by Stephanie Drummond, OTD, OTR/L
One boy on the playground keeps away from his classmates, watching his peers climb structures and run around chasing each other. He observes what they are doing but does not initiate play with another friend or jump into the game in progress. Another girl asks her teacher to push her on the tire swing for the fourth time, begging her to spin it faster than the last. A third student solely ate two containers of applesauce for lunch because it is the only thing that his parents can get him to eat independently. These children each have their own individual strengths and challenges but they all might have something in common: challenges with Sensory Integration.
Sensory Integration is the neurological method by which people receive, incorporate and interpret information from the environment. People receive input from the seven senses: auditory, visual, touch (tactile), smell (olfactory), taste (gustatory), proprioceptive (muscle sense) and vestibular (movement sense). Once the input is received, it is processed so the brain can decide if the input is important and what its properties are. Once this is determined, the brain directs the body to react accordingly, generating an adaptive response. Sensory Processing Disorder occurs when a person is not able to generate an adaptive motor response to his environment because this process is disrupted in some way. A person’s level of arousal is closely tied into their ability to interpret sensory input and generate adaptive responses. If a person is above or below his “optimal level of arousal,” it will be difficult to access higher-level motor and cognitive skills to be able to generate adaptive responses to the environment.
Sensory modulation is the process through which the brain decides if information is important or not. If the information is extraneous, it is filtered out. This is the brain’s filter, and if it is not working, the person may be unable to tune out background input or may interpret input stronger than it is presented. These inputs can be overwhelming and often result in the person being in a high level of arousal. Someone who has modulation difficulties may be in “fight or flight mode” and will have trouble sustaining focus on a task at hand. Furthermore, it is difficult for the brain to discriminate input if the input is not modulated correctly.
Sensory discrimination is when the brain makes sense of the information it receives. Without fully understanding sensory input, a person will have decreased skills. The individual might be uncoordinated or unable to complete motor tasks. Often a person with trouble discriminating input will look for additional input in order to get more information to better understand, resulting in sensory seeking behaviors. Discrimination of different types of inputs leads to different functional outcomes. When the brain successfully discriminates sensory input, it allows the individual to build skills.
A person can have a modulation or discrimination issue in just one sense or across multiple senses. The severity of the sensory processing deficit as well as the sense or combination of senses that it impacts changes the way Sensory Processing Disorder looks and impacts an individual. People who have sensory integration challenges might have difficulty focusing, poor handwriting and other fine motor skills or difficulty with transitions. They might have been delayed in their developmental milestones or may be hypersensitive to certain sounds, movements or feels. They might be picky eaters or refusers of food.
As each person with sensory challenges looks different, Sensory Integration intervention looks different for each person as well. Sensory Integration intervention is a method of intervention done by Occupational Therapists that is based in Sensory Integration theory created by Jane Ayers. It is based on the idea that a meaningful, enhanced sensory experience can change the way the nervous system functions to help increase the integration of input. Each session is individualized and, for children, takes place in a fun, playful environment.
Dr. Stephanie Drummond is a pediatric occupational therapist with over 20 years of education, training, and experience within the field of pediatric occupational therapy. Dr. Drummond graduated Magna Cum Laude with her Bachelors, Masters, and Doctorate of Occupational Therapy from the University of Southern California.
Dr. Drummond completed intensive sensory integration training through the University of Southern California at the Jean Ayres Clinic in Los Angeles, and with Dr. Lucy Jane Miller at the STAR Center in Dever Colorado. She designed and managed the University of Southern California’s Lifestyle Redesign Program at the University of Southern California under the direction of Dr. Florence Clark. Dr. Drummond has received certification to administer the Sensory Integration and Praxis Test (SIPT), Integrative Listening System, Interactive Metronome, Therapeutic Listening, and The Listening Program. She has completed courses in Handwriting Without Tears, First Strokes, Pediatric Feeding, Brain Gym, NOMAS certification (Neonatal Oral Motor Assessment Scale), Floor Time, Neuro-Developmental Treatment (NDT), The Zones of Regulation, the Astronaut Program, and the Alert Program.
She has lectured and given courses on sensory integration, feeding, handwriting readiness and intervention, and has presented to the Occupational Therapy Association of California. She has extensive training with feeding difficulties and sensory based feeding disorders, and worked at Toomey & Associates feeding clinic located at the STAR Center in Denver, CO.