Unit I - Sensory Integration Flashcards
Sensory input is utilized to evaluate motor performance in
feed forward-type movements
sensory integration
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
adaptive response
child can take in sensory info and give a mature and integrated response
3 postulates of sensory integration theory
- 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.
- Individuals who have decreased ability to process sensation also may have difficulty producing appropriate actions, which, in turn, may interfere with learning and behavior.
- Enhanced sensation, as part of meaningful activity that yields an adaptive interaction, improves the ability to process sensation, thereby enhancing learning and behavior.
assumptions of sensory integration theory
- 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
Core elements of SI intervention
- Provide sensory opportunities
- Provide just-right challenge
- Collaborate on activity choice
- Guide self-organization
- Support optimal arousal
- Create play context
- Maximize child’s success
- Ensure physical activity
- Arrange room to engage child
- Foster therapeutic alliance
sensorimotor approaches
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.
sensory stimulation approaches
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.
Sensory integration intervention (the big umbrella)
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.
nervous system components
CNS
PNS
- ANS: sympathetic and parasympathetic
stimulus encoding
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.
receptor fields
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.
lateral inhibition
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.
serial and parallel processing
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.
neurological thresholds
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.
sensory processing
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.
sensory integration evaluation
- 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
Choosing Wisely
don’t provide sensory-based interventions to individual children or youth document assessment results of difficulties processing or integrating sensory info
assessment components
a. Reason for Referral
b. Occupational Profile/Parent & Child Interview
c. Structured Observations
d. Unstructured Observations
e. Standardized Tests
3 classifications of sensory integrative disorders
- Sensory Registration Disorders
- Sensory Sensitivity (Defensiveness)
- Sensory Avoiding
- Poor Registration
- Sensory Seeking - Sensory Modulation Disorders
- activity and arousal - Motor Dyspraxia
- planning movement
- executing movement
sensory sensitivity/defensive
- 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).
sensory avoiding
- 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).
tactile defensiveness
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
gravitational insecurity
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)
sensory seeking
- high neurological threshold
- hyporesponsive
- child enjoys and generates extra sensory experiences
- ACTIVE strategy to meet needs
- difficulty modulating behavior and arousal; “on the go”
sensory registration
- 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
current SI diagnostic taxonomy
*sensory processing must impair daily function
“sensory processing” used rather than “sensory integration” when describing the disorder
updated classification: pattern 1
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
SMD subtypes
- Sensory Overresponsiveness (SOR) - responses with more intensity for a longer duration
- Sensory Underresponsiveness (SUR) - lack of response to sensory info in the environment
- Sensory Seeking/Craving - craves unusual amount of sensory stimulation
updated classification: pattern 2
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)
updated classification: pattern 3
Sensory-Based Motor Disorder (SBMD) - has poor postural or volitional movement as a result of sensory problems
SBMD subtypes
- 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
