Introduction

Sensory integration is a neurological process that takes place in every human body. We all receive sensory information from our bodies and the world around us. Integration allows us to respond easily, effectively and, above all, automatically to specific sensory stimuli (Yack, Aquilla, Sutton, 2014). The founder of sensory integration theory and therapy is considered to be A. Jean Ayres, born in 1915 in California. Sensory integration is the processing of information received by the senses in order to use it in everyday life. Irregularities in this process manifest themselves in the occurrence of specific problems and are referred to as regulation disorders of sensory processing – RDSP (Borkowska, Wagh, 2010) or sensory processing disorder – SPD (Arnwine, 2016). These disorders are neurological in origin and cause the brain to misread the information provided by the senses. As a result, people with these disorders respond inappropriately to ordinary sensory experiences. Normal sensory experiences can be painful or frightening for them. Sensory difficulties often interfere with daily life and can cause problems for the whole family. For several years, there has been a steady increase in the diagnosis of such disorders in children in our country, who require specialist help and support (Borkowska, Wagh, 2010).

The senses help us to experience and respond to our surroundings, protect us and allow us to navigate the world around us. There are seven senses in the human body that work together (Arnwine, 2016): sight, hearing, touch, smell, taste, sense of balance, sense of proprioception. Sensory processing disorders arise when the brain receives erroneous sensory information and have three main subtypes: sensory modulation disorders, sensory motor disorders and sensory differentiation disorders (Borkowska, Wagh, 2010).

Sensory modulation disorders cause the body to misinterpret the type and intensity of sensory information it receives from the environment. The senses may be hypersensitive or hyposensitive to sensory information. Hypersensitivity to sensory stimulation can involve a tendency to react to some harmless sensations as if they were dangerous or painful. In contrast, people showing sensory hyposensitivity do not experience stimulation at the same intensity as those who develop typically. They may need longer or more intensive stimulation (Borkowska, Wagh, 2010). Children with sensory differentiation disorder have difficulty understanding the quality of sensory information received from the environment, and so may experience problems differentiating sounds reaching them from the environment, tastes, smells, food texture. They may not understand what they are touching if they cannot see it or give the impression of clumsy movement (Borkowska, Wagh, 2010). Children with sensory– based movement disorders (dyspraxia and postural disorders) have difficulty responding appropriately to proprioceptive and vestibular stimuli and therefore have difficulty getting their bodies to respond appropriately to their environment (Borkowska, Wagh, 2010).

The aim of this article is to present sensory integration as a neurological process and indicate its importance in everyday human functioning. The article seeks to raise awareness of sensory integration disorders, describes how sensory difficulties affect a child’s functioning in different situations, and provides recommendations for parents and carers of children with sensory integration disorders.

Sensory integration – basic principles

The creator of sensory integration, as already mentioned in the introduction, is considered to be Jean Ayres, whose theory highlights the assumption that various sensory impressions that reach humans en masse through various perceptual modalities must be combined and integrated. The author of the SI concept assumes that perceptual and motor functions were shaped in successive ontogenetic stages along with human development and are therefore a prerequisite and determining factor for a child’s ability to learn. According to her, the integrative functions of sensory perception develop in a natural sequence and every child must complete the same stage of development (Majewska, Majewski, 2016). Each new structure is, in terms of its function, to some extent dependent on previous structures, so disturbances at the basic level can affect the efficiency of higher functions created on their foundation. According to Ayres, neuronal processes in the human brain are largely linear and autonomous. “Sensory integration is the process of organising and processing sensory impressions (sensory stimuli) in order for the brain to create useful bodily response and meaningful perception, emotional response and thinking. Sensory integration is the process of segregating, organising and combining all sensory impressions reaching a person into a complete and comprehensive brain function” (Ayres, 1988). Sensory integration is a neurological process that involves all areas of perception and motor skills and enables an appropriate response to stimuli coming from inside the body and from the environment. An undisturbed sensory integration process is a prerequisite for any meaningful and planned activity (Majewska, Majewski, 2016).

J. Ayres (1988) distinguishes four levels of sensory integration:

Sensory integration dysfunctions have greater effects the lower the developmental level at which the disorder occurs. Dysfunctions at the first level are associated with disturbances in the child’s confidence in gravity and position, movements are often stiff and disharmonious. As a result of dysfunctions occurring at the second level, body perception and the length of concentration time can pose difficulties. Children have difficulty focusing their attention and directing activities towards a specific goal. A sensory integration disorder can be compared to a digestive disorder in the digestive tract or traffic chaos. The brain does not fulfil its natural causative function, it cannot organize the inflow of sensory stimuli, process them and determine an adequate course of action (Majewska, Majewski, 2016).

