As a parent, you know and understand your child better than anyone else.
It is not uncommon for many parents to be confused and frustrated by perplexing behaviors or difficulties seen in their children. Have you ever asked yourself…
- Why is my child so picky about everything? She only likes to wear certain types of clothes and only eats a few types of foods.
- Why does my child have so much trouble doing his homework? He complains that he is always losing his place when copying from the blackboard at school and his schoolwork is so messy.
- When we go to the playground, my child either clings to my side or hangs out over by the fence away from the other children. He always cries when we try to put him on a swing or encourage him to climb on the monkey bars. Will he grow out of this?
- It is so hard to get my child ready for school in the morning! Why does she have such a difficult time waking up and following her morning routine so that she isn’t late every day for the school bus?
It is important for you to know that these are real problems, rather than imagined or related merely to personality, parental influences or typical phases of development (PTN, 2004). Although you can’t put your finger on the problem, you sense that something is just not quite right. You may have heard of the term “sensory integration” but are unsure if it applies to your child. It is common for parents to hear differing opinions and options when their children’s challenges are not easily recognized or understood, however, learning about sensory integration will provide you with some of the answers that you seek! We hope that the information provided here may answer some of your questions and lead you to some resources to address your concerns.
What is Sensory Integration?
Sensory integration is the brain’s ability to take in, process and organize sensory information that we perceive through different sensory systems in our bodies. Through our senses, we develop an understanding of our world, and often times, this occurs without us even being aware. When our sensory systems are working together, it allows us to do the following things:
Pick out a small object located in the bottom of a purse without being able to see inside the purse
Learn how to balance and pedal while riding a bicycle
Be able to get on and off an escalator easily
Know something by its sensory qualities such as color, shape, size, texture taste and smell
Learn to write and draw
Know how close or far away we are from objects and people and avoid bumping into them
Be able to accept touch and be able to wear different types of clothing material without it feeling too itchy or to tight
Tolerate a variety of foods and smells to have a healthy diet
Our emotions, feelings and level of alertness are also affected by our ability to adequately process and organize sensory experiences. Think about how you feel as you experience the following:
- A gentle massage versus being tickled or having a bug crawling on your arm
- Riding a roller coaster versus gently rocking in a rocking chair
- The smell of an apple pie baking in the oven versus the smell of smoke in the attic
- The loud sound of a fire alarm versus the sound of church bells
- Sleeping under a heavy down comforter in a cool room versus being locked out of your house on a cold day
- A warm bath versus a jump into a cold pool
Our brains must be able to organize and process information that comes from our sensory systems in order to respond appropriately. To do so, we must be able to integrate information from all of our sensory systems including:
Protects us from stimuli that are interpreted by the brain as being harmful. Individuals with an over/under sensitive tactile system interpret touch differently. When tactile input is misinterpreted as being harmful, such as stimulation from certain types of clothing, food textures, or unexpected touch, it may elicit negative reactions such as pulling away, increased or agitated activity, or strong emotional responses. The heightened sensitivity to touch, resulting in routine misinterpretation or unusual reaction to touch is referred to as tactile defensiveness.
Allows us to have body scheme or an awareness of our body parts and the physical relationship of our bodies to objects and other people.
Helps us identify the size, shape, and texture of objects in our environment through our sense of touch. Provides us with the ability to distinguish the difference between a coin and a key in a pocket or to realize that a piece of food is still on your lip. Discriminating various aspects of touch provides the foundation for eating various textures of foods, using the hands for refined tasks, and knowing how to interact physically with other people.
The vestibular system provides us with a sense of security when moving. It is the foundation for the development of balance reactions and is important in motor development because of its influence on muscle tone, posture, the ability to use both sides of the body at the same time (bilateral motor coordination), balance, orientation in space, and eye movements. People who are frightened of moving or falling, often have difficulty with vestibular processing.
Proprioception is our muscle and joint sense, which helps us understand where our body is in space without looking. This allows for automatic movements without having to rely on our vision to monitor those movements such as being able to walk up a flight of stairs in the dark. It also provides information about how much force we need to use for tasks such as picking up a glass with different amounts of liquid, manipulating moving parts on a toy, and writing without thinking about the process of forming the letters. The ability to perform tasks without vision, such as wiping our face or pulling up our pants from behind, also requires proprioceptive processing. Oral motor skills require effective proprioceptive awareness, as a child cannot visually monitor their performance and must rely on input from muscles and joints in the mouth.
