Sensory Integration Therapy (SIT) Notes

Sensory Integration Therapy (SIT)
What is Sensory Integration?

  • Neurological process that organizes sensations from the body and environment, including both external stimuli and internal bodily sensations.

  • Necessary for effective body use in the environment, allowing for coordinated and adaptive responses.

  • Foundation for complex learning and behavior, influencing motor skills, social interactions, and emotional regulation.

The 8 Senses

  • Visual: Sight

  • Auditory: Hearing

  • Touch: Tactile perception

  • Smell: Olfactory sense

  • Taste: Gustatory sense

  • Vestibular: Sense of balance and spatial orientation; detects the pull of gravity. Fluid-filled canals in the inner ear move with head movements, sending direction information to the brain. This helps with planning movements and maintaining balance. Critical for posture, balance, and coordinating eye and head movements. Dysfunction can manifest as difficulties with balance, motion sickness, and spatial disorientation.

  • Proprioception: Body awareness and movement; muscles and joints have receptors that tell the brain where body parts are. Enables coordinated movements without needing to visually confirm placement (e.g., putting a spoon to the mouth). Essential for motor control, coordination, and body awareness. Deficits may result in clumsiness, difficulty with motor planning, and reliance on visual cues for movement.

  • Interoception: Awareness of internal bodily states (e.g., hunger, fullness, heart rate, butterflies in the stomach). Involves recognizing and responding to internal cues related to physiological conditions. Impacts emotional regulation, self-awareness, and the ability to respond to bodily needs. Difficulties may manifest as challenges in recognizing hunger, toileting needs, or emotional states.

Ayres' Emphasis

  • Jean Ayres was particularly interested in the interaction between and development of the vestibular, proprioception, touch, vision, and hearing. She saw these as important in supporting our ability to use our body, concentrate, develop self-esteem and confidence as well as having self-control and academic skills. Poorly developed senses are linked to deficits in these abilities.

Importance of Sensory Integration

  • (Video reference)

What is Sensory Integration Disorder (SID)?

  • Neurological disorder resulting from the brain's inability to integrate sensory information, leading to difficulties in processing and responding to sensory input.

  • Individuals with SID struggle to respond appropriately to sensory input, hindering their ability to plan and organize actions effectively. This can affect daily living skills, social interactions, and academic performance.

  • Individuals with SID may resort to primitive survival responses such as fight, flight, or withdrawal when overwhelmed by sensory stimuli.

Causes of SID:

  • Brain not receiving messages due to neuron disconnection, impacting the transmission of sensory information.

  • Inconsistent sensory message reception, leading to unreliable sensory experiences.

  • Sensory messages received but not properly connected with other sensory messages, resulting in fragmented or disorganized perception.

Signs and Symptoms of SID:

  • Oversensitivity or undersensitivity to touch, movement, sights, or sounds, indicating sensory modulation difficulties.

  • Specific learning difficulties or delays in academic achievement linked to sensory processing challenges.

  • Difficulty transitioning between situations due to sensory overload or inability to adapt to new sensory environments.

  • Tendency to be easily distracted / limited attention control, often exacerbated by sensory stimuli.

  • Unusually high or low activity level reflecting sensory seeking or sensory avoiding behaviors.

  • Social and/or emotional problems stemming from difficulties interpreting social cues and managing emotional responses to sensory input.

  • Difficulty learning new movements due to impaired motor planning and coordination.

  • Delays in speech, language, or motor skills associated with sensory processing deficits.

  • Physical clumsiness or apparent carelessness in motor activities.

  • Impulsive behavior, lacking in self-control, often triggered by sensory overload.

  • Inability to unwind or calm down due to heightened sensory arousal.

  • Poor self-concept / body awareness reflecting difficulties in perceiving and understanding one's own body and its relation to the environment.

Examples of Signs & Symptoms

  • Hating haircuts due to tactile oversensitivity.

  • Being unaware of normal touch or pain indicating tactile or proprioceptive under-responsiveness.

  • Trouble focusing and concentrating, often exacerbated by sensory distractions.

  • Shielding eyes from bright lights due to visual oversensitivity.

  • Poor fine motor skills (handwriting, cutting) reflecting deficits in tactile and proprioceptive processing.

  • Selective hearing or difficulty listening in noisy environments due to auditory processing challenges.

  • Picky eating habits related to sensory sensitivities to food textures, tastes, or smells.

