Sensory Integration Therapy in Paediatric Rehabilitation

Original Editor - Syeda Bushra Zehra Zaidi

Top Contributors - Syeda Bushra Zehra Zaidi, Abdullah Mahmoud Fahmy Hassany, Aminat Abolade and Matt Huey

Introduction

Sensory integration therapy (SIT) is grounded on Ayres's theory (ASI) of sensory processing, this intervention method is commonly provided by occupational therapists, who are leading professionals in it . Sensory integration is defined as the process by which one receives and organizes sensations from the environment, it gives them meaning and supports the development of abilities needed for participation in activities of daily living. Dyspraxia and sensory modulation dysfunction are the two primary kinds of dysfunction that are compared and contrasted in sensory integration therapy and sensory integrative dysfunction. In terms of postulated sensory basis and overt signs, we discriminated between two types of dyspraxia (somatic dyspraxia, or deficiencies in bilateral integration and sequencing) and two types of sensory modulation dysfunction (over-responsivity and under-responsivity). We determined the limits and presumptions of SI intervention and theory. Our distinct emphasis on "doing" vocation sets occupational therapy practice apart from all other health professions. The Greek word praxis also means "doing," which serves as a reminder that when applying SI theory, our main focus should be on enabling the adults and children we deal with to accomplish the tasks they need and wish to do.

Techniques in Sensory Integration Therapy

1. Play-Based Activities: Play is the primary medium used in SIT. Occupational therapists design playful activities that involve various sensory experiences to challenge the child's sensory processing abilities. These activities may include playing with swings, trampolines, large balls, and other equipment that provide sensory input.
2. Swinging and Spinning: Swinging and spinning activities are commonly used to provide vestibular (balance and movement) input. These activities can help children regulate their arousal levels and improve their balance and coordination.
3. Deep Pressure Activities: Deep pressure activities, such as squeezing or wrapping the child in a blanket, provide proprioceptive input, which helps the child develop body awareness and calming responses.
4. Brushing Protocol: The Wilbarger Brushing Protocol involves using a soft surgical brush to apply deep pressure to the child's skin. This technique is believed to reduce tactile defensiveness and improve sensory processing.
5. Weighted Vests and Blankets: Weighted vests and blankets are used to provide deep pressure and proprioceptive input. They can help children feel more grounded and focused.
6. Therapeutic Listening: Therapeutic listening involves using specially designed music to stimulate the child's auditory system. It is believed to enhance sensory processing and self-regulation.
7. Visual Stimulation: Activities involving visual stimulation, such as tracking moving objects or playing with colorful lights, can help improve visual processing and attention.
8. Oral Motor Activities: Oral motor activities, like chewing or blowing bubbles, can help improve oral sensory processing and support speech and feeding skills.
9. Environmental Modifications: Occupational therapists may recommend modifying the child's environment to reduce sensory distractions or create opportunities for sensory exploration.
10. Sensory Diet: A sensory diet is a personalized plan that incorporates sensory activities throughout the child's daily routines to meet their sensory needs and enhance participation in daily activities.

Conditions Treated with Sensory Integration Therapy

Sensory Integration Therapy (SIT) is used to treat conditions such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Sensory Processing Disorder (SPD), Developmental Coordination Disorder (DCD), learning disabilities, intellectual disabilities, behavioral disorders, motor skill delays, anxiety disorders, and developmental delays. It aims to address difficulties in sensory processing, improve adaptive responses, and enhance overall functioning. SIT is often used in combination with other therapies and interventions tailored to each individual's needs.

The Role of Pediatric Occupational Therapists

Pediatric occupational therapists play a vital role in promoting children's functional abilities and participation in daily activities. They conduct assessments to identify a child's strengths and challenges related to motor skills, sensory processing, and self-regulation. Based on these assessments, they develop individualized intervention plans to address the child's unique needs. Occupational therapists may use sensory integration therapy to improve sensory processing, and they work on developing fine and gross motor skills to enhance a child's independence. They may recommend adaptive equipment or assistive technology to support children with physical or cognitive challenges. Collaboration with parents, caregivers, and other professionals is essential to ensure a holistic approach to the child's care. Pediatric occupational therapists may work in schools or provide early intervention services for infants and young children. Their goal is to promote optimal development, independence, and quality of life for children and their families.

Recommendations

1. Pediatricians should not use sensory processing disorder as a diagnosis. When these sensory symptoms are present, other developmental disorders—specifically, autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorder, and anxiety disorder—must be considered and thoroughly evaluated, usually by appropriate referral(s) to a developmental and behavioral pediatrician, child psychiatrist, or child psychologist
2. Pediatricians should recognize and communicate with families about the limited data on the use of sensory-based therapies for childhood developmental and behavioral problems.
3. If the pediatrician is managing a child whose therapist is using sensory-based therapies, the pediatrician can play an important role in teaching families how to determine whether a therapy is effective.
4. Pediatricians should inform families that occupational therapy is a limited resource, particularly the number of sessions available through schools and insurance coverage. The family, pediatrician, and other clinicians should work together to prioritize treatment based on the effects the sensory problems have on a child’s ability to perform the daily functions of childhood

Conclusion

In conclusion, Sensory Integration Therapy (SIT) is a beneficial intervention based on Ayres's theory of sensory processing, provided by pediatric occupational therapists to address sensory difficulties in children with various developmental disorders. SIT techniques, such as play-based activities, swinging, deep pressure, brushing, and others, offer a comprehensive approach. SIT can help children with conditions like Autism Spectrum Disorder, ADHD, and sensory processing difficulties, promoting better functioning and quality of life. Collaboration among therapists, parents, and healthcare professionals is vital for personalized care and effective outcomes.

Additional Information

Description: Occupational Therapist Tina Malian discusses what is sensory processing disorder and the array of techniques and equipment used to treat children with sensory processing disorder at Joe DiMaggio Children's Hospital Rehabilitation Centers.

Description: Learn how occupation therapy can be used as a treatment for children who struggle with sensory integration issues. This video shows occupational therapists and health professionals experts, discussing how occupational therapy works, and the benefits that occupational therapy provides.