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What Do Sensory Integration Therapists Do for Children with Autism?

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Updated July 22, 2009

Question: What Do Sensory Integration Therapists Do for Children with Autism?
What exactly does a sensory integration therapist do? What kinds of outcomes can parents expect for their children with autism and sensory processing disorder?
Answer: The idea behind sensory integration therapy is that it is possible to "rewire" the brain of a person with sensory processing disorder in order to improve their daily lives. The concept of sensory integration therapy was first developed by Dr. Jean Ayres, whose theories about neurology and sensory function are embraced by some in the field, yet questioned by others.

Practitioners of sensory integration therapy are usually occupational therapists. Their focus is on the tactile, vestibular and proprioceptive systems. In English, this means that SI therapists work on normalizing patients' reactions to touch, help patients become better aware of their body in space, and help patients work on their ability to manage their bodies more appropriately (run and jump when it's time to run and jump, sit and focus when it's time to sit and focus, etc.).

If a sensory integration (SI) therapist has his or her own office, it may be equipped with a variety of unusual equipment, including swings, therapy balls, slides, ramps, a ball pit, and other sensory materials.

Testing for Sensory Issues

A trained SI therapist evaluates a potential patient for sensory defensiveness, hypersensitivity, and sensory cravings, using several different scoring techniques. Some of the standard tests include:
  • Sensory Integration and Praxis Tests (SIPT) for children between the ages of 4 to 8 years, 11 months
  • The Test of Sensory Integration for children between the ages 3 to 5 years (TSI)
  • The Bruininks Osteretsky Test of Motor Proficiency for ages 5-15 years
  • The PEERAMID for ages 6-14 years.
"Evaluation is complicated; it's not a cookie cutter approach," says Dr. Lucy Jane Miller, director of the Knowledge in Development Foundation, which specializes in sensory dysfunction and sensory dysfunction therapy. "Every child is different, so we need to know what type of vestibular and proprioceptive input does he need. I use stimulation during evaluation to figure out a child's nervous system. I create a chart with 7 systems up and along the side. I try to figure out how each system affects the other. So I don't just assume a child needs brushing -- but try to figure out how I can use auditory input to affect tactile reactions, etc. By the time I get to the tactile system, it's much more ready to be treated."

Depending upon the needs of the patient (usually a child), the SI therapist may use various techniques such as:

  • swinging
  • deep pressure therapy, which may include squeezing, rolling, etc.
  • jumping on a mini or full-sized trampoline
  • playing with a toy that vibrates, is squeezable, etc.
  • gross motor play such as wall climbing, balance beam, etc.
  • brushing and joint compression

The Sensory "Diet"

SI therapists also may develop a sensory "diet," which may include a variety motor activities (spinning, bouncing, swinging, squeezing balls or silly putty, etc.), as well as therapist-provided interventions such as brushing and compressing arms and legs. The idea is that this "diet" will be provided throughout the day, whether by a trained therapist or by teachers, aides or parents. In theory, if a child receives appropriate intervention all day, he or she will be better able to take part in typical daily activities. Over time, say some therapists and parents, children are better able to focus, less likely to "stim" (flap, jump or spin inappropriately), and are often more comfortable in situations that involve a high level of sensory input.

Dr. Miller works specifically toward short term life skills goals such as the ability to stay in a loud space without over-reacting. In her practice, 20-30 sessions plus parent training is often enough to make a big difference in a child's daily life. Other therapists, however, work with children over the long term - sometimes for years.

Sources:

American Association of Pediatrics. Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children. PEDIATRICS Vol. 107 No. 5 May 2001, p. e85.

Baumesiter, AA et al. A critique of the application of sensory integration therapy to children with learning disabilities. J Learn Disabil. 1994 Jun-Jul;27(6):338-50.

Hatch-Rasmussen, Cindy M.A., OTR/L. Sensory Integration Center for the Study of Autism

Miller, Lucy Jane, Ph.D., Director, KID Foundation: Interview, February, 2006.

Miller, Lucy Jane, Ph.D. Sensational Kids: Hope and Help for Children with Sensory Processing Disorder (SPD).

Overview of Sensory Processing Disorder from the Knowledge in Development Foundation website.

Sensory Integration International Website/Ayers Clinic Smith SA, et al. Effects of sensory integration intervention on self-stimulating and self-injurious behaviors. Am J Occup Ther. 2005 Jul-Aug;59(4):418-25.

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