Unit I - Sensory Integration

Question 1

Sensory input is utilized to evaluate motor performance in

Answer 1

feed forward-type movements

Question 2

sensory integration

Answer 2

It is a concept, a body of knowledge, and a treatment philosophy focusing on the ability of humans to organize sensory information for use.
- developed by Jean Ayres

Question 3

adaptive response

Answer 3

child can take in sensory info and give a mature and integrated response

Question 4

3 postulates of sensory integration theory

Answer 4

1. Learning is dependent on the ability to take in and process sensation from movement and the environment and use it to plan and organize behavior.
2. Individuals who have decreased ability to process sensation also may have difficulty producing appropriate actions, which, in turn, may interfere with learning and behavior.
3. Enhanced sensation, as part of meaningful activity that yields an adaptive interaction, improves the ability to process sensation, thereby enhancing learning and behavior.

Question 5

assumptions of sensory integration theory

Answer 5

• CNS is plastic
• sensory integration develops
• brain functions as an integrated whole
• adaptive interactions are critical to SI
• people have inner drive to develop SI through participation in sensorimotor activities

Question 6

Core elements of SI intervention

Answer 6

1. Provide sensory opportunities
2. Provide just-right challenge
3. Collaborate on activity choice
4. Guide self-organization
5. Support optimal arousal
6. Create play context
7. Maximize child’s success
8. Ensure physical activity
9. Arrange room to engage child
10. Foster therapeutic alliance

Question 7

sensorimotor approaches

Answer 7

emphasis is placed on specific motor responses (ie. alternations in muscle tone, more coordinated movement). Sensory is a part of sensorimotor programs, but it is secondary to motor. Generally, suspended equipment is NOT used.

Question 8

sensory stimulation approaches

Answer 8

sensation is applied to, rather than sought by, a child. Sensory stimulation programs are passive and not active, which is a fundamental assumption of sensory integration theory (inner drive and motivation). Sensory stimulation is a component of both sensorimotor and sensory integration approaches but should not be considered sensory integration intervention if only used alone.

Question 9

Sensory integration intervention (the big umbrella)

Answer 9

emphasizes the integration of vestibular, proprioceptive, and tactile sensations and not just on motor responses. This means that the use of suspended equipment is a hallmark of this treatment approach.

Question 10

nervous system components

Answer 10

CNS
PNS
- ANS: sympathetic and parasympathetic

Question 11

stimulus encoding

Answer 11

The CNS relies on the specificity of receptors in order to discriminate the type of sensory input received. Receptors convey the information that a touch was firm instead of soft by encoding the stimulus characteristics into a pattern of action potentials that represent intensity, duration, and movement of the stimulus. Stronger stimulus result in an increase in the frequency of action potentials sent to the CNS.

Question 12

receptor fields

Answer 12

the area around a receptor from which input can be transduced into an electrical signal. An example in the tactile system includes the mechanical receptors in areas of skin surrounding a single receptor, which activates a receptor. Small receptor fields are associated with fine discriminative function.

Question 13

lateral inhibition

Answer 13

the mechanism that helps the CNS to focus input from the receptors and to sharpen its interpretation. It relies on the presence of inhibitory interneurons which help the CNS discriminate and localize the input received. Neurons at the center of the receptor field activate inhibitory interneurons at their first synapse within the CNS and inhibit transmission of the stimulus at the periphery of the receptor field.

Question 14

serial and parallel processing

Answer 14

Serial – actions occur in a sequence in a hierarchical manner.
Parallel- involves the work of more than one pathway in the same time working simultaneously. Visual, proprioceptive, and vestibular often use parallel processing to orient us to our position in space.

Question 15

neurological thresholds

Answer 15

the amount of stimuli required for a neuron to respond. When the nervous system responds quickly to a sensory stimulus, there is a LOW threshold. When the nervous system responds slowly to a sensory stimulus, there is a HIGH threshold.
 Habituation – the process of recognizing familiar stimuli that do not require additional attention. It is important in order to focus on essential information and filter our irrelevant information in the environment.
 Sensitization – the process that enhances the awareness of important stimuli. A child can remain attentive to the environment while engaged in play or learning.
 A child is constantly balancing habituation and sensitization responses.

Question 16

sensory processing

Answer 16

The method the nervous system uses to receive, organize, and understand sensory input. It enables a child to figure out how to respond to environmental demands based on the sensory information that was available to the person.

