Sensory Lecture Flashcards
5-16% of kids have
sensory processing disorder. This does not include ASD
Sensory integration
unconscious process of the brain.
organizes information detected by ones’s senses
gives meaning to what is experienced
allows us to act or respond to the situation we are experiencing in a purposeful manner
forms the foundation for academic learning and social behavior
sensory integration begins when?
when the baby is in the womb and can sense the movements of the mom
sensory integration is the
organization of sensations for use
adaptive response
purposeful, goal directed response to a sensory experience.
master a challenge and learn something new
formation helps the brain to develop and organize itself.
more complex skills can be achieved because of
adaptive responses
the act of play consists of a series of
adaptive responses
As the child is moving through adaptive responses it helps them find that
just right challenge on their own.
As a child is learning to ride a bike sensory experiencing is coming from what?
vision, vestibular input to balance, proprioceptive input to hold and pedal bike, tactile input from handlebars and feet on pedals. this gives a variety of adaptive responses needed to
first month of sensory development
touch, gravity and movement, proprioception, vision, hearing
for touch, sensations must be integrated for what reason?
reflexes to occur in a meaningful way. touch can be a source of important emotional connection
gentle movement tend to
organize the brain and sooth
in the first month of babies life vision is vague and movements begin to become more skilled when
the vision gets better
in the first month a baby adaptive response of vision is
to track object or person
hearing adaptive responses are seen in the first month when
the baby calms to a voice or song and responds to noises.
in the 2nd of t3rd month babies senses begin to
integrate
in 2nd and 3rd month waht are some adaptive responses
gravity and movement
sensation from eye muscles
muscle sensation from neck
brain puts all these sensastions together to know how to hold the head steady.
What integration occurs for grasping to become voluntary?
grasp reflex to be integrated by weight bearing on hands and forearms.
ATNR integrates which brings vision to see hand
in 4th-6th months we can expect what kind of adaptive response
improved coordination between the part so the brain that see with those parts that feel.
What developmental skills might a baby have at 4-6 months
vision is developmentally most advanced sense.
close to independent sitting
rolling
pushing up
prone pivotting
creeping / crawling
All senses need to work together.
between 6-12 months we see more ____________, which requires more _______________ and ___________
locomotion, spatial perception and motor planning.
at 6-12 months what locomotion is happenng?
crawling and creeping
standing and walking
At 6-12 months, what motor planning is happening
movements are planned inside the brain to complete a series of actions in the proper sequence
as my motor movement become more complex what comes next
motor planning.
what is communicating like at 6-12 months
babbling to words
What were the sensory skills that a child needs to integrate in order to reach
intact vestibular system, intact proprioceptive system, vision, tactile
3-7 years the brain is most
receptive to sensations and most able to organize them.
in 2nd year children have
better localization of touch
variations of movement assist in gaining additional sensory awareness
rough and tumble play - input from body and gravity receptors
establishing self-hood
how many years of moving and playing are required to give a child sensorimotor intelligence that can serve as the foundation for intellectual, social and personal development?
7 or 8
What age is the child really testing their sensory motor ability
3-7
what age range do we have more refined tool use
3-7
sensory integration has _________ base
neurological
if adequate sensory experiences are not available at critical periods in development…
Neuronal and brain connectivity abnormalities emerge that influence behavior and impact ability to function.
if we look at kids who were born into orphanges and not taken out of cribs or had supportive environments they had
different development and behaviors than kids who did
Too much or distressing and painful stimuli can generate
stress that is detrimental to brain development
neural plasticity,
ability to shape the development of neural circuits, both structurally and functionally because of cellular and molecular neural activity
Interesting and novel environments lead to significant increases in
dendritic branching, synaptic connections synaptic efficiency and size of brain tissue
neural plasticity is needed
for adaptive responses
sensory integration is based in
neural anatomy
more primitive part so the CNS develop before
maturation of the higher brain centers
The eight senses
vestibular, proprioceptive, tactile, visual, smell, taste, auditory, interception
interception
tactile sense
largest sensory organ in the body
tactile sensory includes
light touch
deep pressure
vibration
temperature
pain
tactile input falls into two categories
protective
discriminitive
light touch
sensed by the movement of hair and the outer skin
auditory processing refers to
how the CNS makes sense of the sounds we hear
Visual processing inclues
binocular vision
stereoscopic vision
ocular motor skills
visual attention and memory
visual perceptual skills
components of auditory include
volume, frequency, auditory sensitivity, duration, localization, sound discrimination, auditory filtering
Taste and smell are
connected
as taste buds and smell receptors develop children may become
picky eaters.
smell is a primitive sense to
alert us to danger
Proprioception
relies on information derived from sensory receptors in joints, muscles, ligaments and connective tissues that tells you where your body parts are without having to see them.
