Sensory Integration Therapy

Center of Development Cookeville 372-2567 developmentaldelay.net

Sensory Processing Disorders

Heidi L. Clopton, OTR/L

Making the Connection: The Brain and Sensory Input

Since the "Era of the Brain" neuroscientists and health care professionals alike have been discovering new information that has opened new doors into the treatment of sensory processing disorders. It is important to understand the connection between basic neural science and sensory processing in order to comprehend the great need for "ordered," not disordered sensory processing for the brain to function properly and learn.

Individuals with severe sensory processing problems usually function at a brain stem level in which primitive instincts for survival and protection are met only, with limited higher cortical learning taking place (see Sensorimotor Integration Supports Pyramid).

Sensory processing problems may come from not having "physical sense of self" (touch and proprioception) which leads to a compromised body system that is "in pieces" so that the brain and body is working on keeping self together (brain stem: survival and protection) and is NOT ready for higher cortical functioning until basic subcortical needs are met.

Why do the power sensations (vestibular, proprioceptive, and touch input) work to help the individual with sensory processing problems get "READY" to process information instead of being bombarded with external stimuli and general Automatic Nervous System functioning?

1. Vestibular Sensations: Set the arousal level to an optimum level to get a calming or arousing response. Most powerful and longest lasting sensation (typically 4-8 hours after 15 minutes on a swing hung from a single point in a linear direction). Vestibular input is a very strong brain stem sensation which is best if done first and followed by proprioception before a cortical task so that the brain stem can take care of and focus on ANS functioning and the cortex can register more information (2 hour to 45 minutes before functional tasks).

2. Proprioception: 9x's rule: For individuals with hypotonia it takes 9 times the effort to get enough tone and to a ready state to even begin to corticalize the information being taken in by muscles and joint receptors. 1 ½ to 2 hour latent affect keeps effects like the sensations are still present.

Proprioceptive input causes a release of Serotonin: which is the master regulator chemical in the cortex
Serotonin and Dopamine levels increase with proprioception
can't get too much serotonin
breaks up dopamine to prevent hyperactivity and over processing of information resulting in a neutral state
Master Modulator Chemical
Sets the firing level for all other neurotransmitters

if released suddenly in large amounts brain responds with endorphins "emotional highs"
self-injury causes release of serotonin (this is why children bite, pinch, hit, head bang, etc.)

When serotonin decreases and norepinephrine increases you will see aggression which often results in the individual receiving proprioceptive and deep touch input (holding down, firm grip, etc.) which enhances serotonin levels back to a calming level causing a terrible cycle of acting out, getting deep touch through punishment, then they get their "fix"-- a release of serotonin to decrease aggression.

3. Tactile: Deep touch is always better than light touch to result in a calming and organizing input, not a protective or avoidance response.

Deep touch: massage, calming due to release of brain chemicals, parasympathetic response
Light touch: fly on skin, being brushed lightly in a crowd, alerting and arousing brain chemicals, sympathetic flight or fright response, aggression, hyperactivity
Deep Massage or Pressure Touch(brushing of skin): Increases Dopamine (Pleasure chemical, activity, helps us stay emotionally neutral and balanced), Nerve Growth Factor Release (fertilizer for neuron growth which creates cortical pathways and more efficient processing), and a Parasympathetic Response (relaxed, neutral, homeostatic state).

Some points to remember:

The reticular formation is responsible for sensory modulation ( remaining in a calm and relaxed state) which is enhanced by vestibular input and proprioception.
The limbic structures MMOVE us: Motivation, Memory, Olfaction, Viscera, Emotion and these structures are enhanced best by Deep Pressure Touch.
Self injurious behaviors are almost always a sure indicator of Sensory Defensiveness!
Self stimulation and "shutdown" are almost always a sure indicator of a Sensory Defensiveness or a Modulation problem!
You have to treat sensory disorders beginning with Sensory Defensiveness through brushing and joint compressions done every 90-120 minutes for at least 2-3 months, followed by a sensory diet routine in their everyday life, then work on sensory modulation, regulation, and integration in that order to gain the best results.
Often is the case that if someone is seeking a certain type of input then it may not indicate that they need it, it is more likely that if they needed more of that input then they would benefit from it (other than release of pleasure chemistry). Whatever sensation they seek the most is often their best integrated sensation. For example: a child that rocks or spins usually has the best integrated vestibular system and this system is working the best for them. A child that avoids touch has the poor touch system.

**We all use sensory calming techniques in our world, many people can be observed "self regulating" or calming themselves in a classroom or work setting such as these behaviors:

fidgeting with pencil
rocking feet
rocking in a chair
squirming in seat
nail biting
smoking
twirling hair
tapping feet or hands on table
doodling
biting lips
leaning heavily onto table
getting up to move around during breaks
going for walks
exercising
and those whose brains and bodies crave more than the usual amount of sensory input to get those pleasure chemicals released do the extreme sports!