Proprioceptive input, obtained through moving, maintains and regulates body functions, including healthy neuromuscular and cardiovascular systems. People who exercise regularly may feel calmer and more alert. Children need increasing amounts of physical activity so that they can stay calm and alert throughout their day and proprioceptive activities can be a wonderful form of stimulation for calming and organizing the nervous system.
Our sense of sight and the ability for both eyes to work together
The auditory system provides us with the ability to hear as well as our ability to correctly understand what it is that we are hearing.
Our sense of taste and smell
Sensory integration is the foundation for us to be able to learn even the simplest things and to behave appropriately throughout our day. Sensations flow into our brain at every moment, and provide us with information that we can use to help us understand what is happening around us, to know what we need to do and to plan how to do those things. The brain detects and organizes these sensations to be able to form perceptions, adapt behavior and to support learning. Even very young children must be able to take in sensory information through all of the senses to perform skills automatically. They must be aware and comfortable with where their bodies are in relation to space; they must know where and how they are being touched and they need to know, without being taught, what sensory information to pay attention to and what to ignore. Many children however, have difficulty organizing information and performing the many complex tasks that are required for learning and functioning in our world. A. Jean Ayres, an occupational therapist and educational psychologist who developed Sensory Integration theory for use in therapy practice, once said, “When the flow of sensation is disorganized, life can be like a rush-hour traffic jam” (1979). These children, who have difficulty processing and using sensory information, may be diagnosed with sensory integration dysfunction, which may result in problems with development, behavior and learning.
Children with sensory integration dysfunction need all the help and understanding we can provide to them throughout their daily activities, to give them the support they need to even attempt routine tasks that most children perform easily.
Signs of Sensory Integration Dysfunction
It is important to understand that not all children with learning, developmental or behavioral problems will have an underlying sensory integrative disorder. We all have different sensory tolerances and preferences, and as we mentioned earlier, these can change throughout our day. As our sensory systems become more and more integrated, we learn how to pay attention to important sensory information and tune out sensory information that is not relevant so that we can adapt our behaviors appropriately. Children with sensory integration dysfunction cannot adequately process sensory information, resulting in some of the following behaviors, that impact independence in daily activities and routines and the necessary foundations for learning:
Child may become overwhelmed by everyday sensory experiences
Irritability or withdrawal when touched
Bothered by tags or seams in clothing
Dislikes brushing teeth, brushing hair or having his/her face washed
Avoids putting hands in sand, finger paint or glue
Does not like to have finger or toe nails cut
Avoids going barefoot when walking or crawling on surfaces such as sand or grass
Avoidance of certain textures of clothing or foods
Frequently gets car sick
Fearful of ordinary movement experiences such as those typically found on a playground or when riding on an escalator or elevator
Dislikes crowded/noisy places such as shopping malls, restaurants or birthday parties; may walk at the end of the line at school
Dislikes swings or carnival rides
Has an exaggerated fear of falling or heights
Reacts to motion or change of head position with signs of distress
Seems afraid of walking on a raised surface such as stepping off of a street curb as though it seems too high
Avoids games that involve unpredictable movements of other children, especially those that may impact balance
Seems bothered by bright lights
Becomes distressed in unusual visual environments such as a bright, colorful room
Frightened by sounds that do not usually cause distress in other children such as a vacuum cleaner or a hair dryer
Responds negatively to loud sounds by running away with hands held over ears
Avoids certain textures or temperatures of foods
Gags at the thought of an unappealing food
Shows distress at smells that other children do not notice
Due to a child’s inability to adequately register sensory information, child may seek more intense sensory experiences
Seeks more intense sensory experiences such as spinning, crashing, bumping
Excessively touches objects or others
Cannot tell what something is by feeling the object without being able to see the object
May not feel or notice pain as much as others
Messy when eating
Does not get dizzy, even after many minutes of spinning, and loves fast moving equipment
Walks into objects as if they were not there
Enjoys watching objects spin
Likes to flip light switches on and off repeatedly
Appears not to hear certain sounds
Licks, smells or mouths non-food objects excessively
Inability to know where the body is in space and how the body moves through space
Tends to lean on objects or others
Bumps into things or other children
Grasps objects too hard or too soft
Chews on toys, clothes or other objects
Breaks things from pressing or pushing too hard on them
Jumps a lot
Misjudges how high or low to move body parts when sitting down or stepping over objects
Maintaining the “just right” level of arousal according to the task demands
Activity level that is unusually high or low with severe fluctuations between one extreme and the other throughout the day
Slow to rise/difficulty falling asleep at bedtime
Frequently wakes in the middle of the night
Problems maintaining attention in the classroom or while doing homework--decreased self control, impulsivity
The ability to organize and mentally manipulate visual stimuli in the brain to be able to discriminate parts from whole, to see an object imbedded with other objects, to understand the objects position in space and to recognize objects that are partially hidden.
