Sensory Integration Therapy and Behavioral Challenges in Autism

Introduction to sensory integration therapy:

Sensory integration (SI) is a framework conceptualized by Dr. A. Jean Ayers, Ph.D. in the 1970s; hence it is currently known as Ayres Sensory Integration (ASI).

Ayers’ principle emphasizes the significance of intersensory integration in functional development, while problems in sensory integration can hinder various aspects of a child’s life, including emotional regulation and participation in daily activities like dressing, playing, and social interactions.

Sensory integration (SI) involves the nervous system’s ability to process sensory input and convert it into appropriate actions. It can be affected by disturbances in registration and modulation, which often involve the limbic system, the vestibular system responsible for body movement sensations, and the proprioceptive system for joint and muscle input.

Ayres proposed that the vestibular system plays a role in determining whether we respond to a stimulus, and vestibular nuclei assign meaning to visual stimuli. Overreactions or underreactions to tactile or vestibular input can lead to issues like gravitational insecurity, fear of movement, and tactile defensiveness.

Sensory deficits are measured through the sensory profile, which consists of interviews with parents, a review of child evaluation reports, and observation of behaviors. After the assessment of data, goals are created to target areas of concern.

Sensory processing differences in autism :

Autism Spectrum Disorders (ASD) are defined clinically by impairment in communication, social interaction, and behavioral flexibility.

ASD is a broad term encompassing a wide range of symptoms, from severe forms like autistic disorder or autism to milder variations like Asperger syndrome (AS) and pervasive developmental disorder not otherwise specified (PDD, NOS). Additionally, it’s important to note that even within a diagnosis of autism, individuals can exhibit a broad spectrum of intellectual abilities.

Children with ASD often report experiencing both hypersensitivities and hyposensitivities in various sensory domains. These sensory behavioral differences can be quite diverse, ranging from mild to severe, just like the variability seen in communication and social deficits within the autism spectrum. Importantly, these sensory differences can persist into adulthood.

Sensory processing involves eight components: the five senses – taste, smell, hearing, seeing and touch; as well as three other components. Vestibular function and proprioception are sometimes referred to as the “sixth and seventh sense.”

Proprioception is a sensation of one’s own body movement or position, such as when a kid lifts their hand and is aware that they are doing so. Vestibular function refers to the inner ear and brain cooperating to manage eye movement, bodily balance, and awareness of one’s own body in relation to other objects around them.

Interoception is a component of self-awareness, allowing us to sense and understand what’s happening within our own bodies. It plays a role in our perception of temperature, thirst, hunger, and various internal bodily sensations. This sensory system helps us maintain our overall well-being and respond to our body’s needs.

Sensory integration and communication skills :

Sensory integration and communication skills are closely linked in individuals with autism spectrum disorder (ASD). Many people with ASD experience sensory processing differences, which can impact their communication abilities in various ways.

Individuals with ASD may be hypersensitive or hyposensitive to sensory stimuli, Sensory sensitivities can affect their ability to focus on communication tasks and may lead to sensory overload or withdrawal in certain environments.

Many individuals with ASD face challenges in verbal and nonverbal communication. They may struggle with language development, social interaction, and understanding nonverbal cues like facial expressions and body language.Sensory-based communication strategies, such as using visual supports like picture schedules, can be effective for individuals with ASD. These tools help provide structure and reduce sensory-related anxiety in communication situations

Sensory integration strategies for autism :

Sensory integration therapy is often provided by professionally trained occupational therapists. It entails particular sensory activities that help the children adjust to light, sound, touch, smell, and other input. Swinging, brushing, playing in a ball pit, and other sensory-related activities may be used as interventions. These activities may result in increased focus, improved behavior, and even reduce anxiety.

• Remedial intervention – involving the use of sensory and motor activities and equipment (e.g., swinging, massage)

• Accommodations and adaptations- wearing earplugs or headphones to diminish noise, or using a textured sponge in the shower.

• Sensory diet program – typically involves a daily plan tailored to an childs sensory needs. It includes a variety of sensory strategies like providing a quiet space, offering a weighted blanket for comfort, incorporating physical activities to regulate sensory input, and providing tangible items like stress balls or fidget toys for sensory distraction or stimulation.

