Sensation Integration Flashcards
Sensory Integration Dysfunction (SID)
Jane Ayers
Used as a specific theory and intervention approach that emerged within the OT field
We CANNOT observe sensory integration
We CAN observe behavior
We hypothesize on theory of neuroscience that integration occurs
Integration
The brain’s ability to effectively manage and interpret information in an organized manner
Highlights sensory processing of information that goes beyond the five senses (+ movement and balance sense)
Dynamic process of interactions organizing info externally and internally
5 senses
They tend to like music Feeding is a difficult issue Grinding teeth Mouth exploring for sensory input Don't like finger pain, sand, crafts, etc.
Dysfunction
The brain cannot analyze, organize, connect, or integrate sensory messages
Exaggerated responses to non-threatening situations
Cannot balance sensory information appropriately
Modulation
Balance of integration and dysfunction
The brain’s regulation of messages by facilitating or inhibiting responses
The NS responds to some stimuli while ignoring others; therefore, an adaptive response is performed
Consistent therapy is necessary for child’s success
Habituation
The process that represents to the NS that something familiar has occurred
Sensitization
The NS’s mechanism that enhances potentially important stimuli; detects harm or danger in a situation
HIGH (habituation)
POOR registration
Sensation SEEKING
LOW (sensitization)
SENSITIVITY to stimuli
Sensation AVOIDING
Sensation seeking
The combination of high neurobiological thresholds and an active self regulation strategy
Enjoys and generates extra sensory input
Adding spice to already seasoned food
Low registration
The combination of high neurological thresholds and a passive self-regulation strategy
Notices sensory stimuli much less than others
Doesn’t get jokes as quickly
Sensation avoiding
The combination of low neurological thresholds and an active self regulation strategy
Bothered by input more than others
Only will eat familiar foods
Sensory sensitivity
The combination of low neurological thresholds and a passive self regulation strategy
Detects more input than others
Afraid of heights and experiencing discomfort
Level I Sensory Integration
Primary sensory system
2 mos
Tactile sense (touch) Vestibular sense (balance and movement) Properties sense (Body px) Visual and auditory sense
Level II Sensory Integration
Foundation of perceptual motor
6-24 mos
Body perception
Bilateral coordination
Lateralization
Motor planning
Level III Sensory Integration
Perceptual motor
3 years old
Auditory processing
Visual perception
Eye-hand/foot coordination
Visual motor coordination
Level IV Sensory Integration
Academic readiness
6 years old
Academic skills
Complex motor skills
Regulation of behavior
Organized behavior
SMD Sensory
Over Responsiveness
Behavioral characteristics associated with sensory over-responsiveness may include…
Aggression Impulsivity Irritability Fussiness Unsociable Avoids group activities Upset by transitions
General Characteristics SMD
Over-reactiveness
Mud or glue on their hands
Crawling, walking barefoot
Feeling crumbs in or around mouth
Having hair, fingernails, or toe nails cut
Food textures
Background noises when trying to concentration
Playing in swings
Fragrances from perfume
SMD Sensory
Under Responsiveness
Indicators of sensory under-responsive behaviors…
Doesn’t cry when hurt or injured
Prefers sedentary activities
Often unaware of what is happening around them
Does not notice food on or around their mouth
Unaware of body sensations (hunger)
SMD Characteristics
Under-reactive
Passive Quiet Withdrawn Difficult to engage in conversation Lost in their own world Slow to respond to directions Easily fatigued
SMD Sensory Seeker
On the move constantly
Likes crashing, bashing, jumping
Strong preference for spinning, swinging, and rolling
Excessive risks during play
Frequently fixates visually on objects
Smells and tastes objects when playing with them
SDD
Sensory Discriminate Disorder
Difficulty following directions and gets easily lost
Aversion to puzzles or other visual games
Frustration when unable to differentiate visual or auditory signals
A need for directions to be repeated
SDD Treatment
Improve relationship btwn child’s body and people and space
Improve motor planning and organization of behavior
Increase somatosensory input while child is navigating 3D space
Increase ability to discriminate force
SBMD
Sensory Based Motor Disorder
Difficulty learning new motor skills
Often trips or bumps into people or things
Is clumsy, awkward, or accident prone
Struggles with multiple step directions
Poor ball handling skills
Difficulty performing self-care tasks
SBMD Treatment
Novel activities
Games that involve specific directions of body parts in space
GOAL *** to have the child independently plan and execute projected action sequences
How Sensory System Affects Everyday Skills
Tactile Perception
He/she avoids touch
Craves touch and may handle/mishandle everything
Cries when pushed to manipulate soft or unstable textures
May lead to oral motor dysfunction
Movement and touch are the child’s first teachers
How Sensory System Affects Everyday Skills
Body Awareness
Unconscious awareness of an individual’s body parts in space
Withdraws from movement experiences
Difficulty orienting arms and legs for getting dressed
How Sensory System Affects Everyday Skills
Motor Planning
Difficulty organizing sequences of movement
Poor gross motor skills
Poor fine motor skills
Poor eye-hand/foot coordination
How Sensory System Affects Everyday Skills
Visual Perceptual Motor
Unable to interpret how objects feel just by looking at them
Having trouble comparing and contrasting similar objects
Difficulty problem solving
How Sensory System Affects Everyday Skills
Emotional security/social skills
Socially distant
Aggressive or hostile for no apparent reason
Dislikes changes
Invade personal space
Assessment
Uncovers hidden processes that contribute to adaptive or maladaptive interactions
Work off these findings for treatment
Often reframes the interpretation of problematic behaviors and mannerisms which allow an intervention plan to be generated
Sensory Integration and Praxis Test
SIPT
Most reliable and comprehensive
19 components
Difficulty with attention, cognition, language, etc.