Difficulty staying within the lines when coloring, drawing or writing
Shows difficulty with puzzles or building with blocks
Gets lost easily
Has trouble recognizing similarities and differences in patterns or designs
Has a hard time finding something in a drawer or picking a face out of a crowd
Has difficulty aligning fasteners on clothing or putting shoes on the correct foot
Attends to “parts” of a project but has trouble getting the “whole picture”
Has difficulty with organizational skills in the classroom such as where to place completed homework, location of the pencil sharpener, copying assignments off of the blackboard, etc.
Has poor eye-hand coordination skills such as those needed to cut along lines and gluing objects in the correct place
Our sense of hearing must be able to inform our brain with information that allows us to process and understand spoken words and where sounds are coming from within our immediate environment. We must also be able to filter sounds that are unnecessary such as the low hum of fluorescent lights in a classroom or the sound of cars going by outside our window. Without the ability to filter this sensory input, we would be unable to focus our attention without being constantly distracted.
Responds inconsistently when spoken to
Seems to misunderstand what is said
Misunderstands similar sounding words such as box and socks
Cannot repeat back what is said
Difficult to understand
Cannot hear well when in a noisy environment
Has difficulty looking and listening at the same time
Tunes out or seems disinterested during group activities
Holds head at an angle to be better able to hear
Speaks in a monotone or exceptionally loud voice
Highly sensitive to noise or hears things that other people do not hear
Motor planning or Praxis is an outcome of good sensory integration. It is the integration of sensations from our skin, muscles and joints and inner ear that provides us with a “map” of our bodies, which allows us to move without having to think about our movements. Motor planning, also called Praxis, is the ability to plan, initiate, grade and execute movements efficiently to accomplish an activity.
Has trouble getting started on or ending activities
Difficulty learning new tasks
May not use a preferred hand consistently
Difficulty manipulating tools or toys
Difficulty using utensils for eating and writing
Problems coordinating the two sides of the body which impacts ball skills and the ability to do well in sports
Inability to imitate someone else’s body movements such as during a game of Simon Says, waving bye-bye, and blowing kisses
Problems with eating or speech/language development
Difficulty building a structure with blocks or legos from a picture or a structure that someone else has built
Seems to do things in inefficient ways and has difficulty following directions
Avoidance of unfamiliar tasks tends to play the same games over and over
Gravitational insecurity is an unusual fear response to movements and/or height that is not typically threatening to other children of the same age (Ayres, 2005).
Becomes anxious when feet are off of the ground
Has an exaggerated fear of falling
Reacts negatively to changes in head position, particularly when the head is inverted forward or backwards
Does not enjoy playgrounds or riding toys as much as other children
Avoids stepping or jumping down from a higher surface to a lower surface
Afraid of losing his or her balance
Avoids climbing activities
Avoids games that involve unpredictable movements such as tag, soccer and dodgeball
Feels insecure in wide open spaces
In young preschool aged children, these can be seen in combination with other sensory signs such as over or under responsivity to touch or movement. In older, school aged children, there may be academic difficulties despite normal to high intelligence.
Fidgets or appears lethargic and uninterested when sitting and listening
Difficulty following classmates in a line
Poor organization of classroom materials
Unable to follow classroom routines
Gets lost in the school hallways
Difficulty carrying lunch tray/spills items during meals
Difficulty copying from the board
Presses to hard/light with pencil and handwriting is messy
Problems with being able to read across a page or line up numbers during math
The inability to plan, gather materials, sequence multiple steps and execute a task to completing efficiently
Difficulty sitting still
Impulsive and does not appear to have a plan of action to accomplish a task
Difficulty with multiple step directions and sequencing the steps of a task
Difficulty adjusting to new situations or environments
Distractible and has difficulty maintaining attention
Decreased frustration tolerance
Difficulty with transitions
Controlling or inflexible
A sense of individual success
Feels badly about himself but doesn’t know why
Appears lazy, bored or unmotivated
May look for ways to avoid tasks that are difficult or embarrassing such as homework
May be considered troublesome or stubborn
If a child has sensory integration dysfunction, it is not likely that he or she will “grow out of it”. The child may learn “splinter skills” that compensates for poor sensory processing however, this only covers up the problem and requires much more effort and energy, leaving less energy left to deal with other things.
