Many of us may have difficulty with sensory processing of stimuli in our environment which can lead us to feeling overwhelmed. Sensory stimuli include everyday things like signs, hearing and noises, touch, our position in space, and much more. So, as we can imagine, having hyperactivity in processing these various stimuli or a hypoactivity (less reactive to these stimuli) can have a major impact on our day and general quality of life. 

Sensory integration has helped many children and adults with hyperactivity and neurodevelopment disorders like attention deficit disorder which overlap with sensory processing disorders. We’d like to discuss today if sensory integration may help you with sensory processing difficulties such as hyperactivity, and if visiting your local occupational therapist might be right for you or a child you care about.

Understanding sensory processing dysfunction (SPD) & hyperactivity

Sensory integration, or sensory processing, is the way our body and central nervous system receive information from the senses and then respond appropriately to use that information either behaviorally or cognitively. Sensory processing dysfunction (SPD) is when the sensory signals are not integrated well by our central nervous systems.

In order to really appreciate and understand the implications, we have to realize that we are constantly receiving sensory information through our senses: touch, sight, hearing, smell, and taste. So when our central nervous system (the brain and spine), whose job it is to integrate and organize the incoming information so we can appropriately respond to our environment, our normal functioning is affected in profound ways. For example, when we touch something hot, like a stove or pan, we immediately pull our hand back or look away from something bright. This immediate response, or reflex, is allowed by proper sensory processing in the central nervous system. 

So when we have a SPD, things such as taste, sounds, or textures on our hands can become confusing, startling, and frankly, quickly overwhelming. Some children and adults who have SPD are affected with multiple senses, or only one. It is important to note that every person with SPD will react differently, and everyone's intensity of responses will differ to stimuli – everyone's SPD and their reactions to it are going to be different.

Hyperactivity from this standpoint of sensory processing can then be understood as a difficulty in effectively regulating and responding to sensory input from the environment due to a heightened sensitivity to the environment. This can also take the form of an increased need for sensory input to maintain an optimal or baseline level of arousal. 

Hypersensitivity can be further broken down into individuals who may also have difficulty in sensory modulation which is the ability to filter out irrelevant stimuli – think about background noise in a cafe that you can easily tune out – and focus or respond appropriately to something else going on, like a conversation with a friend. Some people then may respond by exhibiting hyperactive behaviors as a way to cope or escape from overwhelming sensory input, or may even exhibit under-reactivity to sensory stimuli. 

Oftentimes many children and adults that are suspected to have SPD when they exhibit sensory seeking behaviors which they found pleasurable or regulating. Behaviors like this include touching different textures, jumping, spinning, listening to music more loudly. 

In summary, hyperactivity can be seen through behaviors in which individuals try to modulate sensory overload, such as isolating themselves from certain stimuli, or have difficulty in regulating arousal levels and have phases of being overly aroused (hyperactivity) or under aroused (withdrawal). However, there are also other ways SPD and hyperactivity may present, and it truly differs by the individual.

Sensory integration therapy: an overview

A type of therapy and intervention often performed by specialized occupational therapists in hospitals, Sensory integration therapy (SIT) is aimed at addressing difficulties in sensory processing of environmental stimuli. SIT’s approach was developed by Dr. Ayres in the 1970s and posits that various developmental and behavioral challenges come from sensory processing disorders. 

While there is some empirical evidence supporting SIT (which we will begin talking about in the next section), as well as ongoing research and discussion on the full applications of SIT, let’s first go over how a typical session is conducted.

After an initial introduction is made with the therapist and we transition to the therapy space, safety precautions or guidelines are reviewed with the individual or caregiver. A warm-up activity is designed to engage the individual's unique sensory system to prepare them for their treatment, which can include breathing exercises, stretching, or exercises that promote awareness of our body through activities that involve resistance such as pushing against a point. 

The core of the session involves engaging in sensory-based activities that target specific sensory processing goals which are assessed usually during the first time you meet your occupational therapist. 

Examples of sensory-based activities include:

• Swinging on a platform swing to provide vestibular input (balance system of the body)
• Musical activities and tuning into rhythm to work on auditory input
• Jumping on a trampoline or other surface to engage our awareness of our body via the proprioceptive system
• Using sensory brushes or tactile brushes for deep-pressure stimulation
• Playing with sensory-friendly toys, such as textured balls or vibrating toys
• Engaging in oral motor activities, such as blowing bubbles or chewing on chew toys
• Experiencing different temperatures through hot and cold packs or sensory bins

These activities are designed to provide sensory input across different sensory modalities and can be tailored to an individual's specific sensory processing needs. This is all structured with the occupational therapist when they come up with a plan, and as they reassess progress and goals. 

