Sensory Integration Dysfunction

My daughter has some SI issues. She went to a private SI OT with very good results.

My son has sensory issues. When we realized the extent of the problem toward the end of the 1st grade, the school recommended the book, “Out of Sync Child” because he had many of the characteristics of SID. But when he was diagnosed, it turned out that it was apraxia (plus a few other things). The sensory issues have been a challenge to live with and it has affected him in so many ways even now (he is almost 12). We had private occupational and speech therapy through one of the local hospitals for two years. I’ve worked with him myself on speech using techniques I learned from the hospital’s therapist and greatly benefited from watching the hospital’s occupational therapist work with him to get ideas for home. If you decide to get private therapy, get the pediatric version of it. The pediatric therapists really know how to get the most out of the time they have with the kids in a way a child will learn.

The school provided six years of speech and one year of occupational therapy but it didn’t meet his needs. They didn’t have him long enough or frequently enough for him to build the overall skill level he needed, plus their focus was only on the skills needed to participate at school. He needed to be able to function outside of school too! The school therapists we had were somewhat limited in what they could do. For example, the school speech therapist didn’t prescribe exercises to strengthen muscles necessary for speech where the therapist at the hospital did. Without the exercises, he could’ve practiced his r’s forever and never made progress.

You’re lucky to have the support of your school to get started with therapy so soon. Good luck to you!

Exactly. Our SI OT was board certified in pediatric SI

Thanks for replying. Were you referred to your SI OT by your pediatrician? Thanks!

I’ve yet to hear from the school so I’m hoping at this point that they will be able to give us some strategies for school and home.

It seems from reading Out of Sync that there are different behaviors that are all sensory issues. Our son is more hyposensitive and sensory seeking. I think that there is an auditory component because certain sounds bother him. He is often loud and makes noises in the classroom and has problems with transitions.

I think a therapist mentioned that once he starts Kindergarten he won’t qualify for services, but he does w/ the Early Intervention. So we may need to find a private therapist if he has problems once he starts Kindergarten. I appreciate the information on your experience w/ school and private therapists.

Have the private therapists tried brush therapy? Or pressure activities? Has anyone read The Out of Sync Child Has Fun and is it worthwhile?

Thanks!

Hi Beth,
I’ve looked at “The Out of Sync Child Has Fun” and I thought it was a very good book…particularly for a young child.

I’ve tried to do brushing with my son but unfortunately he is older 8 (if only I had done more of this when he was younger!:-(
and quite tactile defensive (clothing him can be a complete nightmare!!!!).

Unfortunately, looking back, there are a lot of things I wish I would have done. But sometimes you don’t realize what the problems are until they develop.

So if you do suspect any possible LD’s I think it’s best to start working on them as early as possible. That’s what I wish I had done.

Best of luck to you! I hope things work well for your son. :-)

My son has some of these issues. Sensory integration dysfunction encompasses many different types of issues that can all look very different.

I have done all a can to understand my son’s specific problem. In doing so I was able to provide him with an environment that provided the right type of sensory input for him. My son’s issues surrounded his lack of awareness of his body in space (proprioception.) He was constantly seeking proprioceptive input to find his body in space.
I did alot of exercises that targeted this and his OT states that he no longer needs proprioceptive input to self regulate. In other words, he doesn’t need to bounce around like he used to. I think interactive metronome also had a major affect in helping him to self regulate.

Being understanding to my son’s sensory needs has brought us closer and enabled me to work with him on his other learning difficulties. I know when he needs to stop and get a big bear hug from mom.

I will say that since your child has a problem with noise, you might want to consider the listening program which can be done with younger children. I would definitely recommend, “The Out of Sync Child.”

SID itself is not classified as a learning disability but it can be the underlying cause (or a contributing factor) of learning disabilities. We didn’t realize our son had SID issues until he was 7, although he started receiving occupational therapy in K (speech at age 4). I realize now that a lot of his behaviors were connected to SID.

The school did not care about his SID—told us it was medical not educational—but we have received OT because of handwriting/copying off the board issues.
I would think of the school as supplemental to whatever you do at home or privately. We have done private therapy for two years (Neuronet rather than OT because I liked the emphasis of NN on working every day at home—but not widely available). He still receives OT at school but it is 30 minutes a week in a group.

