Many people ask, “What is Sensory Integration.” 

Others ask exactly what “motor planning” means.

Those in the “know” bandy about the term, “sensory processing.”

In a nut shell,  sensory integration relates to the many topics discussed in all the sections of this website.  The sum of the parts, however, do not necessarily equal the whole.  As each aspect of a human’s sensory motor system improves, a synergistic effect occurs, and over all well being moves in a positive direction.

I frequently envied the reading specialist, who could point to specific test scores and reading level to ascertain the gains made in reading proficiency.  The progress made in SI has no such clear cut measure to assess overall growth.  I can look at markers such as trunk strength and sensory questionnaires to mark concrete changes.  But for over all improvements, I look to the parents and teachers to ask what they see in daily life.

For the child struggling with sensory over load, it is a parent’s report of a certain calm and centering that indicates positive change is occurring.  For the posturally insecure, teachers’ report a more confident child on the playground and engaging positively with peers.  For the motor planning challenged, all note a more organized approach to the world; less chaos, less clumsy and fewer emotional outbursts.

These are examples.  Does sensory integration cause all these changes??  Absolutely not.  Working with a child to  bring about  a state of well being takes a team of many caring individuals.  What the SI treatment does, is  to help make the child more available for all the other important interventions needed to boost the child.

The child who cringes with the distress of having peers and teachers brush against the skin, setting off a “fright response,”  can now sit comfortably and receive instruction without that added dose of anxiety.  The child who avoids playing with peers because s/he can’t  figure out how the game is played, might take the risk once confident that the body will figure out to move the “right way.”

Here are the components that make up “Sensory Integration.”

1. 1. Adequate trunk and limb strength
   

2. 2. Good feedback loop so the brain feels and learns how the body is moving
   

3. 3. Feeling touch sensation in a normal way- processes the information accurately
   

                                                                        No overreaction to touch stimuli

4.  Managing visual stimuli and sounds adequately

                                                                     - process/understand the information

                                                                     - not discomforted by lights and noise

5. 5. Equilibrium reactions present, balance is developmentally appropriate and a sense
   

     of control in staying centered is present.

6.  Motor planning ability is in place            - linking multiple motor tasks in a sequence

                                                                    - executing motor tasks simultaneously

                                                                    - execution of motor task is accurate

                                                                    - able to form an idea of how to go about

                                                                      engaging in an activity

7. 7. Processing and acting upon sensory motor information simultaneously
   

                                                                    - talk or sing while moving

                                                                    - managing  multi sources of sensory information 

                                                                   

                                         

For Example:  Simon Says

The child must pay attention to the verbal command (“Simon says...”or  “Do this...”).

The child must observe the visual demonstration of what to do.

The child must execute the motor demand (e.g. Touch your nose and bend your knees).

For Example:  Baseball outfielder

The player must observe the ball flying through the air.

The player must anticipate the trajectory and make a plan where to go.

The player must run towards the anticipated location while preparing the body to catch.

The child must coordinate a run, stop, jump, or whatever necessary to catch the ball successfully.  The eyes are guiding this process throughout.  Strength in the legs, good eye hand skills, balance, timing and bilaterality all play an important part.  

For Example:  Playground with peers

The child observes the equipment and must make a decision where to go.

Assessment of whether negotiation of the equipment will be successful.

Other children run about confusing the decision making process ... follow Peter ...

copy Jane ... Tad runs by knocking into him ... Karen cuts in front and makes it more challenging to get onto the structure ... 

  

Getting at Integration:

All of the component areas reviewed above should be addressed.  They do not need to be addressed in isolation.  Indeed,  working on two or three areas together facilitates an ”integrated response.”

EXAMPLES:

A child learning to tolerate various touch sensations can play with shaving cream on the floor while lying on the tummy.  Using two hands and drawing a specific picture further enhances the coupling of multiple sensory areas.

Areas addressed:

1. 1. Trunk strengthening work while lying on the tummy to work.
   

2. 2. Tactile stimulation
   

3. 3. Bilateral work of two hands working together
   

4. 4. Visual demand of the picture drawn
   

Add verbal directions, for example:  “Draw a circle ... now a square ...”

and you’ve added the auditory and visual perceptual components.

A child needs to  get stronger and develop confidence with movement.  Riding on a tire swing in a gentle swinging motion and eventually introducing rotation helps the child acclimate to specific types of movement.  Add picking up bean bags and tossing them into a bucket.

