Treatment of Infant/Toddler with Sensory Motor Dysfunction Flashcards
what is sensory processing?
- the dynamic neurological process of taking in, processing, and organizing sensation from one’s own body and from the environment
What does this “integrated” sensory information help with?
with planning and organizing one’s movements and behavior effectively
Overarching functions of the CNS
- Thinking, learning, remembering
- Processing sensory information
- Controlling motor skills (gross motor, fine motor, oral motor, ocular motor)
- Controlling behavior and emotions
- Controlling autonomic functions
What are the senses?
- Tactile
- Vestibular
- Proprioception
- Vision
- Auditory
- Gustatory
- Olfatory
- Interception (gut level feeling)
first basic principle
- Most individuals take in and process sensory information automatically and effectively
second basic principle
poor sensory processing often leads to ineffective motor and conceptual leaning (impacts function and participation)
third basic principle
providing enhanced and meaningful sensory experiences results in enhanced sensory processing
Key impairments present in child with sensory motor dysfunction
- Sensory processing dysfunction
- hypotonia
- muscle weakness
- decreased postural control
What type of sensory processing disorder do we as PTs typically see?
Sensory based motor disorder (postural disorder, dyspraxia)
Modulation =
they can interpret things such as when something is a little painful or very painful; over responsive or under responsive
Modulation =
they can interpret things such as when something is a little painful or very painful; over responsive or under responsive
What is sensory modulation
the ability to derive affect or emotional meaning from sensory information
How are dysfunctions in sensory modulation identified?
- When a child over-responds, under- responds, or fluctuates in response to sensory input in a manner disproportionate to that input
there can be dysmodulation of any sensory system EXCEPT
- proprioception
- Proprioception is the great neutralizer… you can always do this when you are unsure
with sensory modulation disorder, children may demonstrate…
- sensory seeking (running into things)
- sensory avoidance
- poor (low) registration
- over-sensitivity to stimuli
*** children may experience one or more of these types of problems
What is sensory discrimination
- the ability to derive perceptual meaning from sensory information
- understanding perceptual meanings leads to conceptual understanding
problems with discrimination may also contribute to what?
problems with praxis
* praxis is really about learning how to do something (we address learning how to move)
2 types of sensory based motor disorders
- postural disorders
- dyspraxia
- May occur concurrent with other SPDs
Symptoms of postural disorder
- Praxis
- Dyspraxia
What is praxis?
- Knowing how to do
- often called “motor planning”
What does praxis refer to?
conceptualize, plan, and perform unfamiliar, skilled movement
What is dyspraxia
difficulty with:
- translating sensory information into physical movement
- unfamiliar movements
- movements that have multiple steps
* may see dysfunction in gross, fine, and/or oral motor abilities
3 potential effects of abnormal muscle, tone, weakness, and poor postural control on movement
- difficulty initiating movement to assume a body posture or to move an extremity in space
- difficulty sustaining the body or extremity posture
- difficulty transitioning out of one posture to another
Examination of Sensory Processing
- Sensory Integration and Praxis Test
- Infant-Toddler Sensory Profile
- Interview (typically was PTs use to identify then refer to OT)
Interview Guides: 0-12 months
Is he/she comfortable being moved?
Interview Guides: 12-18 mo
Does she spend time exploring a toy (using touch, vision, hearing, etc)?
Interview Guides: 18-36 mo
Does he/she shoe good balance and planning skills when playing?
General Principles for Interventions
- Child is usually the expert on their own nervous system
- The child’s “state” will affect what they need and what they don’t need (parent can influence this)
- Identify the sensory aspects of the child’s day/routine that are already positive
- “fun factor”
- Identify natural times of the day for doing certain tasks or activities
- Integrate sensory exploration and experiences into natural tasks and routines
What should you never do?
force a child to touch or move
When a child says stop, what should you do?
stop
does “more” necessarily mean “better?”
no
How can you help the child learn to do tasks for themselves?
- perform self-care tasks
- choosing activities to help them control their “state”
** want to increase confidence by being independent and successful
When should you use techniques to increase proprioception?
in the presence of:
- hypotonia
- joint laxity (with joint in optimal alignment)
- poor body awareness
- Tactile defensiveness
- Anxiety and fear of movement
Techniques to increase proprioception
- weight bearing
- deep pressure
- bouncing
- approximation
-pushing - pulling
- compression garments
what type of training enhances what type of fibers
- endurance training enhances the performance of Type I fibers
- Strength training enhances the performance of type II fibers
What do you need for endurance training for infants and toddlers
repetition and distance
strength training
- use anti-gravity positions
- vary size, shape, weight or toys
- encourage mobility over unleveled or elevated surfaces
- use a variety of dynamic surfaces
- consider aquatic activities
Techniques to improve postural control
- provide a variety of movement experiences in small ranges as tolerated
- provide exposure to novel motor experiences as well as novel environments
- be watchful of positive and negative responses to imposed movement
Newest terminology for autistic spectrum disorder
neuroatypical
Early signs of children with neuroatypical development
- failure to develop speech
- doesn’t respond to name
- auditory discrimination provlems
- lack of eye contact
motor impairments seen in children with neuroatypical development
- hypotonia
- difficulty with motor planning
- toe walking
- lack of fear - risk takers
additional considerations for children with neuroatypical development
- 25% have seizures
- response to hold, cold, and pain
- changes in barometric pressure have been found to increase symptoms
Common behavior issues in children with neuroatypical developement
- restricted and repetitive behaviors
- social communication problems
Evidence-based sensory and motor interventions for children with neuroatypical development
- vestibular activities
- activities to increase proprioception
- deep pressure
- vibration
- physical exercise
- jogging
- swimming
- equine assisted therapy
