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This book is the most comprehensive title on the subject of Sensory Integration Dysfunction. The author, Carol Stock Kranowitz, has done the near impossible in that her book will be beneficial to parents, physicians, teachers and care providers. By combining not only the at home aspect of SID but the clinical assessments, she provides the most comprehensive text to date. Join me in this summary of her book. The italicised words were written by the author. ~ ~ ~ ~ ~ Does MY child have SID??? The first question people ask is, Does MY child have this and what does it mean and what do those initials stand for anyway? SID is Sensory Integration Dysfunction. It is basically a disorganized brain. I know, that seems too simple, but really, that is what all of the medical mumbo jumbo comes down to. Disorganization. How you will know that your child has this or not depends on two things...are you a good observer and are you able to put together what you observe in your child to form a clear picture. SID is not necessarily evident in all kids with ADD/HD. Some have it, some don't. Nor do all SKs have SID. Most have trouble with sensitivity, but the majority will not show the extreme signs of SID. A child with ODD or Asberger's or Autism will not always have SID. The one thing that SID has in common with all of these other things, is that there are times when the symptoms cross over and most of the time, the SID "diet" or teaching process will have a positive impact on all of these children. The first quote from the book that made an impact on me was - "The inability to function smoothly is not because the child won't but because he CAN'T". What a powerful statement and one that most of us here are familiar with - the idea that inborn traits or temperaments are part of who your child is. SID is similar to SK in that it is inborn, but dissimilar because it is not an issue of temperament but of FAULTY WIRING.
The checklist of common symptoms as defined by the author is included in the book. You must keep in mind that with sensory processing problems, it is the frequency, intensity and duration of reaction that will indicate an oversensitive, undersensitive, combination or no problem. Observe your child in these areas and be aware of reactions... 1. Touch - avoid being touched, getting dirty, certain textures of clothing and food -or- unaware of pain, pressure, temperature or how objects feel. 2. Movement - avoids moving or being unexpectedly moved, insecure in regard to gravity, off-balance -or- crave fast, spinning movement such as swinging, rocking, twirling without getting dizzy. 3. Body Position - may be stiff and rigid, tense -or- uncoordinated or may slump and slouch, clumsy or inaccurate "loose, floppy bones" 4. Sights - may become overexcited when there is too much to look at, overreact to bright light, may be hyper-alert -or- may touch everything as if living in "dusk", may miss visual cues from other people 5. Sounds - may cover ears to close out voices or sounds, may complain about the vacuum or may ignore voices and have difficulty following verbal directions, may want the TV -or- radio to be LOUD. 6. Smells - may object to odors like ripe bananas - or - may ignore even the most unpleasant of odors and sniff food, people and objects. 7.
Tastes -
may object to textures and temperatures of foods --or-
may continually taste in inedible objects and may prefer
spicy or very hot foods. The author then goes into a series on behavior problems that list possible symptoms - they may have an SID connection or are caused by some other developmental problem - 1. Unusually high activity level 2. Unusually low activity level 3. Impulsivity 4. Distractibility 5. Muscle tone and motor coordination problems 6. Problems with motor planning 7. Lack of definitive hand preference by the age of 4-5 8. Poor eye-hand coordination 9. Resistance to novel situations 10. Difficulty making transitions 11. High level of frustration 12. Self - regulation problems 13. Academic problems 14. Social problems 15. Emotional problems What is NOT SID is ADD/HD, allergies, nutritional or vitamin deficiencies or when he/she is just behaving like a normal child.
Possible Causes of SID No one knows for sure, however, these theories are the most researched - 1. A Genetic Predisposition 2. Prenatal circumstances 3. Prematurity 4. Birth Trauma 5. Postnatal circumstances such as environmental pollutants, lack of sensory stimulation after birth or a lengthy hospital stay 6. Unknown
To say that this covers a wide range of possibilities is an understatement. Let's consider just one of the theories and see how it pans out. Using my pregnancy and my older child - who is mild to moderately affected by SID (it is generally just an extreme of her SK sensitivity but the practice has been helping)- J. During pregnancy, I lost 26 lbs. in 5 months, I was repeatedly hospitalized, had to take a drug to be able to eat and because of the drug I had constant worries about what I could be doing to my baby. To say it was high stress the first 5 months was accurate. Now, I had noticed an on again, off again rash through out those 5 months but on the 6th month, the rash would not go away. This "hives of pregnancy" resulted in more drugs, more hospitalization, bed rest, isolation and obsession about the health and well being of my baby. She ended up 2 weeks overdue and I had to be induced 2 times for a lengthy - 33 hour delivery. Using the theory that her in-utero time will program her nervous system, what had her time taught her body? She only knew stress and the adrenaline that goes with it. Her body had been exposed at the time of development to a routine of more and more stimulation. Higher and higher doses of drugs and higher and higher exposure to anxiety were all that her developing central nervous system knew. As a result (again, using only this theory) her body had been programmed to respond a certain way. It had been WIRED IMPROPERLY - or had FAULTY WIRING. To combat that initial wiring, it is then my job to TEACH HER BODY about proper stimulus response. I have to in effect, reprogram her body through a series of exercises, a series of OT appointments and through the SID "diet" of exposure to the stimulants and gradual increase of the ones that are triggers. And this is all possible without drugs or drug therapy. It requires practice and consistency and repetition and observation. As for the other theories, they work in a very similar way - what did your child's developing body come to expect or anticipate as the NORM and what did your child's developing central nervous system do to react to the stimuli.
