OT Corner: Making Sense of Sensory Integration
By Amy Wagenfeld, Ph.D, OTR/L
Originally printed in October, 2005

My vision is to devote the next few columns talking about sensory 
integrative issues, such as what is sensory integration, terms generally 
tossed around in sensory integration theory, sensory integrative dysfunction 
(a more PC term than disorder), autism, learning disabilities, ADHD/ADD, 
and their potential links to sensory integration issues, some good 
information sites, and some practical ideas for things you can do at home 
with the kids.

I do hope that throughout this ‘series’ you feel more comfortable with the 
whole idea of sensory integration theory, and more so in feeling that many 
things that you are doing right now, do in fact help support and nourish the 
sensory systems of your little ones.

The late A. Jean Ayres (one of our most ‘prominent’ OTs) pioneered the field 
of sensory integration in the 1960’s.  The roots of sensory integration therapy 
were grounded in neurology, psychology, physiology, and child development, 
to name just a few.  Ayres was particularly interested in the way in which 
some children and adults seemed to demonstrate a great deal of trouble processing 
sensory information, demonstrated learning and attentional problems, and just 
seemed to have difficulty moving through life with ease.  She devoted the rest 
of her professional career to sensory integration research.

When you think of sensory integration, consider it as two separate words.  Sensory 
or sensation refers to how we receive information without being aware of it, 
Integration is how we process and put things together, so combined, sensory 
integration refers to the “unconscious” ability to receive and process sensory 
cues from the environment.  Sensory integration theory takes into account more 
than the sense of hearing and seeing, it also suggests that touch, movement, and 
body position in space have a significant impact on the way in which we interpret 
our environment. 

Now let’s talk about the specifics of sensory integration.  I think that sensory 
integration is best explained in the words of Jean Ayres.  She described sensory 
integration as “The organization of sensation for use.”  It is through sensory 
integration and organization that the nervous system comes together or organizes 
itself so that a person can most effectively and satisfactorily experience the 
environment.  Conversely, sensory integrative dysfunction refers to a disorganized 
nervous system. Someone experiencing a sensory integrative dysfunction would then 
have trouble negotiating his or her environment; just getting through the day might 
be very challenging and very frustrating.

Now that we have talked about what sensory integration IS, let’s talk about who 
administers sensory integration therapy.  First of all, qualified OTs and PTs 
carry out SI therapy.  Here’s the tough part.  In order to administer the only 
standardized evaluation (called the Sensory Integration Praxis Test- SIPT) of 
sensory integration, a therapist MUST have received specialized training and be 
certified to administer, interpret, and make diagnostic predictions based on 
results of the SIPT.  But, an OT or PT who is not certified may certainly use 
sensory integration techniques in their therapy sessions.  Whether you choose to 
pursue specialized treatment by a certified therapist is most definitely your 
preference, and in the Boston area we are fortunate to have in our midst some 
very qualified SI therapists.  [Just a quick aside, and in case you are wondering, 
I am NOT certified to administer the SIPT, but have certainly worked with many 
children with sensory issues.  I also did and do not hesitate to recommend specialized 
evaluation and treatment if I felt the situation is warranted.]  It is not only 
perfectly reasonable, but your right to ask a therapist if he or she is certified 
to administer the SIPT, and if not, if he or she has taken courses or seminars on SI. 
I think this is definitely a case of, “the more you know” rules!

Before I wind up for the month, I’d like to provide you with a working glossary of 
terms that are generally associated with sensory integration.  Next month I will go 
into much greater detail about each of these terms, and more so how dysfunction in 
any of the ‘systems’ might be translated to real life situations, as well as 
specifically talk about sensory integrative dysfunction.

Vestibular System: The sensory system that responds to the position of the head in 
relation to gravity and accelerated or decelerated movement: it integrates neck, 
eye, and body adjustments to movement.* 

Tactile: Pertaining to the sense of touch.*

Tactile Defensiveness: A sensory integrative dysfunction in which tactile sensations 
cause negative emotional reactions.*

Proprioception: Perception of sensations from the muscles and joints.*

Motor Planning (Praxis): The ability of the brain to conceive of, organize and carry 
out a series of unfamiliar actions.*

Apraxia: The lack of motor planning.*

Kinesthesia: Perception of the movement of individual body parts; dependent on proprioception.*

Gravitational Insecurity: An unusual degree of anxiety or fear in response to 
movement or change in head position; related to poor processing of vestibular 
and proprioception information.*

Co contraction: The simultaneous contraction of all the muscles around a joint to stabilize it.*

Some helpful resources….

Sensory Integration and the Child- A Jean Ayres
SI International  www.sensoryint.com
Nashville Sensory Integration Dysfunction Foundation  www.nashvillesid.com
A Parent’s Guide to Understanding Sensory Integration * (glossary terms taken from this booklet)