THE NATURE OF SENSORY INTEGRATIVE THERAPY WITH CHILDREN WITH AUTISM

Dana Mangraviti and Kristina St Germain, Senior Occupational Therapists, Beechpark Services for Children on the Autistic Spectrum

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Sensory Integrative therapy (SI) for children with autism is a greatly sought-after service in Ireland. There are many indications for this type of intervention for children with this condition, as many children with autism have ‘atypical sensory processing’ (Mailloux 2001). ‘Sensory processing’ refers to the experience of detecting sensory stimuli accurately and appropriately responding to them. This includes processing those sensations most often thought of, i.e., touch to the skin, seeing, hearing, smelling and tasting—as well as a couple of other senses often not discussed outside the clinical realm—the proprioceptive and vestibular senses. Proprioception is the perception of body and joint movements and position of the body and body segments in space (Young 2005). The vestibular sense detects movement and also tells our bodies about our relationship to gravity and the space around us (Young 2005).

SI aims to help children make sense of the multitude of information processed by these senses. Every minute of every day our bodies do the job of interpreting what is happening around us. Our bodies have highly developed systems that send loads of information to the brain about what our bodies are doing and what we are experiencing. This includes sending information that tells us things such as where sounds are coming from and whether or not we need to respond to them. The body transmits important information from each of the senses. Consciously and unconsciously, we use this information to act and react to what is occurring in our environment.

Atypical sensory processing can lead to misunderstanding and confusion about what is happening around us. For many children with autism, this can lead to sensations that are very upsetting. When children are confused about what sensations they are experiencing, it is often because they are unable to attach meaningful information to what they feel. They are subject to experiencing sensations without potentially knowing what they are, where they are coming from, or how to respond to them. Children with sensory processing differences can be afraid to move like other children. Quite often they may prefer sedentary activity, or they may refuse to try certain types of equipment in the schoolyard, such as climbing frames or swings. This may be due to an inability to understand how their bodies can move on this equipment actively. Instead, they may find themselves merely reacting to movement which can feel very confusing and unpredictable. They may be aversive to touch and refuse hugs from their parents or insist on wearing specific types of clothing. They may be aversive to eating certain foods due to their sensitivity to texture or taste. These are just a few of the most common problems experienced by children with autism who have sensory processing differences. When children’s responses to sensory experiences are considered carefully using a sensory integrative approach, we can begin to understand how greatly sensory experiences can facilitate and inhibit progress in activities like tooth brushing, eating, and dressing. One of the major goals of SI with this population is to help children attach meaning to sensory input (Young 2005) in order to relieve them of the confusion and irritation that can come from misunderstanding their environment and to give them the foundation for actively engaging with it.

Children with autism can certainly benefit from SI to treat sensory-based differences, however, using this intervention with a population who may have other difficulties in addition to autism (a learning disability or a speech and language disorder) must be done with the awareness that the opportunity for change is also influenced by the presence of such confounding conditions.

Sensory integrative therapy can vary depending on the needs of the child. For a child who may be overwhelmed by visual and auditory stimuli in his environment, therapy may begin with identifying what environments are disconcerting for the child and why. Therapists can recommend strategies to assist the child in reaching a state of calm alertness, whereby they can tolerate different sights and sounds in the environment that may present them with problems. For a child who is sensitive to movement strategies can include resistive input to the joints to promote body awareness, followed by various experiences such as slow and calming linear movement on a swing to gently challenge an overreactive system.

True SI therapy requires the therapy to be self-directed by the child, actively carried out, and meaningful to the child (Young 2005). The child with autism may be motivated to register sensory input if he/she is given a sufficient incentive. For children without autism who have sensory processing differences that can lead to dyspraxia, the innate desire to explore the environment exists. It is poor feedback from the senses that impedes the child’s ability to be successful at play skills and can influence their academic abilities as well. Sensory motor interaction provides the groundwork for later cognitive functions. The more a child’s sensory systems are working together, the more he/she can learn, and it becomes easier. Sensory integration is a continuously flowing process and each level of integration makes the next level possible. SI therapy can be effective because the brain is designed so that those functions that are used are the ones most likely to develop. It can be successful because the therapeutic environment is set up so it is enjoyable for the child to use their sensory processes in a way they have not done before. The therapist ensures during each session that the child is successful with each challenge. Moreover, SI therapy draws from a human drive that compels us towards development, only sometimes this happens in a way that nature was unable to do.

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