SPECTRUM CENTER

Bethesda, MD. Phone: (301) 657-0988

New York, NY. Phone: (212) 223-2928

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Sensory Integration Dysfunction and Autism By Valerie Dejean Danny, a beautiful four-year-old boy, was just a little bit different. After his birth by Cesarean, Danny nursed well and thrived. He reached the major developmental milestones on time -sitting at six months and walking at one year. In other ways, however, Danny was  different;  he never responded to the typical "so big" games, never clapped his hands, and never pointed. In addition, Danny was not a good sleeper and woke frequently at night until he was three years old. When he first began solid food, Danny ate reasonably well, although every new food would initially elicit gagging. Over time Danny began to refuse more and more foods, often without even tasting them. Now Danny has an extremely limited diet and will go without eating at all if his "favorite foods" are not available. Danny is extremely resistant to hygiene activities such as bathing, hair washing, and nail clipping. Getting a haircut is virtually impossible. Danny does not deal will with transitions and seems not to enjoy any of the "normal kid pastimes;  he avoids messy activities such as finger painting or Play Dough. He refuses to sit at story time and in general avoids his classmates, preferring to build complex block-towers in the corner of the room by himself. Danny's pediatrician says there is nothing wrong and suggests that maybe his parents  are over anxious. His grandparents think he is "just spoiled." Parents with children like Danny naturally become frustrated, confused, and tired. What is Sensory Integration Dysfunction? Sensory Integration Dysfunction (SI Dysfunction) is the inability of an individual to appropriately process sensory stimulation. Our brains constantly receive sensory input-our ears constantly hear external and internal sounds, our skin receives constant sensory messages from the air, our clothes, and gravity, our eyes (while open) continually adapt to what is in our line of vision. These sensory messages are, in essence, "food for the brain." In a well-functioning brain, messages from the central nervous system reach their optimal destination in the brain and are responded to appropriately. For individuals with SI Dysfunction, some messages are not received or are perceived improperly. They may be misinterpreted, intensified or omitted, which, in turn does not allow the brain to respond appropriately. The mixed messages and unusual responses leave the individual with SI Dysfunction "out of sync" with his or her world. (See The Out of Sync Child by Carol Kranowitz and Sensory Integration And Your Child by A. Jean Ayres.) The cause of SI Dysfunction is notknown, although there are many theories that range from genetic causesto traumatic birth experiences. SI Dysfunction isalso difficult to diagnose. The body's sensoryintegration systems are complex and interrelated;  when dysfunction occurs, it can manifest in a variety of areas and behaviors. Also, some of the behavioral responses of SI Dysfunctional individuals are very similar to characteristics of other disorders, e.g. ADD. Finally, since many children exhibit similar behaviors in response to certain activities (e.g. a lot of kids hate to have their hair washed), it is difficult to tell if a child's strong negative reaction in one area is "normal" or if it is indicative of a problem. It is necessary, therefore, to view the child overall to determine if, put together, all his or her "little idiosyncrasies" add up to something. Below are some common behaviors and reactions of individuals with SI Dysfunction, broken into four categories: attention and focus, kinesthetic ability, sensory defensiveness, and socialization. Attention and Focus To pay attention, one must be able to not only concentrate on the task at hand, but also filter out irrelevant stimuli. An individual reading a book on the subway is an example of someone "blocking out" irrelevant stimuli-people talking, sound of the subway car,announcements of stations-and focusing her attention on her book. Individuals with SI Dysfunction often cannot discriminate relevant from irrelevant stimuli. For example, a parent may call the child's name repeatedly while in the room with her and she will not respond. Yet she will look up in response to the faint sound of the train whistle as it passes several blocks away. Individuals with SI Dysfunction often key in to background noise (refrigerator motors, washer/dryer cycles) but may be unresponsive to other, more essential stimuli (a question directed to them, the sound of their name). At the same time, these individuals may be hypersensitive to some sounds-the sound of the vacuum cleaner may drive them crazy-but oblivious to others-fire sirens are no big deal.  Some individuals with SI Dysfunction areunable to focus their attention on one task for any length of time.They may wander around a room of toys, pulling out this and that but not really playing with anything. Others will spend hours focusing on one aspect of a toy-they may pull out the "voice box" of a talking stuffed animal and play it over and over to figure out exactly how it works. Still others will play repetitive games -the doll goes in the car, the doll comes out of the car, the doll goes in the car again. Since many individuals with SI Dysfunction have motor planning problems, they often cannot tolerate a change in their game or a rapid transition from one activity to another. Kinesthetic Ability Manychildren with SI Dysfunction are "off balance."They may be physically awkward or clumsy, tripping and falling for noapparent reason. Others are "dare devils" -they donot realize the potential danger of climbing too high, or they maycrave the stimulation of spinning as fast as they can.Still others are overly cautious-they never seem to get hurt and tend to be very careful during physical activities-climbing slowly and carefully on the playground, sitting or crawling over a low step or bump so as not to fall. TheSI Network identifies individuals with SI Dysfunction as often beingsensory seekers, sensory avoiders, or a combination of the two. The sensory seekers  "have nervous systems that are under-responsive to sensation. As a result, they seek out more intense or longer sensory experiences." (SI Network homepage). The sensory seekers may tend to exhibit hyperactive behavior in their unquenchable guest for sensory input. Since they often do not get dizzy, they will swing or spin for prolonged periods. At bedtime, they may find it very difficult to settle down either because they have not received enough stimulation for the day, or because their constant activity has actually over-stimulated them. SensoryDefensiveness Onthe contrary, the sensory avoiders "have nervous systems that areoverly responsive to sensation. As a result theymay have 'fight or flight' responses to sensation, a condition called 'sensory defensiveness'  Those with sensory defensiveness may be uncomfortable in groups or busy places like crowded malls. They may also be unable to tolerate certain fabrics, tags in their clothes, or wrinkles in their socks. Individuals with sensory defensiveness are often very picky eaters -they cannot stand the texture of many foods, and may also be extremely sensitive to odors. Sensory defensive individuals often avoid messy activities such as finger painting, making mud pies, etc. To some of these children a small wet-spot on their shirt is enough to distract them for the entire day -they cannot function until they have changed their shirt. Socialization Socializingcan be difficult for individuals with SI Dysfunction.Their Dyspraxia (poor motor planning) makes it difficult for them toadapt to new situations, a necessary skill in order to play with peers.If they have any sensory defensiveness, they may also shy away from orrespond negatively or aggressively to unexpected touch. Communicating with others may be extremely difficult if filtering out background noise (like extraneous classroom noise) is a challenge. Also, as these children grow, they may become more and more aware of their differences, which can lead to esteem issues.

