Sensory Integration

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Introduction

Sensory integration is also known as sensory processing and it is brain's ability to recognise and to respond to signals sent by our senses. These senses include hearing, vision, smell, taste, touch, proprioception, and vestibular. Sensory integration plays a significant role in the development and maintenance of social-emotional, motor, cognitive, adaptive, and other skills. It impacts the child's participation in daily activities, school activities, and more. When the brain has difficulties processing these various sensory stimuli, the child may be diagnosed with a condition called sensory integration dysfunction (SID) or more recently, sensory processing disorder (SPD). It is a "failure to modulate the effects of incoming sensory inputs." Children can demonstrates either hypo- or hyper-sensitivities to sensory inputs and their obstructed processing and response to sensory information can lead to daily activities limitations. This article discusses sensory integration and sensory integration dysfunction. Additionally, it offers sensory integration therapy recommendations for children with cerebral palsy.

Sensation

Touch or Tactile Sensation

• Information is received from receptor cells in the skin
• Skin (cutaneous) receptors provide information about light touch, pressure, vibration, temperature, and pain. The touch receptors are mechanoreceptors, chemoreceptors and thermoreceptors.
• Mechanoreceptors include the following:
  • Hair follicles
  • Pacinian corpuscles allow to discriminate between smooth and rough surfaces
  • Meissner corpuscles are sensitive to light touches, allows to feel a light tickle
  • Merkel complexes are activated by the applied pressure and location of objects we interact with
  • Ruffini corpuscles are mechanoreceptor activated by stretching the skin
  • C-fiber low threshold mechanoreceptors (LTM) respond to “pleasant” and “affective”mechanical stimulus like gentle stroking and brushing and small changes in skin temperature
• Chemoreceptors are taste receptors.
• Thermoreceptors detect changes in the skin temperature.

Sensory Integration

Sensory integration "is the potential to develop adequate motor and behavioural reactions to stimulus"--Ayres

The input from the senses is received, organised and interpreted to create a reaction appropriate to the type of stimulation received. This is called sensory processing.

Sensory Integration Dysfunction

Sensory Integration Disorder is "difficulty detecting, modulating, interpreting, and/or responding to sensory inputs, which is severe enough to disrupt participation in everyday living activities and routines, as well as learning."

Sensory integration dysfunction is a problem in the ability to ‘‘organise sensory information for use.’’--Ayres

Sensory integration dysfunction may lead to the following deficits:

• initiating or sustaining peer interactions
• developing engaged relationships
• participating in activities of daily living
• regulating arousal behaviours
• language development

Common manifestations of sensory integration processing deficits include the following:

• responses to stimulation more quickly,
• responses to stimulation more intensely,
• responses to stimulation a longer duration than do typically developing individuals

Examples:

1. Extreme responses to stimuli including as noise in a classroom, odors in a restaurant, the touch of clothing, or the movement of playground equipment.
2. "Fight, flight or freeze" behavioural responses in a form of aggression, withdrawal, or preoccupation with the expectation of sensory input.
3. Severe difficulty forming and maintaining peer relationships
4. Extreme efforts to control events in the environment by over-reliance on routines

Sensory Integration Therapy

• Targets seven sensations:auditory, visual, gustatory (taste), olfactory (smell), somatosensory (proprioception and touch), vestibular, and interoceptive (the sense involved in the detection of internal regulation, such as heart rate, respiration, hunger, and digestion)
• It is postulated that SIT directly improve attentional, emotional, motoric, communication, and/or social difficulties

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