Next to vision, hearing is the sense most called upon by parents and teachers to educate, warn, and discipline. You expect your child to listen and understand when you help with homework, explain how to do something, or issue a command. Your child needs to understand language to make that happen and be able to pay attention.

But on a very basic level, he needs to be able to correctly interpret the sound waves that come in through his ears. He needs to be able to pick your words out from other noise in the room. He needs to interpret differences in the pitch and volume of your voice to understand when you're angry or concerned. He needs to tune out distracting information from other senses. He needs to feel basic comfort with his body's position and balance to be able to even concentrate on auditory information. That's a lot of work.

Children with sensory integration disorder may not be able to do that work very efficiently. Your child may actually have trouble with processing information that comes in through the auditory sense, reacting in extreme ways to certain volumes, pitches, or vibrations of sound. Or her reactions to the things she hears may reflect problems with other sensory systems.

An occupational therapist will probably address your child's sensory processing problems with activities that focus on the tactile, proprioceptive, and vestibular systems, since strengthening those areas often improves processing for the auditory system as well. Either way, though, understanding the problem your child may have with sound will help you judge behavioral reactions and make her more comfortable.