Sensory Integration Dysfunction

Rafaele Joudry asks is this yet another label, or a key to unlocking learning in the brain?

The past few decades have generated more and more labels to explain why children have difficulty learning. Dyslexia was replaced by ‘specific reading disorder’ or ‘visual processing disorder’ or dyspraxia. ADD became ADHD ‘inattentive’ or ‘hyperactive’ and now is also broken down into ‘Oppositional Defiance Disorder’ and ‘Conduct Disorder.’
Autism was extended to include Aperger’s, Higher Functioning Autism, Developmental Disintegrative Disorder, Retts disorder and eventually it was safer just to say ‘Autistic Spectrum Disorder.’
Parents may be bewildered by the spectrum of labels and feel fear and apprehension when these start being applied to their child. What does this mean about his or her future potential, and how will it affect the way the child may be treated by the school and community?

Now we are hearing the term ‘Sensory Integration Dysfunction’. Is this yet another label for the experts to add to their bag of tricks, or does it perhaps represent a new level of our understanding of the whole neurological system?

Let us first look briefly at how the brain works. We have eight senses. ‘Eight!’ you exclaim. You may have thought there were only five: hearing, sight, smell taste and touch. New knowledge about the brain, however, requires that we add three more: Vestibular, Proprioception and Interoception. Vestibular is our sense of movement and balance which are detected in part of the inner ear called the semi circular canals. Proprioception is signals sent by our joint receptors to tell us the position and movement of our limbs. Interoception is the sense of our internal organs which lets us feel things like pain, nausea or butterflies in the tummy. These senses are every bit as important to our daily functioning and learning as the well known five.

Sensory information is constantly fed into the brain from our world and our body. All this information, it is now known, enters first through the cerebellum, a cauliflower shaped lobe, about the size of the fist, located at the back of the brain near the brain stem. This is by far the densest part of the brain, containing as many neurons as the entire rest of the brain. It has been called the ‘grand central station,’ for all incoming sensory signals must be processed in the cerebellum before being sent to the right cortical section or ‘department.’ Visual stimuli then goes to the visual cortex, auditory stimuli to the auditory cortex etc. At that point cortical function — i. e. thinking — enables the person to interpret the stimuli and choose appropriate action. Unless all these billions of signals, arriving every second, are downloaded and integrated accurately, the final decision of how to act may not be the best one socially.

Sensory Integration Dysfunction is made up of a number of things. It may be an inability to recognize the ends of your body. Some children will overreact if someone touches them lightly. It may seem as if they are in another world so it takes a bit of effort to get them to communicate. They tend not to move very well through space and may find it difficult to flow throughout the day.

For example, say your boy has been branded difficult and aggressive, and keeps getting hauled up to the headmaster’s office for hitting other kids. Maybe he is a little poorly co-ordinated and kids tease him in the playground. During recess, Smarty pants comes up and yells ‘boo’ from behind, while his offsider waves his arms in front of your boy’s face At the same time his mate accidentally bumps into the boy’s shoulder throwing him off balance. Suppose your boy’s cerebellum isn’t quite firing the way it should. Suddenly he has to process an unexpected noise, quick movement close up in his visual field, being bumped, which jars his tactile receptors, and being thrown off balance which creates havoc in his vestibular system. Not having time to integrate all this stimuli and work out what it means, a fear reaction is triggered in the limbic system, the seat of instinctive emotions in the brain. He automatically hits out at his classmates, and ends up again being branded as a trouble maker.

Of course these difficulties with processing incoming sensory input make it very hard to handle the learning environment. There are always distractions and multiple stimuli in a classroom. Unless these can be assimilated and processed instantaneously it is so easy to get left behind, ridiculed and left out. It is much easier to play up, so often learning difficulties are mistaken for behaviour problems.

How can you help your child, when his brain simply isn’t able to give him information in a fast and orderly enough manner for him to handle our amazingly complex world?

Carmella Kendrick-Smith has been through the experience of helping her child to improve his sensory integration. At preschool it was noticed that her son was having problems moving from one activity to the next. It was almost as though the switch was off so he couldn’t hear the teachers instructions if she asked him to move on to another activity. Carmella was concerned that when he went to kindergarten it would be very hard for him to cope in a larger environment.

When David started kindergarten, which was at the local primary school, he went into an environment that was much more stimulating and overwhelming than the Montessori pre-school he had been in. From day one the teacher was very concerned with his aggressiveness. She said he couldn’t cope in the playground, was falling over and claiming to be pushed.

