How Does your Engine Run?
Christal K. Peters, MS OTR/L
Overview:
 What is sensory integration?
 Examples of challenges
 The Alert Program
 How does your engine run?
 Questions
What is Sensory Integration?
“Sensory integration is the
organization of sensation for
use” (Williams & Shellenberger, 1996)
 Perception and registration of
input
 Processed or integrated to
generate response
The Sensory Systems
Auditory Processing
• Develops closely with
vestibular system
• Important for:
•learning sounds and
words,
•Understanding
directions,
•Planning appropriate
movement response
(based on inner
command)
Brodel (1946)
Vestibular Processing
•Detects
motion
•Two
receptorsrotary
movement
and linear
movement
Brodel (1946)
•Tied to tone,
posture and
attention
Tactile Processing
 Receptors located in our
skin
 Our largest sense organ
 Plays a role in emotional
responses
 “Studies have shown that
without appropriate touch
and handling, the infant will
not thrive normally.” Huss, J.
1997. American Journal of
Occupational Therapy, 28 (1).
Case-Smith (2005)
Visual Processing
•Visual perception
involves integration of
vestibular and
proprioceptive input,
and input around the
eyes to combine with
visual input in creating
a map for navigating the
environment.
Case-Smith (2005)
Proprioceptive Processing
 Perception of joint and body movement and position
of the body in space.
 Receptors in muscles (muscle spindles), tendons (golgi
tendon organ) and joints (Pacinian corpuscles)
 Key for balance between muscle groups and skilled
motor planning!
Case-Smith (2005)
Gustatory and Olfactory Processing
•Taste and smell are
present and well
organized at birth
•Sucking and oral
movements are
adaptive responses
derived from these
senses.
Case-Smith (2005)
The Importance of Arousal
 How Alert one feels
 State of the nervous system
 Arousal = Alert
Williams & Shellenberger (1996)
Self Regulation
•Ability to attain,
maintain and change
arousal appropriate for a
task
•Complex combination of
systems: brain stem,
reticular formation,
hypothalamus, thalamus,
automautic nervous
system, cerebellum,
limbic system, all sensory
systems
Issues with sensory integration:
 Seeking behavior:
 http://www.youtube.com/watch?v=JbQmGBrjy40&NR=1
 http://www.youtube.com/watch?v=iA1jdvA7Or4&feature=related
 Sensitivities:
 http://www.youtube.com/watch?v=7sF31AfJvxw&feature
=related
 Combination:
 http://www.youtube.com/watch?v=htGimFAhMY&feature=related
The Alert Program for Self
Regulation
 By Mary Sue Williams, OTR/L and Sherry
Shellenberger, OTR/L
 Ages 8 and up
 Goals:
 To help children understand and monitor alert level
 To help parents/adults recognize arousal states
 Provide framework and vocabulary fit for children
 Working with occupational therapists 
Stage One: Identify Engine Speeds
 Goals:
 Learn engine words
 Label engine levels/ speeds
 Develop awareness of the feel of their engine speeds
“If your body is like a car engine, sometimes it runs on low,
sometimes on high or sometimes just right.” (Williams &
Shellenberger (1996)
 High:
 Hyped-out, wild, hyper,
hyperactive, out of
control
 Just right:
 Easy to learn, play, get
along with others, have
fun
 Low:
 Couch potato, sluggish,
feeling spacey, look
droopy, low tone,
glassy-eyed
Stage Two
 Goals:
 Introduce sensorimotor
methods to change
engine levels
 Experimentation with
choosing strategies
Ways to Change your Engine!
 Move!
 Look!
 Listen!
 Put something in
your mouth!
 Touch!
Williams & Shelleberger (1996)
MOVE!
Types of movement
 Oscillation-up and down
 Linear-front and back
 Rotary- circles
 Inverted- upside down
 Heavy work
 Crash and bump
Williams & Shellenberger (1996)
Look!
Visual input/ideas
How do you react to
 Open/close window shades
 Dim lighting
 Watch a fireplace
 Florescent lighting
 Watch a fishtank
 Sunlight through bedroom
 Watch sunset/sunrise
window when sleeping
 Rose colored room
 A cluttered desk when
needing to concentrate
 Watch oil and water toys
 Lava lamps, flashlights,
colored light bulbs, light toys,
special lamps
Listen!
Auditory input/ideas
 Variations in noise level
How do you react to?
 Variations in rhythm
 Scratch on chalkboard
 Variations in amount of
auditory distractions
 Listen to classical music
 Listen to hard rock
 Listen to others hum
 Work in quit room
 Work in noisy room
 Sing or talk to self
 Listening programs
 Squeak of a mechanical
pencil
 Fire Siren
 Waking to an unusual noise
 Dog barking
Put something in your mouth!
Oral input/ideas:
 Drink a milkshake
 Eat a cold popsicle
 Suck on hard candy
 Eat a pickle
 Crunch or suck on ice pieces
 Chew gum
 Tongue in cheek movements
 Crunch on
 Chew on pencil/pen
nuts/pretzels/chips
 Eat popcorn/veggies
 Whistle while you work
 Drink hot cocoa or warm
milk
 Chew on coffee swizzle sticks
 Take slow deep breaths
 Drink carbonated drink
Touch!
Tactile input/ideas:
 Twist hair
 Rub gently on skin/clothes
 Move keys or coins in pocket
 Fidgets! Straw, paper clips,
with hands
Cool shower
Warm bath
Receive a massage
Pet a dog or cat
Drum fingers or pencils on
table
pen/pencil, jewelry, toys





Stage Three:
 Goals:
 Choose strategies independently
 Use strategies outside therapy/education time
 Lean to change engine levels when options are limited
 Continue receiving support
 Sensory Tool Box
 http://www.alertprogram.com/
References
Ayers, A.J. (1972). Sensory integration and learning disorders. Los Angeles: Western psychological
Services.
Ayers, A.J. (2005). Sensory integration and the child: understanding hidden sensory challenges. Los
Angeles: Western Psychological Services.
Brodel, M. (1946). Three unpublished drawings of the human ear. Philadelphia: WB Saunders.
Bundy, C., Lane, S.J., & Murray, E. A. (2002) Sensory integration theory and practice. Philadelphia,
PA: F.A. Davis Company.
Carrasco, R.C. (2009, August). Sensory Integration and Neurodevelopmental Treatment (NDT).
Seminar Anchorage, Ak.
Case-Smith, J. (2005), Occupational Therapy for Children. St. Louis, MI: Elsevier Inc.
Henry, D.A. (2008, September). Tool chest: tools for teachers, parents and students. Seminar
presented at the meeting of the Alaska Occupational Therapy Association Anchorage, Ak.
Huss, J. (1997). American Journal of Occupational Therapy, 28 (1).
Miller, L.J. (2003). Empirical evidence related to therapies for sensory processing impairments.
Notational Association of School Psychologists communique, 31, 5. www.nasponline.org.
Williams, M.S., & Shellengerger, S. (1996). How does your engine run? A leader’s guide to the Alert
Program for self-regulation. Albuquerque, NM: TherapyWorks, INC.
Questions?
Williams & Shellenberger (1996)