SID therapy

Sensory Integration therapy, taught or performed by Occupational Therapists, is probably one of the more gentle treatments, especially for tactile sensitivity and motor problems, and may have beneficial effects on other sensitivities and difficulties too (anecdotal evidence only).

SID therapy may include aids such as prism lenses, weighted vests, ball-blankets, as well as treatments such as auditory integration training, sensory stimulation and applying deep pressure on the body, The Wilbarger Protocol For Sensory Defensiveness a.k.a. “brushing”.

“I am a huge SI/OT advocate!  I even brush myself sometimes, though it is difficult to do joint compressions properly and I can’t reach my back. Goodness, I would love to brush my back!

“To those here who don’t know what brushing is – it actually has nothing to do with brushing your skin!  It is where you take a special brush and provide deep pressure (like a massage) evenly across the arms, hands, legs, feet and back and then provide proprioceptive input (joint compressions) to all the large joints of the body.  It was found that using the brush to do the massage-like deep pressure is better than a regular massage. It desensitizes the tactile system, sensitizes the proprioceptive system and regulates the nervous system. It is very important to know that one should never try this without being well trained by someone who knows about SI.  Brushing the wrong way can do damage.  Also, never brush a person’s stomach or chest – it can interfere with the major organ’s functions.

“Brushing was like a miracle with my kids, especially Luke (HFA).  He was so completely overloaded by tactile defensiveness from day one!  At age 2, when I first started studying SI, he wasn’t speaking except echoing TV while it was on, and had spent a year hopping on his toes instead of walking – never sat down, just spent all his waking time hopping on his toes flapping his hands… constantly… I’d say 98% of his day was spent like that.  He needed the hopping and flapping to figure out where his limbs were, and couldn’t stand having anything touching him.

“When I first read about SI, I knew this was the main problem for all three of my kids… I went all out trying to get the kids evals for OT.  Finally it came through and I was trained to brush on the first OT visit.  OMG!  Luke’s response was absolutely amazing!  He laid still on the floor while the OT brushed him (a first) – he loved it.  He got up off the floor and walked, flat footed.  He was calm and not in a frenzied state anymore.  By the end of the day, he was using words… was adding words every day.  That night, he came up to me and sat on my lap!  Before that, any human contact was too painful for him.  Within a week, he had an age-typical vocabulary!  I would always know when it was time to brush him again (the effects wear off in about 1.5 – 2 hours) by watching his feet – if he was up on his toes I’d know it was time.  He would bring me the brush when he felt he needed it.  He started playing with toys… it was amazing!”

Wendi, Aspie mother of spectrum triplets from USA

“I have been brushing Austin since he was 18 months old and boy is it a tremendous help. I think this should become one of the most basic occupational therapy techniques, however not many people have heard of it.”

Jean, non-autistic mother of Aspie son

Just be aware that while it may help, this treatment is not going to change someone’s basic personality, temperament or neurological type.

– Naturally hyperactive, sensory seeking children will still be energetic and intense, only perhaps better able to control their bodies and modulate or focus their energy.

– Naturally introvert, sensitive children will still be predominately introvert and more delicate than the average child, only perhaps less extremely hypersensitive.

Both might require very different approaches relating to their type:

– The best way to support hypo-sensitive, sensory-seeking children, studends, family members, employees etc., besides trying Sensory Integration therapy, is to arrange things to enable them be as tactile and mobile and stimulated as they need (as far as practically possible, taking other people’s needs into consideration as well, of course) if they seem to crave sensory imput.

– And for sensitive people to keep sensory stimuli (sound, light, smell, clutter etc) to a minimum, letting them eat and dress as they prefer (within healthy and reasonable limits) and refrain from touching or hugging until body contact is initiated by the person him/herself. As having delicate senses can also be ecstatically joyous and a source of creative inspiration, some of us are quite happy being sensitive and only wish to be shown some degree of consideration.

“Why is it not okay for a person to be delicate?  Why do we prize delicate objects, but not delicate people?  Why do we recognize that a delicate silk shirt must not be treated the same as a pair of jeans but do not recognize that a delicate child has special care instructions?

“If we accidently put our delicates through the regular wash and they fall apart we admit it is our fault the clothing is damaged.  When we give delicate people the same treatment as others and they fall apart we criticize the delicate person for not being tough enough.”

Ilah, probable Aspie from USA

Also found some info on Wikipedias Sensory integration therapy page which appears to be written by someone who understands the subject well, possibly an OT or a person with SID. It has been challenged due to lack of references, but I find the guidlines excellent and will quote them here in case they are removed.

Hypothesis

Children with sensory integration dysfunction frequently experience problems with their sense of touch, smell, hearing, taste and/or sight. Along with this will often be difficulties in movement, coordination and sensing where one’s body is in a given space. This is a common disorder for individuals with neurological conditions such as an autism spectrum disorder.

Individuals may be overly sensitive to certain textures, sounds, smells and tastes, while wearing certain fabrics, tasting certain foods, or normal everyday sounds may cause discomfort. The opposite is also possible – for example a child with an autism spectrum disorder may feel very little pain or actually enjoy sensations that neurotypical children would dislike: strong smells, intense cold or unpleasant tastes.

The brain seems unable to balance the senses appropriately in cases of Sensory Integration Dysfunction. The brain may not be able to filter out background stimuli yet admit what is important, so the individual may have to deal with overwhelming amounts of sensory input day and night.

