What is a Sensory Integration Disorder?

Jul 29

Does your child seem over sensitive to sound, touch, smell, taste, or other sensory input? Do they become overwhelmed and act erratic or even aggressive when experiencing things that other kids seem to tolerate well? Do you worry that they don’t respond normally to certain stimuli? Your child could be struggling with a sensory integration disorder. Sensory integration disorders are neurodevelopmental conditions that manifest with dysfunctional processing of external stimuli by the brain.

Sensory integration disorders, also known as sensory processing disorders (SPDs) can be very challenging to live with. They can be very isolating for both children and parents, and lead to long-term social difficulties. They can be very confusing and anxiety provoking.

Struggling with sensory processing can make virtually any everyday task difficult to perform. Coordination problems, behavioral issues, anxiety, depression, school failure, social challenges, and a host of other problems may be the result of SPD.

Difficulty tolerating or processing sensory information is a characteristic that may be seen in many developmental behavioral disorders, including autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorders, and childhood anxiety disorders (1). It is important to have your child screened by a neurodevelopmental pediatrician as early as possible if they demonstrate any of these symptoms.

How Common are Sensory Integration Disorders?

A recent study by Owen et al, found that 5-16% of school-aged children currently live with sensory integration disorders (5). Under-and/or over responsiveness to sensory stimulation is estimated to occur in 5–16% of children within the general population, and 40–80% of children with neurodevelopmental disorders.

Such sensory dysfunction can hinder a child’s ability to function in daily activities and age-appropriate learning tasks, and can lead to long-term impairment of intellectual and social abilities (6).

What Causes Sensory Integration Disorders?

The exact cause of sensory processing problems has yet to be identified. It does appear from twin studies that there is a genetic component involved in hypersensitivity to light and sound. Children with SPD can show abnormal brain activity when exposed to light and sound simultaneously, or may experience sensory perseveration, wherein a sensory input reverberates in the brain longer than for normal individuals.

What are the Symptoms of Sensory Integration Disorders?

Sensory integration disorder symptoms often involve an affected child becoming agitated or hyperactive in response to specific forms of sensory input.

One child with SPD may over-respond to touch, and may find the sensation of clothing on their skin to be intolerable. Another child may over-respond to visual or auditory stimuli, and be prone to emotional meltdowns in complicated sensory environments.

Another child may under-respond and show little or no reaction to even extreme stimulation from pain and temperature changes.

Some children may have difficulty processing the input from muscles and joints known as proprioception. These children will show hypotonia and will exhibit poor motor skills.

Still other children may be sensory seekers, and will crave any and all forms of extreme sensation. These children often are misdiagnosed with ADHD and medicated accordingly.

How Do Sensory Integration Disorders Affect the Brain?

Researchers have used diffusion tensor imaging to measure the structural connectivity of children with and without SPD. This advanced form of imaging maps the structural connections between brain regions. The microstructure of the white matter tracts correlates with sensory functioning, in particular in posterior regions of the brain where tracts are responsible for relaying sensory information.

DTI studies have demonstrated abnormal white matter tracts in SPD subjects that serve as connections for the auditory, visual and somatosensory (tactile) systems involved in sensory processing, including their connections between the left and right hemispheres of the brain. The abnormal microstructure of sensory white matter tracts shown with DTI in children with SPD likely alters the timing of sensory transmission, such that processing of sensory stimuli and integrating information across multiple senses becomes difficult or impossible (6).

How are Sensory Integration Disorders Usually Treated?

Struggles with sensory integration are seen in many different neurodevelopmental disorders. Primary treatment for SPD generally involves pharmacological management to reduce behavioral symptoms. While this can be somewhat effective, all medications come with a side effect profile. In some cases, these side effects may create problems almost as significant as the disorder itself (15). SPD children are commonly seen by occupational therapists that specialize in neurodevelopmental disorders. Their treatment protocols usually involve some form of play-based activity geared towards gradual exposure to the sensory stimulation that is problematic.

How may we prevent conditions like sensory integration disorders from happening? One answer may be more maternal touch and connection during infancy. A study by Brauer et al (2) found that children who were touched more by their mothers in infancy had larger volumes of the right dorso-medial prefrontal cortex than those that received lower levels of early touch stimulation. Proper prefrontal cortex development is crucial, as this gives rise to many of the brain’s modulation pathways. The prefrontal cortex is important in processing sensory stimuli and determining behavioral responses. As simple as it may sound, giving our children all the love and attention that they need is critically important. Unfortunately, even with appropriate early paternal interaction, many children still develop SPD.

How is the NeuroRescue Program Different?

One of the most popular approaches to improving sensory processing is sensory integration therapy. Sensory integration therapies involve activities that are believed to organize the sensory system by providing vestibular, proprioceptive, auditory, and tactile inputs. A review of literature by Polatajko and Cantin (3) found many different types of occupational therapy and sensorimotor therapies showing improvement, but with mixed results. They found the most success with sensorimotor exercises using both sensory stimulus and movement of the body itself. Such exercises force us to use our frontal lobe to generate movement at the same time as our parietal lobe processes sensory input. The thought is that if we pair two functions at the same time, we increase the chances of integrating the two more effectively.

A review of published evidence by May-Benson and Koomar (4) found that the sensory integration approach may result in positive outcomes in the areas of sensorimotor skills and motor planning; socialization, attention, and behavioral regulation; reading and reading- related skills; and individualized goals for the study populations.

Although more research needs to be conducted, there are viable strategies to improve sensory integration, developmental motor function, and social interaction. This begins with a thorough evaluation of every neurologic pathway and system involved in sensory processing.

We begin with specific diagnostic testing to measure dysfunction in the vestibular, proprioceptive, auditory, and tactile systems. We almost invariably find some level of foundational neurological deficit in one or more pathways involved in the appropriate processing of these sensory inputs.

