Understanding Sensory Integration – Part 1

So what exactly is sensory processing difficulties or sensory integration difficulties? These are terminologies that have been tossed around almost interchangeably. The concept of sensory integration was first introduced by Dr. Jean Ayres 40 years ago with the available research at that time. She was an occupational therapist, mentor, author and researcher (Ayres, 1972). Dr Ayres introduced sensory integration theory. Since then there have been several researchers and scholars who have been working diligently on expanding the understanding of this concept. In this blog I will highlight Dr Ayers concept of sensory integration and in the subsequent blogs I will discuss the works of other prominent researchers in this field.

Dr Ayres described sensory integration as “a neurological process that organizes sensation from one’s body and from the environment to make it possible to use the body effectively within the environment” (Ayres, 1979, p.11). She introduced the concept that sensory integration is an important type of sensory processing where the central nervous system organizes the sensory information from the body and environment to make it a meaningful integral experience. Sensory integration is nourishing to the brain as it pulls everything together to allow the brain to use the different sensations to form perceptions, behavior and learning.

Dr Ayers describes how sensory integration begins in the womb as the fetal brain senses movements from the mother’s body. She also emphasized that sensory integration has a significant impact across our lifespan from infancy onwards involved in meeting developmental milestones such as crawling, standing, reading, dressing, showering, toileting to riding a bike to name just a few everyday activities. Ayres’ primary objective in developing sensory integration theory was to explain the underlying cause of the problem to determine the optimal mode of intervention. To understand this concept better, we need to pay attention to the different sensory systems that play a part in sensory integration.

The 8 main sensory systems that play a part in sensory integration are:

Tactile (Touch) input

The tactile system is our largest sensory organ in our skin which helps us to experience and understand our everyday senses from the word around us. Tactile input is responsible for interpreting different touch sensations (light, firm, vibrations), temperature differences and pain perception. Importantly, the touch sensation also warn you of dangers in the environment.

Example of symptoms of dysregulation:

Tags in clothing can be uncomfortable for a tactile sensitive child causing the child to strip or take off their clothing wherever they are or as soon as they get home. Seams in socks can be distressing causing them to take their shoes or socks off.

Proprioception input

Proprioceptive input is the sensation from receptors in joints and muscles that informs the person of where their body is in space for spatial orientation. This is also the sensation that is important for us to respond with appropriate force and kinesthetic awareness.

Example of symptoms of dysregulation:

When a child is under-responsive to proprioceptive input, you may see them opening a door or drawer with more force than needed. Or they may lay a heavy tap on your shoulder instead of a soft tap.

Vestibular input

The vestibular system informs your balance, spatial orientation and coordination of movement. Balance is a combination of signals form the eyes, inner ears, skin, muscles and joints.

The inner ear has three loops called the semicircular canals that are filled with fluid and sensory hair that inform us of three movements: up and down movement, side to side movement and tilting movements.

Example of symptoms of dysregulation:

When there is a dysregulation, this child may experience gravitational insecurity which my be displayed as a child being afraid of sitting on a swing or on a toilet especially with their feet of the ground.

Auditory (Sound) input

The auditory input is the processing and perception of sound in the brain whichis important for us to correctly interpret, hear and respond appropriately to the world around us.

Example of symptoms of dysregulation:

Some of these children are over aroused to sounds such as the vacuum cleaner, a dog barking, the flushing toilet, the had drier etc. These sounds can cause distress where the child has to either cover their ears, strikes out at someone to stop the sound, or darts to avoid the sound.

Gustatory (Taste) input

Gustatory is the perception of taste and flavors for the five main taste sensations which are sweet, sour, bitter, salty and umami. The gustatory system is important for ingestion and avoidance.

Example of symptoms of dysregulation:

Picky eaters have a limited range of foods that they will eat which may be due to the taste or texture of the food. This can contribute to ‘failure to thrive’ or have decreased nutritional intake.

Olfactory (Smell) input

The olfactory input is the ability to perceive and interpret odors. Smell like the other sensations is closely connected to emotions. A smell can either bring back good or bad memories of a place, event or person.

Example of symptoms of dysregulation:

Children with sensory issues can be very sensitive to smells, these children can be affected by the smell of perfume, paint, or even the smell of their own bowel movement can be offensive to them.

Visual (Sight) input

The visual input is the ability to see and decipher your environment. If visual information is not perceived and processed accurately it can be distracting and it will interfere with learning.

Example of symptoms of dysregulation:

Certain children may be hypersensitive to light where you’ll see them squinting. For some children reading from a white background is too glaring for them. Children with autism are generally are affected fluorescent light as it tends to flicker and can be very distracting for them. The use of colored overlays may assist in making it easier on their eyes


Interoception is the ability to perceive one’s own bodily sensations such as your gut, heart beat, respiratory sensation such as knowing when you are hungry or when you need to use the toilet.

