Wednesday, October 19, 2011

The Role of the Sensory Integration Therapist

A few weeks ago, a reader asked me how exercise could help a child who could not function at school.  Last week, I talked about how the sensory integration approach works.  This week, I thought I would continue the discussion by explaining what sensory integration therapy has to offer, and talking some more about how we go about accomplishing our objectives.

A sensory integration therapist's role, as I see it:

To improve motor planning and problem solving skills, which the child can then generalize to all learning.

To improve balance and equilibrium responses, so that the child has a reliable, dependable relationship with gravity.

To reduce or eliminate defensive, aversive responses to sensory experiences, so that the child is not bothered or distracted by sound, smell, touch, or light.

To improve neurological functioning by integrating the presence of primitive and postural reflex activity,  so that his movements are not dominated by the involuntary lowering of his muscle tone or involuntary flexor withdrawal when he tries to use his body.

To improve the child's ability to maintain the appropriate level of alertness and arousal for learning in a classroom setting.

To improve the child's ability to filter and discriminate sound.

To increase the length and flexibility of the child's attention span.

To maximize the child's ability to explore and interact with his environment freely and confidently.

To enable the child to self soothe, self regulate, tolerate frustration, solve problems, work independently, and socialize appropriately.

To provide the child with a strong, stable, resilient, flexible  body, and maximize fine and gross motor coordination and age appropriate skills acquisition.

To improve spatial awareness, visual perceptual, and visual motor functioning.

To give the child the inner resources to meet an unfamiliar challenge or obstacle with zest and confidence, by allowing him  to prove to himself, over and over, that he can solve problems and rely on himself.

In addition to these things, a sensory integration therapist can help the child function in class and on the playground by adapting his environment, providing him, his teachers and caretakers strategies to maintain his ability to be present and available for learning in class, prescribing a sensory diet, and by teaching life skills like shoe tying, using utensils, handwriting, telling time, bouncing, catching, and kicking a ball, jumping rope, and any necessary activity of daily living.

Why do sensory integration therapists use suspended equipment?

Children whose nervous systems have not matured along with their chronological ages behave differently than others.  They don't function well at school, because in some areas, they are developmentally behind the other children.  They can't consistently meet the grownups' expectations for comporting themselves, internalizing the rules of the classroom, or keeping up with the academic demands of school.  They can't sit quietly and do their work, they can't contain their impulses, they get into altercations, they talk out of turn, they can't get their work done in class, their work is messy and disorganized, they take up far too much of the grownups' attention.

 Or they do keep it together at school, but then can't manage their behavior once out of the public eye, having one meltdown after another at home.  Perhaps the child is obviously quite intelligent and capable, but in a classroom setting, seems lost and not very bright.

  Some of these children are driven to move and seek sensation, and will have a hard time sitting still.  They are constantly on the go, have a short attention span, and can't walk in a straight line because they have to spin themselves on every streetlight and jump on and off every curb that they pass.  They throw their bodies off of the highest walls they can find, crash into other people, give hugs like rabid bears, throw a ball a hundred miles an hour to someone standing two feet away, unintentionally break crayons and toys, and can't stay organized or get anything done in a chaotic atmosphere.

Others avoid interacting with things and people, sitting quietly, not bothering anyone, but not participating or learning, either.

For the first child, who needs a lot of intensity and endangers himself in order to get it, the suspended equipment can give it to him. With the therapist's direction, the swings can provide high intensity in a safe, controlled, contained way.   Over time, the child will stop seeking, because he no longer needs the huge amount of input to feel at ease in his body.  He also learns to control his impulses and solve problems, because if he does not slow down and think things through while interacting with the suspended equipment, he will fall.

For the avoidant child, working with a therapist on the suspended equipment is an efficient, highly effective way to improve motor planning, gain confidence and strength, and develop a good relationship with gravity.  The swings also affect the part of the inner ear responsible for alertness, so that over time, the child's ability to stay present is improved.

The therapist can also provide suggestions for making homework manageable and for navigating other problem areas in the child's life.

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