Sensory Intregration Dysfunction Checklist and Suggestions for Teachers and Parents

Signs fo Sensory Integration problems and how to address them, are described in this interview with Polly Godwin Emmons and Liz McKendry Anderson, co-authors Understanding Sensory Dysfunction

Interview by Allison Martin

What signs should parents look for if they suspect their children might have severe sensory dysfunction or Asperger's Syndrome?

The following is a checklist of possible signs and symptoms that a child may be experiencing difficulties with sensory integration. This is not meant to be inclusive, but rather an overview of the more common indicators of possible sensory dysfunction:

While the above checklist provides a starting point, we conceptualize sensory integration and its dysfunction is on a continuum Sensory processing is complex because it is not an all or nothing thing. That is why it is critical that we begin looking at development more comprehensively. Therefore, if a parent or a teacher suspects that a child is struggling, then we encourage him/her to become a "detective" and begin to look at the whole child.

Historically, pediatricians, educators and parents have been taught to compartmentalize child development. For example, can a five- month -old baby drink out of a bottle? Can a Kindergartner print his/her first name independently? Traditionally, these questions have been answered by indicating that a skill was either "achieved" or "not achieved". As a result, the developmental timeline may not necessarily reflect "qualitative" differences in performance when assessing skill development. It is our opinion that evaluators (parents, caregivers, daycare providers, teachers or pediatricians) need to be keenly aware of the "quality" of the skill that they are assessing. This is critical for the child with sensory issues. So let's say the kindergartner is able to write his name independently. However, his grasp alternates from a mature to an immature grasp, he has a very light touch, the letters are huge, with many letters formed from the bottom up. Can we really say that this skill is really achieved? Not if we are looking at the quality of the skill.

As sensory "detectives" we look at the whole child, tease apart patterns of behavior, and look at the quality of skills across developmental domains such as cognitive, language and communication skills, adaptive skills, social and emotional skills and motor skills. Our experience as parents and teachers is that sensory integration dysfunction or sensory issues may be associated with, or embedded within, another diagnosis such as ADHD, Learning Disabilities, mental health issues, and Autism Spectrum Disorders. In our opinion, there is always a significant sensory component within Asperger's Syndrome. Interestingly, first person accounts from adult individuals with Asperger's Syndrome describe sensory issues as the primary source of many of their social and communication challenges.

How might severe sensory dysfunction cause problems for children in school?

Because sensory issues are often an underlying component of ADHD, Learning Disabilities, mental health issues and Autism Spectrum Disorders they will often manifest themselves in difficulties with academic achievement and peer interactions. For example, sensory difficulties may show up in learning, attention, coordination, activity level, developmental difficulties, poor self- esteem, and behavior…but they will show up! Often the new social, cognitive and motor demands of the school setting create even more confusion, anxiety and chaos for the child who has sensory integration dysfunction. All too often, the only way the child has of dealing with this environment is to "space out", "act out" and become more rigid, inflexible, anxious, and socially challenge.

Sensory integration is what turns sensation into perception. Perception defines reality to an individual. Sensory integration defines reality. Not your reality, not my reality, his reality and his unique perspective on the world around him. Therefore, it is our belief that everyone working with a child with sensory issues plays an important role in creating an effective and cooperative partnership on behalf of that child. We encourage teachers to learn as much as possible about the child's delay or disability, and consider possible "links" to sensory integration. In doing so, teachers may want to take a new look at assessment and begin to explore the use of adaptations and modifications for their students. We also encourage parents of a child with delays or a disability to become advocates for their child. We would like to point out to parents that it has been our experience that most teachers are doing with the best they can (often with limited training, experience and resources).

>What can parents and teachers do to help their children with sensory integration issues?

In order to help children with these issues parents and teachers must first put on "detective hats", learn to look closely at problematic situations, and develop useful strategies to resolve these situations. In other words, what is the child's behavior really saying…after all, behavior is a means of communication. As sensory detectives, we encourage parents and teachers to analyze the behavior by looking at the situation from the child's "sensory" point of view. Depending on the situation and the sensory needs (Proprioceptive? Vestibular? Tactile?) of the child, there are many useful strategies that can be employed. We include lengthy lists and explanations in our book.

We have been the parents of children with sensory dysfunction for a long time (over 15 years) and have been challenged, not only by their sensory issues but by time spent chasing down "appropriate" programs, services, and diagnoses. It has not always been easy, but it certainly has been a learning process for us. Instead of being tempted to simply judge and move on, we now look at our children, and other children, with a more caring and analytical eye. It is our belief that by developing a greater awareness of sensory integration/dysfunction parents and teachers can help each child reach his or her potential. As you learn more about sensory integration and its possible dysfunction, we encourage you to reflect on your own personal framework…what you already know…what you are already doing…and what information may be most helpful to you. Now is the time to bring sensory dysfunction into the forefront and begin to look at home and school, learning and behavior differently - through a sensory lens.

Looking back, what would you have done differently in terms of sensory integration with your children when they were in school?

Looking back, we would have trusted our instincts more and had more confidence that we knew our children and their needs best. We would have had a stronger advocacy role; insisting on more teacher training on sensory integration, better "matches" between our children and their teachers and facilitated more peer interactions. Positive relationships, especially in the early grades, are so critical! In addition, we would have requested more frequent team meetings so that we could have been kept more "up to date" on how things were going at school.

Polly Godwin Emmons and Liz McKendry Anderson are the authors of the excellent book Understanding Sensory Dysfunction