Sensory-based Motor Disorders Assessment And Intervention Flashcards
1
Q
Categories of sensory integration problems (theories)
A
- modulation problems (over-/under/responses)
- sensory-based motor (postural disorder, vestibular-bilateral disorder, and dyspraxia)
- sensory discrimination disorder
2
Q
Postural disorder
A
- deficits processing vestibular input
- inefficient balance and equilibrium
- decreased core strength
3
Q
Vestibular-bilateral dysfunction
A
- deficit of inability to use two sides of the body together in a coordinated manner
- a function of vestibular-proprioception processing
- often demonstrates no other signs of sensory integration difficulties
- difficulty with team sports, incoordination, and fine motor tasks
4
Q
Dyspraxia
A
- also known as developmental coordination disorder (DCD)
- impaired ability to plan and execute non-habitual motor tasks
- praxis = the ability to conceptualize, plan, and execute a non-habitual motor task
- ideation = the ability to generate ideas of what to do in a novel situation or conceive play possibilities with novel toys (children may wander aimlessly, perform simple repetitive items such as patting or pushing items, or observe others to know what to do
- motor planning = the ability to plan and execute the movement
- very hard to work with because kids have delays across most systems
5
Q
Bundy and Murray Model
A
- poor sensory modulation
- poor praxis
6
Q
Characteristics of sensory based motor disorder
A
- delays meeting motor milestones (having a hard time with age-appropriate occupations)
- difficulties with fine motor and/or gross motor skills (does not have an additional diagnosis that explains the reason for the motor delay)
- absence of additional diagnosis that explains motor delay (no diagnosis of CP, Down Syndrome, and intellectual disability)
- based upon the work of Jane Ayres
- differences in development of motor skills is due to inefficient processing of sensory receptors: specifically vestibular and proprioceptive systems
7
Q
Assessment
A
- occupational profile (you get that from the caregiver or school) = no indicator of other medical issues that may cause delays
- motor assessment (PDMS-3, BOT-3)
- clinical observations
- Structured Observations of Sensory Integration (SOSI-M)
- Comprehensive Observations of Proprioception (COP-R)
8
Q
Assessment of SOSI-M and COP-R
A
- published in 2021
- builds upon the work of Jane Ayres
- standardized for children ages 5-14
- takes 20-40 minutes to administer
- has two components = SOSI-M and COP-R
- SOSI-M = individually administered assessment of motor performance
- COP-R = observational measure of behaviors linked to proprioceptive processing
9
Q
Structured Observations of Sensory Integration Motor (SOSI-M)
A
- you will need to understand the WHY of which one is motor planning, vestibular, etc
14 items that target proprioceptive and vestibular processing linked to postural control and motor planning: - balance
- modified Schilder’s arm extension test
- skipping
- high kneeling
- antigravity extension (prone extension)
- antigravity flexion (supine flexion)
ocular movements - sequential finger-touching
- diadochokinesis
- projected actions = ability to move our body through time and space
Identifies problems in 4 areas: - postural control
- motor planning
- vestibular (including bilateral motor coordination)
- proprioception
10
Q
Comprehensive Observations of Proprioception Revised (COP-R)
A
- can be observed during administation of SOSI-M, during administration of other assessments or during play
- first standardized assessment related to proprioception
Structured at 18 observations of skills and behaviors related to 4 areas of proprioceptive processing: - tone and joint alignment
- behavior manifestations (regulation)
- postural motor
- motor planning
- collects qualitative information related to toe walking, leaning, passive, grading of force, and midrange control
11
Q
Considerations for Intervention
A
- What were the results of your assessment related to occupational profile, clinical observations, and standardized assessments?
- Based upon results of the assessment, what underlying sensory systems needs to be addressed?
- What interventions best help the vestibular, proprioceptive, and tactile system develop?
- How will engaging in these interventions help improve occupations?
12
Q
Sensory discrimination
A
- proprioceptive discrimination problems
- tactile discrimination problems
13
Q
Proprioceptive discrimination problems
A
- its body is not giving good feedback to where its body is in space, where its joints are
- clumsy, trips frequently
- knocks things over (water cups, blocks)
- misjudges personal space
- uses too much or too little force
- poor fine and gross motor skills
14
Q
Tactile discrimination problems
A
- its tactile system is not giving good feedback to engage in occupations
- difficulty interpreting characteristics of tactile
- difficulty manipulating items so it impacts fine motor development
- depends on a visual system to guide participation
- poor fine motor skills
15
Q
Treatment guidelines for sensory discrimination difficulties
A
Provide a variety of sensory input:
- tactile activities
- ball pits
- think tactile for the entire body, not just hands
- proprioception = whole body activities such as trampolines, crash pads, crashing into ball pits, pushing/pulling heavy things
16
Q
Clinical observations of vestibular-bilateral dysfunction
A
- the standardized assessment validates you as a therapist, so include the results when writing up recommendations
- slow to develop hand dominance
- decreased crossing midline
- poor coordination of two sides of the body
- right-left confusion
- difficulties of particular areas of standardized assessments (such as BOT and SOSI-M) related to coordination such as jumping jacks
17
Q
Treatment guidelines for vestibular-bilateral dysfunction
A
- vestibular and proprioception activities requiring symmetrical and asymmetrical movement (think suspended equipment)
- begin with symmetrical movement, then move to asymmetrical movement (think galloping before skipping)
- develop crossing midline
- move from single to complex projected action sequence
- do it in various plans like upright position, prone, supine, and upside down
18
Q
Clinical observations of postural disorder
A
- difficulty assuming and maintaining prone extension posture
- hypotonicity of extensor muscles
- deficit in balance and equilibrium reactions
- below average scores on balance scores on PDMS or BOT
- below average scores for postural control items of SOSI-M
19
Q
Treatment interventions for posture
A
- develop righting and equilibrium reactions with linear movement (tilt bars, swings)
- balance should be unconscious = work activities on an unstable surface with a cognitive focus on another task, balance unconsciously
- move from static to dynamic balance such as balance beams and stilts
20
Q
Observations of children with dyspraxia
A
- clumsy
- slow to develop ADLs
- difficulty in gross motor activities and participation in sports
- poor fine motor related to eating utensils and school tools
- low self-esteem
- easily frustrated, avoids new tasks
- prefers talking as opposed to doing
- disorganized approach to tasks
21
Q
Clinical observations of dyspraxia
A
- poor supine flexion
- difficulties with sequential finger touching
- impaired alternating movements
- below-average scores on standardized gross and fine motor assessments
- difficulties with new motor tasks
22
Q
Interventions for dyspraxia
A
- Ayres sensory integration focusing upon creating a just-right challenge to promote an adapted response and confidence
- consider vestibular, proprioception, and tactile systems
- simple projected action movements to complex projected action movements
- consider specific task-based strategies
- consider cognitive approaches
