Sensory Processing
Or Sensory Integration
Provides foundation that enables meaningful
and purposeful participation in full range of
daily activities
Sensory Processing is Important for:
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Attention
Balance
Emotional Security
Flexibility
Healthy relationships with others
Self comforting
Self esteem
Self protection
Self regulation
Social Skills
Speech and language skills
Plus many other social, emotional, cognitive and gross/fine motor
benefits as well as academics.
Dysfunction in Sensory Processing
Can Affect:
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Academic skills
Adequate work habits
Attention
Auditory discrimination
Balance
Behaviors
Bilateral coordination
Body awareness
Concentration
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Tactile discrimination
Hand writing
Healthy relationships with others
Daily Living skills
Emotional Security
Eye-foot coordination
Eye-hand coordination
Fine motor skills
Flexibility
-ocular motor control
-postural stability
- self -comforting
-self-esteem
-self protection
-self regulation
-Social skills
-speech and language skills
Gravitational security
Normal Sensory Processing
• An Unconscious process of the brain (occurs without us
thinking about it-like breathing)
• Organizes information detected by our senses (taste, sight,
hearing, smell, movement, gravity and position)
• Gives meaning to what is experienced by sifting through all
the information and selecting what to focus on (such as
sitting in class and attending to teacher versus clock ticking,
noise in hallway etc)
• Allows us to respond or act to the situation we are
experiencing in a purposeful manner (known as an adaptive
response)
• Forms underlying foundation for academic learning and
social behavior
Examples of Adaptive Responses
• Physical Responses: increase posture control,
move eyes to look at person talking to you
• Organized autonomic nervous system:
improved digestion, respiration, sleep/wake
cycles.
• Emotional Stability under stressed conditions
• Organized responses to routines
“Normal” Sensory Processing
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Receiving input from the sensory receptors
Relaying information to the brain.
Identifying what information is important.
Blocking information that is not important.
Comparing information with past experience or other types of sensory
experience to form a plan of action if needed.
• Developing a plan.
• Sending the message to the parts of the body needed to execute the plan.
• Carrying out movements as planned. (adaptive response).
• Dysfunction can occur at any stage of the
process!!
Central Nervous System
Sensory
Input
Motor
Output
Brain
Central Nervous System
• The Central Nervous System acts like a “computer.”
• The CNS receives input through the senses, the brain sorts
and organizes the information to generate an output or
response.
• The CNS is composed of the brain, spinal cord, along with the
nerves and end organs (the end of the nerves) that control
our voluntary (reach for coffee cup) and involuntary acts
(breathing).
• The spinal cord, brain stem, cerebellum and cerebral
hemispheres use the sensory input from the receptors to
produce awareness, perception and knowledge, produce body
posture, movements and the planning and coordination of
movements, emotions, thoughts, memories and learning.
Our Senses
• External Senses
• Touch, hearing, sight, taste, smell, body awareness and
movement/balance.
• Internal Senses (these senses run on auto pilot)
• Body centered senses
• Coming from internal organs
• Regulate functions such as hunger, thirst, digestion, body
temperature, sleep, mood, heart rate and state of arousal
• Some children lack internal senses processing and will not
sense if they are hungry or need to go to the bathroom.
Automatic Responses
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See a bear=run/yell. If dysfunction will not identify threat of the bear to
run.
Touch the stove top with your finger=remove finger quickly from the
heat. If dysfunction will not identify the heat and withdraw finger.
Smell a skunk= brain identifies the smell as a skunk. If dysfunction, may
not “smell” the skunk
Eat a large meal=content, sleepy, feeling full. If dysfunction, may not feel
full and keep on eating.
Taste spoiled milk= spit it out. If dysfunction, many not identify the milk
as spoiled.
Combing hair a “normal” act but if dysfunction, may feel like hair is being
pulled out.
Self Regulation
• Modulation- brain turns switches on/off to
regulate activity. Ex. increases activity level with
volleyball and decrease activity with reading a
book.
• Inhibition-brain reduces connections between
sensory intake and behavioral output when
certain sensory information is not needed for a
task. Ex. block noises in classroom. If not able to
inhibit the sensory system my be overstimulate.