STEP-SI
9 years and up
Sensation, Task, Environment, Predictability, Self-monitoring, and Interactions
Each element can be analyzed to determine if these aspects of the child’s life either support or hinder the ability to cope and participate
Sensory Profile
Birth - 6 mos
6 mos - 36 mos
3 years to 9
9 and up (adulthood)
Checklist format completed by the caregiver
Includes sensory processing, modulation, and behavioral responses
Characterizes children’s behaviors and performance in relation to sensory processing
SI Intervention…
Philosophy of practice
Establishes and restores a healthy lifestyle for the child by engaging in meaningful occupations
SI allows…
Running
Jumping
Swinging
Climbing
^ Gross motor play
Multi-sensory activities have calming, alerting, challenging, OR organizing effect
Proprioceptive Sensations
Cornerstone of sensory-integration intervention
Alters levels of arousal and enhances self-regulation
Gateway of fxl movement through traction, compression, movement, or resistance
Vestibular
Swinging through suspended equipment
Tactile
Tactile experiences are essential to SI
Deep pressure contact is a PRIME organizing factor in treatment
Net swing
Good for vestibular input
Can adjust for spinning, close to floor, prone, etc
Tapping the Inner Drive
Back to Limbic system
Works on motivation
Typically developing children naturally seek a great variety of sensory-based activity
Limbic structures in the brain normally orchestrate motivation and drive
Disruption of obsessive, ritualistic, repetitive, or socially inappropriate behaviors
Context of Play
The therapist and the child have the intent to play together
Enter into challenges that are perceived as pleasurable, purposeful, and meaningful
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Weighted vest
Weighed DOWN
2 hours on
30 min off
1/3 child’s bodyweight
Has to be evenly distributed
Work well for kids that tend to be all over the place
Monitor the timing
Compression vest
COMPRESSION
Not an actual weight
Can wear throughout the day time
Gives input ALL OVER
Like a big bear hug
Consistent pressure
Does not stress the joints
Artful Vigilance
The therapist watches for opportunities to engage the child adaptively while altering the sensory and motor challenges
Successful engagement is the key for successful treatment
Monitor for signs of under or over responsiveness
***When a child is fixated TOO much on a swing, make sure they aren’t getting dizzy or sick
Child-centered approach
Therapist to provide structure
Child to provide responses
Provides productive interaction that is initiated by the CHILD’S interest
Adaptive Response
An appropriate action in which the individual responds successfully to environmental demands
Increased adaptation as challenges are posted
Satisfaction in its accomplishments
Just-Right Challenge
The point in therapy where the conditions are right for the child to make an adaptive response
Activities are adapted so the child can meet the task demand
As children change and grow, therapy is continually modified
Wheelbarrow walking
Using upper shoulder girdle
Uses movement and momentum to incorporate UE WB
Active vs Passive Participation
Child MUST participate with the environment to improve the organization in his nervous system
Active physical interaction with sensory experiences is an important factor in brain recovery
Active - Purposeful - Meaningful
USC/WPS Certified
Completed extensive training
Only therapists who are certified can administer the Sensory Integration and Praxis test
3 hours to administer
Looks at movement, touch, modulation
