Book Review: Building Bridges Through Sensory Integration

Building Bridges Through Sensory Integration: Therapy for Children with Autism and Other Pervasive Developmental Disorders
by Ellen Yack, Paula Aquilla, and Shirley Sutton

Building Bridges Through Sensory Integration is a book written by three occupational therapists.  Their goal is to offer a resource to explain what role sensory differences play in autism, and what occupational therapists can do to help children and their parents manage sensory processing differences.

What Do Occupational Therapists Do?

When a child is diagnosed with autism in Manitoba, one of the professionals they are referred to is an occupational therapist.  Many people don’t understand what occupational therapists do, but essentially, their job is to promote skill development and independence in all daily activities.  “Occupational” means “an activity in which one engages.”  For children, occupations include things like playing in the park, licking a popsicle, going to the washroom, playing with friends or a parent, or taking swimming lessons.  If there are barriers, an occupational therapist will help figure out ways to develop needed skills or find workarounds.

One example shared in this book: think of a first grader learning to print.

“To learn this task, the student must have good hand skills, good sitting posture and balance, adequate joint stability and muscle strength, good body awareness and motor planning, mature visual perceptual and visual motor skills, good attending abilities, and adequate sensory integration.

If sensory integration is impaired, a student could have difficulty printing because she may be uncomfortable with the touch of the paper against her arm or may have difficulty attending to the task because she is highly distracted by other activities in the classroom.  If the student has poor motor planning abilities, she may not be able to direct the movements of the pencil to appropriately form the required letter shapes.  If the student has immature sitting balance, the height of the desk and chair may have to be altered to provide maximum stability.”

What is Sensory Integration?

“Picture yourself at a cottage.  You are standing on the dock, about to climb into a canoe.  You put your foot down into the canoe, and as you begin to step in, the canoe starts to rock.  Automatically you adjust your body to keep yourself balanced and slowly sit down, placing yourself in the middle of the seat.

This is sensory integration.”

Simply put, sensory integration is about processing the information our brain receives through our senses in a way that allows us to respond automatically, efficiently, and comfortably.  In the canoe, your touch system tells you that your foot is at the bottom of the canoe, and that the canoe is moving.  Your vision tells you the canoe is lower than the dock.  Your proprioceptive system tells you the position of your muscles and joints.  And your vestibular system tells you that your centre of gravity is off and you are on a moving surface.  If you have good sensory integration, you can unconsciously make adjustments as you lower yourself safely into the canoe, with confidence that you will end up where you want to be.

For children who do not have good sensory integration, climbing into a canoe – and other activities most of us take for granted – can be a disaster.  They cannot interact with the world with confidence that they can manage everyday sensory challenges.

Children with sensory integration problems may be oversensitive or undersensitive in any of the sensory systems.  They may have trouble paying attention to sensory information, or find it overwhelming.  They may not be able to respond appropriately.

Motor planning is the process of deciding what your body has to do, and then doing it.  It is a complex process that includes conceiving, planning, sequencing, and carrying out actions.  It relies on sensory feedback from the body and environment, as well as language, memory, and thinking skills.  Imagine learning to crochet or play tennis for the first time. At the beginning you may be awkward because you are thinking of where parts of your body need to be as they move.  In time, it all becomes automatic.  Motor planning in children with processing problems is often inconsistent, affected by the specific demands of a task or by factors like fatigue.  But planning issues, as well as sensory processing issues, can interfere with a child’s confidence and day to day success as he or she tries to interact, play, and learn.

This book explains the processes and parts of sensory and motor processing in easy to understand detail.

How Can We Figure Out a Child’s Sensory Needs?

The authors strongly recommend consulting an occupational therapist to guide you through the process of assessing a child’s sensory and motor profile.  That’s good advice.  But there is lots of information here to get you started – chapter 4 includes checklists related to common daily activities to help you identify where a child might be having problems.


Chapter 5 and beyond are all about strategies and ideas for building sensory integration.

Is your child behaving in a way that indicates stress or frustration?  Chapter 5 is full of ideas to help relax, organize and alert your child.  There is also a list of specific behaviors – sensory seeking and sensory avoiding – that considers why a child might be doing something, and more appropriate ways to give them what they are looking for.

Chapter 6 is all about ideas to help with self-care, including sleeping, grooming, toilet training, hair combing, eating, and play.

Chapter 7 is about planning for different settings.  All children do better in a predictable environment, and so it’s important to develop supportive habits that can be carried out in different settings.  Children with sensory processing differences often can use some help transitioning between activities as well.  For example, thinking about soft places to land, scheduling calming activities, or using touch to get a child’s attention if using their name doesn’t work as well are all strategies that can be shared.

Chapter 8 is a set of lists – multisensory activitis to provide tactile, vestibular, adn proprioceptive sensations during play.  Most are easy, low cost ideas, and many are traditional activities all children enjoy.  They include tactile, oral motor (mouth), fine motor, and gross motor activities.  Examples include bubbles, ping pong balls, feathers, bubble wrap, peg boards, elastic bands, edible play dough…if you’re looking for ways to engage your child in play, this list will be invaluable.  What this will help you do is to match the activities to your child’s needs and preferences.

The book concludes with equipment ideas and other resources, including books, websites, and videos.

A Detailed and Useful Reference

Building Bridges is a book that every school should have, and it is useful for parents as well.  It’s a good reference to have on hand as your child grows and changes, and also useful to help parents come up with ideas to keep children active and creatively engaged.

Related Resources

A Child’s View of Sensory Processing provides an easy-to-understand description of the seven senses, and what happens if you have sensory processing disorder.

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