Self regulation
• Habituation- we become accustomed to a familiar sensory
message, our brain automatically tunes them out. Ex. tags in
clothes, seat belt. But if the brain does not habituate the
sensation can lead to overstimulation.
• Facilitation- Brain promotes connections between sensory
intake and behavioral output by sending messages of
displeasure (ex. motion sickness) or pleasure (ex. the calming
feeling of rocking in rocking chair).
• Facilitation lets us know when we need to stop activities or
will give us the “go ahead” signal for pleasurable activities.
What happens with Sensory
Processing Dysfunction
• There is a dysfunction of the brain that affects developing
children and adults. These individuals misinterpret everyday
sensory information, such as touch, sound and movement.
Some feel bombarded by sensory information; others seek
out intense sensory experiences or have other problems.
• Children with sensory integration dysfunction affects the way
their brains interpret the information they take in and also
how they act on the information with emotional, attention,
motor and other responses.
What happens to the sensory
information
• 1. The brain does not receive the message due to disconnection in the
neuron cells. Problems
getting the sensory impulse to the brain.
“Bad” wiring so not connecting the information to produce an appropriate
response/action.
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• Sensory Messages are received inconsistently. Problem within the brain
stem filtering the sensory messages. Only portions of the sensory
information/message is received or the brain can’t sort how to use the
sensory information for an appropriate response (action).
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• Sensory messages are received consistently, but do not properly connect
with other sensory messages. Limited “meaning” of the sensory
messages are identified in the brain so unable to produce a
useful/purposeful response.
• When brain poorly processes sensory
messages, inefficient motor, language, or
emotional output is the result. Child has
difficulties figuring out what’s going on inside
and outside of his/her body. The child is
unsure of the information he/she is receiving
from the sensory input is accurate perception
of the information.
• All this information coming into my brain—doesn’t
know what to do!!!!
• The brain has difficulty organizing and sorting the
sensory information it is bombarded with the
information and makes it difficult for a child to focus
on what is important at the time.
Tactile System
• Tactile receptors are located in the skin
• Most primitive type registers light touch (i.e. feel spider crawling on skin)
but POWERFUL alarm system.
• Second type of receptor is for pressure touch. We recognize the “feel” of
things. Ex. in your pocket identify keys or coins with your fingers.
• SUSTAINED OR PRESSURE TOUCH ALSO HAS ROLE IN COUNTERING OR
SUBDUING ALARM AND ANXIETY. EX. baby crying, wrap the baby in
blanket and apply pressure, most babies calm and go to sleep.
• Third type of receptor register heat, cold and pain. This is important for
survival. Ex. finger too close to heat to stove, you will automatically pull
finger away.
Tactile Dysfunction
• May result in self imposed isolation, general irritability, distractibility and
hyper activity.
• Treatment: first important to protect the
individual as much as possible from sudden
and unwanted touch.
• Second-implement various kinds of activities
utilizing sustained pressure can use to
decrease over-reactivity.
Tactile Defensiveness
• Individual is extremely sensitive to light touch
• Tactile system is immature and working improperly
• Abnormal neural signals are sent to the cortex in the brain
which can interfere with other brain processes.
• Brain is overly stimulated and may lead to excessive brain
activity, which neither be turned off nor organized.
• Over-Stimulation in the brain can make it difficult for an
individual to organize one’s behavior and concentrate and
may lead to a negative emotional response to touch
sensations.
Tactile Dysfunction
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Hyperactive
Dislike certain food due to texture
Dislike teeth brushing, using
toothpaste, combing hair, washing
hair, showering
Prefers clothing that totally covers
body , regardless of temperature
Does not like clothing, tags etc
Dislike physical touch
Poor relationship with peers
May become physically or verbally
aggressive when touch is perceived
as a threat
Dislikes groups/crowds
Dislikes hands being dirty
• Hypoactive
• Does not react to painful
experiences
• Has difficulty manipulating tools,
writing, toys
• Craves touch, may touch
constantly or indiscriminately
• Mouth objects
Auditory System (hearing)
• Auditory processing is term used to describe what
happen when your brain recognizes and interprets
the sounds around you.
