SENSORY INTEGRATION DISORDER
THE EFFECT OF INSTITUTIONALIZATION
Not all professionals accept the existence of sensory integration disorder. However, sensory integration theory provides a useful construct to understand and address a wide range of problems.
Normal sensory function depends on receipt of normal sensory inputs during infancy. Children residing in orphanages often lack these experiences. The most pervasive form of sensory deprivation for children residing in orphanages is the lack of nurturing physical contact. Even in well-staffed American orphanages in the 1960s and early 1970s, children were held, "petted," and rocked only approximately 18% as much as family children. In another study, family children received 7-13 times more tactile stimulation than orphanage children.
Auditory and language exposure is greatly reduced in orphanages compared with families: during 4 hours of observation time, orphanage children were spoken to for 13.2 minutes vs. 166.2 minutes for family children. Crib confinement and swaddling thwart the child's natural instincts to explore and master successive sensorimotor tasks. Crying, thumbsucking, rocking, head banging, and other "self-stimulatory" behaviors may be viewed as the child's attempt to satisfy these needs.
Some authors suggest that sensory or perceptual deprivation rather than the lack of parental love is the chief adverse effect of institutionalization. A survey of 22 infants living in a Romanian orphanage revealed poor oculomotor control and responses to tactile deep pressure, which improved after 6 months or "enhanced caregiving." However, attempts to remediate the adverse effects of institutionalization with sensory enrichment alone are only partially successful. Clearly, a loving parent is the best provider of sensory stimulation to the infant. Sensory integration theory also emphasizes the importance of the therapist-child interactions as critical to the therapeutic process and does not see sensory input in isolation as being effective.
From THE HANDBOOK OF INTERNATIONAL ADOPTION MEDICINE by Laurie C. Miller. © 2004 by Oxford University Press, Inc. Used by Permission.