Question 17

sensory integration evaluation

Answer 17

• Situated within a comprehensive assessment of occupational performance
• —Multifaceted – child’s presenting challenges in context of the family and environment
• Practitioners should assess sensory functioning to determine the existence of difficulties in sensory processing and relationship to challenges in occupational and participation

Question 18

Choosing Wisely

Answer 18

don’t provide sensory-based interventions to individual children or youth document assessment results of difficulties processing or integrating sensory info

Question 19

assessment components

Answer 19

a. Reason for Referral
b. Occupational Profile/Parent & Child Interview
c. Structured Observations
d. Unstructured Observations
e. Standardized Tests

Question 20

3 classifications of sensory integrative disorders

Answer 20

1. Sensory Registration Disorders
   - Sensory Sensitivity (Defensiveness)
   - Sensory Avoiding
   - Poor Registration
   - Sensory Seeking
2. Sensory Modulation Disorders
   - activity and arousal
3. Motor Dyspraxia
   - planning movement
   - executing movement

Question 21

sensory sensitivity/defensive

Answer 21

• low neurological threshold
• hyper responsive - overactive nervous system
• PASSIVE self regulation strategy: doesn’t have any plan on how to deal with stimuli
• poor habituation, complain, distracting

General Intervention – desensitize child to noxious sensory input and provide more structured input so that the child does not become overwhelmed in everyday life (compensation).

Question 22

sensory avoiding

Answer 22

• low neurological threshold
• becomes disruptive or agitated with noxious stimuli
• ACTIVE self regulation strategy: avoid experiences
• sets up rituals or routines to avoid things
• resistant to change, stubborn, wear same clothes

General Intervention – desensitize child to noxious stimuli while setting up environment or schedule to make input less available in order to avoid outburst or tantrums (compensation).

Question 23

tactile defensiveness

Answer 23

The child will overreact to certain types of tactile stimuli that most people find to be non-painful. Light touch sensations are especially likely to be disturbing. Characteristics of tactile defensiveness:
 React emotionally to light touch, prefers a firm hug
 May make a big deal out of little scrap or cut
 Avoids certain textures (ie. seams in clothing)
 Dislikes having haircut, nails trimmed
 Avoids messy play
 Walks on tiptoes, avoids walking barefoot
 Picky eater – textures and temperatures

Question 24

gravitational insecurity

Answer 24

the child will overreact to vestibular sensations, especially linear movement through space with the pull of gravity (ie. jumping off equipment). Characteristics of gravitational insecurity:
 Scared of heights
 Avoids stairs, ramps, uneven surfaces
Avoids any activities where he/she is off the ground (ie. playground equipment)

Question 25

sensory seeking

Answer 25

• high neurological threshold
• hyporesponsive
• child enjoys and generates extra sensory experiences
• ACTIVE strategy to meet needs
• difficulty modulating behavior and arousal; “on the go”

Question 26

sensory registration

Answer 26

• high neurological threshold
• hyporesponsive
• appears uninterested in activity or have little response to sensory input
• PASSIVE strategy: appears to “give up” before reaching threshold
• do not seek out sensory experiences that could help

Question 27

current SI diagnostic taxonomy

Answer 27

*sensory processing must impair daily function

“sensory processing” used rather than “sensory integration” when describing the disorder

Question 28

updated classification: pattern 1

Answer 28

Sensory Modulation Disorder (SMD) - when a person has difficulty responding to sensory information/input with behavior that is graded to the degree, nature, or intensity of the sensory input

Question 29

SMD subtypes

Answer 29

1. Sensory Overresponsiveness (SOR) - responses with more intensity for a longer duration
2. Sensory Underresponsiveness (SUR) - lack of response to sensory info in the environment
3. Sensory Seeking/Craving - craves unusual amount of sensory stimulation

Question 30

updated classification: pattern 2

Answer 30

Sensory Discrimination Disorder (SDD) - difficulties interpreting qualities of sensory stimulation (can perceive that it is present but has difficulty detecting what or where the stimuli is)

Question 31

updated classification: pattern 3

Answer 31

Sensory-Based Motor Disorder (SBMD) - has poor postural or volitional movement as a result of sensory problems

Question 32

SBMD subtypes

Answer 32

1. Postural Disorder: difficulty stabilizing the body

2. Dyspraxia: – impaired ability to 1) conceive of a plan 2) sequence the activity 3) and execute NOVEL actions