Sensory Integration and Its Effect on Children

 

 

 

 

 

Michelle Coakley

Research and Reflection

May 6, 2003

 

 

 

            Table of Contents

Page

Abstract………………………………………………………………………                3

Introduction………………………………………………………………….                 4

The Concept of Sensory Intergration………………………………………              4-7

Sensory Integration Dysfunction……………………………………………             7-8

Symptoms of Sensory Integration Dysfunction……………………………              8-10

Treating Sensory Integration Dysfunction…………………………………           10-12    

Sensory Diet…………………………………………………………………          12-14

Case Study #1……………………………………………………………….           14-19

Case Study #2……………………………………………………………….           19-21

Conclusions………………………………………………………………….             21-22

References……………………….. ….……………………………………...                 23

References Consulted……………………………………………………….                 24

 

 

 

 

 

 

 

 

 

Abstract

 

                Sensory Integration Dysfunction is the inability to process information received through the senses.   In 1979, Dr. Jean Ayers developed a theory describing Sensory Integration Dysfunction.   Her theory is being expanded into having Sensory Integration Dysfunction become a formal diagnosis.  Dr. Ayer’s theory has also helped occupational therapists expand their knowledge in treating the dysfunction.

 

            Children that have been diagnosed with Sensory Integration Dysfunction can be treated with a sensory diet. Children with SID are in need of healthy tactile, vestibular, and proprioceptive sensations.  A sensory diet is a planned and scheduled activity program that an occupational therapist sets up for a child with Sensory Integration Dysfunction.   A sensory diet includes a combination of alerting, organizing and calming techniques that lead directly to the "near" senses.   They are designed and developed specifically to meet the needs of the child's nervous system. 

                       

            Children that have been diagnosed with Sensory Integration Dysfunction and are receiving a sensory diet are beginning to thrive.  Children that are being treated will begin to build self- esteem and see themselves in a different light.   Their negative acting out behavior will decrease while their attention spans will increase.  These children that are being treated effectively in school settings with sensory diets built into their day will begin to excel.

 

 

 

 

 

 

 

 

 

 

Introduction

                        Educators and Mental Health Professionals have been “stumped” with behavior patterns of some children.  These children were the ones that were not thriving like others their age.  They didn’t appear to be doing what should have been happening  “naturally”.  These children were bright and healthy, yet they responded very differently to activities than others did in their same age group.  At times these children would act out when it was time to be having fun.   These same children would dive into activities without an ounce of precaution and at times putting themselves in danger.  These behaviors challenged educators and mental health professionals to figure out what was going on for these children and to explore why they were acting the way that they were.

            Mental health professionals and educators began to explore the children’s behaviors, knowing that no child seeks disapproval from adults, that every child wants to learn, and that every child wants to play and have friends.  This in turn led them to the realization that something else was going on for these children that was making it hard for them to go through childhood in a successful and normal manner.  Through initial evaluations and observations of children, researchers were not able to find a pattern of behavior. These children’s behaviors whether displaying hostility, aggression, anger, frustration, tuning-out, whining, silliness, or wildly inappropriate gusto gave investigators the sense that they weren’t like other kids.  

The Concept of Sensory Integration

            Sensory Integration is a normal developmental process involving the ability of the central nervous system (CNS) to organize sensory feedback from the body and the environment in order to make successful adaptive responses (Elmer & Dunn, 1998). The central nervous system consists of countless neurons, the spinal cord, and the brain.   These components work with one another sending messages and information back and forth so that all of our senses can work with one another.  According to Dr. Ayers,  “Over 80 percent of the nervous system is involved in processing or organizing sensory input, and thus the brain is primarily a sensory processing machine (Kranowitz, 1998).

Figure 1.   From The Developing Child.

            We receive information from senses inside and outside our bodies.   The five most familiar senses are taste, seeing, hearing, touch, and smell.  These five are referred to as the “far senses” due to the fact that they take in information from outside our bodies.  We are conscious of our far senses, and we have some control over them (Kranowitz, 1998).   The “far senses” are the most familiar senses to most people but there are many others.                                                                                                                                                    The other senses are referred to as the “near senses” or the “hidden senses”.  These are senses that we are not always aware of or have control over.  These senses respond to what is going on in our bodies.   The “near senses” regulate things such as heart beat, hunger, thirst, blood pressure, body temperature, sleep, mood, and arousal state (Ayers, 1979).

