by Lynn J. Horowitz and Cecile Rost
Hunter House, 2007
Review by Dr. Anthony R. Dickinson & Joy Yip on Jul 26th 2011
A first English language translation from the original Dutch version of 'Help, een druk kind !' (2004), this volume introduces a therapeutic system pioneered by Dr. A. Jean Ayres, an occupational therapist and developmental psychologist, in an attempt to assist parents, caregivers and therapists, in coping with the impulsiveness, restlessness, hyperactivity and inattentiveness of the hyperactive child. Ayres' sensory integration (SI) therapeutic stance views (presumes) such a child to possess information-processing problems endemic to their intrinsic nervous system functioning, and is championed by the current authors, Horowitz & Rost, both of whom use SI therapy techniques in their daily clinical practice. Written for the non-specialist, these authors afford their eight chapters with a focus upon assisting the hyperactive child in particular, and rather than proposing that one deals with the presenting symptoms alone (behavioral problems), they suggest focusing instead upon the neurophysiological level, by improving each child's capacity for integrating sensory input. The repeated claim throughout the book, is that sensory integration problems make it difficult for some children to select and respond appropriately to everyday stimuli or events in their environment, and in turn, thus prevent/hinder development of their learning and socialization skills. It is this problem that SI therapy is here introduced to solve.
Clearly written and easy to read, the authors introduce both theoretical issues and practical skills, with simple (perhaps sometimes too oversimplified ?) discussions concerning how our brains process sensory stimuli, and how each of our sensory awareness channels (incl. vestibular, tactile, auditory, visual, and proprioceptive systems; our sense of smell and taste) operate at different stages of child development. More importantly perhaps, each of the core chapters offer practical and helpful advice for immediate behavioral monitoring and intervention, including the use of calming techniques, deep pressure application and so forth, in assisting hyperactive children to function in a more appropriate ways, both at home or in school. Some of the 'tips' for dealing with aberrant/disruptive behavior are presented in 'case study boxes' occasionally placed within the text pages, and may appear distracting to some readers (better organization/layout would easily remedy this), though largely so presented in order to provide examples of real clinical cases relevant to the adjacent text information each time. Indeed, and although overall convincing, the current reviewers remain concerned re the lack of independent empirical evidence and controlled outcome-studies available in support of the assessment and evaluation of SI therapy, perhaps lending many readers to feel doubt and uncertainty for the effectiveness of SI therapy in countering the hyperactive child's aberrant behaviors. Indeed, this book would be more appealing if clearer evidence of the more successful claims of SI therapy were also presented, together with extensive case studies, thus also providing a more interesting and grounded discussion of the effectiveness of SI as being a more unique therapeutic tool.
The final chapters of the book also offer informative reference tools in its conclusion. A well-documented and published research listing allows the reader to learn more about studies which in particular have involved ADHD children (given the title!). However, the potentially useful behavior checklists provided will by no means allow parents, or those practitioners who work with children, to adequately self-diagnose the extent of any ADD/ADHD spectrum conditions presenting for intervention panning. Lacking in clear guidance as to the use of such assessment tools as provided in the final chapter 'A Questionnaire for Parents', this inclusion was perhaps both premature, and is clearly in need of additional text with regards how one might 'score', or at least interpret, the significance of the results obtained with its use -- an inclusion in the current reviewers view possibly a dangerous option to have provided the concerned reader/parent, if completing this questionnaire without informed professional advice to hand!
This said, the core introductory content of the book does, however, provide a good Primer for anyone wishing to know more about Sensory Integration (SI) Therapy, and will certainly be of some value to anyone wishing to gain a better understanding of hyperactive children. The stated purpose of SI therapy is simply to "improve your child's ability to process and organize sensory information" (p. 89), and proposes therapy techniques which necessarily engage each child (usually 1:1) in client-centered, playful and exploratory activities, specifically designed for the achievement of success and enjoyment of pleasure. SI therapy is thus surely a pleasurable supplemental form of treatment. Many a hyperactive child is likely to benefit from such a pleasurable intervention as SI therapy, if provided by a trained therapist, as a non-medicating child-centered therapeutic intervention.
Failing this, however, it is always useful to encourage your child to raise themselves from the sofa/bedroom, and to 'get out there', and play some active sports such as football or soccer, which will readily enhance sensory-motor integration skills, whilst also burning off a significant amount of pent up nervous energy. DIY SI therapy at minimum cost!
© 2011 Anthony R. Dickinson and Joy Yip
Anthony R. Dickinson [Centre for Brain Disorders, Inst. Neurosci (Chinese Academy of Sciences)] and Joy Yip [Chinese University of Hong Kong (CUHK)].