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Sensory Integration Challenges

Dear Elizabeth,
My son has a hard time with new clothes touching his skin, so getting dressed is becoming a big problem. What can I do to help him feel more comfortable?
Michelle Duffy
Springfield, Missouri
Elizabeth's Tips
Elizabeth Sanchez
Elizabeth Sanchez
  • Kids with sensory challenges experience the world differently
  • Get an evaluation if your child is over or under sensitive
  • Partner with specialists to provide appropriate sensory experiences
Expert Advice
Cheryl Ecker
Cheryl Ecker
Occupational therapist
Sensory Integration Challenges
Healthy sensory integration is the ability to bring in and interpret sensory information, make sense of it, and put it to use. A child with sensory integration challenges experiences a disruption in sensory processing to the point that it affects the childís ability to function.

Dysfunction of sensory integration can occur in many different ways. A person can have a modulation problem, meaning that person is either over-sensitive or under-sensitive to different sensory information. For example, a child might be extremely selective about clothing because of the feel of the clothing. An example of the opposite extreme might be a child who seeks touch input, rubbing his face on chain link fences.

Another way that dysfunction of sensory integration can occur is a perceptual problem. For example, a child might not be able to discriminate how hard his muscles are working and may pet a dog with too much force or break toys.

There is dyspraxia sensory processing plus mental processing. Some children can not figure out how to move their bodies, especially when the task is new. The child might avoid new things or appear clumsy.

Sensory integration is highly individual. One of the challenging things is that it affects function and family routine. If a child is fearful of having his head in a non-vertical position because of his vestibular (movement and gravity sensors) system, then that would affect his willingness to participate in things like hair washing and playground activities. There might be tantrums at bath time or isolation at the playground.

Often Misdiagnosed
Children with sensory Integration challenges are often misdiagnosed. It is not yet a recognizable diagnosis to all psychologists and pediatricians. Because a child with dysfunction of sensory integration tends to be more controlling than other children, he may be diagnosed with OCD. Or if a child has a modulation problem and is seeking a lot of vestibular input, he may me misdiagnosed with ADHD. Sensory processing problems can also be part of the symptomology of other diagnoses such as autism.

Identifying the Signs
Signs can even be seen in premature infants. In the neonatal intensive care unit (NICU) infants have had increased heart rates and lower oxygen saturation in response to too much sensory input (lights, noise, movement, touch). In the home it can be detected early as well. If a child is having extreme aversion to diaper changes or a lot of trouble with transitions to baby food, then it might be a sign of a sensory processing problem.

If a sensory processing problem goes untreated, a child and family develops habits and routines around that problem. For example, a child may only wear one outfit because of the extreme sensitivity to clothing. A parent may become a "short order cook" because of the child's over-sensitivity to foods.

Helping a Child with Sensory Integration Challenges
There are different ways to help a child with sensory integration challenges. One way is in an occupational therapy clinic using specialized equipment with an occupational therapist who has specialized training in sensory integration techniques. In this setting, an occupational therapist provides opportunities for the child to achieve sensory experiences that he might not get in his home and community environment. For example, if the child is seeking a lot of vestibular input, then the child might need a wide range of swinging equipment. While doing these activities that enhance sensory experiences, the therapist is cautiously monitoring the challenge of the activity. She may add a visual challenge while the child is swinging, or if the child is becoming overwhelmed, she might add a calming joint and muscle activity.

Desensitizing a Child
It should be noted that "desensitization" must be done very cautiously, as just forcing a child to experience a noxious sensation repeatedly could cause psychological harm. For example, I am working with two children older than 5 who are diagnosed with "post traumatic stress disorder" because of undue forcing of sensory input.

I think parents need to be aware of their own sensory preferences and challenges and recognize that those are playing into the dynamics of their child's sensory processing. For example, if a parent is over-sensitive to touch, he might be really bothered by a child who seeks a lot of touch. The parent may need to use strategies to cope with his or her own touch sensation problems in order to provide the sensory feedback that his or her child needs.
Child Care Provider Comments
Jennifer Wedlake
Jennifer Wedlake
Mother of one
My son, Finn was very young when he was first diagnosed with Sensory Integration issues. He is wobbly and often has a hard time standing up. He is very sensitive about the food that he eats and wants everything to be pureed. The diagnosis was very helpful for me because it made it easier to understand why Finn was acting out for apparently no reason. After he started becoming more involved in therapy, Iím now seeing a vast improvement from when he was at his worst.

Itís a lot more work having a child with sensory integration challenges. Everything is more of a struggle, whether it is getting dressed, meal time, or play. Luckily Iíve been instructed by the therapist how to make the home life easier for him and also work towards him making progress. Since we started occupational therapy with him at a young age, his food selection has broadly expanded.
Amelia Baker
Amelia Baker
Preschool teacher for 2 years
I am fortunate enough to always have a therapist in group with me so I have been able to learn so much first hand. With the therapists in group I am able to see the entire process from the child ďacting outĒ to the strategies used to calm him or her. If I did not have a therapist working with me, I think I would probably view a lot of the sensory integration issues simply as bad behaviors rather than understanding what is actually going on.

Patience and understanding are KEY in helping children with SI challenges. If the child is over stimulated in the class and needs a break, I will bring them to a calming, comforting environment for a couple of minutes to let their systems calm down and refocus. If the child is under stimulated in class and is clearly "seeking" some sensory input, I will try to give them that input as is fit (whether it's giving them a chewy tube, deep pressure hugs, play putty for them to squeeze, etc). I know I've said this a lot, but it is important to remember that every child's needs are different, and those needs will change as their environment changes.
Dayna Schaaf
Dayna Schaaf
Aunt of a 2-year-old
For my nephew, Finn, it is important to keep his environment simple and avoid loud music or TV in the background. I suggested to Jennifer to keep his room neat and clean to avoid distraction. If his toys are out, he will want to show them ALL to me and he will get frustrated because he can only physically show me one at a time.

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Topic: Special Needs
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