Example of symptoms of dysregulation:

There is a disruption in the message being relayed that causes a delay in the processing of information resulting in the child not realizing they are getting hungry or that they need to use the toilet. This results in the child either getting upset when they do not get their food immediately. The delay in processing the information also affects the timing for going to the toilet on time resulting in toileting accidents.

Dr Ayers described sensory processing dysfunction as ‘traffic jam” in the brain. Here, sensory information gets tied up in traffic where some parts of the brain did not get the important sensory information to get the job done. Hence, this affects the brain’s ability to process or organize the flow of sensory information in a manner that would give the child good, precise, information for the world (Ayres, 1979). She introduced the concept of some children being under -responsive while there are others who are over-responsive. Examples of this would be a child stepping on hot pavement with their bare feet and not flinching. This child is under- responsive to the tactile sensation from the hot pavement. This is dangerous as the child sensory system is not alerting the child and heat from the pavement can blister the child’s feet.

In the next scenario is a child going to the beach and screaming because the child does not like the sensation of sand on their feet. This child is over-responsive to the sensation of sand which is not alarming to others. Dr Ayres was the first to highlight that when sensory information is not processed well, it leads to ineffective behavior and learning for the child. This leads to maladaptive behavior, when sensory information is not processed well, such that the child has difficulty handling or coping with the ordinary demands and stresses in the environment.

On a daily basis, a child with sensory processing dysfunction undergoes constant sensory bombardments which they are unable to control. For these children, every day is a constant battle trying to navigate through normal daily activities such as getting dressed, being on a bus or train with others, having a meal, trying to stay focused in a classroom or trying to play with other children. What’s most distressing and frustrating for these children is that others around them seem oblivious of their discomfort. What others around this child might see is a child withdrawing or overreacting to a situation. When really this child is going through distress and trying to protect him/herself.

Understanding the underlying sensory processing difficulties and how it may manifest as a behavioral response is key in managing these children and also teaching them self-management skills. It is also important to remember once the child’s sensory processing issues are being treated and managed, it is important to also help this child get desensitized by giving them access to the sensory adaptations such as headphones or allowing them to experience different textures with the child being in control when to wear or touch the items. This would help the child in learning self-management skills. Gradual exposure to different sensory sensations in the environment provides the child with opportunities to learn, develop skills, and adapt to the environmental needs. They would have a roadmap in their mind of what possibly to expect and which self-management strategies to use in adapting to their environmental needs.


Ayres, A.J. (1979). What is sensory integration? In A.J. Ayres, Sensory Integration

and the child (pp.1-11). Los Angeles: Western Psychological Services.

Krishnan, K.N.(2018). The SI Solution. The definitive family guide in thriving during sensory

integration dysfunction. Self Published.

What Everyone Should Know About Sensory Integration

Sensory processing issues and difficulties faced by a select group of children and adults have gained more acceptance and understanding in recent years. The constant sensory bombardment in their everyday environment can lead to their sensory systems getting over stimulated or going through a sensory overload that can result in a person having a shut down. This shut down can manifest either in an active manner where we see the child or adult either have a meltdown or suddenly becoming very quiet almost appearing unresponsive. Again, this is not being under -responsive but rather the child or adult has become overwhelmed. I’d also like to point out that there is a difference between meltdowns and tantrums which I’ll address in more detail in an upcoming blog.

A big key factor to remember is that meltdowns are due to a reaction of feeling overwhelmed where there is way too much sensory input coming into their sensory systems such as sounds, tastes, smells, sights, textures which upset not just children but adults as well. There is difference between tantrums and meltdowns. In a tantrum a child has the ability to control that emotion, where you will notice the child can stop in the middle of a tantrums to observe if the parent/ caregiver is watching them. When the desired item or toy is given to them the child, they can or will be able to immediately stop the tantrum.

A meltdown is different as it’s is not in the child’s or adult’s control, it is a result of trying to process too much or many sensory inputs at the same time. For instance, it is like going to a carnival where it can be overwhelming and overstimulating for most children and adults after some time. This is just a glimpse into the everyday world of a sensory challenged child or adult. The discomfort and negative experience can make these children and adults avoid going to certain places like malls, the subway, the airport, school or even work. Think about it, these places have tons of people and you cannot control the environment where there might be a different smell which might be too strong, people bumping into each other because it’s crowded or talking loudly which might hurt the ears of a sensory challenged person because of the pitch of the sounds.

