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Understanding Sensory Integration Dysfunction Disorder

Julia Tagliere
The sensory integration dysfunction disorder is a complex disorder seen mainly in young children. A better understanding of this condition can help parents to cope with its bewildering and frustrating effects.
If you're reading this, chances are that you either suspect that your child has a sensory disorder of some type, or that your child has already received a diagnosis of Sensory Integration Dysfunction Disorder, and you are desperate for more information.
Educating yourself about this complex disorder is the best way for you and your family to learn to cope with its bewildering and frustrating effects.

Understanding the definition.

Making more sense of Sensory Integration Dysfunction Disorder (SIDD) begins with understanding the following definition: A person with SIDD has difficulty with the processing of sensory input. All the information we need, in order to function in the world, comes to us through our sensory systems.
Most of us learned about the five basic senses as children (sight, hearing, smell, taste, and touch), but there are also sensory systems that give us information about movement, gravity, and where or how our bodies are positioned at any given moment.
If there is a problem with the delivery of any of those sensory messages to a child's brain, he is unable to understand the message and may respond to that sensory experience in an unexpected or completely inappropriate way, either seeking ways to avoid that sensory experience at all costs, or pursuing a particular sensory experience to an obsessive degree.
If a child's sensory systems are all functioning properly, he is able to process all the sensory stimuli he encounters and respond in an appropriate way: for example, his mother may spray on a light perfume, and he may respond by saying it smells nice or perhaps that he doesn't like it.
For a child with a sensory disorder, there is what amounts to a neurological 'short circuit' which throws the child's perception of a given sensory stimulus completely out of proportion.
For this child, what seems to his mother a pleasant and subtle hint of fragrance may be overpowering to him to the point of causing nausea, anxiety, tantrums, or even hysteria.
However, sensory disorders do not merely affect a child's sense of smell. A child diagnosed with SIDD frequently experiences difficulties in one or more of the sensory areas, occasionally experiencing a greater sensitivity in one system than in the others.

What does SIDD look like?

The symptoms of sensory integrative function disorder vary in intensity and type, depending on which particular sensory system is being affected.
Children may be highly sensitive to sounds, smells, or touch; on the other hand, they may be highly under-reactive to the stimuli, seeking out more intense experiences, such as wild spinning or crashing into things, to try to satisfy their craving for that sensory input.
Some children alternate between the two extremes. More often than not, it is not solely a child's being hyper-sensitive to smells and sounds or his crashing into everything that first signals the existence of a problem.
There are some general symptoms that parents, teachers, and even caregivers observe that often lead a parent to ask for a referral:
  • Violent, inexplicable tantrums. It is difficult for children, especially younger children, to put into words what has set them off, leaving parents bewildered as to why the child is having a tantrum.
  • Being easily and quickly frustrated at trying to complete routine tasks.
  • Fine or gross motor skills difficulties, such as the child being unable to dress himself at an appropriate age, or being unable to run, hop, or skip without bumping into things.
  • Difficulties with completing puzzles or matching objects, or losing his place while reading.
  • Being easily distracted or having a very short attention span.
This is a very short listing of possible symptoms that might cause a parent or teacher to seek help; there are other possible symptoms that can be found in the resource materials listed at the end of this article.

How is SIDD diagnosed?

Diagnosis of SIDD is done only by a skilled professional, most commonly a licensed occupational therapist with a background in sensory disorders.
Evaluating your child will include a developmental, medical, and academic (if applicable) history of your child; meetings with the parents, teachers, and other professionals who work with your child; formal observations and evaluations of your child, occasionally in multiple settings (home, school, at the therapy site); and standardized testing.
Sensory disorders can be tricky to diagnose, because many of the presenting symptoms of SIDD are also found in children with other disorders (Asperger's Sydrome, Autism, ADD/ADHD); sometimes, the sensory disorders occur in tandem with these other disorders.

Ruling out other problems.

Because SIDD does share symptoms with several other disorders, it is important for parents and pediatricians to rule out any other possible causes of the child's symptoms, especially possible physiological causes. Your pediatrician will want to check several areas first, including, but not limited to:
  • Allergies: What you think of as your child's 'tic' of constantly picking at his nose, may be a response to a seasonal allergy.
  • Sleep apnea related to tonsil/adenoid enlargement: Sleep disturbances can cause a host of problems, as we all know, but severely enlarged tonsils or adenoids can cause a child to react to different foods in a way that mimics a problem with food textures, when it's really a problem with not being able to breathe through his nose.
  • Current medications: Some allergy medications do not list hyperactivity as a side effect, but anecdotal evidence suggests there may be a link. Ask your pediatrician about doing a trial cessation to see how your child responds. It may be that your child simply needs a different medication or dosage.

How is SIDD treated?

SIDD is typically treated through occupational therapy. Depending on the severity of your child's condition, it may be as little as one hour of formal therapy a week, with half an hour of at-home therapeutic activities done by the parent each day, or it may be a more intensive regime.
Generally, the therapist will focus both on activities which will promote better sensory integration for the child, as well as on helping the child to develop appropriate behavioral responses to sensory input.
Depending on a child's specific needs, therapeutic activities may include the use of a therapy ball, swinging, use of a weighted vest, rhythmic jumping, soft brush therapy, deep tissue massage, visual tracking activities, and auditory therapy using headphones.
Therapy for SIDD usually lasts anywhere from six months to two years, depending on the severity of the child's condition.

What can I do to help my child?

There are many things that you can do to help your child:
  • First, and most importantly, be his advocate. There are expert doctors, expert therapists, expert teachers, expert everything, if you want to look hard enough for them, but there are only one or two experts on your child in particular, and those are you, his/her parents.
Be persistent, be methodical, do not give up on your quest to try to discover the answer to his problem.
  • Educate yourself. This article was just a skimming of some of the best information available, but we are learning more about this disorder every day. At the end of the article, you will find some suggested books and websites for additional information.
Use them yourself, and share them with your child's teachers, caregivers, and with his/her pediatrician both to help in obtaining a correct diagnosis, as well as to help them provide a supportive environment for your child.
  • Be firm and consistent with your child about your expectations regarding his behavior. You may now know the reason why he crashes into things, but it is up to you to establish consistent and firm guidelines within which he can still meet his sensory needs, yet still behave in an appropriate fashion.
You will not do your child any favors by letting this disorder control his life or by letting him make this disorder an excuse for poor behavior; you need to help him gain control of his responses to it.
  • Be loving and supportive with your child. Imagine what it must be like to feel as though the entire world around you were constantly attacking you; these children often respond the way they do out of fear and anxiety, out of a loss of control. Let them know that you are there to support them through it all.
  • Do the at-home therapy your therapist recommends; he or she has assigned specific at-home activities to you because your child needs them. Make the time to do them.
Any time that we deal with the central nervous system, we are talking about an enormously complex, and complicated piece of machinery, and children with SIDD have what is essentially a glitch in that machinery.
Understanding that glitch, and taking the steps to help you, your child, and those around him/her, understand it and learn to live with it day by day, can help you and your family to make more sense out of this complex disorder, and help him to respond to the world around him in a better way.
For more information, two of the best books about children and SIDD with which to start are The Out-of-Sync Child, by Carol Stock Kranowitz, as well as her companion work, The Out-of-Sync Child Has Fun.
Sources: 'An Introduction to Sensory Integration', by Nan Arkwright, MOT, OTR; 'Sensory Integrative Dysfunction in Young Children', by Linda C. Stephens, MS, OTR/L, FAOTA.