Vestibular system
receives information about movement and gravitational changes.
vestibular apparatus
otlithic organs
semicircular canals
vestibular system works in conjunction with
proprioceptive system
interoeption
internal body sense that detects essential regulation responses for body functions i
what is included in interoception
heart rate
respiration
blood pressure
hunger
thirst
temperature
bowel and bladder sensations
The ability to sense your interoception play and essential role in out
state of arousal, feelings, emotions and self-awareness
what does a baby get, sensory wise, from playing with a rattle?
proprioceptive, visual, audio, taste, tactile
Sensory processing disorder (SPD)
traffic jam in the brain. all of sensory input is coming in but certain parts of the brain don’t get the information needed to do their job.
In order to get a SPD diagnosis is
they have to know there isn’t damage to the brain.
3 parts of sensory dysfunction
modulation, discrimination, sensory based motor
Sensory modulation of sensory dysfunction
bothered by clothes and materials or tags,
bothered by light touch
excessively ticklish
distressed by others touching you. would rather be the toucher
have to fidget with things
often touching or twisting hair
very sensitive to pain
don’t seem to notice pain (random bruises)
sensory modulation
tendency to generate responses tht are appropriately graded in relation to incoming sensory input
hyper reactivity -
nervous system threshold for sensory input is low requires less intense and less frequent stimuli to respond
mixed reactivity
reaction is strong to some kinds of input and not much to others.
hypo reactivity
threshold for input is high. requires more intense and more frequent stimuli to respond.
sensory problems are highly variable and can change day to day and context to context
True
Sensory discrimination examples
difficult findng things in your purse or pocket
don’t notice if hands or face dirty
bothered by dirty face or hands
loves to touch and be touched
have a hard time feeling touch like a bug on skin
difficulty heating food to the correct temp
difficulty locating items int he cupoboard, drawer closet
difficulty with recognizing/following/interpreting traffic signs
difficulty judging distance
sensory discrimination
trouble distinguishing the salient features of sensory experiences and may struggle to differentiate between two sources of sensory input.
unable to locate where they were touched, may not notice when clothing is not oriented, leaning on peer in circle time
Sensory perception
the brain’s process of giving meaning to sensory information
difficulty with the spatial relationships among stimuli
sensory based motor disorder
Difficulty using sensory feedback loops to guide and control movements and posture in order to meet the physical requirements of a motor task.
decreased balance, low muscle tone, and poor strength and endurance.
Difficulty with motor planning multistep process of deciding what do to, figuring out how to do it and sequencing the steps to execute.
kids who have difficulty with motor planning will often be
observers. they will be on the sidelines because they don’t know how to sequence their movements.
tactile system has what type of challenges
modulation and perception
tactile defensiveness
hyperactivity to ordinary touch
may display emotional response
most comfortable with deep touch.
hyporeactivity
may not notice when messy
may crave strong flavors when eating
may stuff food in their mouth
increased drooling
tactile perception
difficulty interpreting the location, intensity, properties or direction of movement of tactile stimuli
stereognosis.
propioceptive challenges
difficulty interpreting body position and the position and movement of the muscle and joints
kids with proprioceptive challenges may rely heavily on
visual system
kids with proprioceptive challenges may use
too much force, may break toys, crayons, etc.
kids with proprioceptive challenges may seek out excessive input
true
what kind of muscle tone will kids with proprioception challenges present with
low muscle tone
what kind of sensory challenge may lead to a kid being clumsy and awkward
proprioception
Auditory processing (perception)
difficulty discriminating and interpreting sounds, but hearing is not impaired
auditory reactivity
hypersensitive may detect and be distracted by sounds that others don’t seem to hear.
auditory seeker may seek out loud sounds and speak at high volumes
visual sensitivity
hypersensitive to light - can feel dizzy, anxious, fatigue, headaches and uncomfortable.
Contrast sensitivity
difficulty distinguishing between light and dark
vestibular issues, gravitational insecuty
hyperreactivity to vestibular sensations involving linear movement.
vestibular - over responsive to input
may get dizzy or nauseated easily
vestibular - under responsive
to vestibular input
smell and taste sensory issues
over sensitive to taste, smell or both
will reduce the number of foods the child will eat. Might insist on bland foods and will repeat foods
smell and taste sensory issues
under sensitive
will crave strongly flavored foods
Diagnosis that leads to sensory issues
ASD
ADHD
Fragile X
Tourette’s
Schizophrena
CP
Down syndrome
premies
children who need feeding intervention
birth trauma
fetal exposure to drugs and alcohol
Occupational develop with sensory issues
play
leisure
adls
iadls
rest and sleep
educaiton
OT and sensory integration theory
Ayres Sensory integration (ASI)
what are the hallmarks of ASI
individualized OT
child centered treatments “just right challenge”
Specific sensory techniques
sensory diet
group sessions
alert program
how does your engine run, too high too low, gettting them to just right state.
Social stories
make a story about kids needs.
occupational based interventions
participation in swimming, music lessons, dance, chores, meal prep,
coaching
working with families and caregivers and reflected on how did it go done a lot in early intervention.