• We hear when energy that we recognize as sound
travels through the ear and is changed into electrical
information that can be interpreted by the brain.
• The disorder part of auditory processing disorder
means that something is adversely affecting the
processing or interpretation of the information
Auditory System dysfunction
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Difficulties paying attention to and remembering information presented orally
Difficulties carrying out multi-step directions
Poor listening skills, unable to follow verbal directions
Increased time to process auditory information
Low academic performance
Behavior problems
Language difficulties (vocabulary and understanding language)
Difficulty with reading, comprehension etc
Easily upset by sounds (alarms, clock ticking, people talking etc)
Cover ears
Distracted by sounds
Oblivious to sound
Does not respond to name called
Visual System (sight)
• The ability to analyze and interpret visual input is referred to as visual
processing or visual perceptual skills. Affect academics.
• Just because an individual can see clearly does not guarantee that the
brain will be able to make sense of the incoming information.
• Helps us also read body language and other non verbal cues during social
relations.
Over-responsive- dislikes bright lights or sunlight, cover eyes in bright light,
avoids eye contact.
Under-responsive- Stare at bright light, watch flickering or blinking lights,
loose place when reading in book or copying information.
Other dysfunction signs: bumps into things, lacks personal boundaries,
disorganized possessions and space, poor attention to visual details, poor
handwriting, gets lost easily, poor balance
Olfactory (smell) and Gustatory (taste)
• These 2 systems are closely linked.
• They allow us to enjoy tastes and smells of foods and cause us
to react negatively to unpleasant or dangerous sensations.
• Over responsive- won’t try new foods, picky eater, gag on
food textures, bothered by smells.
• Under responsive-smells everything, taste non-food items,
does not notice odors that others notice.
Proprioceptive System (body awareness)
• Components of muscles, joints and tendons that
provide a person with subconscious awareness of
body position.
• Gives the nervous system input on the position of
muscles, joints and tendons. This is important as it
provides us with information on how far to reach,
how much pressure to use, where we are in space
and what our body scheme is.
• Essential in helping our bodies assimilate and process
both movement (vestibular) and touch (tactile)
information
Proprioceptive Dysfunction
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Clumsiness
Tendency to fall
Lack of awareness of body position in space
Resistance to new motor activities
Stiff uncoordinated movements
Craves sensation of deep pressure against the body
Over responsive- seeks jumping, bumping, crashing, stomping
feet with walking
• Under responsive- weak grasp , poor endurance, clumsy,
awkward movements.
Vestibular System (movement and
balance)
• The vestibular system conveys sensory information
about head orientation and motion from receptors
in the inner ear. Its three main functions are
• Coordination of head and eye movement
• Helping to maintain upright posture and balance
(equilibrium)
• Conscious perception of spatial orientation and
motion
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Vestibular System does more than allow us to stand upright:
• Coordinates information from vestibular organs in inner ear.
• Eyes:20% of visual neurons respond to vestibular stimulation (spinning,
head shaking or rocking). If visual information removed (eyes
closed/dark), the individual will feel as if they are drifting or falling.
• Auditory Information-anything affect auditory information can affect
vestibular functions.
• Pressers on the soles of the feet-provide information to vestibular areas
of the brain regarding surface standing on. Allow us to calculate weight
and posture adjustments that will allow upright balance and movement.
• Facial and eye nerves and masseter muscle of jaw-respond to vestibular
information.
Dysfunction in Vestibular System
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Dysfunctions in the vestibular system can cause anxiety or panic attacks, a need for
self-stimulation, abnormalities in muscle tone, difficulty defecating, teeth grinding
and chin tapping, hand flapping, academic problems, drooling, etc. Exercises that
activate a wide range of inputs to the vestibular system have been found to be
effective in reducing or eliminating vestibular problems.
Over active vestibular system: anxious with feel leave ground, over excited with
movement, get car sick, scare to jump etc, tries to control and manipulate to avoid
distressing sensations, which may make them appear obstinate and
uncooperative, wants constant physical support from adults.
