Basics Of Sensory Integration

Question 1

Sensory integration

Answer 1

• refers to the neurological organization of sensory information for functional behavior
• is a frame of reference = helps guide specific intervention strategies

Question 2

Jean Ayres

Answer 2

• occupational therapist with a post-doctorate in neuroscience
• researched the relationship between the sense and behaviors in children
• originator of sensory integration concepts
• work focused upon impact of the vestibular systems, proprioception system, and somatosensory (tactile) system
• concerned with how the brain function affects a child’s successful participation in occupation
• her practice approach is trademarked as Ayres Sensory Integration (ASI)

Question 3

Sensory integration

Answer 3

• neural organization of sensory input for functional behavior
• sensory stimulation
• processed within brain
• appropriate response

Question 4

Fundamental concepts

Answer 4

• sensory input is necessary for optimal brain function (if individuals are in a deprived environment, they are not going to have optimal brain function)
• neural plasticity = the ability of experience to shape the development of neural circuits
• goal of sensory integration based therapy = a better ability to adapt to new situations
• decreased processing of sensory inputs interferes with learning and engagement in meaningful occupations
• efficient sensory integration yields adaptive responses, improves sensory processing, thus improving engagement in meaningful occupations

Question 5

Key concepts of Ayres Sensory Integration (ASI)

Answer 5

• adaptive response
• child-led
• inner drive
• just right challenge

Question 6

Adaptive response

Answer 6

• when a challenge presented in the environment is successfully met
• sensory input comes in, is efficiently processed in the brain, and then produces a response
• generated from a child actively doing
• NOT a child receiving passive input

Question 7

Inner drive

Answer 7

• desire in children to develop sensory integration through exploration of their environment and develop adaptive responses

Question 8

Just right challenge

Answer 8

• challenges which are complex that they get overwhelmed or cause failure, nor simple that they are uninterested
• task requires effort but is accomplishable (tries new things, they meet success and then it gives them confidence to try new things)
• supports feelings of mastery and confidence

Question 9

The proximal senses (vestibular proprioception somatosensory - tactile)

Answer 9

• lay the foundation for more complex development
• mature early
• related to lower CNS centers (Brainstem, cerebellum, and thalamus)
• proximal senses for a foundation for complex cognitive and social skills to develop

Question 10

Diagram on slide 12

Answer 10

• intellectual and academic ability, behavioral self-regulation, and complex motor skills
• postural control, balance, and tactile perception
• vestibular system, proprioceptive system, and tactile system

Question 11

Vestibular system

Answer 11

• located within the inner ear
• otolithic system = pull of gravity on the body, linear movement (utricle and saccule; our vision helps us to stabilize balance, when we close our eyes, we are more dependent on vestibular and proprioception systems)
• semicircular canals = movement through space, rotary movement, and acceleration/deceleration
• well developed by 5th month in utero
• input processed in cerebellum

Question 12

The vestibular system impacts…

Answer 12

• head righting, balance, and equilibrium reactions (recalibrating)
• posture = muscle tone
• coordination of eye and head movements
• bilateral coordination
• projected action sequences (movement through time and space)
• sensory modulation

Question 13

Balance and equilibrium (vestibular system)

Answer 13

• linked to otolithic system and impact of gravity on body
• the ability for the head and body to maintain an upright position
  Signs of dysfunction:
• clumsy, may fall a lot and not catch self
• lack of protective response
• cautious in play, not a risk taker
• low scores on standardized balance sub tests of PDMS and BOT-3

Question 14

Posture and muscle tone (vestibular system)

Answer 14

• linked to otolithic system and gravity’s pull on body
• decreased strength and endurance (specifically in extensor muscles)
  Signs of dysfunction:
• decreased ability to keep body in upright posture in classroom chair or circle time at school
• often lays on floor to play versus upright
• may be called “lazy” (doesn’t mean it’s true, they just can’t move their body upright against gravity)
• decreased prone extension position

Question 15

Bilateral coordination (vestibular system)

Answer 15

• the ability to coordinate the two sides of the body in a coordinated manner
• related to both sides working synchronous and asynchronous
  Signs of dysfunction:
• difficulties with jumping jacks, skipping, and jump rope
• decreased ball skills
• challenges with fine motor skills related to lead/assist such as cutting, stringing beads, and lacing
  Also related to:
• avoidance of crossing midline during upper extremity tasks
• poor bilateral oculomotor pursuit
• late establishment in the hand/foot dominance
• directional confusion

Question 16

Projected action sequences

Answer 16

• the ability to move the body in time and space, linked to semicircular canals
• considers the child moving in the environment, and also other objects moving in the environment
• simple projected action sequence
• complex projected action sequence

Question 17

Simple projected action sequence

Answer 17

The child moves, but items within the environment are not moving

Question 18

Complex projected action sequence

Answer 18

The child is moving and items within the environment is moving

Question 19

Proprioceptive system

Answer 19

• sensory receptors located within muscle and tendons
  Impacts:
• awareness of body position without visually monitoring
• ability to control the amount of force necessary to complete a task
• sensory modulation

Question 20

Sensory modulation

Answer 20

Proprioceptive input has a calming impact on other sensory systems

Question 21

Awareness of body position (proprioceptive system)

Answer 21

• allows you to complete activities without using your eyes
  Signs of dysfunction:
• clumsy
• drop items, spills items frequently
• knocks things over, such as blocks
• may stand too close to other people, bump into people due to decreased awareness of body

Question 22

The force it takes to complete a task (proprioceptive system)

Answer 22

• the ability to grade movements of the joints to utilize the correct amount of force to complete an activity
  Signs of dysfunction:
• difficulty throwing balls accurately
• breaks items
• when writing exerts too much force and rips paper or too little force and cannot see writing

Question 23

Somatosensory system

Answer 23

• tactile system
• information from the skin that protects us from harm and exposure
• the earliest system to develop in utero (developed by 12 weeks)

Question 24

Tactile system registers…

Answer 24

• light touch
• discrimination
• pressure
• pain
• temperature

Question 25

Signs of dysfunction of tactile system

Answer 25

• messy eater due to decreased awareness
• may be unaware if clothing is on incorrectly
• difficulties completing fine motor tasks
• difficulties with modulation and the ability to maintain a calm, alert state