Sensory integration therapy
||It has been suggested that this article be merged into Sensory Processing Disorder. (Discuss) Proposed since July 2014.|
||The neutrality of this article is disputed. (June 2012)|
Sensory integration therapy or sensory processing therapy attempts to treat Sensory processing disorder. Some of these treatments (for example, sensorimotor handling) have a questionable rationale and no empirical evidence. Other treatments have been studied, with small positive outcomes, but few conclusions can be drawn due to methodological problems with the studies. These treatments include prism lenses, physical exercise, auditory integration training, and sensory stimulation or inhibition techniques such as "deep pressure"—firm touch pressure applied either manually or via an apparatus such as a hug machine or a pressure garment. Although replicable treatments have been described and valid outcome measures are known, gaps exist in knowledge related to Sensory processing disorder and therapy. Because empirical support is limited, systematic evaluation is needed if these interventions are used.
Children with Sensory processing disorder experience problems with their sense of touch, smell, hearing, taste and/or sight. Along with this might possibly be difficulties in movement, coordination and sensing where one's body is in a given space. According to proponents of sensory integration therapy, Sensory processing disorder is a common disorder for individuals with neurological learning disabilities such as an autism spectrum disorder, Attention Deficit Hyperactivity Disorder (ADHD), and sensory modulation dysfunction
According to proponents of sensory integration therapy, individuals afflicted by Sensory processing disorder may be overly sensitive to certain textures, sounds, smells and tastes, while wearing certain fabrics, tasting certain foods, or normal everyday sounds supposedly cause discomfort. Proponents also claim that, for example, a child with an autism spectrum disorder may feel very little pain or actually enjoy sensations that neurotypical children would dislike: strong smells, intense cold or unpleasant tastes.
Typical therapies for different senses
The sense of touch varies widely between children experiencing Sensory processing disorder. When children enjoy the feel of sticky textures, the therapist may use materials such as glue, play dough, stickers, rubber toys and sticky tape. Other materials that can be useful for tactile sensation include water, rice, beans and sand. Conversely, children who are very sensitive to touch may go through a brushing program that attempts to desensitize children to touch by systematically brushing their body at regular intervals throughout the day. The brushing program is called the Wilbarger protocol, named after Patricia Wilbarger, the occupational therapist that developed it.
Children on the autism spectrum often enjoy a sense of firm overall pressure. This can be provided by weighted belts, weighted blankets, or being squashed by pillows and firm hugs. These can form a basis for play, interaction and showing affection. Experiences that may be claustrophobic for neurotypical children may be enjoyed, such as being squashed between mattresses, and making tunnels or tents from blankets over furniture.
A therapist will be aware of a child's response to the smell of substances, and may experiment with putting different fragrances in play dough or rice. If a child actively likes strong odors, specific toys with this feature can be used in therapy.
Sound can be focused on by experimenting with talking toys, games on computers, musical instruments, squeaky toys and all sorts of music. Clapping together, rhymes, repeating phrases and tongue twisters are useful activities. Some children on the autism spectrum respond to music but not voices, in which case a melodic or “sing-song” voice may be preferred. The therapist may try different tones of voice, pitches, and gauge a child's reaction.
The Proprioceptive System helps children (and adults) to locate their bodies in space. Autistic children often have poor proprioception and will need help to develop their coordination. Therapy may include wearing weighted belts, weighted blankets, weighted vests, or bouncing on a trampoline or a large ball, skipping or pushing heavy objects.
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The Vestibular system is located in the inner ear. It responds to movement and gravity and is therefore involved with our sense of balance, coordination and eye movements. Therapy can include hanging upside down, rocking chairs, swings, spinning, rolling, somersaulting, cartwheels and dancing. All these activities involve the head moving in different ways that stimulate the vestibular system. The therapist will observe the child carefully to be sure the movement is not over stimulating.
Back and forth movement is typically less stimulating than side-to-side movement. The most stimulating movement tends to be rotational (spinning) and should be used carefully by the therapist. Ideally therapy will provide a variety of these movements. A rocking motion will usually calm a child while vigorous motions like spinning will stimulate them. Merry-go-rounds, being tossed on to cushions or jumping trampolines can be favorite activities with some children.
Learning new skills involving movement
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Skills such as tying shoe laces or riding a bike can be difficult as they involve sequences of movements. Therapy to help in this area may use swimming, mazes, obstacle courses, constructional toys and building blocks.
Difficulty with using both sides of the body together can occur in some cases of Sensory processing disorder. A therapist may encourage a child with crawling, hopscotch, skipping, playing musical instruments, playing catch and bouncing balls with both hands to help with bilateral integration.
Hand and eye coordination can be improved with activities such as hitting a ball with a bat, popping bubbles, and throwing and catching balls, beanbags and balloons.
Research on Sensory Integration Therapy
Although Sensory Integration Therapy is widely used and supported by anecdotal evidence, there is as yet little research that would establish it as an evidence-based treatment. One study found only poor quality evidence providing either no, or at best, equivocal support for Sensory Integration therapy (Dawson and Watling 2000). There have been many studies done but these have not been conducted rigorously enough for Sensory Integration Therapy to be considered an evidence-based treatment, despite it being widely used as an intervention for Autism and other developmental disorders.
- Multisensory integration
- Occupational science
- Occupational therapy
- Sensory processing
- Sensory overload
- Sensory Processing Disorder Foundation
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