He Sensory integration disorder , Also known as sensory regulation disorder of processing or sensory processing disorder, and It is a problem of neurological origin that causes difficulties in the processing of the information coming from the different sensorial organs, the Vestibular system (Perceiving the movement) and the proprioception or consciousness of the body itself.
This disorder can occur either when the brain does not sense sensory signals or when it does not respond well to them (STAR Institute, 2016). He nervous system Handles the information irregularly, giving rise to anxiety And confusion in the affected.
It is a problem that occurs between 5 and 16% of children of school age; And affects endless activities of people's daily lives. It may appear in both children and adults, and is a diagnosis that is increasing; Despite not being adequately recognized.
There are many therapies to be able to improve it, however, this condition has no cure.
Characteristics of sensory integration
These are processes of neurological organization that aims to give an adequate response to the stimuli that arrive through the senses and their processing and subsequent interpretation by the sensory centers of the brain. In addition, to respond to the environment, the senses help us to survive, learn and enjoy.
Anna Jean Ayres
For sensory integration, brain Must collect isolated information from each sensory organ that is processed in different parts of the nervous system.
However, the connections between the brain areas, in addition to certain areas that are responsible for integration, will make us perceive globally; Combining the best data (Koleva, Efe, Atasoy & Kostova, 2015).
The Theory of Sensory Integration and its therapy was developed in 1960 by a psychologist and American neuroscientist named Jean Ayres.
What pathologies do you associate with?
It may appear in conjunction with other neurological problems such as Attention deficit disorder and hyperactivity (ADHD), autism , dyslexia , Developmental dyspraxia, Tourette syndrome Or delays in speech (Goldstein & Morewitz, 2011).
Types
It has been classified by Case-Smith (2005) and Miller et al. (2007) in 3 diagnostic groups:
Type 1: Sensory modulation disorder
This entails that those affected do not respond to sensory stimulation have a reaction below normal and even carry out behaviors to try to stimulate their senses. That is, your brain can not classify or define the information that comes from the senses in intensity, duration, complexity or novelty.
In this way, they are not able to adapt their behavior to existing sensations.
Those who present it often react with fear and negative behaviors, are self-absorbed, being self-stimulation behaviors such as swaying or beating themselves. All this gives them problems in relating to others.
Within this type there may be several subcategories. For example, there are children who may have a fault in a component of sensory modulation, such as the sensory register. Problems in this phase of perception would affect the attention to sensory stimuli, which causes them to fail to capture information that healthy individuals do not perceive.
Another type of alteration can be gravitational insecurity, which consists of an abnormal response of anxiety or fear when changing the position of the head. This change involves the sensory systems Proprioceptive And vestibular.
Type 2: Motor sensory disorder
The characteristic of this subtype is that they present disorganized movements and motor clumsiness, since they can not process sensory information normally.
Type 3: Sensorial discrimination
The problem in this case is centered in the differentiation of the information that arrives from the senses, which gives rise to difficulties as Dyspraxia Or problems in postural control. Children who have this deficit often have low school performance.
Causes
The exact causes are not known and are still being studied. Research hitherto hints that the sensory integration disorder has an important hereditary component.
However, complications can also influence pregnancy or childbirth, or factors of the environment; Such as having received little or no Sensory deprivation in his infancy.
It is also associated with this condition being born with a lower than normal weight or ahead of time.
All this is linked to abnormalities in brain functioning. Scientists from the University of California at San Francisco This studio , Which indicates the existence of alterations in the microstructure of the White substance of the brain In children with this problem.
More specifically, a reduction in the white matter of regions such as the back of the hard body , The inner capsule and the semioval center (called the white matter of this zone"corona radiata") and posterior thalamic radiations (Owen et al., 2013).
Manifestations
In addition, affected individuals vary in a wide range of dysfunction in sensory processing, which encompasses different levels of hyposensitivity and hypersensitivity to stimuli.
The first is that the information of the senses does not come to be considered, as if it were not grasped or grasped very slightly (for example, it can touch something very hot without burning); While the second implies the opposite: even slight contact with clothes, for example, can be perceived with dread.
Sensory integration disorder can also vary in the affected senses, presenting some difficulties in a single sensory modality, others in several and even others in all (Goldstein & Morewitz, 2011).
Others, however, are true seekers of emotions always aware of how to stimulate their senses and love to capture intense information, but in a pathological way. Caution is required because it is often misdiagnosed as ADHD (STAR Institute, 2016).
In adults it is manifested as problems to follow a routine or to keep a job, besides difficulties for social relations and leisure; Although it can also occur depression And isolation.
Here are some signs of this disorder as an example:
- Feeling annoyed by unexpected touch contact, however slight. Especially if it is touched in certain parts of the body or embraced.
- Discomfort when placing certain garments, fabrics, rubbing with labels... or accessories that are tight to the skin.
