How Does Sensory Integration Therapy Work?

A reader left me a great question in the comments after I described a little girl who was struggling in her daily life. She asked how exercise could solve this child's problems.


A. Jean Ayres, who founded sensory integration therapy, was an occupational therapist and developmental psychologist whose work was based on the theory that learning problems and behavioral issues were caused by faulty processing of sensory information.

  According to Dr. Ayres, learning is a function of the brain.   If we improve the brain's ability to perceive, remember, motor plan, and solve problems, and to perceive sensory information correctly and respond to it accordingly, this skill can be generalized to all learning, including academic learning.  By having the child participate in specific movement experiences which integrate and strengthen an immature, inefficient nervous system, sensory integration therapy can, over time, correct the underlying issues that prevent the child from succeeding in school.

What we know, and how we learn, is through the brain. When we are babies, we train our brains to learn by moving through and exploring our environments.  As we sit up, turn over, reach for things, creep, crawl, cruise, and walk, we teach our bodies, and our eyes and hands as they work together, to do what we tell them to do.   We learn to discriminate, so that we can attend to what is important and  filter out what is not.  We learn to struggle for what we want to achieve, and not give up until we succeed.  We develop vision, balance,  core strength, equilibrium, hand eye coordination, and fine and gross motor control. We integrate the workings of the senses as they take in information, the brain as it perceives them, and the body as it acts on them, so that over time, the brain and body evolve into a unified, graceful, efficient whole.

Until a child is about six, virtually all learning, and all understanding, is based on his physical interaction with the environment.  This is why it's so important not to restrain children in playpens, strollers, and carseats, park them in front of televisions and computers, and force them to sit still.  It impedes their development.

As a sensory integration therapist, my concern is how the child's body is functioning.  When I evaluate a child, I am looking for how well the child responds to the demands I place on him and on his body.  This will give me direct insight into the child's difficulty functioning in the classroom.

How long can the child sit still and attend to the task at hand without losing focus?  Does he need frequent movement breaks?  Does he complain about fatigue, make conversation instead of engaging with the test materials, or otherwise try to divert my attention?  Does he lie on the table or rest his head in his hand when he is working? Does he rub his eyes?  Does his hand hurt because he is gripping his pencil too hard? Will his hands coordinate together when he cuts with scissors?

Can the child hold on to me if I put him on my back, or are his legs too weak to grip?  Does he move his head back to  midline if I lean to the side?  If I push him, will he fall, or do his core strength and equilibrium enable him to stay strongly upright?  If I place him over a large ball and tip him forward, do his arms shoot out to protect his head? Is he able to balance on one foot?    Can he run up and down stairs without using the rail for balance?

Does he startle and pull away when I touch him?  When I put him on all fours and turn his head, will he stay stable, or will his arms and back lose their tone and collapse?

When asked to do an unfamiliar task, can the child mentally form a motor plan and execute it without too much difficulty, or does he get lost and frustrated?

Can the child make eye contact with me?  Is he interested in pleasing me and in my reactions, or is he indifferent to me?  Does he have a sense of humor? Can he chat, or does he monologue?  What does he do if another child or therapist enters the testing area?

What is the child's breathing like?  Is he a picky eater? Can he sleep through the night?  How does he behave when he wakes up in the morning?  Does he have enough energy to get through the day?

Does the child get overly excited when he is stimulated, or does he shut down when confronted with intense or unfamiliar sensations?

Assessing how the child's body works, and how it habitually responds to the demands of daily life, is crucial to understanding what underlies the child's learning and  behavioral difficulties.  The body is the foundation for the brain.  If the foundation is shaky, and does not offer adequate support, the workings of the brain, and the eyes and hands, will suffer.

A child who is living in a body that falls out from under him when he wants to use it, won't do what he tells it, and doesn't keep him strongly,  sturdily, upright, is living in a body that does not support the work of his brain, eyes, and hands.  A body that won't keep him effortlessly upright when he sits in a chair or on the floor, won't keep him safe from falling while running on the playground or allow him to keep up in gym class, won't filter out background noise and movement, startles and flinches at the slightest provocation, won't correctly inform him about where he is in space, and constantly tells him that sounds are too loud, smells are disgusting, fruits and vegetables are yucky, paint, glue, and clay are nasty, and his clothes are tight and scratchy, is not a body that will allow him to navigate the complicated, demanding, exhausting world of school without a tremendous struggle.  His internal disorganization, weakness, unreliable sensory processing, and poor balance will be directly reflected in his behavior.  He will be either acting out, attempting to communicate his distress, or he will be tuned out, in an attempt to leave his body.  Neither one of these responses is appropriate for classroom participation, and  prevent him from being able to learn and to formulate and express his ideas.  A child who lives in this kind of body is "out of synch."

My job as a sensory integration therapist is to provide the child with a strong, stable, reliable, resilient body and a brain that perceives and responds accurately to the information conveyed by the child's senses.

In addition, I must educate his parents and his teachers about how to best support him, so that his environment is conducive to learning.