Dysfunction in Sensory Integration (DSI)
or Sensory Defensiveness
Our brain processes information received
from our senses, including sight, hearing and touch. When this system is working
properly it is said to be integrated. If the brain is not processing sensory
information well, there is said to be a Dysfunction in Sensory Integration, or DSI.
Sometimes it is also known as Sensory Defensiveness.
Sensory integration problems have
reportedly been seen in children who were born prematurely or with a low birth weight, or
in kids who spent their early months in East European orphanages where they were rarely
picked up or spoken to. Problems may also occur in children have too much sensation
in their early environment, such as in children suffering from abuse or Post Traumatic
Stress. Many autistic children appear to have DSI based on their avoidance of
In theory, children with DSI either avoid
sensation or seek it. "Sensory Defensiveness" describes a condition where
the child's neurology has become overly sensitized to sensory input.
In some ways Sensory Integration theory
appears to be mainstream. One of my local hospitals put out a flyer on it.
Stories have appear in the press. But there doesn't appear to be much science
that supports the concept or treatment of DSI, either, so it's controversial. And
expensive, unless insurance covers the cost.
Lucy Miller, Ph.D., University of Colorado
Health Science Center, is a leading expert in the field. She asserts that as many as ten
percent of the population have DSI. (1)
On the other hand we have Martha Denckla,
MD, a neurologist with John Hopkins Univ. School of Medicine, who feels that some of these children are just naturally more or less
sensitive to stimulation. "I dont think we really know enough to say, oh, if we
do this exercise or this intervention, were going to rewire this nervous system in
the right way."
The concept of DSI was pioneered by Jean Ayres, Ph.D., who noted that practitioners applied the theory inappropriately and made
unrealistic claims of treatment efficiency. "It is believed to be either
omnipotent or no good at all." (2)
Signs of DSI (2):
Overly sensitive to touch, movement, sights, or
Underreactive to touch, movement, sights, or sounds
Social and/or emotional problems
Activity level that is unusually high or unusually low
Physical clumsiness or apparent carelessness
Impulsive, lacking in self control
Difficulty making transitions from one situation to another
Inability to unwind or calm self
Poor self concept
Delays in speech, language, or motor skills
Delays in academic achievement
An assessment for DSI is generally made by an Occupational
Therapist (OT) who is trained in DSI. One way to find a qualified OT is to call your
nearest Children's Hospital and ask them.
Treatment consists of occupational therapy. Some of
the activities used are pretty common sense. For example, if a child fears falling,
he spends time swinging from a rope to get used to the sensation.
(1) PBS Health Watch Feature at http://www.pbs.org/healthweek/featurep1_515.htm
(2) Sensory Integration International at http://www.sensoryint.com/index.htm
20/20 "Sensory Overload" at http://abcnews.go.com/onair/2020/2020_000721_sensoryintegration_feature.html
Good Morning America "Bad Sensations" at www.abcnews.go.com/onair/DailyNews/000724_sensoryexpert_chat.html