  • Oversensitivity to loud sounds indicating auditory over-responsiveness.

  • Chewing on everything as a sensory seeking behavior.

  • Smelling people, food, and objects to gain additional sensory input.

  • Complaining about clothing tags due to tactile oversensitivity.

  • Hating being tickled or cuddled, indicating tactile defensiveness.

  • Poor gross motor skills (running, riding a bike) reflecting vestibular and proprioceptive deficits.

  • Difficulty dressing oneself due to challenges in motor planning and tactile processing.

  • Sitting with legs in a "W" position to increase stability or compensate for poor core strength.

  • Always walking on tiptoes, potentially indicating tactile defensiveness or proprioceptive seeking.

  • Being particular about socks (or never going barefoot) due to tactile sensitivities.

Sensory Integration Therapy (SIT) - History

  • Pioneered by A. Jean Ayres, an occupational therapist with training in neuroscience and educational psychology.

  • Ayres popularized the term "sensory integration."

  • Developed the Southern California Sensory Integration Tests (SCSIT) to assess sensory integration components and guide treatment. These tests provide valuable insights into a child's sensory processing abilities.

  • Ayres developed theories about typical patterns of disability based on results from her testing and observations of children, contributing to the understanding of sensory integration dysfunction.

  • Ayres created methods of treatment for specific patterns of disability using what she called enhanced sensory experiences, focusing on individualized interventions to address specific sensory processing deficits.

Jean Ayres' Definition of Sensory Integration

  • "The organization of sensations for use. Our senses give us information about the physical conditions of our body and the environment around us… The brain must organize all of our sensations if a person is to move and learn and behave in a productive manner."

What is SIT?

  • Treatment for developmental disorders involving sensory processing dysfunction, aiming to improve sensory modulation and integration.

  • Offered by certified occupational and physical therapists trained in sensory integration techniques.

  • Founded on the assumption that the child is either understimulated or overstimulated by the environment, and interventions are tailored to address these imbalances.

  • Aims to improve the brain's ability to process sensory information, leading to better daily functioning, emotional regulation, and social participation.

  • Sensory input from the environment is critical for brain development and learning, shaping neural pathways and influencing adaptive behaviors.

  • The brain can change in response to sensory input, and rich sensory experiences can stimulate change in the brain through neuroplasticity.

  • The goal is to improve how the brain processes and adapts to sensory information, not to teach specific skills, but rather to enhance underlying sensory processing abilities.

Key Components of SIT

  • Activities involve vestibular, proprioceptive, and tactile stimuli, tailored to the child's specific sensory processing deficits.

  • Treatment is typically one-on-one with an occupational therapist to provide individualized attention and support.

  • Use physical activities and exercises to help children learn to interpret and use sensory information more effectively, enhancing sensory discrimination and integration.

Implementation of SIT

  • Starts with assessment by an occupational therapist to identify sensory processing patterns and deficits.

  • Therapist plans and conducts a program with activities to stimulate sensory responses, targeting specific areas of sensory dysfunction.

Principles of SIT

  • Just Right Challenge: The child must be able to successfully meet the challenges that are presented through playful activities, promoting a sense of accomplishment and motivation.

  • Adaptive Response: The child adapts her behavior with new and useful strategies in response to the challenges presented, demonstrating improved sensory processing and motor skills.

  • Active Engagement: The child will want to participate because the activities are fun and intrinsically motivating.

  • Child Directed: The child’s preferences are used to initiate therapeutic experiences within the session, fostering a sense of ownership and engagement.

  • Designed to encourage movement and play to promote sensory exploration and integration.

  • Involves activities combining sensory input with motion alongside an occupational therapist and/or peers, facilitating social interaction and sensory integration.

Sensory Integration Techniques

  • (No specific techniques listed)

Effectiveness of SIT

  • Limited and inconclusive evidence regarding the long-term effectiveness of SIT.

  • Conflicting studies: some show no benefits, others find significant results, highlighting the need for further research.

  • Lack of well-designed studies with rigorous methodologies.

  • Not generally harmful, but some therapies may be uncomfortable for certain individuals.

  • Commonly used and supported by many experts in the field of occupational therapy.

  • May be more useful for younger children whose brains are more adaptable to sensory input.

  • Potential benefits include decreased sensitivities to stimuli and improved ability to play, learn, and interact with the environment.