Sensory Integration

Question 1

Premise of Sensory Integration Theory (and it’s founder!)

Answer 1

• adequate sensory processing in the nervous system plus the integration of sensory information in the brain will lead to adaptive behavior and functional abilities
• based on neuroscience, developmental psychology, occupational therapy, and education
• Jean Ayres

Question 2

Definition of Sensory Integration

Answer 2

• the neurobiological process that organizes sensation from one’s own body and from the environment and makes it possible to use one’s body effectively with the environment.
• the spatial and temporal aspects of input from different sensory modalities are interpreted, associated, and unified.

Question 3

Sensory integration is ____________ ____________ and praxis and ____________ are both end products of sensory integration

Answer 3

information processing, perception

Question 4

Main points of sensory integration theory

Answer 4

• an individual’s interaction with the environment influences the development of the brain
• the nervous system is plastic (able to change)
• Sensorimotor experiences affect the brain’s plasticity
• Sensorimotor development is a part of learning.

Question 5

Different types of sensory input

Answer 5

• Visual
• Auditory
• Tactile
• Olfactory
• Gustatory
• Vestibular (balance)
• Proprioception (position in space)

Question 6

Visual input

Answer 6

enter the brain through the visual structures in the eyes; input is affected by levels of light and whether objects are standing still or moving

Question 7

Auditory input

Answer 7

input that enters the brain through the auditory structures of the ear; affected by volume and sound quality

Question 8

Tactile input

Answer 8

input enters the brain through the small nerve endings under the skin; get different feelings from texture, consistency and temperature

Question 9

Olfactory input

Answer 9

input that enters the brain through the olfactory neurons in the nasal cavity

Question 10

Gustatory

Answer 10

input that enters the brain through the taste buds on the tongue

Question 11

Vestibular input

Answer 11

input that enters the brain through the structures of the inner ear

Question 12

Proprioceptive input

Answer 12

input that enters the brain through the stretch receptors in the muscles, ligaments, and joint tissues.

Question 13

Which sensory system is the foundation of all others and why?

Answer 13

VESTIBULAR
- it is an important element of the CNS and crucial for the development of balance, coordination, motor control of the eye, bilateral coordination, and developing confidence and trust in movement. It allows us to develop a tolerance to motion, and fundamental functions such as posture and spatial orientation are affected by the vestibular processing system.

Question 14

Sensation seeking

Answer 14

enjoy sensory input and are constantly seeking for more within their environment

Question 15

Low registration

Answer 15

interpret sensory input around them less (at lower intensity levels) than others, and notice less in their environment

Question 16

Sensation avoiding

Answer 16

may appear bothered or overwhelmed by sensory input and tend to avoid these experiences as much as possible

Question 17

Sensory sensitivity

Answer 17

detect the sensory input around them more than others, and even notice sensory input that others may miss- they have a greater awareness of input.

Question 18

Signs of difficulty with the sensory system

Answer 18

• avoids or actively seeks out swinging, jumping, or climbing
• lack of coordination, frequent falling
• slow, cautious movement
• Easily becomes dizzy or never seems to become dizzy
• Watches moving/rotating objects (i.e. fans or clocks)
• prefers to sit during activities or has difficulty sitting still/paying attention
  -Slouches, holds head up with hands, prefers lying down

Question 19

Sensory processing disorder

Answer 19

Now an IND diagnosis- the inability to adequately process sensory information from multiple sources, resulting in maladaptive responses to the environment.

Question 20

Three categories of sensory processing disorders

Answer 20

1. Sensory modulation disorder
   - over-responsive (sensitive)
   - Under- responsive (slow)
   - Craving (seeking)
2. Sensory discrimination disorder
   - trouble discriminating between different senses
3. Sensory-based movement disorder
   - dyspraxia
   - postural disorders

Question 21

Sensory modulation disorder

Answer 21

• difficulty adjusting the nervous system to changes in sensory input (frequency, intensity, duration, complexity, novelty)

3 subcategories:
- Sensory over-responsivity: Responds to sensation faster, more intensely, longer duration; sensory overload causes a sympathetic reaction; difficulty in new environments; may present as sensory defensiveness;
child’s behavior is often rigid and controlling and will depend on which sensory systems are affected
- Sensory under-responsivity: decreased awareness, orientation, and response to sensory input, requires intense sensory input to notice and therefore takes longer to respond; appear sedentary, lethargic, apathetic; mislabeled “lazy” or unmotivated; child is often quiet and passive, appears withdrawn, difficult to engage with and/or self-absorbed because they do not detect sensory input in their environment; may lead to poor body awareness, clumsiness or movements that are not graded appropriately.
- Sensory-seeking: preference for intense and extreme sensory input; impulsive, intense, highly energetic, constantly moving, careless, restless, unsafe; high pain tolerance; the child will make vocal sounds to stimulate their auditory system, play roughly with toys, prefer spicy food, spin or rock self, fidget with objects, etc.

