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(Autism and Sensory Integration Therapy) Research paper draft review

teresam74 1 / -  
Dec 3, 2011   #1
Specific from instructor... looking for a review listing 3 areas of weakness in need of attention.

What I already know of this draft: I tend to use run-on sentences, transitions and flow needs some help. Does it work enough to show my purpose? Is the thesis evident...weak, strong??

Autism and Sensory Integration Therapy

Children with Autism display developmental differences that set them apart socially, academically and emotionally from children without Autism. These differences are often reflected in the peculiar behaviors and mannerisms Autistic children exhibit, which often make daily life a constant struggle. It is believed that these behaviors are actually coping mechanisms designed to help with a dysfunction within their sensory system, a dysfunction known as sensory processing disorder (SPD). Sensory integration therapy can help reconstruct sensory pathways and eliminate the need for the bizarre coping behaviors. Thus, offering Autistic children the chance to level the developmental playing field and prosper as non Autistic children.

Before I explain how this sensory integration therapy helps the Autistic child let me first delve more into the sensory system inner workings. In a normal functioning system the body receives sensory sensations which the brain then processes and formulates a proper response and acts upon that information. In an Autistic child this process malfunctions with input unable to be deciphered. The problem is often that either too little input is received or too much input is coming in and overwhelming their systems. Children that receive too little input are categorized as Hypo-sensitive, with sluggish sensory receptors. The children receiving too much input are categorized as hypersensitive, with sensory receptors that appear to be in overdrive. These categories of input are important to understand as I move forward and explain sensory sensations received in the various systems that makeup the sensory system.

The first and largest of these systems is the tactile system. This system involves touch sensations characterized as light touch, pain, pressure and temperature. These sensations are received through nerves underneath the skins surface. (Hatch) This is a massive system if you consider that stimulation can occur simultaneously on all surfaces of the skin. Children classified as tactile hypersensitive may react negatively to tactile stimulation. This is known as tactile defensiveness or tactile avoidant. Children may feel irritation or pain from the lightest touch. They may avoid hugs or other affectionate gestures. These children are often irritated by fabric in bedding or clothing worn, specifically tags sewn in the neck of shirts. (Kranowiz, 23) They may also avoid contact with various surfaces such as walking on grass or in sand. Wounds as simple as a simple scratch are perceived to be much more intense. Hypersensitive children may appear to be wimpy and baby like. Often they lag behind peers in age appropriate behaviors which make them targets for bullying and rejection.

On the opposing end, hypo-sensitive children crave and actively seek stimulation. These children are known for constantly touching things or bumping into things. Many enjoy rough play and do not realize they are playing too rough often hurting their friends. They may also seem to find humor in hitting others, to them being rough feels good unable to understand that others feel pain from this same behavior. Injuries received by the hypo-sensitive child may go unnoticed until someone points it out or the child notices they are bleeding, pain simply does not register a response. (Krakow, 25) They may also wear clothing inappropriate to the weather such as saying they do not need a jacket on a cold and snowy day. Similar to the hypersensitive children these behavior responses and difference makes rejection by peers a common occurrence.

These two types differ greatly from the non Autistic peers. Developing typically children have a natural ability to decipher tactile input and act appropriately. The light touch such as that from a feather is deciphered as a light pleasurable tickle causing them to laugh. (Kranowz, 23) As they walk outside on a snowy day they feel the cold and instantly respond by retreating for a warm jacket and gloves. Pain from an injury will result in an age appropriate response to level of pain the injury causes. Their behaviors are well regulated an appropriate to the stimuli input they have received.

The next system to make up the sensory system is the proprioceptive system. This system involves sensations received through the muscles, joints and tendons. The role of this system is to allow the body to sense itself within the physical environment. Children displaying a dysfunction within this system are described as clumsy and highly accident prone. They may display the inability to position the body effectively or lack proper posture such as always slouch while sitting. They also lack ability in fine tuning motor movement skills. Children with a dysfunction may have difficulty with age appropriate tasks such as fastening buttons, zippers, properly holding a pencil or using utensils.

A dysfunction in this system also hinders the brain's ability to create, organize, and properly follow through with actions that are unexpected and unfamiliar to the child. For example, they may lack the ability to properly address falling. They appear to lack self preservation instinct. A developing typically child would extend arms or brace themselves from being injured during a fall, a child with a dysfunction will simply fall with no response to "save" themselves. This is in part due to a dysfunction within the third sensory system, the vestibular system. This system helps the body coordinate movement while it maintains balance and equilibrium. In the last example during a fall, the body receives input through movement of the body (vestibular system) but is unable to connect that input with a response from the muscles (proprioceptive system) needed to extend arms and brace the child from the fall. Another example is walking down a flight of stairs. A typical proprioceptive system would understand one foot then the next easily going down stair to stair. In a malfunctioning system the act of one foot then next may not be understood. Most of Autistic children hold stair railings (even beyond the age where it is needed) and the same foot hits each consecutive step, the second foot is simply there to hold them unable to sync with the other and aid in going down.

The last system to make up the sensory system is the vestibular system. The vestibular system is connected to the inner ear so movement is its primary role, specifically movement that involves the head. For the hypersensitive child movement can be extremely overwhelming, their system is unable to break the input down and compartmentalize the information. Think in terms of spinning in circles and trying to walk as soon as you stop, dizziness makes this difficult. The hypersensitive child often interprets the slightest movement in this way, with a constant inability to find balance in their surroundings. You will find that these children often dislike and avoid playground swings, ladders and slides, knowing that in the past the feeling aroused was not enjoyable. In early years or for non verbal children this if often misunderstood as a fear rather than as self preservation coping response. They prefer more sedentary type play and activities they often have great focus on tasks they enjoy.

