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Dysfunction in Sensory Integration (DSI) or Sensory Defensiveness

Our brain processes information received from our senses, including sight, hearing and touch.  When this system is working properly it is said to be integrated.  If the brain is not processing sensory information well, there is said to be a Dysfunction in Sensory Integration, or DSI.   Sometimes it is also known as Sensory Defensiveness.

Sensory integration problems have reportedly been seen in children who were born prematurely or with a low birth weight, or in kids who spent their early months in East European orphanages where they were rarely picked up or spoken to.  Problems may also occur in children have too much sensation in their early environment, such as in children suffering from abuse or Post Traumatic Stress.  Many autistic children appear to have DSI based on their avoidance of sensation.

In theory, children with DSI either avoid sensation or seek it.  “Sensory Defensiveness” describes a condition where the child’s neurology has become overly sensitized to sensory input.

In some ways Sensory Integration theory appears to be mainstream.  One of my local hospitals put out a flyer on it.   Stories have appear in the press.  But there doesn’t appear to be much science that supports the concept or treatment of DSI, either, so it’s controversial.  And expensive, unless insurance covers the cost. 

Lucy Miller, Ph.D., University of Colorado Health Science Center, is a leading expert in the field. She asserts that as many as ten percent of the population have DSI. (1)

On the other hand we have Martha Denckla, MD, a neurologist with John Hopkins Univ. School of Medicinewho feels that some of these children are just naturally more or less sensitive to stimulation. “I don’t think we really know enough to say, oh, if we do this exercise or this intervention, we’re going to rewire this nervous system in the right way.”

The concept of DSI was pioneered by Jean Ayres, Ph.D., who noted that practitioners applied the theory inappropriately and made unrealistic claims of treatment efficiency.  “It is believed to be either omnipotent or no good at all.” (2)

Signs of DSI (2):

Overly sensitive to touch, movement, sights, or sounds
Underreactive to touch, movement, sights, or sounds
Easily distracted
Social and/or emotional problems
Activity level that is unusually high or unusually low
Physical clumsiness or apparent carelessness
Impulsive, lacking in self control
Difficulty making transitions from one situation to another
Inability to unwind or calm self
Poor self concept
Delays in speech, language, or motor skills
Delays in academic achievement

An assessment for DSI is generally made by an Occupational Therapist (OT) who is trained in DSI.  One way to find a qualified OT is to call your nearest Children’s Hospital and ask them.

Treatment consists of occupational therapy.  Some of the activities used are pretty common sense.  For example, if a child fears falling, he spends time swinging from a rope to get used to the sensation. 

(1) PBS Health Watch Feature at http://www.pbs.org/healthweek/featurep1_515.htm  

(2) Sensory Integration International at http://www.sensoryint.com/index.htm

News Articles:

20/20 “Sensory Overload” at http://abcnews.go.com/onair/2020/2020_000721_sensoryintegration_feature.html

Good Morning America “Bad Sensations” at www.abcnews.go.com/onair/DailyNews/000724_sensoryexpert_chat.html