Don't we ALL have some of these symptoms? The author states, Not being in control of oneself is very unpleasant, but an occasional disorganizing experience is normal. It is when the brain is so disorganized that a person has difficulty functioning in daily life that the person is diagnosed as having Sensory Integration Dysfunction. She then includes two sample sensori-motor history questionnaires, which I will not print - the length and the possibility I could misprint something is too great. Check out the book.
And finally, in this section we have discussed some of the signs and signals of SID or some checkpoints of which you need to be aware. But this is not the end of the discussion, this book should help do the following - "Get information and share it with doctors or caregivers; accept the child does not fit your metal ideal; provide the child with a well-balanced sensory diet; be patient, consistent and supportive; and help the child take control of his or her own body and life."
Understanding Sensory Integration and What Can Go Wrong... In this section the author reviews the developmental stages, the normal processing and the mis-wiring. She goes into a discussion on the senses, their use and appropriate process. Her emphasis is on the following--- The Far Senses - We have many senses- more than many people know! Most people are familiar with the five senses of hearing, seeing, taste, smell and touch. These are sometimes called the "far senses" because they respond to external stimuli that come from outside our bodies. and then The Near Senses with a special emphasis on these topics... The tactile sense (touch), the vestibular sense (gravity and balance) and the proprioceptive sense (body position). The tactile, vestibular and proprioceptive senses are fundamental. They lay the groundwork for a child's healthy development.
After a quick review of how the senses gather information and work together to form proper responses, she follows with... No one part of the central nervous system works alone. Messages must go back and forth from one part to another, so that touch can aid vision, vision can aid balance, balance can aid body awareness and body awareness can aid movement, movement can aid learning, and so forth. When sensory messages come in, and motor messages go out, in a synchronized way, we can do what we need to do. The more efficient our brain is at processing sensory intake, the more effective our behavioral output will be. The more effective our output, the more feedback we receive to help us take in new sensory information and continue the never-ending process of sensory integration. The normal development of SI is - Level 1 - Primary sensory systems by 2 mos.; Level 2 - Perceptual-Motor Foundations by 1 year; Level 3 Perceptual Motor Skills by 3 yrs. and Level 5 - Academic Readiness. When Sensory Integration is Inefficient ...dysfunction occurs when the open-ended, reciprocal process of intake/organization/output is disrupted. Here is what may happen - 1st, Inefficient sensory intake 2nd, Neurological disorganization 3rd, Inefficient motor, language or emotional output... The brain of a child with inefficient sensory integration does not operate smoothly... So as you can see, there is a complex system that must be wired properly for the child or adult to function. If anything goes wrong, the whole system functions improperly...one faulty part will seize the unit. Ms. Kranowitz uses the phrase "A Short in the Circuitry" to give a simple explanation for why the child cannot process information properly. The child may have one of 3 possibilities in the realm of SID... 1) Hypersensitivity...the brain of the hypersensitive child registers sensations too intensely... 2) Hyposensitivity...the brain of the hyposensitive child registers sensations less intensely than normal... 3) A Combination of Hyper- and Hyposensitivity...the child may seek intense sensory experiences such as spinning on playground equipment - but be unable to tolerate them. Or he may seek intense experiences some days but avoid them on other days. His over- or underreaction may depend on the time of day, the place and the stimulus. Now combine those tendencies with the senses and your SID child may have any number of combinations of hypo, hyper or both, to vestibular, proprioceptive and tactile areas. She goes on to include in this chapter "Five Important caveats" which I think are worth noting... 1) The child with SID does not necessarily exhibit every characteristic. 2) Sometimes the child will show characteristics of a dysfunction one day but not the next. 3) The child may exhibit characteristics of a particular dysfunction yet not have that dysfunction. 4) The child may be both hypersensitive and hyposensitive. 5) Everyone has some SI problems now and then, because no one is well regulated all the time. We as parents of SKs or SIDs can relate to the list and the idea that it is the frequency, the duration and the consistency of the reaction. What is difficult at times is whether the reactions are SID related or just part of normal growing up. Your parental observations and your understanding of your child's "normal" range are essential to proper diagnosis.
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