Question 22

Sensory-based Motor disorder

Answer 22

incorrect processing of sensory information leads to motor problems that affect POSTURAL control and/or MOTOR PLANNING (praxis)

Question 23

Sensory discrimination disorder

Answer 23

incorrect processing of sensory input ( i.e., kiddo stares for a long time at a row of beads and then spins in a circle)- incorrect bodily response to visual input

Question 24

Which disorders are often primary to sensory processing disorders (i.e. sensory processing disorder would be secondary to these)

Answer 24

Autism, ADHD (sensitive to visual input - distractibility-; under-responsive to auditory input; often seek vestibular and prop. input), Cerebral palsy (especially sensitive to tactile, olfactory, and gustatory input; difficulty interpreting vestibular and prop. input; may have sensory symptoms that resemble Autism), TBI (sensory issues correspond to the damaged areas of the brain), DCC (difficulty with vestibular and auditory input, sensory modulation, and difficulty integrating sensory input to perform motor tasks), Fragile X syndrome (similar to Autism), Sensory deprivation (difficulty with sensory modulation and emotional regulation

https://sensoryhealth.org/basic/subtypes-of-spd

Question 25

Sensory Integration and Praxis Tests (SIPT)

Answer 25

Ages: 4-0 to 8-11
Admin: child asked to complete activities defined on 17 different subtests
Areas evaluated: visual, tactile, and kinesthetic perception; motor performance

Question 26

Sensory Profile 2

Answer 26

Versions: infant (0-6 months), toddler (7-35 months), child (3-14 years), short form (3-14 years), school companion (3-14 years), and Spanish Caregiver forms (3-14 years)
Admin: questionnaires completed by child’s caregivers and teachers
- Areas evaluated: Sensory Systems split into auditory, visual, tactile, movement, body position, and oral input; Behavior is split into attention, behavioral, and social-emotional factors; sensory processing patterns are split into registration, seeking, avoiding, sensitivity

Question 27

Adolescent/Adult Sensory Profile

Answer 27

Age: 11 years through adulthood
Admin: questionnaires completes by child’s caregiver, teacher or self
Areas evaluated: Sensory systems split into social participation, vision, hearing, touch, body awareness, balance and motion, planning and ideas

Question 28

Test of Sensory Function in Infants (TSFI)

Answer 28

Age: 4-18 months
Admin: 24 items through simple interaction with the infant
Areas evaluated: overall sensory processing as well as subdomains: reactivity to deep pressure, visual-tactile integration, adaptive motor function, ocular motor control, reactivity to vestibular stimulation

Question 29

Berk Test of Sensory Integration

Answer 29

Age: 3-5 years
Admin: child asked to perform 36 test items scored on a numerical scales
Areas evaluated: overall sensory processing as well as these three subdomains: postural control, bilateral motor integration, reflex integration

Question 30

What is the goal of sensory integration intervention?

Answer 30

to improve the processing and integration of sensory information to allow participation in childhood occupations, including ADLs, school work, extracurriculars, and play.

Question 31

General principles of OT treatment for SPDs

Answer 31

1. the focus of treatment is primarily on tactile, vestibular, and proprioceptive processing (as these three systems form the base of sensory processing)
2. Treatment should provide a just-right challenge
3. the treatment environment should be enticing, encouraging the child to actively engage in play.
4. Treatment is child-directed. Child directs treatment by giving behavioral cues that the Th observes and reads. The TH adjust treatment based on these cues that indicates what the child wants and will find enticing.

Question 32

Treatment of Tactile Defensiveness

Question 33

Treatment of difficulty regulating arousal levels

Question 34

Treatment for children who crave movement

Question 35

Treatment for difficulty with tactile discrimination

Question 36

Adaptations for auditory defensiveness

Question 37

Adaptations for Sensitivity to light frequencies

Question 38

Adaptations for tactile defensiveness

Question 39

Adaptations for difficulty with modulation

Question 40

Adaptations for difficult regulating levels of arousal

Question 41

Sensory Diets

Question 42

Wilbarger Brushing protocol

Question 43

Equipment commonly used in SI therapy

Answer 43

• ball pit
• chewable toys (direct sensory and oral stimulation and calming/self-regulatory input
• Therapeutic swings (swinging and providing sensory input can have a powerful impact on the brain’s ability to process and use sensory information)

Question 44

Praxis

Question 45

Praxis - broken into 4 steps