Sensory Integration Dysfunction
Carol Kranowitz, author of The Out-of-Sync Child, describes some of the signs of Sensory Integration problems in children in this interview.
Interview by Allison Martin
How did you come to be interested in Sensory Dysfunction?
I wondered why some of my preschool students were not "doin' what comes naturally." They were bright and healthy, yet they responded in unusual ways to classmates, teachers, and ordinary nursery school activities. Some children avoided altogether the experiences that their schoolmates enjoyed, while others dove into activities without an ounce of precaution.
Were these out-of-sync kids behaving inappropriately on purpose? Of course not! No child seeks disapproval of his significant olders. Every child wants to learn; every child wants to play and have friends. Something else was going on that made it so difficult for them to succeed in their occupation of childhood.
Until I learned about SI dyfunction, I could not find a pattern in these children. The only common thread - and this is what troubled me the most - was their sadness. Whether their modus operandi was hostility, aggression, anger, frustration, tuning-out, whining, silliness, or wildly inappropriate gusto, they all seemed to sense that they weren't like the other kids. They didn't feel a sense of belonging.
There had to be an explanation, and I had to find it.
What do you find to be the most common sensory problems among children?
Children with Sensory Integration dysfunction exhibit unusual responses to touch and movement experiences.
If they are oversensitive to touch sensations (tactile defensiveness), they will avoid touching and being touched and will shy away from messy play, physical contact with others, pets, certain textures of fabric, many foods, bumpy sock seams, etc. On the other hand, if they are under-responsive to touch sensations, they'll crave touching and being touched. These children will be fingerpainting their arms, stuffing their mouths with too much food, shouting indoors, turning up the volume and bumping and crashing into people and furniture.
If children are oversensitive or defensive to movement experiences, their feet will never leave the ground. They will shun playground equipment and object to riding in the car or elevator. They may refuse to be picked up. Or, if they are under-responsive, they may crave intense movement, and seem always to be in upside-down positions, swinging on the tire swing for long periods, and on-the-go constantly -- jumping, bouncing, rocking and swaying.
It is important to note that many children are over-reactive to sensations, covering their ears when a truck rattles by, or pinching their nostrils to avoid smelling an old banana. And many children are undersensitive, perhaps liking spicy pizza and fireworks more than others do. We wouldn't necessarily say that these kids have Sensory Integration dysfunction. It is unusual reactions to touch and movement that suggest Sensory Integration dysfunction.
If parents suspect that their child may have sensory integration difficulties, what do you suggest they do?
- Be a detective! Keep notes on your child's atypical behavior. Does his reaction to a sensory stimulus occur with frequency, intensity and duration? For instance, does the child have a heck of a time calming down after getting a splinter or being knocked down?
- Ask yourself the "WH" questions, i.e., When did it happen? Where? Who was involved? What happened or what was said? How did your child respond? After taking notes for a while, you may be able to see the pattern and find the answer to the trickier question of "Why did it happen?"
- Find an occupational therapist certified to provide Sensory Integration treatment.
Have you learned more about sensory integration dysfunction since you wrote the book that you would like to share with parents?
Yes, I'm learning more about the distinction between two broad kinds of dysfunction. One kind is a problem with regulation, or modulation, of sensory stimuli. When children are hyper-responsive (over-responsive) to sensations, they will be "sensory defensive" -- on alert and ever vigilant to protect themselves from real or imagined hazards in a scary and confusing world. When chidren are hypo-responsive (under-responsive) to sensations, they are not defensive enough and are more likely to have trouble protecting themselves.
The second broad kind of dysfunction is one in which the child has difficulty processing sensory information. (This child may or may not have a modulation problem described above.) The child's central nervous system is inefficient at integrating, interpreting, analyzing, associating, and generally making use of sensory information. For example, the teacher will say, "Get out your pencil," and the child will get out the ruler. Although he has handled pencils many times, each time is the first time. The result of a processing problem is dyspraxia. Dyspraxia is the inability to carry out a sequence of actions that are necessary to do something the child wants to do, such as get on a bike, or climb a ladder, or answer a question.