Q: Our preschool son is said to suffer from a sensory integration problem because he has problems interacting with a group. To me, this sounds the same as being an introvert. What can we expect? Is this something he will outgrow? Will this affect him in school, and what can we, his parents, do for him?
A: It is difficult to determine exactly what is going on with your child from the information in your letter. We are not aware of sensory integration dysfunction as a cause for group interaction problems, unless the child is simply unable to handle the amount of stimulation he is receiving from a group of children. It is not the same as being an introvert.
Sensory integration (S.I.) dysfunction was first identified by an occupational therapist named Jane Ayres in the early 1970s. Some occupational therapists use the sensory integration treatment approach for children demonstrating certain behavioral and functional characteristics, while other mental health practitioners may not recognize the treatment as a useful approach.
Those who recognize S.I. say that some of the symptoms include:
* Over-sensitivity to touch, movement, sights or sounds. They may withdraw when touched, avoid certain textures of clothes or food, be distractible or fear ordinary movement activities.
* Under-reactivity to sensory stimulation. This is the opposite of the former symptom. These children may seek out intense sensory experiences, such as body whirling or crashing into objects. Some children fluctuate between being over-and under-responsive.
* Unusually high or low activity level. The child may be constantly on the go or slow to activate, or can fluctuate between the two.
* Coordination problems. Some children may have unusually poor balance and appear very clumsy, while others have difficulty learning tasks requiring motor coordination.
* Delays in speech, language, motor skills or academic achievement. There may be problems in this area despite normal intelligence.
* Poor organization of behavior. The child may be impulsive or distractible and show a lack of planning in approach to tasks.
* Poor self-concept. Sometimes a child appears bored, lazy or unmotivated, and may be considered troublesome or stubborn. Family tension, poor self-concept and a general feeling of hopelessness may prevail.
Children with this problem typically have more than one of the signs. Professionals believe that these children have difficulty processing information derived from the senses - and accurately using the information to get along in the world.
Some occupational therapists believe that many learning disabled (LD) and attention deficit-hyperactivity disordered (ADHD) children suffer from sensory integration problems. There is, however, considerable debate about how may LD/ADHD children actually have a sensory integration problem.
Other professionals see other causes for the seven symptoms above and may arrive at a different diagnosis and treatment plan. This treatment plan could include occupational therapy for sensory or motor (movement) problems.
When a physician refers a patient to an occupational therapist for sensory integration treatment, the child is thoroughly evaluated and a treatment plan is devised. Therapy occurs at least twice a week, from 15 to 60 minutes, depending on the child's needs and tolerance level. Depending on the severity, therapy may be necessary for only two or three months, or it may be required indefinitely.
Through training and careful observation of the child, parents can eventually become sensitive to the kinds of stimulation that cause a reaction in the child. Once they understand how a child is perceiving the world, a parent is better able to respond effectively.
* Kent is the director of marketing at Riverside Psychiatric Institute. If you have questions send them to Gail Kent, c/o Daily Press, 7505 Warwick Blvd., MP 1203, Newport News, Va 23607. Clinical information was provided by Dennis Kade, Ph.D., a clinical psychologist specializing in neuropsychology at Riverside Center for Psychological Services, and Leslie May, a registered occcuaptional therapist and director of Occupational Therapy at Riverside Regional Medical