is dirty after eating snack. A child with poor vestibular and  proprioceptive discrimination may avoid playing on swings, or hesitate walking down a flight of stairs without stopping and looking at each one.

A child who presented with both of these challenges would be given specific materials and therapeutic activities by an occupational therapist to address his/her challenges.


Recommendations for parents:

Dr. Ayres believed in the essential importance of play for a child’s sensorimotor development.

“Through play the child obtains the sensory input from his body and from gravity that is essential for both motor and emotional development. The sensory input is what makes it “fun”.

  • If you have concerns that your child may have sensory-integration difficulties an evaluation by an occupational therapist trained in sensory-integration therapy will define your child’s areas of challenge and make recommendations for treatment.

For additional resources:

  • Sensory Integration and the Child by A.Jean Ayres, Ph.D.
  • The Out-of- Sync Child by Carol Stock Kranowitz, M.A.
  • The Out-of Sync Child has Fun by Carol Stock Kranowitz, M.A.