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Autism Speaks - Exploring Sensory Integration Therapies




Autism Speaks researchers have shown that a therapy called sensory integration can help children overcome sensory difficulties that may impact daily living and their quality of life. A sensory integration approach is a technique practiced by occupational therapists.

The theory focuses on improving efficient sensory processing/motor integration. It's an underlying problem in autism, attention deficit hyperactivity disorder and autonomic nervous system disorders, like postural orthostatic tachycardia syndrome (POTS). It can also accompany other mental health conditions.

Therapies

Occupational and physical therapists can help children with sensory processing difficulties. For example, a child who has trouble modulating sensory input may benefit from a sensory diet, which is a regimen of activities that meet a child’s specific needs for vestibular, proprioceptive and deep pressure touch sensations. Other supports like scheduled sensory breaks and weighted vests can also help children function more successfully at home and school.

These therapies, however, aren’t just play — they must be delivered using clinical reasoning. This is because sensory integration theories are just one component of a therapist’s broad knowledge base, which should be applied to best serve each individual. 'Bottom-up' sensory integration interventions that address underlying SPDs to improve functional outcomes include the Ayres Sensory Integration(r) therapy approach, the Wilbarger Protocol and sensory-based treatments. These strategies differ from 'top-down' sensory interventions, which do not address underlying SPDs but rather focus on adapting environments and tasks to promote sensory modulation.

Activities

The activities therapists use to stimulate sensory integration are varied and fun. They often involve movement and play, as well as pushing, pulling, carrying and/or balancing heavy objects, to help kids develop proprioceptive sense of where their bodies are in space (i.e. where their hands are, their feet are).

Often they involve crossing the midline of the body to engage both sides and promote bilateral coordination skills. And some involve oral input activities to address children who have difficulty chewing and swallowing, which affects their dietary intake and nutrition.

These days we are seeing a lot of sensory strategies become "mainstream" and available to the general public. From fidget spinners to Pop-It's to cozy weighted blankets, we see sensory strategies in use everywhere. Yet it is the therapeutic application of these that really drives positive change. In the case of sensory integration therapies, this means getting those vital pathways established that allow us to take in all the information we are exposed to, organize it and then respond appropriately.

Tools

The ability to take in sensory information from the outside world and within one’s own body, organize it, interpret it, and make a meaningful response is what most of us take for granted. However, for many children with sensory processing challenges, this process is not as smooth.

They may have difficulty accessing the preschool or school curriculum due to motor issues such as dyspraxia or postural instability, or they might have difficulty learning because of difficulty attending to tasks for long enough to demonstrate mastery. They might also have trouble playing with their peers because of a lack of body awareness or fear of bumping into them or they might be over- or under-reactive to sensations like physical bumps, bright lights, or noise.

Sensory integration therapy can be used to address these issues but only if the techniques are carried out at home and school. Equipment such as weighted vests, blankets, fidget toys and chewable jewelry can help, but so can a range of techniques such as sensory brushing, incorporating vestibular stimulation, or using sequenced movements.

Challenges

If you are using sensory strategies with your students, please be sure to communicate to your therapists any successes and challenges. Different children need different types of support. For example, a wobble cushion might help one child but not another.

Occupational and physical therapists have developed techniques to enhance sensory experiences for students. These approaches, called sensory integration/sensory processing therapy (SI/SP-T), include both behavioral and physical strategies such as movement, acupressure, weighted vests and other equipment to increase tactile and proprioceptive input and to decrease over-responsivity to input.

Because SI/SP-T involves many incidental communication transactions that are known to be developmental facilitators, it's important to control for these confounds in order to evaluate the unique impact of these treatments. This can be done by applying behavioral event coding and other tools that have been used to evaluate applied behavior analysis interventions. These measures will also inform the development of a measurable theory of change for testing SI/SP-T.