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Sensory integration

General overview

Sensory Integration® or ASI® (Ayres Sensory Integration®) was originally developed by A. Jean Ayres (occupational therapist, also PhD in psychology and neuroscience) in the 1960s.
In neurophysiology, sensory integration refers to the process by which the nervous system transforms sensations into perceptions, i.e. organizes sensory information from the body and the environment in order to know how to use it effectively for action (movement, behaviour or thought).
The different sensory systems are the tactile, auditory, visual, gustative/olfactive, vestibular, proprioceptive systems. According to Jean Ayres, the effective integration of these sensations constitutes the basis for further learning and allows the development of the skills necessary for social interaction, but also for the regulation of emotions.
According to Ayres, sensory information is not processed by the nervous system in isolation. Sensory systems do not develop independently of each other. Visual and auditory processing also depend on the body's sensations. By working the different sensory systems simultaneously, learning and behaviour can be influenced. For example, the ability to concentrate, maintain attention and remain stable are related to how well the nervous system responds to tactile sensations.

Main objectives of the method

Good sensory integration means good processing of information received by the brain and good coordination of movement, behaviour and gestures.

The method is based first of all on a precise evaluation of sensory integration disorders, which are divided into three subtypes of problems: 

- sensory discrimination disorders (related to the senses)
- sensory modulation disorders (hyper-reactivity, hyperreactivity, sensory research)
- motor disorders of sensory origin (dyspraxia, postural disorders)
The SIPT test (17 tests), lasts 2 to 4 hours. It has been developed on the basis of a statistical study of several thousand children, allowing baseline measures and correlations between deviation from the norm and disorders to be established. 

The method then proposes to reduce these disorders by means of exercises allowing sensory stimulation adapted to the child's needs and which makes sense to him or her.

Specificities of the method
  • 1 hour sessions, usually once or twice a week
    In a (neuro)sensory integration session, the child benefits from a controlled sensory body experience and thus develops a response adapted to his environment.
    A safe / secure environment (mats, trampolines...) that includes equipment to provide vestibular stimulation, proprioceptive, tactile sensations and opportunities for movement planning (its organisation in time and space).
    Activities promote optimal postural control of the body, oral and eye movements, bilateral motor control, and adjust posture in response to changes in gravity.
    Material arrangements (media, equipment used)
    Trampolines, swings...
    Balloons, rollers
    Mats, tilt wall, bricks, climbing wall...
    Sandbox, pasta, beads, beads...

  • Practitioners are usually occupational therapists trained in sensory integration. 

Who is this method for ?
  • 10-12% of children are reported to have sensory integration disorders (McIntosh, Miller, Shyu, & Hagerman, 1999).
    They are more common in atypical children: 40-80% of children with neurodevelopmental conditions such as autism or hyperactivity have sensory integration disorders (Baranek et al., 2002). 

  • Symptoms of sensory integration disorders:
    Hyper or hypo-sensitivity to sensations (noise, textures, tastes, smells, visual stimuli)
    Difficulty organizing or filing 
    Standing too close or too far away from others during interactions
    Extreme emotional reactions and/or difficulties with transitions
    Tendency to look at or avoid peers rather than interact with them
    Difficulty concentrating, tendency to jump from one activity to another

What parents say about it
Scientific references

A systematic review of sensory-based treatments for children with disabilities: the study concluded that there was no evidence of efficacy demonstrated in the studies (in particular related to the lack of a recognised evaluation standard for the identification of sensory integration disorders, methodological problems identified for these studies).
According to the recommendations for good practice in the field of autism established by the HALDE in 2012:
"The so-called "sensory integration" practices, which are very diverse, have not proven to be effective in light of published data; however, for certain children/adolescents with PDD whose assessments of functioning show sensory or motor particularities, the practices below may provide benefits in terms of attention, stress reduction or behaviour unsuitable for sensory stimulation (expert agreement).
In cases where significant hypersensitivity exists, work to attenuate or modulate this exacerbated sensoriality can be proposed, as well as environmental design to act on disturbing sensory stimuli (light, noise, etc.). In cases where hyperacusis is detected and causes suffering in the child/adolescent, hearing filters can be proposed to limit the negative effects of hyperacusis on the child/adolescent's concentration".

Music therapy for people with autism spectrum disorder
Rhythmic auditory stimulation in rehabilitation of movement disorders: review 
Rhythm, movement, and autism: using rhythmic rehabilitation research as a model for autism
Sensory processing in autism: a review of neurophysiologic findings
Sensory perception in autism
An exploration of sensory and movement differences from the perspective of individuals with autism.
Evidence that the pattern of visuomotor sequence learning is altered in children with autism.
Motor persistence and inhibition in autism and ADHD
Behavioural and neural basis of anomalous motor learning in children with autism

Any remarks or comments ?

This work is based on a collaborative approach to sharing research and family experience.

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