التكامل الحسيSensory Integration
Introduction:
Sensory integration is a process by which the brain processes and integrates sensory information coming from different senses. This process helps the child interact with his environment effectively and appropriately to his needs, as there are some children who suffer from a disorder in the sensory integration process, which means that they cannot process sensory information correctly or organize their response to it. This may lead to difficulties in attention, concentration, learning, communication, behavior, and social interaction with others, forcing children to resort to repetitive compensatory movements and stereotypical behaviors.
What is meant by sensory integration:
It is the process of organizing the inputs (stimuli) coming from our bodies and environment that the brain receives through the senses (hearing / sight / touch and contact / taste / vestibular / smell / deep and muscle sense / visceral sense)
to process, interpret, give meaning to, integrate information, benefit from it, and form perceptions, cognitive complexes, concepts, and experiences, so the individual learns and behaves naturally.
Meaning that just as food nourishes the body after digestion, sensory integration processes and encodes stimuli to nourish the brain. Therefore, sensory stimuli must be organized, translated and integrated, and then the brain integrates them together and sensory integration occurs. Here, the process of perception occurs, concepts and experiences are formed, and a person can learn from the sensory experiences he goes through. ?? Where did the Sensory Integration Theory come from?
The first to establish the theory of sensory neuro-integration is the American occupational therapist (Anna Jane Ayres), who is a specialist in occupational therapy and is famous for interpreting and publishing the theory of sensory integration and defending the rights of people with special needs. She talked about this theory in 1972 and published her first book in 1987. She had a famous saying, which is:
(Sensory integration represents food for the mind, just as food represents food for the body).
Jane Ayres defined sensory integration as:
The nervous process that organizes the sensations in the human body and its environment and enables it to use them effectively in the surrounding environment.
How does sensory integration happen:
Williamson and Anzalone (1996) identified five interrelated elements that help understand how sensory integration happens. These elements are:
Sensory Registration
Orientation
Interpretation
Organization of Response
Execution of Response
1-Sensory Registration:
Sensory registration initially occurs when we become aware of a sensory event, "something touches me" or "I hear something." We may not be aware of certain types of sensory input until we reach a sensory threshold or intensity. The sensory threshold level varies throughout the day based on your previous sensory and emotional experiences, as well as whether you are alert or stressed and what you expect.
We may not be able to hear a mosquito buzzing through a window, but when it flies over your head, you will definitely know that you hear something. You have heard that sound before, and you expect the mosquito to land on you, bite you, and make you itch for days.
When you are hypervigilant or stressed, your sensory threshold is lower. You may register inputs (sensory stimuli) that you have previously ignored. If you are awakened in the night by a loud bang, you may become hypervigilant and hyper-alert, and you may notice or “register” creaking stairs and furniture that have never caught your attention before.
Examples of increased response:
Annoyance when hearing certain sounds
Sensitivity to light
Discomfort from certain textures
Aversion to certain smells and foods
Irrational fear of heights and movement
Repeated startle reactions
Examples of decreased response:
Not paying attention to sudden or loud sounds
Not recognizing painful bruises or wounds, etc.
Not recognizing the presence of food on the face
Loss of attention to the surrounding environment, people, or things
Does not feel dizzy when spinning excessively
Delayed responses or reactions
2-Orientation:
Sensory orientation allows us to draw attention to new incoming sensory information "Something is touching my arm" or "I hear something buzzing around my head" We can determine which sensory information needs our attention and which information can be ignored. This is what happens through sensory modulation and the functions of inhibition and facilitation.
3- Interpretation:
Our brains can interpret sensory information and classify its type. The ability to interpret sensory information allows us to determine how to respond and whether the information carries a threat or not. Thus, we can compare new sensory experiences with old experiences. Our language, memory, and emotional centers participate in the interpretation process. "I smell something, it smells like bread, I like this smell, it makes me happy, the smell reminds me of my childhood days, I can tell where the smell is coming from."
Your nervous system is also programmed to respond to sensory inputs to protect you from harm and direct the appropriate response.
Examples of sensory defensive behaviors:
Touch or tactile defensiveness (avoiding touch by others – dislike of wet toys – irritation from certain clothes and signs)
Auditory defensiveness (hypersensitivity to loud and unexpected sounds or to specific sounds – fear of appliances such as vacuums or hair dryers).
Visual defensiveness (hypersensitivity to strong and different types of light – avoiding or narrowing the eyes to sunlight – avoiding eye contact with people – aversion to glare from television or computers).
Gravitational instability (fear and aversion to movement and changes in body position – discomfort from changes in head positions – fear of lifting the feet off the ground).
Oral defensiveness is a combination of increased sensitivity to touch, smell and taste and includes (aversion to certain types of food textures – and difficulty brushing teeth).
Other - (A person may be hypersensitive to smells and tastes - Perceiving the smells of people and things - Some children may vomit due to certain smells - Recognizing certain brands of food by tasting them).
