Sensory Integration: Difference between revisions
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== Introduction == | == 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.<ref>Chumburidze N. Sensory Integration. Plus Course 2024</ref> 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).<ref>Miller LJ, Nielsen DM, Schoen SA, Brett-Green BA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759332/pdf/fnint-03-022.pdf Perspectives on sensory processing disorder: a call for translational research.] Front Integr Neurosci. 2009 Sep 30;3:22. </ref> <ref name=":0" /> It is a "failure to modulate the effects of incoming sensory inputs."<ref>Barakat MKA, Elmeniawy GH, Abdelazeim FH. [https://bfpt.springeropen.com/articles/10.1186/s43161-021-00044-w Sensory systems processing in children with spastic cerebral palsy: a pilot study.] Bull Fac Phys Ther. 2021; 26 (27).</ref> 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. | 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.<ref name=":1">Chumburidze N. Sensory Integration. Plus Course 2024</ref> 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).<ref>Miller LJ, Nielsen DM, Schoen SA, Brett-Green BA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759332/pdf/fnint-03-022.pdf Perspectives on sensory processing disorder: a call for translational research.] Front Integr Neurosci. 2009 Sep 30;3:22. </ref> <ref name=":0" /> It is a "failure to modulate the effects of incoming sensory inputs."<ref>Barakat MKA, Elmeniawy GH, Abdelazeim FH. [https://bfpt.springeropen.com/articles/10.1186/s43161-021-00044-w Sensory systems processing in children with spastic cerebral palsy: a pilot study.] Bull Fac Phys Ther. 2021; 26 (27).</ref> 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. | ||
== | == Senses == | ||
=== Touch or Tactile Sensation === | === Touch or Tactile Sensation === | ||
| Line 16: | Line 16: | ||
* Skin (cutaneous) receptors provide information about light touch, pressure, vibration, temperature, and pain. The touch receptors are mechanoreceptors, chemoreceptors and thermoreceptors. | * 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: | * ''Mechanoreceptors'' include the following: | ||
** Hair follicles | ** Hair follicles which affect touch perception | ||
** Pacinian corpuscles allow to discriminate between smooth and rough surfaces | ** Pacinian corpuscles allow to discriminate between smooth and rough surfaces | ||
** Meissner corpuscles are sensitive to light touches | ** Meissner corpuscles are sensitive to light touches and allow to feel a light tickle | ||
** Merkel complexes are activated by the applied pressure and location of objects we interact with | ** Merkel complexes are activated by the applied pressure and location of objects we interact with | ||
** Ruffini corpuscles are | ** Ruffini corpuscles are 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<ref>Huzard D, Martin M, Maingret F, Chemin J, Jeanneteau F, Mery PF, Fossat P, Bourinet E, François A. [https://www.science.org/doi/epdf/10.1126/sciadv.abo7566 The impact of C-tactile low-threshold mechanoreceptors on affective touch and social interactions in mice.] Sci Adv. 2022 Jul;8(26):eabo7566.</ref> | ** C-fiber low threshold mechanoreceptors (LTM) respond to “pleasant” and “affective”mechanical stimulus like gentle stroking and brushing and small changes in skin temperature<ref>Huzard D, Martin M, Maingret F, Chemin J, Jeanneteau F, Mery PF, Fossat P, Bourinet E, François A. [https://www.science.org/doi/epdf/10.1126/sciadv.abo7566 The impact of C-tactile low-threshold mechanoreceptors on affective touch and social interactions in mice.] Sci Adv. 2022 Jul;8(26):eabo7566.</ref> | ||
* ''Chemoreceptors'' | * ''Chemoreceptors'' respond to chemicals in taste, smell and in internal changes. They regulate cardiovascular and respiratory functions. | ||
* ''Thermoreceptors'' detect changes in the skin temperature. | * ''Thermoreceptors'' detect changes in the skin temperature. | ||
=== Proprioception === | |||
[[Proprioception]] (kinaesthesia) helps us to move because of the information arising from skin, muscles, joints, ligaments, and bones.<ref name=":1" /> It allows us to perceive the location, movement, and action of the body.<ref name=":2">Proske U, Gandevia SC. [https://journals.physiology.org/doi/epdf/10.1152/physrev.00048.2011 The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force.] Physiol Rev. 2012 Oct;92(4):1651-97.</ref> | |||
* With change in position, the tissue surrounding moving joint becomes deformed<ref name=":2" /> | |||
* [[Muscle Spindles|Muscle spindle]]<nowiki/>s are considered to have the major role in kinaesthesia<ref name=":2" /> | |||
* The [[Skin Anatomy, Physiology, and Healing Process|skin receptors]] provide additional information<ref name=":2" /> | |||
