Sensory Integration

In December I received an email from the wonderful OT at Aiden's old school with his Occupational Therapy Score Results. Her and I had previously discussed what she observed and believed Aiden would benefit from a couple sessions of OT per week. At the time I was so busy with the holidays and our upcoming move that I pushed the email aside and let it be. I had enough going on, let alone enough of reading where my son lacked. I knew it wouldn't be that pretty, not bad, but not good, and I needed a break.

Well, after reading this post, from a very dear friend of mine back in Texas, I knew I needed to face the facts and open his OT test results. I'm glad I did.


Aiden has been receiving PT services from the county since he was first evaluated at three months old. He has always been behind in his gross motor skills, but seems to catch up, until it's time for that "next level" of locomotion. There has never been any concern though to get an occupational therapist involved. In fact, this past July was his six month review from our county and he tested within normal limits for all motor skills except locomotion (since, at 16 months, he still wasn't walking). I've never had concerns about his sensory integration, until after feeling I could have written this post from the same great friend, and asked his OT at his school to look at this as well.

Here is a summary of his test results (which was completed at 19 months of age and he is now 22 months):

Warning note - unless you're interested in each little boring detail, skip to the end ... I like to document all the boring stuff too, just in case it helps another parent going through similar situations, especially with the AWESOME reports we got from Aiden's school).

Gross Motor Skills

• Aiden is functioning at the 11-month level for stationary gross motor skills and at the 11 month old level for locomotion (he was not walking at this time, but is almost running now).
• Aiden is functioning at the 12 month level for object manipulation (ability to manipulate balls - throwing, catching, kicking - again, he's come along way since this).

Fine Motor Skills:

• Aiden is functioning at the 14-month level for grasping skills
• Aiden is functioning at the 15-month old level for visual-motor integration

Sensory Integration

First, a little bit of background on this. Sensory integration is the organization of sensations for use. Our senses give us information about the physical conditions of our body and the environment around us. The brain must organize all of these sensations if a person is to move, learn, and behave in a productive manner. Sensory integration refers to how a child processes and interprets sensory input such as touch, movement, visual, and auditory information in a purposeful and organized manner. When students receive inaccurate or unreliable sensory input, their ability to process the information and create responses is disrupted (Dunn, 1991)
To assess Aiden's sensory functioning, the Winnie Dunn Infant/Toddler Sensory Profile was completed by Aiden's daddy and me, along with clinical/classroom observations. There are three areas into which Aiden could fall:

• Typical Performance - indicate typical sensory processing abilities
• Probable Difference - indicates the child is performing between the 2nd and 16th percentile (representing 14% of the population sample).
• Definite Difference - indicates the child is performing like a child in the lowest of 2% of the standardization sample.

And Aiden's results:

Aiden demonstrates Typical Functioning in the areas of General Processing, Visual Processing, Tactile Processing, Sensation Seeking, Sensory Sensitivity, and Threshold.

Aiden demonstrates Probable Differences in Auditory Processing (go figure), Vestibular/Proprioceptive Processing and Oral Sensory Processing.

• Auditory Processing - hmmm ... ya, makes sense, he's deaf, it's what I work on day in and day out.
• Vestibular/Proprioceptive Processing - In a nutshell, these two units challenge the child's ability to respond to movement and understand his/her own body when it comes to interpreting gravity and movement sensations. This can affect muscle tone, equilibrium responses, bilateral coordination, spatial perception, emotional expression, and self-stimulating behaviors. This explains a lot. Aiden is constantly seeking vestibular stimulation, which is why he is constantly on the go and has no fear of the consequences of his actions.
• Oral Sensory Processing - Aiden has a hyposensitivity when it comes to this. He's a very messy eater, stuffs food in his mouth and pockets it in his cheeks, and we are always watching for him for what he puts in his mouth (from CI batteries cages to crayons to cat food)

Aiden demonstrates Definite Differences in Low Registration. Children with low registration fail to notice sensory stimuli in their environment; they tend to not notice what is going on around them and miss cues that might guide their behavior . It is said that children tend to appear uninterested and can have a dull or flat affect and possibly low energy levels (which is SO NOT Aiden, the boy doesn't sit still for a second!)

All this, along with the fact he's a typical, very hyper almost two year old, explains why Aiden has NO FEAR; why he climbs onto EVERYTHING (window sills, his sisters bunkbed, anything with shelves, table tops, counters etc); why he cannot sit still for even short periods of time (unless it's Elmo); why he can't focus on one activity, unless I'm sitting right next to him, and even then the activity is very short lived, which makes at home therapy VERY HARD; why he climbs up the couch and then hangs from the back of it and laughs; why he doesn't cry much when he hits his head; why he has such a high tolerance for pain.

All of these can have an effect on his receptive and expressive language as his mind is constantly working on overdrive to find the next best thing to get into. Along with this, having a high tolerance for pain can have a huge effect on a child's maps since they don't always show visible signs that it's just "too loud".

Aiden was making some wierd noises after one particular mapping session and about the same time, I read the post mentioned above. I called our audiologist and shared Aiden's OT report with her and inquired about him possibly having a high tolerance for pain. She got us in the next day and gave Aiden a "softer" program to work with and he's been doing much better ever since.

As parents to a hearing impaired child, we know all too well how stressful all the appointments, testing, and therapies throughout this journey can be. Since the day I found out Aiden was deaf, I have focused my energy on the one thing I wanted him to do the most - HEAR and SPEAK. I wasn't aware of terms like "sensory integration" and "proprioceptive processing" much less realized these could possibly be holding him back from learning just how to hear and speak.

With that said, we have a lot to focus on this new year. I feel like we're back at square one. Yes, we've come a long way since this time last year, but as we approach Aiden's first hearing birthday, I feel like we're so far behind and now have a couple more ingredients to add to our mixing pot.

Yet I look at the positives. Aiden IS hearing; he has a pretty small vocabulary, but by golly, he IS talking; and above all else, he is such a HAPPY little boy. We are in a new location, with new resources, and building a whole new team for our little monkey. I don't know the final plan yet, or what tomorrow will bring. We have a lot to learn. I do know we'll get to where we need to be when we're supposed to be there. Let's just hope it's sooner than later.