• Environmental modifications- such as using white noise machines and carefully selected decor and furnishings, can help decrease sensory stimulation. These changes can create a more sensory-friendly environment. • Education- Including family members, caregivers, and administrators, about the influence of sensory functions on performance and ways to minimize their negative impact on function is crucial for creating a supportive and understanding atmosphere that promotes the well-being of individuals with sensory processing needs

Sensory integration techniques:

* Play-Based Activities: Play-based activities are a central component of Sensory Integration Therapy (SIT). Occupational therapists use these activities to challenge a child’s sensory processing abilities. Examples of such activities include playing on swings, trampolines, and using large balls and other equipment that offer sensory input. These activities aim to help children develop their sensory processing skills

* Deep pressure activities: are important in Sensory Integration Therapy. They involve actions like squeezing or wrapping the child in a blanket. These activities provide proprioceptive input, which can enhance the child’s body awareness and promote calming responses. Deep pressure activities are often used to help children regulate their sensory experiences and create a sense of comfort and security.

* The Wilbarger Brushing Protocol is a sensory technique used in some therapy programs. It entails using a soft surgical brush to apply deep pressure to a child’s skin. This technique is to reduce tactile defensiveness and improve sensory processing. It’s typically employed by occupational therapists as part of a sensory integration approach to help children who have sensory sensitivities or processing difficulties.

* Therapeutic Listening: Therapeutic listening involves using specially designed music to stimulate the child’s auditory system. It is believed to enhance sensory processing and self-regulation.

* Visual stimulation activities: These activities may include tracking moving objects or playing with colorful lights. They can be part of sensory therapy to enhance a child’s visual skills and attention, particularly in cases where there are sensory processing challenges related to visual stimuli.

* Oral motor activities: chewing or blowing bubbles, can be effective in improving oral sensory processing. These activities are often used to support speech and feeding skills. By engaging in oral motor activities, children can enhance their oral sensory awareness and develop the necessary skills for speech and feeding.

* Sensory Diet: A sensory diet is a personalized plan that incorporates sensory activities throughout the child’s daily routines to meet their sensory needs and enhance participation in daily activities.

Behaviour challenges in autism :

Challenging behaviors commonly associated with autism spectrum disorder (ASD) include

* Aggression: Aggressive behaviors towards others, like hitting, biting, or scratching.

* Self-Injurious Behaviors (SIB): Actions such as head-banging, hand-biting, or hair-pulling.

* Tantrums: Outbursts of extreme frustration or distress, which can be severe.

* Sensory Sensitivities: Overreactions or aversions to sensory stimuli, leading to challenging behaviors.

* Repetitive Behaviors: Obsessive or repetitive actions, like hand-flapping or rocking.

* Communication Difficulties: Difficulty expressing needs and frustrations, which can lead to challenging behaviors.

* Routine Dependence: Difficulty coping with changes in routine or transitions.

* Social Challenges: Struggles with social interactions and understanding social cues.

Addressing these challenges often requires a tailored and multidisciplinary approach, which may include behavioral therapy, sensory interventions, speech therapy, and individualized support plans.

sensory processing and social skills :

Sensory processing and social skills are often areas of challenge for individuals with autism.

* Sensory Processing:

• Sensory sensitivities: Many children with autism have heightened or diminished responses to sensory stimuli, such as sensitivity to loud noises or aversion to certain textures.

• Sensory seeking: Some children may seek out sensory experiences, like stimming (self-stimulatory behaviors) to regulate their sensory input.

• Sensory regulation difficulties: Difficulty in regulating sensory input can impact attention, behavior, and emotional regulation

* Social Skills:

• Challenges with social communication: Individuals with autism may struggle with non-verbal communication, such as making eye contact, understanding facial expressions, and using appropriate body language.

• Difficulty in understanding social cues: They might find it challenging to interpret social situations and respond appropriately.

Limited social interactions: Some children may prefer solitary activities or struggle to engage in reciprocal social interactions.

Interventions, therapies, and support can help individuals with autism improve their sensory processing and social skills. Applied Behavior Analysis (ABA), speech therapy, occupational therapy, and social skills training are among the strategies used to address these challenges. Individualized approaches are essential to meet each person’s unique needs.