Sound sensitivity can be dealt with through sound therapy. We’ve used The Listening Program—it is the mildest and can be done at home without professional supervision.

I would suggest gymnastics and swimming as activities that help sensory integration as well as the activitives in the Out of Sync Child.

Beth

Laura,

Thanks for the encouragement. The therapist said they are seeing a lot of children with sensory issues lately, which led me to believe they are diagnosing it more readily.

If our son had not had such serious problems at pre-school things would be different. He has problems at home, but not like he has had at school. The sounds have been a problem in school and also clumsy and aggressive behavior. So far he is only hypersensitive to sounds. I thought he might have ADHD, but they pretty much ruled that out the day they observed him.

So now we are hoping the therapy will help! We are doing some activities at home, but he is still having difficulty with school.

Good luck to you also!

Linda F.,

I’m glad your son has started self regulating. I think our son also has proprioceptive issues. We thought it was ADHD at first. He has had a lot of problems with school setting because of his activity level, clumsiness, and somewhat random and aggressive behavior.

We are hoping that the school therapists will be able to help him.

This is all new to us. We had never heard of this before and hope that public school will take his problems seriously, since he does not have a learning disability by their definition.

Sounds like you have had much success so that is encouraging.

Thanks again!

Thank you for your information. I’ve never heard of Neuronet. Would like to hear more about it!

We have had him in a lot of activities, but swimming is one should probably start trying again. He has really enjoyed it in the past. Does your child swim daily? We have him in 1 a week gym class and try to get him outside everyday.
He still has some school problems, though it has improved some (the nicer weather has allowed us to get him out more).

I hope the public school will take his condition seriously. His behaviors have posed problems in pre-school setting, so they were the ones who recommended we have the school district observe him. The school district told me he qualifies for services now, but wouldn’t in kindergarten.

Looking forward to his receiving therapy as the school district has not called yet to set an appointment.

Thanks, again!

My son didn’t have brush or pressure therapy, but maybe it wasn’t appropriate to his issues or maybe they were doing something else that was working. I’m not familiar with either of the therapies, so I don’t know.

“Out of Sync Child” was very good. Even though it didn’t turn out that my son had SID, it was re-assuring to know that there were other children with the same unusual sensitivities and behavior and what kind of help to look for.

Beth,

Just so you know, there are many experts who view SID therapy with some skepticism. The prevailing medical view is that the symptoms that we call SID are real but that brushing and other SID therapies are not effective in dealing with those symptoms. Those views are based on a number of studies that, to date, have not shown a provable effect from the therapy. Of course, that doesn’t necessarily mean that your child would not benefit. It only means that so far the evidence does not support that these therapies are effective for MOST children exhibiting sensory symptoms.

This is just my opinion, as a parent whose child received SID therapy (as well as “straight” OT), but I think the benefits of OT mostly lie in the practice of things that the child has difficulty doing, and in the individualized attention and teaching. My child definitely would not have learned to write without OT, but I found occupational therapists far to willing to diagnose him with SID without pointing that the symptoms he was exhibiting were in fact extremely consistent with ADHD and learning disabilities. As it turned out, my son did have ADHD and LDs that OT really could not address.

A while ago I posted a question about whether SID exists as a separate diagnostic entity, as opposed to being a collection of symptoms that tell us that a person has a neurological problem of some sort (LD and ADHD being “brain” problems). I still don’t know the answer, but I really do wonder about that. Kids with all kinds of brain-based difficulties, from cerebral palsy, to autism, to Down’s syndrome, and LDs and ADHD all tend to exhibit sensory symptoms, which would support the view that SID is not really a stand-alone problem. I guess what I’m really saying, in what I hope is a positive way, is: don’t rule out ADHD or LD or CAPD or dyspraxia as a diagnosis based on the OT evaluation of your child. OT may help with any of those diagnoses but it just won’t be enough. Your child is very young and the younger you start with remediation efforts, the better the result.

Andrea

People tend to find what they are looking for. And they look for what they are familiar with. So you have to be really, really careful to look for unbiased evaluations.

