Sensory Integration Dysfunction - Becoming a Sensory Detective

By Polly Godwin Emmons and Liz McKendry Anderson.
Authors of Understanding Sensory Integration

People often ask, "What constitutes sensory integration dysfunction or a sensory processing disorder? When do we know the child has sensory integration dysfunction? What is the difference between a sensory issue and sensory dysfunction?" These are good questions and this remains a somewhat complicated issue. First of all, sensory integration dysfunction by itself is not a clinical diagnosis, according to the DSM-IV (American Psychiatric Association 2000). Which, translated, means that there are no blood tests of biological markers, so basically it requires a health professional (usually an occupational therapist or a physical therapist) working from an observational checklist marking off specific indicators under specific categories. Second, the term "sensory integration dysfunction" is often used interchangeably with "sensory dysfunction" and sensory processing disorder," making things confusing at times. And frequently sensory integrations dysfunction is concurrent with diagnoses such as autism spectrum disorder, cerebral palsy, Down syndrome, ADHD, learning disabilities, etc. However, it has been our experience as teachers (special education and general education) that sensory integration dysfunction is most often a co-condition with another diagnosis. Only rarely have we encountered a child with a straight diagnosis of only sensory integration dysfunction.

Again, it is our belief that there is a significant difference e between sensory integration dysfunction and a mild sensory issue. For us the bottom line is "Are the sensory difficulties impacting daily living, relationships, learning, and behavior; and, if so, to what degree?" Here is where we need to talk about degree and quality. Now, for a four-year old who is exhibiting "typical behavior in every other area but refuses to put her hands in the sandbox, is this really a big problem? Is it really pervasive? Is it really adversely impacting her life? Could it be that this is just a "stage" or something ephemeral? In other words, will she grow out of this? And, does it really matter if she does? (There are plenty of adults who do not lie to get their hands dirty.) However, if she doesn't like to put her hand in the sandbox, and gags when she touches blue or finder paint, and falls out her chair, and the slide terrifies her, and her mother has intense daily power struggles with her about what hose is going to wear and what she is going to eat, and is obviously overwhelmed by large group activities, now do we have a big problem? Is it pervasive? Is it impacting her life/learning/social development? Maybe. At this point, as parents and as teachers, we would want to take a closer look at this child's level of previous experience and exposure these types of activities. If lack of exposure and experience can be ruled out as a strong contributing factor, then we would recommend t this child's parent that she receive further evaluation while at the same time begin to kick into gear some sensory-based strategies to help this child's individual needs.

If, as a parent or a teacher, you suspect that a child (or your child) has significant sensory issues or sensory integration dysfunction, you now become the detective. Now is the time to start documenting your dealing with the inevitably complicated array of service providers, and gathering information that will be useful for a professional assessment.

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