SENSORY INTEGRATION THERAPY
Children with Autism Spectrum Disorders such
as Autism or
Asperger's syndrome with frequently have sensory
problems with touch, smell, hearing, taste and sight. They may
be overly sensitive to certain textures, sounds, smells and tastes.
Wearing certain fabrics, tasting certain foods, or normal everyday
sounds may cause emotional outbursts. The opposite is also possible
- the child with an Autism Spectrum Disorder may feel very little
pain or actually enjoy sensations we would dislike: strong smells,
intense cold or unpleasant tastes. Along with this will frequently
be difficulties in repetitive
behaviors, movement, coordination and sensing where one's body
is in a given space.
Sensory Integration Therapy is a type of occupational
therapy that places a child in a room specifically designed to stimulate
and challenge all of the senses. During the session, the therapist
works closely with the child to encourage movement within the room.
During the session, the therapist works closely with the child to
encourage movement within the room. Sensory integration therapy
is driven by four main principles:
• Just Right Challenge (the child must be able
to meet the challenges through playful activities)
• Adaptive Response (the child adapts behavior to meet the challenges
• Active Engagement (the child will want to participate because
the activities are fun)
• Child-directed (the child's preferences are used to initiate therapeutic
experiences within the session).
Sensory Integration therapy is careful to not
provide children with more sensory stimulation than they can cope
with. The occupational therapist looks for signs of distress.
Children with lower sensitivity (hyposensitivity)
may be exposed to strong sensations such as stroking with a brush,
vibrations or rubbing. Play may involve a range of materials to
stimulate the senses such as play dough or finger painting. They
should be encouraged to use scissors, construction toys, markers
Children with heightened sensitivity (hypersensitivity)
may be exposed to peaceful activities including quiet music and
gentle rocking in a softly lit room. Treats and rewards may be used
to encourage children to tolerate activities they would normally
Guidelines for children with heightened sensitivity
• The child finds it easier to initiate hugging
than receive it
• Touch is more tolerable when the child anticipates
• Firm, unmoving touch is better than light or
• Light touch may be tolerable after firm unmoving
• Initial stimulation may be unpleasant but tolerated later.
sensory integration Therapy for different SENSES
The sense of touch varies widely between children
on the autism spectrum. Many kids enjoy the feel of sticky textures.
Try experimenting with glue, play dough, stickers, rubber toys,
sticky tape. Other things that can be great for tactile sensation
are water, rice, beans and sand.
Children with Autism often enjoy a sense of firm
overall pressure, such as wrapping them up in blankets, being squashed
by pillows and big hugs. These can form a great basis for play,
interaction and showing affection. Experiences that may be claustrophobic
can be liked, such as being squashed between mattresses, and making
tunnels or tents from blankets over furniture.
"Our son hates light touches. But we now
play 'monster attacks', where we pick him up, turn him upside down,
spin him around, throw him on the couch, bury him under cushions
then sit on him, yelling and carrying on the whole time! He loves
it, and over time we worked in hugs and strokes at the end of it
all. Now we can show him affection normally as well, and he is more
comfortable with the rough and tumble play of other young boys".
Appreciation of firm pressure to light touch seems
to be very common on the autism spectrum. Try using deep pressure
with the palm of your hand instead of stroking or light touch. Some
children love being tickled, while of course others will hate it.
Be aware of your child's response to the smell
of substances too. Experiment with putting different fragrances
in play dough or rice. If your child actively likes strong odors,
find toys that specialize in this.
Experiment with talking toys, games on computers,
musical instruments, squeaky toys and all sorts of music. Clapping
together, rhymes, repeating phrases and tongue twisters are useful
Some children on the autism spectrum respond
to music but not voices. If so, try speaking in a melodic or “sing-song”
voice and see if the response improves. Try different tones of voice,
pitches, and gauge your child' reaction. Loud or unexpected sounds
generally won't be liked. Explain noisy toys to the child first
then introduce it at a distance. In extreme cases, it may be worth
introducing noise-making toys using social
As you can gather, parents may need to play detective
in finding the sensations their child is enjoying. Autistic kids
were often reported as staring at nothing when young by their parents,
when they were actually entranced by the movement of shadows on
a wall, or listening to wind moving through the trees outside. Parents
may need to work hard to find the things their child enjoys visually.
It could be anything that is long and narrow. I might be things
of a precise shade of orange. A preference for looking at straight
lines is often reported. There are many toys that aim at stimulating
sight with bright color schemes and flashing lights. Remember your
child probably won't want to be taken by surprise!
The Proprioceptive System helps children (and
adults) to locate their bodies in space. Autistic children often
have have poor proprioception and will need help to develop their
coordination. Therapy may include playing with weights, bouncing
on a trampoline or a large ball, skipping or pushing heavy objects.
The Vestibular System is located in our inner
ear. It responds to movement and gravity and is therefore involved
with our sense of balance, coordination and eye movements. Therapy
can include hanging upside down, rocking chairs, swings, spinning,
rolling, somersaulting, cartwheels and dancing. All these activities
involve the head moving in different ways that stimulate the vestibular
system. Be careful to observe the child carefully to be sure the
movement is not over stimulating.
Back and forth movement appears less stimulating
than side-to-side movement. The most stimulating movement tends
to be rotational (spinning) and should be used carefully. Ideally
activities will provide a variety of these movements. A rocking
motion will usually calm a child while vigorous motions like spinning
will stimulate them. Merry-go-rounds, being tossed on to cushions
or jumping trampolines can be real favorites with some children.
Experimenting and careful introduction of each activity is the way
Learning new skills involving movement
Skills such as tying shoe laces or riding a bike
can be difficult as they involve sequences of movements. Therapy
to help in this area may use swimming, mazes, obstacle courses,
constructional toys and building blocks.
Difficulty with using both sides of the body together
Crawling, hopscotch, skipping, playing musical
instruments, playing catch and bouncing balls with both hands are
some of the many activities that can help with bilateral integration.
Hand and eye coordination
Activities may include hitting with a bat, popping
bubbles, throwing and catching balls, beanbags and balloons.
Is Sensory Integration Therapy a proven treatment?
Although Sensory Integration Therapy is widely
used and supported by anecdotal evidence, there is as yet little
research that would establish it as an evidence-based
treatment. One study found only poor quality evidence providing
either no, or at best equivocal, support for Sensory Integration
therapy (Dawson and Watling 2000). There have been many studies
done but these have not been conducted rigorously enough for Sensory
Integration Therapy to be considered an evidence-based treatment,
despite it being widely used as an intervention for Autism and other
I can't afford these therapies, or they don't exist in my area
The good news is that as with many intervention
therapies, they can be done at home by the parents. When finances
are a problem, you may be able to have one or two sessions with
an occupational therapist who is experienced in Sensory Integration
Therapy to get advice on home-based therapies. Contact your local
Autism or Asperger's association as they will be able to put you
in touch with free or low-cost services.
When there are no services in your area, you can
still do home-based
therapies. This fact sheet offers some ideas and there are many
books available on Sensory Integration Therapy. Also, some Autism
associations may respond to email enquiries from parents in remote
Sensory issues are explored further in the Sensory
Problems fact sheet.
to read an interview with Lorna Jean King on Sensory Integration
Click here for the full
range of Asperger's and Autism fact sheets at www.autism-help.org
This autism fact sheet is licensed under the GNU
Free Documentation. It is derivative of an Autism and Asperger's
syndrome-related articles at http://en.wikipedia.org