Interesting point. My son was diagnosed with SID by an occupational therapist specializing in SID. The OT prescribed therapy twice a week. I really wanted a home based therapy to allow for intensive work and decided to do Neuronet therapy instead. Here we really have worked at underlying sensory motor functioning to make it more automatic. I think she sees sensory integration like you do–as an indication that the brain is neurologically organized—and her therapy is oriented to helping the brain become more neurologically organized.

My son never really did the descriptions in the Out of Sync Child very well—except for three pages which talked about the relationship of the vestibular system to vision and auditory processing. I honestly think that for him, you are right, the SID characteristics are part of his larger LD problem. But I have a friend whose daughter is a much more classic case of SID. She is 4 and is receiving OT therapy now. I wonder if that will be enough or like my son, it only indicates the presence of a broad spectrum of neurological issues.

Beth

http://www.neuronetonline.com/

Here is the web site. She has trained lots of people but few have gone through the entire program to become certified. Most have incorporated techniques into the therapy they are already doing—OT, speech, for example. As a result, it is difficult to find anyone doing this therapy unless you live in Florida or Chicago.

Beth

Beth,

SID is many different things. The Out of Sync Child is for laymen so does not get into the specifics. I never really found my son in that book either except in a few things.

I have a textbook on the subject that is very detailed and discusses the various types of SID. I found my son described to a T. The book states that bilateral motor and sequencing deficits are part of one type of SID. Understanding this helped me to understand what type of environment he needed.

The work involving neuroplasiticity indicates that an enriched environment, specifically movement, can form new neural connections. As we both know, these changes have only been found to take place when the changes were made to the whole environment of the animal under study.

I have tried to provide my son with an enriched environment in all his deficits areas.

You can call it SID or call it whatever you want but the reality is you have to provide stimulation in the deficit areas to change the brain.

Oh, I totally agree on the neuroplasticity—my child is not the same kid he was two years ago neurologically (he was actually drawing birds the other day—from picture he was looking at a book!!!!) I just think that Andrea has a good point–that for many kids SID type issues are part of a larger constellation of problems. While a diagnosis of SID by itself may not be that meaningful for these kids, I would say that it might be indicative of a certain class of learning disabilities that my son and yours both have–that have a definite sensory motor component. In both of our cases, improving sensory motor processing (whatever label you use) has improved our boys ability to learn. It seems to me that not all learning disabilities are like that—many are more cognitively based.

BTW, I can certainly see how bilateral coordination is a SID type issue but less clear to me how sequencing is. Can you explain?

Beth

I totally agree. Some issues are more cognitively bases. My personal opinion is that those issues are easier to remediate than the lower level sensory issues.

I also agree it matter little what you call it. It is only that it is only in sensory integration theory that I have found specific brain based explanations of my son’s particular issues. They actually even pinpoint where in the brain the problem is based on the symptoms. There is quite a bit of research cited.

This is way oversimplified but here goes, this is from the book;

“Disorders of bilateral integration and sequencing are considered to be a specific disorder of motor planning characterized by problems with planning and producing bilateral and projected action sequences.”

They differentiate motor deficits from the specific problem of motor planning/bilateral integration related to a sequencing deficit. It makes sense to me with regards to my son. He is not clumsy and actually appears quite coordinated. His motor issues are related to his inability to plan and sequence his movements bilaterally.

There are numerous research citations from the field of neuroscience. This is not just speculation.

I hope this makes sense. It just made sense to me. Maybe you would need to know my son to have it make sense.

Interesting … A neurologist would likely label your child’s difficulties as developmental coordination disorder or perhaps some sort of static encephalopathy, while an OT would say SID. Perhaps these really are just different names for the same brain problem. The big question for us as parents is what is the best therapy, regardless of what name you give the problem? So far treatments like Interactive Metronome have a better track record (at least as shown by research) than does sensory integration therapy.

Andrea

So true, Victoria, and not just of OTs.

Andrea

Yes, but the neurologist would only treat the symptoms.

I guess that is where I have a problem with that particular label.

We just know so much about brain plasticity that is not taken into account with those labels. I have often thought that the brain plasticity studies using mice and monkeys looks very much like those mice and monkeys are receiving and enriched environment that could also be called intensive OT.

I honestly don’t think a neurologist would give my son that label anymore.

His most recent OT report suggests that most of his sensory integration issues are resolved. I don’t think this is 100% true but I think if I took him to a neurologist he would wonder what we were even doing in his office.