Sensory Integration Disorder

Some children have weaknesses in the neurological systems that process and regulate sensations. They may have difficulty organizing information from all their senses or just one or two of them. The senses include: vision, hearing, tactile sensation, smell, taste, and proprioception (the ability to sense one’s body position and body part positions in space). Instead of enjoying music or an exciting baseball game, they might be overwhelmed by high-pitched sounds in the music or being in a crowd. Rather than securely feeling where their body is in space or where their limbs are, these children are disoriented and can be somewhat clumsy. Sensory Integration Disorder (SID) is a subtle, but disturbing, disruption in the circuits responsible for processing sensory information. Some research has suggested it is due to abnormalities in large cells (magnocellular theory) found in the circuits that process all types of sensory information. Similar abnormalities of the large cells has been reported to underlie sensory problems in dyslexia and in schizophrenia (although there is no known link between SID and schizophrenia). Most children with SID have difficulty with one or two types of sensation – for example, touch (tactile) and body sense (proprioception). Children with SID may have extreme adversive and emotional reactions to sensation they have difficulty processing. For example, thy may show tactile defensiveness – shying away from light touch, but seek heavy compressive stimulation, such as bear hugs.

SID can have profound effects on a child’s ability to be successful at home, in school, and in the world. Not only can tantrums in reactions to uncomfortable sensations alienate peers and disrupt class or home life, but SID makes it difficult to learn. Imagine trying to study Economics in the middle of a roaring crowd at a football stadium or while swirling around on a funhouse spinning floor. For children with SID, this may be how the classroom environment seems to them. Some children with SID will be very distractible or even hyperactive as they avoid adversive sensations and seek preferred sensations. This can lead to a mislabel of ADHD. Tactile defensiveness can leadn the child to have difficulties in group settings. Age-appropriate play can be upsetting because of the many opportunities for unexpected touch. Difficulty tolerating loud noises may make it grueling to endure busy cafeterias or lead to explosive tantrums in reactions to fire drill alarms.

Certain characteristics are suggestive of SID and may prompt you to seek further evaluation for your child.

1)      Becoming distressed, uncomfortable or agitated in response to certain types of sensation. This can include certain sounds (e.g., high-pitched), lights (e.g., fluorescents), tactile sensations (e.g., light touches), textures (e.g., food textures), smells, or body positions.

2)      Has episodes of dizziness or even confusion when exposed to adversive stimuli.

3)      Tolerates own self-initiated touch, but reacts negatively to touches from others.

4)      Becomes distressed or uncomfortable when situated within a group of people due to anticipation or fear of being touched.

5)      Socially engaging with others, but avoids touch.

6)      Seeking certain sensations that are soothing (e.g., covering ears, vigorous physical activity, or deep pressure).

7)      Distractibility and/or hyperactivity in association with one or more of the above.

If you suspect your child has SID, it can be important to get further evaluation. Special accommodation at school may be helpful to foster your child’s opportunities to learn. For example, placing your child’s desk away from a busy part of the room or allowing your child to stand at the end of the line when the class is lining up, or allowing your child to do something else when the class is working with clay, may prevent many overwhelming situations for your child with SID. Physical Therapy and Occupational Therapy can help alleviate aspects of SID. Tactile training and auditory stimulation programs can help your child adapt and tolerate sensations. Medications cannot eliminate SID, but for some children, medications alleviate the severity of the sensory experience.