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Sensory Integration and Motor Control

The author and initial researcher of Sensory Integration Theory is Dr. A. Jean Ayers, PhD, Occupational Therapist.  Her work presents an expansive theory describing how the brain and the body processes, organizes, and integrates the sensations received through sight, sound, touch, taste, smell, body position, and movement. 

Students with visual impairment rely on hearing, touch, body position and movement sensations for everyday activities.  Normally these activities are directed by vision. Sensory Integration theory provides a framework to help emphasize and explain the role of all our sensory systems.  It also provides recommendations for sensory processing disorders.

Touch

The tactile system processes touch experiences felt through the skin as light touch, firm touch or pressure, static touch, moving touch, temperature, pain and comfort.  There are two primary functions of the tactile system. One is protection and the other is discrimination.  The protective touch function is neurologically bound to the limbic system of the brain.  This system is described as the emotional control center with direct connections to the primal flight or fight responses.  The protective function of the skin is reflexive and primarily unconscious with touch sensations automatically categorized into calming, soothing, familiar sensations - or into danger reactions. The discrimination functions of the skin are conscious, cognitive tasks that are learned through experience.  These include touch localization, recognition, and stereognosis. Localization refers to knowing where on the body one is being touched. Tactile recognition is required to learn characteristics of objects such as size, shape, texture, and the weight of items.  Stereognosis is object recognition through touch.

Signs of tactile system imbalance:

• Reacts negatively to touch, does not like being picked up or hugged.
• Does not like being touched and may rub or press on their skin after being touched.
• Startles easily.
• Inability to feel touch immediately and responses are delayed.
• Extraordinarily high or low tolerance for pain. 
• Does not like certain clothing or tags in clothes and wears clothes for the wrong season.
• Does not like band-aids or stickers on skin.
• Uncomfortable wearing shoes or socks or unwilling to walk barefoot.
• Does not like brushing hair or teeth or cleaning and trimming nails.
• Avoids certain foods because of texture or does not chew food well.
• Rejects touching messy materials and will not handle clay, mud, shaving cream.
• Washes or wipes hands often.
• Uses fingertips instead of the entire hand.
• Has a hard time sitting still.
• Is poorly coordinated, is a heavy walker, or walks on toes.
• Craves touch and may over-touch others or objects.
• Doesn’t notice when hands or face are messy
• Doesn’t notice when clothes are twisted or when feet are not well placed in shoes.

Body Position

Proprioception refers to body position sensation and is required to regulate movement and posture. This system allows us to feel the position of our limbs for motor control and to determine the amount of strength needed for specific actions, or graded force. It is an unconscious feedback system between the muscles & joints of the body and the brain. The receptor stimulus is the bending, straightening, pulling, and compressing of the body’s joints between the bones. Proprioception is closely connected to both the tactile and the vestibular systems.

Signs of proprioceptive system imbalance:

• Has difficulty planning and executing motor tasks for gross or fine motor activities - getting on or off a bike or riding toy, climbing on/off playground equipment, buttoning clothes, turning on/off a faucet, pouring, etc…
• Has a high need for jumping.
• Enjoys hanging by the arms.
• Tends to lean on or hang on people or furniture.
• Enjoys falling down.
• Assumes odd body positions.
• Is clumsy and plays roughly.
• Breaks toys often.
• Grips a pen or pencil too loosely or too tightly.
• Has difficulty with fine motor skills for picking up small objects.
• Did not crawl much during early development.
• Difficulty grading muscle force – muscle exertion is either too much or too little to manipulate objects and perform tasks.
• Puts non-food items in the mouth, chews on clothes, or grinds teeth.
• May hit, pinch, or bite themselves or others.

Movement

Vestibular processing refers to movement and balance sensations.  These are the combined functions of the semicircular canals of the inner ear, basal ganglia, cerebellum and the cerebral motor cortex. This system regulates the feelings of motion such as balance, acceleration, deceleration, starts and stops, direction, rhythm, and creates and stores patterns of movement. The hair cells inside the semicircular canals are activated according to position and movement of the head in relation to gravity. Vestibular processing is likely to be impacted by auditory impairment.

Signs of vestibular system imbalance:

• Difficulty maintaining balance and controlling the speed and direction of movement.
• Poor balance reactions such as protective extension or righting responses.
• Poor spatial orientation and is easily confused by directions.
• Fears being upside down or tipped sideways.
• Is anxious when feet are not touching the ground.
• Is anxious about walking up or down inclines.
• Is anxious walking up or down stairs.
• Rejects unfamiliar movement activities and is afraid to move backwards.
• Is afraid of movement, or is gravitationally insecure.
• Gets motion sickness easily.
• Is anxious about swimming.
• Seeks out gross motor movement and may have a very high tolerance to spinning.
• Possible extraneous or non-purposeful movements.
• Can’t sit still – craves movement.
• Likes to fall without regard of safety.
• Difficulty with self regulation.
• Needs to be moving but this may interfere with listening and interacting.
• Needs to be moving in order to listen or be attentive.
• Needs to jump or spin.
• Likes inverted upside down position.
• High or low muscle tone, the vestibular system combines with the proprioceptive system to regulate muscle tone.

Lisa Ricketts, OTR
Texas School for the Blind and Visually Impaired
lisaricketts@tsbvi.edu
512-206-9190

Occupational Therapy and Sensory Integration

Lisa Ricketts, OTR

As an Occupational Therapist at TSBVI, I am inspired to learn all I can about the Theory of Sensory Integration by Dr. Jean, A. Ayres. As a specialist for children with visual impairment and multiple disabilities, I am studying the impact of vision loss on the other senses and overall developmental progression. I also work at a Sensory Integration Clinic here in Austin for the treatment of autism and sensory processing disorders.  I am lucky to be surrounded by expert teachers, therapists, school psychologists, and most importantly by my students who I learn from every day. The purpose of this information is to share terminology, explanation, and problem solving ideas with students, parents, and teachers to improve learning.

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