            There are three other senses that are also key for the development of a healthy child.  They include the tactile, vestibular, and proprioceptive senses.  The tactile sense deals with touch and it receives its information primarily through the skin.  Tactile sensations play an important role in protection from danger.  Tactile senses can determine a soft touch of a teddy bear versus the crawling legs of a spider.

             The vestibular sense is responsible for processing information about movement, gravity, balance and head position.  The vestibular sense receives its information from the inner ear mainly.  The vestibular sense is central in maintaining muscle tone, coordinating the two sides of the body, and holding the head upright against gravity.  This sense can be thought of as the foundation for orientation of the body in relation to surrounding space (Ayers, 1979).

              Closely related to the vestibular sense is the propioceptive sense, which gives an awareness of body position.  The propioceptive sense gets its information from muscles, joints, and ligaments.  It is the propioceptive sense that makes it possible for a person to skillfully guide his arm or leg movements without having to observe every action (Ayers, 1979).  When an individual’s propioceptive sense is working effectively he or she is able to adjust their body position in a smooth manner.

            The tactile, vestibular, and propioceptive systems begin to function very early in life, even before birth (Bee, 1997).   These senses are particularly important in providing knowledge about how the body moves and how it can be used to act on the environment. These basic senses are closely connected to each other and form interconnections with other systems of the brain.   The interplay among the various senses is complex, and is necessary in order for a person to interpret a situation accurately and to make an appropriate response.  It is this organization of the senses that is termed Integration Sensory.

Sensory Integration Dysfunction

            Sensory Integration Dysfunction is the inability to process information received through the senses (Kranowitz, 1998).  Dr. Jean Ayers, PhD., an occupational therapist, developed a theory around Sensory Integration Dysfunction in 1979. She stated that Sensory Integration Dysfunction (SID) was the result of inefficient neurological processing.  Her theory explained the relationship between children’s behavior and their brain functioning.  Sensory Integration Dysfunction does not imply brain damage but rather what Dr. Ayers called “indigestion of the brain” or a “traffic jam in the brain” (Ayers, 1979).

            Sensory Integration Dysfunction is the disruption in the process of intake, organization and output of sensory information. This dysfunction happens in the central nervous system causing the brain to be unable to analyze, organize, connect or integrate the sensory messages that it is receiving (Sutton, 1999).   When a child’s sensory intake is inefficient he or she may be taking in too much or too little stimulation.  If too much information is taken in, it causes the brain to overload and causes the individual to avoid sensory stimuli.  When too little information is taken in, the brain seeks more stimuli.   

Due to this fact a child exhibiting Sensory Integration Dysfunction cannot respond to the sensory information that it receives in a meaningful and consistent manner.  This inability to process sensory information makes it difficult for the child to plan and organize what he or she needs to do resulting in learning becoming a challenge.

            Neurological disorganization can happen in three different ways.  The first way that it can occur is through the neuron cells (Bundy, 2002).  The second way neurological disorganization occurs is that the sensory messages are being received in an inconsistent manner.   The final way has sensory messages being received consistently but not connecting properly with other sensory messages.  Inefficient motor, language, or emotional output occurs when the brain poorly processes sensory messages, which deprive us of motor response in order to behave in a purposeful way (Kranowitz, 1998).

            Sensory Integration Dysfunction can be found in children of all age groups as well as at all intellectual levels and social-economic groups.    Although this dysfunction can be found in a wide variety of children, research clearly identifies sensory integration problems in children with developmental or learning disabilities.  Independent studies show that a sensory integrative dysfunction can be found in up to 70% of children who are considered learning disabled by schools.

                Several other factors are contributing to the increase of children being diagnosed with Sensory Integration Dysfunction.  One factor is that more and more children are being born prematurely.  These children are entering the world with fragile and easily over-stimulated nervous systems.  Another factor involves children being diagnosed with autism. Children with Autism seek out certain types of sensations and are extremely hypersensitive to other types.  These are just a few factors that have increased the number of children being treated for Sensory Integration Dysfunction.

