Autism Treatment: Understanding Sensory Integration
Understanding what can go wrong with sensory integration is crucial in Autism treatment. Here is a simple explanation.
My previous post on this topic focused on defining two senses which are often overlooked: proprioceptive and vestibular. The hope in defining those essential senses is that you as a parent or practitioner will have a more concrete view of how our systems work and what happens when something goes wrong. The next important idea to consider is the that of sensory integration: how all of these systems work together.
A basic definition of integrate, according to Webster’s Dictionary, is “to form, coordinate, or blend into a functioning or unified whole.” When you have anything with multiple parts (such as the computer or mobile device you’re on right now, for instance), all of those parts need to work together in order for the system to work. If my keypad stopped working right now it would directly impact my ability to continue writing this post. I may still be able to use my mouse or touch screen to perform certain functions on my computer, but it would be much more difficult and I would have to find a whole new way of doing things. In this instance my computer would not be integrating all of its functions properly, and that one glitch would have a tremendous impact on my desired “functioning”.
We could make endless analogies of how essential integration is in every aspect of our lives, but let’s go ahead and delve in to how this relates to the sensory system. We learned last time that we have not only 5, but 7 senses: Taste, touch, sight, sound, smell, proprioception, and vestibular. Each of these plays a vital role in our everyday functioning and survival, and when one or more of them decides not to play well together (or integrate as part of a unified whole) then everything becomes difficult.
Imagine a pizza. My favorite kind is the classic pepperoni, preferably from a local joint called Rock Creek Pizza Co. I’m telling you, their sauce is amazing and goes right to the edge, and the pepperoni has the perfect slightly toasted crunch to it. Heaven. So why is it such a pleasing experience for me? It’s because all of my senses work together to make it a beautifully integrated experience.
The first thing I notice when I walk into Rock Creek Pizza Co is the smell. Ah, the smell of pizza coming right out of the oven, nothing compares! I even love the smell of pizza boxes, mostly because of what’s inside Visually, this pizza is perfect. I love the interplay of the red sauce, white cheese, a little crust, and those toasted pepperonis. For the tactile sense (or touch), I feel the somewhat sharp edge of crust when I pick up my piece, but also notice the slight tenderness in which it bends in my hand before it reaches my mouth. And then of course comes the taste. Like I said, it’s one of the best pizzas out there in my opinion, with an unrivaled sauce and perfect interplay of flavor. Then I hear the sound of biting through the crunchy pepperoni and crust, not to mention the sounds of people in the kitchen and the crackling fire. My proprioception allows me to accurately pick up my slice and bring it to my mouth, and my vestibular sense keeps me feeling grounded and comfortable in my chair, thank goodness.
Although we take it for granted, all of these senses are constantly working together to make a whole experience out of everything we do. In other words, they are integrating to make sense and meaning out of the day to day moments. If one of my senses in the pizza example wasn’t working correctly (say my sense of smell was picking up on fish instead of pizza, ugh), then the entire experience would be tainted. Who wants to smell fish when they’re eating pizza? (Unless of course you’re one of those who digs the anchovies. If so, more power to you!).
When you think about how much sensory processing goes into one little moment (like eating a piece of pizza), it’s no wonder that some of these processes can become disrupted and not work properly. And as we’ve seen, if one sense is “out of sync” so to speak, then it has a dramatic impact on the entire experience. For kids and adults with sensory integration problems, this is a day to day reality. And a frustrating one at that.
What can go wrong…
One way that the sensory might “go wrong” is that all of the senses are intact, but they are not processed simultaneously as they should be. Have you ever watched a movie and had the sound and audio get out of sync with each other? I was on a flight to Singapore once when my movie kept doing that over and over and I either had to close my eyes or restart the movie. The lack of synchronization was frustrating for me, so I had to deprive my sense of sight in order to manage the sensory input, or try to make it right.
Now imagine having that lack of synchronization (or integration) in everyday life! Perhaps auditory input arrives half of a second too late, or maybe one ear processes info too late while the other is still intact. As you can imagine, this would easily result in consistently confusing and overwhelming noise. The result may be that a child covers his or her ears to block out sounds, deprives another sense to improve focus (as I did with closing my eyes during the movie), or perhaps they simply do not respond to verbal information because it does not make sense to them. I see all of these responses in my clients, and while it is not always clear what the source of the problem is, it is clear that there is something going on with the sensory system.
It is essential to understand that all of these responses are valid. Most often they are the best way the child has found to make sense of what is otherwise a very confusing world for them. I am a strong believer in not trying to “force” certain responses (such as eye contact) if the child is physically unable to process more than one sense at a time. For some students, having to look someone in the eye takes over their sensory processes and while doing so they may be unable to process any other sensory information (such as aural information). So asking a child to look at me and follow my directions simultaneously may be far more than their system is able to handle. Being aware of this as a parent and/or therapist is essential in diminishing frustration when asking a child to do something that is physiologically beyond their reach.
We could continue to go into depth on how important sensory integration is for the overall functioning of each of us, but we’ll stop here for now. Hopefully this has given you a better picture of how important integration is and why it’s such a big deal if one part is not working in tandem with the others. We all need our systems to “play well together” in order to feel comfortable in our own skin.
In future posts I will talk more about this topic and how therapy (especially music therapy) can help children be able to better integrate their systems. Until then!