Heidi Clopton, Occupational Therapist Adapted from Bonnie Hanschu course Evaluation and Treatment of Sensory Processing Disorders

Vestibular Input: Movement and Balance

Movement is the Key to Learning

Sensory Calming Quicklist

Pediatric Occupational, Physical, Behavior, Nutrition, and Speech & Language Therapies 1080 Neal Street, Suite 300 Cookeville, TN 38501 Phone: (931) 372-2567, Toll-Free: (877) 372-2567 Fax: (931) 372-2572 Email: covd@covd.biz

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Clopton, OTR/L Making the Connection: The Brain and Sensory Input Since the "Era of the Brain" neuroscientists and health care professionals alike have been discovering new information that has opened new doors into the treatment of sensory processing disorders. It is important to understand the connection between basic neural science and sensory processing in order to comprehend the great need for "ordered," not disordered sensory processing for the brain to function properly and learn. Individuals with severe sensory processing problems usually function at a brain stem level in which primitive instincts for survival and protection are met only, with limited higher cortical learning taking place (see Sensorimotor Integration Supports Pyramid). Sensory processing problems may come from not having "physical sense of self" (touch and proprioception) which leads to a compromised body system that is "in pieces" so that the brain and body is working on keeping self together (brain stem: survival and protection) and is NOT ready for higher cortical functioning until basic subcortical needs are met. Why do the power sensations (vestibular, proprioceptive, and touch input) work to help the individual with sensory processing problems get "READY" to process information instead of being bombarded with external stimuli and general Automatic Nervous System functioning? 1. Vestibular Sensations: Set the arousal level to an optimum level to get a calming or arousing response. Most powerful and longest lasting sensation (typically 4-8 hours after 15 minutes on a swing hung from a single point in a linear direction). Vestibular input is a very strong brain stem sensation which is best if done first and followed by proprioception before a cortical task so that the brain stem can take care of and focus on ANS functioning and the cortex can register more information (2 hour to 45 minutes before functional tasks). 2. Proprioception: 9x's rule: For individuals with hypotonia it takes 9 times the effort to get enough tone and to a ready state to even begin to corticalize the information being taken in by muscles and joint receptors. 1 ½ to 2 hour latent affect keeps effects like the sensations are still present. Proprioceptive input causes a release of Serotonin: which is the master regulator chemical in the cortex Serotonin and Dopamine levels increase with proprioception can't get too much serotonin breaks up dopamine to prevent hyperactivity and over processing of information resulting in a neutral state Master Modulator Chemical Sets the firing level for all other neurotransmitters if released suddenly in large amounts brain responds with endorphins "emotional highs" self-injury causes release of serotonin (this is why children bite, pinch, hit, head bang, etc.) When serotonin decreases and norepinephrine increases you will see aggression which often results in the individual receiving proprioceptive and deep touch input (holding down, firm grip, etc.) which enhances serotonin levels back to a calming level causing a terrible cycle of acting out, getting deep touch through punishment, then they get their "fix"-- a release of serotonin to decrease aggression. 3. Tactile: Deep touch is always better than light touch to result in a calming and organizing input, not a protective or avoidance response. Deep touch: massage, calming due to release of brain chemicals, parasympathetic response Light touch: fly on skin, being brushed lightly in a crowd, alerting and arousing brain chemicals, sympathetic flight or fright response, aggression, hyperactivity Deep Massage or Pressure Touch(brushing of skin): Increases Dopamine (Pleasure chemical, activity, helps us stay emotionally neutral and balanced), Nerve Growth Factor Release (fertilizer for neuron growth which creates cortical pathways and more efficient processing), and a Parasympathetic Response (relaxed, neutral, homeostatic state). Some points to remember: The reticular formation is responsible for sensory modulation ( remaining in a calm and relaxed state) which is enhanced by vestibular input and proprioception. The limbic structures MMOVE us: Motivation, Memory, Olfaction, Viscera, Emotion and these structures are enhanced best by Deep Pressure Touch. Self injurious behaviors are almost always a sure indicator of Sensory Defensiveness! Self stimulation and "shutdown" are almost always a sure indicator of a Sensory Defensiveness or a Modulation problem! You have to treat sensory disorders beginning with Sensory Defensiveness through brushing and joint compressions done every 90-120 minutes for at least 2-3 months, followed by a sensory diet routine in their everyday life, then work on sensory modulation, regulation, and integration in that order to gain the best results. Often is the case that if someone is seeking a certain type of input then it may not indicate that they need it, it is more likely that if they needed more of that input then they would benefit from it (other than release of pleasure chemistry). Whatever sensation they seek the most is often their best integrated sensation. For example: a child that rocks or spins usually has the best integrated vestibular system and this system is working the best for them. A child that avoids touch has the poor touch system. **We all use sensory calming techniques in our world, many people can be observed "self regulating" or calming themselves in a classroom or work setting such as these behaviors: fidgeting with pencil rocking feet rocking in a chair squirming in seat nail biting smoking twirling hair tapping feet or hands on table doodling biting lips leaning heavily onto table getting up to move around during breaks going for walks exercising and those whose brains and bodies crave more than the usual amount of sensory input to get those pleasure chemicals released do the extreme sports! Heidi Clopton, Occupational Therapist Adapted from Bonnie Hanschu course Evaluation and Treatment of Sensory Processing Disorders	Related Topics: Joint and Muscle Input Proprioception Vestibular Input: Movement and Balance Movement is the Key to Learning Sensory Calming Quicklist

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