Under the guidance of an occupational therapist, there are many advantages of sensory integration therapy:

• Non-invasive: no surgery or procedure which involves the individual needing recovery time
• Evidence-based techniques: Techniques are rooted in sensory integration theory and draw upon techniques grounded in evidence and SIT continued to develop with ongoing research
• Developmentally appropriate: techniques and therapy are designed to meet you wherever you are developmentally, appropriate for age, ability, and sensory processing needs
• Collaborative: Sessions quite often involve collaboration between the therapist, caregiver and the individual, which fosters a supportive environment and supports progress
• Complementary approach: Can complement and support other therapeutic interventions such as occupational therapy, speech therapy, and behavioural therapy, to provide a comprehensive approach and nuanced approach
• Empowerment and self-advocacy: Through participation in therapy in a supportive environment, an understanding of sensory processing strengths and challenges can be achieved, empowering them to advocate for their sensory needs and seek out strategies to support their well-being

Overall, SIT, through structured sensory experiences and sensory exploration, can help individuals improve their ability to regulate responses to sensory input and manage sensory-related challenges more effectively. Working with an occupational therapist in SIT can also lead to empowerment and self-advocacy over time as individuals can explore in a structured manner strengths and challenges, empowering them to advocate for their sensory needs and seek out strategies to support their well-being.

Current research on sensory integration therapy & hyperactivity

As one may suspect, given that sensory integration therapy has been around since the 1970s, there has been a lot of research. 

A 2015 study review published in the American Journal of occupation studied sensory integration therapy in children with Autism showed promising results. While the study's aim was on studying autism, the findings can provide insight into hyperactivity and sensory integration therapy specifically. The systematic review found some evidence supporting interventions (SIT) to have provided improvements in sensory and motor outcomes which have implications for involving hyperactivity as individuals with autism have a recognized overlap with sensory processing difficulties. The study, while it had a relatively small sample size, found positive outcomes with sensory interventions in two randomized controlled trials on children's performance on using Goal Attainment Scaling – reducing behaviors linked to sensory problems.

Another systematic review study reviewed 30 studies published from 1985 to 2017 that examined the effects of sensory interventions, including SIT, on children with autism spectrum disorder on the effects of self-regulation and attention. Overall, the review had mixed results and evidence regarding the efficacy of sensory integration therapy as well as other sensory interventions. The review concluded that not all sensory interventions used by occupational therapists to address attention and self-regulation worked equally well. However, SIT and massage interventions had the highest quality of evidence, with both receiving a moderate score for their efficacy.

These studies contribute to the growing body of research on sensory integration therapy and provide insights into its potential benefits and limitations for children with autism spectrum disorders. Further research is needed to clarify the mechanisms of action, identify optimal intervention strategies, and determine the long-term outcomes of sensory integration therapy in this population.

Sensory integration therapy for other sensory disorders

While SIT is used by occupational therapists to help treat hyperactivity in various conditions, many individuals with disorders such as autism spectrum disorder and attention deficit disorder also benefit from SIT. 

Another 2009 study investigated sensory modulation disorder (SMD), a specific kind of sensory processing disorder identified by difficulties regulating responses to sensory input, which can lead to hyperactivity. A specific rare SMD was studied that affects 5% of children who have sensory over or under-responsiveness to various stimuli and involved 78 children in the study. Sensory testing was conducted to assess the detection of pain thresholds for various stimuli across different parts of the body and found that some children experienced decreased sensitivity to cold and longer-lasting pain sensations compared to children in the control group of the study.

As sensory intervention therapy is grounded in sensory processing theory, it may prove to be an effective modality for other disorders with other neurodevelopmental disorders, such as intellectual disabilities, speech and language disorders, and motor coordination difficulties, who experience co-occurring sensory processing difficulties. SIT may also help individuals with anxiety disorders who may experience heightened sensitivity to stimuli which contribute to feelings of anxiety and distress and SIT may help develop coping skills and sensory triggers. 

FAQs

Does insurance cover sensory integration therapy?

It depends on your insurance as well as if you may need a referral. Many insurance companies do cover SIT if deemed medically necessary by a doctor.

Where do you receive sensory integration therapy?

It is best to consult your doctor for a referral first. However most occupational therapists practice in a clinic and are associated with a hospital. 

Can sensory integration be helpful for me if I don’t have the disorders spoken about in this article? 

After reading this article, if there seems to be a sensory processing problem you are incurring, whether or not it be from autism spectrum disorder, ADHD or another neurodevelopmental disorder, it is possible sensory integration therapy could help you. It could be worth it to consult your doctor as well as an occupational therapist.

Summary

Sensory integration therapy is grounded in sensory processing theory and was founded in the 1970s. Used by many occupational therapists to help patients with various disorders that may involve sensory processing dysfunction, it is a powerful and versatile modality. There is still ongoing research, but with a good body of research already done, individuals struggling with processing stimuli through any of the senses (touch, taste, hearing, smell, vision) may benefit. 

While responses to sensory processing dysfunction differ in response, as in some people react by isolating themselves and some look for optimum arousal and certain stimuli – and differ in origin of the disorder such as if someone has ADD, Autism, or another disorder – many people can possibly benefit from seeing an occupational therapist and possibly getting sensory integration therapy.