Symptoms of Sensory Integration Dysfunction

            From time to time everyone shows signs of Sensory Integrative problems due to the fact that no one is well regulated all the time.  If you went for time with out sleep, it would effect your motor reflexes and your ability to concentrate.  During the time that you are trying to “catch up on sleep” you may react differently to stimuli then you would have if you were well rested.  It is impossible to provide a list of concrete symptoms due to the fact that sensory integration dysfunction can effect each person in a different manner.  The Table 1             below is a basic list of symptoms broken down into categories according to the different sense.

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

 

Treating Sensory Integration Dysfunction

            The first step for treating SID is to document the child’s behavior as it differs from others their age.   It is crucial to document not only the behavior but also the time of day and the circumstances in which the behavior was displayed.  When documenting behavior it is helpful to also keep track of when the child is doing well and the circumstances for the positive behavior.  By doing this it helps to gather information around what interventions are working and where the deficit sensory issues are. 

The next step is to have a formal individualized evaluation done on the child to measure their skill level.   Depending on the child’s problem, the professional would be a pediatrician, a pediatric eye doctor, an audiologist, a speech/language clinician or pathologist, or an occupational therapist (Kranowritz, 1998).  The first step of the evaluation consists of a questionnaire done by the parents (although, sometimes teachers fill out the questionnaire).  The questionnaire consists of a number of questions in regards to medical, sensorimotor, developmental, and family history.  This information helps the professional assess your child and his/her behavior.   The professional’s evaluation is based on standardized testing and observations of the child.  The evaluation can occur in a matter of hours or can take a number of days.  The length of time depends on how long a professional needs to observe a child to make an accurate diagnosis for treatment.

One of the primary tests that is used is called the Bruininks-Osteretsky Test of Motor Proficiency.     This test consists of a number of activities that test a child’s balance, bilateral coordination, upper-limb coordination and visual-motor control.  In this test standard scores below 6 are considered Poor, scores of 6 to 11 are considered Below Average, scores of 12 to 18 are considered Average, and scores 19 to 23 are considered Above Average, and scores above 23 are considered High.

Once a child has been diagnosed there are a number of treatments that can be applied to improve the child’s sensory needs.  The most popular treatment is provided by Occupational Therapists.  Occupational Therapy is always concerned with how people function in their daily life tasks and roles.  Sensory Integration Therapy takes place in a setting that invites play since one of the most important roles of a child is play.

During Sensory Integration Therapy, the Occupational Therapist guides the child through activities that challenge his or her ability to respond successfully to the environment.  These activities are generally chosen by the child, with the therapist’s guidance, to provide the right mix of tactile, proprioceptive and vestibular sensory input to meet the child’s specific developmental needs. Over time the activities gradually increase in difficulty so the challenge is always at the best level to promote growth and mature response.

  The child’s active participation, motivation, and exploration are important aspects of therapy.  Under these conditions, a child’s successful movement enables his or her nervous system to develop in a more mature fashion.  It is also important that a child is invested and interested in the therapy activities.  When a child is interested and invested in the therapy, it is then that you will begin to see changes in the way that the child gets his/her sensory needs meet.  Also a child’s participation, motivation and exploration in therapy will also improve his/her response to the daily challenges of life.

 

Sensory Diet

In addition to therapy it is important for children to have a “sensory diet”.  A sensory diet is a planned and scheduled activity program that an Occupational Therapist develops to help a person become more self-regulated. They are designed and developed specific to meet the needs of the child's nervous system. "Just as the five main food groups provide daily nutritional requirements, a daily sensory diet fulfills physical and emotional needs" (Kranowitz, 1998).   A balanced diet is like a fitness plan that is designed to enhance a child’s ability to function smoothly, whether a child is in or out of sync (Kranowitz, 1998).

A sensory diet includes a combination of alerting, organizing and calming techniques that lead directly to the "near" senses.  Alerting activities benefit the under sensitive child that may be in need of a boost to become effectively aroused.  Organizing activities help regulate a child’s responses to situations and calming activities help the oversensitive child decrease hyper-responsiveness to sensory stimulation.  In the chart below are some activities that can be done for some of the techniques.

