Sensory Integration

in the Home:
An overview

Presented by:
Laurie Johnson, MHS, OTR/L
Adrienne Rousseau, parent of Autistic Child
The neurological process that organizes sensation from one’s own body and
from the environment and makes it possible to use the body effectively
within the environment. (Ayres, 1979)
Figure 11-8 Sensory Integration Theory and Practice, 2nd ed.
Anita Bundy, Shelley Lane, Elizabeth Murray
“The capacity to regulate and organize the degree, intensity, and
nature of responses to sensory input in a graded and adaptive
manner. This allows the individual to achieve and maintain an
optimal range of performance and to adapt to challenges in daily
life.” (Miller & Lane, 2000)
 Passive Active

High Poor Sensory

Threshold Registration Seeking

Low Defensive Avoiding

Threshold

Dunn, W (2002). Implementing a Sensory Processing Approach In School Practice.

SCOTA Conference, Charleston, SC.
“the multisensory experiences that one normally seeks on a daily basis to satisfy one’s
sensory appetite; a planned and scheduled activity program that an occupational therapist
develops to help a person become more self-regulated.” (Kranowitz, 1998)

The amount and type of sensory input needed to be

most alert, adaptable, and skillful in one’s environment.
With the right input, our bodies feel calm, alert and
ready to tackle daily challenges. Negative sensory input
can have a disorganizing affect on the body.
 Tactile
Sensation derived from stimulation to the
skin (Bundy, et al. 2002)
 Tactile
• underresponsiveness/ poor registration
•Defensive/ Avoiding
principles:
Alerting Calming
Light touch Firm pressure on skin, longer duration
Tickling Hold hand firmly
Hot or cold food (strong temperature) Avoid unnecessary touch and forewarn of
necessary touch
Playing in textures (rice, sand, beans,
finger painting, playdoh) Weighted vests, blankets, etc.
Go barefoot, use textured towels/ Wilbarger Brushing Program (under OT
blankets/ objects direction)
Chose crafts with touch feedback (gluing, Oral tactile defensiveness strategies
clay molding, etc) .
 Proprioception
Sensations derived from movement (ie.
Speed, rate, sequencing, timing, and
force) and joint position. Derived from
stimulation to muscle and, to a lesser
extent, joint receptors, esp. from
resistance to movement. (Bundy, et al. 2002)
 Proprioception
. •Underresponsive/ seeking as a modulator
•Defensive?? (little evidence for)
principles

Calming/ Organizing

“Heavy work”, jump, crash, resistance,

push/pull

i.e. squeeze ball, carry groceries, jump on

trampoline, tug of war, weighted
bookbag, pillow crashing, hanging by
arms or climbing
 Vestibular
“Sensation derived from stimulation to the
vestibular mechanism in the inner ear that
occurs through movement and position of
the head; contributes to posture and the
maintenance of a stable visual field” (Bundy et
al., 2002)
 Vestibular
•Underresponsiveness/ poor registration/ seeking
•Defensive/ Avoiding
•Gravitational Insecurity
Alerting
Changes in speed and direction
Change of head position
Swinging (tire swing with lots of
directional changes)
Sliding
Somersaults
Dragging on a blanket
Bouncing on adult’s knee/ therapy ball
Movement activity prior or during a
thinking task
Movement breaks in class (accompany on
errands to office, library, etc.)
Calming
Linear, predictable, repetitive
Head moving in straight line
I.e.. Rocking chair, bouncing up and
down, gentle linear swinging
Allow child to direct
Couple with “organizing inputs”
(proprioceptive input, deep pressure,
etc.)
I.e. Swing and crash! Child swings
with feet held firmly with pulling/
pushing, etc.
By: Wiley Miller
Non Sequitar
 Visual
•Underresponsive/ Seeking
•Defensive/ Avoiding

Alerting Calming
High intensity, contrast, or change of Low contrast, dim
stimuli

i.e. bright lights, contrasting colors i.e. low lights, uncluttered

Cover blocks in foil, roll a clear ball
with moving objects inside, highlight
words, label drawers with bright
colors
Use visual input to engage the seeking
child
environments, decreased competing
stimuli with attending to a task, set
up visual blinds with sheets over
cluttered areas, allow visual breaks
in a dark room
 Auditory
•Underresponsive/ Seeking
•Defensive/ Avoiding

Alerting
Strong intensity or changing sounds
Music with unpredictable rhythm
I.e.. Ring bell at stimuli you want child to
attend to
Calming
Repetitive, constant, quiet
Rhythmic music,
Quiet spaces for child to retreat to when over
stimulated
Carry headphones with calm, rhythmic music
Warn of loud noises, use earplugs
In Class, seat away from loud speakers and
traffic
 Taste/ Smell
•Underresponsive/ Seeking
•Defensive/ Avoiding

Alerting
Strong intensity
i.e. Spicy, sour, such as warheads, sour
patch kids, BBQ sauce, sour straws)
Calming
Mild intensity, nondistinct or familiar
qualities, gradually progress tastes
to expand diet
i.e. Use unscented cleaning products/
soaps, start with bland foods (cream
of wheat, mashed potatoes)
 There is no recipe that always
works! Many children do
confusing things!!
Examples

