Pioneering a special field of occupational therapy in the 1960s, Dr Jean Ayres defined sensory integration as the process by which our brains process information from all our senses and use it to regulate our motor activities. From the 1990s, her theories of sensory integration dysfunction, presented in works such as Sensory Integration and Learning Disorders (1973) were found to be relevant to understanding Autism as a neurological disorder that includes problems of perceptual and sensory processing and impaired motor skills. Experiences reported by autistic savants like Temple Grandin and Donna Williams have also increased our understanding. While most sensory integration therapists work with very young children, their insights and techniques can also help with teenagers and adults.
Sensory integration theory helps to explain unusual behaviours observed to some degree in most people with Autism. These include their abnormal perceptions of any sensory stimuli, and their responses expressed in “sensory defensive behaviours” as well as in high levels of anxiety and difficulties in attending to tasks, controlling impulses, tolerating frustration and balancing emotional reactions. Such behaviours are not consistent all the time or in different environments, and each individual has a unique combination. People with Autism may actually seek some sensations to block out other sensations, or they may seem unresponsive because their nervous systems “shut down” to protect them from sensory overload. People with Autism show abnormal reactions to the more commonly understood senses of sight, hearing, taste and smell, but the theory of sensory integration is explained with special reference to three systems–tactile (touch), vestibular (movement and gravity), and proprioceptive (awareness of body position).
These insights have been developed into an understanding of the movement disorders or differences of persons with Autism (and others) as a result of their unreliable sensory feedback. These may be latent at all times, but most difficult when starting, executing, continuing, stopping, combining and switching movements or actions. Problems with sensory integration help to explain the behaviours variously described as stereotypic, self-stimulatory, impulsive, perseverative and non-responsive, as well as what others see as profound difficulties with communication and relationships.
Occupational therapists who work in this field have developed detailed assessment tools to measure sensory integration dysfunction and consistent strategies to manage challenging behaviour. Successful sensory integration techniques include the Wilbarger Protocol for Sensory Defensiveness, the Sensory Diet, general calming and alerting strategies, weighted jackets, caps and blankets. In Building Bridges through Sensory Integration (3rd ed. 2015), advice is offered on adapting home, school and childcare environments and routines to be more consistent and predictable, as well as creative suggestions for activities, equipment and resources.
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