Sensory integration therapy with children

This involves occupational therapy with the child placed in a room specifically designed to stimulate and challenge all of the senses. During the session, the therapist works closely with the child to encourage movement within the room. The therapy is driven by four main principles:

• Just Right Challenge (the child must be able to meet the challenges through playful activities)

• Adaptive Response (the child adapts behavior to meet the challenges presented)

• Active Engagement (the child will want to participate because the activities are fun)

• Child-directed (the child’s preferred activities are used in the session).

Sensory Integration therapy is careful to not provide children with more sensory stimulation than they can cope with. The occupational therapist looks for signs of distress. Children with lower sensitivity (hyposensitivity) may be exposed to strong sensations, while children with heightened sensitivity (hypersensitivity) may be exposed to quieter activities. Treats and rewards may be used to encourage children to tolerate activities they would normally avoid. For more information on Sensory Integration Dysfunction, see the Sensory Problems fact sheet.

Guidelines for children with heightened sensitivity

Parents can find it very distressing if their child rejects hugs, cuddles and other demonstrations of affection. This can be interpreted as a personal rejection when it is a discomfort with unpleasant touch. These guidelines may help in more appropriate touch with autistic children who have hypersensitivity:

• The child finds it easier to initiate hugging than receive it

• Touch is more tolerable when the child anticipates it

• Firm, unmoving touch is better than light or moving touch

• Light touch may be tolerable after firm unmoving touch

• Initial stimulation may be unpleasant but tolerated later.

Typical therapies for different senses

The sense of touch varies widely between children experiencing sensory integration dysfunction. When children enjoy the feel of sticky textures, the therapist may use materials such as glue, play dough, stickers, rubber toys and sticky tape. Other materials that can be useful for tactile sensation include water, rice, beans and sand.

Children on the autism spectrum often enjoy a sense of firm overall pressure. This can be given by wrapping them up in blankets, being squashed by pillows and firm hugs. These can form a basis for play, interaction and showing affection. Experiences that may be claustrophobic for neurotypical children may be enjoyed, such as being squashed between mattresses, and making tunnels or tents from blankets over furniture.

A therapist will be aware of a child’s response to the smell of substances, and may experiment with putting different fragrances in play dough or rice. If a child actively likes strong odors, specific toys with this feature can be used in therapy.

Sound can focused on by experimenting with talking toys, games on computers, musical instruments, squeaky toys and all sorts of music. Clapping together, rhymes, repeating phrases and tongue twisters are useful activities. Some children on the autism spectrum respond to music but not voices, in which case a melodic or “sing-song” voice may be preferred. The therapist may try different tones of voice, pitches, and gauge a child’s reaction.

Proprioceptive system

The Proprioceptive System helps children (and adults) to locate their bodies in space. Autistic children often have have poor proprioception and will need help to develop their coordination. Therapy may include playing with weights, bouncing on a trampoline or a large ball, skipping or pushing heavy objects.

Vestibular system

The Vestibular system is located in the inner ear. It responds to movement and gravity and is therefore involved with our sense of balance, coordination and eye movements. Therapy can include hanging upside down, rocking chairs, swings, spinning, rolling, somersaulting, cartwheels and dancing. All these activities involve the head moving in different ways that stimulate the vestibular system. The therapist will observe the child carefully to be sure the movement is not over stimulating.

Back and forth movement is typically less stimulating than side-to-side movement. The most stimulating movement tends to be rotational (spinning) and should be used carefully by the therapist. Ideally therapy will provide a variety of these movements. A rocking motion will usually calm a child while vigorous motions like spinning will stimulate them. Merry-go-rounds, being tossed on to cushions or jumping trampolines can be favorite activities with some children.

Learning new skills involving movement

Skills such as tying shoe laces or riding a bike can be difficult as they involve sequences of movements. Therapy to help in this area may use swimming, mazes, obstacle courses, constructional toys and building blocks.

Difficulty with using both sides of the body together can occur in some cases of sensory integration dysfunction. A therapist may encourage a child with crawling, hopscotch, skipping, playing musical instruments, playing catch and bouncing balls with both hands to help with bilateral integration.

Hand and eye coordination can be improved with activities such as hitting a ball with a bat, popping bubbles, and throwing and catching balls, beanbags and balloons.

Research on Sensory Integration Therapy Although Sensory Integration Therapy is widely used and supported by anecdotal evidence, there is as yet little research that would establish it as an evidence-based treatment.

4 Comments »

  1. If I do this on myself but do it the wrong way could I hurt myself? I heard it could hurt a child but I can’t cause damage to myself can I?

    • Ing said,

      I’m sorry, I really don’t know since we don’t have this therapy in my country, I’ve just heard good things about it online and posted the info above as a potential avenue to be investigated further.

      I suggest you ask an occupational therapist or google for someone teaching the protocol and ask them. (I’d be happy to hear from you again with their reply and your results.)

      There are also two yahoo groups with experienced and helpful members who may know:

      http://groups.yahoo.com/group/adultsid/
      http://health.groups.yahoo.com/group/spdadultshare/

  2. Karen said,

    OK–where do I get the brush? I have been dreaming about something like that to lie on, on my back, and here it is! Please let me know any suggestions of where to get this brush… or can you use a regular hairbrush with plastic bristles?

    • Ing said,

      I have no idea, dear. As I wrote above, I live in Sweden. Google?


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