Sensory integration

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Sensory integration is the coordination, the interaction of different sensory qualities and systems. It takes place in the tertiary association areas of the angular gyrus and supramarginal gyrus of the dominant hemisphere. As a transition region, these sensory centers in Brodman areas 39 and 40 and probably also 37 combine the secondary visual, auditory and kinaesthetic association areas. These research results are due to topical brain research in connection with functional and pathophysiological approaches.

Examples

1. The gravitational stimulus that acts on the vestibular system in the inner ear ( utricculus and sacculus ) triggers the provision of muscle activities ( proprioception ).
2. Balance stimuli (someone pushes us or we stand on only one leg) stimulate receptors in the semicircular canals of the inner ear and provoke an adjustment in posture (we do not fall).
3. Eyes follow a moving object.
4. We hear a noise and turn our head to the sound source.
5. Eyes control the movement when writing (eye-hand coordination) together with the tactile (touch stimuli via skin receptors) and proprioceptive (deeply sensitive stimuli via joint, tendon and muscle receptors ).

Sensory integration disorders

Sensory integration disorders are disorders of the interaction of the sensory modalities . See also Disorders of Sensory Processing .

Examples:

1. The vestibular stimulus does not lead to an appropriate posture. The basic tension of the muscles is too low ( hypotonic ). Maintaining adequate postural stability requires conscious effort and attention. This attention is then lacking for other activities. It can happen that a child at school copies from the blackboard and falls off the chair because all the attention is absorbed from writing and is no longer available for postural control. Such children appear limp. Some surrender to this slackness, others fight against it. This struggle manifests itself in motor restlessness, which is similar in appearance to attention deficit disorder (ADD / ADHD) , but is not identical to it. While in the latter case, the lack of attention is the cause of the motor restlessness, here it is exactly the opposite: Hypotonus demands restlessness of movement that draws attention away from other activities (participation in class). The aim is to increase the muscle tone with the success of an improved self-perception (via the joint and muscle receptors). However, these efforts generally do not lead to a permanent improvement in the basic muscle tension ( basic tone ).
2. A child is tactile and proprioceptive and therefore cannot plan his movements sufficiently. This manifests itself in clumsiness ( dyspraxia ).
3. A child is tactile or vestibular over- sensitive. This type of hypersensitivity is also called a modulation disorder , which means that the child's nervous system cannot adequately modulate the incoming stimuli, i.e. filter them (formatio reticularis) or inhibit them. Another name for this form is tactile defense .
4. In the case of tactile defensiveness, the child mainly avoids unexpected contact with other people or materials with a diffuse stimulus quality (foam, wool, paste, etc.). It reacts to such contact aggressively or defensively, following an evolutionarily old pattern. Such people often try to control encounters with other people or avoid situations in which unexpected contact can occur (queues, discos, subway rides). This can lead to social anxiety and behavioral problems.

Vestibular defensiveness is a dramatic form of fear of heights. The fear can be triggered by everyday activities such as swinging, cycling, or climbing stairs.

Adults can also be affected by sensory integration disorders. However, it is mostly people who already had perception problems as children.

Sensory-integrative functions can also be impaired by neurological diseases ( stroke , multiple sclerosis ). In this context, however, one does not speak of an SI interference. The term SI disorder refers to a brain physiological dysfunction (an inadequate connection of nerve cells and brain structures), but not to the morphological changes that occur in the diseases mentioned (destruction of brain tissue or nerve pathways).

People with an autism spectrum diagnosis often have peculiarities in sensory perception, such as increased or decreased pain perception for different sensory channels. Some see a typical characteristic in the often inflexible change of attention from one sensory channel to another. Dinah Murray and Wendy Lawson described this as monotropism , Donna Williams as monotrack, and specifically monoprocessing.

The psychosocial dimension of sensory integration

Social relationships are spatial relationships. This is already clear in the usage of the language: To be close to someone, to stand by someone, to feel drawn to someone, to be aloof, to be above something, to subordinate oneself, to get on top of things, to cling, to let go, to trick someone, to be repulsive, to distance oneself, to bow to make someone are terms that describe social relationships on the basis of spatial relationships. Those who cannot assess distances well sometimes come too close or not close enough to others and therefore experience U. Rejection instead of affection . Or he lets others get too close and thus experiences unpleasant encounters . Everyone needs a personal sphere. For most people, this is a distance of about 1.5 meters. Whenever possible, most of them keep this distance. Only if it cannot be avoided (in the elevator, the subway, in the football stadium) will we tolerate falling below this distance. If it falls below this limit, the others feel harassed and may react aggressively. Children with sensory-integrative limitations sometimes not only run against door frames because their body structure is underdeveloped, but also bump into other people. Those who only inadequately feel where they are in the room can also only poorly relate to others.

Sensory integration therapy

Sensory integration therapy was largely developed by the American occupational therapist and psychologist A. Jean Ayres . In addition to extensive, partly standardized diagnostic procedures, occupational therapists mainly use free behavioral observation.

The aim of the therapy is to improve sensory integration. Means are the targeted stimulation or the targeted stimulus z. B. through therapeutic riding .

For example, the basic muscular tension can be improved by linear acceleration (roller-boarding, trampoline jumping, swinging in the hammock).

A somato-sensory dyspraxia , i.e. a limitation of the motor planning ability , is addressed by provoking motor adaptations.

Tactile and vestibular defensiveness can be inhibited by proprioceptive stimuli (deep pressure, pressure and pull, work against resistance).

As a rule, the therapy is non-direct: the therapist lets the child show him the direction. The therapeutic work can only be successful if the child experiences the importance of his or her actions in the activity.

SI therapy is mainly used in children, but now also in adults, especially in the case of mental illnesses that are accompanied by disorders of body perception (schizophrenia). SI therapy is also used in geriatrics for people with dementia.

See also

• Field of experience for developing the senses

literature

• A. Jean Ayres : Building blocks of child development. Berlin 2002.
• Waltraud and Winfried Doering: Sensory integration areas of application and comparison with other funding methods / concepts. Dortmund 1992.
• Fisher / Murray / Bundy: Sensory Integration Therapy. 1st edition Berlin 1998.
• Nicole Hendriks, Manuela Freitag: Sensory Integration. In: Norbert Kühne , K. Zimmermann-Kogel: Practical book social pedagogy. Vol. 2. Bildungsverlag EINS , Cologne 2005, pp. 95–118.
• Rega Schaefgen: Practice of Sensory Integration Therapy - Experiences with an occupational therapy concept 1st edition 2007.
• Kesper / Hottinger: Mototherapy for sensory integration disorders - a guide to practice. 6th edition 2002.
• Renate Zimmer : Handbook of Sensory Perception - Basics of a Holistic Education. Herder Verlag, Freiburg, Basel, Vienna, ISBN 3-451-26905-8 .

Web links

• Society for Sensory Integration Jean Ayres, Germany and International e. V.

Individual evidence

1. ↑ Peter Duus: Neurological-topical diagnostics . 5th edition. Georg Thieme Verlag Stuttgart 1990, ISBN 3-13-535805-4 ; P. 389.
2. ^ Gudrun Schaade : Dementia, therapeutic treatment approaches for all stages of the disease. Springer, Heidelberg 2009, pp. 41-58.