- Special disgust for staining, or, on the contrary, rejecting personal hygiene activities. Rather, they often manifest a strong avoidance towards certain contact such as water, toothbrush or something that stains their skin as food or paint.
- Great activity, or, can be extremely sedentary.
- Hypersensitivity to sounds, either by their frequency or volume. Or discomfort when meeting in noisy environments or hearing unfamiliar voices or in another language.
- Excessively low or high pain threshold.
- Great discomfort when picking up intense smells or very spicy food.
- As for the vision, rubs their eyes or flashes assiduously, takes longer to learn to read, bother to look at moving or bright objects, avoid visual patterns or lights, have problems to discriminate between colors, shapes or sizes, etc.
- Delay in the fine motor, that is the one that allows to color, to write or to button a button.
- Deficits in gross motor skills, which influence walking, climbing stairs or running.
- Clumsy and chaotic movements.
- Muscle tone too high or low.
- Oral problems such as frequent drooling or nausea, hypersensitivity in the mouth, delayed speech, panic to try new foods, etc.
- Difficulties in relationships with others, being isolated.
- Discomforts related to the vestibular system such as being moved by another person, riding in an elevator or a means of transport, activities that require changing the head position, head-down, jump, ride on a rocker, etc.
Diagnosis
There are many difficulties at present to diagnose this condition, since many health professionals do not know how to recognize the sensorial deficits of this type and go ahead to classify it as another different disorder that can present similar symptoms.
That is why there are other experts who are promulgating this condition and demanding that it be recognized and investigated more deeply.
One way to diagnose sensory integration disorder is by completing lists of behaviors such as Biel & Peske's Sensory Checklist (2005) or Winnie Dunn's Sensory Processing Disorder Checklist (2014), which lists behaviors and They should be answered if it is something that happens frequently or not or is something that the person avoids, seeks, both, or is neutral.
Treatment
The treatment depends on the characteristics of the child, but does not have a cure, but consists of improving the life of the affected person as much as possible within their problem, and can obtain very good results if treated properly.
Sensory Integration Therapy
It can be useful for many of the affected and basically consists of exposing in a structured and repetitive way to different sensorial stimuli. It can be done as a game and its objective is that, through the brain plasticity , The mechanisms are changing and gradually integrating more information.
Make you feel better
The most common is to alleviate their discomfort with different techniques. Once detected the things that are unpleasant for the person, they try to avoid these situations, to diminish them, or to try to face them in a gradual way.
For example, a child with this problem might detest certain clothing or fabric type, therefore, could stop using that garment.
Another example would be a child who can not stand brushing his teeth because of the hypersensitivity of his gums. One thing that can be done against this is to get accustomed to using the toothbrush, using a rubber thimble or a wipe first. In pharmacies there are several products that can be useful for massaging the gums or mouth.
Model DIR
Stanley Greenspan and Serena Wieder's Developmental, Individual-based model is an intervention program for children with sensory integration disorders, special needs or any type of autism.
It focuses on developing or building capacities so that the child learns to function properly in life: how to pay attention, how to relate to others, how to communicate what he needs and achieve academic goals.
"I" Refers to individual differences, arguing that we must know how to perceive things, which is different in each child (search for sensations, hypersensitivity or hyposensitivity...)
While R Talks about the learning links with others, that adjust to their individual differences so that they can achieve it.
This technique uses the emotions and interests of the child to create learning interactions that start the different parts of the brain to work together. It also sets challenges to gradually become more complicated for children, such as environmental changes.
Usually includes exercises for problem-solving training.
To achieve the goals, it often takes the joint work of several professionals, combining therapy for language or for food, occupational therapy, Neuropsychological rehabilitation , Educational programs and even biomedical interventions.
References
- About SPD. (S.f.). Retrieved on July 20, 2016, from STAR Institute for Sensory Processing Disorder
- Dunn, W. (s.f.). Sensory Processing Disorder Checklist. Retrieved on July 20, 2016, from SPD parent zone
- Goldstein, M.L., Morewitz, S. (2011). Sensory Integration Dysfunction. In Chronic Disorders in Children and Adolescents. (Pp. 125-130). New York: Springer Science & Business Media.
- Koleva I., Efe R., Atasoy E. & Kostova Z.B. (2015). Education in the 21st century, theory and practice, St. Kliment Ohridski University Press.
- Owen, J.P., Marco, E.J., Desai, S., Fourie, E., Harris, J., Hill, S. S., &... Mukherjee, P. (2013). Abnormal white matter microstructure in children with sensory processing disorders. Neuroimage: Clinical, 2844-853.
- Peske, B. &. (2005). Sensory Checklist. Obtained from Sensory Smarts
- What is Sensory Processing? (S.f.). Retrieved on July 20, 2016, by Sensory Smarts
- Wieder, G. &. (S.f.). What is the DIR® / Floortime ™ Model? Retrieved on July 20, 2016, by Stanley Greenspan