 

Alerting	¨      Crunching pretzels, dry cereal, carrots, crackers, or ice cubes ¨      Take a shower ¨      Bouncing on a therapy ball or beach ball ¨      Jumping up and down on a mattress or trampoline
Organizing	¨      Chewing on granola bar, licorice, gum, or bagels ¨      Hanging by hands from a chin up bar ¨      Pushing or pulling heavy loads ¨      Getting into an upside down position
Calming	¨      Sucking a pacifier, hard candy, frozen bar or spoonful of peanut butter ¨      Pushing against walls with hands, shoulders, back, buttocks, and head ¨      Rocking, swaying, or swinging slowly back and forth ¨      Cuddling or back rubbing ¨      Taking a bath

Table 2.  Techniques to Alert, Organize, and Calm the “Near Senses”.  (Kranowitz, 1998)

These activities can be done both at home and in the school environment.  It is important that these activities be structured and occur at certain times during the day when the child is in need of more or less stimulation.  It is important to supply the child with an activity that the child wants to participate in.  The child should also be the one that directs the activity. It is important to monitor the activities so the child doesn’t over stimulate or misuse the technique.  All of these activities should be advised by an Occupational Therapist to make sure that the activity is meeting the sensory needs of the child.  In addition to the activities above the chart below are some activities that can be done to develop Tactile, Vestibular, and Proprioceptive Integration.

Activities to Develop Tactile Integration
¨       “Can you describe it?” Game – Provide objects with different texture, temperature, and weight and ask child to describe what they are holding ¨       Oral Activities – licking sticker, blowing whistles and kazoos, blowing bubbles ¨       Hands on Cooking – kneading cookie dough or bread ¨       Science Activities – touching worms, digging in garden, and planting seeds ¨       Handling Pets – stroking or brushing animals fur ¨       Box Play – allow child to build and stack boxes of different sizes ¨       Swaddling – roll child tightly in a blanket ¨       People Sandwich – place child between gym mats and sit lightly on top ¨       Back Rubs – apply deep and firm pressure on child’s back Dress Up – have child dress up in furry and feathery items	¨       Rub-a-Dub-Dub -  rubbing a variety of textures of child’s skin ¨       Water Play – allowing child to play in sink full of sudsy water with toys ¨       Water Painting – giving child a bucket of water and paint brush  and allow them to paint things outside ¨       Finger Painting – add sand to paint for texture ¨       Finger Drawing – draw with shapes, letters, and numbers on the child’s back.  Then have child guess what it is. ¨       Sand Play – sandbox with toys for the child to explore with ¨       Feelie Box – cut a hole in the top of shoebox and fill with a variety of object.  Have child feel and guess what items are ¨       “Can you find it?” Game – Hide objects in sandbox or feelie box.  Ask child to find objects ¨       Secret Hideaway – have child build a hideaway with blankets and sheets
Activities to Develop Vestibular Integration
¨      Riding in Vehicles – have child use bikes and scooters improve balance ¨      Jumping on Trampoline – use a mattress or small trampoline ¨      Walking on Unstable Surfaces – have child walk on sandy beach, a wood bridge, or grassy meadow ¨      Riding, Balancing and Walking on Seesaw ¨      Sitting on a T-Stool – this helps child improve balance ¨      “Sitting Ball” – have child sit on ball during activities that require their focus	¨      Hoppity Hopping – have child jump on ball with handle on it ¨      Rolling – allow child to roll on floor or down a grassy hill ¨      Swinging in A Blanket – two adults hold the ends of blanket (like a hammock) and child lays on blanket while adults swing it ¨      Spinning – have child spin on tire swing ¨      Sliding – see how many different ways the child can slide down the slide ¨      Rhythmic Rocking – use a rocking chair ¨       Somersaulting
Activities to Develop Proprioceptive
¨       Body Squeeze – pull child into your body ¨       Bear Hugs – wrap arms around child and give them a giant hug ¨       Pouring -  fill pitcher with sand or beans and allow child to pour contents from one container to the other ¨       Opening Doors – have child practice opening doors ¨       Ripping Paper – let child make confetti ¨       Tug of War- try game sitting, kneeling, and standing ¨       Playing Toss- use a ball,  bean bag, or pillow and toss them back and forth ¨       Arm Wrestling – let your child win but use some force	¨       Carrying Heavy Loads – have child carry heavy things such as laundry, grocery bags, books,  etc ¨       Pushing and Pulling – have child push things around the house and at school ¨       Hanging by Arms – allow child to hang from  a chin bar or monkey bar ¨       Pillow Crashing – pile pillows up and allow child to crash into them ¨       Hermit Crab – place a large bag of rice or beans on child’s back and let them move around ¨       Leap frog/Horsie – any type of contact sport