Carmella was told that her son had Sensory Integration Dysfunction in his final year of preschool. It was recommended that he see a particular occupational therapist who recommended that he receive at least 12 sessions of occupational therapy in conjunction with Sound Therapy.

Carmella’s first reaction was to be very concerned because she thought it was something that was permanent and could not be fixed. She had noticed that he was different to her eldest child in that he was less physical and didn’t seem to like touch. He never sought out hugs and kisses but Carmella thought this was just his personality and didn’t realize he had a problem with people touching him in a light way.

She was very concerned however that he was going to be branded a ‘naughty boy’, because she realized that he had a tendency to lash out and overreact if he was approached from behind.

Carmella had never heard of Sensory Integration Disorder so she decided to inform herself and went to the library and borrowed a book called Why Aren’t I learning? which she found was a useful resource book on sensory integration treatments including Sound Therapy. Doing this reading helped as it made her realize that sensory integration is taken seriously by professionals.

Her son started Sound Therapy at home which she found was the most convenient and cost effective way to do it. The program involved him listening through headphones to specially filtered stories and music that stimulate and rehabilitate not only the ear but the whole auditory system. She would put the headphones on and take them off once he’d fallen asleep. She found that he would actually seek it out and enjoyed going from the Grimm’s Fairy Tales to the Aboriginal stories and even reciting some of the poems.

Carmella quickly noticed that home became more peaceful. The changes in her son were that he was able to feel and see in a better way. It seemed that his senses were actually responding differently. She reports that he now communicates better, is more focused and can move more freely from one activity to the next, without the previous high levels of frustration on his part. She no longer fears that he will have to be labelled a naughty boy. She realizes that his previous behaviour was due to a lot of pain that he was going through, the frustration of not being understood and not wanting to be bumped and touched lightly.

Carmella says ‘I believe he’s less hostile because he’s happier with himself. He now reacts differently to touch and he realizes that deep pressure hugs are good for him.’

She is also aware that his auditory receptivity has improved noticeably. ‘In the past you would talk to him and it was almost as though he wasn’t aware that you were trying to communicate whereas now it’s getting through to him a lot quicker and he does give the eye contact, which he never did before.’

In the early years, David had a set of the classic symptoms which so often seem to accompany learning and behaviour problems. He had chronic ear infections from when he was born. He has allergies, hay fever, croup, and has had his tonsils and his adenoids out.

Every winter he would be on antibiotics and Carmella now believes that a lot of damage occurred then. She thinks Sound Therapy has opened up his ears and repaired a lot of the damage which probably explains why he is now responding better to people talking to him. At the same time the occupational therapist worked on the vestibular system through movement activities and helped him to understand his body better and to be more grounded and stable.

The field of sensory integration gives new insight into many of the commonly known learning difficulties. Not only that, but it offers up treatment methods that are non invasive, drug free and harmless, because they simply use the body’s own sensory pathways to provide a therapeutic stimuli to the brain.

Sensory Integration Disorder was first identified by the occupational therapist, A. Jean Ayres Ph D, about forty years ago. Dr Ayres led her profession in developing intervention strategies through physical therapy programs. Her work is outlined in the fascinating and highly accessible book The Out of Synch Child, by Carol Stock Kranowitz, MA. Kranowitz describes how Sensory Integration Dysfunction plays a significant part in ADHD, autism and learning difficulties.

Other pioneering educational specialists have added to our understanding of how to treat this disorder with different forms of sensory input, in particular Sound Therapy. Dr Tomatis discovered the vital role that the ear plays in our co-ordination, and how that affects learning as a whole. His life work was to develop a method of filtering sound so it provides a gymnastic rehabilitation to the ear muscles.

Dr Levinson, a world renowned psychiatrist and neurologist, also did ground-breaking work in the 1970s and 1980s on the role of the vestibular system and the cerebellum in learning difficulties. After examining over 35,000 subjects, Levinson concluded that 90% of learning problems originate in the ear.

Dr Levinson states: ‘ Only inner ear/cerebellar vestibular mechanisms can explain all the signs and symptoms characterizing ADD/ADHD, dyslexia/LD mood/anxiety, psychosomatic and balance/co-ordination/rhythmic disorders.’

Carmella says of her experience, ‘It’s made me feel good that I’ve been proactive in assisting David get to where he should be, and that is taking in all the senses in a good way. I feel very good that we have some safe and non invasive therapies that have made a difference. Its a safety net for him, and I feel very good about it.’

Rafaele Joudry is the author of the new book: “Why Aren’t I learning? Listening is the key to overcoming learning difficulties”.

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