In our everyday lives, we process the world using our senses. Whether we’re sitting, walking, talking, or eating, more than one of our senses is involved so that each action is coordinated and understood accordingly.
Some children diagnosed with autism spectrum disorder (ASD) find it difficult to process sensory information and integrate sensory stimuli. Because every individual with autism is different to the other, his/her experience of sensory stimuli is different. Nonetheless, in order to be more functional, building the ability to regulate the senses often requires therapy.
One form of therapy is sensory integration therapy (SIT). Sensory integration therapy falls under the practice occupational therapy (OT) which is provided by qualified OT therapists. SIT delivers interventions and strategies designed to help children with autism who have difficulty processing sensory stimuli.
Poor regulation of sensory input can lead to anxiety and can be very stressing for non-verbal autistic children who can not communicate their difficulties, so therapy is key.
Let’s take a closer look at the definition of sensory integration, as well as what SIT is and how it can help children with autism.
What is sensory integration?
When a certain stimuli comes into contact with your senses, such as hearing, touch, taste, and smell; your nervous system receives and interprets this stimuli—this process is known as sensory integration.
Various activities require multiple senses acting simultaneously—for example when a child is eating, his/her sense of smell is activated so that the child recognizes what he/she is eating. Meanwhile, his/her sense of hearing naturally filters out background noise, the child’s sense of sight is also activated; adding to it the sense of touch that informs the child about the texture of the food. However, if any of these senses are either over or under stimulated (as they often are in children with autism), the child’s desire to eat is affected and the food might not be enjoyed.
There are autistic children who are hypo-reactive; these children typically don’t appear to be responsive to sensory stimuli that are noticeable to others. Children with autism who are hypo-reactive to sensory stimuli seek sensory stimuli to increase their arousal. Typically, this appears as repetitive behaviors. It is often difficult for them to engage in focused activities because they constantly need to feed their sensory needs. They can be categorized as “wild” or “disruptive”.
In most cases, autistic children with hyper-reactive sensitivity are often hypervigilant, over-aroused, find it difficult to regulate negative emotions, and also are avoidant of certain everyday tasks. When they sense too much input, they tend to withdraw or “shut down”. Group settings or social settings can often be overwhelming. Because of this, these children are often labelled as “shy”.
What are the three levels of sensory integration?
The theory of sensory integration was developed by American occupational therapist Anna Jean Ayres. Ayre’s theory proposes that the development of sensory integration occurs at three levels; the tactile, vestibular, and proprioceptive system.
The tactile system feeds information such as light, touch, pain, and pressure and these are important for us to perceive and be aware of our environment. The vestibular system is located in the inner ear and it aids in detecting movement or changes in the body position. Finally, the proprioceptive system is responsible for your subconscious awareness of your body in space. It includes your muscles, joints and tendons.
When a child plays with an object, he/she engages his/her tactile sense which tells him/her about the object’s texture, as well their visual input which feeds information about size, color, and shape. On the other hand, the proprioceptive system sends information to the brain with information about your muscles and joints in relation to the rest of your body; when a child plays with an object, the proprioceptive system feeds information about his/her hand movements. The vestibular system provides information about balance and movement, for example, when your child is on a swing, or is spinning; his/her vestibular sense is in play.
Impact of dysfunction in these systems
The tactile system: When a child’s tactical system is affected, he/she might respond by withdrawing from any form of physical contact, refusing to eat textured food, avoiding touching sand or paint, and/or avoiding certain types of clothing.
The vestibular system: When your child is sensitive to vestibular stimulation, it can be expressed through a fear of using swings, slides, climbing stairs, or in crawling and walking. Typically, these children are thought of as “clumsy”. On the other hand, when he/she lacks vestibular stimulation (hyporeactive vestibular system), the child may appear aggressive in his/her behaviors; for example, these children tend to jump or spin often.
The proprioceptive system: When a child has a weak proprioceptive system, they tend to lack awareness of themselves when standing or walking or sitting and struggle to manipulate small objects.
Sensory integration therapy for autism?
SIT is an child-centered intervention program that aims to improve the integration of sensory information in children with autism by using sensory-rich activities so they can become more adaptive to sensory input. The application of sensory integration therapy is dependent on the goals of each individual; this is because every individual with autism experiences different levels of sensory stimuli.
There are two types of sensory sensitivity modulations that sensory integration therapy targets, namely hypo-reactive and hyper-reactive sensitivity. When a child experiences challenges with overstimulation (hyper-reactivity) or under-stimulation (hypo-reactivity), he/she can experience difficulty in the following areas: gross motor development, fine motor development, speech-language development, social skills, and attention. Sensory integration therapy for autistic children targets all these areas of difficulty to aid the child’s functionality.
What are sensory integration techniques?
The aim of sensory integration therapy is to develop a child’s sensory system to elicit adaptive responses through play activities. Play activities could include using swings, a trampoline, or slides. The SIT technique is usually performed by qualified occupational therapists whose role is to engage the child to participate in a series of challenging sensory processing activities.
The therapist works with the parent, as well as other clinicians, and develops strategies targeted at aiding the child’s hyper-reactivity or hypo-reactivity. Ultimately, the process of sensory integration therapy seeks to develop the child’s sensory integration system and target dysfunction. A child-centered intervention program tailored to each individual is important because the experiences of every child with autism are different and unique from each other.
Several studies have shown that sensory integration therapy is effective in treating sensory difficulties among autistic children. The result of one study showed that, through sensory integration therapy, several children with autism had significant change in motor skills behavior. This indicates sensory integration therapy directly impacts the functioning of the nervous system, improving its ability to adjust and recover, which ultimately results in adaptive behaviors
The evidence speaks to the effectiveness of SIT for children with autism who experience sensory difficulties. Parents looking to learn more should consult a qualified occupational therapist with training in sensory integration if their child finds it difficult to regulate his/her sensory input.
Abdel Karim, A.E., Mohammed, A.H. (2015) Effectiveness of sensory integration program in motor skills in children with autism. The Egyptian Journal of Medical Human Genetics, 16, 375–380,.http://dx.doi.org/10.1016/j.ejmhg.2014.12.008
Case-Smith, J., Weaver, L. L., Fristad, M. A. (2015) A systematic review of sensory processing interventions for children with autism spectrum disorders. Autism, 19(2), 133–148, doi: 10.1177/1362361313517762
Hatch-Rasmussen, C. (2014) Family and Community Resource center https://www.crporegon.org/cms/lib/OR01928264/Centricity/Domain/45/Sensory%20Integration.pdf
Schaaf, R.C., Benevides, T., Mailloux, Z. et al. (2014) An Intervention for Sensory Difficulties in Children with Autism: A Randomized Trial. Journal of Autism and Developmental Disorders, 44, 1493–1506 . https://doi.org/10.1007/s10803-013-1983-8
Smith Roley, S., Mailloux, Z., Glennon, T. J. (2007) Understanding Ayres’ Sensory Integration. Occupational Therapy Practice 12(7). https://digitalcommons.sacredheart.edu/cgi/viewcontent.cgi?article=1017&context=ot_fac