Sensory integration dysfunction can be considered a hidden problem because it is not as noticeable as physical impairments or speech delays (PTN, 2004). When a problem is difficult to see or understand, parents and children may begin to blame themselves which can result in family tension, poor self-esteem and a general feeling of hopelessness.
How can I help my child?
Contact someone who will understand your concerns
If you believe that your child might have a sensory integration problem, you will need the help of professionals with advanced training in the area of sensory integration. Often, this professional will be a pediatric occupational therapist, however, many pediatric physical and speech and language therapists also have this type of training and knowledge. In addition, physicians, psychologists, and teachers may also be aware of these types of problems and can offer assistance with appropriate referrals (PTN, 2004).
Seek a qualified professional who can evaluate Sensory Integration and Praxis
When beginning your search for someone to evaluate and treat your child with sensory integration dysfunction, it is important to seek professionals with advanced training and certification in the area of Sensory Integration. The therapist who evaluates and treats your child should be someone who has received post-baccalaureate training in sensory integration theory and treatment and who has pursued advanced continuing education in this area. It is always appropriate to ask a professional when and how he or she was trained in evaluation and treatment of sensory integration. If the Sensory Integration and Praxis Tests (SIPT) are used in evaluation, the therapist should be certified in its administration and interpretation. For a listing of therapists trained in sensory integration in your area, please refer to www.wpspublish.com.
Once you have found a therapist in your area who is expertly knowledgeable in the area of sensory integration, the therapist may evaluate your child using the Sensory Integration and Praxis Test (SIPT), which is a standardized assessment that assesses your child’s functioning in the following areas: visual perception, somatosensory processing (touch and proprioception), vestibular processing, eye-hand coordination and motor planning or praxis.
Your child’s evaluation may take between 1 ½ -3 hours and will also include structured observations of responses to sensory stimulation, posture, balance, coordination, and eye movements as well as informal observation of spontaneous play. You may also be asked to complete questionnaires that provide information about your child’s development and typical behavior patterns. If your child has difficulty taking tests, the therapist will use play-based and observational approaches to gather the information that is needed.
Following the evaluation, you will receive a report that provides you with test scores, an interpretation of what the scores indicate, and whether or not a sensory integrative disorder is present. The therapist will then make recommendations regarding the appropriateness of therapy using a sensory integrative approach.
Typically, intervention for sensory integration dysfunction is provided by a pediatric occupational therapist and therefore, the treatment is referred to as occupational therapy utilizing Ayres’ sensory integration approach. With specialized training, pediatric physical therapists or speech and language therapists may also use sensory integrative procedures as a treatment approach.
Occupational therapists use a sensory integration approach when a child has difficulties with the processing of sensory information resulting in the inability to be purposeful in desired activities in daily life (occupations) including independence in daily living skills, using these skills in daily routines and learning these skills in the context of daily life.
Physical therapists use a sensory integration approach to address difficulties that the child may have with motor learning, motor control and motor programming that is necessary for reaching developmental milestones, improving coordination and praxis.
Speech and language pathologists use sensory integration methods to address deficits in speech and language and oral motor skills to improve problems associated with oral motor apraxia.
The type and frequency of intervention is usually based on the results of the assessment and the family’s priorities. Intervention can take place in a gym setting with specialized equipment or be provided in a home or school environment if these settings are equipped with the materials and equipment needed to elicit the types of play experiences that will be most helpful to the child. Typically, the child is seen individually which allows the therapist to carefully monitor the child’s reactions to the environment.
When first observing a therapist who is providing intervention using sensory integration procedures, it may not be readily apparent how the activities will help solve the child’s main difficulties. For example, it may seem confusing to learn that having your child throw bean bags at a target while swinging on suspended equipment is actually working on the foundations needed to address his or her handwriting problems. Furthermore, the intervention for another child with handwriting difficulties might focus on lots of climbing to develop whole-body motor planning foundations needed to master the formation of individual letters and numbers. It is important to remember that intervention using sensory integration procedures is designed to address the underlying sensory and motor foundations that help a child learn new skills more easily.
The principles of sensory integration theory that guide intervention stress the importance of incorporating the child’s interests into the therapy sessions. Intervention occurs within the context of play to allow the child to develop abilities in a fun and self-motivating way. The therapist aims to provide the just-right amount of help to adequately challenge the child while ensuring sufficient success. This can be a tricky balance and constant adjustments must be made in response to the child’s reactions. Because this approach is so individualized, it would be impossible to have one set routine that would meet the needs of every child.
