"What is Sensory Integration? And Dysregulation?"

"What is Sensory Integration? And Dysregulation?"

The brain is shaped like a giant, wrinkly walnut. Not the shell, but the nut, half of a walnut. It has two sides, the left side and the right side. The outside of the brain is grey, or what we call grey matter. The inside is white, or what we call white matter. The brain conducts electrical impulses. The white matter is white because it is better wrapped with a myelin sheath, which allows electrical impulses to conduct faster. In other words, "information" moves faster in the white matter, at the inside of the brain.

We’re familiar with five senses: touch, taste, smell, sight, and hearing. The sequence of events: That starts at the surface of the body, it interactions with sensory organs within the body, sensory organs turn it into information as an electrical impulse, that electrical impulse shoots upwards through a nerve toward the brain. It reaches the brain to the grey matter, and then it gets flipped and swirled and flipped again...or in other words, it gets integrated, in the white matter section of the brain. The brain makes unconscious decisions on how to react to this information so that it takes care of the body.

If the brain gets information, integrates that information and figures out that the body is at risk for falling down, the brain decides to extend your arms out. This would be an example of a Protective Reflex, in which one extends his or her arms. Here's another example: You put on a t-shirt that has pokey seams and a plastic tag at the back of the neckline. Your body gets the sensation that the plastic tag is there. The information is sent upwards toward the brain. The information gets flipped, turned, and mulled over in the white matter, the middle sections of the brain. The brain makes an unconscious decision that even though that sensation is there, it's going to ignore its presence. This unconscious decision to ignore additional sensory information that is of the same type of information is called sensory gating. The brain is going to ignore that the plastic tag is there. And then you're not annoyed by it and you're free to focus on something else for the rest of the day.

Dysregulation occurs when the brain is unable to integrate the information that the sensory organs send upwards toward the brain. These sensory organs, for touch, taste, smell, sight, and hearing, are located at the skin, the tongue, the nose, the eyes, and the ears. They get the information from our immediate environment and turn it into an electrical impulse. The electrical impulses travel up to the grey matter, into the white matter. It's there, in the white matter, the middle of the brain, where dysregulation occurs. Research has shown, that through method of analyzing EEG's, people with sensory dysregulation have different physiological markers than people who do not have sensory dysregulation (Davies, Chang, & Gavin, 2009). In other words, their brains really do behave and respond differently even if they receive the same stimulus in the physical environment to their bodies. Their brain already perceives it differently before they can even consciously react to it.

Here are some additional examples of dysregulation:  a shirt’s plastic tag that never gets ignored, the buzzing sound of appliances never gets ignored, the smells that everyone else finds faint is extremely strong to you, the specks on the wall or clutter are hard to tune out and continually capture your attention, and extreme difficulty eating specific texture of foods. There are many other types of examples. Some involve understanding one's body position and movement, resulting in clumsiness. Some involve interoception, resulting in misperception of one’s internal body functions and subsequent discomfort and reduced coping in much needed situations. There are other factors and many more examples.

When dysregulation occurs, we only see what the brain has decided to do about it, after many sequential events spanning only milliseconds. Often times, the brain is stressed out and is sending signals to our muscles and arms and legs to get rid of what it perceives as irritating. Or the brain tells the body to leave the immediate environment. Or it finds ways to sooth the body in ways that most people would not find soothing. The brain might choose to get nauseas. The brain might choose to gag. Sometimes, the person has years of experience to cope on their own, however, they might be unable to ignore the sounds or smell. Poor coping might take on this form: The person experiencing dysregulation is physically present, however they’re unable to actively listen or enjoy the other aspects of the environment. The person might be there physically, but it may be too distracting for them to think or feel as clearly as they would like to or be expected to.

Dysregulation affects one's capacities to think, even if one is able to withstand the proximity of the stimulus in the environment. People who have difficulty with sensory integration and subsequent dysregulation often experience consequences within a variety of their lives: it can affect their relationship to the family, their self-esteem, dating, friendship-making, their relation to social media, and their ability to communicate and ask for help when they need it (Koenig and Rudney, 2010). Occupational therapists are trained to assist person who experience difficulty with sensory integration and subsequent dysregulation. Every person is different; figuring out a pattern to distinguish what their body decides is overwhelming or underwhelming is what occupational therapists do first when partnering to assist a client (Dunn, 2007).

References:

Davies, P., Chang, W., & Gavin, W. (2009). Maturation of sensory gating performance in children with and without sensory processing disorders. International Journal of Psychophysiology 72, 187-197. http://dx.doi.org/10.1016/j.ijpsycho.2008.12.007

Dunn, W. (2007). Ecology of human performance model. In S. Dunbar (Ed.), Occupational therapy models for intervention with children and families (pp. 127-156). Thorofare, NJ: Slack.

Koenig, K., & Rudney, S. G. (2010). Performance challenges for children and adolescents with difficulty processing and integrating sensory information: A systematic review. American Journal of Occupational Therapy, 64, 430-442. https://doi.org/10.5014/ajot.2010.09073