* The [[Golgi Tendon Organ|Golgi tendon organs]] contribute to proprioception<ref name=":2" /> | |||
=== Vestibular Sense === | |||
Vestibular system provides information about movement, gravity, and changing head position:<ref name=":1" /> | |||
* It informs us that we are moving or stationary. | |||
* It provides information about direction and speed of our movements. | |||
* It helps to stabilise our eyes when we are moving. | |||
* It informs us if objects around us are moving or stationary. | |||
=== Hearing === | |||
* Auditory system processes the sounds of the environment.<ref name=":1" /> | |||
* Auditory receptors in the inner ear identify various sound stimuli: its intensity, frequency and spectrum.<ref name=":1" /> | |||
* Posture control can be influenced by sound frequency.<ref>Siedlecka B, Sobera M, Sikora A, Drzewowska I. [https://www.actabio.pwr.wroc.pl/Vol17No3/11.pdf The influence of sounds on posture control]. Acta of Bioengineering and Biomechanics 2015;17(3):95-102.</ref> | |||
* It allows us to respond to sound stimuli accordingly, like when there is a safety concern acknowledged by the alarm sound.<ref name=":1" /> | |||
=== Visual === | |||
* Helps us see and perceive the environment around us<ref name=":1" /> | |||
* Visual system identifies sights and understands what the eyes see<ref name=":1" /> | |||
* Visual inspection is an important component in maintaining body balance as it helps in body position in space<ref>Pankanin E. The importance of visual control in the process of maintaining the balance of the body. Journal of Education, Health and Sport. 2018;8(8):381-387.</ref> | |||
=== Smell === | |||
* It allows us to distinguish various odours in the environment.<ref name=":1" /> | |||
* It helps us to identify safe or potentially dangerous situations.<ref name=":1" /> | |||
=== Taste === | |||
* It allows us to distinguish four different tastes: sweet, sour, salty, and bitter.<ref name=":1" /> | |||
* It allows us to identify desirable foods that are pleasant to us as well as those that are potentially undesirable, such as a bitter dish.<ref name=":1" /> | |||
== Sensory Integration == | == Sensory Integration == | ||
| Line 37: | Line 76: | ||
* language development | * language development | ||
In general, the manifestations of sensory integration processing deficits may include the following:<ref name=":0" /> | |||
* responses to stimulation more quickly | * responses to stimulation more quickly | ||
* responses to stimulation more intensely | * responses to stimulation more intensely | ||
* responses to stimulation a longer duration than do typically developing individuals | * responses to stimulation a longer duration than do typically developing individuals | ||
Examples: | Examples:<ref name=":0" /> | ||
# Extreme responses to stimuli including as noise in a classroom, odors in a restaurant, the touch of clothing, or the movement of playground equipment. | # Extreme responses to stimuli including as noise in a classroom, odors in a restaurant, the touch of clothing, or the movement of playground equipment. | ||
| Line 49: | Line 88: | ||
# Severe difficulty forming and maintaining peer relationships | # Severe difficulty forming and maintaining peer relationships | ||
# Extreme efforts to control events in the environment by over-reliance on routines | # Extreme efforts to control events in the environment by over-reliance on routines | ||
# | #Behaviour regulation problems like temper tantrums, outbursts, hitting, kicking, biting, or spitting | ||
#Profound withdrawal from group | |||
#Slow to respond to sensation requiring "more intense stimuli to respond to the demands of the situation"<ref name=":0" /> | |||
=== Sensory Integration Dysfunction and Cerebral Palsy === | === Sensory Integration Dysfunction and Cerebral Palsy === | ||
Children with cerebral palsy often have deficits in one or more sensory systems, including proprioception, tactile sensation, and visual perception.<ref name=":1" /> Their reaction to sensory stimuli may be as follow: | |||
* '''Hyper-responsiveness to tactile input''':<ref name=":1" /> | |||
** Do not like to be touched | |||
** Avoidance of activities that involve getting messy, | |||
** Resistance to light touches | |||
** Avoidance of certain types of clothing | |||
* '''Hypo-responsiveness to tactile input''':<ref name=":1" /> | |||
** Lacking ability to localise touch or response when touched | |||
** Placing items in the mouth | |||
** Preference for activities or situations involving brushing hair, touching or hugging | |||
** Failure to recognise when hands or face are messy | |||
** Enjoyment of activities involving vibration | |||
* '''Hypo-responsiveness to proprioceptive input''':<ref name=":1" /> | |||