4-Response regulation:
Our brains decide whether a response to a specific sensory message is necessary or not and accordingly choose the type of response. Sensory messages are divided into several types, including physical, emotional and cognitive.
5-Response implementation:
Implementing the response, whether motor, cognitive or emotional, resulting from the sensory message is the final stage of the sensory integration process. If the response is motor, this action generates a new sensory experience as the brain receives information about the body's movement and the process begins again.
The ability to implement the appropriate response depends on the previous elements and sufficient motor planning capabilities to be able to perform the targeted activities.
When does sensory integration begin?? And when does it end?? :
The individual's sensory integration begins at the fetal stage, where the senses develop early in the pregnancy stages. The fetus's brain senses the movement of the mother's body, and then his senses interact with each other and with the stimuli he is exposed to until the end of his life (death).
The prevalence of Sensory Processing Disorder (SPD)
10-12% within normal development
30% in people with various difficulties
40-60% in children with ADHD
70%, with children diagnosed with autism constituting the highest percentage
Stages of Sensory Integration
Jane Ayres has identified four stages of sensory integration development in children, which are:
The first stage
In the first year of a child's life, tactile and vestibular sensations, as well as muscles and joints, are integrated in children, and thus a connection occurs between the infant and his mother, as the three senses are integrated in the first year (tactile/muscular/vestibular). They are the first three senses that work through one basic thing, which is the relationship between the child and his mother, as she is the one who develops those three senses for her child.
The second stage:
It usually occurs in the second year of the child's life, where there is a basic rule, which is emotional stability and physical awareness (the internal mental map), which paves the way for motor development and increasing use of the body against gravity.
The third stage:
It occurs in the third year of the child's life, where speech and language depend on the integration of the sense of hearing with the vestibular sensations, muscle and joint sensations, touch and sight, where the auditory and vestibular sensation systems are closely linked because the child pays attention and listens to others and moves his mouth and tongue to pronounce words.
The integration of vestibular sensations and muscle and joint sensations gives the child the ability to control eye movements to follow a line of printed words, and purposeful activity becomes possible when the hands are directed by the eyes and the body begins to work as a whole.
Stage Four:
The age of four years, where sensory integration and sensory integration should have developed well in the child, and with the rule of joint work between the brain and the body, each of them can develop its specialization, so hand control is necessary to control fine movements and eye control leads to reading from right to left or from left to right, and there are other aspects of specialization in the two halves of the brain to organize and perform its tasks more effectively in academic learning and in other aspects of continuous growth and development.
Symptoms of sensory processing disorder:
Poor attention and distraction.
Avoid looking or eye contact with people.
Weak ability to retrieve information and events.
Weak ability to organize body movement in a timely manner.
Inability to distinguish one sound from another or one symbol from another.
Mental confusion.
Weak ability to express desires clearly.
Extreme annoyance in crowded places.
Extreme annoyance with some sounds.
Excessive performance of movements.
Impulsivity.
Hyperactivity or excessive laziness.
Weak oral movements such as chewing or swallowing.
Weak bilateral coordination (using both sides of the body together).
Inaccuracy in performing fine skills (drawing/cutting/disassembling/assembling).
Slow response to instructions and commands.
Difficulty receiving information or stimuli.
Inability to coordinate the process of speaking, whether quickly or slowly.
Inability to determine places and directions.
Inability to perceive time and time.
Walking on tiptoes.
Discomfort when wearing clothes.
Intolerance and rejection of foods (solid/mixed/spicy).
Discomfort when (touching/cutting/washing/combing) hair.
Discomfort when looking at bright lights.
Intolerance to touching things with different textures.
Selective eating.
Language delay.
Inability to specialize motor.
The goal of sensory integration:
Relieve the child's suffering and achieve sensory balance.
Open sensory channels so that the child can communicate with the world around him.
Increase body sense and physical awareness.
Activate and stimulate nerve cells.
Achieve calm and relaxation for the child.
Sensory satisfaction of the child's senses.
Activate the child's sensory cells.
Achieve sensory balance.
Communicate and interact with the child's surrounding environment in an organized and more effective way.
Introduce stimuli and output responses.
References:
1- Duaa Abdel Latif Othman (2015). Developing a multi-source program based on the theory of sensory integration to develop auditory and visual processing skills and reduce repetitive movements and stereotypical behavior in autistic children. PhD thesis. Department of Educational Technology. Faculty of Education. Alexandria University.
2- Ellen Yak, Paula Aquila, Shirley Sutton. Translated by: Mounir Zakaria. (2017) Building Bridges Through Sensory Integration, Riyadh: Fahad National Library Catalog.
3-Williamson, G. & Anzalone, M. (2001). Sensory Integration and Self-Regulation in Infants and Toddlers: Helping Very Young Children Interact with Their Environment. Arlington: Zero to Three.
4-Ayers, A. J. (1998). Sensory integration and the child: understanding hidden sensory challenges, Los Angeles, CA: WPS.