Deficits in body awareness are a hallmark of sensory processing disorders. These involve problems in hearing, body awareness, balance and motion, and planning and ideation, as well as with touch and vision (7). Research has demonstrated that children with SPD show deficits in brain processing of sensory feedback, involving the cerebellum, parietal lobe, and prefrontal cortex (8). These deficits in somatosensory feedback promote increased dependence on visual and spatial processing as well as on attention and memory for motor learning (7).

This impairment in body awareness manifests as developmental coordination disorders, but also makes these individuals very visually dependent. They are forced to rely on vision to make sense of where they exist in space, and as such any impairment in eye movement or visual processing can lead to a marked increase in symptoms. It is common for these children to demonstrate meltdowns in visually complicated environments. Oculomotor rehabilitation has been shown to be very helpful for these children (9).

As with all neurodevelopmental disorders, it is extremely common for us to see retained primitive reflexes in SPD children. Primitive reflexes are a series of motor patterns we all have ingrained in our spinal cords and brainstems. These reflexes use sensory input to drive motor responses that help the brain develop. The parts of the brain that are stimulated by these reflexes function as integration nodes that facilitate proper connectivity within the developing brain. These reflexes are normal when present in infants, but by roughly 10 months of age most primitive reflexes should be fully extinguished. If something goes wrong to interrupt the integration of primitive reflexes, sensory processing disorder is commonly the result (10).

We examine all of our neurodevelopmentally challenged patients for retained primitive reflexes, and employ specific repatterning exercises to help integrate any retained reflexes and restore appropriate connectivity between brain regions. We couple these exercises with unique and precise sensory stimulation to promote rapid neurodevelopmental gains.

The communication between the sensory and motor systems is impaired in sensory processing disorders. Motor coordination is almost inevitably dysfunctional on some level in SPD. An essential component of motor coordination is motor timing, which is frequently compromised in these individuals.

Rhythmic motor entrainment therapy has been shown to be very helpful for these children. We use a computerized device called the Interactive Metronome to rehabilitate these pathways, which has been demonstrated to be very effective (11). We couple this with therapy protocols such as the NeuroSenorimotor Integrator system to help restore motor timing, motor control, sensory integration, executive function, and behavioral control.

We employ a wide variety of different therapies in the treatment of sensory integration disorders. Every therapy or modality is well validated in current neuroscience research.

Our therapies may include eye movement strategies to improve attention and focus (16), or motor entrainment therapies to improve coordination and cognition (17). In older individuals they may involve specific forms of electrical stimulation (18), or transcranial magnetic stimulation to facilitate improvement in motor learning and coordination (19). They may involve dietary modulation and supplementation strategies (20), or hyperbaric oxygen therapy to reduce repetitive, self-stimulatory and stereotypical behaviors, and impairments in communication, sensory perception, and social interaction (21). They may involve photobiomodulation strategies to reduce irritability and other associated symptoms and behaviors (22). They may involve vestibular rehabilitation exercises to improve balance and postural control (23), or even exercises performed in a virtual reality environment to improve social interaction and cognition (24). They may also involve probiotics and other forms of supplementation to address the inflammatory and dysbiotic aspects of your child’s condition (25).

Every NeuroRescue Program is different. It is impossible to take a cookie-cutter approach to the treatment of a condition as complex as a sensory integration disorder. No two brains are alike, and nor are any of our NeuroRescue Programs.

How Does the NeuroRescue Program Work?

We design your child’s unique NeuroRescue Program to be among the most comprehensive diagnostic and therapeutic protocols available today. We create individual NeuroRescue Programs based on a comprehensive analysis of every relevant neurological system and pathway, using gold-standard, cutting edge neurodiagnostic testing technologies and examination procedures and state-of-the-art therapies.

Our examination allows us to identify the areas and pathways of the brain that are involved in your child’s condition. We do this by precisely quantifying the function of their visual, vestibular, and proprioceptive systems through computerized analysis of eye movements, inner ear reflexes, and balance in a host of different sensory conditions.

We employ technologies including Videooculography and Saccadometry to measure several classes of eye movements. We use Video Head Impulse Testing to measure the function of their inner ear, and Computerized Dynamic Posturography to assess their balance in different sensory conditions.

We use NeuroSensoryMotor Integration testing to evaluate hand-eye coordination and cognition, and Virtualis testing to assess dynamic eye tracking and perception of vertical in a virtual reality environment.

We combine all of this with a comprehensive physical and neurological examination of sensory, motor, autonomic, and cognitive systems. We review any relevant laboratory testing, radiological imaging, and prior neurodiagnostic testing, and integrate that information with our findings.

We use this information to identify which parts of the nervous system are working properly, which systems are struggling, and the precise point at which systems fatigue.

We can then design a NeuroRescue Program that is unique and specific to your child’s brain, and theirs alone. The NeuroRescue Program works to rejuvenate and reintegrate the damaged neurons and pathways in the central and peripheral nervous systems. It works to improve energy, endurance, and functional capacity within their involved fragile systems.

We use our technologies and procedures to not only see what we need to address, but also when it is time to stop and let your child rest. We address their impaired neurological function from multiple angles of therapy, and provide metabolic support to improve neurological recovery.

The NeuroRescue Program allows us to rebuild integration between pathways to maximize their efficiency and endurance. And by focusing on the integration of systems, we can do more than just get pathways working better, we can get them working together again. This gives us our best opportunity to help your child live a healthy, vibrant, and fulfilling life.

Your Next Best Step:

Living with a sensory integration disorder can be challenging, but there is hope for recovery and remission. To see if the NeuroRescue Program is right for you, contact one of our patient care coordinators to schedule your Discovery Day.

And remember, it’s never too late to start getting better.