Sensory Integration and Its importance in treating ASD

Written By: 
By Isha Soni, Occupational Therapist, Child Guidance Centre and Department of Behavioral Sciences and Mental Health, Sahyadri Hospitals Pune

So what is sensory integration (SI) and why is it necessary to have a sensory screening done for a suspected child with Autism? According to the latest DSM-V Criteria, in order to diagnose Autism, the following is necessary:

“Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).”

One of the definitions of SI is “the neurological process that organizes sensation from one’s own body and from the environment and makes it possible to use the body effectively within the environment”

Simplified, this means that we all have 5 + 2 senses in our body, they being vision in eyes, smell/olfactory sense in the nose, touch in the skin, taste/gustatory sense in the mouth and hearing/auditory sense in the ears. Also we have two movement senses, first one being proprioception in muscles and joints of the body i.e. sense of position of body or body segments in space and the amount of force/pressure our muscles are exerting. The second movement sense is the “vestibular” i.e. sense of movement and position of the head in space.

Most of us have a good level of functioning at which we perceive a sensory stimuli from the surroundings and integrate it within our body, thus helping us to function efficiently in our daily lives.

In children with ASD who have a sensory processing disorder these senses do not communicate right with the brain, as some of the roads (nerves and tracts connecting the senses to the brain) are bumpy and rough instead of  smooth super highways. You can also think of the senses to have a broken volume control i.e too high or too low. Eg: a gentle touch can be perceived as a dangerous stimuli (hypersensitivity) or the child feels every possible object in his surrounding by hands (sensory seeking).

An Occupational therapist by doing SI therapy helps to build up connection between the senses and your brain i.e. you are repairing/ re-wiring the brain This approach is based on the neuro plasticity of brain, meaning ability of the brain structures to change. By doing SI therapy the roads become smooth superhighways and help a child to function efficiently in his daily life.

The most common sensory issues the kids with Autism demonstrate are hypersensitivity/ extreme dislike to hair cut, nail cut, tip toe walking, reacting negatively to non noxious stimuli as of a cooker whistle, vacuum cleaner, extremely fearful of swings/slides, holding the pencil too light or very hard, pinching parents/guardians, stomping foot heavily while walking, poor fine motor skills and being picky eaters. Also most of the children with Autism go through “sensory overload” i.e. they see and feel all the senses at once which is too much for them to assimilate and hence behave in an inappropriate manner. By doing this (rocking, covering their ears and shouting) they are not misbehaving but trying to calm themselves.

An SI therapy session consists of the child going through various sensory experiences adjusted to his sensory functional level. This provides him with just the right challenge to create an adaptive response i.e. bring him near normal level of functioning. This is a very time consuming process and we recommend minimum twice to thrice a week for 3 to 6 months of therapy to see a subtle change in the child.

SI therapy benefits children having autism, learning difficulties, specific sensory processing disorders, attention deficits and hyperactivity problems, visuo-perceptual difficulties fine motor and praxis problems. SI therapy aims at providing stimulation that will address certain brain levels (primarily subcortical) enabling them to mature and function as an integrated whole.
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