When you have a tactile defensive kid what do you have to rule out?
motor issues
Sensory integration development for 2nd year of life
- balance and dynamic postural control
- fine motor skills for play and self help skills
- development of body scheme and motor planning (praxis)
- development of ideation
- sense of self as a power agent.
Sensory integration between 3 and 5
Sensorimotor functions as the foundation for higher intellectual abilities
——-play shifts, they can play with a friend, more imagination
Strong inner drive
What is the first step in evaluating sensory processing?
Observation and caregiver interview
what are some of the things that we would observe or ask the caregiver about
sensitivities or under responsiveness to sensory input
self regulation
behavioral observations
what is the second part in a sensory processing screen?
Informal assessments
SI screen
What is the 3rd step in sensory processing in children?
Formal Assessment
- Sensory profile 2
- sensory processing measure
Waht are the things that we would comment on in the sensory processing part of the evaluation template?
sensitivities
under responsive
over responsive
self regulation
behavioral observation
Who might we interview for the SI interviews
Family member, teachers & those with the child throughout the day are valuable sources of sensory information!
Initial phase of assessment to ID concerns and determine further examination
The caregiver interview. it’s just the beginning
Ask leading questions to uncover if possible sensory issue or something else?
sensory interview, we want to find the deeper meaning. is it
Unstructured Observations:
in natural environment if possible- during play, mealtime, circle time etc…base observation off of interview questions.
Structured observations
How does the child react to novel or unpredictable input?
Examples of Commonly Used Clinical Observations:”
-Crossing Body Midline
-Equilibrium Reactions
-Muscle Tone
-Prone Extension
-Supine Flexion
What are common issues in Sensory Integration that we should be looking out for??
- Sensory Reactivity (over/under)
- Discrimination and Perception
- Vestibular-Bilateral
- Praxis
- Sensory Seeking
What are the 3 main sensory processing disorders?
- Sensory Modulation Disorder
- Sensory Based Movement Disorder
- Sensory Discrimination Disorder
3 sensory modulation disorders
sensory over responsiveness
sensory under responsiveness
sensory craving
2 sensory based motor disorders
Dyspraxia
postural disorder
Sensory discrimination disorder
Discrimination:
Brain’s ability to distinguish between different sensory stimuli.
Postural Disorder
vestibular problems
Motor outcomes of vestibular processing
bilateral motor difficulties can e linked to delays in body midline development.
Praxis problems
The ability to conceptualize, plan and execute a non-habitual motor act.
Difficulty imitating actions
Difficulty with oral praxis can affect eating skills or speech
Problems with ideation
What kind of issue is it when
Kids are very routine in their play because it’s challenging to think of new ways to do that task.
praxis problems
Sensory Seeking
Sensory Craving
seek out intense sensory stimulation
generate additional sensory ijnput to compensate
regulate the arousal level
modulate hyper or hypo-reactivity in other sensory systems
Informal Assessment
SI Screen
A. Ocular Motor Control & Eye Preference
B. UPPER EXTREMITY CONTROL/MODULATION Of MOVEMENT
C. ANTIGRAVITY POSITIONS/POSTURAL CONTROL/ BALANCE AND EQUILIBRIUM
D. EQUILIBRIUM REACTIONS
E. STANDING BALANCE
F. PROTECTIVE EXTENSION
Sensory profile 2
Overview:Standardized forms completed by caregivers and teachers to assess children’s sensory processing patterns
Age Range:Birth–14:11 (depending on form)
Other Languages:Spanish
Administration:Paper-and-pencil or online
Completion Time:5–20 minutes
Forms:
Infant Sensory Profile 2:Birth–6 months Toddler Sensory Profile 2:7–35 months Child Sensory Profile 2:3–14 years School Companion Sensory Profile 2:3–14 years (Teacher form) Short Sensory Profile 2:3–14 years (screen)
dunn’s model
Neurological Thresholds
- The way the nervous system responds to sensory input.
- Need balance between low and high so that we notice just enough things to keep aware and attentive
- At the extreme ends of the neurological threshold are
- At the other end are self regulations strategies
A child is unable to tolerate a change in their head position and movement backward or upward through space. What type of sensory modulation dysfunction is this child presenting?
Gravitational insecurity
In sensory integration practice what is a successful response to an environmental challenge?
adaptive response
What is a sensory modulation condition in which the individual fails to notice or is relatively unaffected by sensory stimuli to which most people respond.
underresponsive
What is the tendency to generate responses that are appropriately graded in relation to incoming sensations, neither underreacting nor overreacting to them?
Sensory modulation
Dunn model of sensory - 4 patterns
(1) sensation seeking (high threshold and active self-regulation strategy)
(2) sensory avoiding (low thresholds and active self-regulation strategy)
(3) sensory sensitivity (low threshold and passive self-regulation strategy)
(4) low registration (high threshold and passive self-regulation strategy).
Vision perception difficulties
difficulty interpreting features of visual stimuli despite adequate visual acuity