A professional trained in SI should help

interpret the child’s behavior and develop an
appropriate program
Xander

Age 5
 Defensive Tactile Sense
What it looks like in Xander
• Defensive with light touch, will
not tolerate hair-brushing,
haircuts, hair washing, etc.
• Particular about type of
clothing, how it fits, tags must be
cut out.
• Difficulty walking barefoot on
grass, and must assimilate to
sand slowly. Change in walking
surface is tough when barefoot.
• Defensive with gentle touch or
affection, prefers firm pressure
when touched.
How we treat Xander
• Equipment we have: resistance
tunnel, brush, koosh balls,
cotton balls, sand, rice, beans
playdoh, vibrating tools, and
any food he will tolerate.
• Wilbarger brushing/joint
compression protocol.
• Throughout the day we
encourage Xander to try new
input, with each success he is
rewarded.
• Educate those Xander interacts
with.
 Seeker Proprioceptive Sense
What is looks like in Xander How we treat Xander
• Seeks high impact in play- • Equipment we have: mini-
running, jumping, bumping into trampoline, weighted vest, bear
people and objects often. hug vest, weighted shoes,
pillow and blanket, ball pit,
• Runs, jumps, bounces, wiggles
therapy ball, vibrating tools,
nearly continuously! (Looks a lot
joint compressions (with
like hyperactivity.)
brushing protocol).
• Even “at rest” he often rolls, kicks,
• Allow plenty of time for
flicks his arms/legs, drags his head,
gross motor play, including
etc.
lots of rough play (wrestling,
• Seeks deep impact during typical “steam roller”, pillow fights).
daily routine activities- rubbing
• Regular proprioceptive
against walls as he walks, bouncing
activity (every 15-30 minutes).
off of or pushing on objects.
 Fluctuates Vestibular Sense

What is looks like in Xander How we treat Xander

• At times he strongly seeks • Equipment we have: swings

vestibular input by spinning, (indoor and outdoor), scooter
hanging upside down from board, mini-trampoline, therapy
furniture, standing on his head, ball, during summer we go to the
swinging, riding his bike. pool often.

• Other times he avoids taking his • During periods of seeking, we

feet off the ground, resists give Xander sensory choices to
movement in the car, avoids feed his need - then transition to
swings, dislikes riding in the new activities.
stroller/wagon..
 Fluctuates Visual Sense
What it looks like in Xander
• Easily overwhelmed in cluttered
environment with numerous
stimuli to accept
• Easily distracted by visual
stimulus in every day
environment and sometimes hides
eyes
• Easily distracted by school
work/ therapy/ ABA work that is
visually over stimulating; making
it difficult to complete an
assignment or task.
•Sometimes repeatedly tracks for
How we treat Xander
• During defensive times we give
him time in a dark room,
sometimes with his eyes/head
covered.
• In the community we take a
blanket which he will pull over
his head when over stimulated.
• Hand held video games give
him something to focus on when
the surroundings are too much to
handle.
• We often use visual supports/
but keep them simple and avoid
extraneous pictures/ colors
 Defensive Auditory Sense
What it looks like in Xander
• Defensive with loud sounds or
too many sounds at once. If
more than one person speaks at
once, he is easily upset.
• Often screams or begins self
stimulatory behavior in
situations he cannot control
when the auditory stimuli is
overwhelming.
• Puts his hands over his ears
and seeks a secluded space,
usually with his own verbal
protest…attempting to drown out
the offensive noise.
How we treat Xander
• At home we limit unnecessary
noise, enforce strict rules
regarding appropriate speaking,
give warnings for loud noises.
• In times of unexpected loud
noise, we give bear hugs while
removing him calmly and quietly
from the noise/situation
immediately.
• Outside our home we prepare by
describing noises he will hear, or
give him headphones to drown out
the noise.
 The Sensory Diet
It is very important that regular sensory activities are used to keep
Xander centered for optimal function throughout the day.

Morning Routine Evening Routine

Brushing/Joint Compressions
At school: Bear Hug Vest,
Weight Vest, Crash mat,
Brushing/Joint Compression
After school: Quiet Activity
(rest time)
Sensory Choice(s)
Afternoon Activities including
calming input & brushing
Brushing/Joint Compressions
Outside Play
Sensory Choice(s)
Dinner
Bath/Brush Teeth/Pajamas
Brushing/Joint Compressions
Quiet Time (reading, tv,
massage)
Other ways to handle Sensory Integration
difficulty…

Social Stories
Visual Schedule

“How does your engine run?”

(ALERT Program)
 Special
Circumstances
GROCERY STORE
DOCTOR
DENTIST LIBRARY
WALMART
 Some of Xander’s successes…
(all previously impossible with STRONG resistance)

• Xander tolerates his hair grown out and cut rather

than buzzed!
• Xander goes to the dentist and has his teeth
cleaned!
• Xander jumps in the pool, dives for toys, and
completes a somersault!
• Xander eats a regular meal at school!
• Xander calmly says “no thanks” to sensory input
he doesn’t want, rather than screaming “NOOO!”
References:

Ayres, A. J. (1979). Sensory Integration and the Child. Los Angeles: Western Psychological
Services.

Bundy, A., Lane, S., Murray, E. (2002). Sensory Integration Theory and Practice, 2nd Ed.
Philadelphia. F.A. Davis.

Case-Smith,J. (2000, Sept.). Intervention Strategies for Children With Autism. Seminar
handouts from lecture at SCOTA Conference, Charleston, SC.

Dunn, W. (2002, Feb.). Implementing a Sensory Processing Approach in School Practice.

Seminar Handouts from lecture at SCOTA Conference, Charleston, SC.

Kranowitz, Carol Stock. The Out of Sync Child: Recognizing and Coping with Sensory
Integration Dysfunction. New York, NY: The Berkley Publishing Group, 1998.

McIntosh, D.N., Miller, L. J., Shyu, V. & Hager, R. J. (1999). Sensory-modulation disruption,
electrodermal responses, and functional behaviors. Developmental Medicine & Child
Neurology, 41, 608—615.

Miller, L. J., & Lane, S. J. (March 2000). Towards a consensus in terminology in sensory
integration theory and practice: Part 1: Taxonomy of neurophysiological processes. Sensory
Integration Special Interest Quarterly, 23, 1-4.