Sensory integration and attachment

Jan 31 2012 8:05PM

Here is an overview of my learning.... ... I know this is long but if you are interested it may be worth a read and feel free to add your comments/experiences!!!! But always seek professional help if you think your little one has sensory or attachment issues.

I would like to thank another message board user for rekindling my interest in sensory integration. I did some basic training a while back that I have reviewed since the posting. I am going to summarise some of the information here but my advice is ALWAYS SEEK PROFESSIONAL SUPPORT of a suitably qualified Occupational Therapist if you feel your little one has sensory issues....

Sensory integration concerns the organisation of sensations from our body, the environment and our actions. It involves the seven senses (vestibular, proprioception, tactile, auditory, vision, gustatory and olfactory) working in a coordinated way. As follows:

1. Sensory registration: the brain filters information and determines what is important. It registers the sensory information and this is brought to our attention e.g. we smell a rose among numerous other smells; we hear a teacher talking among classroom chitchat etc.

2. Sensory modulation is the ability to regulate and organise sensory information and adapt our responses accordingly so that we are neither over nor under stimulated .e.g. so we are not too quiet in a loud environment or too noisy in a quiet on!

3. We need an optimum level of arousal to learn that is midway between a high level of arousal (over reactive) and low arousal under reactive). Optimum arousal enables the child to focus. Arousal levels tend to rise when we are stressed and lower when we are calm. If the arousal level is too low then the child may appear lethargic, floppy, slow, distracted; if the arousal level is too high then the child can appear wound up, unable to concentrate, on the move, and fidgety.

4. Sensory processing difficulties result from the child being unable to register and or modulate sensory information. They are categorised as follows:

High Threshold + Passive regulation = poor registration High Threshold + Active regulation = sensation seekingLow Threshold + Passive regulation =sensitivity to stimuliLow Threshold + Active regulation = sensation avoiding

The threshold is the level of sensory information required to illicit a response The degree to which a child self regulates is described as either active or passive. Sensory Integration difficulties are normally described as involving poor registration, sensation seeking behaviours, sensitivity to stimuli and sensation avoiding behaviours. These are detailed below. Bracketed terms describe the senses that are implicated in a specific problem.

Poor registration

Generally the child is apathetic, low in mood, uninterested tired and self absorbed. She may not respond to her name or follow instructions (auditory).She may have poor balance, be clumsy or have difficulty copying or following text (vestibular). She may drop items, have poor grasp or be messy (tactile). She may have speech and eating difficulties (oral). She may have difficulty distinguishing shapes or finding hidden figures (visual), may be clumsy or bump into things (proprioception).

Sensation seeking

She may be active on the go! She may shout, bang objects, and play loud music ( auditory); She may fidget, stroke objects, and explore with her hands (tactile). She may bounce, move, spin and rock; and not sit still, (vestibular). She may mouth objects (oral)’ She may look at shiny objects, flick her fingers; have an interest in mobiles and jewellery.(visual). She may bang her hands and objects; jump and tap her legs ( proprioceptive).

Passive regulation

She may be fussy, distractible, overactive, hyper-vigilant (fright/flight) and complaining in nature. She may overreact to light touch and may not like her head touched or her hair cut (touch). She may have difficulty blocking out noise e.g. vacuum cleaners, classroom noise; and is very sensitive to noise (auditory). She dislikes her feet being off the ground (vestibular). She is a fussy eater and dislikes her teeth being brushed (oral). She doesn’t like bright/flashing lights (Visual).

Sensation Avoiding

She has a need for predictable routine and structure if this is not forthcoming she will experience the fight/flight response. She avoids certain games involving touch (tactile). She covers her ears or she may create her own sounds to drum out the background noise or she may leave the area, or demonstrate challenging behaviours in order to leave (auditory). She may avoid swings (vestibular). She may avoids certain food or having her /teeth brushed (oral). She may prefer dark rooms and cover her eyes(visual).

All the above applies to children of both genders!!!

Not surprisingly, other factors play a part such as anxiety, tiredness, disruption and medical conditions e.g. ASD.... but what about trauma???? Well Caroline Archer in her First Steps in Parenting the Child Who Hurts gives us a clue.

She says that a positive attachment can foster neurological development and the organisation of the senses. This comes because the parent figure is able to soothe and stimulate the child so that s/he feels safe and so that the brain is able to develop normally. She says that the first three years of life (including time in the womb) are critical to the child’s ability to integrate information and modulate his or her level of arousal. She states that the healthy development of the limbic system helps a child to regulate his/her emotion, alertness, sleep and waking patterns. And moreover shows how the limbic system then links with the development of the cerebral cortex (organisational thinking area). Trauma disrupts this process of development and the child may be in a permanent state of stress so avoidance or hyper-vigilant may result....and then the child may suffer attachment difficulties too.

My questions are... how do you know what difficulties are trauma related and what are primarily sensory integration needs? Is the neural development such that the two have become inter-twined? Is it that the trauma of neglect or abuse actually changes how the child responds? So does a neglected child need plenty of stimulation to be able to learn or is there a level where it becomes too much for a child? Equally does a child who is abused become so overwhelmed that s/he develops either anxiety, avoidance or dissociative-based attachments? I'm afraid I don't have the answers.... but some occupational therapy solutions are:

A sensory diet: sensory activities to enable an appropriate level of arousal; to promote sensory integration; to facilitate adaptive responses. Find out what the child likes and dislikes and use to activate or calm a child. Repeat these activities throughout the day. Alerting activities for the under-stimulated child e.g. playing with or drinking cold water, eating chewy sour sweets, playing in cooler temperatures, walking barefoot, using light touch, playing fast music, being in brightly lit areas, sitting on a move and sit cushion, playing on a trampoline or a movement , therapy ball. Calming activities are suggested for a hyper-vigilant child e.g. the playing of soft, quiet music; the use of a clam voice; enabling the child to massage a toy or stroke a pet; the use of weighted jackets; activities that involve slow rhythmic movement such as playing on swings, sitting on hammocks, and swimming; and the provision of a safe space.

Always follow the advice of a therapist as some children suffer sensory overload and could feel sick and quite unwell.

I hope this is of interest. It has certainly got me thinking about Floreana. She is very active so I wonder whether she is sensation seeking. This would make sense given that she experienced neglect. But she is also frightened by change so we may have to deal with a child who is like the road runner and very highly strung...... that's if this link ever becomes a match but we won't go there.....

Back to Blogs