Under-active vestibular system: moves constantly, poor endurance, clumsy, has
trouble doing anything requiring both sides of the body, thrill seeker, confuses
right/left, reverse letters and reads words backwards, can not follow a moving
object, draw a line, does not become dizzy even after minutes of spinning, loves
fast moving equipment, has trouble holding head up while sitting, does not
attempt to catch self when falling.
Types of Sensory Integration/Processing
Dysfunction
• Sensory Modulation Dysfunction
• Difficulties in the capacity to regulate and organized the
degree and intensity of the response to sensory input in a
graded and adaptive manner.
• This regulates mood, attention, level of arousal and activity
level.
• Psychological reactions are internal, unconscious and out of
the individuals control.
• Difficulty tolerating or adjusting to minor changes in routine,
disregard or impaired ability to interact with others, disrupted
sleep and wake cycles, attention problems, easily distracted ,
or fixated on one activity with difficulty shifting focus, feel
uncomfortable in busy environments.
Three Subtypes of modulation dysfunction
• 1. Sensory Avoiding-(over responsive): the CNS is over responsive to
sensation. The nervous system feels sensation too easily or too intense
and the individual feels like they are constantly bombarded with
information. Consequently they have a “fight or flight” response to
sensation and often referred to as “sensory defensive.”
• 2. Sensory Under responsitivity: poor sensory registration or awareness.
Sensory system does not register information effectively and may require
excessive amounts of sensory input in order to process sensation to
produce a response. Need a “boost” to go and do activities.
• 3.Sensory Seeking/Craving: The system does not easily notice sensory
input and thus seeks out sensory stimulation. The sensory seeking is
performed to raise arousal levels. Sensory seeking can be observed in
individual who are over responsive to sensory input.
Sensory Discrimination Disorder
• Difficulties with correctly registering or
recognizing sensory input on a neurological
level in order to use the information
functionally. Sensory Discrimination is often
causes of dyspraxia or poor motor
coordination.
• Problems with discerning and assigning
meaning to sensory stimuli.
Sensory Based Movement
Disorders
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Dyspraxia: Problem with planning, sequencing and executing unfamiliar actions
resulting in awkward and poorly coordinated motor skills typically seen with
sensory deficits. May experience awkward, poorly coordinated motor skills.
Dyspraxia may also co-occur with perceptual, visual motor or language problems.
Poor ability to generate a learned activity to other similar motor skills. Poor
sequencing or rhythm of motor actions. Dyspraxia individuals usually have poor
sensory modulation and poor sensory discrimination.
Poor Ocular Disorder: Difficulties with control of posture or quality of movements
seen in low muscle tone or joint instability and/or poor functional use of vision.
May have hypo or hypertonic muscle tension/tone or joint instability. Poor muscle
co-contraction for movement against gravity and poor posture control. Difficulties
with oculo-motor control and functional vision. This often co-occurs with
vestibular, proprioceptive and/or visual-motor problems.
Sensory Integration Therapy
• Sensory Integration is a therapy approach that involves controlling sensory
stimulation in order to elicit an ‘adaptive response’ (and action or
response to the situation in a purposeful manner) according to the child’s
brain functions. Therapy usually involves activities that provide Tactile
(touch), Proprioceptive (body position sense) and Vestibular (body
movement sense) as stimulation.
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• Sensory Integration therapy strategies are designed to keep a flow of
neuro-chemical steady in the brain throughout the day for improved
learning. Very important to implement therapy strategies daily and
consistently throughout the day as instructed by your therapist to obtain
benefits.
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Therapy is graded to “just right challenge”
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Hyper responsiveness
Normal Range
Hypo-responsive
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Over-registration
“Engine High”
Optimal
“Just Right”
Under-registration
“Engine Low”
Activities are implemented to assist with organizing the sensory information to allow the
child to move toward participation in activities in the “just right” mode. These activities are
planned, scheduled activities imbedded through the day to help the individuals achieve or
obtain the “just right.”
Treatment Strategies
Heavy Work Activities (proprioceptive Input)
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If engaged in for 10-15 minutes tends to last around 2 hours
Heavy work activities are used with sensory processing difficulties to help increase attention, decrease
defensiveness, as well as assisting with regulating and modulating the nervous system, assists with
organizing, improve body awareness and improvements in muscle tone and assist with calming for sleep.
