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

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Introduction

Sensory integration therapy (SIT) is grounded on Ayres theory (ASI) of sensory processing, this intervention method is commonly provided by occupational therapist, who are leading professionals in it . Sensory integration is defined as the process by which receives and organizes sensations from environment, it gives them meaning and supports development of abilities needed for participation in activities of daily living

Assessment and Evaluation in Ayres Sensory Integration Therapy

The Assessment in Ayres Sensory Integration (EASI) aims to offer a valid and dependable battery of tests for evaluating essential sensory integration processes that support behavior, learning, and engagement. The EASI minimizes the effects of culture, language knowledge, and past experience while measuring sensory perception, postural/ocular/bilateral motor integration, praxis, and sensory reactivity.  The EASI exams are intended for children ages 3 to 12 and will be provided in an affordable and easily accessed format to professionals who have received the necessary training.

The EASI's development priorities

Comprehensiveness: the inclusion of essential functions needed to evaluate sensory integration in its whole and spot dysfunctional patterns so that participation issues can be recognized and handled in a suitable and efficient manner.

Time: 1 to 1.5 hours for administration; in the end, basal and ceiling points are guided by predictive technology to guarantee testing of the most important things based on age and functioning level.

Scoring: techniques intended to be as easy to understand and use as feasible.

Materials: non-paper materials are easily obtained as products that can be purchased or printed via 3D printing, at a low cost for both initial and replacement pieces; consideration was given to keep materials as minimal, simple, and light-weight as possible. Test sheets and forms were developed to be printed on home printers with measurements designated for various paper sizes used in different countries.

Constructs

The Ayres Sensory Integration® (ASI) constructs, which have been honed and improved by research since the 1960s, serve as the foundation for the particular tests of the EASI. These constructions are as follows:

Sensory PerceptionTactile Proprioception Vestibular Visual Auditory Localization	PraxisSomatosensory Based Praxis Ideation Based Praxis Visual Based Praxis Language-Based Praxis
Ocular-Postural-Bilateral Motor IntegrationOcular Motor/Ocular Praxis Postural Control & Balance Bilateral Integration	Sensory ReactivityHyper-reactivity Hypo-reactivity

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 Paediatric Occupational Therapists

Paediatric 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. Paediatric 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. Paediatricians 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 paediatrician, child psychiatrist, or child psychologist
2. Paediatricians 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 paediatrician is managing a child whose therapist is using sensory-based therapies, the paediatrician can play an important role in teaching families how to determine whether a therapy is effective.
4. Paediatricians should inform families that occupational therapy is a limited resource, particularly the number of sessions available through schools and through insurance coverage. The family, paediatrician, and other clinicians should work together to prioritize treatment on the basis of the effects the sensory problems have on a child’s ability to perform daily functions of childhood

Conclusion

In conclusion, Sensory Integration Therapy (SIT) is a beneficial intervention based on Ayres theory of sensory processing, provided by paediatric 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 Milian discusses about 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 childern who struggle with sensory integration issues. This video shows occupational therapist and health professionals xperts, discussing how occupational therapy works, and benfits that occupational therapy provide.