Advice From the OT, Part 6: Identifying and Helping Students with Sensory Integration Issues

by Loren Shlaes, OTR/L

What is Sensory Integration/Occupational Therapy?
Occupational therapy assists people who for various reasons cannot meet their responsibilities and are not functioning at their highest potential. A child who is not succeeding in school and can’t meet the grownup’s expectations falls into this category.

Sensory integration based occupational therapy can be very helpful to a child who is struggling in the classroom by strengthening his body, correcting delays in his neurological maturation, improving the way his senses take in and respond to his environment, and helping him become more emotionally flexible. School based therapists also work on helping the child with his hand eye and fine motor coordination, handwriting, social skills, and anything else a child needs to succeed in the classroom.

What Does Sensory integration Mean?
Sensory integration refers to the ability to take in, perceive, and act on sensory information in an accurate way. Our behavior is based on our perceptions of the world around us. If a child cannot correctly perceive and interpret what goes on around him, or if his balance is off and his coordination is poor, his behavior and actions are going to reflect that.

Children who could benefit from sensory integration therapy are notable for being unable to meet the expectations of the grownups. They are “out of synch” in the classroom.An “out of synch” child may have some of these issues:
-Can’t maintain focus in a noisy classroom
– Can’t sit still
– Has a hard time internalizing and following the unspoken expectations and routines of the classroom and acts as if every day is the first day of school
– Has continual difficulty controlling impulses
– Lashes out when others come into his personal space
– Refuses to interact with classroom materials such as paint, chalk, clay or glue
– Has difficulty transitioning between activities
-Is emotionally rigid, can’t roll with the punches, needs to be in control, has difficulty socializing in an age appropriate way
– Has a tough time modulating behavior; can go from zero to 60 in a second; his responses are often not appropriate to the situation
– Slumps over his desk; rubs his eyes; his handwriting is painful, illegible, and slow, with a poor grasp; he may use too much force and break his pencil frequently; he has difficulty organizing his work on the page
-Appears to not understand what is said to him; can’t pick out teacher’s voice over other noise in classroom; can’t recall or follow long strings of instructions
– Is easily distractible; looks up at every ambient sound or movement and then has a hard time refocusing
-Is clumsy, trips and falls frequently, holds onto the handrail and uses step to step gait pattern on the stairs, can’t do what the other children do in gym or on the playground
– Behaves in unexpected or inappropriate ways in noisy or chaotic environment
-Is frequently tuned out, not present
-Requires constant redirection and guidance from adults; takes up more than his fair share of attention
-Does not like to play in groups, mostly chooses to play alone
– Sits with a frozen expression in class, especially when it’s noisy
– Is obviously bright but can’t get his work done on time; poorly organized
– Does not have a flexible attention span; he is either unable to focus at all, or he is so hyper-focused that he is in his own world
– Has a short attention span, poor frustration tolerance, is unable to self soothe or self regulate in an age appropriate manner
– Is anxious, needs constant reassurance, seems lost and can’t follow directions.

If you have a child who is struggling in your classroom with any of these issues, a referral for an occupational therapy evaluation is in order.

How Can I Help a Child With Sensory Issues?
Here are some easy things you can do to help a child who is struggling:
– Children who are easily distracted do best when they are sitting with their backs covered. Providing a child who is bothered by people walking by with a chair tucked into a corner can lower anxiety levels and allow the child to focus.
– Children who are very sensitive to noise don’t do well in noisy classrooms. Some things that might help: providing him with a quiet corner to do his work, providing him with earplugs that dampen but don’t block out sound, allowing headphones that play soft music or cancel noise during busy times, providing the child with something to chew (chewing dampens sound by activating the muscles that protect the eardrums).
– A child with visual issues needs to sit close to the board and would probably have an easier time reading with his work placed vertically in front of him. This reduces visual distortion and helps the child sit more easily by allowing him to keep his head upright. An inexpensive slant board can be rigged up by taping together several old fashioned ring binders.
– Gum, candy, and fidget toys may be the bane of a teacher’s existence, but for a child who has a hard time sitting still or staying alert, they are a necessity. Chewing is grounding, calming, and organizing. Sucking pulls the eyes in close together which makes it easier to see close work. Sucking on a strongly flavored candy like a Warhead or a Tearjerker is especially arousing and alerting.
-An object to manipulate, and busy hands makes sitting still infinitely easier, which anyone who has made a chain of paper clips, folded a gum wrapper into an origami shape, doodled a cartoon, or systematically torn the label off of a soda bottle during a long meeting knows only too well.
– I send a little ziploc bag of toys to school at the beginning of every school year for the teacher to hand out to my little friends when appropriate. Stretchy frogs, Bucky Balls, and miniature transformer toys are excellent for discreetly keeping hands busy and minds alert. If none of those things are available, there are always drinking straws and paper clips.
– If there is room in your classroom, a large cardboard box, like the kind a washing machine comes in, can be a very handy place for any child who is overwhelmed by the busyness and noise in the classroom to regroup. Put a few cushions in there and leave the flaps on so the child can have some privacy when he needs it. No following him in there and forcing him to do his lessons while he’s hiding; let him come out when he’s ready.
– Many children with visual issues can’t copy from the board, so an email home with the assignments would be helpful, or he can be assigned a buddy who can make sure he’s copied everything down correctly.

A Final Thought
In order for children to feel safe and secure and to trust the grownups, they have to know that the grownups are strong, wise, and can keep them safe. Don’t be afraid to have high standards, clear expectations, and strong boundaries in your classroom. Your children will love you for it.