Sensory Integration Disorder

The human brain is a complicated and delicate instrument, which provides us with the ability to think, speak and control a myriad of functions such as motor movements and visual perception. But sometimes, malfunctions in the brain short-circuit those abilities, causing problems such as Sensory Integration Dysfunction and Nonverbal Learning Disorder.

Sensory Integration Dysfunction and Nonverbal Learning Disorder are frequently confused. Both are neurological disorders which involve the way the brain functions, but affect different aspects of learning and social processes.

Sensory processing refers to the way the nervous system receives messages from the senses and turns them into motor and behavioral responses, according to the Sensory Processing Disorder (SPD) Foundation. SPD, previously known as sensory integration or SI, results when the brain does not organize sensory signals into proper responses. The SPD Foundation cited neuroscientist A. Jean Ayres, PhD metaphor comparing SPD to a neurological “traffic jam” that prevents the brain from receiving needed information to interpret sensory information correctly. The result creates problems with daily tasks and causes problems with motor skills, behavioral problems, anxiety, depression, and problems with schoolwork.

Sensory Integration Dysfunction affects a person’s ability to correctly process sensory information. The disorder manifests itself in many forms, making symptoms vary from child to child. Although it was first noticed in children with autism or autistic tendencies, it also is seen in children with other disabilities, including cerebral palsy or attention deficit disorder.

The level of deficit also varies from child to child, from mild to severe. Some children with SID are hyposensitive to outside stimuli, while others are hypersensitive to outside stimuli. A hyposensitive child may continually bump into things to obtain extra stimulation, but a hypersensitive child avoids being touched or touching things.

Children with SID can have processing deficits in one or more areas, including visual and auditory processing. When a child has a visual processing deficit, he or she has difficulty verbalizing the word for an object, or the child may see an object but the brain does not process what is being seen.

With an auditory processing deficit, the child hears what is being said, but could take several minutes before understanding occurs. For children with auditory processing deficits, giving one instruction at a time helps the child process what he or she is being asked to do. Allow the child to complete the task before giving instructions for another.

Symptoms exhibited by a child with sensory integration dysfunction may include:

A tendency to spin, swing, or jump. The motion appears to calm the child.

sensitivity to the feel of clothing. The child does not like tags in clothing and can be particular about his or her socks.

The child may want a particular food and not want to eat anything else.

Oversensitivity or undersensitivity to smells. The child may sniff people, objects, and/or food,

Oversensitivity or undersensitivity to sounds. The child may frequently cover his or her ears.

The child may have an exceptionally high pain tolerance.

An unusually high or low activity level may be present and the child tires easily.

There is a resistance to new situations.

A child with sensory integration disorder may also have poor coordination and poor muscle tone. Some children with the disorder are impulsive, while others are distractible. Many also walk on their toes consistently to avoid the sensation associated with putting their feet on the floor.

The most common treatments for children with SPD include occupational therapy and listening therapy. Physical therapists, speech/language therapists and others trained to use a sensory integration approach also may help with a child’s treatment. The family also plays an integral part in a child’s treatment by identifying priorities and serving as an expert on the child and his or her problems and behaviors. Together, a treatment program is formulated for the child.

On the other hand, Nonverbal Learning Disorder is a neurological language disorder that affects a person’s visual-spatial, intuitive, and organizational abilities. It also can affect the ability to evaluate information and overall processing function.

Children with NLD will have early speech and vocabulary development, exceptional abilities for rote memory, and attention to detail. The child also will develop reading skills at an early age and likely is an excellent speller. NLD children also have exceptional verbal abilities and retain auditory information well.

However, children with NLD, according to the Nonverbal Learning Disorders Association, also show a lack of coordination, problems with balance and a lack of visual-spatial organization. Those with the disorder have poor visual recall and problems with special perception.

Other problems include an inability to comprehend nonverbal communication, difficulty transitioning to new situations and underdeveloped social judgment.

As with SID, the levels of severity for people with NLD vary with the individual, which makes each person’s disorder somewhat unique. NLD also is helped with therapy.

Those affected by NLD may have low muscle tone, and some need lifelong support with cognitive and organizational skills, muscle skills, and social skills. The child with NLD faces confusing sensory stimuli. Although children with NLD may love to read and have exceptional memory and vocabulary skills, they also have problems with use of everyday language skills such as tone of voice, inference, written and facial expression, and gestures.

NLD affects the person’s understanding of patterns and spoken instructions. For instance, lining up columns of numbers is a problem for those with NLD, and they will have trouble picturing spoken directions. The disorder can lead to coordination problems and poor balance, causing a tendency to fall.

The most important support for those affected by NLD, according to the NLD Foundation, is environment. A positive and safe school and home environment is needed. Symptoms of NLD include:

Problems with motor coordination.

Poor visual-spatial-organizational abilities.

Difficulty with nonverbal problem solving.

Problems dealing with negative feedback.

Difficulties in dealing with cause-effect relationships.

Inability to discern incongruities in information or situations.

Well-developed rote verbal and memory skills.

Problems with arithmetic, compared to excellent reading skills.

Tendency to be verbose.

Reliance on language for social relating and information gathering.

Poor social perception, judgment, and social interaction skills.

A tendency toward social withdrawal and isolation as the child gets older.

Interventions that can help those with NLD include clearly stated expectations, consistency in scheduling, computer use, language based therapy, occupational and physical therapy, and social skills training. A host of other interventions also can be used to assist those with NLD.

According to a 2002 article for the American Speech-Language-Hearing Association (ASHA) Leader Online, those with NLD may appear to have excellent verbal fluency, but have many communication and language problems. Their apparent language competence is superficial and they do not fare well when a situation calls for deep comprehension, the use of contextual information, or complicated social interaction.

The article also indicates descriptions of NLD are very similar to descriptions of other conditions, including semantic-pragmatic disorder, pragmatic language impairment, high-functioning autism, and Asperger’s syndrome. The author suggested the description of nonverbal learning disability used in the educational arena is the same as what is called pragmatic language impairment in the speech-language field. It was also suggested that additional systematic research is necessary to establish an empirical base for the diagnosis of NLD.