1. 1. Trunk strengthening while hugging the tire to stay on.
   

2. 2. Building equilibrium reactions by needing to reposition self periodically to maintain
   

     balance and stay on.

3. 3. Learning to tolerate movement-swinging and rotation
   

4. 4. Eye hand coordination to pick up the bean bags
   

5. 5. Bilateral as one hand hangs onto tire as the other reaches
   

6. 6. Coupling of movement, balancing demands and bilateral, eye hand motor task
   

     requires sensory integration

Add verbal directions:  “Pick up the blue one, now the red ...try to pick up two ..”

Auditory and some cognitive processing are added in.

Determining how much a child can handle:

1. 1. Start simple.  ALWAYS begin with an activity you know will be successful for the child.
   

      E.G. If you are not sure about catching a ball start with rolling it.

2.  Introduce one component and if this is managed with ease, introduce one more element.

     E.G.  Tolerates shaving cream at the table so move it to the mats for a postural challenge.

     E.G.  Bouncing on an exercise ball, then add a reaching or catching demand.

3. 3. Mix up the challenge.  Sometimes add a new visual demand, sometimes language.
   

4. 4. Change the way to play on a specific piece of equipment slightly to add a new challenge.
   

     E.G.  Carry a ball tucked under the chin while crab walking

     E.G.  Use only foot to propel the scooter, then only hands

NOTE:  Some children have multiple issues that make prioritizing and understanding how to get started difficult.  Others may have only one or two areas of concern, but these are quite intense in nature.  In these instances,  consulting a professional trained in sensory processing, motor planning and sensory integration are important to make sure the best approach is taken.  Sensory Integration trained occupational and physical therapists are the experts in this area.  Make sure that the OT’s and PT’s are trained in working with children and have training and background in these areas.  Sensory Integration International is a good place to start to find one of these professionals.

Equipment:

While some therapist have the luxury of beautiful clinics with state of the art equipment, that is not reality for most families, schools and many itinerant therapists.  Here is a guide of equipment that is easily transportable and affordable.  Each piece of equipment listed has multiple functions.

1. 1. Most discount stores have inexpensive over sized plastic balls-approximately 18 inches in
   

     diameter.  In the spring many grocery stores and pharmacies carry these as well.  They

     cost less than $10.  I have used them with children up to 6-7 years old and they have

     never popped.

    

2. 2. Exercise balls can be found at some toy stores and many catalogs.  Determine the size
   

     based on the child.  The legs should be flexed with feet comfortably on the floor while

     sitting on the ball.  The child can use Mom’s Pilates exercise ball but more support will

     need to be provided by the adult as the oversized ball will not “fit” the child.  Many

     activities cannot be done with a big ball since the child cannot sit independently on it.

   

3. 3. Scooters have a broad range of quality and pricing.  Inexpensive plastic scooters can be      
   

     purchased from many catalogs.  Deluxe scooters with foam cushioning can also be

     found at a higher cost.  The important thing is to make sure that the wheels roll in 360

     degrees.  Otherwise the scooter will not move well and will be frustrating for the child.

     

     I have used a scooter built by my husband over 20 years ago.  Teenagers, weighing

     over 130 pounds have used this over the years and it is still working beautifully.  The

     cost of materials to build a scooter like this today would be around $40.

     Design and instruction to build follow below.

4. 4.  A simple tilt board provides opportunities for movement and balancing.  This also
   

      can be made.  Otherwise, there are plastic varieties and circular discs.  References

      for these follow below.

5. 5.  Swings: 
   

      Tire swings can be made from tires!  These can be rigged to backyard

      structures or inside a building.  Instructions on proper installation can be found

      from Southpaw.

      Net swings are inexpensive swing.  The same concept can be applied using

      large reinforced pieces of lycra.

CAUTION: 

1. -With all suspended (hanging) equipment, make sure that a qualified contractor is consulted regarding the load bearing capacity of the beams that the swing is to be attached to.  Southpaw* provides SPECS that can be used as a guide.
   

2. - With any rotational device, guidance from a professional is important because spinning
   

    and rotation can have an adverse effect on children and must be monitored carefully.

6. 6. Barrels:
   

     Fiber barrels can be found in industrial areas.  Google search and see what you can find

     in your area. 

     Catalogs* offer a variety of foam and inflatable barrels.  