This differs greatly from the hypo-sensitive children who are often constantly on the go seeking stimulation. Their systems have a dysfunction in the receiving of the input. They simply do not register the input. Spinning in a circle seems to have little effect on them unless extended for a longer duration. This type of child will actively seek out movement such as that from swings, slides or fast moving amusement rides. They appear to be on the move constantly, unable to sit still and may lack focus for more than a minute. These children also display bizarre behaviors such has hand flapping, spinning or rocking themselves when they need stimulation but are in an environment where sitting still is more appropriate.

In addition to movement children with vestibular dysfunction also display sensitivities to sound. Which makes sense when you consider the vestibular system involves the inner ear which is in close proximity to the auditory system. Hypersensitive children may cover ears or express a flight response, fleeing at the occurrence of unexpected sound. They may also be hyper vigilant and unable to tune out every day sounds such as the hum of refrigerator, a clock ticking or environmental sounds like birds or passing cars. (Kranowiz, 42) This inevitably hinders their ability to focus and stay on task. In contrast hypo-sensitive children may not register these sounds. They often appear to ignore those speaking to them or may be mistaken as deaf.

Those are the three systems of the sensory system broken down with the various behaviors these children use to cope. Keep in mind that the body functions using information from all of these systems, typically simultaneously. Examining the systems in this way makes understanding why Autistic children behave the way they do easier. It makes empathizing with them easier. Unfortunately empathy does little in helping them unless steps are taken to help them correct the malfunction or teach how to effectively live with the malfunction. This is where sensory integration therapy becomes so important.

This therapy is comprised of strategies, known as a sensory diet, of exercises and activities that target specific sensory systems. Each diet is child specific to their specific needs. Occupational therapists "focus on increasing a child's ability to tolerate a variety of sensory experiences, both the activities and environment should be assessed for a "just right" fit with the child." (Autism-help) This takes skill and patience. Once sensory diets are decided upon the child will have a regular and consistent schedule with the occupational therapist, and incorporate as much of the sensory recommendations into every day life. Consistency is crucial.

Therapy specifically targeting the tactile system may include messy play and varied textured play activities. Messy play may include play dough, silly putty, slime, shaving cream, glue, finger paints. Children may also sift through various tubs filled with textured items such as rice, pebbles or sand. Activities may also include walking on grass, sand, rocks or emerging the body within a variety of items like ball pits and textured tunnels. Weighted (heavy) activities target all three systems but are specifically designed to around sending input to the muscles and joints. Activities may include pushing and pulling weight objects as well as squeezing, pulling and pinching resistant materials. Movement activities target the vestibular system. Swinging, spinning and inverting the body to an upside down position are common activities. Therapies offered to the hyper and hypo sensitive children are the same, proper balance for each is the key to effectiveness.

These activities and exercises may seem like typical everyday things that all children do. But, remember in the Autistic child the pathways are broken and therefore responses are out of sync. Like physical therapy on the body sensory integration therapy heals and strengthens the sensory connections. Think in terms of following a map to get form point A to point B with recommended pit stops along the way for fuel. Sensory integration therapy is training the brain by showing children that stimulation (point A) needs to follow the path of receiving, organizing and interpreting (the recommended pit stops) and respond with the appropriate behaviors (point B). Reconnecting this pathway will make every day life easier. It will also lessen the behaviors and mannerism that set Autistic children apart from others. This alone will have a large impact in their overall development.

Despite my obvious belief in sensory integration therapy's abilities to help Autistic children, the effectiveness has been deemed inconclusive by much of the medical community. Most studies make this claim due to an overall lack of effectiveness in all participants of the study. With that said nearly all studies I reviewed indicated that many, if not a majority, of the participants had marked improvements noted in self stimulation behaviors after therapy intervention. Per the conclusion of a pilot study conducted on the effectiveness of intervention therapy "fewer autistic mannerisms appeared after interventions. Previous studies found similar outcomes when assessing the reduction of stereotyped or self-stimulatory behaviors...after sensory-based interventions." (Pfeiffer). The same result is shown in a study conducted by Temple University, "In 2007, 71 percent of parents who pursued alternatives to traditional treatment used sensory integration methods, and 91 percent found these methods helpful." Again these studies are unable to state empirically that therapy does in fact change sensory response, because not all children respond with a marked change in behavior. But the evidence does exist that sensory integration therapy has in fact had a positive effect on some children.

In conclusion we can see that that the many behaviors Autistic children exhibit are directly related to a malfunction within their sensory systems. We can also see that these behaviors hinder these children from adapting to their surroundings. This inability to properly adapt makes interactions with peers and overcoming developmental obstacles unnecessarily difficult. Lessening these burdens through sensory integration therapy means allowing these children a better opportunity to sensory malfunctions and properly react to the senses with behaviors that do not set the apart from peers

Works Cited

Autism-Help. "Sensory Problems and Autism". n.p. n.d. Autism-Help. Web. 02 November 2011.
Hatch-Rasmussen, Cindy M.A., OTR/L. "Sensory Integration". Autism Research Institute. Web. 29 November 2011.
Kranowtiz, Carol Stock, M.A. Out of Sync Child. New York: The Berkley Publishing Company, 1998. Print
Pfeiffer, B. A., Koenig, K., Kinnealey, M., Sheppard, M., & Henderson, L. (2011). Research Scholars Initiative-Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. American Journal of Occupational Therapy, 65, 76-85

Temple University. "Autistic Mannerisms Reduced By Sensory Treatment." Science 2008. Web. 17 Nov. 2011.

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