** Biting or chewing on non-food objects | |||
** Engaging in pinching or hitting others or oneself | |||
** Difficulty to changing body posture to match activity demands | |||
** Expressing low, high, or variable muscle tone impacting the processing of proprioceptive information | |||
* '''Hyper-responsiveness to proprioceptive input:'''<ref name=":1" /> | |||
** Crying in weight-bearing positions or when joints are moved | |||
** Choosing not to move or engage in activities | |||
* '''Hyper-responsiveness to vestibular input:'''<ref name=":1" /> | |||
** Overreacting when moved in space | |||
** Becoming fearful of bouncing or swinging | |||
** Disliking sudden or quick movements | |||
* '''Hypo-responsiveness to vestibular input:'''<ref name=":1" /> | |||
== Sensory Integration Therapy == | == Sensory Integration Therapy == | ||
Revision as of 01:35, 13 February 2024
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Introduction[edit | edit source]
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.[1] 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).[2] [3] It is a "failure to modulate the effects of incoming sensory inputs."[4] 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.
Senses[edit | edit source]
Touch or Tactile Sensation[edit | edit source]
- 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 which affect touch perception
- Pacinian corpuscles allow to discriminate between smooth and rough surfaces
- Meissner corpuscles are sensitive to light touches and allow to feel a light tickle
- Merkel complexes are activated by the applied pressure and location of objects we interact with
- Ruffini corpuscles are 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[5]
- Chemoreceptors respond to chemicals in taste, smell and in internal changes. They regulate cardiovascular and respiratory functions.
- Thermoreceptors detect changes in the skin temperature.
Proprioception[edit | edit source]
Proprioception (kinaesthesia) helps us to move because of the information arising from skin, muscles, joints, ligaments, and bones.[1] It allows us to perceive the location, movement, and action of the body.[6]
- With change in position, the tissue surrounding moving joint becomes deformed[6]
- Muscle spindles are considered to have the major role in kinaesthesia[6]
- The skin receptors provide additional information[6]
- The Golgi tendon organs contribute to proprioception[6]
Vestibular Sense[edit | edit source]
Vestibular system provides information about movement, gravity, and changing head position:[1]
- It informs us that we are moving or stationary.
- It provides information about direction and speed of our movements.
- It helps to stabilise our eyes when we are moving.
- It informs us if objects around us are moving or stationary.
Hearing[edit | edit source]
- Auditory system processes the sounds of the environment.[1]
- Auditory receptors in the inner ear identify various sound stimuli: its intensity, frequency and spectrum.[1]
- Posture control can be influenced by sound frequency.[7]
- It allows us to respond to sound stimuli accordingly, like when there is a safety concern acknowledged by the alarm sound.[1]
Visual[edit | edit source]
- Helps us see and perceive the environment around us[1]
- Visual system identifies sights and understands what the eyes see[1]
- Visual inspection is an important component in maintaining body balance as it helps in body position in space[8]
Smell[edit | edit source]
- It allows us to distinguish various odours in the environment.[1]
- It helps us to identify safe or potentially dangerous situations.[1]
Taste[edit | edit source]
- It allows us to distinguish four different tastes: sweet, sour, salty, and bitter.[1]
- It allows us to identify desirable foods that are pleasant to us as well as those that are potentially undesirable, such as a bitter dish.[1]
Sensory Integration[edit | edit source]
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[edit | edit source]
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."[3]
Sensory integration dysfunction is a problem in the ability to ‘‘organise sensory information for use.’’[9]--Ayres
Sensory integration dysfunction may lead to the following deficits:[3]
- initiating or sustaining peer interactions
- developing engaged relationships
- participating in activities of daily living
- regulating arousal behaviours
- language development
In general, the manifestations of sensory integration processing deficits may include the following:[3]
- responses to stimulation more quickly
- responses to stimulation more intensely
- responses to stimulation a longer duration than do typically developing individuals
Examples:[3]
- Extreme responses to stimuli including as noise in a classroom, odors in a restaurant, the touch of clothing, or the movement of playground equipment.
