Sensory Integration
Dysfunction
.
By Valerie Dejean,
Director, Spectrum Center and Certified Tomatis Consultant
Danny is a beautiful
four-year-old boy with two loving parents. After his birth by Cesarean,
Danny nursed well and thrived. He reached the major developmental
milestones on time - sitting at six months and walking at one year. In
other ways however, Danny was just a bit different: he never responded
to the typical "so big" games, never clapped his hands, never pointed.
In addition Danny was not a good sleeper, and woke frequently at night
until he was three years old. When he first began solid food, Danny ate
reasonably well although every new food would initially elicit gagging.
Over time, Danny began to
refuse more and more foods, often without even tasting them. Now Danny
has an extremely limited diet, and will go without eating at all if his
"favorite foods" are not available.
Danny is extremely resistant to hygiene activities like bathing, hair
washing, and nail clipping. Getting a haircut is virtually impossible.
Danny does not deal will with transitions, and seems not to enjoy any
of the "normal kid pastimes, like going to the playground or spending
time at the beach. He also detests crowds; his parents have all but
stopped taking him out anywhere for fear of "making a scene." At
preschool, Danny's teacher reports that he avoids messy activities such
as finger painting or Play Dough.
He refuses to sit at story time, and in
general avoids his classmates, preferring to build complex block-towers
in the corner of the room by himself. Danny's pediatrician says there
is nothing wrong and suggests that maybe you're over anxious parents.
His grandparents think he is "just spoiled." As parents your
frustrated, confused, and tired.
What is Sensory Integration Dysfunction?
Sensory Integration Dysfunction (SI Dysfunction) is the inability of an
individual to appropriately process sensory stimulation. Our brains
constantly receive sensory input-our ears constantly hear external and
internal sounds, our skin receives constant sensory messages from the
air, our clothes, and gravity, our eyes (while open) continually adapt
to what is in our line of vision. These sensory messages are, in
essence, "food for the brain."
In a well-functioning
brain, messages from the central nervous system reach their optimal
destination in the brain and are responded to appropriately. For
individuals with SI Dysfunction, some messages are not received or are
perceived improperly. They may be misinterpreted, intensified or
omitted, which, in turn does not allow the brain to respond
appropriately. The mixed messages and unusual responses leave the
individual with SI Dysfunction "out of sync" with his or her world.
(See the Out of Sync Child by Carol Kranowitz and Sensory Integration
And Your Child by A. Jean Ayres.)
The cause of SI Dysfunction is not
known, although there are many theories that range from genetic causes
to traumatic birth experiences. SI Dysfunction is also difficult to
diagnose. The body's sensory integration systems are complex and
interrelated; when dysfunction occurs, it can manifest in a variety of
areas and behaviors. Also, some of the behavioral responses of SI
Dysfunctional individuals are very similar to characteristics of other
disorders, e.g. ADD. Finally, since many children exhibit similar
behaviors in response to certain activities (e.g. lots of kids hate to
have their hair washed), it is difficult to tell if a child's strong
negative reaction in one area is "normal" or if it is indicative of a
problem. It is necessary, therefore to view the child overall to
determine if, put together, all his or her "little idiosyncrasies" add
up to something. Below are some common behaviors and reactions of
individuals with SI Dysfunction, broken into four categories: attention
and focus, kinesthetic ability, sensory defensiveness, and
socialization.
Attention and Focus
To pay attention, one must be able to not only concentrate on the task
at hand, but also filter out irrelevant stimuli. An individual reading
a book on the subway is an example of someone "blocking out" irrelevant
stimuli-people talking, sound of the subway car, announcements of
stations-and focusing her attention on her book. Individuals with SI
Dysfunction often cannot discriminate relevant from irrelevant stimuli.
For example, a parent may call the child's name repeatedly while in the
room with her and she will not respond. Yet she will look up in
response to the faint sound of the train whistle as it passes several
blocks away. Individuals with SI Dysfunction often key in to background
noise (refrigerator motors, washer/dryer cycles) but may be
unresponsive to other, more essential stimuli (a question directed to
them, the sound of their name).