For intervention using sensory integration principles to be the most effective, the child’s family should also be actively involved, with a constant exchange of information regarding the child’s reactions to various situations in real life. Discussion between the therapist and parent can help identify which kinds of activities are likely to go well, and which may be more difficult. Strategies used successfully during intervention can also be tailored for use at home. It is often beneficial for parents to observe all or parts of therapy sessions. When parents and therapists work together, they both gain insights that lead to a better understanding of the child, as well as more effective intervention.
It is important to be aware that there are many individuals and organizations that claim to provide sensory integration but do not follow the principles of Ayres Sensory Integration. Beware of:
someone who says that they are providing occupational therapy activities but is not an occupational therapist
someone who says that placing your child in front of a computer program is doing sensory integration
someone who provides passive sensory stimuation to your child and calls it sensory integration
Helping your child at home
You may now have a better understanding of some of your child’s behaviors but now you need practical suggestions that will help you and your child make it through each day with a sense of mastery and enjoyment. The following information may give you some practical ideas that will help your child actively participate in activities and daily routines. Included in these suggestions are:
(referenced from Home Accommodation Checklist, OTA Watertown)
Sensory Diet Activities
A “sensory diet” refers to activities that provide organizing sensory input and can be incorporated into daily routines. Organizing inputs usually take the form of something in the mouth, frequent movement breaks, heavy work to the muscles and joints and deep pressure. For most of us, subtle sensory input activities such as chewing on the end of a pencil, bouncing a leg under a table, or exercising, are sufficient enough to contribute to an organized arousal state. However, the individual that experiences difficulties with sensory processing may need a greater intensity, frequency and duration or organizing sensory input.
Sensory accommodations are ways to adapt the child’s daily environments to provide sensory support and sensory opportunities depending on the needs of the child. Since it is so important for a child to direct their sensory exploration and to limit sensory input when necessary, providing a sensory rich environment allows a child to obtain what they need when they need it. For example, for a child who seeks movement, having movement breaks scheduled frequently during the day and possibly having a basket of fidget toys available would help this type of child accomplish his or her school work in a timely manner.
Provide deep pressure hugs or massage
Have child wear a weighted backpack or fanny pack during the day
Use a heavy blanket to wrap and roll your child up like a hotdog
Squish your child between large sofa cushions
Have your child participate in heavy work activities such as pushing the grocery cart as you fill it with groceries
Let your child jump on a trampoline
If your child plays with stuffed animals, weight them by fill ing them with bags of aquarium rocks or other non-toxic materials
Go to the playground or park and swing, slide, ride the merry-go-rounds, etc.
Encourage your child to move rather than moving providing the movement for them.
Never spin, twirl or swing a child excessively for too long of a time
Allow your child’s feet to remain on the ground while slowly moving forward and backward (forward and backward movement is more comfortable than rotary movement)
Engage your child in imaginative play which may distract him from movements that are scary
Provide added weight such as wrist or ankle weights during climbing or movement experiences
Consider going to new parks or playgrounds in advance of play dates or birthday parties so that the child can familiarize himself on the equipment at his own pace and to work through some of his fears.
Seat your child in the middle seat in the back so that he or she can see out the front window while the car is moving
Provide your child with something to suck on or chew such as pretzel sticks, gold fish crackers, rice cakes or crunchy cereals and he or she can also suck a liquid from a resistant sports bottle
Place window shades on the side windows to cut down overwhelming visual input and bothersome sun light during the drive
Play calming music
Avoid using strong air fresheners
Light ticklish touch is usually more irritating than firm constant touch pressure. Use the palm of your hand to touch your child rather than your fingertips if possible.
Have your child play with different textures of fabrics such as wool, cotton, satin, corduroy, etc.
Paint or draw in pudding, shaving cream or finger paint.
Scoop and pour items such as rice, beans, shredded paper, styrofoam peanuts, or popcorn kernels.
Hide objects in the rice or beans and try to find them without looking.
Allow the child to stand at the back of the line in school instead of between two other children.
Pay attention to the types of fabrics on clothing and try to find fabrics and clothing that your child tolerates such as seamless socks. Let your child wear clothing that he or she prefers and avoid crowded areas.
Encourage active child directed tactile exploration and heavy work activities that will help your child organize and integrate more intense tactile experiences.
