Sensory integration (SI) is about how our brain receives and processes sensory information so that we can do the things we need to do in our everyday life. There is a theory of sensory integration and a therapeutic approach based on the theory.
Our understanding of sensory integration was initially developed in the late 60s and 70s by Jean Ayres, an occupation therapist and psychologist with an understanding of neuroscience, working in the United States of America.
Jean Ayres was interested in explaining how difficulties with receiving and processing sensory information from one’s body and environment could relate to difficulties at work for example or using one’s body to engage in everyday life. Jean Ayres defined sensory integration as: “The neurological process that organises sensation from one’s own body and from the environment and makes it possible to use the body effectively with the environment” (1972).
The 7 senses:
In Sensory Integration we are interested in at least seven senses. You can probably immediately think of 5 – seeing, hearing, tasting, smelling and the sense of touch.
The other two are proprioception and vestibular.
Our muscles and joints have tiny sensory receptors that tell our brain where our body parts are. When you put a spoon to your mouth, you don’t need to look at the spoon to see where it is or feel for your mouth to know where to place the spoon; you know where your hand is in relation to your mouth. It is largely your proprioceptive receptors giving you this information. Your brain then uses this information to plan movements so that you can coordinate your body.
In our inner ear we have small, fluid filled canals, the fluid in these canals moves every time we move our head. Receptors in these canals pick up the direction of movement and send this information on to our brain. So we know if we are moving forwards, backwards, side to side, tilting our head, turning round or moving up and down. Once again, our brain uses this information to plan for movements and help us maintain our balance. We continue to see the link between poorly developed senses and these abilities both in research and in practice.
Sensory integration problems:
Parham and Mailloux (2015) identified four categories of sensory integration problems:
- Problems with sensory modulation.
- Sensory discrimination and perceptual problems.
- Vestibular bilateral functional problems.
- Praxis problems.
Problems with sensory modulation occur when our brain either over responds to, or under responds to sensory information. For example, if someone over responds to touch they may be very aware of the label in the back of their clothes. If someone is under responsive to touch they may not notice someone tapping them on the shoulder. We could all say we have similar experiences, but for some people the degree to which their brain under or over responds impacts on their ability to do the things they need to do in everyday life. As a result, they could become distressed or miss out on things that could keep them safe. Problems with modulation can cause the person to become anxious, fearful, angry and frustrated.
People often compensate for problems with modulation. The types of strategies they may use could be to remove their clothes, not wash, and flap their hands, rock or to withdraw from social contact. That is not to say that these behaviours mean that the person has a problem with sensory modulation, these behaviours could be a result of a number of other things, but sensory modulation is one thing to think about and a trained Sensory Integration therapist would be able to help with this thinking. It has been found that people can be over responsive or under responsive in all the different senses, they can be over responsive in one sense and under responsive in another. For some people they can be over responsive and under responsive within the same senses. Responsiveness can be dependent on a situation, for example a stressful situation can make us more and sometimes less aware of sensation.
One of the essential elements of self-organisation includes the way we modulate sensory and motor information. Sensory modulation is part of the human condition and is an ongoing process that we often pay little attention to. As we become more aware of the different strategies we tend to use to self-organise, in order to functionally engage in meaningful life activities, we become much more aware of our unique system tendencies and preferences and of the repertoire of activities (habits and rituals) we use to self-organise and participate in meaningful life activities. The kinds of activities used to wake up and prepare for the day typically differ from those of night time rituals used to prepare for going to sleep at night. When feeling well, little attention needs to be paid to the habitual strategies used to shift dynamic states given the demands of the task at hand, however, when not well more attention is often necessary. In this way, the relevance of sensory modulation strategies becomes increasingly apparent, particularly when working with individuals experiencing escalating symptoms and among those in dynamic crisis states.
Miller, Reisman, McIntosh & Simon (2001) refer to sensory modulation as, “the capacity to regulate and organise the degree, intensity and nature of responses to sensory input in a graded and adaptive manner. This allows the individual to achieve and maintain an optimal range of performance and to adapt to challenges in daily life” (p. 57). Sensory modulation is typically explored from both neuro-physiological and behavioural levels of observation; however, works in the field of nonlinear science are affording the ability to research the complex dynamics of sensory modulation and sensory approaches.
Potential Benefits of Sensory Modulation Strategies
The following is a list of examples of some of the potential benefits of the mindful and individualised use of sensory modulation strategies:
- Increased self-awareness
- Increased ability to self-nurture
- Increased resilience
- Increased self-esteem and body image
- Increased ability to engage in therapeutic activities
- Increased ability to engage in self-care activities
- Increased ability to engage in meaningful life roles
- Increased ability to engage in social activities
- Increased ability to cope with triggers
Sensory discrimination and perceptual problems
This is when the brain has difficulties with making sense of the sensory information it receives. The person then struggles to interpret subtle differences in the sense. For example, being able to feel two different points of touch that are close together – this is useful when we are doing things like doing up buttons. The brain also has difficulty with giving meaning to the information it is receiving. If these problems are with proprioception or touch a person can seem clumsy, or use too much or too little force when doing things. People with visual perceptual problems may have difficulties with finding objects in cluttered environments, or finding a word on a page. These problems can be identified by a trained SI practitioner using a standardised assessment tool.
Vestibular-bilateral functional problems
These problems are a result of problems with our vestibular sense and can result in poor balance and difficulties with coordinating two sides of the body. Balance and coordination problems could be a result of a range of different problems and a SI practitioner will be able to identify whether the difficulties are a result of problems with the vestibular system.
Praxis is how our brain plans for and carries out movements we have not done before. For children this could be learning to jump, for adults it may be learning to drive or use chopsticks. You may have heard terms such as dyspraxia or motor planning problems; this is what we mean when we say praxis problems. Not all problems with praxis are a result of sensory integration. Jean Ayres identified two types of praxis difficulties associated with underlying sensory issues. She called one somatodyspraxia and the other visuodyspraxia. Somatodyspraxia is when a person has problems with praxis as well as problems with processing touch and proprioceptive senses, while visuodyspraxia is a problem with praxis and visual processing. Some people have been found to have both of these problems, while others have one or the other.
The different parts of our body that receive sensory information from our environment (such as our skin, eyes and ears) send this information up to our brain. Our brain interprets the information it receives, compares it to other information coming in as well as to information stored in our memory and then the brain uses all of this information to help us respond to our environment. Therefore sensory integration is important in all the things that we need to do. With new brain imaging techniques in the last 20 years, much of what Ayres’ postulated has been supported.
Reference: Champagne, T. (2008). Sensory Modulation & Environment: Essential Elements of Occupation (3rd Ed.). Southampton, MA: Champagne Conferences & Consultation. Revisions have been made since the Champagne, 2006 version.