Ch 20 — SI Flashcards
Sensory integration is…
the organization of sensation for use
SI theory
concepts that promote understanding the child and planning appropriate intervention
SI assessment
methods to determine whether a child has SI problems, and if so, which types
SI intervention
strategies designed to improve the child’s difficulties with sensory-motor functioning and participation
hypo
seeking more
not getting enough of sensory systems
hyper
having too much
avoiding sensory systems
T/F: Sensory input is necessary for optimal brain function and development
True
Adaptve response for Neurobiologically Based Concepts
➢A successful response to an environmental challenge.
➢Response is a little more complex than previously done.
➢Child must be actively in control.
➢Builds on the child’s inner drive.
➢An adaptive response leads to more complex sensory integration at a neural level.
➢Process involves neural plasticity.
Neural plasticity enables more….
complex behavioral patterns to emerge as adaptive responses are made
T/F: Body-centered senses (tactile, proprioceptive, and vestibular) mature earlier than visual and auditory systems, and lay a foundation for development of increasingly more complex sensory-motor processes, social interactions, and occupational engagement.
True
when does SI mature?
7-10 years
Child’s inner drive leads to seeking of “just-right challenges” meaning:
Not so easy that no effort is required
Not so difficult that child will fail
mastery of challanges invovles
engagement in more complex occupations
Sensory integrative development that is not optimal may lead to
behavioral, social, academic, or motor coordination difficulties
Southern California Sensory Integration Tests
SCSIT
Sensory Integration and Praxis Tests
SIPT
four major areas in which SI problems may occur:
➢Sensory reactivity
➢Sensory discrimination and perception
➢Vestibular-bilateral functions
➢Praxis
brushing protocol
wilbarger
Sensory reactivity is also called
sensory modulation, responsiveness, or responsivity
unusually strong, negative response to an ordinary sensory experience
Hyper-reactivity
easily upset by light touch sensations (e.g., from clothing, food, and people)
Tactile defensiveness
distressed by environmental noise, loud or shrill sounds
Auditory hyper-reactivity
can hyper-reactivity may be present in how many sensory modalities
one or multiple sensory modalities
unusually weak or absent response to sensory experience
Hypo-reactivity
Example of sensory registration problem:
does not notice that an object or environmental feature is present
Reactivity Problems and Participation for Tactile defensiveness
➢Avoids and upset by certain clothing and food textures
➢Avoids and upset by being in close proximity to other people, as in parties or standing in line
Reactivity Problems and Participation with Gravitational insecurity
➢Terrified of walking on uneven surfaces or moving through space
➢Avoidance of movement and playground activities
gravitational insecurity
Hyper-reactivity to vestibular sensations (movement through space)
Sensory registration problem
Hypo-reactivity (does not notice sensory information)
Reactivity Problems and Participation with Sensory registration problem
➢Bumps into objects as if they are not there
➢Does not notice presence of people
➢Safety issues: may step into traffic
Tactile discrimination and perception problems may invovle
➢Difficulty interpreting tactile stimuli (not necessarily avoiding it, which is hyper-reactivity)
➢May affect development of fine motor skills
➢May be seen along with visual perceptual problems
Proprioception problems
➢Inaccurate perception or unaware of body position.
➢Often clumsy, awkward.
➢May seek firm pressure, jumping or walking forcefully, and joint compression for extra sensory feedback.
➢Praxis is usually affected.
Vestibular-Bilateral Problems Involves difficulties with:
➢Postural control, balance, and equilibrium responses
➢Bilateral coordination
➢Sequencing of actions smoothly in time and space
➢Projected action sequences: accurately anticipating how and when to initiate action in response to movement of body and objects in space
ability to conceptualize, plan, and execute a nonhabitual motor act
praxis
Dyspraxia may involve ideation problem by
creation of an idea for a new way to move in order to obtain a goal
May involve motor planning problem is
knowing how to sequence movements in a new way.
Dyspraxia negatively affects acquisition of new skills such as
dressing, handwriting, playing games, and participation in sports
Frequent seeking of intense sensory experiences may occur for multiple reasons:
➢To compensate for poor discrimination/perception by generating additional strong sensory information
➢To self-regulate arousal level
➢To modulate hypo- or hyper-reactivity in other sensory systems
➢An expression of poor praxis, which limits ideas and strategies for movement
➢An expression of the child’s temperament
Secondary Effects of Sensory Integration Difficulties
Often misinterpreted as purely behavioral or psychological issues, limit a child’s participation, and undermine self-esteem and self-confidence
Interviews and questionnaires
➢Sensory profile
➢Sensory processing measure
Observations of the child involve
➢Informal observation of spontaneous behavior in home, community, and/or clinical settings
➢Structured clinical observations of child doing therapist-directed tasks
Standardized testing
➢Sensory integration and Praxis tests
➢Bruininks-Oseretsky test of motor proficiency
➢School function assessment
Consideration of available services and resources
➢Interpretation of assessment findings
➢Recommendations
Individual Ayres Sensory Integration® (ASI) intervention
➢Applied on an individual basis.
➢Strong relationship between therapist and child.
➢Engages the child’s inner drive to actively explore the environment.
➢Involves a balance between structure and freedom.
➢Therapist presents “just-right challenges.”
➢Values child’s active participation.
➢Outcomes directly address child’s participation in home, school, and/or community activities.
Individual ASI intervention
➢Draws on the child’s interests and imagination.
➢Provides a just-right challenge
➢Uses space with equipment selected for specific child’s needs
ASI intervention should involve
key elements identified in the Fidelity Measure for ASI Intervention
Other OT Interventions for Children With SI Problems
•Training in specific skills
•Group activity programs
•Specific sensory techniques (massage protocols and weighted vests)
•Environmental modifications to reduce impact of sound or lighting
•Cognitive interventions such as the Alert Program for Self-Regulation
•Occupation-based interventions, such as horseback riding or yoga
•Parent or teacher education, coaching, and consultation
Measuring Intervention Outcomes of occupational therapy may include
➢increase in frequency or duration of adaptive responses.
➢increasingly more complex adaptive responses.
➢improvement in gross and fine motor skills.
➢improvement in cognitive, language, or academic performance.
➢increase in self-confidence and self-esteem.
➢enhanced occupational engagement and social participation.
➢enhancement in family life.
dyspraxia?
motor planning problem