Table 3.  Activities to Develop the Tactile, Vestibular, and Proprioceptive Senses.  (Kranowitz, 1998)

 

Case Study #1

                The first case study that I performed was with an 8-year-old boy named Coty.  Coty attends an alternative school for children with behavioral and emotional challenges.  This school is where I have been employed for the past ten years.  Coty is in the youngest of the five classrooms at the program.  He is in a multi-age classroom with nine other children ranging from the age of six to ten.  Within his classroom he is one of the smallest children in size.

            Within the classroom setting he has a difficult time sitting at his desk for long periods of time.  He has a tendency to wander around the classroom, stand by his desk, or lies on the floor by his desk.    He seems to struggle more in the classroom when the environment becomes very loud and unsettled.  Coty has a difficult time verbalizing his thoughts and feelings.  When he becomes upset with something he will begin to acting out either in a non-complaint or aggressive manner.  

Coty is very protective of desk space in the classroom.  He gets easily frustrated when others sit at his desk, touch his desk or even walk or stand to close to his space.  His frustration is usually displayed in an aggressive manner. Due to his unpredictable aggressive behavior, his classmates are fearful of him.

During the course of the day his classroom goes through a number of transitions.  He has a difficult time adjusting to change in the schedule as well as times when things in the classroom are less structured.  It is during this times that he will either begin to act out behaviorally or he will withdraw from the group.  The times when transitions appear to be the most challenging for him are the ones in which he needs to leave his original classroom to go to another space within the school building.

            At recess time, Coty likes to play by himself.   He again prefers that others who are playing near him keep out of his “space”.   He likes to build things with blocks, cardboard boxes and other miscellaneous objects around the classroom.  Coty occasionally likes to go outside for recess when the weather is nice.  He doesn’t appear to like the cold or very hot weather.  When he does chose to go outside he tends to engage in-group play.  He will stand off to the side and observe others with an appearance of some interest in joining the activity.  Although, at times he does decide to take part in the group activity but he has a difficult time bringing his energy level back down when the activity comes to an end.

            When it comes to hands on activities he doesn’t like to get messy or dirty.  He likes projects that are “nice and neat”.  He will become very quiet during these times and refuse to participate in the activity.  Coty is not able to verbalize why he won’t participate or what it is about the activity that bothers him.  It is clear that during these times that something is bothering him.  Adults are puzzled around why he won’t participate when his classmates are participating and having fun.  

            Coty’s teachers have a point system in their classroom.  They track the child’s ability to follow directions first time given, respectful communication with others, and ability to complete tasks.   At the end of each week they total each area targeted and come up with an average.  In all of the areas Coty’s averages are below 40% for two consecutive months.  This data shows that he is struggling in a number of areas within the classroom setting.   During the two-month period, Coty was also spending a large amount of time out of the classroom due to his aggressive behaviors toward his classmates.  When he was spending time out of the classroom he was having a difficult time connecting thoughts, feelings, and his reactions. 

            Coty’s parents report some of the same behaviors above happening at home as well.  His parents express that due to the fact that his time at home is not as structured as his school day. They have found that any time they change plans that Coty ends up having a temper tantrum.  At first his parents thought that his tantrums were triggered because he didn’t get his own way (which they later learned was not the cause of his tantrums).   They have also seen him lacking impulse control around the house.  He would just do something and than claim that he wasn’t sure why he had done it.  Coty’s parents report that he has been a difficult child to raise.  They describe that they constantly feel like they are “walking on egg shells” when Coty is around.  This feeling has caused a strain on their relationship with their son.   They state that at times they are not sure how to intervene or react to his acting out behavior.