For children and teenagers, going into the cafeteria in school can be overwhelming because of the smells, the sounds of plates, cups, and eating utensils hitting and the sounds of children playing and laughing can be overwhelming. For this reason, schools can be a place these children may shy away from or it becomes a struggle to get a child ready for school. For a sensory sensitive or over responsive child, playing in a playground or amusement park may become a challenge as there may be many loud and unpredictable sounds they cannot control such as laughter, screaming children or the unexpected crying of a child. I once had a teenager I was treating who refused to enter my therapy room when the other therapist I was sharing my therapy space with had an infant, toddler or younger child. When I asked him why he was apprehensive, he told me the sounds of children speaking in high pitched voices or crying hurt his ears so he’d prefer not to come in. He would become anxious when younger children such as his younger cousins were around him.

These sensory children also find the park sensory challenging as it can be both visually and tactile overstimulating with other children running around and children bumping into other children while they are playing. In the playground, the different equipment elicit different movement experiences such as coming down a slide or walking up a rope ladder, swinging high or coordinating on the monkey bar. These children may seem”bossy”, needing things to be done in a certain way or may appear clingy to a parent or teacher as they need the world to be in a certain way for them to be able to function well in it. These sensory experiences can be overwhelming for them and it’s usually out of their control as its stemming physiologically. There is now a growing body of knowledge that is showing that their autonomic system- sympathetic and parasympathetic systems work differently in these children. This is where trained sensory integration occupational therapist can assist with helping the child or adult find out which of their underlying sensory systems are affected and design individually tailored sensory strategies/ adaptations to best fit the needs of that child or adult.

There seems to be growing acknowledgement both in the US and internationally of the sensory challenges faced by these children and adults as they navigate through everyday activities that is both taxing and sometimes over stimulating to their sensory systems. This is not bad behavior or these individuals trying to be challenging. It’s rather a way to protect themselves from the overwhelming sensory bombardment. Huge steps have been taken in the right direction to make the community more inclusive for these individuals with sensory challenges This is the result of the tireless efforts of organizations, research and parent groups that have advocated for the needs of these sensory challenged children and adults. We now see a growing number of places in the community acting as agents of change for those with sensory needs by creating a sensory safe and friendly experience for these children and adults. These resources in the community have proactively trained their staff in recognizing sensory difficulties and how to manage a sensory situation when there has been a sensory overload. Listed below are a few sensory friendly resouces:

Miami International Airport Multi-Sensory Room

We all know how going to a busy airport waiting in line and waiting for your flight can be over stimulating. So this airport has paved the way in making it more sensory accommodating as these children wait to take their flight.

American Airlines Holds Mock Flights for Children with Autism


This trial run helps children with autism better anticipate and understand what is expected when taking a flight such as waiting in line, going through security and the experience of being on a plane ready for take off.

Oregon Zoo launches new sensory inclusive program


We know every child enjoys going to the zoo with the school or with family and friends. The Oregon Zoo are training their staff to recognize guests with sensory needs and how to manage a situation when there has been a sensory overload. The zoo also has available to guests, bags equipped with noise canceling headphones, fidget tools, verbal cue cards and weighted lap pads. They also provide an app for social stories to assist in anticipating what to expect in the zoo.

Seaworld Orlando Water Park is a Certified Autism Center


The water park provides specific information about the different attractions and accommodations to help guests make informed choices of what would best suite the needs of the child or adult. The water park also has a quiet room with adjustable lighting for taking a break and regrouping.

A Dental Clinic For Special Needs in Phonenix


Lets’s face it not many of us like going to the dental clinic but it’s even more challenging for a child with sensory issues. But we know how important dental hygiene is for our overall health. Many children with sensory difficulties struggle with brushing their teeth and having dental work done. This group of dentists have come together to make the sensory accommodation necessary to help these children with physical and intellectual disabilities ease into having dental work done on them.

Sensory Friendly Films- AMC, Regal Cinemas, Frank Theaters Cine bowl & Grille


Movie theaters such as AMC, Regal Cinemas and Cine Bowl have partnered with Autism Society to make it sensory accommodating and friendly where the lights can be turned up or the sound turned down, there is also opportunity to move around, shout or even sing. The sensory friendly film program is available on the second and fourth Saturday which is family friendly and Tuesday evenings is forthe mature audience. Check out your local theater listings and check out #AMCSensoryFriendly

Sensory Friendly Malls


Most of us know how overwhelming it can be going to a mall and this can become even more intense during the holidays. Although not comprehensive, I have listed a few places that provide sensory accommodations to make that mall experience a lot more enjoyable for our sensory children and adults.

I plan to have this as a growing resource and welcome ideas or other resources that you may know of that I can add to this list. Please subscribe to be on my newsletter and share your sensory story or journey. If you have any topics of interest, let me know and I will address them on my blogs.

Join me on my next blog on Understanding Sensory Integration!