Sensory Integration Education

Consider your self-regulation situation, right now, as you are reading this article. Say your goal is to get to the end of the article. This goal requires you to focus your attention: you may have reduced external distractions; you will need to manage any emotional reactions or physiological intrusions that could interfere with your attention; and you will need to stay alert - so you may be sipping a drink or shifting in your chair.

During these few moments, your central nervous system has been registering, integrating and processing a huge amount of complex information from your external and internal environment. The process is both “top-down”, as you consciously ready yourself to focus on the article, but also ‘bottom-up”, as various structures in your brainstem and limbic system monitor and respond to demands in your environment. Your body is doing an awful lot for you to self-regulate enough to simply sit still and read to the end of this article!

What Is Self Regulation?

But what do we mean by self-regulation? For our purposes, self-regulation refers to the way in which we regulate our emotions, our levels of arousal, stress levels and levels of attention so that we can carry out the things we need and want to do in our daily life. Self-regulation occurs within our central nervous system and it includes both our ability to consciously and automatically regulate our emotions, stress response, alertness and attention. It’s the conscious element of self-regulation which means we can learn strategies to improve focus, or help to keep us calm or alert.

What Is Sensory Integration?

What is the link between emotional self-regulation and sensory integration? Firstly, a little about sensory integration. Sensory integration is a theory and a therapeutic approach originally proposed by Dr Jean Ayres. Sensory integration theory draws on evidence related to how the brain works and how neurons in the brain can develop new pathways and strengthen pathways through learning and repetition.

The different parts of our body that receive sensory information from our environment (such as our skin, eyes and ears) send this information up to our brain. Our brain interprets the information it receives, compares it to other information coming in as well as to information stored in our memory and then the brain integrates and uses all of this information to help us respond to our environment. Therefore, sensory integration is important in all the things that we need to do (such as getting dressed, eating, socialising, learning and working).

For most of us, the development of sensory integration occurs when we are young as part of our normal development and in the things we do such as rolling, crawling, walking and in play; for others sensory integration is less well developed – and this can lead to difficulties.

The Link Between Self-Regulation and Sensory Integration

The association between sensory integration difficulties and self-regulation has long been of interest to SI therapists. And many parents of children with sensory integration, or sensory processing, difficulties express concerns about their child’s abilities to manage their emotions. A study by Cohn and colleagues (2014) found that 72 percent of parents whose children were referred to sensory integration therapy reported concerns for, or hopes of improvement in, their child’s self-regulation ability.

Ayres identified that successful development of sensory integration underpins emotional stability, attention span and activity levels.

Because tactile, vestibular and proprioceptive systems support the child’s ability to engage with their environment, Ayres argued that these systems also support development of emotional stability because being unable to properly engage with the environment would be a frustrating, overwhelming or disengaging experience. The auditory and visual systems are also important: if a child’s auditory or visual threshold is too low, they are more likely to focus on these sensations and find it difficult to pay attention and focus on other stimuli, impacting on their ability to focus and engage with the social world.

Sometimes, our level of arousal can be very high - for example, when we are feeling worried, angry, stressed or excited. Other times, our level of arousal is too low, such as when we are feeling sad or tired. When our level of arousal is too high or low this can impact on our ability to do daily tasks. We need our level of arousal to be just right for that activity, whether it is reading, playing a game of tennis or winding down for bed.

Sensory integration difficulties can lead to increased sympathetic nervous system arousal and a heightened stress (fight-or-flight) response.

Think about a person who is under-responsive to sound or even a situation where you are so focused on what you are doing that you are not aware of sounds around you. Someone calls your name but you don’t notice. By the time the call has got your attention, they are so close and loud that it startles you, triggering a fight-or-flight response in your sympathetic nervous system.

On the other hand, if a person’s central nervous system struggles to inhibit sensory information, such as sound, they would experience those senses more intensely than other incoming information. Situations that others would find non-threatening, would be for that individual very stressful. Think about a person who is over-responsive to sound or times when you are more alert to a sound, such as when you are convinced there is someone outside your home. Every sound then would alert your sympathetic nervous system.

Research has shown that sensory over-reactivity and anxiety are found to occur together. And we understand that sensory reactivity can lead to a fight-or-flight response. This heightened activity of the sympathetic nervous system can make it more difficult for a person to regulate their stress response.

It is also important to note that a person who has needed to manage difficulties related to sensory integration all day, will have been in a constant state of fight-or-flight, and will have depleted resources by the end of the day. For example, an adult who has had to try to focus at work with auditory over-reactivity or the child with low postural tone who has had to sit still all day, will come home tired with their reserves run low. That child, struggling with the ability to self-regulate at home after school, could react by charging around the house, being over emotional and quick to react or be unwilling to do anything: they can’t modulate their responses any longer after having held it together at school all day.

How Can SI Therapy Help With Self Regulation?

A qualified sensory integration practitioner can assess an individual’s needs and abilities and make recommendations for specific exercises and activities, as well as adjustments to their home/school/work environment, that can develop and improve self-regulation.

A qualified sensory integration practitioner will have gained additional in-depth postgraduate training following their initial qualification to become a therapist. This training involves developing a detailed understanding of the neuroscience and evidence base underpinning sensory integration, as well as developing expertise in assessing and providing intervention for people with sensory integration difficulties.

Want to learn more?

If you are a qualified occupational therapist, physiotherapist or speech and language therapist and are interested in learning more about sensory integration (SI) theory and the benefits of a sensory integration-informed approach to your practice, why not take a look at our SI postgraduate courses which are accredited by the UK’s award-winning Sheffield Hallam University. Our free online course ‘Transform Your Practice with Sensory Integration: A Free Course for Therapists’ is a good starting place for understanding more about SI and its relevance to your clinical practice.