            His behavior both at home and school display many characteristics of a child with Sensory Integration Dysfunction.  Coty was referred to have an evaluation done by an Occupational Therapist.  Once the evaluation was complete, his parents and school team looked over the recommendations and implemented them into his school day and at home.  The recommendations addressed ways to improve his tactile, proprioceptive, and vestibular senses.

            With the recommendations a sensory diet was established for Coty.         Every morning when he arrived at school he was given 15-20 minutes outside on the playground.  Adults guided his play encouraging him to use the tire swing, the monkey bars, and slide different ways down the slide.  On days when the weather prevented him from going outside he was able to use the gym space for his morning routine.  In the gym he would hop on the hoppity hop, spin on the scooter, or jump on the trampoline. The outside and gym activities were not only used in the morning.  Adults would monitor his sensory needs during the day and make the activities available when he appeared to need more stimulation.   During the first few days that this routine was followed, Coty’s attention span in class increased.  He appeared to be calmer when entering his classroom for the morning activities.

            In his classroom a number of accommodations were made based on his sensory needs.  He teachers no longer insisted that he sit at his desk during independent activities. His teachers provided him with a beanbag and clipboard during independent work times.  Other times when he need to be in his desk space they provided him with a T-stool and a therapy ball to sit on.  His teachers found less work resistance from him once they modified where and how he got his work done.  The teachers also reported that he was able to focus on activities for a longer period of time and that for the first time he was seeing a task through to it’s completion. 

            At home and school, Coty’s teachers and parents began working on developing his tactile sensory input.  They did this by not touching him unexpectedly and making sure that when they did touch him that they did so in a firm manner.  Adults began giving Coty “bear hugs” and “high 5’s” randomly throughout the day as well.  His mom began doing deep pressure massages in the morning and prior to him going to bed.  Adults found that his aggression level appeared to decrease when the way that he was touched was adjusted.  Coty was able to verbalize that light touch made him feel uncomfortable and that firm touches felt better.

            Although Coty continues to be challenged with the way that his body takes in sensory input his team has seen a significant improvement in his behavior.  Coty’s percentages in the areas of following directions, respectful communication, and task completion have risen tremendously.  During the month following the implementation of his sensory diet he was averaging 70% or better in the targeted areas.  Coty’s parents have reported that he seems to be more adjusted when he arrives home from school.  They explained that he comes home calmer and excited that he had a successful day at school.

 

Case Study #2

 

            Raymond is a twelve-year-old boy who also attends the alternative school where I work.  Raymond is also in a multi-age classroom with other eleven and twelve years olds.    He has been in the alternative program for just over a year.  Prior to his placement he was attending a public school but was not in a regular classroom.  He was working with an individual aide in a small room where he had little interactions with other students.  Raymond currently lives with his mother and is the only child living in the home.

            Raymond is a very quiet child most of the time.  He rocks and sways his body repeatedly throughout the school day.  Raymond is very clumsy and is constantly bumps into things.   He refers to himself as “having two left feet”.    He states that no matter how hard he tries he still messes things up somehow.  When observing Raymond, he has a difficult time holding his pencil and other small objects.  It looks as if holding his pencil is painful experience.  Due to his difficulty holding and manipulating items, he tends to avoid activities that require him to do so.  This causes a number of problems during academic time in his classroom.

            His mother reports that at home he is just as clumsy.  She worries that he is going to hurt himself because he is so clumsy.  She explains that she warns him at times that something is about to happen but he still bumps into it anyway.   His mother used the example,  “I tell him to come into the kitchen slowly but he doesn’t.  He comes flying in and bumps into the table every night.”  She also explained that he has a tendency to bump into the front door even when she tells him to open it first. His mother worries that he is going to seriously get hurt one of these times because he doesn’t seem to stop and think before he does things.

His mother continued to describe that at times Raymond struggles to get dressed on his own.  She explained that he can’t seem to manipulate his arms and legs into his clothing like other children his age.  His mother finds herself helping him get dressed just to speed the process up.  This has been a frustrating issue for both Raymond and his mother.  Raymond reports “that he just can’t seem to get his arms and legs to do what he wants, even when he watches them”.