Provide consistent home routines
Use picture cues to help your child understand the sequences of events or activities
Help your child manage time with the use of an egg timer
Model new activities for your child
Work on increasing your child’s ability to sequence more steps to an activity by adding additional task requirements one by one
Vary the environment and familiar activities to encourage adaptation and variety in play
Try playing games differently such as building with different sized blocks
Create a repetoire of songs that can be used during transitions such as the “clean-up “ song, wake up song, good bye, all done, etc.
Help the child learn to clean up one activity before starting another by using labeled bins or drawers
Help your child identify when his approach is not working and work together to try another way of doing the task
Have a consistent bedtime routine and start it before your child becomes over tired and moves into overdrive.
Provide relaxing activities one hour or more prior to bedtime such as a soothing bath, quiet music, reading in bed, etc.
A heavy comforter or sleeping bag can provide deep calming pressure which can help a child fall asleep
Place pillows or large stuffed animals on the edges of the bed to make the bed seem smaller and to provide a more enclosed sleeping space
Provide window darkening shades or curtains
Respect your child’s choice in sleepwear. Some children with tactile sensitivities often prefer soft cotton pajamas without feet and some children prefer tighter fitting pajamas that provide touch pressure. Still others like loose fitting clothes at night.
Be cautious around highly stimulating activities such as birthday parties, mall outings, recess or lunchtime at school, or playgrounds. Your child may be bothered by the amount of sensory input that these situations create. Allow your child to adjust as he or she feels comfortable and only spend as much time in these activities as your child feels comfortable.
If you know that your day will include highly sensory activities, provide more calming and organizing activities the rest of the day.
Shorten family gatherings or outings as needed. Get a sitter to come and stay with your child while you go grocery shopping or to the mall. If you have to take your child, take them when it is less busy.
Before entering a stimulating situation, help your child to engage in gross motor movement such as running or jumping in a safe place, or engage him in “heavy work” activities such as pushing on the wall and trying to move it.
To facilitate eye contact, get down at your child’s eye level when speaking to him
Embellish your facial expressions and the tone of your voice to help your child understand what you are trying to communicate
Model appropriate social interactions such as saying hello, goodbye and please and thank you. Provide your child with concrete cues for social interaction such as “Here comes Sam, let’s say hello to him”
Play peek a boo and hide and seek games with your child to encourage interactions and social give and take
Encourage cause and effect play to help your child understand how she can impact interactions with objects and people
Encourage your child to engage in dramatic play such as dress-up, playing with cars, dolls or farm animals or acting out simple scenes themselves with puppets.
Expose your child to interactions where turn taking is necessary such as imitating sounds back and forth, taking turns during a cooking or clean up task or playing simple board games.
Encourage your child to make choices and begin to teach simple negotiation if your choice does not match theirs such as this time we will play your way and next time, we will try it my way.
(adapted from Home Checklist, Occupational Therapy Associates, Watertown,)
To Learn More…
The following publications are suggested if you wish to learn more about sensory integration.
Sensory Integration and The Child - By A. Jean Ayres- Published by Western Psychological Services
Love Jean - By A. Jean Ayres, Brian Erwin and Zoe Mailloux- Published by Crestport Press
Applying Sensory Integration Principles Where Children Live, Learn and Play - Written and produced by Pediatric Therapy Network
Tools for Parents - By Diana Henry - www.ateachabout.com
For More Information Contact:
The American Occupational Therapy Association Sensory Integration Special Interest Section PO Box 31220
Bethesda, MD 30824-1220 - (310) 652-2682 - www.aota.org
The USC/WPS Comprehensive Program in Sensory Integration - Leading to Certification in Sensory Integration including administering and interpreting the Sensory Integration and Praxis Tests offered through the University of Southern California/Western Psychological Services
- (800) 648-8857 - www.wpspublish.com
University of Southern California - Division of Occupational Science and Occupational Therapy - (323) 442-2850
Pediatric Therapy Network -(310) 328-0276 - www.pediatrictherapynetwork.org
SPD Foundation - (303) 794-1182 - www.SPDFoundation.net
Ayres, Jean A. (2005) Sensory Integration and the Child . Los Angeles, CA. Western Psychological Services
Coleman, Gina G., Mailloux, Zoe and Roley, Susanne S. (2004) Sensory Integration: Answers for Parents.
Laurel, Marci K., Trott, Maryann Colby, and Windeck, Susan L. Sensabilities: Understanding Sensory Integration