The Spectrum Center Method:  Tomatis  plus Sensory Integration The body has three main systems that organize sensory information: the vestibular (somatic) system, the visual (spatial) system, and the cochlear (linguistic) system. Two of these systems-the vestibular and the cochlear systems -are housed in the ear, and provide the brain with 90% of all of its sensory input. Using the Tomatis Method of auditory stimulation, the Spectrum Center stimulates the ear, "reprogramming" these two major sensory systems so that individuals receive and process sensory information more appropriately. During the auditory stimulation process, each individual is also engaged in occupational therapy activities designed to further stimulate sensory integration. Spectrum Center Listening Therapists engage each child in gross motor activities such as swinging, spinning, and jumping, plus fine motor and tactile stimulating activities such as playing with various textures (Play Dough, gak, etc.), stringing beads, and doing puzzles. Finally, the Spectrum Center uses audio-vocal training to further hone the sensory systems of the inner ear, helping the individual with SI Dysfunction to learn to discriminate between essential stimulation and background noise. .         Next page: SENSORY HISTORY OF AUTISM AND PDD COPYRIGHT VALERIE DEJEAN, 2000-2006

Further Reading: The Spectrum Center Method Sensory Integration Dysfunction Attention Deficits Disorders (ADD/ADHD) Integrated Therapy Services Tomatis Method Listening with a Purpose