Q&A about Sensory Integration Therapy

Lorna Jean King, OTR, FAOTA, is a pioneer of sensory integration therapy.  A colleague of the late A. Jean Ayres, she founded The Center for Neuro-developmental Studies (CNS) in Phoenix.  Here are her thoughts about sensory integration.

Q: What is the goal of sensory integration?

A: To facilitate the development of the nervous system’s ability to process sensory input.  SI pulls together all sensory messages to form coherent information on which we can act.  This normal process is disrupted in autistic individuals, 85-90% of whom have SI problems.

Q: Please comment on the relationship between behavior and sensory needs.

A: Behavior is communication.  Observing what triggers the behavior, we can modify the environment and help the child learn self-calming techniques that improve behavior.

Q: What should parents look for when deciding whether to have their child evaluated?

A: The child who is unusually fearful of movement, or who lacks normal fear of falling, may have vestibular difficulties.  A hypersensitive child is also a candidate.  This child may over-react to noise or light touch.  He may dislike cuddling, having his hair combed or washed, or being bathed or dressed.

Q: What advice do you give parents of a recently diagnosed child?

A: MOVE!  Encourage climbing, walking, and swinging.  Massage children who are hypersensitive to touch with lotion or powder, or give an extra-long rub down after a bath to help overcome oversensitivity.  Many activities you would normally do with ordinary children are needed in much larger quantities by the child with autism or other dysfunction.

Q: What senses does SI therapy involve?

A: SI therapy works with all the senses, but the vestibular, tactile, and proprioceptive senses are most important.  They are the largest sources of input and are connected to everything else.  For example, the vestibular system and the visual system are very closely associated.  Often, a child’s ability to coordinate his eye movements will improve as he receives enough vestibular input.

Hearing is also very important. One promising therapy is Auditory Integration Training (AIT), which aims to balance the reception of auditory input so the child won’t be hyper-responsive to sound. With AIT, many children show increases in language and decreases in sound sensitivity, although some show no improvement.

Q: What behaviors result from SI therapy?

A: A decrease in tantrums and fears, and increased eye contact and interaction. Also, less hypersensitivity to light touch, better use of discriminative touch to learn, and more appropriate responses to heat, cold, and pain.

Q: How much therapy is necessary?

A: Usually, more is better. In some schools, a therapist may see a child for 30 minutes, once or twice weekly.  This helps, but improvement is slow.  If we start intensive treatment with a preschooler, then the child improves faster.

Q: Is one ever too old to benefit from SI therapy?

A: No. Throughout life, the nervous system develops by making new neuronal connections.  As some connections disappear through disuse, others form as a result of new experience.  We’ve had good results with teenagers and adults.

Q: How about handling problems at school?

A: Many school problems can be dealt with effectively by simply changing the environment.  Sitting on a ball or T-stool provides extra vestibular and proprioceptive input, which helps the nervous system organize and process information.  The child can then attend.  If a child is upset, offer a large box lined with pillows, and a book or tape.  Respite from a potentially stressful situation is more effective than “time out.”

Q: How about the home environment?

A: Therapists can teach parents calming techniques, such as rocking, swinging, or wrapping the child in a big quilt for a few minutes. Basically, parents need to find what works with their particular child.

Q: Please describe your Center.

A: It is a non-profit corporation and school, providing the most advanced neurodevelopmental therapeutic methods for autistic and other developmentally delayed children and adolescents.  It is an integrated program that combines OT, speech and music with academics.