How can I help my child?
Contact someone who will understand your concerns:
If you believe that your child might have a sensory integration problem, you will need the help of professionals with advanced training in the area of sensory integration. Often, this professional will be a pediatric occupational therapist, however, many pediatric physical and speech and language therapists also have this type of training and knowledge. In addition, physicians, psychologists, and teachers may also be aware of these types of problems and can offer assistance with appropriate referrals (PTN, 2004).
Seek a qualified professional who can evaluate Sensory Integration and Praxis:
When beginning your search for someone to evaluate and treat your child with sensory integration dysfunction, it is important to seek professionals with advanced training and certification in the area of Sensory Integration. The therapist who evaluates and treats your child should be someone who has received post-baccalaureate training in sensory integration theory and treatment and who has pursued advanced continuing education in this area. It is always appropriate to ask a professional when and how he or she was trained in evaluation and treatment of sensory integration. If the Sensory Integration and Praxis Tests (SIPT) are used in evaluation, the therapist should be certified in its administration and interpretation. For a listing of therapists trained in sensory integration in your area, please refer to www.wpspublish.com.
Once you have found a therapist in your area who is expertly knowledgeable in the area of sensory integration, the therapist may evaluate your child using the Sensory Integration and Praxis Test (SIPT), which is a standardized assessment that assesses your child’s functioning in the following areas: visual perception, somatosensory processing (touch and proprioception), vestibular processing, eye-hand coordination and motor planning or praxis.
Your child’s evaluation may take between 1 ½ -3 hours and will also include structured observations of responses to sensory stimulation, posture, balance, coordination, and eye movements as well as informal observation of spontaneous play. You may also be asked to complete questionnaires that provide information about your child’s development and typical behavior patterns. If your child has difficulty taking tests, the therapist will use play-based and observational approaches to gather the information that is needed.
Following the evaluation, you will receive a report that provides you with test scores, an interpretation of what the scores indicate, and whether or not a sensory integrative disorder is present. The therapist will then make recommendations regarding the appropriateness of therapy using a sensory integrative approach.
Typically, intervention for sensory integration dysfunction is provided by a pediatric occupational therapist and therefore, the treatment is referred to as occupational therapy utilizing Ayres’ sensory integration approach. With specialized training, pediatric physical therapists or speech and language therapists may also use sensory integrative procedures as a treatment approach.
· Occupational therapists use a sensory integration approach when a child has difficulties with the processing of sensory information resulting in the inability to be purposeful in desired activities in daily life (occupations) including independence in daily living skills, using these skills in daily routines and learning these skills in the context of daily life.
· Physical therapists use a sensory integration approach to address difficulties that the child may have with motor learning, motor control and motor programming that is necessary for reaching developmental milestones, improving coordination and praxis.
· Speech and language pathologists use sensory integration methods to address deficits in speech and language and oral motor skills to improve problems associated with oral motor apraxia.
The type and frequency of intervention is usually based on the results of the assessment and the family’s priorities. Intervention can take place in a gym setting with specialized equipment or be provided in a home or school environment if these settings are equipped with the materials and equipment needed to elicit the types of play experiences that will be most helpful to the child. Typically, the child is seen individually which allows the therapist to carefully monitor the child’s reactions to the environment.
When first observing a therapist who is providing intervention using sensory integration procedures, it may not be readily apparent how the activities will help solve the child’s main difficulties. For example, it may seem confusing to learn that having your child throw bean bags at a target while swinging on suspended equipment is actually working on the foundations needed to address his or her handwriting problems. Furthermore, the intervention for another child with handwriting difficulties might focus on lots of climbing to develop whole-body motor planning foundations needed to master the formation of individual letters and numbers. It is important to remember that intervention using sensory integration procedures is designed to address the underlying sensory and motor foundations that help a child learn new skills more easily.
The principles of sensory integration theory that guide intervention stress the importance of incorporating the child’s interests into the therapy sessions. Intervention occurs within the context of play to allow the child to develop abilities in a fun and self-motivating way. The therapist aims to provide the just-right amount of help to adequately challenge the child while ensuring sufficient success. This can be a tricky balance and constant adjustments must be made in response to the child’s reactions. Because this approach is so individualized, it would be impossible to have one set routine that would meet the needs of every child.
For intervention using sensory integration principles to be the most effective, the child’s family should also be actively involved, with a constant exchange of information regarding the child’s reactions to various situations in real life. Discussion between the therapist and parent can help identify which kinds of activities are likely to go well, and which may be more difficult. Strategies used successfully during intervention can also be tailored for use at home. It is often beneficial for parents to observe all or parts of therapy sessions. When parents and therapists work together, they both gain insights that lead to a better understanding of the child, as well as more effective intervention.
It is important to be aware that there are many individuals and organizations that claim to provide sensory integration but do not follow the principles of Ayres Sensory Integration. Beware of:
· someone who says that they are providing occupational therapy activities but is not an occupational therapist
· someone who says that placing your child in front of a computer program is doing sensory integration
· someone who provides passive sensory stimuation to your child and calls it sensory integration
Helping your child at home:
You may now have a better understanding of some of your child’s behaviors but now you need practical suggestions that will help you and your child make it through each day with a sense of mastery and enjoyment. The following information may give you some practical ideas that will help your child actively participate in activities and daily routines. Included in these suggestions are:
(referenced from Home Accommodation Checklist, OTA Watertown)
Sensory Diet Activities
A “sensory diet” refers to activities that provide organizing sensory input and can be incorporated into daily routines. Organizing inputs usually take the form of something in the mouth, frequent movement breaks, heavy work to the muscles and joints and deep pressure. For most of us, subtle sensory input activities such as chewing on the end of a pencil, bouncing a leg under a table, or exercising, are sufficient enough to contribute to an organized arousal state. However, the individual that experiences difficulties with sensory processing may need a greater intensity, frequency and duration or organizing sensory input.
Sensory accommodations are ways to adapt the child’s daily environments to provide sensory support and sensory opportunities depending on the needs of the child. Since it is so important for a child to direct their sensory exploration and to limit sensory input when necessary, providing a sensory rich environment allows a child to obtain what they need when they need it. For example, for a child who seeks movement, having movement breaks scheduled frequently during the day and possibly having a basket of fidget toys available would help this type of child accomplish his or her school work in a timely manner.