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Proprioceptive input is the performance of tasks that involve heavy resistance and input to the muscles
and joints, and is essential in help our bodies assimilate and process both movement (vestibular) and
touch (tactile) information. This system and these activities provides our body with information on how far
to reach, how much pressure, where we are in space, what our body scheme is, assist with regulating and
calming our system.
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Proprioceptive system gives the nervous system input on the position of muscles, joints and tendons.
These activities are imperative for children who have difficulties regulating their arousal levels. These
individuals require regular heavy input into their neurological systems to assist with calming them
down. The thought is these activities help their bodies receive regular input into their muscles and joints
in the most appropriate way so they can get the input they crave and settle their bodies.
Proprioceptive Input
Weighted vest
Stationary Bike
Weighted blanket
Bag of Balls
Pressure clothing (vests, tops)
Bozu
Wall Push Ups
Cocoon
Scooter Board
Physioball between back and wall
Bouncing/Jumping Activities (ball, trampoline)
Body Sox
Ball Chair
Cloud
Hang hugs/compressions
Fidget/squishy balls
Brushing protocol
Oral motor activities (gum, candy)
Finger Ball Roll
Air Bed
Vestibular Activities
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Lycra Swing
Gym Spin (red/blue in sensory room)
Desk chair
Red rotation board
Purple rocker
Rocking Chair
Aromatherapy
• Essential oils and/or lotion may be used for
sensory strategies to assist with calming;
organizing also has been known to assist with
behaviors, aggressions and obsessions.
• Therapist will indicate on sensory data tracker
the type of scent and how to use.
References
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Sensory Integration and Practice 2nd Edition, 2002. Anita C Bundy, Shelly J. Lane and Elizabeth A. Murray.
Exploring the Spectrum of Autism and Pervasive Developmental Disorders, 2000, Carolyn Murray – Slutsky, MS, OTR, Betty A.
Paris, PT.
Sensory Profile Users Manual, Winnie Dunn, PHD, OTR, FAOTA 1999.
Ready Bodies and Learning Minds, 2nd Edition, Athena Oden, PT.
The Out of Sync Child by Carol Kranwitz, MA 2005.
www.spiralfoundation.net
www.OTOUTCOMES.com
www.sensory-processing-disorder.com
www.kidscando.org
A. Jean Ayers, Sensory Integration Theory and Practice
Raising a Sensory Smart Child: The Definitive Handbook for Helping your Child with Sensory Integration Issues (Lindsey Biel,
Nancy Peske)
Too Loud, Too Bright, Too Fast, Too Tight: What to do If You are Sensory Defensive in an Over stimulating World (Sharon
Heller)
SPD network
Sensory Integration Dysfunction. “The Misunderstood, Misdiagnosed and Unseen Disability” (Sandra Nelson).
Sensory Integration and Learning Disorder by A. Jean Ayes, PHD.
Sensory Integration and the Child by A. Jean Ayres, PHD.
Sensational Kids : Hope and Help for Children with Sensory Processing Disorder by Lucy Jane Miller, PHD, OTR
Additional Information
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Raising a Sensory Smart Child: The definitive Handbook for Helping Your Child
with Sensory Processing Issues by Lindsey Biel.
The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder,
Revised Edition by Carol Kranowitz and Lucy Jane Miller.
The Out-of-Sync Child Has Fun, Revised Edition: Activities for Kids with Sensory
Processing Disorder by Carol Stock Kranowitz.
The Ultimate Guide to Sensory Processing in Children: Easy Everyday Solutions to
Sensory Challenges by Roya Ostovar.
Sensational Kids: Hope and Help for Children with Sensory Processing Disorder by
Ph.d, OTR, Lucy Jane Milder and Doris A. Fuller.
Too Loud, Too Bright, Too Fast, Too Tight: What to do If you are Sensory Defensive
in an over stimulating world by Sharon Heller.
Making Sense of your Senses: A workbook for Children with Sensory Processing
Disorder by Christopher Auer and Michelle A. Auer.