The difficulty with sensory integration issues

Sensory integration issues affect many children for different reasons and take on very different forms for each individual.

Often people assume that SI are disabilities when really they are extraordinary abilities.  It is important to understand that an autistic/adhd/gifted child each have different needs but all have sensory issues. One thing that I am becoming very aware of is that SI issues change as my children are growing up, many issues are resolving themselves by the age of 7 as long as appropriate sensory and food diet are put in place. Thus the importance to take any diagnostics of autism, adhd or giftedness or other thing with a grain of salt, unless symptoms are very severe.

The website upside down school room indicates: that there are many overlapping biochemical and neurodevelopmental issues with AD/HD, learning disabilities and Autism Spectrum Disorder. (For more info go to The Autism Spectrum). Frankly having come across autistic children in my professional research, I strongly believe that autism  is a result of super sensitive people just coping by shutting off overloading inputs….and adhd acting them out…

what is very important to understand is that each person is unique and has unique si issues. So learning to listen to children is key to be able to help them in the various social contexts they inhabit.

Some information on SI in Gifted People: I have bolded what seems important from this article.

The article : ” Asynchronous development and sensory integration intervention in the gifted and talented population” gives a great definition of what sensory integration issues mean to specialist who tend to focus on sensory integration issues as dysfunctions. But the author, Anne Cronin, points out that :

Most occupational therapists providing sensory integration do not have any training in the special developmental and behavior issues of gifted children. Dabrowski (1964) described patterns of overexcitabilities consisting of inborn, heightened abilities to receive and respond to stimuli. His theory related to creativity and the creative process, and has been widely applied to the gifted population. Overexcitabilities are expressed in heightened sensitivity, awareness, and intensity. Mendaglio (1995) and Lind (2000) offer similar views. These authors do not describe these overexcitabilities as “disorders,” rather as characteristic features of the exceptionally creative. 

Dabrowski goes on to state that “Each form of overexcitability points to a higher than average sensitivity of its receptors. As a result a person endowed with different forms of overexcitability reacts with surprise, puzzlement to many things, he collides with things, persons, and events which in turn brings him astonishment and disquietude” (1964 p.7). Is Dabrowski describing something that Sensory Integration trained therapists would label a “sensory modulation disorder”? The two look the same to me as a clinician. 

So, do highly gifted children with clearly identified “overexcitabilities” need occupational therapy? This is where it all gets muddled. The first question for parents to ask is “Do your child’s reactions to sensory experiences limit his or her ability to do things that are meaningful and important to the child or to your family?” If you answer is no then I would suggest you look at some sensory integration materials and perhaps the “Alert Program” (Therapy Works, 2000) as a tool to help your child recognize and learn to manage their own excitabilities. Although they may not be experiencing difficulties now, having a language to discuss what they are feeling and being aware that not all people experience things in the same way, are important tools in helping the child cope when new challenges emerge. I do not think that you must have an occupational therapist involved at this level, although an assessment and the development of a “sensory diet” may streamline the self-education process.

For those of you who did feel that your child does have activity limitations secondary to their sensory sensitivity, I have provided some more detailed information. All of the published research on the efficacy of Sensory Integration has been conducted on children with identified delays. Highly gifted children with identified difficulties in some area are considered twice exceptional (or as having dual exceptionalities). In most cases, the twice exceptional label is given when the child’s intelligence scores are in the gifted range, but some other score, like reading, language, or attention, fall below a normative range. I think that the outcome studies can be considered without reserve for this group of children. Most Sensory Integration research has focused on observable motor behaviors and studies have consistently shown the gains are few and unpredictable, similar in general to similar focused 1-to-1 perceptual-motor training programs (Wilson, et al. 1992, 1994; Bundy Lane and Murray, 2002). In response to these findings, researchers have expressed concerns about the appropriateness of the outcome measures used (Polatajko et al., 1992; Cohn and Cermak, 1998). Cohn (2001a, 2001b) and Cohn, Miller and Tickle-Degnan (2000) have done some innovative studies to address the need for different outcome measures. This research identifies parent expectations from therapy and positive outcomes perceived by parents whose children received sensory integrative therapy. Interesting to our discussion, one of the major benefits reported by parents was a language to describe sensory sensitivities, and strategies to address and avoid sensory “meltdowns.” 

Even without dual exceptionalities, children can have participation limitations that are very distressing and limiting. Typically, in these children, the scores on all testing are so high that they do not qualify for either a label or services, but there are wide discrepancies in their scores. For example, verbal and analytic scores can be in the profoundly gifted range, while motor skills and attention may be in the low normal range. The outcome studies for Sensory Integration interventions are not strong, even with the “usual” populations, and so may be even less applicable to our gifted kids. For parents with kids of this type, I would advise learning more about sensory integration and the Alert Program (Therapy Works, 2000). I have been very successful in supporting kids with a sensory diet and with a framework like the Alert Program to educate them on the basics of self-regulation. In both Dabrowski’s theory and in Sensory Integration, the unusual sensory reactions are seen as an integral part of the individual to be accommodated and to be worked with. In fact, many of the strategies offered by Lind (2000) for dealing with “over-excitabilities” are similar to sensory integration strategies. 

Attached as an appendix are a brief description of a sensory diet and a non-standardized sensory history. In summation, I believe that sensory integration strategies can be highly useful in aiding families in understanding and accommodating their highly sensitive children. I am hesitant to label this condition a disorder, and do not see intervention changing the condition, as much as educating everyone on strategies to manage and regulate the sensitivities. I do think that seeking out an occupational therapist with experience in sensory integration can be very helpful, but be aware that you, as parents, will need to educate her or him or the unique aspects of the gifted child. Be sure and ask questions, and encourage therapists to consider and explore research documenting the outcomes of therapy with the gifted population.

Read more at: Asynchronous development and sensory integration intervention in the gifted and talented population