The Right Diagnosis
The characteristics that are linked with sensory integration (SI) dysfunction can be similar to many other diagnoses like ADD or ODD or RAD. It is important to accurately assess what is going on with each child because the interventions are very different depending on the issue. The wrong intervention depletes a family's time, energy, and money, and frustrates a child who is trying.
There are some generalized behaviors typically observed for sensory integration dysfunction that are important for parents to be aware of. Catching problems with sensory integration early can prevent more complicated difficulties later. Below is a brief list of behaviors that are often indicative of a sensory integration problem.
Oversensitive to touch, movement, sights, sounds, and taste/food textures: What parents may see in the child are behaviors of irritability or withdrawing when touched on the head, shoulders, or hands, or when being lovingly kissed and hugged. These children don't seem to explore or touch things. The children may have a limited repertoire of food items and will not accept new textures of foods. Parents may notice that their child has a strong, fearful reaction to ordinary movements such as being held or avoids typical playground equipment. Some children don't seem to explore or touch things. Typical grooming routines such as bathing or hair brushing bring on tantrums that are exhausting to the parents. Being in crowds or noisy places may cause crying or withdrawal.
Underreactive to sensory stimulation: These children may seek out intense sensory experiences and may constantly trip, fall, or bump into things, seemingly oblivious to bumps and bruises they may get in the process. They may not realize they are hugging a friend too tightly and may seem aggressive because they are rough with their toys and other children. They may also crave the experience of movement on swings and jumping or running. These are children who are incredibly active -- walking or running across the playground, unaware of swings or bicycles. Sometimes they can even walk into a tree or a car without even taking note. Like the oversensitive child, these children also do not explore items, and play skills, if any, are very limited and very routine.
Activity level that is unusually high: Children with SI problems may demonstrate hyperactivity or appear in constant movement. They are usually impulsive in behaviors. These children are often known to break their toys while trying to manipulate them. Their attention span is quite short, often going from one subject to another in short time spans. Hyperactivity combined with distractibility is one of the reasons many children with SI difficulties are sometimes misdiagnosed as having ADHD.
Coordination problems: These children appear clumsy with some having difficulty learning new motor tasks. They may regularly bump into things, seem to have trouble orienting themselves in space, or show difficulty with writing or catching a ball. These children need more practice time to learn typical activities such as bike riding or skating.
Delays in speech, language, or academic achievement: Children with SI issues often exhibit delays in language acquisition or academic achievement. This is because they are distracted by the sensory input they are experiencing, or have such a difficult time organizing it in a meaningful way, that they can't focus on learning the skills. These children most often have average or above average intelligence, but have problems learning because of interference from the sensory system.
Poor organization of behavior: Some children may appear interested in a toy but then throw it aside or be immediately distracted by something else. They run around a lot but do not organize their activity to climb or explore equipment in the playground, or play creatively with toys. Some may have difficulty choosing a toy to play with out of a large assortment or seem resistant to putting toys back in the playbox.
Difficulties with transitions: They may seem stubborn and uncooperative when it is time to change an activity, i.e., from watching television to having dinner, or if there is a sudden change in the daily schedule (for example playtime is delayed another hour). Children with difficulties in transitions need a more structured and predictable environment than other children.
Poor self-concept: Ongoing negative feedback for their behavior when they actually want to please others usually lowers self-esteem. They often experience frustration at not being able to succeed at tasks and are usually not able to understand why they didn't succeed when they are trying so hard.
Problems with socialization/peer relationships: Children with SI difficulties may stand closer than is comfortable to other children, hug or hold hands too tightly, be too rough when playing with others, be uncomfortable with touch or common activities such as going on the slide or swing at the park. These behaviors, rooted in SI dysfunction, can cause difficulties with peer social relationships.