In our last blog we had a brief look at how the worlds of sensory integration and baby/toddler therapy meet. We summarised the sensory systems involved and how occupational therapists can assist parents and infants with feeding and sleep routines. In this blog post we look a little closer at sensory integration therapy for infants.
Sensory integration therapy for infants is made up of three different modes of therapy:
- Hands on therapy using Sensory Integration methods
- Home programmes
It is important to remember that scheduling hands on time with tiny tots can be really challenging, especially when the parents are already struggling to achieve a calm-alert state with their baby. For this reason, we often ask parents to come as they are, whatever the time of day, so that we can see the struggles and experience it with them. Often an unhappy baby gives us a lot more information than a calm or sleepy one.
During counselling sessions we try to empower parents. The objectives are to help the parents to understand the sensory contributions to the child’s behaviour, and how they can better deal with them. This could include feeding tips, positioning, adjustments to the environment and more.
- Hands on SI methods
There is a time and a place for hands on therapy with the infant population. Individualised and direct intervention is designed using Ayres Sensory Integration® (ASI®) theory and principles to remediate the identified problems. Although the principles are the same, experience with the younger population is vital as the babies express their discomfort differently to older children. Outcomes are similar and include modulation of sensory input, regulation of sensation and state, and improved sensory processing. Successful adaptive responses are often subtle and reported back by the parents as the child is able to adjust better to different environmental demands once they go home.
- Home programmes
As with older children, home programmes form part of a sensory integration approach. This often forms part of the counselling sessions as parents have much more time to implement the strategies than the therapist. This includes modifications to the child’s environment to fit the child’s needs.
As with older children, sensory integration makes use of the ability of the central nervous system’s ability to change (plasticity). For this reason, early intervention is so critical. The earlier the intervention, the better the trajectory for later development. When the child’s ability to process and organise sensory input improves, it allows for an adaptive response. In the case of the infant, this sensory integration happens within the context of their normal daily activities.
Some examples of aims for infant therapy may include:
- Achieving an optimal level of arousal and self-regulation through alerting/calming input
- Promoting and supporting self-regulation
- Desensitising the neurological systems to tolerate certain daily activities
- Improving registration
- Organising sustained attention
- Facilitating organised and sustained activity, or
- Eliciting an adaptive response.
The infant practice
There are not many differences in the look and setup of an infant practice. There should be equipment and toys to stimulate each of the sensory systems, including:
- Tactile equipment
- Vestibular equipment
- Age appropriate toys or household objects with appropriate affordances
- A sensory rich and motorically challenging environment
Some toys might look specifically like they belong in a nursery. A baby slide could fit indoors, and a rocking horse provides wonderful opportunities for movement. A safe and quiet space for little ones to escape to is also a great idea. Tactile opportunities abound with a variety of mats and different balls in ball pits as you need less space, or perhaps even various smaller rooms, in which to work.
In summary, infant sensory integration therapy stems from the same theory and work of Jean Ayres, however, a careful eye for differences, and a very important relationship with the parents, will guide therapy practice. It is wonderful to find a mentor with years of experience to guide you, as sound theory can then be backed up with subtle observations and a little intuition, to ensure the baby and parents cope better with the demands of various environmental challenges.
[This article was written by Karen Powell, adapted from information from Meg Faure’s Infant Sensory Integration Training (ISIT) – 2019. Karen works primarily with infants and toddlers in private practice and is currently serving on SAISI’s board.]