Sensory Integration

Sensory Integration Dysfunction Overview:


Sensory Integration Dysfunction (SID) refers to the difficulty or inability the brain has in correctly processing information brought in by the senses. Children with Sensory Integration (SI) issues have difficulty organizing and processing sensory input from their environments. This may lead to behaviors that often limit their play, socialization, fine motor, gross motor and self- care skills to varying degrees. Sensory Integration Dysfunction can present itself in many forms and are commonly noticed in children with Autism and is also often seen in children with other disabilities such as ADD/ADHD or can be present by itself. It presents itself in a number of sensory seeking, sensory avoiding and Dyspraxic characteristics (clumsy, awkward movement patterns, difficulty planning movements). These issues can present range from mild to severe and impact on daily life accordingly.



Children with Sensory Integration Dysfunction Often Display Some or Many of the Following Behaviors:

Activity Level:

  • Frequently seeks out movement experiences that might interfere with daily life activities

  • Might take excessive risks at school, home or within the community.

  • Seems hyperactive

  • Might seem lethargic and sluggish / avoiding movement activities more as compared to peers

  • Seems slow to respond to movement demands or requests


  • Difficulty paying attention

  • Easily distracted

  • Difficulty following directions, poor attention span

  • Frequently moves from one activity to another, difficulty finishing tasks / games

  • Acute awareness of background noises which interferes with attention


  • Might prefer to be in the dark / Avoids bright lights or lights in general

  • Seeks out looking at / staring at lights or objects / toys with spinning parts and / or flashing lights

  • Excessive, prolonged staring at people or objects

  • Avoidance of / poor eye contact

  • Might seem to fixate on staring at spinning or repetitively moving objects / toys or lights such as fans, leaves on trees etc.

  • Stares at lights / flashing lights

  • Difficulty with visual perceptual skills such as puzzles

  • Difficulty copying work accurately from the board (incorrect copying / misses lines)

Touch Processing (Under-Responsive):

  • Decreased awareness of pain or temperature / little or no crying when obviously hurt

  • Has to touch everything and touches people / objects to the point of irritation

  • Frequently or always wants to be barefoot or with minimal clothing

  • Seems to not be aware of food around mouth, mess on hands etc.

  • Leaves clothes twisted around body seemingly unaware

Touch Processing (Over-Responsive):

  • Exceptionally low pain tolerance complains of being hurt when accidentally touched

  • Walks on toes to avoid sensory input from the bottom of the feet

  • Frequently complains how clothing feels, agitated by tags on clothes as well as seams on socks (Clothing has to be positioned perfectly )

  • Avoids getting messy in glue, sand, finger paint, tape

  • Is sensitive to certain fabrics (clothing, bedding)

  • Avoids going barefoot, especially in grass or sand

  • The child may react strongly to stimuli on face, hands and feet

  • Avoids contact with or seems agitated by messy media such as finger paint, glue, sand, etc.

  • Avoids or responds negatively to grooming activities such as brushing the teeth, washing face, brushing or cutting hair

  • Refusal to wear certain clothes or insist on wearing long sleeves/pants to limit skin exposure

  • Frequently adjusts clothing

  • Extreme responses to accidental touch for example striking out at someone who accidentally brushes by them

Over-Responsiveness to Movement / Vestibular Input:

  • Becomes anxious or distressed when feet leave the ground

  • Avoids climbing or jumping in general

  • Hesitant to approach or play on age appropriate playground equipment

  • Avoids or gets overly anxious on amusement park rides

  • Can become car sick / nauseous when riding in a car

  • Hesitates going up and down steps

  • Fearful in space (on the swings, seesaw or heights)

Under-Responsiveness to Movement / Vestibular Input:

  • Excessively seeking out or fearful of movement activities, such as swinging, climbing, etc.