A terrific resource for sensory integration activities will be found in:

Carol S. Kranowitcz, The Out of Sync Child and The Out of Sync Child has Fun

More thoughts on the striving towards sensory integration:

All human being have a need for touch and movement.  While we may debate the origin of the human species, we are at our core, creatures who need to move to stay healthy.

The focus of movement has always been on strengthening muscles, bones and keeping us trim and limber.  It is important for people to understand that our brains need movement as well.  It is by providing stimulation on a regular basis EVERY DAY,  not a few scheduled exercise sessions a week, that our brains stay regulated.

Some people have “demanding neurologies.”  They scream out, “gotta move,”  and if they don’t go out and run 5 miles, ride a bike, pump metal, do yoga or whatever, they feel off kilter.

Others have more forgiving sensory processing systems and don’t nag quite as much, so feel less compelled to jump into the pool or go on a hike.  Yet, there are those days when they may feel ...  CRANKY.  They can pop the can of beer or uncork a bottle of wine to relax, but their bodies would be much happier with a walk around the block.

Imagine my anxious excitement  attending my very first OT class.  I conjured up thoughts of Freud and anatomy.   What would we learn first?!    The professor led us to tables with ...

FINGER PAINTS.  I was mortified.  I was attending an IVY LEAGUE school.  What with the finger paints- I last played with these in kindergarten.  After 15 minutes we were asked to share our experiences.  What we all found after our initial nervousness melted away was silly enjoyment and eventually relaxation.  Some found their creativity piqued.  Others simply enjoyed the texture of the paint.  Along with analyzing every component of this activity:(bilateral ... eye hand ... finger dexterity ... emotional release ... social catalyst ... levels of play ...  language demands ... etc.) we discovered that we just plain felt good after engaging in such a mindless, stress free activity. 

I come from a background, in which, I thought every family in America started dinner with  appetizers and martinis (the adults).  It wasn’t until sometime in grade school that I discovered this wasn’t always the case.  So you can understand why I summarized this class experience by saying,  “I get it, instead of mixing the drinks at the end of the day say, “Honey, let’s whip out the finger paints!”

There are many ways to get a release from the stresses of the day.  For some people it is exercising rigorously, for others it is throwing a clay pot (making it, not destroying it).  Each offers lovely motor and sensory experiences that the brain craves and needs to stay healthy and organized.

Now think of all children.  Those little bodies, still seriously in what Piaget terms the SENSORY MOTOR stage until about 7 or 8 years old, needing to sit many hours a day at school.  Imagine harnessing the body for many more hours to a series of additional structured activities. 

FINDING THE BALANCE:

Here is the paradox. 

1.  Motor activities are very important.

2. 2. Mindless free play, much like my finger paint experience,  is essential.
   

So the art and challenge for parents, teachers and other child care professionals is finding the right balance.  Providing the learning experiences that help build proficiency in all facets of life, including motor skills, gross and fine, through structured classes and sports teams can be very beneficial.  Team experiences offer many very important skills in socialization, cooperation, etc.  

Just as important, however is the unstructured free time and “assessment free” play that allows the child time to work at their own motor planning, figuring out how to move the body in random ways and come up with ideas of how to play. 

Happily, much has been written recently on the importance of play.

A good starting point are two seminal works:

David Elkind,  The Power of Play

Richard Louv, The Last Child in the Woods

Resources:

*www.southpaw.com

*www.theraproducts.com

For information on Sensory Integration:  http://www.siglobalnetwork.org/about.htm

Building a scooter:

Materials:

Heavy duty castors (found at hardware stores)

1 inch thick plywood

carpet scrap to cover

Heavy duty staples

1.  Measure  child’s trunk (arm pit to middle of hips)  and width of the body

2. 2. Cut out wood to approximately this dimension (may add inches to leave room
   

     for growth)

3. 3. Bolt in (per instruction) castors on each corner of the rectangular piece of wood-
   

     approximately 1 inch in from corner

4.  Cover carpet over wood surface and staple underneath (make sure to cover edges)

 

Note:  Pink was selected as the color for this scooter in honor of Dr. Jean Aryres,  a pioneer in the study of Sensory Integration; discovering the developmental disorder known as Sensory Integration Dysfunction.  It was rumored that pink was her favorite color.  FYI:  The blocks in the Sensory Integration and Praxis Test battery are pink.