- "Fight, flight or freeze" behavioural responses in a form of aggression, withdrawal, or preoccupation with the expectation of sensory input.
- Severe difficulty forming and maintaining peer relationships
- Extreme efforts to control events in the environment by over-reliance on routines
- Behaviour regulation problems like temper tantrums, outbursts, hitting, kicking, biting, or spitting
- Profound withdrawal from group
- Slow to respond to sensation requiring "more intense stimuli to respond to the demands of the situation"[3]
Sensory Integration Dysfunction and Cerebral Palsy[edit | edit source]
Children with cerebral palsy often have deficits in one or more sensory systems, including proprioception, tactile sensation, and visual perception.[1] Their reaction to sensory stimuli may be as follow:
- Hyper-responsiveness to tactile input:[1]
- Do not like to be touched
- Avoidance of activities that involve getting messy,
- Resistance to light touches
- Avoidance of certain types of clothing
- Hypo-responsiveness to tactile input:[1]
- Lacking ability to localise touch or response when touched
- Placing items in the mouth
- Preference for activities or situations involving brushing hair, touching or hugging
- Failure to recognise when hands or face are messy
- Enjoyment of activities involving vibration
- Hypo-responsiveness to proprioceptive input:[1]
- Biting or chewing on non-food objects
- Engaging in pinching or hitting others or oneself
- Difficulty to changing body posture to match activity demands
- Expressing low, high, or variable muscle tone impacting the processing of proprioceptive information
- Hyper-responsiveness to proprioceptive input:[1]
- Crying in weight-bearing positions or when joints are moved
- Choosing not to move or engage in activities
- Hyper-responsiveness to vestibular input:[1]
- Overreacting when moved in space
- Becoming fearful of bouncing or swinging
- Disliking sudden or quick movements
- Hypo-responsiveness to vestibular input:[1]
Sensory Integration Therapy[edit | edit source]
- 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)[3]
- It is postulated that SIT directly improve attentional, emotional, motoric, communication, and/or social difficulties[10]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
References[edit | edit source]
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 Chumburidze N. Sensory Integration. Plus Course 2024
- ↑ Miller LJ, Nielsen DM, Schoen SA, Brett-Green BA. Perspectives on sensory processing disorder: a call for translational research. Front Integr Neurosci. 2009 Sep 30;3:22.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Camarata S, Miller LJ, Wallace MT. Evaluating Sensory Integration/Sensory Processing Treatment: Issues and Analysis. Front Integr Neurosci. 2020 Nov 26;14:556660.
- ↑ Barakat MKA, Elmeniawy GH, Abdelazeim FH. Sensory systems processing in children with spastic cerebral palsy: a pilot study. Bull Fac Phys Ther. 2021; 26 (27).
- ↑ Huzard D, Martin M, Maingret F, Chemin J, Jeanneteau F, Mery PF, Fossat P, Bourinet E, François A. The impact of C-tactile low-threshold mechanoreceptors on affective touch and social interactions in mice. Sci Adv. 2022 Jul;8(26):eabo7566.
- ↑ 6.0 6.1 6.2 6.3 6.4 Proske U, Gandevia SC. The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force. Physiol Rev. 2012 Oct;92(4):1651-97.
- ↑ Siedlecka B, Sobera M, Sikora A, Drzewowska I. The influence of sounds on posture control. Acta of Bioengineering and Biomechanics 2015;17(3):95-102.
- ↑ Pankanin E. The importance of visual control in the process of maintaining the balance of the body. Journal of Education, Health and Sport. 2018;8(8):381-387.
- ↑ AYRES AJ. THE DEVELOPMENT OF PERCEPTUAL-MOTOR ABILITIES: A THEORETICAL BASIS FOR TREATMENT OF DYSFUNCTION. Am J Occup Ther. 1963 Nov-Dec;17:221-5.
- ↑ Miller LJ, Fuller DA, Roetenberg J. (2014). Sensational Kids: Hope and Help for Children With Sensory Processing Disorder (SPD). New York, NY: Penguin.