  • Seems to have no / little sense of fear

  • Seems to always be on the go

  • Spins, jumps excessively

Response to Noise / Sound (Auditory Input):

  • Oversensitivity to / more acutely aware of sounds in general

  • Appears scared / unusually startled by every day noises

  • Responds with anxiety / overly negative to unexpected or loud noises such as alarms, fire truck, fire alarm, etc. (more difficulty than expected calming afterwards)

  • Holds hands over ears in response to even daily life noises such as for e.g. coughing, laughing, toilet flushing, cars

  • Cannot walk with background noise

  • Might also seem oblivious within an active / noisy environment

  • Might often appear to not hear when name is called or have difficulty paying attention to relevant auditory stimuli within a noisy background (for example teacher s voice within classroom)

Response to Taste / Smell:

  • More limited diet than others his / her age due to being a picky eater

  • Overly sensitive to / annoyed by everyday smells that others might just ignore

  • Unusual sensitivity to sounds and smells

  • Avoids certain tastes/smells that are typically part of children's diets

  • Frequently has hands in mouth / mouths non-food objects (when not age appropriate)

  • Frequently smells nonfood objects

  • Seeks out certain tastes or smells

  • Does not seem to smell strong odors

Body Position in Space / Posture:

  • Hangs on other people, furniture, objects, even in familiar situations

  • Seems to have weak muscles, tires easily, has poor endurance

  • Joints might appear hyper mobile ( double-jointed )

  • Appears to walk stiffly / awkward / uncoordinated

  • Turns whole body to look instead of trunk rotation or turning head

  • Often or always walks on toes

  • Confusion over left and right as well as directional confusion

  • Frequently bumps into objects / appears clumsy or accident prone

  • Seems to easily get lost at times, even in familiar spaces

Toy Manipulation / Classroom Tool Use:

  • Poor coordination, difficulty planning motor movements when playing with toys or using classroom tools

  • Limited play skills due to difficulty figuring out how to play with toys

  • Awkward crayon or marker grasp

  • Excessive or insufficient pressure when drawing / writing / coloring

  • Difficulty with tasks requiring the coordinated use of both hands such as catching or hitting a ball, holding down paper with assistor hand while writing or turning paper while cutting etc.

  • Difficulty operating scissors

  • Poor or delayed handwriting / pre-writing development / Difficulty learning how to form letters

Behavior / Social:

  • Can appear anxious in social situations or in general

  • Has difficulty making friends

  • Might have difficulty expressing emotions / might appear to have a flat affect

  • Overly affectionate with others / Seems to have difficulty maintaining personal space within a social setting

  • Unexpectedly explosive / tantrums easily

  • Resistant to new situations

  • Responds more negatively to changes in routine than others might

  • Difficulty stopping one activity to start another / difficulty transitioning

  • Gets easily aggressive or angry when in a group, in line at school, does not like to be touched, even accidentally

  • Avoids physical contact

  • Impulsiveness and poor frustration tolerance leads to conflict or difficulty waiting turns

  • Seems accident prone

  • Seems to have a harder time than others calming down

  • Appears to get easily over-stimulated


Our Occupational Therapists Can Help With Sensory Integration Difficulties:

Sensory Processing and Modulation Assessment: To narrow down and pin-point your child's specific Sensory Integration issues as well as recommendations for home and school to address these issues.


Standardized Testing: To assess how your child is performing in terms of coordination, dexterity as well as visual-motor integration skills compared to peers.


Therapeutic Listening: Assessment and Intervention - This listening program is geared to improving tolerance to noise, language development, movement processing as well as attention, body in space awareness and social connectedness.


Sensory Integration Therapy Services: Our experienced Occupational Therapists help to improve your child's ability to organize the central nervous system through specific sensory input and activities and therapeutic activities. The suspended equipment/swings as well as multi-sensory movement and tactile toys within our Sensory-Motor Gym are geared specifically to the needs of children with Sensory Integration.


Sensory Diets and Practical Home Recommendations: Our therapists help parents cope with daily challenges manifesting as a result of Sensory Integration Dysfunction. Children with Sensory Integration Dysfunction often need to experience specific movement and touch experiences daily in order to feel regulated and calm as well as to learn effectively. Our therapists assess your child's Sensory Integration needs and prescribe home activities in order to facilitate improved calming, self-organization, attention and an improved ability to deal with daily life challenges.


School Consultations: We consult with school personnel to assess your child's needs within the functional environment. Through these visits our Occupational Therapists provide relevant, practical Sensory Diet and other classroom/school recommendations to maximize participation.


Home Visits: Some therapy sessions and assessments can be performed within the home environment. Many parents find this helpful in terms of first hand observations and behavior. Our Occupational Therapists asses the home environment and make recommendations regarding how to modify the environment as well as on how to use everyday materials within the home to address and help change your child's responses to sensory input.