Raymond is another child that displays symptoms from Sensory Integration Dysfunction.  He was also evaluated by an Occupational Therapist and a sensory diet was established to begin to meet his sensory needs.  His sensory diet consists of activities to build mainly on his vestibular and proprioceptive senses. Raymond was under stimulated due to his fear of failing or messing up at what he was asked do.  The activities that he was given to do he was able to begin to feel successful and less of a failure.  Raymond was also provided with activities that would challenge him to begin to have awareness of his body’s positioning.  Once he established an awareness of his body’s position he was able to do so across settings.  At times he would become frustrated but was able to bounce back to another activity and continue to move forward.

Raymond teachers provided him with a bigger chair to sit in at his desk to help him keep his balance better.  He was also given pencil grips that helped him to maneuver his pencil in a smooth manner.  During times when he needs to work with small objects his teachers modify the activity to help Raymond feel a sense of success.

After several months on his new sensory diet adults saw an improvement in his self-esteem, his willingness to take on new challenges increased, and his frustration level decreased.  Raymond appeared to “come out of his shell” both at home and school, once his sensory needs were being meet.  Raymond was able to express that he is feeling better about himself and he is not as fearful to try new things.  He states “I am still clumsy but not as bad as I used to be”. 

Raymond’s mother reported that he is beginning to dress himself with some assistance from her.  She says that he doesn’t appear to act as “helpless” as before the sensory diet. His mother has seen a change in his attitude toward trying tasks that used to be painful for him in the past.  Due to his attitude change she has seen an improvement in the relationship that she has with her son.  She reported that they seem to have less and less power struggles over the day to day routine.

Conclusion

            In the two case studies above it is very clear that the two children suffered from Sensory Integration Dysfunction.  These two boys were displaying behaviors that were puzzling to both their parents and to the adults working with them.    Reflecting back on the work that was done with the boys prior to their evaluations it became clear that some of the interventions that were done by myself, other teachers, and their parents were only making matters worse.  For instance, prior to my knowledge of Coty’s issues around touch, I would touch him without asking or lightly.  When I did this I would get a strong reaction from him.  He would pull away, begin yelling at me, or even display aggression towards me.  I thought that he was having a bad day or that it was something about me personally that he didn’t like.  After having him evaluated and looking over the recommendations made by the Occupational Therapist things started to make sense to me.  I began to adjust my approach when intervening with Coty.  I made sure that whenever possible I asked him if I could touch him and I made sure that when I did that I did so in a firm manner.  Coty no longer pulled away from me and he began asking for “high 5’s” and bear hugs from me.

This is just one example of an adjustment that I have made with one particular student.  Based on theses two students I have begun to explore other children’s behavior within the program where I work.  I have found that many children display Sensory Integration Dysfunction.  These children have been labeled with a number of diagnoses. Currently, Sensory Integration Dysfunction is not a diagnosis in the DSM V but researchers are pushing hard for it to be in the DSM VI.   Once it becomes a diagnosis the more mental health professionals and educators will look at Sensory Integration Dysfunction and it’s solutions in a different light.

Children that are evaluated and treated for Sensory Integration Dysfunction appear to be “having fun” naturally for the first time in their life.    These children learn to play for the first time in a way that feels good. They appear to feel a sense of success and begin to thrive in all areas of their life. These children when properly treated begin to excel for the first time in school and they are excited to attend from one day to the next.   Many adults, either working with or parenting these children, have changed their feelings and inter-reactions with these children.  This in turn has changed the negative feelings that both adults and children have had toward one another.  Relationships between adults and these children have greatly improved.   Adults are now beginning to understand and meet children’s sensory needs.

References

 

 

Ayers, A.J.  Sensory Integration and the Child.  Los Angeles: Western Psychological Services, 1979.

 

Ayers, Jean.  Sensory Integration and Learning Disorders. Los Angeles: Western Psychological Services, 1979.

 

Bee, Helen.  The Developing Child. 8^th ed. New York: Longman, 1997.

 

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