Sensory integration therapy involves stimulating the sensory organs and eliciting an adaptive response according to the neurological needs of the individual child. Therapy usually involves movements of the entire body, including stimulation of the balance system, self-perception and the sense of touch. The aim of therapy is to improve processing in the brain and to organise sensations correctly (Ayres, 1988). Sensory integration therapy includes the integration of basic postural responses and, depending on the needs of the individual child: surface and deep sensation, vestibular activities, praxis, right–left differentiation and spatial orientation. It leads to improvements in large and small motor skills, visual and auditory abilities, concentration and attention time (Drabarek, Kloze, Szydłowska-Grajcar, 2010). Therapy of sensory integration disorders can be carried out by appropriately trained therapists in specialised centres and clinics, but invaluable results can be achieved in ordinary, everyday life by providing the child with the right quantity and quality of stimuli and paying attention to them and their importance (Borkowska, Wagh, 2010). Properly performed everyday activities and properly directed child’s play or playing with a child are the most appropriate and simplest form of SI therapy.

Identification of sensory integration problems

Sensory integration, or the use of sensory information to function, is a process that begins before birth and continues throughout our lives (Yack, Aquilla, Sutton, 2014). Sensory integration contributes to the development of self-regulation, comfort, motor planning, motor skills, attention and readiness to learn. It is responsible for self–service activities, play and work. To assess sensory integration, it is essential to know the child’s history and sensory profile. This process enables the recognition of sensory– based behaviours as well as the environments and circumstances in which these behaviours occur. J. Ayres developed tests to assess abnormalities in the development of sensory integration processes. The indicative and simplest one is the clinical observation test. There are also more accurate tests, known internationally as “Southern Californian” tests.

However, these can only be carried out by appropriately trained individuals (Borkowska, Wagh, 2010). The most common symptoms of sensory integration dysfunction in children are abnormal reactivity to stimuli, especially touch (excessive or too weak), too low or too high levels of attention and activity, motor coordination disorders, delays in motor development, speech development, language development, learning difficulties, behavioural disorders, lack of self-acceptance or self-esteem. The most common types of disorders of the sensory systems are hypersensitivity or hyposensitivity. Hypersensitivity manifests itself in the form of motor and emotional hyperactivity and concentration problems. /hyposensitivity is manifested by disturbances in the sensation of one’s own body and the surrounding space. There are many more difficulties in children’s daily functioning resulting from sensory integration disorders. These can manifest themselves in the form of disorders in the development of motor skills. Children often do not understand instructions, cannot imitate the movements of others, lack the ability to manipulate objects and play. They often suffer from muscle sensory disorders. SI disorders are also accompanied by difficulties in performing precise activities, related to drawing, writing, graphomotor skills in general. Such children get tired more quickly, function worse in a group and do not do well in team games. Małgorzata Stańczyk (2014) points to the following symptoms that may indicate sensory processing disorders: excessive or insufficient sensitivity to pain or temperature;

Diagnosing disorders in the development of sensory integration is not easy and requires extensive knowledge and experience. Not all parents have access to specialists who diagnose disorders and provide sensory integration therapy, therefore they can independently take many actions aimed at correcting and compensating for the disorders observed in their children.

Proper organisation of the environment to support children with SI disorders

The SI process begins in the womb and rapidly develops in early childhood. All information received by the sensory systems and organs must be integrated to provide the basis for the development of cognitive skills. The combination andprocessing ofthesensations of touch, taste, smell, sense of balance, posture, vision, hearing, movement is understood as the fundamental base on which the complex skills of acting, speaking and learning are formed. All children function better in a predictable environment. Providing a child with an environment that is structured and ordered helps to compensate for their difficulties with language, sequencing, attention transfer and memory. Such strategies also provide consistent and reliable sensory information. Thanks to a well-organised space in the home environment, children have a sense of control because they are able to anticipate what they will do during the day. It is therefore worth paying attention to consistency in the environment and schedule. A quiet place to play and an organised home allow the child to regulate activity levels and become more relaxed and comfortable (Yack, Aquilla, Sutton, 2014).

Many children find it beneficial to organize their environment in such a way that allows them to provide calming stimuli, such as music, slow rhythmic rocking, slow rocking or massage with pressure. Parents of children with sensory integration disorders can benefit from sensory strategies to compensate for SI dysfunctions and enable them to use the sensory stimuli that the child can process best (Yack, Aquilla, Sutton, 2014).

Sensory strategies to use in the home environment:

Suggestions for exercises to be used in sensory therapy

Conclusion

Sensory integration disorders are an increasingly common problem among children. Information overload, noise, pollution and overexposure to electronic screens all contribute to difficulties in correctly processing and interpreting sensory stimuli. As a result of these interactions, some children experience difficulties in social, educational and emotional functioning. The first years of a child’s life are an important time for an intensive acquisition of experiences of the surrounding world through various senses. As a result of incorrect sensory processing, the child may not function properly, which is manifested by delayed motor development, increased or decreased levels of arousal and activity, sluggishness, difficulty maintaining balance, eye-hand coordination, auditory perception and concentration, and delayed speech development (Wasilewski, 2015). Understanding sensory integration disorders provides an opportunity to organise effective support for children affected by this problem. Collaboration between parents, teachers and sensory therapy professionals is key. The introduction of appropriate educational, therapeutic and environmental strategies can significantly improve the quality of life of children with sensory integration disorders. It is also worth emphasising that educating the public about this disorder is important. Increasing awareness among teachers, parents and peers can contribute to creating an understanding and accepting environment for children with sensory integration disorders.