At the same time, these
individuals may be hypersensitive to some sounds-the sound of the
vacuum cleaner may drive them crazy-but oblivious to others-fire sirens
are not big deal. Some individuals with SI Dysfunction are unable to
focus their attention on one task for any length of time. They may
wander around a room of toys, pulling out this and that but not really
playing with anything. Others will spend hours focusing on one aspect
of a toy-they may pull out the "voice box" of a talking stuffed animal
and play it over and over to figure out exactly how it works. Still
others will play repetitive games-the doll goes in the car, the doll
comes out of the car, the doll goes in the car again. Since many
individuals with SI Dysfunction have motor planning problems, they
often cannot tolerate a change in their game or a rapid transition from
one activity to another.
Kinesthetic Ability
Many children with SI Dysfunction are "off balance." They may be
physically awkward or clumsy, tripping and falling for no apparent
reason.
Others are
"dare devils" as they do not realize the potential danger of climbing
too high, or they may crave the stimulation of spinning as fast as they
can. Still other are overly cautious-they never seem to get hurt and
tend to be very careful during physical activities-climbing slowly and
carefully on the playground, sitting or crawling over a low step or
bump so as not to fall.
The SI Network (www.sinetwork.com) identifies individuals with SI
Dysfunction as often being sensory seekers, sensory avoiders, or a
combination of the two. The sensory seekers "have nervous systems that
are under-responsive to sensation. As a result, they seek out more
intense or longer sensory experiences." (SI Network homepage). The
sensory seekers may tend to exhibit hyperactive behavior in their
unquenchable guest for sensory input. Since they often do not get
dizzy, they will swing or spin for prolonged periods.
At bedtime, they may find
it very difficult to settle down either because they have not received
enough stimulation for the day, or because their constant activity has
actually over-stimulated them.
Sensory Defensiveness
On the contrary, the sensory avoiders "have nervous systems that are
overly responsive to sensation. As a result they may have 'fight or
flight' responses to sensation, a condition called 'sensory
defensiveness'" (SI Network, homepage). Those with sensory
defensiveness may be uncomfortable in groups or busy places like
crowded malls. They may also be unable to tolerate certain fabrics,
tags in their clothes, or wrinkles in their socks. Individuals with
sensory defensiveness are often very picky eaters-they cannot stand the
texture of many foods, and may also be extremely sensitive to odors.
Sensory
defensive individuals often avoid messy activities such as finger
painting, making mud pies, etc. To some of these children a small
wet-spot on their shirt is enough to distract them for the entire
day-they cannot function until they have changed their shirt.
Socialization
Socializing can be difficult for individuals with SI Dysfunction. Their
Dyspraxia (poor motor planning) makes it difficult for them to adapt to
new situations, a necessary skill in order to play with peers. If they
have any sensory defensiveness, they may also shy away from or respond
negatively or aggressively to unexpected touch. Communicating with
others may be extremely difficult if filtering out background noise
(like extraneous classroom noise) is a challenge. Also, as these
children grow, they may become more and more aware of their
differences, which can lead to esteem issues.
How Can The Spectrum Center Help?
Finally, at the Spectrum Center, Valerie Dejean, Director of the Center
and certified Tomatis Consultant, has pioneered using Tomatis'
developmental theories in conjunction with the sensory integration
theories of Dr. A. Jean Ayres.
Through this unique
perspective, known as the Spectrum Center Method, Ms. Dejean has
developed techniques of evaluating and treating through The
Integrators. This involves addressing all the ears functions; balance,
visual, and auditory Through individually designed programs
delivered by the Tomatis Electronic Ear, the Spectrum Center has
achieved phenomenal results since 1992. As individuals wear
their headphones and listen to their personally-developed auditory
stimulation program, Spectrum Center staffs work with them on a variety
of activities that supports the program they are receiving through the
Tomatis Electronic Ear. These include gross motor activities-swinging,
jumping, climbing-fine motor activities-puzzles, peg boards, stringing
beads-and tactile stimulation-playing with various textures such as
play dough, dried beans, etc. This intensive sensory retraining program
has helped individuals with Sensory Integration Dysfunction.
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